Home Bad things can happen: are medical students aware of patient centered care and safety?
Article
Licensed
Unlicensed Requires Authentication

Bad things can happen: are medical students aware of patient centered care and safety?

  • Adrian Gillissen EMAIL logo , Tonja Kochanek , Michaela Zupanic and Jan Ehlers
Published/Copyright: November 9, 2022
Diagnosis
From the journal Diagnosis Volume 10 Issue 2

Abstract

Objectives

Quality and safety in healthcare are of the utmost importance, but little is known about whether undergraduate students are aware of patient safety concepts. The objectives of our study were to assess the perception of medical students of challenges in patient safety, and collect their perceptions of error management and prevention.

Methods

This study used an exploratory mixed method strategy. The first study phase collected data from semi-structured interviews of 28 students. Based on this, an online survey was constructed and sent to about 80,000 medical students in Germany. 1053 replies were received and analyzed for responses based on gender, curriculum type (problem based [PBC] vs. science based curriculum [SBC]) and years of training.

Results

Most students understand the importance of patient safety, error avoidance, and the challenges of patient safety interventions. Four themes were identified: (a) the culture of patient safety (what is a good doctor? Doctors’ responsibility), (b) the working environment (the inevitability of mistakes, high work load, hierarchy, competition, teamwork), (c) the challenges of risk reduction (error avoidance, management, skills), and (d) materialistic issue (income vs. humanistic values). Female students were more risk aware than male students. Sixteen percent of students expect negative effects (e.g. punishment) when medical errors were disclosed in a team. Regardless, >70% regard teamwork as an effective error avoidance measure. Error disclosure willingness was high (89.7%).

Conclusions

Although not formally part of the curriculum, students had a positive perspective concerning patient safety. The opportunities and challenges for incorporating patient safety content into the training curriculum were identified and presented.

Keywords: error management; medical errors; medical students; patient safety; perceptions
Corresponding author: Adrian Gillissen, MD, MSC, Department of Medicine, Faculty of Health, Institute for Didactics and Educational Research in Health Care, Witten/Herdecke University, Alfred-Herrhausen-Str. 50, 58455 Witten, Germany, Phone: +49-2302-926-78603, Fax: +49-2302-926-929, E-mail:

Funding source: Kreiskliniken Reutlingen GmbH

Award Identifier / Grant number: UW/H 11.540

  1. Research funding: Kreiskliniken Reutlingen GmbH, Reutlingen, Germany. Grant No.: UW/H 11.540.

  2. Author contributions: Adrian Gillissen (AG) and Jan Eherls analyzed and interpreted the qualitative data (student interviews). AG was the major contributor in writing the manuscript. Tonja Kochanek translated the German citations of the qualitative study part into English and was responsible for the organization of the quantitative study part. Michaela Zupanic did the statistics on the quantitative study part. All authors reviewed the analysis and the final text. All authors read and approved the final manuscript for submission.

  3. Competing interests: The authors declare that they have no competing interests.

  4. Informed consent: Informed consent was obtained from all individuals included in this study. All participants of the qualitative study part agreed further to the audio recording either verbally or in written form. Confidentiality was warranted through an anonymization process.

  5. Ethics approval: Research involving human subjects complied with all relevant national regulations and institutional policies. The study was performed in accordance with the Declarations of Helsinki. Ethical approval of the study was obtained prior to the first interview from the University Faculty of Medicine and Dentistry Committee for Ethics at the University Witten-Herdecke (# 137/2919).

References

1. World Health Organization. WHO patient safety curriculum guide for medical schools. Geneva/Switzerland: World Health Organization; 2009.Search in Google Scholar

2. de Vries, EN, Ramrattan, MA, Smorenburg, SM, Gouma, DJ, Boermeester, MA. The incidence and nature of in-hospital adverse events: a systematic review. Qual Saf Health Care 2008;17:216–23. https://doi.org/10.1136/qshc.2007.023622.Search in Google Scholar PubMed PubMed Central

3. Batchelder, AJ, Anderson, L. Defining patient safety: a student perspective. Med Sci Educ 2019;29:399–408. https://doi.org/10.1007/s40670-018-00690-1.Search in Google Scholar PubMed PubMed Central

4. Nie, Y, Li, L, Duan, Y, Chen, P, Barraclough, BH, Zhang, M, et al.. Patient safety education for undergraduate medical students: a systematic review. BMC Med Educ 2011;11:33. https://doi.org/10.1186/1472-6920-11-33.Search in Google Scholar PubMed PubMed Central

5. Opitz, E, Bösner, S, Heinis, S, Stibane, EC, Jerrentrup, A. Patientensicherheit schon im Studium vermitteln. Internist 2020;61:444–51. https://doi.org/10.1007/s00108-020-00772-6.Search in Google Scholar PubMed

6. Kerfoot, BP, Conlin, PR, Travison, T, McMahon, GT. Patient safety knowledge and its determinants in medical trainees. J Gen Intern Med 2007;22:1150–4. https://doi.org/10.1007/s11606-007-0247-8.Search in Google Scholar PubMed PubMed Central

7. Leape, LL. Who’s to blame? Joint Comm J Qual Patient Saf 2010;36:150–1. https://doi.org/10.1016/s1553-7250(10)36026-0.Search in Google Scholar PubMed

8. Liu, H, Li, Y, Zhao, S, Jiao, M, Lu, Y, Liu, J, et al.. Perceptions of patient safety culture among medical students: a cross-sectional investigation in Heilongjiang Province, China. BMJ Open 2018;8:e020200. https://doi.org/10.1136/bmjopen-2017-020200.Search in Google Scholar PubMed PubMed Central

9. Doyle, P, VanDenKerkhof, EG, Edge, DS, Ginsburg, L, Goldstein, DH. Self-reported patient safety competence among Canadian medical students and postgraduate trainees: a cross-sectional survey. BMJ Qual Saf 2015;24:135–41. https://doi.org/10.1136/bmjqs-2014-003142.Search in Google Scholar PubMed PubMed Central

10. Braun, LT, Zwaan, L, Kiesewetter, J, Fischer, MR, Schmidmaier, R. Diagnostic errors by medical students: results of a prospective qualitative study. BMC Med Educ 2017;17:191. https://doi.org/10.1186/s12909-017-1044-7.Search in Google Scholar PubMed PubMed Central

11. Braun, LT, Borrmann, KF, Lottspeich, C, Heinrich, DA, Kiesewetter, J, Fischer, MR, et al.. Scaffolding clinical reasoning of medical students with virtual patients: effects on diagnostic accuracy, efficiency, and errors. Diagn Berl Ger 2019;6:137–49. https://doi.org/10.1515/dx-2018-0090.Search in Google Scholar PubMed

12. Alser, M, Böttcher, B, Alfaqawi, M, Jlambo, A, Abuzubaida, W, Abu-El-Noor, N. Undergraduate medical students’ attitudes towards medical errors and patient safety: a multi-center cross-sectional study in the Gaza Strip, Palestine. BMC Med Educ 2020;20:447. https://doi.org/10.1186/s12909-020-02375-z.Search in Google Scholar PubMed PubMed Central

13. Ban, KA, Chung, JW, Matulewicz, RS, Kelz, RR, Shea, JA, Dahlke, AR, et al.. Gender-based differences in surgical residents’ perceptions of patient safety, continuity of care, and well-being: an analysis from the flexibility in duty hour requirements for surgical trainees (FIRST) trial. J Am Coll Surg 2017;224:126–36.e2. https://doi.org/10.1016/j.jamcollsurg.2016.10.043.Search in Google Scholar PubMed

14. de Feijter, JM, de Grave, WS, Dornan, T, Koopmans, RP, Scherpbier, AJ. Students’ perceptions of patient safety during the transition from undergraduate to postgraduate training: an activity theory analysis. Adv Health Sci Educ Theory Pract 2011;16:347–58. https://doi.org/10.1007/s10459-010-9266-z.Search in Google Scholar PubMed PubMed Central

15. Kopelman, P. The future of UK medical education curriculum - what type of medical graduates do we need? Future Hosp J 2014;1:41–6. https://doi.org/10.7861/futurehosp.14.011.Search in Google Scholar PubMed PubMed Central

16. Howarth, SD, Fielden, SA, O’Hara, JK. How do we educate medical students interprofessionally about patient safety? A scoping review. J Interprof Care 2022;36:259–67. https://doi.org/10.1080/13561820.2021.1878116.Search in Google Scholar PubMed

17. Curry, LA, Krumholz, HM, O’Cathain, A, Plano Clark, VL, Cherlin, E, Bradley, EM. Mixed methods in biomedical and health services research. Circ Cardiovasc Qual Outcomes 2013;6:119–23. https://doi.org/10.1161/circoutcomes.112.967885.Search in Google Scholar

18. Fetters, MD, Curry, LA, Creswell, JW. Achieving integration in mixed methods designs-principles and practices. Health Serv Res 2013;48:2134–56. https://doi.org/10.1111/1475-6773.12117.Search in Google Scholar PubMed PubMed Central

19. Onwuegbuzie, AJ, Bustamante, RM, Nelson, JA. Mixed research as a tool for developing quantitative instruments. J Mix Methods Res 2010;4:56–78. https://doi.org/10.1177/1558689809355805.Search in Google Scholar

20. Pluye, P, Hong, QN. Combining the power of stories and the power of numbers: mixed methods research and mixed studies reviews. Annu Rev Publ Health 2014;35:29–45. https://doi.org/10.1146/annurev-publhealth-032013-182440.Search in Google Scholar PubMed

21. Onwuegbuzie, AJ, Slate, JR, Leech, NL, Collins, KM. Conducting mixed analyses: a general typology. Int J Mult Res Approaches 2007;1:4–17. https://doi.org/10.5172/mra.455.1.1.4.Search in Google Scholar

22. Johnson, RB, Onwuegbuzie, A. Mixed methods research: a research paradigm whose time has come. 2004;33:14–26, https://doi.org/10.3102/0013189x033007014.Search in Google Scholar

23. Drost, E. Validity and reliability in social science research. Educ Res Perspect 2011;38:105–24.Search in Google Scholar

24. Yazdi-Feyzabadi, V, Nakhaee, N, Mehrolhassani, MH, Naghavi, S, Homaie Rad, E. Development and validation of a questionnaire to determine medical orders non-adherence: a sequential exploratory mixed-method study. BMC Health Serv Res 2021;21:136. https://doi.org/10.1186/s12913-021-06147-3.Search in Google Scholar PubMed PubMed Central

25. Ryan, GW, Bernard, HR. Data management and analysis methods. In: Handbook of qualitative research. 2nd ed. Sage Publications Ltd; 2000:769–802 pp.Search in Google Scholar

26. Mayring, P. Qualitative inhaltsanalyse. In: Mey, G, Mruck, K, Herausgeber. Handbuch Qualitative Forschung in der Psychologie: band 2: designs und Verfahren [Internet]. Wiesbaden: Springer Fachmedien; 2020:495–511 pp.10.1007/978-3-658-26887-9_52Search in Google Scholar

27. Rahm, AK, Töllner, M, Hubert, MO, Klein, K, Wehling, C, Sauer, T, et al.. Effects of realistic e-learning cases on students’ learning motivation during COVID-19. PLoS One 2021;16:e0249425. https://doi.org/10.1371/journal.pone.0249425.Search in Google Scholar PubMed PubMed Central

28. Tenny, S, Brannan, GD, Brannan, JM, Sharts-Hopko, NC. Qualitative study. In: StatPearls [Internet]. Treasure Island (FL). StatPearls Publishing; 2021. Available from: http://www.ncbi.nlm.nih.gov/books/NBK470395/.Search in Google Scholar

29. Tavakol, M, Torabi, S, Akbar Zeinaloo, A. Grounded theory in medical education research. Med Educ Online 2006;11:4607. https://doi.org/10.3402/meo.v11i.4607.Search in Google Scholar PubMed

30. Cross, EM, Chaffin, WW. Use of the binomial theorem in interpreting results of multiple tests of significance. Educ Psychol Meas 1982;42:25–34. https://doi.org/10.1177/0013164482421003.Search in Google Scholar

31. Liao, JM, Etchegaray, JM, Williams, ST, Berger, DH, Bell, SK, Thomas, EJ. Assessing medical students’ perceptions of patient safety: the medical student safety attitudes and professionalism survey. Acad Med J Assoc Am Med Coll 2014;89:343–51. https://doi.org/10.1097/acm.0000000000000124.Search in Google Scholar PubMed

32. Carruthers, S, Lawton, R, Sandars, J, Howe, A, Perry, M. Attitudes to patient safety amongst medical students and tutors: developing a reliable and valid measure. Med Teach 2009;31:e370-6. https://doi.org/10.1080/01421590802650142.Search in Google Scholar PubMed

33. Nadarajan, SP, Karuthan, SR, Rajasingam, J, Chinna, K. Attitudes toward patient safety among medical students in Malaysia. Int J Environ Res Publ Health 2020;17:E7721. https://doi.org/10.3390/ijerph17217721.Search in Google Scholar PubMed PubMed Central

34. Alshahrani, S, Alswaidan, A, Alkharaan, A, Alfawzan, A, Alshahrani, A, Masuadi, E, et al.. Medical students’ insights towards patient safety. Sultan Qaboos Univ Med J 2021;21:e253-9. https://doi.org/10.18295/squmj.2021.21.02.014.Search in Google Scholar PubMed PubMed Central

35. Kamran, R, Bari, A, Khan, RA, Al-Eraky, M. Patient safety awareness among undergraduate medical students in Pakistani medical school. Pakistan J Med Sci 2018;34:305–9. https://doi.org/10.12669/pjms.342.14563.Search in Google Scholar PubMed PubMed Central

36. Kiesewetter, J, Kager, M, Lux, R, Zwissler, B, Fischer, MR, Dietz, I. German undergraduate medical students’ attitudes and needs regarding medical errors and patient safety--a national survey in Germany. Med Teach 2014;36:505–10. https://doi.org/10.3109/0142159x.2014.891008.Search in Google Scholar PubMed

37. Leung, GKK, Ang, SBL, Lau, TC, Neo, HJ, Patil, NG, Ti, LK. Patient safety culture among medical students in Singapore and Hong Kong. Singap Med J 2013;54:501–5. https://doi.org/10.11622/smedj.2013172.Search in Google Scholar PubMed

38. Doja, A, Bould, MD, Clarkin, C, Eady, K, Sutherland, S, Writer, H. The hidden and informal curriculum across the continuum of training: a cross-sectional qualitative study. Med Teach 2016;38:410–8. https://doi.org/10.3109/0142159x.2015.1073241.Search in Google Scholar

39. Kirwan, M, Riklikiene, O, Gotlib, J, Fuster, P, Borta, M. Regulation and current status of patient safety content in pre-registration nurse education in 27 countries: findings from the Rationing - missed nursing care (RANCARE) COST Action project. Nurse Educ Pract 2019;37:132–40. https://doi.org/10.1016/j.nepr.2019.04.013.Search in Google Scholar PubMed

40. Ginsburg, LR, Tregunno, D, Norton, PG. Self-reported patient safety competence among new graduates in medicine, nursing and pharmacy. BMJ Qual Saf 2013;22:147–54. https://doi.org/10.1136/bmjqs-2012-001308.Search in Google Scholar PubMed PubMed Central

41. Najjar, S, Baillien, E, Vanhaecht, K, Hamdan, M, Euwema, M, Vleugels, A, et al.. Similarities and differences in the associations between patient safety culture dimensions and self-reported outcomes in two different cultural settings: a national cross-sectional study in Palestinian and Belgian hospitals. BMJ Open 2018;8:e021504. https://doi.org/10.1136/bmjopen-2018-021504.Search in Google Scholar PubMed PubMed Central

42. Fischer, MA, Mazor, KM, Baril, J, Alper, E, DeMarco, D, Pugnaire, M. Learning from mistakes. Factors that influence how students and residents learn from medical errors. J Gen Intern Med 2006;21:419–23. https://doi.org/10.1111/j.1525-1497.2006.00420.x.Search in Google Scholar PubMed PubMed Central

43. Lee, HY, Hahm, MI, Lee, SG. Undergraduate medical students’ perceptions ad intentions regarding patient safety during clinical clerkship. BMC Med Educ 2018;18:66. https://doi.org/10.1186/s12909-018-1180-8.Search in Google Scholar PubMed PubMed Central

44. Chen, YC, Issenberg, SB, Issenberg, Z, Chen, HW, Kang, YN, Wu, JC. Factors associated with medical students speaking-up about medical errors: a cross-sectional study. Med Teach 2022;44:38–44. https://doi.org/10.1080/0142159x.2021.1959904.Search in Google Scholar PubMed

45. López-Hernández, LB, Díaz, BG, González, EOZ, Montes-Hernández, KI, Díaz, SS, Toledo-Lozano, C, et al.. Quality and safety in healthcare for medical students: challenges and the road ahead. Healthc 2020;8:E540. https://doi.org/10.3390/healthcare8040540.Search in Google Scholar PubMed PubMed Central

46. Schwendimann, R, Blatter, C, Dhaini, S, Simon, M, Ausserhofer, D. The occurrence, types, consequences and preventability of in-hospital adverse events - a scoping review. BMC Health Serv Res 2018;18:521. https://doi.org/10.1186/s12913-018-3335-z.Search in Google Scholar PubMed PubMed Central

47. Pham, JC, Aswani, MS, Rosen, M, Lee, H, Huddle, M, Weeks, K, et al.. Reducing medical errors and adverse events. Annu Rev Med 2012;63:447–63. https://doi.org/10.1146/annurev-med-061410-121352.Search in Google Scholar PubMed

48. Mohsin, SU, Ibrahim, Y, Levine, D. Teaching medical students to recognise and report errors. BMJ Open Qual 2019;8:e000558. https://doi.org/10.1136/bmjoq-2018-000558.Search in Google Scholar PubMed PubMed Central

49. de Feijter, JM, de Grave, WS, Hopmans, EM, Koopmans, RP, Scherpbier, AJ. Reflective learning in a patient safety course for final-year medical students. Med Teach 2012;34:946–54. https://doi.org/10.3109/0142159x.2012.714873.Search in Google Scholar

50. Leung, GKK, Patil, NG. Patient safety in the undergraduate curriculum: medical students’ perception. Hong Kong Med J Xianggang Yi Xue Za Zhi 2010;16:101–5.Search in Google Scholar

51. Olde Bekkink, M, Farrell, SE, Takayesu, JK. Interprofessional communication in the emergency department: residents’ perceptions and implications for medical education. Int J Med Educ 2018;9:262–70. https://doi.org/10.5116/ijme.5bb5.c111.Search in Google Scholar PubMed PubMed Central

52. Samra, R, Cox, T, Gordon, AL, Conroy, SP, Lucassen, MFG, Griffiths, A. Factors related to medical students’ and doctors’ attitudes towards older patients: a systematic review. Age Ageing 2017;46:911–9. https://doi.org/10.1093/ageing/afx058.Search in Google Scholar PubMed PubMed Central

53. Hojat, M, DeSantis, J, Shannon, SC, Speicher, MR, Bragan, L, Calabrese, LH. Empathy as related to gender, age, race and ethnicity, academic background and career interest: a nationwide study of osteopathic medical students in the United States. Med Educ 2020;54:571–81. https://doi.org/10.1111/medu.14138.Search in Google Scholar PubMed PubMed Central

54. Reimer, D, Russell, R, Khallouq, BB, Kauffman, C, Hernandez, C, Cendán, J, et al.. Pre-clerkship medical students’ perceptions of medical professionalism. BMC Med Educ 2019;19:239. https://doi.org/10.1186/s12909-019-1629-4.Search in Google Scholar PubMed PubMed Central

55. Genn, JM, Harden, RM. What is medical education here really like? Suggestions for action research studies of climates of medical education environments. Med Teach 1986;8:111–24. https://doi.org/10.3109/01421598609010737.Search in Google Scholar PubMed

56. Tokuda, Y, Goto, E, Otaki, J, Jacobs, J, Omata, F, Obara, H, et al.. Undergraduate educational environment, perceived preparedness for postgraduate clinical training, and pass rate on the National Medical Licensure Examination in Japan. BMC Med Educ 2010;10:35. https://doi.org/10.1186/1472-6920-10-35.Search in Google Scholar PubMed PubMed Central

57. Cleland, JA, Johnston, P, Watson, V, Krucien, N, Skatun, D. What do UK medical students value most in their careers? A discrete choice experiment. Med Educ 2017;51:839–51. https://doi.org/10.1111/medu.13257.Search in Google Scholar PubMed

58. Li, SYW, Cox, AL, Or, C, Blandford, A. Effects of monetary reward and punishment on information checking behaviour. Appl Ergon 2016;53 Pt A:258–66. https://doi.org/10.1016/j.apergo.2015.10.012.Search in Google Scholar PubMed

59. Kiesewetter, J, Kager, M, Fischer, MR, Kiesewetter, I. Validation of a German short version of the Attitudes towards Patient Safety Questionnaire (G-APSQshort) for the measurement of undergraduate medical students’ attitudes to and needs for patient safety. GMS J Med Educ 2017;34:Doc8.Search in Google Scholar

Supplementary Material

The online version of this article offers supplementary material (https://doi.org/10.1515/dx-2022-0072).

Received: 2022-06-27
Accepted: 2022-10-25
Published Online: 2022-11-09

© 2022 Walter de Gruyter GmbH, Berlin/Boston

Articles in the same Issue

  1. Frontmatter
  2. Editorials
  3. An equation for excellence in clinical reasoning
  4. Quantifying diagnostic excellence
  5. Review
  6. A scoping review of distributed cognition in acute care clinical decision-making
  7. Opinion Papers
  8. Context matters: toward a multilevel perspective on context in clinical reasoning and error
  9. Occam’s razor and Hickam’s dictum: a dermatologic perspective
  10. Original Articles
  11. Differences in clinical reasoning between female and male medical students
  12. Introducing second-year medical students to diagnostic reasoning concepts and skills via a virtual curriculum
  13. Bad things can happen: are medical students aware of patient centered care and safety?
  14. Impact of diagnostic checklists on the interpretation of normal and abnormal electrocardiograms
  15. Cerebrospinal fluid lactate as a predictive biomarker for tuberculous meningitis diagnosis
  16. Empowering quality data – the Gordian knot of bringing real innovation into healthcare system
  17. Collective intelligence improves probabilistic diagnostic assessments
  18. Why people fail to participate in annual skin cancer screening: creation of the perceptions of annual skin cancer screening scale (PASCSS)
  19. Instructions on appropriate fasting prior to phlebotomy; effects on patient awareness, preparation, and biochemical parameters
  20. Clinician factors associated with delayed diagnosis of appendicitis
  21. Real-world assessment of the clinical performance of COVID-VIRO ALL IN rapid SARS-CoV-2 antigen test
  22. Lack of a prompt normalization of immunological parameters is associated with long-term care and poor prognosis in COVID-19 affected patients receiving convalescent plasma: a single center experience
  23. Letters to the Editor
  24. Uncontrolled confounding in COVID-19 epidemiology
  25. VAPES: a new mnemonic for considering paroxysmal disorders
  26. Congress Abstracts
  27. SIDM2022 15th Annual International Conference
https://doi.org/10.1515/dx-2022-0072
Keywords for this article
error management; medical errors; medical students; patient safety; perceptions

Articles in the same Issue

  1. Frontmatter
  2. Editorials
  3. An equation for excellence in clinical reasoning
  4. Quantifying diagnostic excellence
  5. Review
  6. A scoping review of distributed cognition in acute care clinical decision-making
  7. Opinion Papers
  8. Context matters: toward a multilevel perspective on context in clinical reasoning and error
  9. Occam’s razor and Hickam’s dictum: a dermatologic perspective
  10. Original Articles
  11. Differences in clinical reasoning between female and male medical students
  12. Introducing second-year medical students to diagnostic reasoning concepts and skills via a virtual curriculum
  13. Bad things can happen: are medical students aware of patient centered care and safety?
  14. Impact of diagnostic checklists on the interpretation of normal and abnormal electrocardiograms
  15. Cerebrospinal fluid lactate as a predictive biomarker for tuberculous meningitis diagnosis
  16. Empowering quality data – the Gordian knot of bringing real innovation into healthcare system
  17. Collective intelligence improves probabilistic diagnostic assessments
  18. Why people fail to participate in annual skin cancer screening: creation of the perceptions of annual skin cancer screening scale (PASCSS)
  19. Instructions on appropriate fasting prior to phlebotomy; effects on patient awareness, preparation, and biochemical parameters
  20. Clinician factors associated with delayed diagnosis of appendicitis
  21. Real-world assessment of the clinical performance of COVID-VIRO ALL IN rapid SARS-CoV-2 antigen test
  22. Lack of a prompt normalization of immunological parameters is associated with long-term care and poor prognosis in COVID-19 affected patients receiving convalescent plasma: a single center experience
  23. Letters to the Editor
  24. Uncontrolled confounding in COVID-19 epidemiology
  25. VAPES: a new mnemonic for considering paroxysmal disorders
  26. Congress Abstracts
  27. SIDM2022 15th Annual International Conference
Sign up now to receive a 20% welcome discount
Institutional Access
How does access work?
Have an idea on how to improve our website?
Please write us.
© 2025 De Gruyter Brill
Downloaded on 11.9.2025 from https://www.degruyterbrill.com/document/doi/10.1515/dx-2022-0072/html
Scroll to top button