Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
Scand J Public Health. 2011 May;39(3):245-54. doi: 10.1177/1403494810393301. Epub 2011 Jan 24.
Sickness absence is a common ''prescription'' in health care in many Western countries. Despite the significance of sick-listing for the life situation of patients, physicians have limited training in how to handle sickness-certification cases and the research about sickness-certification practices is scarce.
Gain knowledge on physicians' learning regarding management of sickness certification of patients in formal, informal, and non-formal learning situations, respectively, and possible changes in this from 2004 to 2008.
Data from two comprehensive questionnaires to physicians in Sweden about their sickness-certification practice in 2004 (n = 7665) and 2008 (n = 36,898); response rates: 71% and 61%, respectively. Answers from all the physicians ≤64 years old and who had sickness certification tasks (n = 4019 and n = 14,210) were analysed.
ratings of importance of different types of learning situations for their sickness-certification competence.
Few physicians stated that formal learning situations had contributed to a large or fairly large extent to their competence in sickness certification, e.g. undergraduate studies had done that for 17%, internship for 37%, and resident training for 46%, respectively. Contacts with colleagues had been helpful for 65%. One-third was helped by training arranged by social insurance offices. There was a significant increase between 2004 and 2008 in all items related to formal and non-formal learning situations, while there were no changes regarding informal learning situations.
This study of all physicians in Sweden shows that physicians primarily attain competence in sickness certification in their daily clinical practice; through contacts with colleagues and patients.
在许多西方国家，病假是医疗保健中常见的“处方”。尽管病假登记对患者的生活状况意义重大，但医生在处理病假证明方面的培训有限，而且关于病假证明实践的研究也很少。
分别了解医生在正式、非正式和非正规学习环境中管理患者病假证明的学习情况，以及 2004 年至 2008 年期间可能发生的变化。
对瑞典的医生进行了两次全面的问卷调查，内容是他们在 2004 年（n=7665）和 2008 年（n=36898）的病假证明实践；回应率分别为 71%和 61%。分析了所有年龄≤64 岁且有病假证明任务的医生（n=4019 和 n=14210）的答案。
对不同类型学习环境对其病假证明能力的重要性的评价。
很少有医生表示，正式学习环境对他们的病假证明能力有很大或相当大的贡献，例如，本科学习对 17%的人、实习对 37%的人、住院医师培训对 46%的人有帮助。与同事的接触对 65%的人有帮助。三分之一的人受益于社会保险办公室安排的培训。在与正式和非正规学习环境相关的所有项目中，2004 年至 2008 年间都有显著增加，而非正式学习环境则没有变化。
这项对瑞典所有医生的研究表明，医生主要通过与同事和患者的接触，在日常临床实践中获得病假证明的能力。
