ORIGINAL RESEARCH / ORİJİNAL ARAŞTIRMA
2015
The Investigation of Family Physicians’ Affinity to VdGM and Triteness of
VdGM in Turkey
Türkiye’de Aile Hekimlerinin VdGM Olan İlgisi ve VdGM’nin Bilinirliliğinin
Araştırılması
AUTHORS /
YAZARLAR
Özgür Erdem
Kayapınar Family Health
Center Number 9,
Diyarbakır, Turkey
Hüseyin Can
Department of Family
Medicine, Kâtip Çelebi
University Medical
Faculty, Izmir, Turkey
Zelal Akbayın
Hürriyet Family Health
Center, Bağcılar,
Istanbul, Turkey
Murat Altuntaş
Sütçüler Family Health
Center Number 4,
Sütçüler, Isparta, Turkey
Hayriye Külbay
Zümrütevler Family
Health Center Number 1,
Maltepe, Istanbul,
Turkey
ABSTRACT
Aim: The Vasco da Gama movement (VdGM) is the WONCA Europe working group for new and
future General Practitioners. The purpose of this observational paper is to investigate the affinity of
family physicians’ to VdGM and the triteness of VdGM in Turkey.
Methods: In May 2012, in the 11th National Family Medicine (FM) Conference and in September
2012, in the 6th FM Fall School, a study titled “VdGM, FM Experience in Europe and Turkey
Comparison” was presented. In these presentations, a global look at VdGM was provided through the
comparisons of FM Practices in Turkey and other European Countries. In this cross-sectional study the
survey form included 10 Likert Scale items, and three open ended items.
Results: In total, the sample size was 106. However, only 78 participants (73.6%) filled out the
survey form. Out of the two presentations, the participants reported positive affinity towards VdGM at a
rate of 67% and 98%.
Conclusion: Although the GPs did not know very well about the VdGM, their interests in VdGM
were at positive and required levels. Since GPs and trainees forms the future FM community, more
efforts to introduce and increase the activities of VdGM are necessary.
Keywords: Vasco da Gama Movement, Family Medicine, General Practitioners, Turkey
ÖZET
Amaç: Vasco da Gama movement (VdGM) WONCA Avrupa çatısı altında faaliyet gösteren yeni ve
gelecek genç aile hekimlerinin bir çalışma grubudur. Bu gözlemsel çalışmada Türkiye’de Aile
Hekimlerinin VdGM olan ilgisi ve VdGM’nin bilinirliliğinin araştırılması amaçlandı.
Yöntemler: Mayıs 2012’de 11. Ulusal Aile Hekimliği Kongresi ve Eylül 2012’de 6. Aile Hekimliği
Güz Okulunda “VdGM hareketi, Avrupa Aile Hekimliği Deneyimleri ve Türkiye Karşılaştırması” başlıklı
sunumlar yapıldı. Bu sunumlarda VdGM aracılığı ile Avrupa’nın değişik ülkelerinde gözlemlenen Aile
Hekimliği Uygulamalarının Türkiye ile karşılaştırılarak dinleyicilere Aile Hekimliği ve VdGM ile ilgili
global bir bakış açısı sunuldu. Bu kesitsel çalışmada anket formu 10 soru ve 3 tane açık uçlu sorudan
oluşmaktaydı.
Bulgular: Her iki oturuma toplam 106 kişi katıldı. Bunların %73.6’sı (n=78) uygulanan anket
formunu doldurdu. Anket sonuçlarına göre katılımcılar, VdGM çatısı altında yapılan sunum ve
organizasyona %67 ile %98 oranları arasında pozitif puan verdi.
Sonuç: Katılımcı Aile Hekimlerinin çoğu VdGM’ye yabancı olmakla beraber VdGM’ye olan ilgileri
pozitif ve üst düzeydeydi. Aile Hekimlerinin ülkemizdeki Aile Hekimliği disiplininin potansiyel yarınları
olduğu varsayılırsa bu hareketin tanıtılması ve Aile Hekimlerinin organize edilmesi ve/veya organize
olması için daha fazla faaliyete ihtiyaç vardır.
Anahtar kelimeler: Vasco da Gama Movement, Aile Hekimliği, Türkiye, Aile Hekimleri
Corresponding Author / İletişim için
Dr. Özgür Erdem
Kayapınar Family Health Center Number 9, Diyarbakır, Turkey
E-posta: [email protected]
Date of submission: 14.10.2014 / Date of acceptance: 29.05.2015
105
Erdem O et al. The Investigation of Family Physicians’ Affinity to VdGM and Triteness of VdGM in Turkey
Introduction
The Vasco da Gama movement (VdGM) is the
WONCA Europe working group for new and future
General Practitioners (GP). The movement is the
continuation of the work that was started during the
first preconference meeting for junior doctors during
the WONCA Europe conference in Amsterdam in
2004. The ideals were set down in a meeting in
January 2005 in Lisbon, the home port of Vasco da
Gama, from where he set out on a similar voyage of
discovery, and for this reason his name has been
applied to the movement. It was formally launched at
the Kos WONCA Europe Conference in September
2005. Successful Pre-conferences have been held in
Florence 2006, Paris 2007, Istanbul 2008, Basel
2009, Malaga 2010, Warsaw 2011, Vienna 2012 and
Prague in 2013. This is a new and exciting
movement, setting out on a journey of discovery,
developing ideas for the discipline of GP in the
future. The movement defines new and future doctors
as those in training for GP and in the first five years
after qualification as a GP (1).
Turkey is among the first founding 11 countries
in Amsterdam and has been involved in the
movement since its foundation. Turkey was
represented by Nil Tekin, Fatma Gökşin Cihan and
Erhan Burgut in 2004 in Amsterdam, in 2005 in Kos
and in 2006 in Florence (2,3).
Turkey was represented in pre-conferences
respectively by Nil Tekin in 2007, Paris; Zelal
Akbayın in 2008, Istanbul; Özgür Erdem in 2009,
Basel; Hayriye Külbay in 2010, Malaga; Murat
Altuntaş in 2011, Warsaw; Cemil Işık Sönmez in
2012, Vienna and Arzu Ayraler in 2013, Prague (4-6).
After those developments in Europe, Turkey has
tried to institutionalize and found its own VdGM. In
2009 Zelal Akbayın took the duty of representing
Turkey which was firstly represented by Nil Tekin. In
2010, VdGM Turkey Exchange group and VdGM
Turkey Research group were established on the first
hand. In 2011, VdGM Turkey Education & Training
Image Group and VdGM Beyond Europe Group were
established. With the foundation of these four groups
the institutionalization of VdGM Turkey was
completed (7).
Turkish GPs participating in that movement since
106 the very beginning, on one hand tried to
institutionalize as parallel with Europe; on the other
hand, continued to deliver lectures to inform the other
family physicians and trainees in Turkey. In this
respect, a number of sessions concerning VdGM
were held in some national congresses.
The purpose of this observational paper is to
investigate the affinity of family physicians’ to
VdGM and the triteness of VdGM in Turkey. The
results from this study will certainly provide feedback
about VdGM Turkey and will be instrumental in
evaluation of its activities. Finally, we will get a
better knowledge about the extent to which GPs of
Turkey are aware of VdGM and their attitudes
towards it.
Methods
This is a descriptive, cross-sectional study. In
May 2012, in the 11th National FM Conference and
in September 2012, in the 6th FM Fall School, a
study titled “VdGM, FM Experience in Europe and
Turkey Comparison” was presented. In these
presentations, a global look at VdGM was provided
through the comparisons of FM Practices in Turkey
and other European Countries. The presenters of
these two sessions were the members of VdGM
Turkey who previously participated in WONCA
Europe Pre-conferences or VdGM Exchange Program
in previous years.
A survey form investigating the opinions of GPs
and trainees about VdGM was distributed before
these two meetings (Table 1). At the beginning of the
study secured ethical approval from Turkish
Association of Family Physicians and the survey was
applied upon consent of the participants. There were
in total 106 people attending both presentations.
From the national conference, 37 participants filled
out the survey form, while 41 participants did so from
the Fall School. Some participants left the survey
forms blank. In this cross-sectional study the survey
form included 10 Likert Scale items, and three open
ended items. The five-point Likert scale responses
ranged from “strongly agree” to “strongly disagree”.
Measurement Scale: 5. Strongly agree, 4. Agree,
3. Undecided, 2. Disagree, 1. Strongly disagree.
Participants responding with “strongly agree” or
Euras J Fam Med 2015;4(3):105-10
“agree” were considered as displaying positive
affinity. In the statistical analyses of the data, we used
SPSS 15.0 for Windows. The results are presented
using mean, standard deviation, count and
percentages.
Results
In total, the sample size was 106. However, only
78 participants (73.6%) filled out the survey form.
Out of the two presentations, the participants reported
positive affinity towards VdGM at a rate of 67% and
98% (Table 1).
Table 1. The survey form investigating presentation about
VdGM
5*
4*
3*
2* 1*
%
%
%
% %
1 Presenters clearly stated the
purpose of the presentation 56.4 34.6 5.1 1.3 2.6
2 Presenters had effective
communication skills
69.2 25.6 2.6
3 The information presented
was new to me
35.9 37.2 17.9 6.4 2.6
0 2.6
4 Several audio-visual
presentation tools were used 48.7 28.2 16.7 3.8 2.6
5 Presenters were motivated
and passionate about the
content of the presentation
74.4 23.1 1.3
6 The content of the
presentation was theoretical
8.9
7 The presentation was
well-organized
58.9 35.9 2.6
0 1.3
37.
10.3 14.1 29.5 2
0 2.6
8 Presenters were open to
questions from the audience 50.0 37.2 8.9 1.3 2.6
9 The content of the
presentation was related to
my work
62.8 29.5 5.1
10 This presentation will be
helpful when I go back to
my practice
46.2 26.9 20.5 2.6 3.8
0 2.6
*5.Strongly Agree, 4.Agree, 3.Undecided, 2.Disagreee, 1.Strongly
Disagree
As for the open ended question of “What was the
most impressing part of this presentation?”; the most
commonly provided responses were “original”,
“impressive”, and “interactive presentation” (Table
2).
Table 2. “The most impressive parts of the presentation for
me”*
• Presenters’ motivation and willingness to share their
experience,
• Impressive introduction, interactive presentation style,
content, and technique,
• I liked that the presentation was conversational.
• I liked the points highlighted by the presenters.
• Presenters’ confidence and friendliness,
• Everything was beautiful. Thanks for everything.
• Presenters’ team spirit,
• Well-organized presentation,
• Comparisons between five countries FM practices.
• Presenters’ positive attitude and friendliness,
• For presenting such a topic,
• For highlighting the differences in FM practices carried
out in different countries and increasing the awareness
related to these differences,
• The notion that FM practices will improve in Turkey,
• The information that in England the number of patients
per an GP is on average 900-1000,
• A young, dynamic, and hardworking team. Wish you
best success on your future endeavors.
* Responses were displayed based on their frequency from high to
low
For the question of “What did you learn from this
presentation”; the most common response was “I
learned detailed information about the FM practices
in Europe” (Table 3).
Table 3. “What did you learn from this presentation?”*
• I learned detailed information about the FM practices
in Europe. Thank you!
• FM practices require team work.
• Following the activities of VdGM well will be helpful
for my career.
• I have been an GP for a year now and I should hurry
before my 2nd year is over.
• I was able to evaluate FM practices from different
countries together.
• I didn’t know about VdGM Movement. I learned
about its activities for the first time during this
presentation.
• Very Encouraging.
• In England, 20 years ago, per one GP on average there
were 4000 patients. Now this number is down to 1000
patients.
• Problems are all the same.
• We still have a long way to go.
• Consultation via phone and e-mail are viable
practices.
• Practices in other countries are not as well evolved as
I have thought.
• I should be an GP in Europe.
• I noticed that it is necessary to know about FM
practices in other countries and advances about FM.
• Made me feel as if I traveled, observed, and came
back.
• Reading is not enough; it is necessary to enroll in
exchange programs in order to observe and learn from
others.
* Responses were displayed based on their frequency from high to
low
107
Erdem O et al. The Investigation of Family Physicians’ Affinity to VdGM and Triteness of VdGM in Turkey
Finally, as for the question of “What are your
recommendations for the VdGM”; the most
commonly reported responses included “more
advertisement of VdGM and its activities” and
“efforts for the involvement of more GPs across
Turkey” (Table 4).
Table 4. “What are your recommendations for the
VdGM?” *
• More advertisement of VdGM and its activities and
more efforts for the involvement of more GPs across
Turkey,
• More reach-out to young FM doctors and trainees.
Every trainee should have a mentor.
• The capacity of the Exchange program should be
increased so that more trainees can have the chance to
benefit from the Exchange program.
• More FM doctors from other countries should be
invited to Turkey under the Exchange program.
• More frequent VdGM meetings/ conferences are
necessary for advertising its activities.
• This presentation can be distributed via Turkish
Association of Family Physicians (TAHUD) across all
trainees in video/audio/text format.
• With the VdGM perspective, GP’s rights should be
re-evaluated.
• Positive FM Practices in Europe should be reported to
National Health Ministry
• In a longer meeting I’d like to listen to presenters’
experience with more detailed information.
• VdGM members who had the chance to observe
practices in other countries should share their
experience and knowledge with the Turkish National
Health Ministry
• I have been practicing GP for the last 3 years and I just
now learned about VdGM movement. Shame on me
and my mentors.
• They are always the same people who are doing the
presentations. We should also hear from other people.
• I haven’t been practicing GP for a long time. I have
been involved in another profession (tourism). I only
came to gain some insight about the topic. I liked it.
* Responses were displayed based on their frequency from high to
low
Discussion
VdGM is open to all trainees and junior GPs who
are interested in topics such as Recruitment,
Exchange, Education, Training and Research in
108 primary care in an international setting. European
juniors interested in these topics can register as a
member of the various theme groups, which can be
found on the VdGM website. The exchange offers the
opportunity to learn about another primary healthcare
system, live in a different culture and savor a real
taste of what life is really like for a family doctor
outside one's own country. It enables junior family
doctors to reflect on their own practice, allows the
sharing of knowledge and experiences at an
international level, as well as improves language
skills, and creates new professional and personal
relationships. It is a unique experience, that we hope
in the future will become an integral part of GP
training as it inspires junior doctors to take an active
part in the development of FM. Furthermore, it
enhances collaboration between the national
organizations of GP (8-10).
The participants have the unique opportunity to
feel the vibe of what is going on in the European GP
scene first-hand, express their own viewpoints and
values and extend their horizons learning from other
countries, cultures and contexts. To help in achieving
these ambitions each WONCA Europe organization is
asked to develop a robust process of identifying and
sponsoring new and future GP to the movement
(1,11,12).
The VdGM has been hosting pre-conferences
prior to the WONCA Europe conferences since 2005
in Kos. These pre-conferences are an occasion to
bring together future and young GP from all over
Europe, to discuss about Research, Education and
Training, Image and the possibilities to exchange
experiences in GP. These pre-conferences are also a
great opportunity to get familiar with WONCA
Europe and its different working parties, since the
different working groups are facilitated by
EURACT-members. These pre-conferences are
progressively popular. In 2009, VdGM welcomed 65
preconference participants in Basel and received
messages from previous participants willing to join
the preconference a second time (13,14).
As a result of the literature search, we did not
notice any significant research papers published on
VdGM neither in Turkey nor in Europe. This
preliminary study found that GPs and trainees
Euras J Fam Med 2015;4(3):105-10
reported positive affinity towards VdGM at a rate of
67% and 98%. Participants’ responses to the question
of “What was the most impressing part of this
presentation?” included “original”, “impressive”,
“interactive presentation” and “good team spirit by
the presenters” indicated that VdGM has a positive
impression on GPs in Turkey.
The responses such as; “I learned detailed
information about the FM practices in Europe”, “It
was so motivating”, and “I learned about the VdGM
movement for the first time at this meeting” to the
question of “What did you learn from this
presentation?” were encouraging for VdGM Turkey
to continue its activities.
Finally, most commonly reported responses to the
question of “What are your recommendations for the
VdGM” were as follow: “more advertisement of
VdGM and its activities” and “efforts for the
involvement of more GPs across Turkey” should be
implemented. All these findings indicated that the
interest towards VdGM is positive and it provided
VdGM Turkey with motivation and encouragement to
continue its efforts.
Conclusion
Although the GPs did not know very well about
the VdGM before the presentations, their interest in
VdGM were at positive and required levels. Since
these GPs and trainees forms the future FM
community of Turkey, more efforts to introduce and
increase the activities of VdGM Turkey are necessary.
In order to do these, more members from the VdGM
should contribute to its efforts and practices.
Acknowledgements
On behalf of my colleagues, I would like to thank
to Turkish Association of Family Physicians
(TAHUD) and Turkish Foundation of Family
Medicine (TAHEV) for their support in the
presentations. We appreciate all family physicians
who participated in the study for their valued
contributions.
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