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The SPES (Primary Care, Environment, and Health) program is a training program offered by the Department of General Medicine at the Montpellier-Nîmes School of Medicine.

The start of the school year is often a time for reflection and renewal. It’s a time when many people think about their future prospects—the perfect opportunity to explore continuing education options! To mark this occasion, we’d like to introduce you to one of our 198 university diplomas (DU) and inter-university diplomas (DIU): the DU in “From Normal Cells to Tumor Cells.” To do so, we sat down with the two co-directors of this program, Ms. Szablewski and Mr. Ramirez. Here’s the interview.

 

Ms. Szablewski, Mr. Ramirez, good morning. Could you please briefly introduce yourselves?

VS: I am Dr. Vanessa Szablewski, MCU-PH in Pathological Anatomy and Cytology at the Montpellier University Hospital. I specialize in hematopathology and ENT pathology. For my research, I am affiliated withINSERM UMR 1058, “Pathogenesis and Control of Chronic and Emerging Infections.” My research focuses on the role of human papillomaviruses (HPVs) in cancers of the head and neck region.

JMR: I have held a Ph.D. in Biological Sciences for Health since 2005. After completing my dissertation, I conducted several postdoctoral fellowships abroad—in Washington, D.C., in the United States; at the Geneva University Hospital in Switzerland; and at the CIC (Centro de Investigación contra el Cáncer) in Spain—before finally returning to France to join the IRMB in Montpellier. In 2015, I was hired as an associate professor at the Montpellier-Nîmes Faculty of Medicine in Professor Thierry Lavabre-Bertrand’s department, where I teach histology and cell biology. In 2019, Vanessa and I created the first website featuring virtual slides that combines three disciplines: anatomy, pathological anatomy, and histology.

 

You are both in charge of the university certificate program “From Normal Cells to Tumor Cells.” What motivated you to create this program?

JMR: Histology and pathological anatomy are two closely related disciplines; it seemed to me that it is essential for a researcher in the field of health to be familiar not only with histology (the study of tissues) but also with pathological tissues.

 

Who is this training primarily intended for? How long does it last?

VS: This program is intended for all researchers working in the field of oncology, as well as those who wish to learn about human tissues and the diseases associated with them. It is also intended for physicians who wish to pursue a career in research or for oncologists who wish to acquire a solid foundation in scientific oncology. The program spans one academic year, but classes are held between February and June. The curriculum includes 52 hours of instruction, divided into 6 modules.

 

What added value will future graduates gain from this program? Does it open up new career paths for enrolled students?

JMR: The primary benefits are, first and foremost, the acquisition of new fundamental skills that will better equip future physicians or researchers in the field of oncology to perform their duties. Second, for all future physicians, the ability to better interpret medical findings provided by a physician specializing in pathological anatomy.

 

Older adults account for more than 20% of the French population (Source: INSEE 2020), yet the aging process remains poorly understood. Thanks to the simulation tools offered in this innovative workshop, participants will be able to take a leap forward in time by several years. This will allow them to hone their skills in supporting older adults through hands-on experience.

Why this workshop?

This workshop, offered by the School of Geriatrics and Gerontology, was created to allow participants to experience the main impairments associated with aging. 

It is led by its administrative manager, Myriam Taroudjit, and Marie-Laure Portalez, a design engineer. 

Special equipment allows participants to experience firsthand the main age-related sensory impairments. This helps them recognize the challenges faced by older adults and better understand their behaviors and specific needs.

“True experiential learning aimed at improving the quality of life for older adults”

The effectiveness of this simulation-based method was the subject of a study conducted by medical students at Julius-Maximilians University in Würzburg (Dr. med. Filz S.A., Dr. med. Swoboda W., et al.).

The research, conducted in the form of practical training sessions that involved wearing a simulation suit, yielded the following results:

  • Ability to empathize with the living conditions of an elderly person after the practicum: 83% of participants.
  • Ability to put oneself in the shoes of an older adult after the practicum: 90% of participants.
  • Understanding of an older adult’s physical condition after the practicum: 95% of participants

 

How?

Using simulation scenarios consisting of several elements, participants put themselves in the shoes of an older adult by experiencing the physical and emotional challenges associated with aging.

Here are a few examples: 

  • SPECIAL GLASSES

    They cause a change in color perception, grainy blurriness, sensitivity to glare, and/or a narrowing of the visual field

  • HEARING AID

    It causes high-frequency hearing loss

  • THE WEIGHT VEST

    This vest allows participants to experience spinal curvature, forward pelvic tilt, postural weakness, restricted mobility, loss of strength, increased physical stress, and/or impaired balance.

  • GLOVES

    They cause restricted hand mobility, reduced dexterity, and diminished tactile sensation

  • ANKLE WEIGHTS

    Ankle weights cause a loss of muscle strength, impaired coordination, and an unsteady gait due to shuffling one's feet

  • THE SOFT INSOLE OF THE OVERBOOT

    This unique insole provides a cushioned feel and reduces the sensation of contact with the ground, creating a feeling of instability.

  • SPECIAL GLOVES

    These other gloves allow for the simulation of tremors, which are realistically reproduced through electrical muscle stimulation and a continuously adjustable control module

Feedback from Our Students

Every year, this innovative workshop is offered to the School’s students to complement their curriculum and deepen their understanding of older adults. The feedback has been overwhelmingly positive:

Stéphanie: “This workshop was very interesting, and everyone who works with older adults should have the opportunity to participate in this simulation workshop. Losing one’s senses is very unsettling.

Mariam: “This afternoon, I experienced firsthand what the older adults I care for go through every day: muscle pain, hearing and vision problems, and slowed movements—all caused by an environment that is no longer safe for them to navigate.”

Maïlys: “In a professional setting, I will pay even closer attention to these ‘pains’ and how people experience and cope with them in their daily lives, so that I can best tailor my responses to their needs.”

 

More photos: 

As discussions about student mental health have resurfaced in the wake of the health crisis and amid reforms to graduate-level programs, our faculty teams have developed—in collaboration with students and service users—a one-of-a-kind educational concept. Temporarily titled “Interpersonal Skills and Therapeutic Communication,” this empathy-focused curriculum represents a true ethical and pedagogical innovation. To learn more, we spoke with the project’s leaders: Dr. Amandine Luquiens and Prof. Céline Bourgier, as well as Théo Lacoste, a student member of the steering committee.

 

The Origins of a Project Centered on Empathy

A need for evaluation arising from the R2C evaluation procedures

In 2018, the reform proposal for the second cycle of medical studies (R2C) was presented to the various academic leaders at the Faculty, prompting a response from Prof. Céline Bourgier. She noted that, under the R2C, student assessment would focus, among other things, on evaluating students’ interpersonal skills and empathy through the Certificate of Clinical Competence (C3). However, at that time, our curriculum did not include any courses entirely dedicated to developing this skill. 

Joined in 2019 by Dr. Amandine Luquiens, a psychiatrist specializing in addiction medicine at the Nîmes University Hospital, the two doctors will therefore team up to lead the project to develop an innovative teaching unit capable of meeting the requirements of R2C. Their first step is to assess the current level of empathy among medical students.

 

A striking finding: medical students’ empathy declines as they progress through their studies

Their initial findings are surprising. In fact, as they conducted their literature review, the two practitioners discovered that medical students tend to experience a decline in empathy throughout their studies. “This decline begins at the same time as hospital rotations. It appears that the gap between the ‘idealized view of the healthcare profession’ and the ‘reality of the healthcare profession’ is a triggering factor,” – explains Amandine Luquiens

Another observation: this decline is very strongly correlated with the burnout and depression that healthcare students may experience.

 

A structured educational program to halt this decline and ensure higher-quality care in the future

These findings have motivated the project leaders to create a new, innovative teaching unit (UE) with a twofold objective: 

  • To provide students with the tools and skills necessary to improve the quality of careby instilling in them a person-centered approach rather than focusing solely on symptoms or medical conditions
  • Preventing psychosocial risks—not only for patients, but also for students—future healthcare professionals.

These two complementary elements will therefore be developed jointly by a dedicated committee composed of faculty, students, and users.

 

An EU built collaboratively to foster skills related to empathy toward oneself and toward patients

Stages in the Development of the EU

Such an EU requires a period of development followed by a trial phase, which will be implemented within the Faculty in five major stages: 

  • STEP 1

    Establishment of a cross-functional steering committee

    Since this was a course developed collaboratively, the instructors were committed to creating a steering committee that included students so that the course would be tailored to their needs as much as possible. The committee is also supported by the Faculty’s Academic Council (then chaired by Prof. Denis Morin) and is composed of instructors from diverse backgrounds and specialties to ensure a comprehensive view of the project.

  • Assessment of the Current Situation and Expansion of the Steering Committee

    With the help of the academic administration staff, Amandine Luquiens and Céline Bourgier are compiling a list of the existing course units and courses within the program, focusing on the patient-physician relationship, the development of the care relationship, and interpersonal skills. This allows them to connect with the instructors teaching the existing courses and to include them on the steering committee for the new course unit.

    STEP 2

  • STEP 3

    Revision of existing courses, development of the UE

    The steering committee proposes a new structure for the existing courses over a five-year period. This involves reorganizing them into a more logical sequence, with a more gradual implementation that aligns with students’ entry into hospital internships. In addition to restructuring the existing curriculum, new courses are being proposed to round out the program, such as the therapeutic communication module, which is divided into three progressive levels and will incorporate the pre-existing theater workshop.

  • Incorporating the EU into the curriculum of a pilot class

    The 2021–22 DFGSM2 class is the pilot class and marks the launch of all EU courses over the 5-year program. In addition, a few modules are offered to DFGSM3 students to test the courses (Step 6). 

    STEP 4

  • STEP 5

    A cohort-based study of students to evaluate teaching

    To measure the impact of teaching on students, three cohorts are regularly evaluated based on criteria related to empathy, as well as well-being and their understanding of the therapeutic relationship. The DFGSM2 21-22 cohort will be compared to the DFGSM3 21-22 cohort, which will have benefited from a reduced course load, and to the DFASM1 21-22 cohort, which will not have been able to take the various EU modules.

 

An EU program designed to help students learn about emotion management

As Théo Lacoste, Student Vice-Dean for 21-22, points out, medical students are “perfectionists”: “They are selected because they are the best. And this selection process continues over the years. The need to be—or at least to appear—‘flawless’ at every level—whether professionally or emotionally—persists until it becomes an almost cultural component of our way of thinking.” 

However, it is precisely an process of acculturation on this subject that this course unit is intended to foster: Amandine Luquiens explains: “We are seeking to foster this awareness among students—and even within the Faculty as a whole. The Faculty takes care of its students, and students must take care of themselves. We will thus help them acquire tools that enable them both to protect themselves and to combat ‘emotional suppression’—a management strategy that doctors have been using for many years to address the patient-caregiver relationship.”

 PTo achieve this goal, the EU is structured around four major modules, all of which are mandatory: 

  • Introduction to Meditation Mindfulness
  • Exchange of Best Practices among peers: this module encourages open discussion and helps participants better understand professional communication within a healthcare team
  • Therapeutic Communication : a multi-year module featuring theoretical instruction on announcements, the integration of theater workshops, and simulation workshops.
  • Stigmatization in Healthcare : a module featuring user testimonials in which individuals share with students their personal experiences with situations they may have encountered during their care journey

 

In summary: an innovative initiative in more ways than one

Humanism is a core value of the Faculty. It is an integral part of its history, but it also serves as a guiding principle for its future, as evidenced by this program, which is innovative in more ways than one. Indeed, this is an ethical and pedagogical innovation

  • co-created with students, faculty, users, and administrative staff: a true example of cross-functional collaboration among the women and men of our community 
  • that focuses on a genuine social for health science students and that is addressed early enough in their academic program to address it proactively and long enough to address it in depth
  • which includes theoretical modules but also, and above all, highly practical modules, centered on a human-centered approach to the patient-caregiver relationship, particularly through simulation workshops
  • Skills Developer key skills centered on empathy and interpersonal skills: essential tools for a more humane approach to medicine
  • carrying a message for both students and their future patients

 

Opportunities for other degree programs

The introduction of this course unit into the medical curriculum inevitably raises questions about the other programs offered by the faculty (midwifery, paramedicine). “Medicine is relatively behind compared to other programs,” admits Dr. Luquiens. “Indeed, there are already course units in the other programs, but not in such a structured, phased manner. The idea, therefore, is that once this course unit has been refined, we will ‘spread’ it to the other programs, with the aim of taking a transdisciplinary approach to these skills.”

 

Every year, the Faculty organizes "Printemps de la Médecine," an event for general practitioners. Find all the details in this article!

An event for general practitioners

These events provide an opportunity to review all the major medical developments of the year in the morning and to explore best practices in areas of routine medical practice through workshops in the afternoon. This event, like previous ones, will be submitted to the ANDPC website for certification, and the Faculty will handle registrations for physicians wishing to participate. In the meantime, mark this date on your calendar!

For any additional information, particularly regarding the program and registration procedures, please feel free to contact the office in charge of CPD administration at the Faculty at the following address:  med-fmc-dpc@umontpellier.fr.

 

  • 8:30 a.m.

    Overview of the Day

  • New for 2022

    with Dr. Camille Roubille (8:40 a.m. – 9:10 a.m.), Prof. Hubert Blain (9:10 a.m. – 9:40 a.m.), and Dr. David Costa (9:40 a.m. – 10:10 a.m.)

    8:40 a.m.

  • 10:10 a.m.

    Use and Cost of Diabetes Medications

    Dr. Laurence Papinaud

  • The Role of the Endocrinologist

    Prof. Éric Renard

    10:30 a.m.

  • 11:00 a.m.

    The Role of the Nephrologist

    Prof. Moglie Le Quintrec

  • The Role of the Cardiologist

    Prof. François Roubille

    11:30 a.m.

  • 12:00 p.m.

    End of the morning session

    A Message from the Dean
    A Message from the Board of the Hérault Departmental Medical Association (News from the Association by Dr. Philippe Cathala)

  • 2 workshops (2 hours each) from among the 5 workshops offered

    • Workshop 1 – 2:00–4:00 p.m. (General Practice): Management of Sleep Complaints in General Practice
    • Workshop 2 (MG): Behavioral Disorders in Older Adults
    • Workshop 3 (MG): Pre-Exposure Prophylaxis (PrEP)
    • Workshop 4 (Residents and Interns): Medical Confidentiality When the Patient Is at Risk: The Case of Violence Against Women
    • Workshop 5 (Residents and Interns): Practical Management of Wounds and Pressure Ulcers

    WORKSHOPS TO CHOOSE FROM

 

To register, click the link below! The Office of Continuing Medical Education and CPD looks forward to seeing many of you there!

The SPES (Primary Care, Environment, and Health) program is a training initiative organized by the University Department of General Practice at the Montpellier-Nîmes School of Medicine and the Avicenne University Multidisciplinary Health Center in Cabestany. A one-day training session for general practice residents, as well as a public lecture, will take place on September 9, 2021.

 

The Origins of the Project

It is part of the call for proposals launched by the Occitanie Regional Health Agency (ARS) as part of the 3rd Regional Health and Environment Plan, of which it is one of the selected projects. In particular, it aims to increase awareness of environmental health among citizens and healthcare professionals.

Project Organization

To that end, it is organized in three stages:

  • A distance learning program offered to general practice residents (first year of the DES in General Practice) and faculty members in the Department of General Practice.

  • This in-person training session will take place on Thursday, September 9, 2021, at the historic building of the Montpellier-Nîmes School of Medicine. Intended for first-year general practice residents pursuing a DES (Specialized Medical Degree), the morning will be devoted to presentations and discussions with experts in environmental health, and the afternoon to working sessions with the residents to collaboratively develop their thesis projects in environmental health.

  • A public lecture will be held on the evening of Thursday, September 9, 2021, at the historic building of the Montpellier-Nîmes School of Medicine. Aimed at the general public, this year’s lecture will focus on air pollution.

Learn more about the SPES program

Meeting with the Academic Advisor

Dr. François Carbonnel, an associate professor at the Schools of General Medicine within the Montpellier-Nîmes Faculty of Medicine and a general practitioner at the Avicenne MSPU, has been selected as the winner of the call for proposals organized by the Occitanie Regional Health Agency (ARS).

Why did you decide to launch this Primary Care, Environment, and Health training program?

The environment can pose risks to our societies and to our health. This training program helps raise awareness among our colleagues about what environmental health is. We want to educate them about this field, which is still relatively unknown.

What is the purpose of this new training program?

Through this training, future general practitioners will first be able to identify environmental health risks so that they can treat them. Second, they will be able to predict and prevent them.

Who is this training course intended for?

This training program is primarily intended for residents and faculty in general practice. The goal is for this program to become a sustainable and useful resource so that we can offer it on a broader scale and ensure that environmental health issues are addressed across all regions.

September 9

The event will consist of two parts: the first part will be dedicated to training residents and faculty in general practice. The second part, open to the general public, will feature a lecture.

Here is the schedule for these two games:

Schedule for the day for interns

  • 8:30 a.m.

    Welcoming Participants

  • 9H

    Official Speeches

  • 10H

    Designing Spaces to Combat a Sedentary Lifestyle by G. Ninot

  • 11H

    Air Pollution by I. Annesi-Maesano

  • 12H

    Allergies and the Environment by P. Demoly

  • 13H

    Lunch break

  • 14H

    Thesis-Advising Workshops on Environmental Health Led by DUMG Members

Conference Program for the General Public

  • 5:30 p.m.

    “Environmental Health at the University of Montpellier and in Our Regions”

  • 6:30 p.m.

    “Air Pollution” Speaker: Prof. Isabella Annesi-Maesano, INSERM Research Director, Co-Director of the Desbrest Institute of Epidemiology and Public Health (IDESP), UMR 1302, INSERM and the University of Montpellier


Please note that this program is subject to change depending on the public health situation.

 

 

 

"The Avicenne Multidisciplinary University Health Center (MSPU) was inaugurated in Cabestany, near Perpignan, in 2018. In June 2021, two additional MSPUs were added to this regional network. To mark this opening, a formal ceremony was held on Thursday, May 27 to review the Cabestany MSPU and present the plans for the two new MSPUs.”

 

MSPU: What is it?

A Multidisciplinary Health Center is a multiprofessional health center that has entered into an agreement with the Regional Health Agency (ARS) and a university with a medical program to promote training and research in primary care. 

 

Avicenne's MSPU: A Positive Assessment

This MSPU, led by Dr. Mark OUDE ENGBERIK and comprising some 30 healthcare professionals from various fields, has carried out several projects over the past five years. Two major projects were discussed at this conference:

  • The TSAPPproject, which aims to train healthcare professionals on providing access to care for people with disabilities.
  • The SPES (Primary Care, Environment, and Health) project, which aims to promote health and environmental awareness among professionals and the general public.

In terms of academic programs, this MSPU has 16 clinical instructors in various fields of health care and accepts 6 to 10 interns per year.

Two new MSPUs in the region

Following the success of the projects carried out by the Avicenne MSPU, two other centers were opened in the region to meet local needs in this area.

  • MSPU LA SOURCE

    • Opened in February 2020, this MSPU is located in Vergèze and is managed by Dr. Céline Varraut.
    • It has 25 professionals working in 10 different healthcare fields
    • It focuses its objectives on three main areas: the region, training, and care
  • MSPU Pauline Lataud

    • This MSPU operates at multiple locations; it has facilities in Castries, Prades-le-Lez, Saint-Georges-d’Orques, and Vendargues, and is managed by Dr. Philippe Lognos.
    • It has 50 professionals working in 9 different healthcare fields
    • It also focuses its objectives on the same themes as the previous one.

A joint project is taking shape around these three MSPUs: to build a research network and make the service accessible to local residents.