Medical radiation protection practice within the EEC

International Nuclear Information System (INIS)

Fitzgerald, M.; Courades, J.-M.

1991-01-01

The Proceedings of this meeting give a comparative overview of current legislation and practice in the European Member States. This publication represents the most comprehensive collection of data on the legal and administrative aspects of medical radiation protection within the EEC. (author)

General practice registrars' intentions for future practice: implications for rural medical workforce planning.

Science.gov (United States)

Harding, Catherine; Seal, Alexa; McGirr, Joe; Caton, Tim

2016-11-01

The models of practice that general practice registrars (GPRs) envisage undertaking will affect workforce supply. The aim of this research was to determine practice intentions of current GPRs in a regional general practice training program (Coast City Country General Practice Training). Questionnaires were circulated to 220 GPRs undertaking general practice placements to determine characteristics of ideal practice models and intentions for future practice. Responses were received for 99 participants (45%). Current GPRs intend to work an average of less than eight half-day sessions/week, with male participants intending to work more hours (t(91)=3.528, P=0.001). More than one-third of this regional cohort intends to practice in metropolitan centres. Proximity to family and friends was the most important factor influencing the choice of practice location. Men ranked remuneration for work as more important (t (88)=-4.280, Pmedical graduates intend to own their own practice compared with 52% of international medical graduates (χ 2 (1)=8.498, P=0.004). Future general practitioners (GPs) intend to work fewer hours than current GPs. Assumptions about lifestyle factors, practice models and possible professional roles should be carefully evaluated when developing strategies to recruit GPs and GPRs into rural practice.

Medical home capabilities of primary care practices that serve sociodemographically vulnerable neighborhoods.

Science.gov (United States)

Friedberg, Mark W; Coltin, Kathryn L; Safran, Dana Gelb; Dresser, Marguerite; Schneider, Eric C

2010-06-14

Under current medical home proposals, primary care practices using specific structural capabilities will receive enhanced payments. Some practices disproportionately serve sociodemographically vulnerable neighborhoods. If these practices lack medical home capabilities, their ineligibility for enhanced payments could worsen disparities in care. Via survey, 308 Massachusetts primary care practices reported their use of 13 structural capabilities commonly included in medical home proposals. Using geocoded US Census data, we constructed racial/ethnic minority and economic disadvantage indices to describe the neighborhood served by each practice. We compared the structural capabilities of "disproportionate-share" practices (those in the most sociodemographically vulnerable quintile on each index) and others. Racial/ethnic disproportionate-share practices were more likely than others to have staff assisting patient self-management (69% vs 55%; P = .003), on-site language interpreters (54% vs 26%; P primary care practices serving sociodemographically vulnerable neighborhoods were more likely than other practices to have structural capabilities commonly included in medical home proposals. Payments tied to these capabilities may aid practices serving vulnerable populations.

Self-medication practices and predictors for self-medication with ...

African Journals Online (AJOL)

Background: Self-medication with antimalarials and antibiotics is highly practiced worldwide particularly in developing countries including Tanzania. This study was carried out to determine self-medication practices with antimalarials and antibiotics, and as well as predictors for self-medication among urban communities of ...

Knowledge and Practice of Self-medication among Undergraduate Medical Students

Directory of Open Access Journals (Sweden)

Anishma Karmacharya

2018-05-01

Full Text Available Introduction: Self-medication is an important aspect of self-care. It is a common practice in society and medical students are no exception. The aim of this study was to explore the knowledge and practice of self-medication among students of a medical school in Western Nepal. Methods: A cross sectional study was conducted among basic science and clinical students after obtaining prior consent from those willing to participate. Respondents’ degree of agreement with a set of 25 statements was noted using Likert scale to assess their knowledge. The practice of self-medication was studied by asking about the use of selected groups of medicines during the past one-year period and noting the pattern of use. Results: Three hundred and thirty of the 356 students (92.6% participated in the study. Mean knowledge score was 93.2 (SD = 8.1. Self-medication was practiced by 83.3% (n = 275 of respondents. Knowledge about self-medication differed among respondents according to gender (p = 0.03 and nationality (p = 0.04 but not other variables. Practice of self-medication was associated with father’s profession (p = 0.03 and nationality of the respondents (p = 0.04. Conclusions: Students’ knowledge about self-medication was good and they commonly practiced self-medication. Pain-killers were the most commonly used drug.

Troubling Muddy Waters: Problematizing Reflective Practice in Global Medical Education.

Science.gov (United States)

Naidu, Thirusha; Kumagai, Arno K

2016-03-01

The idea of exporting the concept of reflective practice for a global medical education audience is growing. However, the uncritical export and adoption of Western concepts of reflection may be inappropriate in non-Western societies. The emphasis in Western medical education on the use of reflection for a specific end--that is, the improvement of individual clinical practice--tends to ignore the range of reflective practice, concentrating on reflection alone while overlooking critical reflection and reflexivity. This Perspective places the concept of reflective practice under a critical lens to explore a broader view for its application in medical education outside the West. The authors suggest that ideas about reflection in medicine and medical education may not be as easily transferable from Western to non-Western contexts as concepts from biomedical science are. The authors pose the question, When "exporting" Western medical education strategies and principles, how often do Western-trained educators authentically open up to the possibility that there are alternative ways of seeing and knowing that may be valuable in educating Western physicians? One answer lies in the assertion that educators should aspire to turn exportation of educational theory into a truly bidirectional, collaborative exchange in which culturally conscious views of reflective practice contribute to humanistic, equitable patient care. This discussion engages in troubling the already-muddy waters of reflective practice by exploring the global applicability of reflective practice as it is currently applied in medical education. The globalization of medical education demands critical reflection on reflection itself.

Oral cancer--current knowledge, practices and implications for training among an Irish general medical practitioner cohort.

LENUS (Irish Health Repository)

Ni Riordain, Richeal

2009-11-01

This study investigated the current knowledge and practices of general medical practitioners (GMPs) in Ireland regarding the examination of the oral cavity and the detection of oral malignancy and the training they had received at both undergraduate and postgraduate level and since commencing in practice. A questionnaire survey of GMPs in Ireland was conducted. One hundred and fifty four (65.3%) of the practitioners reported regularly examining the oral mucosa of their patients. Almost half of these (n=68) further qualified this response by stating that they only examined the oral mucosa if the patient reported pain in this area or if the patient specifically requested an oral examination for some reason. Eighty one (34.3%) practitioners surveyed felt confident in their ability to detect oral malignancies with the remaining two thirds unsure of whether they would be able to detect oral cancer. There was a significant association between the undergraduate and postgraduate teaching on examination of the oral cavity and whether practitioners felt confident in their ability to detect oral cancer [chi(2)(1)=4.811, p<0.05]. A statistically significant association was also found between the undergraduate and postgraduate teaching on the diagnosis of oral malignant disease and whether practitioners felt confident in their ability to detect oral cancer [chi(2)(1)=6.194, p<0.05]. In conclusion the level of knowledge of Irish general medical practitioners needs to be addressed with appropriate initiatives both at undergraduate level and via CME.

Quality management of clinical-practical instruction for Practical Year medical students in Germany - proposal for a catalogue of criteria from the German Society of Medical Education.

Science.gov (United States)

Raes, Patricia; Angstwurm, Matthias; Berberat, Pascal; Kadmon, Martina; Rotgans, Jerome; Streitlein-Böhme, Irmgard; Burckhardt, Gerhard; Fischer, Martin R

2014-01-01

Amended in 2013, the current version of the German Medical Licensure Regulation contains structural specifications that are also required of non-university institutions involved in Practical Year clinical training. The criteria are worded in relatively general terms. Furthermore, not all of the structural specifications can be readily applied to every subject area. In order to ensure commensurability in Practical Year instruction in Germany, not least in light of recently introduced Practical Year mobility, it is necessary to define consistent quality criteria for Practical Year training. The authors therefore propose a catalogue of criteria for the quality management process in Practical Year instruction facilities. In January 2014, the board of directors of the German Society for Medical Education decided to establish a committee comprised of representatives from various German medical faculties. In a process similar to the Delphi methodology, the group developed criteria for structure, process and outcome quality in Practical Year training in Germany. The criteria developed for structure, process and outcome quality apply to Practical Year training in academic teaching hospitals and university medical centres. Furthermore, modalities for review are proposed. The present catalogue of criteria is intended to contribute to the formation of a basis for the most consistent quality standards possible for Practical Year instruction in Germany.

Lessons learned from the reimbursement profile of a mature private medical toxicology practice: office-based practice pays.

Science.gov (United States)

Thompson, Trevonne M; Leikin, Jerrold B

2015-03-01

We previously reported the financial data for the first 5 years of one of the author's medical toxicology practice. The practice has matured; changes have been made. The practice is increasing its focus on office-based encounters and reducing hospital-based acute care encounters. We report the reimbursement rates and other financial metrics of the current practice. Financial records from October 2009 through September 2013 were reviewed. This is a period of 4 fiscal years and represents the currently available financial data. Charges, payments, and reimbursement rates were recorded according to the type and setting of the medical toxicology encounter: forensic consultations, outpatient clinic encounters, nonpsychiatric inpatient consultations, emergency department (ED) consultations, and inpatient psychiatric consultations. All patients were seen regardless of ability to pay or insurance status. The number of billed Current Procedural Terminology (CPT) codes for office-based encounters increased over the study period; the number of billed CPT codes for inpatient and ED consultations reduced. Office-based encounters demonstrate a higher reimbursement rate and higher payments. In the fiscal year (FY) of 2012, office-based revenue exceeded hospital-based acute care revenue by over $140,000 despite a higher number of billed CPT encounters in acute care settings, and outpatient payments were 2.39 times higher than inpatient, inpatient psychiatry, observation unit, and ED payments combined. The average payment per CPT code was higher for outpatient clinic encounters than inpatient encounters for each fiscal year studied. There was an overall reduction in CPT billing volume between FY 2010 and FY 2013. Despite this, there was an increase in total practice revenue. There was no change in payor mix, practice logistics, or billing/collection service company. In this medical toxicology practice, office-based encounters demonstrate higher reimbursement rates and overall

Radiation sterilization of medical products- current trends and future prospects

International Nuclear Information System (INIS)

Sharma, G.

1997-01-01

In medical practice use of sterile pharmaceuticals and single use disposable medical devices is steadily increasing. Sterile pharmaceuticals like injections and ophthalmic ointments are required for therapy. Medical devices are employed for diagnostic, drug administration or corrective purposes, and as implants for temporary, short term or long term residence in the human system. All these products are made available in sterile form by treating them to a suitable process of sterilization i.e. dry/wet heat, ethylene oxide (EtO) gas or ionizing radiation. In this paper current trends and future prospects of radiation sterilization of medical products are given in detail. 9 refs., 7 tabs

Integrating advanced practice providers into medical critical care teams.

Science.gov (United States)

McCarthy, Christine; O'Rourke, Nancy C; Madison, J Mark

2013-03-01

Because there is increasing demand for critical care providers in the United States, many medical ICUs for adults have begun to integrate nurse practitioners and physician assistants into their medical teams. Studies suggest that such advanced practice providers (APPs), when appropriately trained in acute care, can be highly effective in helping to deliver high-quality medical critical care and can be important elements of teams with multiple providers, including those with medical house staff. One aspect of building an integrated team is a practice model that features appropriate coding and billing of services by all providers. Therefore, it is important to understand an APP's scope of practice, when they are qualified for reimbursement, and how they may appropriately coordinate coding and billing with other team providers. In particular, understanding when and how to appropriately code for critical care services (Current Procedural Terminology [CPT] code 99291, critical care, evaluation and management of the critically ill or critically injured patient, first 30-74 min; CPT code 99292, critical care, each additional 30 min) and procedures is vital for creating a sustainable program. Because APPs will likely play a growing role in medical critical care units in the future, more studies are needed to compare different practice models and to determine the best way to deploy this talent in specific ICU settings.

Strategic planning: how medical practices can succeed in a post-healthcare-reform world.

Science.gov (United States)

Howrigon, Ron

2013-01-01

This article addresses the recent trend of physicians being pressured to sell to hospitals in order to stay in practice. The author utilizes his experience in the healthcare industry to identify causes of this trend and ways in which physician groups can avoid finding themselves in these situations. The author uses real data from an existing medical practice to support his ideas and demonstrate how implementing change now will be beneficial for the success of this medical practice in the future. Objective practice evaluation and the execution of an efficient strategic plan are cited as the most important factors contributing to the financial solvency of medical practices in the current and future healthcare environment.

Medical devices regulations, standards and practices

CERN Document Server

Ramakrishna, Seeram; Wang, Charlene

2015-01-01

Medical Devices and Regulations: Standards and Practices will shed light on the importance of regulations and standards among all stakeholders, bioengineering designers, biomaterial scientists and researchers to enable development of future medical devices. Based on the authors' practical experience, this book provides a concise, practical guide on key issues and processes in developing new medical devices to meet international regulatory requirements and standards. Provides readers with a global perspective on medical device regulationsConcise and comprehensive information on how to desig

Medication management policy, practice and research in Australian residential aged care: Current and future directions.

Science.gov (United States)

Sluggett, Janet K; Ilomäki, Jenni; Seaman, Karla L; Corlis, Megan; Bell, J Simon

2017-02-01

Eight percent of Australians aged 65 years and over receive residential aged care each year. Residents are increasingly older, frailer and have complex care needs on entry to residential aged care. Up to 63% of Australian residents of aged care facilities take nine or more medications regularly. Together, these factors place residents at high risk of adverse drug events. This paper reviews medication-related policies, practices and research in Australian residential aged care. Complex processes underpin prescribing, supply and administration of medications in aged care facilities. A broad range of policies and resources are available to assist health professionals, aged care facilities and residents to optimise medication management. These include national guiding principles, a standardised national medication chart, clinical medication reviews and facility accreditation standards. Recent Australian interventions have improved medication use in residential aged care facilities. Generating evidence for prescribing and deprescribing that is specific to residential aged care, health workforce reform, medication-related quality indicators and inter-professional education in aged care are important steps toward optimising medication use in this setting. Copyright © 2016 Elsevier Ltd. All rights reserved.

Practice transition in graduate medical education.

Science.gov (United States)

Shaffer, Robyn; Piro, Nancy; Katznelson, Laurence; Gephart, Melanie Hayden

2017-10-01

Debt repayment, professional negotiation and practice management skills are vital to a successful medical practice, yet are undervalued and seldom taught in graduate medical education. Medical residents need additional training to confidently transition to independent practice, requiring the development of novel curricula. Medical residents need additional training to confidently transition to independent practice METHODS: We developed a trial practice management curriculum to educate senior residents and fellows through voluntary workshops. Topics discussed in the workshops included debt repayment, billing compliance, medical malpractice, contract negotiations, and lifestyle and financial management. Resident self-confidence was assessed, and feedback was obtained through voluntary survey responses before and after attendance at a workshop, scored using a Likert scale. Twenty-five residents from 20 specialties attended a 1-day session incorporating all lectures; 53 residents from 17 specialties attended a re-designed quarterly session with one or two topics per session. Survey evaluations completed before and after the workshop demonstrated an improvement in residents' self-assessment of confidence in contract negotiations (p practice (p practice. One hundred per cent of respondents agreed that the presentation objectives were relevant to their needs as residents. Participant responses indicated a need for structured education in practice management for senior trainees. Senior residents and fellows will benefit most from curricula, but have high familial and professional demands on their schedules. © 2017 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

Radiological accidents in medical practice

International Nuclear Information System (INIS)

Cardenas Herrera, Juan

2012-01-01

Different radiological accidents that may occur in medical practice are shown. The following topics are focused: accident statistics for medical exposure, accidental medical exposures, radiotherapy accidents and potential accidental scenarios [es

Medical Students' Perspective Towards Their Future Medical Practice

African Journals Online (AJOL)

Objectives:To evaluate the influencing factors towards choice of the medical profession and attitude towards future medical practice. Subjects and methods: One hundred thirty four students of the Gondar College of Medical Sciences were included in the study. Data was collected by using self-administered questionnaires.

The Impact of Baccalaureate Medical Humanities on Subsequent Medical Training and Practice: A Physician-Educator's Perspective.

Science.gov (United States)

Barron, Lauren

2017-12-01

This reflective essay is an attempt to organize trends in feedback I have observed during ten years of coursework, conversations, and correspondence with former students associated with the Medical Humanities Program at Baylor University. Over the years, recurrent themes arise when speaking with alumni about whether and how their medical humanities experience intersects with their current training. I have identified five particular domains in which baccalaureate medical humanities training affects students' subsequent healthcare professions training and practice: context and complementarity, clinical relevance, reflective practice, professional preparedness and vocational calling. I created an instrument of open-ended questions for each of these categories and posted it to social media with an invitation for alumni to respond. This informal survey was conceived as an exploratory exercise with the intent to help generate a foundation for more formal qualitative research in these five domains. In this essay, I offer my own reflections together with those of former students on the impact of baccalaureate-level medical humanities training in order to illustrate the benefits in each domain for subsequent healthcare training and practice. The need for qualitative research that explores the impact of baccalaureate medical humanities merits collaboration between multiple centers of investigation across many disciplines, and across the divide between premedical and medical educators.

Special Forces Medical Sergeants' perceptions and beliefs regarding their current medical sustainment program: implications for the field.

Science.gov (United States)

Wilson, Ramey L; DeZee, Kent J

2014-01-01

Special Forces Medical Sergeants (SFMS) are trained to provide trauma and medical care in support of military operations and diplomatic missions throughout the world with indirect physician oversight. This study assessed their perceptions of the current program designed to sustain their medical skills. An Internet-based survey was developed using the constructs of the Theory of Reasoned Action/Planned Behavior and validated through survey best practices. Of the 334 respondents, 92.8% had deployed at least once as an SFMS. Respondents reported spending 4 hours per week sustaining their medical skills and were highly confident that they could perform their duties on a no-notice deployment. On a 5-point, Likert-type response scale, SFMS felt that only slight change is needed to the Special Operations Medical Skills Sustainment Course (mean: 2.17; standard deviation [SD]: 1.05), while moderate change is needed to the Medical Proficiency Training (mean: 2.82; SD: 1.21) and nontrauma modules (mean: 3.02; SD: 1.22). Respondents desire a medical sustainment program that is provided by subject matter experts, involves actual patient care, incorporates new technology, uses hands-on simulation, and is always available. SFMS are challenged to sustain their medical skills in the current operational environment, and barriers to medical training should be minimized to facilitate sustainment training. Changes to the current medical sustainment program should incorporate operator-level perspectives to ensure acceptability and utility but must be balanced with organizational realities. Improving the medical sustainment program will prepare SFMS for the challenges of future missions. 2014.

Establishment of medical education upon internalization of virtue ethics: bridging the gap between theory and practice.

Science.gov (United States)

Madani, Mansoureh; Larijani, Bagher; Madani, Ensieh; Ghasemzadeh, Nazafarin

2017-01-01

During medical training, students obtain enough skills and knowledge. However, medical ethics accomplishes its goals when, together with training medical courses, it guides students behavior towards morality so that ethics-oriented medical practice is internalized. Medical ethics is a branch of applied ethics which tries to introduce ethics into physicians' practice and ethical decisions; thus, it necessitates the behavior to be ethical. Therefore, when students are being trained, they need to be supplied with those guidelines which turn ethical instructions into practice to the extent possible. The current text discusses the narrowing of the gap between ethical theory and practice, especially in the field of medical education. The current study was composed using analytical review procedures. Thus, classical ethics philosophy, psychology books, and related articles were used to select the relevant pieces of information about internalizing behavior and medical education. The aim of the present study was to propose a theory by analyzing the related articles and books. The attempt to fill the gap between medical theory and practice using external factors such as law has been faced with a great deal of limitations. Accordingly, the present article tries to investigate how and why medical training must take internalizing ethical instructions into consideration, and indicate the importance of influential internal factors. Virtue-centered education, education of moral emotions, changing and strengthening of attitudes through education, and the wise use of administrative regulations can be an effective way of teaching ethical practice in medicine.

Medical emergencies in dental practice.

LENUS (Irish Health Repository)

Wilson, M H

2009-06-01

Serious medical emergencies are fortunately a rare occurrence in the dental practice environment; however, if an emergency situation is encountered a delay in treatment may result in potentially avoidable consequences. The risk of mortality or serious morbidity can be reduced by ensuring that basic emergency equipment and medications are in place, and that the dental team is appropriately trained in basic life support measures. This article aims to provide an overview of the basic emergency medications and equipment that should be present in dental practices, and to discuss specific responses to some of the more common adverse medical events that can present while providing dental treatment.

Workplace etiquette for the medical practice employee.

Science.gov (United States)

Hills, Laura

2010-01-01

Medical practice workplace etiquette is slowly being modified and fine-tuned. New workplace etiquette rules have become necessary because of advances in communications technology, shifting norms, and expectations of what constitutes good manners. Today's medical practice employees must concern themselves with traditional workplace manners but also the manners that come into play when they make or receive cell phone calls, text messages, and e-mails, and when they use social networking media outside of work. This article offers 25 rules for good manners in the medical practice that relate to the ways employees interact with people today, whether face-to-face or when using electronic communications technologies. It offers practical guidelines for making introductions both inside and outside the medical practice. This article also provides a self-quiz to help medical practice employees assess their workplace etiquette intelligence and 12 tips for good workplace table manners.

Prevention of DNA contamination during forensic medical examinations in a clinical forensic medical service: A best practice implementation project.

Science.gov (United States)

Lutz, Tasha

2015-01-01

Contamination of forensic specimens can have significant and detrimental effects on cases presented in court. In 2010 a wrongful conviction in Australia resulted in an inquiry with 25 recommendations to minimize the risk of DNA contamination of forensic specimens. DNA decontamination practices in a clinical forensic medical service currently attempt to comply with these recommendations. Evaluation of these practices has not been undertaken. The aim of this project was to audit the current DNA decontamination practices of forensic medical and nursing examiners in the forensic medical examination process and implement changes based on the audit findings. A re-audit following implementation would be undertaken to identify change and inform further research. The Joanna Briggs Institute's Practical Application of Clinical Evidence System and Getting Research into Practice were used as the audit tool in this project. A baseline audit was conducted; analysis of this audit process was then undertaken. Following education and awareness training targeted at clinicians, a re-audit was completed. There were a total of 24 audit criteria; the baseline audit reflected 20 of these criteria had 100% compliance. The remaining 4 audit criteria demonstrated compliance between 65% and 90%. Education and awareness training resulted in improved compliance in 2 of the 4 audit criteria, with the remaining 2 having unchanged compliance. The findings demonstrated that education and raising awareness can improve clinical practice; however there are also external factors outside the control of the clinicians that influence compliance with best practice.

Medical practice in organized settings. Redefining medical autonomy.

Science.gov (United States)

Astrachan, J H; Astrachan, B M

1989-07-01

Physicians are perplexed by the ongoing erosion of their individual professional autonomy. While the economic forces underlying such change have received much attention, the evolution of new organizational forms that modify and often diminish medical autonomy is less well understood. The practice of medicine is becoming more organized and more hierarchical. We emphasize the importance of organized medical groups, including the medical staff organization, as structures for appropriate peer monitoring, and for counterbalancing the burgeoning influence of governance and administrative constraints on practice. There is an ongoing tension within organizations between management, governance, and physicians. Over time one or another of these groups achieves some measure of dominance, but good management requires a balance of power. The role of the medical staff, which is poorly represented in some health care institutions and under threat in others, is considered. In general, we find that medical work is becoming more hierarchical, and that physician "leaders" do not substitute for collegial processes.

Medicine for the wandering mind: mind wandering in medical practice.

Science.gov (United States)

Smallwood, Jonathan; Mrazek, Michael D; Schooler, Jonathan W

2011-11-01

Mind wandering--defined as a cognitive focus on information that is unrelated to immediate sensory input or the task at hand--is a ubiquitous characteristic of the human condition. When it occurs, the integrity of a wide range of cognitive skills can be compromised. The current paper describes the phenomenon of mind wandering, explores its potential role in medical practice and considers how the education system may profitably control this ubiquitous cognitive state. We argue that because many aspects of a medical professional's work (such as fatigue and depression) maximise the mind's tendency to wander, this experience is likely to be a common occurrence in many medical situations. We then review the psychological literature on mind wandering as it relates to medical practice. Based on this review, we suggest that because mind wandering interferes with an individual's ability to integrate current events into a more general context, its occurrence may lead to downstream problems in the way that symptoms are interpreted and treated. Finally, because the experience of mind wandering is often both difficult to control and hard to recognise, it is difficult to prevent. We argue that techniques that help individuals to become more mindful have the potential to ameliorate the cost of mind wandering to the medical profession. Given the ubiquitous nature of the experience of mind wandering, the integration of mindfulness training into medical education programmes could be of general benefit to society at large. © Blackwell Publishing Ltd 2011.

Medical Residents’ and Practicing Physicians’ e-Cigarette Knowledge and Patient Screening Activities

Directory of Open Access Journals (Sweden)

Karen W. Geletko

2016-11-01

Full Text Available Purpose: The purpose of this study was to compare medical residents and practicing physicians in primary care specialties regarding their knowledge and beliefs about electronic cigarettes (e-cigarettes. We wanted to ascertain whether years removed from medical school had an effect on screening practices, recommendations given to patients, and the types of informational sources utilized. Methods: A statewide sample of Florida primary care medical residents (n = 61 and practicing physicians (n = 53 completed either an online or paper survey, measuring patient screening and physician recommendations, beliefs, and knowledge related to e-cigarettes. χ 2 tests of association and linear and logistic regression models were used to assess the differences within- and between-participant groups. Results: Practicing physicians were more likely than medical residents to believe e-cigarettes lower cancer risk in patients who use them as an alternative to cigarettes ( P = .0003. Medical residents were more likely to receive information about e-cigarettes from colleagues ( P = .0001. No statistically significant differences were observed related to e-cigarette knowledge or patient recommendations. Conclusions: Practicing primary care physicians are accepting both the benefits and costs associated with e-cigarettes, while medical residents in primary care are more reticent. Targeted education concerning the potential health risks and benefits associated with the use of e-cigarettes needs to be included in the current medical education curriculum and medical provider training to improve provider confidence in discussing issues surrounding the use of this product.

Medical Providers' Oral Health Knowledgeability, Attitudes, and Practice Behaviors: An Opportunity for Interprofessional Collaboration.

Science.gov (United States)

Shimpi, Neel; Schroeder, Dixie; Kilsdonk, Joseph; Chyou, Po-Huang; Glurich, Ingrid; Penniman, Eric; Acharya, Amit

2016-03-01

Evaluation of current knowledgeability, attitudes, and practice behaviors of medical providers from a large health care system toward oral health was undertaken as a pilot effort to better understand and integrate oral health into the overall health care delivery. Invitations to complete a 28-question survey, designed in a web-based platform (SurveyMonkey(®)), were emailed to 1407 medical multispecialty physicians, residents, and nurses within the health system. The questionnaire included sections on provider demographics, oral health knowledgeability and attitudes, and current practice conducting oral health screenings. A 14% (n = 199/1407) response rate was achieved for survey completion. There were 16% who reported good coverage of oral/dental health topics in their medical training curriculum. Competency level was practice, while >80% answered knowledge-based questions correctly. Frequency rates for dental referral by the medical providers were 32% 'frequently' and 68% 'infrequently.' Perceptions of optimal frequency for conducting oral health assessment in their professional practices ranged from 69% indicating 'frequently' to 25% indicating 'infrequently.' Overall, positive attitudes were observed toward incorporation of oral health examination into medical practice. The study identified lack of oral health treatment and infrequent referral by medical providers to dental providers. Results support likelihood for acceptance of care models that incorporate a medical/dental team-based approach complemented by oral health training for medical providers to enhance holistic health care delivery. Limitations of this pilot study include potential selection bias and lack of generalizability beyond our institution; further studies are planned in additional settings statewide to validate findings. Copyright © 2016 Elsevier Inc. All rights reserved.

Using Rituals to Strengthen Your Medical Practice Team.

Science.gov (United States)

Hills, Laura

2015-01-01

Rituals can cement the identity of and strengthen the bonds between any people, including the members of the medical practice team. This article presents the idea that the medical practice manager is in the ideal position to create and use rituals for team building. It defines the term ritual, and explores how rituals differ from customs or traditions. As well, it describes six benefits of rituals and the hallmarks of the most effective team rituals; describes seven creative and interesting corporate rituals that medical practice managers can study for inspiration; suggests 20 excellent opportunities within the medical practice calendar year for medical practice team rituals; and identifies six kinds of rituals that are used in organizations. Finally, this article provides a four-step action plan for ritualizing your medical practice team's morning huddles.

Transition of Research into Medical Practice

Science.gov (United States)

Polk, James D.; Johnson-Throop, Kathy A.

2010-01-01

This slide presentation reviews the process of transforming medical research into practical medicine for astronauts and for every day people. Several examples of medical practices that started in space medical research and then were proved useful in other settings: Actigraphy, bone density scanning, the use of Potassium Citrate as a countermeasure used to lessen the risk of kidney stone formation, and ultrasound uses in remote and telemedicine,

The current practice of mentoring across Accreditation Council of Graduate Medical Education – International accredited programs in Qatar from faculty and trainees perspectives

Science.gov (United States)

Suliman, Shireen; Al-Mohammed, Ahmed; Al Mohanadi, Dabia; Allen, Margaret; Bylund, Carma L

2018-01-01

Purpose Mentoring plays a vital role in academic productivity, personal development, and career guidance for students, residents, fellows, and junior faculty. A culture of mentoring is spreading across residency and fellowship training programs in Hamad Medical Corporation, the main teaching tertiary care facility in Qatar. However, there is insufficient knowledge about the current practice of mentoring in these programs. Methods We conducted a cross-sectional study by surveying all faculty and trainees in all residency and fellowship training programs in Qatar. Each completed a web-based questionnaire that asked about the current experience, self-efficacy and measures of improvement of the current practice of mentoring across training programs. Results A total of 393/650 faculty members (61%), 187/250 fellows (74%), and 405/650 residents (62%) responded to the two surveys. Most (74% of faculty members) reported being current mentors, while 67% of residents and fellows reported that they currently have mentors. Faculty who received training in mentoring and those who had an established formal mentoring program in their departments were more likely to enroll in mentoring than others (86%, Pmentoring initiative in their departments were to develop a structured mentoring program and to train the mentors. Content analysis revealed participants’ confusion differentiating between the terms mentoring and supervision. Conclusion Based on the current study, many existing mentoring relationships have an evident confusion between supervision and mentoring roles. Developing structured mentoring program and training both faculty and trainees in mentoring is recommended to improve the current practice of mentoring within the training programs. PMID:29416385

Educating physicians in evidence based medicine: current practices and curricular strategies

NARCIS (Netherlands)

Maggio, L.A.

2015-01-01

Evidence based medicine (EBM) is “the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients.” The practice of EBM is an expectation of professional healthcare and requisite component in many medical school curricula. Yet, despite

Guide of good practices in medical physics - French Society of Medical Physics

International Nuclear Information System (INIS)

Rosenwald, Jean-Claude; Aventin, Christophe; Coste, Frederic; Francois, Pascal; Ginestet, Chantal; Perrin, Benedicte; Salvat, Cecile; Caselles, Olivier; Dedieu, Veronique; Dejean, Catherine; Batalla, Alain; Guillaume, Bonniaud; Le Du, Dominique; Lisbona, Albert; Marchesi, Vincent; Sarrazin, Thierry; Mazeron, Jean-Jacques; Lipinski, Francis; Vera, Pierre; Vermandel, Maximilien; Ducou le Pointe, Hubert; Vidal, Vincent; Henry, Cecile; Mazeau-Woynar, Valerie; Prot, Camille; Valero, Marc; Aubert, Bernard; Etard, Cecile; Jimonet, Christine; Roue, Amelie; Sage, Julie; Bardies, Manuel; Beauvais, Helene; Bey, Pierre; Costa, Andre; Desblancs, Claire; Eudaldo, Teresa; Farman, Bardia; Ferrand, Regis; Garcia, Robin; Giraud, Jean-Yves; Husson, Francois; Koulibaly, Malick; Carlan, Loic de; Manens, Jean-Pierre; Naudy, Suzanne; Noel, Alain; Pilette, Pierre; Verdun, Francis; Bouette, Aurelien; Breen, Stephen; Bridier, Andre; Chauvenet, Bruno; Chavaudra, Jean; Gardin, Isabelle; Herlevin, Karine

2012-01-01

After a presentation of the methodological approach used to write this book, the first chapter addresses the profession of medical physicist: medical physics in France (history, evolution of the profession, of the education and of regulation), legal framework (related to the medical use of ionizing radiations, legal texts directly concerning medical physics, regulations impacting the professional practice of medical physicists), scopes of intervention of the medical physicist (context, missions, dose management, image quality, quality management and safety, relationship with the patient, education, training and research, relationships with industry, cost management), operating conditions, and good professional practices. The second chapter addresses the principles of management of quality and safety: quality management in medical physics, safety management, quality and safety in health care facilities. The third part addresses good practices in medical physics: general principles of working methods, equipment management, participation to clinic activities

Assessment and modelling of general practice and community setting capacity for medical trainees in northern New Zealand.

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Goodyear-Smith, Felicity; Al-Murrani, Abbas

2017-09-22

To estimate the capacity of general practice to accommodate undergraduate and postgraduate medical trainees, and model efficient ways to utilise identified capacity and increase capacity. We conducted an online survey, with phone follow-up to non-responders, of all general practices in the northern half of New Zealand. The main outcome measures were current placements and future intentions for taking medical trainees; factors influencing decisions and possible incentives to take trainees. Sixty percent of existing practices take no medical trainees. On average, practices take trainees for 50% of available cycles per year. Postgraduate trainees displace undergraduate student placements due to space limitations. Only 1.9% practices demonstrate current capacity for full vertical training by taking all three types of trainee (undergraduate, PGY, registrar). Modelling on current use means 69 additional practices will be needed to be recruited by 2020. A number of strategies are presented aimed at increasing short-term undergraduate teaching practice capacity in New Zealand, but also relevant to Australia and elsewhere. In the long-term, establishment of the proposed School of Rural Health would enable integrated vertical teaching and address the GP training capacity issues.

Outcomes of an Advanced Ultrasound Elective: Preparing Medical Students for Residency and Practice.

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Prats, Michael I; Royall, Nelson A; Panchal, Ashish R; Way, David P; Bahner, David P

2016-05-01

Many medical specialties have adopted the use of ultrasound, creating demands for higher-quality ultrasound training at all levels of medical education. Little is known about the long-term benefit of integrating ultrasound training during undergraduate medical education. This study evaluated the effect of a longitudinal fourth-year undergraduate medical education elective in ultrasound and its impact on the future use of ultrasound in clinical practice. A cross-sectional survey of medical graduates from The Ohio State University College of Medicine (2006-2011) was done, comparing those who participated and those who did not participate in a rigorous ultrasound program for fourth-year medical students. A 38-item questionnaire queried graduates concerning ultrasound education in residency, their proficiency, and their current use of ultrasound in clinical practice. Surveys were completed by 116 respondents, for a return rate of 40.8% (116 of 284). The participants of the undergraduate medical education ultrasound elective (n = 61) reported more hours of ultrasound training after graduation (hands-on training, bedside scanning, and number of scans performed; P practice (P medical education ultrasound elective produced physicians who were more likely to seek additional training in residency, evaluate themselves as more proficient, and use ultrasound in their clinical practice. Early training in bedside ultrasound during undergraduate medical education yields physicians who are better prepared for integration of ultrasound into clinical practice. © 2016 by the American Institute of Ultrasound in Medicine.

Self-medication practice among undergraduate medical students in a tertiary care medical college, West Bengal.

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Banerjee, I; Bhadury, T

2012-01-01

Self-medication is a widely prevalent practice in India. It assumes a special significance among medical students as they are the future medical practitioners. To assess the pattern of self-medication practice among undergraduate medical students. Tertiary care medical college in West Bengal, India. A cross-sectional questionnaire-based study was conducted among the undergraduate medical students. Out of 500 students of the institute, 482 consented for the study and filled in the supplied questionnaire. Fourteen incomplete questionnaires were excluded and the remaining 468 analyzed. It was found that 267 (57.05%) respondents practiced self-medication. The principal morbidities for seeking self-medication included cough and common cold as reported by 94 students (35.21%) followed by diarrhea (68 students) (25.47%), fever (42 students) (15.73%), headache (40 students) (14.98%) and pain abdomen due to heartburn/ peptic ulcer (23 students) (8.61%). Drugs/ drug groups commonly used for self-medication included antibiotics (31.09%) followed by analgesics (23.21%), antipyretics (17.98%), antiulcer agents (8.99%), cough suppressant (7.87%), multivitamins (6.37%) and antihelminthics (4.49%). Among reasons for seeking self-medication, 126 students (47.19%) felt that their illness was mild while 76 (28.46%) preferred as it is time-saving. About 42 students (15.73%) cited cost-effectiveness as the primary reason while 23 (8.62%) preferred because of urgency. Our study shows that self-medication is widely practiced among students of the institute. In this situation, faculties should create awareness and educate their students regarding advantages and disadvantages of self-medication.

Self-medication practice among undergraduate medical students of ...

African Journals Online (AJOL)

1Department of Family and Community Medicine, Faculty of Medicine, 2Faculty of Medicine, Jazan University, Jazan, Kingdom ... Results: Self-medication practice was highly prevalent among the medical students, with 87 % ... as part of self-care to improve the health care ..... No conflict of interest associated with this work.

Virtue in Medical Practice: An Exploratory Study.

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Kotzee, Ben; Ignatowicz, Agnieszka; Thomas, Hywel

2017-03-01

Virtue ethics has long provided fruitful resources for the study of issues in medical ethics. In particular, study of the moral virtues of the good doctor-like kindness, fairness and good judgement-have provided insights into the nature of medical professionalism and the ethical demands on the medical practitioner as a moral person. Today, a substantial literature exists exploring the virtues in medical practice and many commentators advocate an emphasis on the inculcation of the virtues of good medical practice in medical education and throughout the medical career. However, until very recently, no empirical studies have attempted to investigate which virtues, in particular, medical doctors and medical students tend to have or not to have, nor how these virtues influence how they think about or practise medicine. The question of what virtuous medical practice is, is vast and, as we have written elsewhere, the question of how to study doctors' moral character is fraught with difficulty. In this paper, we report the results of a first-of-a-kind study that attempted to explore these issues at three medical schools (and associated practice regions) in the United Kingdom. We identify which character traits are important in the good doctor in the opinion of medical students and doctors and identify which virtues they say of themselves they possess and do not possess. Moreover, we identify how thinking about the virtues contributes to doctors' and medical students' thinking about common moral dilemmas in medicine. In ending, we remark on the implications for medical education.

Nutrition in Medicine: Medical Students׳ Satisfaction, Perceived Relevance and Preparedness for Practice

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Victor Mogre

2018-03-01

Discussion: Students were dissatisfied with their current education in nutrition, felt inadequately prepared to provide nutrition care and considered nutrition education to be highly relevant to their future practice. The findings of this study provide additional evidence that suggests changes in the current format and content of nutrition education in medical education.

Conducting financial due diligence of medical practices.

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Louiselle, P

1995-12-01

Many healthcare organizations are acquiring medical practices in an effort to build more integrated systems of healthcare products and services. This acquisition activity must be approached cautiously to ensure that medical practices being acquired do not have deficiencies that would jeopardize integration efforts. Conducting a thorough due diligence analysis of medical practices before finalizing the transaction can limit the acquiring organizations' legal and financial exposure and is a necessary component to the acquisition process. The author discusses the components of a successful financial due diligence analysis and addresses some of the risk factors in a practice acquisition.

Medical ethics research between theory and practice.

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ten Have, H A; Lelie, A

1998-06-01

The main object of criticism of present-day medical ethics is the standard view of the relationship between theory and practice. Medical ethics is more than the application of moral theories and principles, and health care is more than the domain of application of moral theories. Moral theories and principles are necessarily abstract, and therefore fail to take account of the sometimes idiosyncratic reality of clinical work and the actual experiences of practitioners. Suggestions to remedy the illness of contemporary medical ethics focus on re-establishing the connection between the internal and external morality of medicine. This article discusses the question how to develop a theoretical perspective on medical ethical issues that connects philosophical reflection with the everyday realities of medical practice. Four steps in a comprehensive approach of medical ethics research are distinguished: (1) examine health care contexts in order to obtain a better understanding of the internal morality of these practices; this requires empirical research; (2) analyze and interpret the external morality governing health care practices; sociological study of prevalent values, norms, and attitudes concerning medical-ethical issues is required; (3) creation of new theoretical perspectives on health care practices; Jensen's theory of healthcare practices will be useful here; (4) develop a new conception of bioethics that illuminates and clarifies the complex interaction between the internal and external morality of health care practices. Hermeneutical ethics can be helpful for integrating the experiences disclosed in the empirical ethical studies, as well as utilizing the insights gained from describing the value-contexts of health care practices. For a critical and normative perspective, hermeneutical ethics has to examine and explain the moral experiences uncovered, in order to understand what they tell us.

Self-medication practice among undergraduate medical students in a tertiary care medical college, West Bengal

Directory of Open Access Journals (Sweden)

I Banerjee

2012-01-01

Full Text Available Background: Self-medication is a widely prevalent practice in India. It assumes a special significance among medical students as they are the future medical practitioners. Aim: To assess the pattern of self-medication practice among undergraduate medical students. Settings and Design: Tertiary care medical college in West Bengal, India. Material and Methods: A cross-sectional questionnaire-based study was conducted among the undergraduate medical students. Results: Out of 500 students of the institute, 482 consented for the study and filled in the supplied questionnaire. Fourteen incomplete questionnaires were excluded and the remaining 468 analyzed. It was found that 267 (57.05% respondents practiced self-medication. The principal morbidities for seeking self-medication included cough and common cold as reported by 94 students (35.21% followed by diarrhea (68 students (25.47%, fever (42 students (15.73%, headache (40 students (14.98% and pain abdomen due to heartburn/ peptic ulcer (23 students (8.61%. Drugs/ drug groups commonly used for self-medication included antibiotics (31.09% followed by analgesics (23.21%, antipyretics (17.98%, antiulcer agents (8.99%, cough suppressant (7.87%, multivitamins (6.37% and antihelminthics (4.49%. Among reasons for seeking self-medication, 126 students (47.19% felt that their illness was mild while 76 (28.46% preferred as it is time-saving. About 42 students (15.73% cited cost-effectiveness as the primary reason while 23 (8.62% preferred because of urgency. Conclusion: Our study shows that self-medication is widely practiced among students of the institute. In this situation, faculties should create awareness and educate their students regarding advantages and disadvantages of self-medication.

Practical trials in medical education

DEFF Research Database (Denmark)

Tolsgaard, Martin G; Kulasegaram, Kulamakan M; Ringsted, Charlotte

2017-01-01

participants across several settings and (iii) multiple outcome measures with long-term follow-up to evaluate both benefits and risks. Questions posed by practical trials may be proactive in applying theory in the development of educational innovations or reactive to educational reforms and innovations. Non......CONTEXT: Concerns have been raised over the gap between education theory and practice and how research can contribute to inform decision makers on their choices and priorities. Little is known about how educational theories and research outcomes produced under optimal conditions in highly...... controlled settings generalise to the real-life education context. One way of bridging this gap is applying the concept of practical trials in medical education. In this paper we elaborate on characteristics of practical trials and based on examples from medical education we discuss the challenges...

A preliminary taxonomy of medical errors in family practice.

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Dovey, S M; Meyers, D S; Phillips, R L; Green, L A; Fryer, G E; Galliher, J M; Kappus, J; Grob, P

2002-09-01

To develop a preliminary taxonomy of primary care medical errors. Qualitative analysis to identify categories of error reported during a randomized controlled trial of computer and paper reporting methods. The National Network for Family Practice and Primary Care Research. Family physicians. Medical error category, context, and consequence. Forty two physicians made 344 reports: 284 (82.6%) arose from healthcare systems dysfunction; 46 (13.4%) were errors due to gaps in knowledge or skills; and 14 (4.1%) were reports of adverse events, not errors. The main subcategories were: administrative failure (102; 30.9% of errors), investigation failures (82; 24.8%), treatment delivery lapses (76; 23.0%), miscommunication (19; 5.8%), payment systems problems (4; 1.2%), error in the execution of a clinical task (19; 5.8%), wrong treatment decision (14; 4.2%), and wrong diagnosis (13; 3.9%). Most reports were of errors that were recognized and occurred in reporters' practices. Affected patients ranged in age from 8 months to 100 years, were of both sexes, and represented all major US ethnic groups. Almost half the reports were of events which had adverse consequences. Ten errors resulted in patients being admitted to hospital and one patient died. This medical error taxonomy, developed from self-reports of errors observed by family physicians during their routine clinical practice, emphasizes problems in healthcare processes and acknowledges medical errors arising from shortfalls in clinical knowledge and skills. Patient safety strategies with most effect in primary care settings need to be broader than the current focus on medication errors.

Growing a medical practice with social media marketing.

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Laban, Jake

2012-01-01

Many medical practices are facing the lack of practice growth that their social media efforts are generating. This article provides concrete ideas that can be put in place by any medical practice to realize sustainable practice growth through social media marketing. In the article, the author demonstrates that social media marketing of the medical practice has become absolutely essential in today's evolving, competitive, and fast-paced environment. This demonstration is made through an exploration of the evolution of what "good" marketing has looked like for medical practices over time. In addition, attention is paid to the shift in the definition of good marketing that is required for the practice that is preparing a social media-marketing plan. Specifically, the article investigates the proven requirements for a balanced blend of unique and engaging promotional and nonpromotional community outreach, which is required on a daily basis to achieve the significant, lasting, and sustainable growth that the practice wishes to achieve.

[Quality assurance and quality improvement in medical practice. Part 3: Clinical audit in medical practice].

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Godény, Sándor

2012-02-05

The first two articles in the series were about the definition of quality in healthcare, the quality approach, the importance of quality assurance, the advantages of quality management systems and the basic concepts and necessity of evidence based medicine. In the third article the importance and basic steps of clinical audit are summarised. Clinical audit is an integral part of quality assurance and quality improvement in healthcare, that is the responsibility of any practitioner involved in medical practice. Clinical audit principally measures the clinical practice against clinical guidelines, protocols and other professional standards, and sometimes induces changes to ensure that all patients receive care according to principles of the best practice. The clinical audit can be defined also as a quality improvement process that seeks to identify areas for service improvement, develop and carry out plans and actions to improve medical activity and then by re-audit to ensure that these changes have an effect. Therefore, its aims are both to stimulate quality improvement interventions and to assess their impact in order to develop clinical effectiveness. At the end of the article key points of quality assurance and improvement in medical practice are summarised.

A guide for good practices in medical physics - French Society of Medical Physics

International Nuclear Information System (INIS)

Rosenwald, Jean-Claude; Aventin, Christophe; Coste, Frederic; Francois, Pascal; Ginestet, Chantal; Perrin, Benedicte; Salvat, Cecile; Caselles, Olivier; Dedieu, Veronique; Dejean, Catherine; Batalla, Alain; Guillaume, Bonniaud; LeDu, Dominique; Lisbona, Albert; Marchesi, Vincent; Sarrazin, Thierry; Mazeron, Jean-Jacques; Lipinski, Francis; Vera, Pierre; Maximilien Vermandel; Ducou le Pointe, Hubert; Vidal, Vincent; Henry, Cecile; Mazeau-Woynar, Valerie; Prot, Camille; Valero, Marc; Aubert, Bernard; Etard, Cecile; Jimonet, Christine; Roue, Amelie; Sage, Julie; Bardies, Manuel; Beauvais, Helene; Bey, Pierre; Costa, Andre; Desblancs, Claire; Eudaldo, Teresa; Farman, Bardia; Ferrand, Regis; Garcia, Robin; Giraud, Jean-Yves; Husson, Francois; Koulibaly, Malick; Carlan, Loic de; Manens, Jean-Pierre; Naudy, Suzanne; Noel, Alain; Pilette, Pierre; Verdun, Francis

2012-12-01

After a presentation of the methodological approach used to write this book, the first chapter addresses the profession of medical physicist: medical physics in France (history, evolution of the profession, of the education and of regulation), legal framework (related to the medical use of ionizing radiations, legal texts directly concerning medical physics, regulations impacting the professional practice of medical physicists), scopes of intervention of the medical physicist (context, missions, dose management, image quality, quality management and safety, relationship with the patient, education, training and research, relationships with industry, cost management), operating conditions, and good professional practices. The second chapter addresses the principles of management of quality and safety: quality management in medical physics, safety management, quality and safety in health care facilities. The third part addresses good practices in medical physics: general principles of working methods, equipment management, participation to clinic activities

Medical practice and social authority.

Science.gov (United States)

Pippin, R B

1996-08-01

Questions of medical ethics are often treated as especially difficult casuistical problems or as difficult cases illustrative of paradoxes or advantages in global moral theories. I argue here, in opposition to such approaches, for the inseparability of questions of social history and social theory from any normative assessment of medical practices. The focus of the discussion is the question of the legitimacy of the social authority exercised by physicians, and the insufficiency of traditional defences of such authority in liberal societies (voluntarist, informed consent approaches), as well as traditional attacks on such strategies (ideology critique). Seeing such authority as institution bound and role based, it is argued, can help reframe, more broadly and more adequately, what is an "ethical problem" in medical practice and why.

Translational ethics? The theory-practice gap in medical ethics.

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Cribb, Alan

2010-04-01

Translational research is now a critically important current in academic medicine. Researchers in all health-related fields are being encouraged not only to demonstrate the potential benefits of their research but also to help identify the steps through which their research might be 'made practical'. This paper considers the prospects of a corresponding movement of 'translational ethics'. Some of the advantages and disadvantages of focusing upon the translation of ethical scholarship are reviewed. While emphasising the difficulties of crossing the gap between scholarship and practice, the paper concludes that a debate about the business of translation would be useful for medical ethics.

The importance of health advocacy in Canadian postgraduate medical education: current attitudes and issues

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Alexander Poulton

2015-12-01

Full Text Available Background: Health advocacy is currently a key component of medical education in North America. In Canada, Health Advocate is one of the seven roles included in the Royal College of Physicians and Surgeons of Canada’s CanMEDS competency framework. Method: A literature search was undertaken to determine the current state of health advocacy in Canadian postgraduate medical education and to identify issues facing educators and learners with regards to health advocacy training. Results:  The literature revealed that the Health Advocate role is considered among the least relevant to clinical practice by educators and learners and among the most challenging to teach and assess. Furthermore learners feel their educational needs are not being met in this area. A number of key barriers affecting health advocacy education were identified including limited published material on the subject, lack of clarity within the role, insufficient explicit role modeling in practice, and lack of a gold standard for assessment. Health advocacy is defined and its importance to medical practice is highlighted, using pediatric emergency medicine as an example. Conclusions: Increased published literature and awareness of the role, along with integration of the new 2015 CanMEDS framework, are important going forward to address concerns regarding the quality of postgraduate health advocacy education in Canada.

The importance of health advocacy in Canadian postgraduate medical education: current attitudes and issues.

Science.gov (United States)

Poulton, Alexander; Rose, Heather

2015-01-01

Health advocacy is currently a key component of medical education in North America. In Canada, Health Advocate is one of the seven roles included in the Royal College of Physicians and Surgeons of Canada's CanMEDS competency framework. A literature search was undertaken to determine the current state of health advocacy in Canadian postgraduate medical education and to identify issues facing educators and learners with regards to health advocacy training. The literature revealed that the Health Advocate role is considered among the least relevant to clinical practice by educators and learners and among the most challenging to teach and assess. Furthermore learners feel their educational needs are not being met in this area. A number of key barriers affecting health advocacy education were identified including limited published material on the subject, lack of clarity within the role, insufficient explicit role modeling in practice, and lack of a gold standard for assessment. Health advocacy is defined and its importance to medical practice is highlighted, using pediatric emergency medicine as an example. Increased published literature and awareness of the role, along with integration of the new 2015 CanMEDS framework, are important going forward to address concerns regarding the quality of postgraduate health advocacy education in Canada.

Self-medication practice in Ethiopia: a systematic review

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Ayalew MB

2017-03-01

Full Text Available Mohammed Biset Ayalew Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia Background: Self-medication patterns vary among different populations, and are influenced by many factors. No review has been done that comprehensively expresses self-medication practice in Ethiopia. The aim of this study was to provide an overview of the literature on self-medication practice in Ethiopia.Materials and methods: Databases (PubMed, Google Scholar, ResearchGate, and Hinari were searched for published studies on the practice of self-medication in Ethiopia without restriction in the year of publication or methodology. Some studies were also identified through manual Google search. Primary search terms were “self medication”, “Ethiopia”, “self care”, “non-prescription”, “OTC drug use”, “drug utilization”, and “drug hoarding”. Studies that measured knowledge only or attitude only or beliefs only and did not determine the practice of self-medication were excluded.Results: The database search produced a total of 450 papers. After adjustment for duplicates and inclusion and exclusion criteria, 21 articles were found suitable for the review. All studies were cross-sectional in nature. The prevalence of self-medication varied from 12.8% to 77.1%, with an average of 36.8%. Fever/headache, gastrointestinal tract diseases, and respiratory diseases were the commonest illnesses/symptoms for which self-medication was taken. The major reasons for practicing self-medication were previous experience of treating a similar illness and feeling that the illness was mild. Analgesics/antipyretics, antimicrobials, gastrointestinal drugs, and respiratory drugs were the common drug classes used in self-medication. Mainly, these drugs were obtained from drug-retail outlets. The use of self-medication was commonly suggested by pharmacy professionals and friends

Emergency room management of ureteral calculi: current practices.

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Phillips, Elizabeth; Kieley, Sam; Johnson, Elizabeth B; Monga, Manoj

2009-06-01

To evaluate current practice patterns in U.S. emergency departments (EDs) for the diagnosis, treatment, and counseling of patients with ureteral calculi. Hospital-based ED physicians were invited by e-mail to participate in a Survey-Monkey survey. E-mails were delivered in March 2008 by Direct Medical Data using a listserv provided by the American Medical Association. Of the e-mails sent, 173 e-mails were opened, and 135 physicians responded. Physicians were compensated with a $10 Amazon.com gift card. Ninety percent of ED physicians use noncontrast CT as their initial imaging modality, and 63% use alpha-blockers for medical expulsive therapy. Only 13% of evaluated EDs have guidelines for the management of renal colic, and only 58% of these guidelines that recommend the use of an alpha-blocker. Alpha-blocker use was more common with physicians who have been practicing fewer than 5 years (81%) compared with those with more than 10 years of experience (56%). The majority of physicians used ketorolac and morphine to achieve effective analgesia. Although the average responses concerning the chance of spontaneous stone passage for stones 4 mm (44%) were close to evidence-based values, great variation in the answers was noted (standard deviations: 12% and 22%, respectively). Indeed, 38% of respondents stated that stones 95% chance of passage. Twenty-eight percent of ED physicians would arrange follow-up with a primary care physician, while the remainder would arrange follow-up with a urologist. This study establishes a need for educational opportunities for ED physicians in the management of renal colic. The development of collaborative practice guidelines between urology and emergency medicine associations may be warranted.

[Medical practice in support of hypertension as risk factor kidney in general medical practice, and primary prevention in children in schools, and the pregnant woman in Annaba (Algeria)].

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Rayane, R

2014-06-01

To study medical practice in the management of hypertension as a factor in renal risk in general medical practice and primary prevention in children at school, and pregnant women under prenatal monitoring. The longitudinal study, observational over a year, focused on medical practice in schools, maternal health and medical practice among 100 physicians (general practitioner and specialist practitioner) in Annaba (Algeria). In children in schools, measurement of blood pressure is never done on the grounds because this gesture is considered unnecessary in 100% of cases. In pregnant women, the measurement of blood pressure is not performed in more than 26% of pregnant women because it is deemed unnecessary by the midwife in 89% of pregnant women and default material in 11% of they. In current medical practice, 69% of doctors routinely take blood pressure. For the rest, represented mainly by specialists, it is the patient who does not justify. Sixty-two percent of physicians, that is hypertension, above 140/90mmHg, and 15% of physicians that is hypertension, above 145/95mmHg. Among the physicians, 58.7% did not use urinary strip, either, because they think that this review should be done in a laboratory (64.8%), or because the urinary strip are not available at even consulting (35.2%). Inadequacies in the coverage (care) of the HTA are real. Their effects on the progress of prevalence of the renal insufficiency chronic terminal treated are possibly important. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Description of a practice model for pharmacist medication review in a general practice setting

DEFF Research Database (Denmark)

Brandt, Mette; Hallas, Jesper; Hansen, Trine Graabæk

2014-01-01

BACKGROUND: Practical descriptions of procedures used for pharmacists' medication reviews are sparse. OBJECTIVE: To describe a model for medication review by pharmacists tailored to a general practice setting. METHODS: A stepwise model is described. The model is based on data from the medical chart...... no indication (n=47, 23%). Most interventions were aimed at cardiovascular drugs. CONCLUSION: We have provided a detailed description of a practical approach to pharmacists' medication review in a GP setting. The model was tested and found to be usable, and to deliver a medication review with high acceptance...

International Medical Graduates in the US Physician Workforce and Graduate Medical Education: Current and Historical Trends.

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Ahmed, Awad A; Hwang, Wei-Ting; Thomas, Charles R; Deville, Curtiland

2018-04-01

Data show that international medical graduates (IMGs), both US and foreign born, are more likely to enter primary care specialties and practice in underserved areas. Comprehensive assessments of representation trends for IMGs in the US physician workforce are limited. We reported current and historical representation trends for IMGs in the graduate medical education (GME) training pool and US practicing physician workforce. We compared representation for the total GME and active practicing physician pools with the 20 largest residency specialties. A 2-sided test was used for comparison, with P  < .001 considered significant. To assess significant increases in IMG GME trainee representation for the total pool and each of the specialties from 1990-2015, the slope was estimated using simple linear regression. IMGs showed significantly greater representation among active practicing physicians in 4 specialties: internal medicine (39%), neurology (31%), psychiatry (30%), and pediatrics (25%). IMGs in GME showed significantly greater representation in 5 specialties: pathology (39%), internal medicine (39%), neurology (36%), family medicine (32%), and psychiatry (31%; all P  < .001). Over the past quarter century, IMG representation in GME has increased by 0.2% per year in the total GME pool, and 1.1% per year for family medicine, 0.5% for obstetrics and gynecology and general surgery, and 0.3% for internal medicine. IMGs make up nearly a quarter of the total GME pool and practicing physician workforce, with a disproportionate share, and larger increases over our study period in certain specialties.

Professional courtesy--current practices and attitudes.

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Levy, M A; Arnold, R M; Fine, M J; Kapoor, W N

1993-11-25

Physicians have long provided care free of charge or at a reduced rate as a professional courtesy to other physicians and their families. We conducted a stratified national mail survey to assess the extent to which this practice has changed in recent years. Using the American Medical Association's 1991 master list of physicians, we selected a random sample of 4800 practicing physicians from 12 direct-care specialties. These physicians were asked about their current policy and opinions regarding professional courtesy. Of the 2224 respondents, 2127 (96 percent) offered professional courtesy, defined as providing free or discounted health care to physicians and their families. Psychiatrists were less likely to offer professional courtesy than physicians in any of the other specialties (80 percent vs. 91 to 99 percent, P courtesy included billing only the insurance company (75 percent), providing care at no charge (49 percent), and giving a partial discount (23 percent). Twenty-three percent of the respondents reported that they had changed their policy regarding professional courtesy since starting to practice. Among those who had changed their policy, the most common changes were to increase the practice of billing only the insurance company (67 percent) and to provide care at no charge less often (58 percent). The majority of physicians responding to the survey thought that professional courtesy solidified bonds between physicians (79 percent) and was sound business practice (62 percent); 12 percent believed that it was too expensive to offer free or discounted care as a professional courtesy, and 14 percent thought that the practice had negative effects on the physician-patient interaction. Our survey of physicians involved in direct patient care indicates that, with the exception of psychiatrists, almost all American physicians offer free or discounted care as a professional courtesy and support the practice.

Medical practice branding using cable television.

Science.gov (United States)

Miaoulis, George; Kissinger, Mark; Sirko-Fiorilli, Mary Ann

2005-01-01

Genesis Medical Associates is an independent primary care practice in the suburbs of Pittsburgh. Given competitive pressures, a member of the physician leadership began thinking about the need for the practice to develop an "identity and awareness" program to set the practice apart from the competition. The idea for branding the campaign began when Dr. Rob Potter, Jr., was attending a Pittsburgh Pirates baseball game and a fan said to him, "You're that doctor I see on television" in the nursing home commercial. Triggered by this experience, Potter saw the opportunity to develop an awareness and identity campaign for Genesis. In this article we share the reasons for, the steps taken, and initial results in developing a medical practice branding strategy.

Medical end-of-life practices among Canadian physicians: a pilot study.

Science.gov (United States)

Marcoux, Isabelle; Boivin, Antoine; Mesana, Laura; Graham, Ian D; Hébert, Paul

2016-01-01

Medical end-of-life practices are hotly debated in Canada, and data from other countries are used to support arguments. The objective of this pilot study was twofold: to adapt and validate a questionnaire designed to measure the prevalence of these practices in Canada and the underlying decision-making process, and to assess the feasibility of a nationally representative study. In phase 1, questionnaires from previous studies were adapted to the Canadian context through consultations with a multidisciplinary committee and based on a scoping review. The modified questionnaire was validated through cognitive interviews with 14 physicians from medical specialties associated with a higher probability of being involved with dying patients recruited by means of snowball sampling. In phase 2, we selected a stratified random sample of 300 Canadian physicians in active practice from a national medical directory and used the modified tailored method design for mail and Web surveys. There were 4 criteria for success: modified questions are clearly understood; response patterns for sensitive questions are similar to those for other questions; respondents are comparable to the overall sampling frame; and mean questionnaire completion time is less than 20 minutes. Phase 1: main modifications to the questionnaire were related to documentation of all other medical practices (including practices intended to prolong life) and a question on the proportionality of drugs used. The final questionnaire contained 45 questions in a booklet style. Phase 2: of the 280 physicians with valid addresses, 87 (31.1%) returned the questionnaire; 11 of the 87 declined to participate, for a response rate of 27.1% (n = 76). Most respondents (64 [84%]) completed the mail questionnaire. All the criteria for success were met. It is feasible to study medical end-of-life practices, even for practices that are currently illegal, including the intentional use of lethal drugs. Results from this pilot study

Forty project management strategies for the medical practice staff.

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Hills, Laura Sachs

2010-01-01

Most every medical practice will embark at one time or another on a large and complex new project. The practice may, for instance, undertake a project in office construction or renovation, practice expansion, new technology, or a new large-scale event. The medical practice staff may find itself creating the project plan, overseeing its execution, and working through the plan day to day until its completion. In short, the staff may find itself responsible for project management. This article contains 40 specific, easy-to-implement project management strategies medical practice employees can use to manage both the large and small projects they undertake on behalf of the practice. It suggests effective project management strategies the staff can use before the onset of a new project as well as strategies to help define the project, to deliver the project, and to close and review the project. This article also describes five reasons medical practices often fail at project management and suggests more effective approaches that will ensure that the projects the medical practice undertakes are completed well, on time, and within budget.

Medication management and practices in prison for people with mental health problems: a qualitative study

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Bowen, Robert A; Rogers, Anne; Shaw, Jennifer

2009-01-01

Abstract Background Common mental health problems are prevalent in prison and the quality of prison health care provision for prisoners with mental health problems has been a focus of critical scrutiny. Currently, health policy aims to align and integrate prison health services and practices with those of the National Health Service (NHS). Medication management is a key aspect of treatment for patients with a mental health problem. The medication practices of patients and staff are therefore ...

Medical physics practice and training in Ghana.

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Amuasi, John H; Kyere, Augustine K; Schandorf, Cyril; Fletcher, John J; Boadu, Mary; Addison, Eric K; Hasford, Francis; Sosu, Edem K; Sackey, Theophilus A; Tagoe, Samuel N A; Inkoom, Stephen; Serfor-Armah, Yaw

2016-06-01

Medical physics has been an indispensable and strategic stakeholder in the delivery of radiological services to the healthcare system of Ghana. The practice has immensely supported radiation oncology and medical imaging facilities over the years, while the locally established training programme continues to produce human resource to feed these facilities. The training programme has grown to receive students from other African countries in addition to local students. Ghana has been recognised by the International Atomic Energy Agency as Regional Designated Centre for Academic Training of Medical Physicists in Africa. The Ghana Society for Medical Physics collaborates with the School of Nuclear and Allied Sciences of the University of Ghana to ensure that training offered to medical physicists meet international standards, making them clinically qualified. The Society has also worked together with other bodies for the passage of the Health Profession's Regulatory Bodies Act, giving legal backing to the practice of medical physics and other allied health professions in Ghana. The country has participated in a number of International Atomic Energy Agency's projects on medical physics and has benefited from its training courses, fellowships and workshops, as well as those of other agencies such as International Organization for Medical Physics. This has placed Ghana's medical physicists in good position to practice competently and improve healthcare. Copyright © 2016 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

Being part of a multi-generational medical practice team.

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Hills, Laura

2010-01-01

What happens when you find yourself working in your medical practice every day with co-workers who are the ages of your parents or children? Do you find yourself reverting to age-related roles? Do you become exasperated with or bewildered by the values and behaviors of older or younger colleagues? This article explores the challenges and opportunities the medical practice staff member faces when he or she is part of a multi-generational medical practice team. It describes the tensions that often occur when a medical practice staff runs the gamut from those who remember using a library card catalog and those who can't remember the days before Google. It describes the core values, career goals, key formative events, and attitudes that may have shaped the thinking and behavior of the four generations that may work in the medical practice today: Traditionalists, Baby Boomers, Generation X, and Generation Y. It suggests preferred communication and learning methods for staff members of different generations. Finally, this article offers 10 best practices for working in a multi-generational staff and for creating a supportive multi-generational medical practice culture.

Current trends in endodontic practice: emergency treatments and technological armamentarium.

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Lee, Michelle; Winkler, Johnathon; Hartwell, Gary; Stewart, Jeffrey; Caine, Rufus

2009-01-01

The current clinical practice of endodontics includes the utilization of a variety of new technological advances and materials. The last comprehensive survey that compared treatment modalities used in endodontic practices was conducted in 1990. The purpose of the current survey was to determine the frequency with which these new endodontic technologies and materials are being used in endodontic practices today. An e-mail questionnaire was sent to the 636 active diplomates of the American Board of Endodontics with current e-mail addresses. Two hundred thirty-two diplomates responded for a response rate of 35%. Calcium hydroxide was found to be the most frequently used intracanal medicament for all cases diagnosed with necrotic pulps. Ibuprofen was the most frequently prescribed medication for pain, and penicillin was the most frequently prescribed antibiotic when an active infection was present. Eighty-two percent of the respondents are still incorporating hand files in some fashion during the cleansing and shaping phase of treatment. Lateral condensation and continuous wave were the most common methods used for obturation. Digital radiography was reported as being used by 72.5% of the respondents, whereas 45.3% reported using the microscope greater than 75% of the patient treatment. Ultrasonics was used by 97.8% of the respondents. It appears from the results that new endodontic technology is currently being used in the endodontic offices of those who responded to the survey.

Leadership development in UK medical training: pedagogical theory and practice.

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Bekas, Stavros

2015-01-01

PHENOMENON: The central role of clinical leadership in achieving the vision of quality and productivity could be attained by investing in its development in postgraduate medical education. A critical review of selected literature is presented. The author identifies some of the main theoretical constructs related to leadership; the pedagogical underpinning of medical leadership programs; their learning objectives; and the mixture of methods, individual and collective, to achieve them. INSIGHTS: How to best develop leadership through medical education remains an open debate. Experiential learning, reflective practice, action learning, and mentoring could provide the foundations of leadership development. Application of the aforementioned should be cautious due to limitations of the concept of leadership as currently promoted and lack of robust evaluation methodologies.

Is your practice at risk for medical identity theft?

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Weinstock, Donna

2014-01-01

Medical identity theft has become increasingly prevalent. Medical practices need to take action and have policies and procedures in place to prevent data breaches. This will protect both the patient and the practice from medical identity theft.

Radiology Physician Extenders: A Literature Review of the History and Current Roles of Physician Extenders in Medical Imaging.

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Sanders, Vicki L; Flanagan, Jennifer

2015-01-01

The purpose of the literature review was to assess the origins of radiology physician extenders and examine the current roles found in the literature of advanced practice physician extenders within medical imaging. Twenty-six articles relating to physician assistants (PAs), nurse practitioners (NPs), radiologist assistants (RAs), and nuclear medicine advanced associates (NMAAs) were reviewed to discern similarities and differences in history, scope of practice, and roles in the medical imaging field. The literature showed PAs and NPs are working mostly in interventional radiology. PAs, NPs, and RAs perform similar tasks in radiology, including history and physicals, evaluation and management, preprocedure work-up, obtaining informed consent, initial observations/reports, and post-procedure follow-up. NPs and PAs perform a variety of procedures but most commonly vascular access, paracentesis, and thoracentesis. RAs perform gastrointestinal, genitourinary, nonvascular invasive fluoroscopy procedures, and vascular access procedures. The review revealed NMAAs are working in an advanced role, but no specific performances of procedures was found in the literature, only suggested tasks and clinical competencies. PAs, NPs, and RAs are currently the three main midlevel providers used in medical imaging. These midlevel providers are being used in a variety of ways to increase the efficiency of the radiologist and provide diagnostic and therapeutic radiologic procedures to patients. NMAAs are being used in medical imaging but little literature is available on current roles in clinical practice. More research is needed to assess the exact procedures and duties being performed by these medical imaging physician extenders.

A multi-disciplinary approach to medication safety and the implication for nursing education and practice.

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Adhikari, Radha; Tocher, Jennifer; Smith, Pam; Corcoran, Janet; MacArthur, Juliet

2014-02-01

Medication management is a complex multi-stage and multi-disciplinary process, involving doctors, pharmacists, nurses and patients. Errors can occur at any stage from prescribing, dispensing and administering, to recording and reporting. There are a number of safety mechanisms built into the medication management system and it is recognised that nurses are the final stage of defence. However, medication error still remains a major challenge to patient safety globally. This paper aims to illustrate two main aspects of medication safety practices that have been elicited from an action research study in a Scottish Health Board and three local Higher Education Institutions: firstly current medication safety practices in two clinical settings; and secondly pre and post-registration nursing education and teaching on medication safety. This paper is based on Phase One and Two of an Action Research project. An ethnography-style observational method, influenced by an Appreciative Inquiry (AI) approach was adapted to study the everyday medication management systems and practices of two hospital wards. This was supplemented by seven in-depth interviews with nursing staff, numerous informal discussions with healthcare professionals, two focus-groups, one peer-interview and two in-depth individual interviews with final year nursing students from three Higher Education Institutions in Scotland. This paper highlights the current positive practical efforts in medication safety practices in the chosen clinical areas. Nursing staff do employ the traditional 'five right' principles - right patient, right medication, right dose, right route and right time - for safe administration. Nursing students are taught these principles in their pre-registration nursing education. However, there are some other challenges remaining: these include the establishment of a complete medication history (reconciliation) when patients come to hospital, the provision of an in-depth training in

Replication of clinical innovations in multiple medical practices.

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Henley, N S; Pearce, J; Phillips, L A; Weir, S

1998-11-01

Many clinical innovations had been successfully developed and piloted in individual medical practice units of Kaiser Permanente in North Carolina during 1995 and 1996. Difficulty in replicating these clinical innovations consistently throughout all 21 medical practice units led to development of the interdisciplinary Clinical Innovation Implementation Team, which was formed by using existing resources from various departments across the region. REPLICATION MODEL: Based on a model of transfer of best practices, the implementation team developed a process and tools (master schedule and activity matrix) to quickly replicate successful pilot projects throughout all medical practice units. The process involved the following steps: identifying a practice and delineating its characteristics and measures (source identification); identifying a team to receive the (new) practice; piloting the practice; and standardizing, including the incorporation of learnings. The model includes the following components for each innovation: sending and receiving teams, an innovation coordinator role, an innovation expert role, a location expert role, a master schedule, and a project activity matrix. Communication depended on a partnership among the location experts (local knowledge and credibility), the innovation coordinator (process expertise), and the innovation experts (content expertise). Results after 12 months of working with the 21 medical practice units include integration of diabetes care team services into the practices, training of more than 120 providers in the use of personal computers and an icon-based clinical information system, and integration of a planwide self-care program into the medical practices--all with measurable improved outcomes. The model for sequential replication and the implementation team structure and function should be successful in other organizational settings.

Perception of illegal practice of medicine by Brazilian medical students.

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Lins, Liliane; Herbas, Suzana; Lisboa, Larissa; Damasceno, Hannah; Menezes, Marta

2014-06-01

Illegal practice of medicine by medical students is a worldwide problem. In Brazil, information about this issue is scarce. To describe the perception of illegal practice of medicine by medical students. A cross-sectional study in a stratified random sample of 130 medical students in the 6th to 12th semesters from a private faculty of medicine in Salvador, State of Bahia, Brazil, from September to October 2011. Students responded to a standardised questionnaire about the illegal practice of medicine by medical students. Knowing medical students who practised medical activities without supervision was reported by 86% of the respondents, and 93.8% had heard about someone who performed such practices. Medical specialties most often associated with illegal practice were general medicine (78.8%) and occupational health (55.9%). Illegal practice of medicine was more common in peripheral cities/towns (83.9%) than in the State capital, Salvador City (52.4%). Only 10.5% of illegal activities were reported to the authorities. Unsupervised medical practice was more often reported in the 8th-9th semester (56.8%) and 10th-11th semester (54.4%) of medical school. Illegal practice of medicine was commonly reported by the medical students questioned. The high frequency of reported illegal practice for financial reasons highlights the need for greater availability of paid internships for medical students. Educational institutions represent the social control responsible for supervising the activities of academics. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Medical Residents' and Practicing Physicians' e-Cigarette Knowledge and Patient Screening Activities: Do They Differ?

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Geletko, Karen W; Myers, Karen; Brownstein, Naomi; Jameson, Breanna; Lopez, Daniel; Sharpe, Alaine; Bellamy, Gail R

2016-01-01

The purpose of this study was to compare medical residents and practicing physicians in primary care specialties regarding their knowledge and beliefs about electronic cigarettes (e-cigarettes). We wanted to ascertain whether years removed from medical school had an effect on screening practices, recommendations given to patients, and the types of informational sources utilized. A statewide sample of Florida primary care medical residents (n = 61) and practicing physicians (n = 53) completed either an online or paper survey, measuring patient screening and physician recommendations, beliefs, and knowledge related to e-cigarettes. χ 2 tests of association and linear and logistic regression models were used to assess the differences within- and between-participant groups. Practicing physicians were more likely than medical residents to believe e-cigarettes lower cancer risk in patients who use them as an alternative to cigarettes ( P = .0003). Medical residents were more likely to receive information about e-cigarettes from colleagues ( P = .0001). No statistically significant differences were observed related to e-cigarette knowledge or patient recommendations. Practicing primary care physicians are accepting both the benefits and costs associated with e-cigarettes, while medical residents in primary care are more reticent. Targeted education concerning the potential health risks and benefits associated with the use of e-cigarettes needs to be included in the current medical education curriculum and medical provider training to improve provider confidence in discussing issues surrounding the use of this product.

Measuring Changes in the Economics of Medical Practice.

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Fleming, Christopher; Rich, Eugene; DesRoches, Catherine; Reschovsky, James; Kogan, Rachel

2015-08-01

For the latter third of the twentieth century, researchers have estimated production and cost functions for physician practices. Today, those attempting to measure the inputs and outputs of physician practice must account for many recent changes in models of care delivery. In this paper, we review practice inputs and outputs as typically described in research on the economics of medical practice, and consider the implications of the changing organization of medical practice and nature of physician work. This evolving environment has created conceptual challenges in what are the appropriate measures of output from physician work, as well as what inputs should be measured. Likewise, the increasing complexity of physician practice organizations has introduced challenges to finding the appropriate data sources for measuring these constructs. Both these conceptual and data challenges pose measurement issues that must be overcome to study the economics of modern medical practice. Despite these challenges, there are several promising initiatives involving data sharing at the organizational level that could provide a starting point for developing the needed new data sources and metrics for physician inputs and outputs. However, additional efforts will be required to establish data collection approaches and measurements applicable to smaller and single specialty practices. Overcoming these measurement and data challenges will be key to supporting policy-relevant research on the changing economics of medical practice.

Learning medical history in Oslo: training for medical practice.

Science.gov (United States)

Larsen, O

1999-03-01

The teaching in medical history at the University of Oslo, Norway, is given as an integrated part of the student training for practical work in health care and community health. I summarize here the underlying argumentation and the teaching experiences, concluding that this is felt as an effective way to convey relevant medical historical knowledge and skills to the future doctors.

Branding your medical practice.

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Maley, Catherine; Baum, Neil

2010-01-01

Branding is the process of differentiating your medical practice from all other practices in the industry. Branding takes into account the "look and feel" of your office, you and your staff your materials, and every other detail that gives your patients clues as to who you are and what you value. This article will review the strategies that go into building your own solid brand so your existing patients, as well as prospective ones, are attracted and loyal to you and your brand.

Urogenital disease: current medical need and recent advances.

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Holoboski, M

1998-11-01

The Medicinal Chemistry Division session on Urogenital Disease began with an overview by Dr P-O Andersson (Pharmacia and Upjohn, MI, USA) of current medical need and recent advances in the field. Dr Andersson drew attention to the limited interest that pharmaceutical companies have historically shown in the area of non-malignant diseases of the urogenital tract. Conditions such as bladder overactivity and urinary incontinence, benign prostatic hyperplasia (BPH) and erectile dysfunction have been poorly understood and have been regarded as unavoidable consequences of old age. One factor, which further compounds the problem, is that many people do not seek treatment, a practice which tends to lower the awareness of these conditions.

The New World of Interaction Recording for Medical Practices.

Science.gov (United States)

Levy, Michael

2016-01-01

Today's medical practice staff communicates remotely with patients, pharmacies, and other medical providers in new ways that go far beyond telephone calls. Patient care and communication are now being provided via telecommunications technologies, including chat/IM, screen, Skype, and other video applications. This new paradigm in patient care, known as "telehealth" or "telemedicine," could put medical practices at risk for noncompliance with strict HIPAA and other regulations. Interaction recording encompasses these new means of communication and can help medical practice staff achieve compliance and reduce financial and liability risks while improving operations and patient care. This article explores what medical practices need to know about interaction recording, what to look for in an interaction recording solution, and how to best utilize that solution to meet compliance, manage liability, and improve patient care.

AAPM Medical Physics Practice Guideline 3.a: Levels of supervision for medical physicists in clinical training.

Science.gov (United States)

Seibert, J Anthony; Clements, Jessica B; Halvorsen, Per H; Herman, Michael G; Martin, Melissa C; Palta, Jatinder; Pfeiffer, Douglas E; Pizzutiello, Robert J; Schueler, Beth A; Shepard, S Jeff; Fairobrent, Lynne A

2015-05-08

The American Association of Physicists in Medicine (AAPM) is a nonprofit professional society whose primary purposes are to advance the science, education and professional practice of medical physics. The AAPM has more than 8,000 members and is the principal organization of medical physicists in the United States.The AAPM will periodically define new practice guidelines for medical physics practice to help advance the science of medical physics and to improve the quality of service to patients throughout the United States. Existing medical physics practice guidelines will be reviewed for the purpose of revision or renewal, as appropriate, on their fifth anniversary or sooner.Each medical physics practice guideline represents a policy statement by the AAPM, has undergone a thorough consensus process in which it has been subjected to extensive review, and requires the approval of the Professional Council. The medical physics practice guidelines recognize that the safe and effective use of diagnostic and therapeutic radiology requires specific training, skills, and techniques, as described in each document. Reproduction or modification of the published practice guidelines and technical standards by those entities not providing these services is not authorized.The following terms are used in the AAPM practice guidelines:Must and Must Not: Used to indicate that adherence to the recommendation is considered necessary to conform to this practice guideline.Should and Should Not: Used to indicate a prudent practice to which exceptions may occasionally be made in appropriate circumstances.

Prevalence & Practice of Self-Medication in Ernakulum District, southern India

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Nimitha Paul

2017-09-01

Full Text Available Introduction Self-medication can lead to many problems and has many concerns associated with it including development of drug resistance. The objectives of the current study were to assess the prevalence of self-medication practices among people residing in selected urban and rural areas of Ernakulam district, to assess the pattern of use of self-medications and to determine the differences, if any, between the rural, urban and slum population in the prevalence and pattern of use of self-medications Methods A community based cross-sectional study was conducted and 539 individuals from urban, rural and urban slums of Ernakulam district, Kerala were interviewed using a structured questionnaire. Data was tabulated in MS Excel and analysed using IBM Statistical Package for Social Science (SPSS version 15. Descriptive statistics such as frequency and percentage was used to summarize the data. Univariate and multivariate analysis was done to assess the factors associated with self-medication Results In the study, 21.5% (114/539 reported that they practised self-medication within last three months. Major indications for self-medication were aches and pain (28.9%, fever (22.8% and chronic diseases (13.7%. Among those who practised self-medication, 6.1% (7/114 used antibiotics. In the final logistic regression model, being in urban area [urban areas (OR 5.8, 95% CI 3.2-10.4, urban slums (OR 2.9, 95% CI 1.5-5.4] and increasing age groups [18-59 years (OR 2.1 95% CI 1.1-3.8 and more than 60 years (OR 3.2 95% CI 1.6-6.5] were associated with self-medication practices. Conclusion Holistic approach should be taken to prevent the problem of self-medications, which includes proper awareness and education to public, improving access to care and regulation of pharmacies regarding sale of drugs.

Medical Ethics in Contemporary Clinical Practice

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John R. Williams

2005-11-01

Full Text Available This review article describes and analyzes ethical issues in medical practice, particularly those issues encountered by physicians in their relationships with their patients. These relationships often involve ethical conflicts between 2 or more interests, which physicians need to recognize and resolve. The article deals with 4 topics in clinical practice in which ethical conflicts occur: physicians' duty of confidentiality in a digital environment, their responsibilities for dealing with abuses of the human rights of patients, their role in clinical research, and their relationships with commercial enterprises. The ethical policies of the World Medical Association provide the basis for determining appropriate physician conduct on these matters. The article concludes with reflections on the need for international standards of medical ethics.

Cognitive bias in clinical practice - nurturing healthy skepticism among medical students.

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Bhatti, Alysha

2018-01-01

Errors in clinical reasoning, known as cognitive biases, are implicated in a significant proportion of diagnostic errors. Despite this knowledge, little emphasis is currently placed on teaching cognitive psychology in the undergraduate medical curriculum. Understanding the origin of these biases and their impact on clinical decision making helps stimulate reflective practice. This article outlines some of the common types of cognitive biases encountered in the clinical setting as well as cognitive debiasing strategies. Medical educators should nurture healthy skepticism among medical students by raising awareness of cognitive biases and equipping them with robust tools to circumvent such biases. This will enable tomorrow's doctors to improve the quality of care delivered, thus optimizing patient outcomes.

Nurses' clinical reasoning practices that support safe medication administration: An integrative review of the literature.

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Rohde, Emily; Domm, Elizabeth

2018-02-01

To review the current literature about nurses' clinical reasoning practices that support safe medication administration. The literature about medication administration frequently focuses on avoiding medication errors. Nurses' clinical reasoning used during medication administration to maintain medication safety receives less attention in the literature. As healthcare professionals, nurses work closely with patients, assessing and intervening to promote mediation safety prior to, during and after medication administration. They also provide discharge teaching about using medication safely. Nurses' clinical reasoning and practices that support medication safety are often invisible when the focus is medication errors avoidance. An integrative literature review was guided by Whittemore and Knafl's (Journal of Advanced Nursing, 5, 2005 and 546) five-stage review of the 11 articles that met review criteria. This review is modelled after Gaffney et al.'s (Journal of Clinical Nursing, 25, 2016 and 906) integrative review on medical error recovery. Health databases were accessed and systematically searched for research reporting nurses' clinical reasoning practices that supported safe medication administration. The level and quality of evidence of the included research articles were assessed using The Johns Hopkins Nursing Evidence-Based Practice Rating Scale©. Nurses have a central role in safe medication administration, including but not limited to risk awareness about the potential for medication errors. Nurses assess patients and their medication and use knowledge and clinical reasoning to administer medication safely. Results indicated nurses' use of clinical reasoning to maintain safe medication administration was inadequately articulated in 10 of 11 studies reviewed. Nurses are primarily responsible for safe medication administration. Nurses draw from their foundational knowledge of patient conditions and organisational processes and use clinical reasoning that

Current trends in medical English education and the Japan College of Rheumatology International School.

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Jego, Eric Hajime; Amengual, Olga

2017-11-01

In light of the present revolution happening in medical education in Japan as medical schools implement new curricula to conform to global standards, there is a growing demand for more internationalization and higher quality practical medical English education. In response, many institutions including governmental organizations, universities and academic associations are moving ahead with new initiatives to adapt to these changing demands. This paper reviews the current trends and innovations in medical English education in Japan. This paper also describes one initiative by the Japan College of Rheumatology (JCR) known as the JCR International School held yearly in Karuizawa. By examining recent trends and innovations in medical English education in Japan, the most relevant and applicable can be elucidated to illuminate a path forward for improved medical English education within the JCR.

THE CURRENT PRACTICES FOR TESTING FOR HYPERGLYCAEMIA IN PREGNANCY (HIP IN THE MEDICAL COLLEGE INSTITUTIONS IN INDIA

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Hema Divakar

2017-04-01

Full Text Available BACKGROUND The aim of the study is to determine the current practices in the medical college institutions pan India for testing for Hyperglycaemia in Pregnancy (HIP to detect gestational diabetes and highlight areas that need additional attention in order to ensure adherence to current national guidelines. MATERIALS AND METHODS Questionnaires were used to obtain information regarding the testing strategy for hyperglycaemia in pregnancy. The questionnaires were filled out by the teaching faculty of the OB/GYN departments of 47 medical college institutions in India. The perceptions regarding the prevalence of diabetes in pregnancy in India and the needs for capacity building were assessed. RESULTS Forty seven respondents answered the questionnaires. The majority of respondents (95.83% reported that all pregnant women were offered (universal testing for hyperglycaemia in pregnancy and 37.5% reported that women were screened both in early and midtrimester of pregnancy. Most reported that testing for HIP took place once at booking, irrespective of the gestational age (39.58%. Thirty three (70.21% respondents reported using the single-step nonfasting method to diagnose hyperglycaemia. Furthermore, 21.28% of respondents reported using a glucometer to determine the concentration of blood glucose in plasma, while 68.08% reported using a lab analyser. The instructions for the testing were offered by consultants and postgraduates in a vast majority of cases (87.5%. The staff communicated with the women in a significantly less number of cases (12.5%. 65.96% of respondents felt that all women readily agreed to follow this advice. The majority of respondents (89.35% reported having noticed an increase in the number of women with hyperglycaemia. Furthermore, 91% of all the respondents felt there was a need to train medical personnel to test and manage hyperglycaemia. CONCLUSION Our study confirms the continued wide variability in testing for HIP in India with

Current Medical Journalism Needs Major Revisions

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Alireza Baratloo

2018-05-01

Full Text Available Medical journalism commenced during early nineteenth century as an impressive adjunct for medical education. It is considered as a platform to share the results of the research studies and to disseminate medical information that could impact the present concept and practice of the medicine field. Medical journalism gained immense attention over the years; however, the present scenario revealed certain limitations. A rise in the number of researchers, by interest or forcefully, has led to an increase in the journal count, resulting in several fake research articles being published in the journals. This leads to inappropriate research and low quality of journals, where the data appearing in the research articles is not authentic; thus, the journals publishing such articles face several issues while verifying the authenticity of the data provided. All journals, in particular, the recent ones strive to achieve immense importance in regards to the impact factor, h-index, and similar quality assessments; however, attaining similar scores as that of the well-known journals is impossible. Hence, as a futile effort, the editorial team of the new or latest journals consider adding more references in their articles in order to achieve a higher score; however, certain references from the previously published papers, may decode as a conflict of interest. Based on an unwritten and unavailable rule, all new journals try to publish papers in same format as publishing in famous journals, and do not dare to deconstruct it. It seems that deconstruction should also be performed by the old journals founded the current style! In order to avoid the aforementioned issues, the Advanced Journal of Emergency Medicine emerged with the concept of being different, deconstructive, and without any futile competition with the other journals. Accordingly, we consider a large audience with several degrees of medical education to participate in the field of research, make the

Connecting Technological Innovation in Artificial Intelligence to Real-world Medical Practice through Rigorous Clinical Validation: What Peer-reviewed Medical Journals Could Do

Science.gov (United States)

2018-01-01

Artificial intelligence (AI) is projected to substantially influence clinical practice in the foreseeable future. However, despite the excitement around the technologies, it is yet rare to see examples of robust clinical validation of the technologies and, as a result, very few are currently in clinical use. A thorough, systematic validation of AI technologies using adequately designed clinical research studies before their integration into clinical practice is critical to ensure patient benefit and safety while avoiding any inadvertent harms. We would like to suggest several specific points regarding the role that peer-reviewed medical journals can play, in terms of study design, registration, and reporting, to help achieve proper and meaningful clinical validation of AI technologies designed to make medical diagnosis and prediction, focusing on the evaluation of diagnostic accuracy efficacy. Peer-reviewed medical journals can encourage investigators who wish to validate the performance of AI systems for medical diagnosis and prediction to pay closer attention to the factors listed in this article by emphasizing their importance. Thereby, peer-reviewed medical journals can ultimately facilitate translating the technological innovations into real-world practice while securing patient safety and benefit.

Connecting Technological Innovation in Artificial Intelligence to Real-world Medical Practice through Rigorous Clinical Validation: What Peer-reviewed Medical Journals Could Do.

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Park, Seong Ho; Kressel, Herbert Y

2018-05-28

Artificial intelligence (AI) is projected to substantially influence clinical practice in the foreseeable future. However, despite the excitement around the technologies, it is yet rare to see examples of robust clinical validation of the technologies and, as a result, very few are currently in clinical use. A thorough, systematic validation of AI technologies using adequately designed clinical research studies before their integration into clinical practice is critical to ensure patient benefit and safety while avoiding any inadvertent harms. We would like to suggest several specific points regarding the role that peer-reviewed medical journals can play, in terms of study design, registration, and reporting, to help achieve proper and meaningful clinical validation of AI technologies designed to make medical diagnosis and prediction, focusing on the evaluation of diagnostic accuracy efficacy. Peer-reviewed medical journals can encourage investigators who wish to validate the performance of AI systems for medical diagnosis and prediction to pay closer attention to the factors listed in this article by emphasizing their importance. Thereby, peer-reviewed medical journals can ultimately facilitate translating the technological innovations into real-world practice while securing patient safety and benefit.

KNOWLEDGE, ATTITUDE AND PRACTICE OF SELF-MEDICATION AMONG MEDICAL COLLEGE STUDENTS IN KERALA

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Messaline

2016-05-01

Full Text Available BACKGROUND & RATIONALE Self-medication is defined as the selection and use of medicines by individuals to treat self-recognised illness or symptoms. Practice of self-medication, especially by medical students can cause wastage of resources, bacterial resistance, drug addiction and serious adverse drug reactions. The objective of our study is to evaluate the knowledge, attitude and practice of selfmedication among medical college students in Kerala. METHODS AND MATERIAL MBBS students of a private medical college were included in the study. The students filled a structured pretested questionnaire and descriptive statistics was applied to the data with SPSS version 20. RESULTS Out of 300, 264 (88% students had taken self-medication over the past 1 year. Past exposure with the same drug was the significant source of information for the drugs (49.2% and the drugs frequently self-medicated were analgesics 34.4% (91 and antipyretics 30.3% (80. More than half of the students, 66% (198 students had expressed positive and 34% (102 students had expressed negative attitude towards self-medication. Around 66% students declared that they were not aware of the dose, frequency and adverse effects of the drugs. CONCLUSION The pattern of self-medication practice from our study was similar to other studies done in various parts of India. Similar studies in future will provide adequate information to regulatory authorities to implement these results on strict drug dispensing and drug advertising policies. KEYWORDS Self-medication, Medical College Students, Kerala.

Pattern of medication selling and self-medication practices: A study from Punjab, Pakistan.

Science.gov (United States)

Aziz, Muhammad Majid; Masood, Imran; Yousaf, Mahreen; Saleem, Hammad; Ye, Dan; Fang, Yu

2018-01-01

Access to medicines without prescription is a major contributing factor for self-medication practices. This study was designed to examine the ratio of non-prescribed medicines sales and self-medication practices in Punjab, Pakistan. This study also evaluates the reasons for self-medication within its communities. An observational study was conducted in 272 systemically selected pharmacies to analyze medicines-related sales, with or without prescription. A cross-sectional survey was performed between June 2015 and November 2016. Consumers were interviewed about their self-medication practices. Of the pharmacies surveyed, 65.3% participated in the study. A total of 4348 medicines were purchased for self-medication by 3037 consumers (15.2% of all study participants), of which 873 (28.7%) participated in an interview. Majority (81.2%) medicine purchaser, (90.9%) interview participants, and (59.4%) drug users were male. On average, each community pharmacy sold 7.9 medicines without prescription each day, to an average of 5.5 customers. Many participants (28.9%) had matriculation in their formal education. The medicines most often sold for self-medication were analgesics and antipyretics(39.4%). More than 25% of participants reported fever symptoms and 47.8% assumed their illness was too trivial to consult a doctor. Media advertisements were the most common source of information for participants (46.7%). Many types of medicines were often sold without prescription from community pharmacies. Self-medication was common practice for a wide range of illnesses. Pakistan also needs effective implementation of policies to monitor medication sales. Public education about rational medication and limits to advertising medicine are very necessary.

MO-D-211-01: Medical Physics Practice Guidelines - The Minimum Level of Medical Physics Support in Clinical Practice Settings.

Science.gov (United States)

Chan, M; Fontenot, J; Halvorsen, P

2012-06-01

The American Association of Physicists in Medicine (AAPM) has long advocated a consistent level of medical physics practice, and has published many guidelines and position statements toward that goal, such as Science Council Task Group reports related to calibration and quality assurance, Education Council and Professional Council Task Group reports related to education, training, and peer review, and Board-approved Position Statements related to the Scope of Practice, physicist qualifications, and other aspects of medical physicspractice. Despite these concerted and enduring efforts, the profession does not have a clear and concise statement of the acceptable practice guidelines for routine clinical medical physics. As accreditation of clinical practices becomes more common, Medical Physics Practice Guidelines (MPPGs) will be crucial to ensuring a consistent benchmark for accreditation programs. The AAPM will lead the development of MPPGs in collaboration with other professional societies. The MPPGs will be freely available to the general public. Accrediting organizations, regulatory agencies and legislators will be encouraged to reference these MPPGs when defining their respective requirements. MPPGs are intended to provide the medical community with a clear description of the minimum level of medical physics support that the AAPM would consider to be prudent in all clinical practice settings. Support includes but is not limited to staffing, equipment, machine access, and training. These MPPGs are not designed to replace extensive Task Group reports or review articles, but rather to describe the recommended minimum level of medical physics support for specific clinical services. This course will describe the purpose and scope of MPPGs, the procedure for the development of a MPPG, as well as the progress of Therapy MPPG TG #1 on "Evaluation and quality assurance of x-ray based image guided radiotherapy systems" and Diagnostic MPPG TG #2 on "CT Protocol management

Truth telling in medical practice: students' opinions versus their observations of attending physicians' clinical practice.

Science.gov (United States)

Tang, Woung-Ru; Fang, Ji-Tseng; Fang, Chun-Kai; Fujimori, Maiko

2013-07-01

Truth telling or transmitting bad news is a problem that all doctors must frequently face. The purpose of this cross-sectional study was to investigate if medical students' opinions of truth telling differed from their observations of attending physicians' actual clinical practice. The subjects were 275 medical clerks/interns at a medical center in northern Taiwan. Data were collected on medical students' opinions of truth telling, their observations of physicians' clinical practice, students' level of satisfaction with truth telling practiced by attending physicians, and cancer patients' distress level when they were told the truth. Students' truth-telling awareness was significantly higher than the clinical truth-telling practice of attending physicians (pmedical students' opinions on truth telling and attending physicians' actual clinical practice. More research is needed to objectively assess physicians' truth telling in clinical practice and to study the factors affecting the method of truth telling used by attending physicians in clinical practice. Copyright © 2012 John Wiley & Sons, Ltd.

(Re-)reading medical trade catalogs: the uses of professional advertising in British medical practice, 1870-1914.

Science.gov (United States)

Jones, Claire L

2012-01-01

This article explores how medical practitioners read, used, and experienced medical trade catalogs in late-nineteenth- and early-twentieth-century Britain. Reader responses to the catalog, a book-like publication promoting medical tools, appliances, and pharmaceuticals, have been chronically understudied, as have professional reading practices within medicine more generally. Yet, evidence suggests that clinicians frequently used the catalog and did so in three main ways: to order medical products, to acquire new information about these products, and to display their own product endorsements and product designs. The seemingly widespread nature of these practices demonstrates an individual and collective professional desire to improve medical practice and highlights the importance of studying professional reading practices in the cultural history of medicine.

Self-Medication Practice with Nonprescription Medication among University Students: a review of the literature

Directory of Open Access Journals (Sweden)

Dedy Almasdy

2011-09-01

Full Text Available Objective: To review the literature relating to self-medicationpractice with nonprescription medication among universitystudents.Methods: A narrative review of studies on self-medicationpractice with nonprescription medication among universitystudent was performed. An extensive literature search wasundertaken using indexing services available at UniversitiSains Malaysia (USM library. The following keywords wereused for the search: self-care, self-medication, over-thecountermedicine, nonprescription medicine, minor illnesses,minor ailment, university population and communitypharmacy. Electronic databases searched were Science Direct,Medline, ISI Web of Knowledge, Inside Web, JSTOR, SpringerLink, Proquest, Ebsco Host and Google Scholar. Theseelectronic databases were searched for full text paperspublished in English.Results: Eleven studies were identified. In general, the reviewhas shown that self-medication practice with nonprescriptionmedication highly prevalence among university students. Thereasons for self-medication are vary among this populationand the main symptoms leading to self-medication areheadache or minor pain; fever, flu, cough, or cold; anddiarrhoea.The common medication is analgesic, antipyreticproducts, cough and cold remedies, anti allergy andvitamins or minerals. The sources of the medicines arepharmacy, home medicine cabinet, supermarket/shopand other person such as family, friend, neighbours andclassmates. The sources of drug information are familymember, previous experience, pharmacy salesman,doctor or nurse, advertisement and others. The reviewalso has shown that the self-medication practice couldhave many problems.Conclusions: The review provides insights about theself-medication practices among the university students.These practices were highly prevalence among universitystudents. The symptoms leading to self-medication arevary, thus the medication used and the medicationsources. It needs an adequate drug information

[Evidence based medicine. A new paradigm for medical practice].

Science.gov (United States)

Carneiro, A V

1998-01-01

Modern medical practice is an ever-changing process, and the doctor's need for information has been partially met by continuous medical education (CME) activities. It has been shown that CME activities have not prevented clinical knowledge, as well as medical practice, from deteriorating with time. When faced with the need to get the most recent and relevant information possible, the busy clinician has two major problems: most of the published medical literature is either irrelevant or not useful; and there is little time to read it. Evidence-based medicine constitutes a new paradigm for medical practice in the sense that it tries to transform clinical problems into well formulated clinical questions, selecting and critically appraising scientific evidence with predefined and rigorous rules. It combines the expertise of the individual clinician with the best external evidence from clinical research for rational, ethical and efficacious practice. Evidence-based medicine can be taught and practiced by physicians with different degrees of autonomy, with several subspecialties, working in the hospital or in outpatient clinics, alone or in groups.

Medical Genetics In Clinical Practice

African Journals Online (AJOL)

1974-08-24

Aug 24, 1974 ... Genetics is now an important facet of medical practice. and clinical ... facilities for cytogenetic and biochemical investigation are an essential ..... mem, and Rehabilitation (WHO Technical Report Series No. 497). Geneva: WHO ...

Perceptions and practices of self-medication among medical students in coastal South India.

Directory of Open Access Journals (Sweden)

Nithin Kumar

Full Text Available Self-medication is a common practice worldwide and the irrational use of drugs is a cause of concern. This study assessed the prevalence of self-medication among the medical students in South India. The data was analysed using SPSS version 11.5. A total of 440 students were included in the study. The prevalence of self-medication was 78.6%. A larger number of females were self-medicating (81.2% than males (75.3%. The majority of the students self-medicated because of the illness being too trivial for consultation (70.5%. Antipyretics were most commonly self-medicated by the participants (74.8%. Only 47% of the participants opined that self-medication was a part of self-care and it needs to be encouraged. 39.3% of the participants perceived that the supply of medicine without prescription by the pharmacist can prevent the growing trend of self-medication. Easy availability and accessibility to health care facilities remains the cornerstone for reducing the practice of self-medication.

Library instruction in medical education: a survey of current practices in the United States and Canada.

Science.gov (United States)

Nevius, Amanda M; Ettien, A'Llyn; Link, Alissa P; Sobel, Laura Y

2018-01-01

The most recent survey on instruction practices in libraries affiliated with accredited medical institutions in the United States was conducted in 1996. The present study sought to update these data, while expanding to include Canadian libraries. Additional analysis was undertaken to test for statistically significant differences between library instruction in the United States and Canada and between libraries affiliated with highly ranked and unranked institutions. A twenty-eight-question survey was distributed to libraries affiliated with accredited US and Canadian medical schools to assess what and how often librarians teach, as well as how librarians are involved in the curriculum committee and if they are satisfied with their contact with students and faculty. Quantitative data were analyzed with SAS, R, and MedCalc. Most of the seventy-three responding libraries provided instruction, both asynchronously and synchronously. Library instruction was most likely to be offered in two years of medical school, with year one seeing the most activity. Database use was the most frequently taught topic, and libraries reported a median of five librarians providing instruction, with larger staffs offering slightly more education sessions per year. Libraries associated with highly ranked schools were slightly more likely to offer sessions that were integrated into the medical school curriculum in year four and to offer sessions in more years overall. In US and Canadian libraries, regardless of the rank of the affiliated medical school, librarians' provision of instruction in multiple formats on multiple topics is increasingly common.

Current status of education and training in medical physics in developing and developed countries

International Nuclear Information System (INIS)

Kulkarni, N.S.

2008-01-01

Significant resources are allocated for applying Medical Physics to health care. State-of-the-art technological developments have made this discipline valuable in early diagnosis and treatment of many diseases, particularly cancer. The current challenge is the dire need of harmonizing the standards of practice, including equipment, quality assurance, safety, education and training in Medical Physics across various countries. With experiences gained from the successes and failures in this field, standards of practice have evolved in the developed as well as the developing countries, but at different rates. Considerations of cost-benefit and priorities have led to increased gap in these standards of practice. In this presentation, the status of the education and training component of selected countries representing the two domains will be discussed. Possible causes, as well as the means adopted by the national and international organisations to bridge the gaps, will also be a part of the discussion. Suggestions for future improvements will be offered for consideration

Using electronic clinical practice audits as needs assessment to produce effective continuing medical education programming.

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Klein, Doug; Staples, John; Pittman, Carmen; Stepanko, Cheryl

2012-01-01

The traditional needs assessment used in developing continuing medical education programs typically relies on surveying physicians and tends to only capture perceived learning needs. Instead, using tools available in electronic medical record systems to perform a clinical audit on a physician's practice highlights physician-specific practice patterns. The purpose of this study was to test the feasibility of implementing an electronic clinical audit needs assessment process for family physicians in Canada. A clinical audit of 10 preventative care interventions and 10 chronic disease interventions was performed on family physician practices in Alberta, Canada. The physicians used the results from the audit to produce personalized learning needs, which were then translated into educational programming. A total of 26 family practices and 4489 patient records were audited. Documented completion rates for interventions ranged from 13% for ensuring a patient's tetanus vaccine is current to 97% of pregnant patients receiving the recommended prenatal vitamins. Electronic medical record-based needs assessments may provide a better basis for developing continuing medical education than a more traditional survey-based needs assessment. This electronic needs assessment uses the physician's own patient outcome information to assist in determining learning objectives that reflect both perceived and unperceived needs.

Applying adult learning practices in medical education.

Science.gov (United States)

Reed, Suzanne; Shell, Richard; Kassis, Karyn; Tartaglia, Kimberly; Wallihan, Rebecca; Smith, Keely; Hurtubise, Larry; Martin, Bryan; Ledford, Cynthia; Bradbury, Scott; Bernstein, Henry Hank; Mahan, John D

2014-07-01

The application of the best practices of teaching adults to the education of adults in medical education settings is important in the process of transforming learners to become and remain effective physicians. Medical education at all levels should be designed to equip physicians with the knowledge, clinical skills, and professionalism that are required to deliver quality patient care. The ultimate outcome is the health of the patient and the health status of the society. In the translational science of medical education, improved patient outcomes linked directly to educational events are the ultimate goal and are best defined by rigorous medical education research efforts. To best develop faculty, the same principles of adult education and teaching adults apply. In a systematic review of faculty development initiatives designed to improve teaching effectiveness in medical education, the use of experiential learning, feedback, effective relationships with peers, and diverse educational methods were found to be most important in the success of these programs. In this article, we present 5 examples of applying the best practices in teaching adults and utilizing the emerging understanding of the neurobiology of learning in teaching students, trainees, and practitioners. These include (1) use of standardized patients to develop communication skills, (2) use of online quizzes to assess knowledge and aid self-directed learning, (3) use of practice sessions and video clips to enhance significant learning of teaching skills, (4) use of case-based discussions to develop professionalism concepts and skills, and (5) use of the American Academy of Pediatrics PediaLink as a model for individualized learner-directed online learning. These examples highlight how experiential leaning, providing valuable feedback, opportunities for practice, and stimulation of self-directed learning can be utilized as medical education continues its dynamic transformation in the years ahead

Steve Jobs provides lessons for any medical practice.

Science.gov (United States)

Ornstein, Hal; Baum, Neil

2013-01-01

Steve Jobs is inarguably the greatest inventor and creative genius since Thomas Edison. He provided technology that enhances communication on a global level. Jobs also provided ideas and suggestions that could work in any medical practice regardless of the size of the practice, the location of the practice, or the employment model. His advice can be transferred from a high-tech business that employs thousands to a high-touch medical practice that has only a few employees. This article will list a few of Jobs leadership characteristics and how they might apply to physicians, their teams, and their practices. Wouldn't you like to be the Steve Jobs of healthcare? If so, read on!

Admirable dishonesty in medical practice.

Science.gov (United States)

McCabe, Matthew

2013-01-01

Historically, the ethics of dishonesty within the physician-patient relationship has been analyzed largely from the deontological and consequentialist viewpoints. In this essay I offer a new exploration of dishonesty from the recently developed Virtue Ethics of Care perspective. First, I will explain and justify a general prescription for honest conduct within the relationship. Next, I will explore the conditions under which the Virtue Ethics of Care would find acts of dishonesty in medical practice to be admirable. Here, the moral distinction between lying and deception will be discussed. Then, two special contexts in medical practice, paternalistic dishonesty and patient dishonesty, will be analyzed. I will close with a discussion of the role of trust in the relationship and how it acts to prevent the Virtue Ethics of Care from sliding down the path toward objectionable acts of dishonesty.

Toward a more professional and practical medical education: a novel Central European approach.

Science.gov (United States)

Drexel, Heinz; Vonbank, Alexander; Fraunberger, Peter; Riesen, Walter F; Saely, Christoph H

2015-01-01

We here present an innovative curriculum for a complete medical education that conforms to the current European Bologna system of academic training. The curriculum aims at raising doctors who are excellently prepared for clinical work over as short a time as 5 years; it provides a comprehensive, yet shorter than usual, education that strongly pronounces the importance of increasing the students' practical clinical competences and rigorously excludes superfluous contents. The curriculum encompasses 52 modules, 32 at the bachelor's and 20 at the master's level. Already at the level of the bachelor degree, full employability is given; the students finish the master's course as medical doctors optimally prepared to manage patients at the level of postgraduate medical education. The structure of the curriculum is modular; each modular component is essential for medical education and contains an average of five European Credit Transfer System credits, amounting to 150 hours of education. Depending on the subspecialty, the courses include lectures, seminars, practical laboratory training, and clinical training at varying quantities. In addition to attendance times, sufficient time slots are prepared for self-study in lectures, seminars, and practical work. With our curriculum, we provide an easily applicable backbone for a modern course of medicine that can be installed also at smaller academic institutions.

Undergraduate Training in Human Sexuality—Evaluation of the Impact on Medical Doctors' Practice Ten Years After Graduation

Directory of Open Access Journals (Sweden)

Mary Clegg, MSc, COSRT Accredited UKCP Registered

2016-09-01

Conclusion: The results show a link between the undergraduate teaching of sexual medicine and education and a subsequent proactive approach to sexuality issues; unfortunately, the study does not provide any information about the level of skills or ability in this field of medicine. We have confirmed that the Sheffield model might be suitable for teaching sexual medicine issues in the United Kingdom but cannot confirm that the current format is suitable for international undergraduate audiences. Future study could include other medical schools and a comparison of sexual medicine practice among physicians who received undergraduate medical education and overall numbers could be increased to compare current practice with the number of hours of sexual medicine education as a key parameter.

Information Governance: A Model for Security in Medical Practice

Directory of Open Access Journals (Sweden)

Patricia A.H. Williams

2007-03-01

Full Text Available Information governance is becoming an important aspect of organisational accountability. In consideration that information is an integral asset of most organisations, the protection of this asset will increasingly rely on organisational capabilities in security.  In the medical arena this information is primarily sensitive patient-based information. Previous research has shown that application of security measures is a low priority for primary care medical practice and that awareness of the risks are seriously underestimated. Consequently, information security governance will be a key issue for medical practice in the future. Information security governance is a relatively new term and there is little existing research into how to meet governance requirements. The limited research that exists describes information security governance frameworks at a strategic level. However, since medical practice is already lagging in the implementation of appropriate security, such definition may not be practical although it is obviously desirable. This paper describes an on-going action research project undertaken in the area of medical information security, and presents a tactical approach model aimed at addressing information security governance and the protection of medical data. 

Medical Robots: Current Systems and Research Directions

Directory of Open Access Journals (Sweden)

Ryan A. Beasley

2012-01-01

Full Text Available First used medically in 1985, robots now make an impact in laparoscopy, neurosurgery, orthopedic surgery, emergency response, and various other medical disciplines. This paper provides a review of medical robot history and surveys the capabilities of current medical robot systems, primarily focusing on commercially available systems while covering a few prominent research projects. By examining robotic systems across time and disciplines, trends are discernible that imply future capabilities of medical robots, for example, increased usage of intraoperative images, improved robot arm design, and haptic feedback to guide the surgeon.

Self Medication: Predictors and Practices among Rural Population of Nellikuppam Village, Kancheepuram District, Tamil Nadu

Directory of Open Access Journals (Sweden)

Kalaivani Annadurai

2017-01-01

Full Text Available Background: Inappropriate self medication is one of the leading causes of growing antibiotic resistance in developing nations which poses a major public health threat worldwide and assessment of self medication practices is essential for better understanding of the problem. Aim and Objectives: To find out the predictors of self medication use among the residents of Nellikuppam village, Kancheepuram District, Tamil Nadu. To assess the self medication practices among the residents of Nellikuppam village, Kancheepuram District, Tamil Nadu. Material and Methods: This was a descriptive cross sectional study conducted among 335 adult households with six months recall period in Nellikuppam village of Tamil Nadu during May to October, 2014 using a pretested semi-structured questionnaire. Results: Prevalence of self medication among adult rural population was 53.43% and only half of the study population opined that it was harmful. Pharmacists (72.06% were the major source of drug information on self medication. Paracetomol (84.91% was the commonest drug used for self medication. Major predictors were perception of illness as minor ailment and unavailability of doctors in their locality. Nearly half of the current self medication users (47.49% were in the idea of practicing self medication in the future. Conclusion: This study results implies the need for proper enforcement of legal measures towards the restriction of over the counter medicine and creating awareness among general population on adverse reaction of self medication.

21 CFR 110.5 - Current good manufacturing practice.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 2 2010-04-01 2010-04-01 false Current good manufacturing practice. 110.5 Section...) FOOD FOR HUMAN CONSUMPTION CURRENT GOOD MANUFACTURING PRACTICE IN MANUFACTURING, PACKING, OR HOLDING HUMAN FOOD General Provisions § 110.5 Current good manufacturing practice. (a) The criteria and...

Consumerism: forcing medical practices toward patient-centered care.

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Ozmon, Jeff

2007-01-01

Consumerism has been apart of many industries over the years; now consumerism may change the way many medical practices deliver healthcare. With the advent of consumer-driven healthcare, employers are shifting the decision-making power to their employees. Benefits strategies like health savings accounts and high-deductible insurance plans now allow the patients to control how and where they spend their money on medical care. Practices that seek to attract the more affluent and informed consumers are beginning to institute patient-centered systems designs that invite patients to actively participate in their healthcare. This article will outline the changes in the healthcare delivery system facing medical practices, the importance of patient-centered care, and six strategies to implement to change toward more patient-centered care.

Extracorporeal membrane oxygenation: current clinical practice, coding, and reimbursement.

Science.gov (United States)

Schuerer, Douglas J E; Kolovos, Nikoleta S; Boyd, Kayla V; Coopersmith, Craig M

2008-07-01

Extracorporeal membrane oxygenation (ECMO) is a technique for providing life support for patients experiencing both pulmonary and cardiac failure by maintaining oxygenation and perfusion until native organ function is restored. ECMO is used routinely at many specialized hospitals for infants and less commonly for children with respiratory or cardiac failure from a variety of causes. Its usage is more controversial in adults, but select medical centers have reported favorable findings in patients with ARDS and other causes of severe pulmonary failure. ECMO is also rarely used as a rescue therapy in a small subset of adult patients with cardiac failure. This article will review the current uses and techniques of ECMO in the critical care setting as well as the evidence supporting its usage. In addition, current practice management related to coding and reimbursement for this intensive therapy will be discussed.

Challenges of safe medication practice in paediatric care--a nursing perspective.

Science.gov (United States)

Star, Kristina; Nordin, Karin; Pöder, Ulrika; Edwards, I Ralph

2013-05-01

To explore nurses' experiences of handling medications in paediatric clinical practice, with a focus on factors that hinder and facilitate safe medication practices. Twenty nurses (registered nurses) from four paediatric wards at two hospitals in Sweden were interviewed in focus groups. The interviews were analysed using content analysis. Six themes emerged from the analysed interviews: the complexity specific for nurses working on paediatric wards is a hindrance to safe medication practices; nurses' concerns about medication errors cause a considerable psychological burden; the individual nurse works hard for safe medication practices and values support from other nurse colleagues; circumstances out of the ordinary are perceived as critical challenges for maintaining patient safety; nurses value clear instructions, guidelines and routines, but these are often missing, variable or changeable; management, other medical professionals, the pharmacy, the pharmaceutical industry and informatics support need to respond to the requirements of the nurses' working situations to improve safe medication practices. Weaknesses were apparent in the long chain of the medication-delivery process. A joint effort by different professions involved in that delivery process, and a nationwide collaboration between hospitals is recommended to increase safe medication practices in paediatric care. ©2013 Foundation Acta Paediatrica. Published by Blackwell Publishing Ltd.

Medical students' perception of dyad practice

DEFF Research Database (Denmark)

Tolsgaard, Martin G; Rasmussen, Maria Birkvad; Bjørck, Sebastian

2014-01-01

Training in pairs (dyad practice) has been shown to improve efficiency of clinical skills training compared with single practice but little is known about students' perception of dyad practice. The aim of this study was to explore the reactions and attitudes of medical students who were instructed....... The students felt dyad practice improved their self-efficacy through social interaction with peers, provided useful insight through observation, and contributed with shared memory of what to do, when they forgot essential steps of the physical examination of the patient. However, some students were concerned...

AAPM-RSS Medical Physics Practice Guideline 9.a. for SRS-SBRT.

Science.gov (United States)

Halvorsen, Per H; Cirino, Eileen; Das, Indra J; Garrett, Jeffrey A; Yang, Jun; Yin, Fang-Fang; Fairobent, Lynne A

2017-09-01

The American Association of Physicists in Medicine (AAPM) is a nonprofit professional society whose primary purposes are to advance the science, education, and professional practice of medical physics. The AAPM has more than 8,000 members and is the principal organization of medical physicists in the United States. The AAPM will periodically define new practice guidelines for medical physics practice to help advance the science of medical physics and to improve the quality of service to patients throughout the United States. Existing medical physics practice guidelines will be reviewed for revision or renewal, as appropriate, on their fifth anniversary or sooner. Each medical physics practice guideline represents a policy statement by the AAPM, has undergone a thorough consensus process in which it has been subjected to extensive review, and requires the approval of the Professional Council. The medical physics practice guidelines recognize that the safe and effective use of diagnostic and therapeutic radiology requires specific training, skills, and techniques, as described in each document. Reproduction or modification of the published practice guidelines and technical standards by those entities not providing these services is not authorized. The following terms are used in the AAPM practice guidelines: Must and Must Not: Used to indicate that adherence to the recommendation is considered necessary to conform to this practice guideline. Should and Should Not: Used to indicate a prudent practice to which exceptions may occasionally be made in appropriate circumstances. Approved by AAPM Professional Council 3-31-2017 and Executive Committee 4-4-2017. © 2017 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine.

Updated posters to help manage medical emergencies in the dental practice.

Science.gov (United States)

Jevon, P

2015-09-11

Medical emergencies can occur in the dental practice. Medical Emergencies in the Dental Practice and Emergency Drugs in the Dental Practice posters have been designed to help dental practitioners to respond effectively and safely to a medical emergency. These posters, endorsed by the British Dental Association, are included with this issue of the British Dental Journal. Further copies can be downloaded from: https://www.walsallhealthcare.nhs.uk/medical-education.aspx.

Medical student attachments in private practice – The experience ...

African Journals Online (AJOL)

Background: Medical student attachments with family/general practitioners (GPs) in non-academic or private practice are a valued resource in the undergraduate teaching of Family Medicine. This study describes the experience and views of GPs in private practice with final-year medical student attachments from the ...

Educational theory and medical education practice: a cautionary note for medical school faculty.

Science.gov (United States)

Colliver, Jerry A

2002-12-01

Educational theory is routinely cited as justification for practice in medical education, even though the justification for the theory itself is unclear. Problem-based learning (PBL), for example, is said to be based on powerful educational principles that should result in strong effects on learning and performance. But research over the past 20 years has produced little convincing evidence for the educational effectiveness of PBL, which naturally raises doubts about the underlying theory. This essay reflects on educational theory, in particular cognitive theory, and concludes that the theory is little more than metaphor, not rigorous, tested, confirmed scientific theory. This metaphor/theory may lead to ideas for basic and applied research, which in turn may facilitate the development of theory. In the meantime, however, the theory cannot be trusted to determine practice in medical education. Despite the intuitive appeal of educational theory, medical educators have a responsibility to set aside their enthusiasm and make it clear to medical school faculty and administrators that educational innovations and practice claims are, at best, founded on conjecture, not on evidence-based science.

The future of practical skills in undergraduate medical education - an explorative Delphi-Study.

Science.gov (United States)

Dannenberg, Katja Anne; Stroben, Fabian; Schröder, Therese; Thomas, Anke; Hautz, Wolf E

2016-01-01

64% of young medical professionals in Germany do not feel adequately prepared for the practical requirements of the medical profession. The goal of "outcome-orientated training" is to structure medical curricula based on the skills needed when entering the workforce after completing undergraduate medical education, and thus to bridge the gap between the skills graduates have attained and those necessary for a career in the medical profession. Outcome frameworks (OFs) are used for this purpose. In preparation for developing the National Competence-Based Catalogue of Learning Objectives for Medicine (NKLM) - the German OF - the "Consensus Statement of Practical Skills in Undergraduate Medical Education" (which structures the teaching and acquisition of practical skills in Germany and which strongly influenced the "Clinical-Practical Skills" chapter of the NKLM) was published in 2011. It is not uncommon for at least a decade to elapse between the definition and implementation of an OF and the students' graduation, which can further increase the gap between necessary and acquired skills. Thus, the purpose of this paper is to posit theses for future development in healthcare and to apply these theses to a current OF. Partially structured interviews with experts were used to generate theses pertaining to general, future development in healthcare. These theses were assessed by physician experts based on the likelihood of implementation by the year 2025. The 288 learning goals of the consensus statement were assessed for their relevance for medical education in the interim. 11 theses were generated for the development of medicine, and these theses were assessed and discussed by 738 experts. These theses include the increase in diseases associated with old age, the increasing significance of interprofessional cooperation, and the growing prevalence of telemedicine applications. Of the 288 learning goals of the consensus statement, 231 of the goals were assessed as relevant

"Fossils" of practical medical knowledge from medieval Cairo.

Science.gov (United States)

Lev, Efraim; Amar, Zohar

2008-09-02

To asses the scientific value of the practical medical fragments found in the Cairo Genizah (10th century), as a useful source for ethnopharmacological purposes (in exposing rare and usually inaccessible original medieval practical knowledge of medicinal substances to present-day researchers), and to reconstruct the practical drugs and their uses. A methodology distinguishing between theoretical (about 1500 fragments) and practical medical knowledge (about 230 fragments) was created and used. The information regarding the practical medicinal substances was extracted from prescriptions (140), lists of drugs (70) and few letters of physicians. The reconstructed lists of practical (278) and theoretical (414) drugs allow us to recognize and quantify the gap between them in medieval times (136). We propose that the data obtained from ancient prescriptions is comparable to ethnopharmacological surveys. The finding of plants such as myrobalan, saffron, licorice, spikenard and lentisk, all of which have scientifically proven anti-microbial/bacterial and anti-fungal activity, sheds a helpful light on the medical decision-making of the medieval practitioners in respect of the plants they applied as drugs. With the wealth of information meticulously assembled from these time capsules we expect to make a significant contribution to contemporary efforts at locating modern drugs in ancient roots and gauging their feasibility.

Medication management and practices in prison for people with mental health problems: a qualitative study.

Science.gov (United States)

Bowen, Robert A; Rogers, Anne; Shaw, Jennifer

2009-10-20

Common mental health problems are prevalent in prison and the quality of prison health care provision for prisoners with mental health problems has been a focus of critical scrutiny. Currently, health policy aims to align and integrate prison health services and practices with those of the National Health Service (NHS). Medication management is a key aspect of treatment for patients with a mental health problem. The medication practices of patients and staff are therefore a key marker of the extent to which the health practices in prison settings equate with those of the NHS. The research reported here considers the influences on medication management during the early stages of custody and the impact it has on prisoners. The study employed a qualitative design incorporating semi-structured interviews with 39 prisoners and 71 staff at 4 prisons. Participant observation was carried out in key internal prison locations relevant to the management of vulnerable prisoners to support and inform the interview process. Thematic analysis of the interview data and interpretation of the observational field-notes were undertaken manually. Emergent themes included the impact that delays, changes to or the removal of medication have on prisoners on entry to prison, and the reasons that such events take place. Inmates accounts suggested that psychotropic medication was found a key and valued form of support for people with mental health problems entering custody. Existing regimes of medication and the autonomy to self-medicate established in the community are disrupted and curtailed by the dominant practices and prison routines for the taking of prescribed medication. The continuity of mental health care is undermined by the removal or alteration of existing medication practice and changes on entry to prison which exacerbate prisoners' anxiety and sense of helplessness. Prisoners with a dual diagnosis are likely to be doubly vulnerable because of inconsistencies in substance

Sociomateriality in medical practice and learning: attuning to what matters.

Science.gov (United States)

Fenwick, Tara

2014-01-01

In current debates about professional practice and education, increasing emphasis is placed on understanding learning as a process of ongoing participation rather than one of acquiring knowledge and skills. However, although this socio-cultural view is important and useful, issues have emerged in studies of practice-based learning that point to certain oversights. Three issues are described here: (i) the limited attention paid to the importance of materiality - objects, technologies, nature, etc.-- in questions of learning; (ii) the human-centric view of practice that fails to note the relations among social and material forces, and (iii) the conflicts between ideals of evidence-based standardised models and the sociomaterial contingencies of clinical practice. It is argued here that a socio-material approach to practice and learning offers important insights for medical education. This view is in line with a growing field of research in the materiality of everyday life, which embraces wide-ranging families of theory that can be only briefly mentioned in this short paper. The main premise they share is that social and material forces, culture, nature and technology, are enmeshed in everyday practice. Objects and humans act upon one another in ways that mutually transform their characteristics and activity. Examples from research in medical practice show how materials actively influence clinical practice, how learning itself is a material matter, how protocols are in fact temporary sociomaterial achievements, and how practices form unique and sometimes conflicting sociomaterial worlds, with diverse diagnostic and treatment approaches for the same thing. This discussion concludes with implications for learning in practice. What is required is a shift from an emphasis on acquiring knowledge to participating more wisely in particular situations. This focus is on learning how to attune to minor material fluctuations and surprises, how to track one's own and others

Attitude and awareness of medical and dental students towards collaboration between medical and dental practice in Hong Kong.

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Zhang, Shinan; Lo, Edward C M; Chu, Chun-Hung

2015-05-02

Medical-dental collaboration is essential for improving resource efficiency and standards of care. However, few studies have been conducted on it. This study aimed to investigate the attitude and awareness of medical and dental students about collaboration between medical and dental practices in Hong Kong. All medical and dental students in Hong Kong were invited to complete a questionnaire survey at their universities, hospitals and residential halls. It contained 8 questions designed to elicit their attitudes about the collaboration between medical and dental practice. Students were also asked about their awareness of the collaboration between dentistry and medicine. The questionnaires were directly distributed to medical and dental students. The finished questionnaires were immediately collected by research assistants on site. A total of 1,857 questionnaires were distributed and 809 (44%) were returned. Their mean attitude score (SD) towards medical-dental collaboration was 6.37 (1.44). Most students (77%) were aware of the collaboration between medical and dental practice in Hong Kong. They considered that Ear, Nose & Throat, General Surgery and Family Medicine were the 3 most common medical disciplines which entailed collaboration between medical and dental practice. In this study, the medical and dental students in general demonstrated a good attitude and awareness of the collaboration between medical and dental practice in Hong Kong. This established an essential foundation for fostering medical-dental collaboration, which is vital to improving resource efficiency and standards of care.

High prevalence of self-medication practices among medical and pharmacy students: a study from Jordan.

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Alkhatatbeh, Mohammad J; Alefan, Qais; Alqudah, Mohammad A Y

2016-05-01

To assess self-medication practices and to evaluate the impact of obtaining medical knowledge on self-medication among medical and pharmacy students at Jordan University of Science and Technology. This was a cross-sectional study. A well-validated questionnaire that included 3 sections about self-medication was administered to the subjects after introducing the term "self-medication" verbally. 1,317 students had participated in the study and were subgrouped according to their academic level into seniors and juniors. Compared to the general population rate of 42.5%, self-medication practice was reported by (1,034, 78.5%) of the students and most common amongst pharmacy students (n = 369, 82.9%) compared to Pharm.D. (n = 357, 77.9%) and medical students (n = 308, 74.4%) (p = 0.009). There was no significant difference between juniors and seniors (557, 79.1% vs. 477, 77.8%, p = 0.59, respectively). Headache (71.2%) and common cold (56.5%) were frequent ailments that provoked self-medication. Analgesics (79.9%) and antibiotics (59.8%) were frequently used to self-treat these aliments. Reasons for self-medication included previous disease experience (55.7%); minor aliments (55.3%); and having enough medical knowledge (32.1%). Medicines were used according to instructions obtained mainly from the leaflet (28.8%); pharmacist (20.7%); and university courses (19.7%). Senior students were more aware of the risk of self-medication than junior students. The majority of students frequently advise other people about self-medication (83.6%). Self-medication was common among students irrespective to their level of medical knowledge. Obtaining medical knowledge increased the students' awareness of the risk of self-medication which may result in practicing responsible self-medication. However, medical teaching institutions need to educate students about the proper use of medicines as a therapeutic tool.

Protocol for audit of current Filipino practice in rehabilitation of stroke inpatients.

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Gonzalez-Suarez, Consuelo B; Dizon, Janine Margarita R; Grimmer, Karen; Estrada, Myrna S; Liao, Lauren Anne S; Malleta, Anne-Rochelle D; Tan, Ma Elena R; Marfil, Vero; Versales, Cristina S; Suarez, Jimah L; So, Kleon C; Uyehara, Edgardo D

2015-01-01

Stroke is one of the leading medical conditions in the Philippines. Over 500,000 Filipinos suffer from stroke annually. Provision of evidence-based medical and rehabilitation management for stroke patients has been a challenge due to existing environmental, social, and local health system issues. Thus, existing western guidelines on stroke rehabilitation were contextualized to draft recommendations relevant to the local Philippine setting. Prior to fully implementing the guidelines, an audit of current practice needs to be undertaken, thus the purpose of this audit protocol. A clinical audit of current practices in stroke rehabilitation in the Philippines will be undertaken. A consensus list of data items to be captured was identified by the audit team during a 2-day meeting in 2012. These items, including patient demographics, type of stroke, time to referral for rehabilitation management, length of hospital stay, and other relevant descriptors of stroke management were included as part of the audit. Hospitals in the Philippines will be recruited to take part in the audit activity. Recruitment will be via the registry of the Philippine Academy of Rehabilitation Medicine, where 90% of physiatrists (medical doctors specialized in rehabilitation medicine) are active members and are affiliated with various hospitals in the Philippines. Data collectors will be identified and trained in the audit process. A pilot audit will be conducted to test the feasibility of the audit protocol, and refinements to the protocol will be undertaken as necessary. The comprehensive audit process will take place for a period of 3 months. Data will be encoded using MS Excel(®). Data will be reported as means and percentages as appropriate. Subgroup analysis will be undertaken to look into differences and variability of stroke patient descriptors and rehabilitation activities. This audit study is an ambitious project, but given the "need" to conduct the audit to identify "gaps" in current

Depression in medical students: current insights

Directory of Open Access Journals (Sweden)

Moir F

2018-05-01

Full Text Available Fiona Moir,1 Jill Yielder,2 Jasmine Sanson,3 Yan Chen4 1Department of General Practice and Primary Health Care, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand; 2Medical Programme Directorate, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand; 3Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand; 4Centre for Medical and Health Sciences Education, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand Abstract: Medical students are exposed to multiple factors during their academic and clinical study that have been shown to contribute to high levels of depression, anxiety, and stress. The purpose of this article was to explore the issue of depression in the medical student population, including prevalence, causes, and key issues, along with suggestions for early identification and support from one medical school in New Zealand. After establishing that the prevalence of depression is higher for medical students than the general population, the key issues explored include assessment used in the program, characteristics of the student population (such as Type A personality and perfectionism, resilience, selection procedures, students’ motivation, and the nature of the clinical environment. This review includes several recommendations to improve students’ psychological health such as positioning well-being within an overarching comprehensive workplace wellness model and integrating peer and faculty-led support into the day-to-day running of the institution. It also highlights the advantages of the addition of a well-being curriculum, as skills to prevent and manage distress and depression are relevant in supporting the competencies required by medical practitioners. It concludes that medical schools need wide-ranging strategies to address the complexities associated with the particular student

A systematic review of medical practice variation in OECD countries.

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Corallo, Ashley N; Croxford, Ruth; Goodman, David C; Bryan, Elisabeth L; Srivastava, Divya; Stukel, Therese A

2014-01-01

Major variations in medical practice have been documented internationally. Variations raise questions about the quality, equity, and efficiency of resource allocation and use, and have important implications for health care and health policy. To perform a systematic review of the peer-reviewed literature on medical practice variations in OECD countries. We searched MEDLINE to find publications on medical practice variations in OECD countries published between 2000 and 2011. We present an overview of the characteristics of published studies as well as the magnitude of variations for select high impact conditions. A total of 836 studies were included. Consistent with the gray literature, there were large variations across regions, hospitals and physician practices for almost every condition and procedure studied. Many studies focused on high-impact conditions, but very few looked at the causes or outcomes of medical practice variations. While there were an overwhelming number of publications on medical practice variations the coverage was broad and not often based on a theoretical construct. Future studies should focus on conditions and procedures that are clinically important, policy relevant, resource intensive, and have high levels of public awareness. Further study of the causes and consequences of variations is important. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Top Ten Embezzlement Risks in Your Medical Practice.

Science.gov (United States)

Shorr, Jay A

2015-01-01

Medical practices are often faced with employee embezzlement and theft. To protect themselves and their practices, physicians and practice executives should have in place policies and procedures for identifying and handling unethical behaviors by employees. This article deals with the common risks in healthcare practices and provides suggestions to help mitigate the risk of embezzlement.

The Medical Ethics Curriculum in Medical Schools: Present and Future.

Science.gov (United States)

Giubilini, Alberto; Milnes, Sharyn; Savulescu, Julian

2016-01-01

In this review article we describe the current scope, methods, and contents of medical ethics education in medical schools in Western English speaking countries (mainly the United Kingdom, the United States, and Australia). We assess the strengths and weaknesses of current medical ethics curricula, and students' levels of satisfaction with different teaching approaches and their reported difficulties in learning medical ethics concepts and applying them in clinical practice. We identify three main challenges for medical ethics education: counteracting the bad effects of the "hidden curriculum," teaching students how to apply ethical knowledge and critical thinking to real cases in clinical practice, and shaping future doctors' right character through ethics education. We suggest ways in which these challenges could be addressed. On the basis of this analysis, we propose practical guidelines for designing, implementing, teaching, and assessing a medical ethics program within a four-year medical course. Copyright 2016 The Journal of Clinical Ethics. All rights reserved.

Acute care patient portals: a qualitative study of stakeholder perspectives on current practices.

Science.gov (United States)

Collins, Sarah A; Rozenblum, Ronen; Leung, Wai Yin; Morrison, Constance Rc; Stade, Diana L; McNally, Kelly; Bourie, Patricia Q; Massaro, Anthony; Bokser, Seth; Dwyer, Cindy; Greysen, Ryan S; Agarwal, Priyanka; Thornton, Kevin; Dalal, Anuj K

2017-04-01

To describe current practices and stakeholder perspectives of patient portals in the acute care setting. We aimed to: (1) identify key features, (2) recognize challenges, (3) understand current practices for design, configuration, and use, and (4) propose new directions for investigation and innovation. Mixed methods including surveys, interviews, focus groups, and site visits with stakeholders at leading academic medical centers. Thematic analyses to inform development of an explanatory model and recommendations. Site surveys were administered to 5 institutions. Thirty interviews/focus groups were conducted at 4 site visits that included a total of 84 participants. Ten themes regarding content and functionality, engagement and culture, and access and security were identified, from which an explanatory model of current practices was developed. Key features included clinical data, messaging, glossary, patient education, patient personalization and family engagement tools, and tiered displays. Four actionable recommendations were identified by group consensus. Design, development, and implementation of acute care patient portals should consider: (1) providing a single integrated experience across care settings, (2) humanizing the patient-clinician relationship via personalization tools, (3) providing equitable access, and (4) creating a clear organizational mission and strategy to achieve outcomes of interest. Portals should provide a single integrated experience across the inpatient and ambulatory settings. Core functionality includes tools that facilitate communication, personalize the patient, and deliver education to advance safe, coordinated, and dignified patient-centered care. Our findings can be used to inform a "road map" for future work related to acute care patient portals. © The Author 2016. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com

South African medical schools: Current state of selection criteria and medical students' demographic profile.

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van der Merwe, L J; van Zyl, G J; St Clair Gibson, A; Viljoen, M; Iputo, J E; Mammen, M; Chitha, W; Perez, A M; Hartman, N; Fonn, S; Green-Thompson, L; Ayo-Ysuf, O A; Botha, G C; Manning, D; Botha, S J; Hift, R; Retief, P; van Heerden, B B; Volmink, J

2015-12-16

Selection of medical students at South African (SA) medical schools must promote equitable and fair access to students from all population groups, while ensuring optimal student throughput and success, and training future healthcare practitioners who will fulfil the needs of the local society. In keeping with international practices, a variety of academic and non-academic measures are used to select applicants for medical training programmes in SA medical schools. To provide an overview of the selection procedures used by all eight medical schools in SA, and the student demographics (race and gender) at these medical schools, and to determine to what extent collective practices are achieving the goals of student diversity and inclusivity. A retrospective, quantitative, descriptive study design was used. All eight medical schools in SA provided information regarding selection criteria, selection procedures, and student demographics (race and gender). Descriptive analysis of data was done by calculating frequencies and percentages of the variables measured. Medical schools in SA make use of academic and non-academic criteria in their selection processes. The latter include indices of socioeconomic disadvantage. Most undergraduate medical students in SA are black (38.7%), followed by white (33.0%), coloured (13.4%) and Indian/Asian (13.6%). The majority of students are female (62.2%). The number of black students is still proportionately lower than in the general population, while other groups are overrepresented. Selection policies for undergraduate medical programmes aimed at redress should be continued and further refined, along with the provision of support to ensure student success.

Predictors of a positive attitude of medical students towards general practice - a survey of three Bavarian medical faculties.

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Schneider, Antonius; Karsch-Völk, Marlies; Rupp, Alica; Fischer, Martin R; Drexler, Hans; Schelling, Jörg; Berberat, Pascal

2013-01-01

Germany is witnessing an increasing shortage of general practitioners (GPs). The aim was to determine predictors of the job-related motivation of medical students of three medical faculties with different institutionalisation of general practice as an academic discipline. Medical students were surveyed with a standardised questionnaire about their attitudes towards general practice and their motivation to work as a GP in different working conditions. Predictors for positive attitudes and motivation were calculated using logistic regression models. 940 (15.2%) out of 6182 medical students from three Bavarian medical faculties participated in an online survey. 585 (62.7%) were female, and the average age was 25.0 (standard deviation 3.7). The average grade of a university-entrance diploma was 1.6 (standard deviation 0.5). 718 (76.4%) could imagine working as a GP. However, they favoured being employed within another organisation and not having their own private practice (65.5% vs. 35.1%). "Presence of a professorship of general practice" was associated with a positive attitude towards general practice (OR 1.57; 95%CI 1.13-2.417). Motivation for working as a GP was associated with "being female" (OR 2.56; 95%CI 1.80-3.56) and "presence of a professorship of general practice" (OR 1.68; 95%CI 1.14-2.46). Having a lower grade for one's university-entrance diploma was associated with a higher preference to work in one's own practice (OR 1.39; 95%CI 1.02-1.90). A high amount of medical students were open-minded towards general practice. However, they favoured employment within an organization over working in their own practice. Institutionalisation of general practice as an academic discipline might be of importance to gain positive attitudes towards general practice and motivate medical students to work as a GP.

[Medical technology and medical education].

Science.gov (United States)

von Mallek, D; Biersack, H-J; Mull, R; Wilhelm, K; Heinz, B; Mellert, F

2010-08-01

The education of medical professionals is divided into medical studies, postgraduate training leading to the qualification as a specialist, and continuing professional development. During education, all scientific knowledge and practical skills are to be acquired, which enable the physician to practice responsibly in a specialized medical area. In the present article, relevant curricula are analyzed regarding the consideration of medical device-related topics, as the clinical application of medical technology has reached a central position in modern patient care. Due to the enormous scientific and technical progress, this area has become as important as pharmacotherapy. Our evaluation shows that medical device-related topics are currently underrepresented in the course of medical education and training and should be given greater consideration in all areas of medical education. Possible solutions are presented.

Public attitudes toward practice by medical students: a nationwide survey in Japan.

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Murata, Kyoko; Sakuma, Mio; Seki, Susumu; Morimoto, Takeshi

2014-01-01

It is essential for medical students to interact directly with patients. However, patients may be reluctant to be seen by medical students in settings in which they may also be seen by senior staff. To understand patients' attitudes toward practice by medical students and consider the factors involved in obtaining patients' cooperation, we conducted a nationwide cross-sectional survey. We randomly selected 2,400 adult participants from all over Japan. Trained research assistants inquired about participants' experiences and attitudes toward practice by medical students using a questionnaire. We compared differences in attitudes between participants who were accepting of practice by medical students and those who were not, as well as differences between participants who had experienced practice by a medical student versus those who had not. A total of 1,109 (46%) participants were included in the study. Eleven percent (117/1109) of the participants had experienced practice by a medical student. One fourth of participants were accepting of practice by medical students, and experienced participants were significantly more likely to be accepting of practice by medical students than inexperienced participants (45% vs. 24%, ppractice by medical students among accepting participants with previous experiences included "polite," "kind," and "hard-working." Fifty-nine percent (637/1088) of participants indicated that they would request a senior staff member's supervision when being seen by a medical student. The present nationwide survey suggests that education emphasizing bedside manner may be effective in promoting patients' cooperation of medical students. In addition, providing information to patients about medical students and efforts to increase supervision during clinical clerkship should be emphasized to foster the public's cooperation.

Balancing your personal and professional lives: help for busy medical practice employees.

Science.gov (United States)

Hills, Laura Sachs

2008-01-01

It is extremely difficult for most people to balance work and home life. This is especially true of employees who work in fast-paced medical practices where they are on the go all day. Each medical practice employee must find his or her own way to balance work and life, but fortunately, the process can usually be boiled down to some basics. This article outlines a strategy for establishing the top five priorities in the medical practice employee's life. It suggests that medical practice personnel can develop and use a personal mission statement as a life guide. This article also suggests specific strategies medical practice employees can use to protect and make the best use of their private time. It provides examples of how medical practice personnel have changed their lives by dropping unnecessary activities from their daily schedules. Finally, this article offers guidance about getting children to help working parents balance their work and private lives, 10 additional tips for work/life balance, a work/life balance self-assessment quiz, and a template the medical practice employee can use to create a customized personal mission statement.

Medical telerobotic systems: current status and future trends.

Science.gov (United States)

Avgousti, Sotiris; Christoforou, Eftychios G; Panayides, Andreas S; Voskarides, Sotos; Novales, Cyril; Nouaille, Laurence; Pattichis, Constantinos S; Vieyres, Pierre

2016-08-12

Teleoperated medical robotic systems allow procedures such as surgeries, treatments, and diagnoses to be conducted across short or long distances while utilizing wired and/or wireless communication networks. This study presents a systematic review of the relevant literature between the years 2004 and 2015, focusing on medical teleoperated robotic systems which have witnessed tremendous growth over the examined period. A thorough insight of telerobotics systems discussing design concepts, enabling technologies (namely robotic manipulation, telecommunications, and vision systems), and potential applications in clinical practice is provided, while existing limitations and future trends are also highlighted. A representative paradigm of the short-distance case is the da Vinci Surgical System which is described in order to highlight relevant issues. The long-distance telerobotics concept is exemplified through a case study on diagnostic ultrasound scanning. Moreover, the present review provides a classification into short- and long-distance telerobotic systems, depending on the distance from which they are operated. Telerobotic systems are further categorized with respect to their application field. For the reviewed systems are also examined their engineering characteristics and the employed robotics technology. The current status of the field, its significance, the potential, as well as the challenges that lie ahead are thoroughly discussed.

Medical engagement and organizational characteristics in general practice.

Science.gov (United States)

Ahnfeldt-Mollerup, Peder; dePont Christensen, René; Halling, Anders; Kristensen, Troels; Lykkegaard, Jesper; Nexøe, Jørgen; Barwell, Fred; Spurgeon, Peter; Søndergaard, Jens

2016-02-01

Medical engagement is a mutual concept of the active and positive contribution of doctors to maintaining and enhancing the performance of their health care organization, which itself recognizes this commitment in supporting and encouraging high quality care. A Medical Engagement Scale (MES) was developed by Applied Research Ltd (2008) on the basis of emerging evidence that medical engagement is critical for implementing radical improvements. To study the importance of medical engagement in general practice and to analyse patterns of association with individual and organizational characteristics. A cross-sectional study using a sampled survey questionnaire and the official register from the Danish General Practitioners' Organization comprising all registered Danish GPs. The Danish version of the MES Questionnaire was distributed and the survey results were analysed in conjunction with the GP register data. Statistically adjusted analyses revealed that the GPs' medical engagement varied substantially. GPs working in collaboration with colleagues were more engaged than GPs from single-handed practices, older GPs were less engaged than younger GPs and female GPs had higher medical engagement than their male colleagues. Furthermore, GPs participating in vocational training of junior doctors were more engaged than GPs not participating in vocational training. Medical engagement in general practice varies a great deal and this is determined by a complex interaction between both individual and organizational characteristics. Working in collaboration, having staff and being engaged in vocational training of junior doctors are all associated with enhanced levels of medical engagement among GPs. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

The influence of experiential learning on medical equipment adoption in general practices.

Science.gov (United States)

Bourke, Jane; Roper, Stephen

2014-10-01

The benefits of the availability and use of medical equipment for medical outcomes are understood by physicians and policymakers alike. However, there is limited understanding of the decision-making processes involved in adopting and using new technologies in health care organisations. Our study focuses on the adoption of medical equipment in Irish general practices which are marked by considerable autonomy in terms of commercial practice and the range of medical services they provide. We examine the adoption of six items of medical equipment taking into account commercial, informational and experiential stimuli. Our analysis is based on primary survey data collected from a sample of 601 general practices in Ireland on practice characteristics and medical equipment use. We use a multivariate Probit to identify commonalities in the determinants of the adoption. Many factors, such as GP and practice characteristics, influence medical equipment adoption. In addition, we find significant and consistent evidence of the influence of learning-by-using effects on the adoption of medical equipment in a general practice setting. Knowledge generated by experiential or applied learning can have commercial, organisational and health care provision benefits in small health care organisations. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Keeping the medical practice financially viable: a marketer's approach.

Science.gov (United States)

Patrick, Michelle L; Capraro, Anthony J; Credito, Candace M

2002-01-01

This paper explores a way that medical practices might develop a higher margin revenue source by offering a differentiated service that caters to patients who value more personalized service. Using SERVQUAL, German patients were surveyed to determine if there is a relationship between a desire for personalized service and a willingness to pay a premium for medical care. The results indicate that a greater desire for personalized care distinguishes those who pay a premium for medical care from those who do not. This suggests that medical practices can differentiate their service based on more personalized care and charge a higher fee for this service.

Marketing the academic medical center group practice.

Science.gov (United States)

Eudes, J A; Divis, K L

1992-01-01

From a marketing perspective, there are many differences between private and academic medical center (AMC) group practices. Given the growing competition between the two, write John Eudes and Kathy Divis, it is important for the AMC group practice to understand and use these differences to develop a competitive market advantage.

Preparing medical students for clinical practice: easing the transition.

Science.gov (United States)

Teagle, Alexandra R; George, Maria; Gainsborough, Nicola; Haq, Inam; Okorie, Michael

2017-08-01

The transition from medical student to junior doctor is a challenge; the UK General Medical Council has issued guidance emphasizing the importance of adequate preparation of medical students for clinical practice. This study aimed to determine whether a junior doctor-led simulation-based course is an effective way of preparing final year medical students for practice as a junior doctor.We piloted a new 'preparation for practice' course for final year medical students prior to beginning as Foundation Year 1 (first year of practice) doctors. The course ran over three days and consisted of four simulated stations: ward round, prescribing, handover, and lessons learnt. Quantitative and qualitative feedback was obtained.A total of 120 students attended (40 on each day) and feedback was collected from 95 of them. Using a scale of 1 (lowest) to 5 (highest), feedback was positive, with 99% and 96% rating 4 or 5 for the overall quality of the program and the relevance of the program content, respectively. A score of 5 was awarded by 67% of students for the ward round station; 58% for the handover station; 71% for the prescribing station, and 35% for the lessons learnt station. Following the prescribing station, students reported increased confidence in their prescribing.Preparation for practice courses and simulation are an effective and enjoyable way of easing the transition from medical student to junior doctor. Together with 'on-the-job' shadowing time, such programs can be used to improve students' confidence, competence, and ultimately patient safety and quality of care.

Medicine as a Community of Practice: Implications for Medical Education.

Science.gov (United States)

Cruess, Richard L; Cruess, Sylvia R; Steinert, Yvonne

2018-02-01

The presence of a variety of independent learning theories makes it difficult for medical educators to construct a comprehensive theoretical framework for medical education, resulting in numerous and often unrelated curricular, instructional, and assessment practices. Linked with an understanding of identity formation, the concept of communities of practice could provide such a framework, emphasizing the social nature of learning. Individuals wish to join the community, moving from legitimate peripheral to full participation, acquiring the identity of community members and accepting the community's norms.Having communities of practice as the theoretical basis of medical education does not diminish the value of other learning theories. Communities of practice can serve as the foundational theory, and other theories can provide a theoretical basis for the multiple educational activities that take place within the community, thus helping create an integrated theoretical approach.Communities of practice can guide the development of interventions to make medical education more effective and can help both learners and educators better cope with medical education's complexity. An initial step is to acknowledge the potential of communities of practice as the foundational theory. Educational initiatives that could result from this approach include adding communities of practice to the cognitive base; actively engaging students in joining the community; creating a welcoming community; expanding the emphasis on explicitly addressing role modeling, mentoring, experiential learning, and reflection; providing faculty development to support the program; and recognizing the necessity to chart progress toward membership in the community.

Biomedical waste management in Ayurveda hospitals - current practices & future prospectives.

Science.gov (United States)

Rajan, Renju; Robin, Delvin T; M, Vandanarani

2018-03-16

Biomedical waste management is an integral part of traditional and contemporary system of health care. The paper focuses on the identification and classification of biomedical wastes in Ayurvedic hospitals, current practices of its management in Ayurveda hospitals and its future prospective. Databases like PubMed (1975-2017 Feb), Scopus (1960-2017), AYUSH Portal, DOAJ, DHARA and Google scholar were searched. We used the medical subject headings 'biomedical waste' and 'health care waste' for identification and classification. The terms 'biomedical waste management', 'health care waste management' alone and combined with 'Ayurveda' or 'Ayurvedic' for current practices and recent advances in the treatment of these wastes were used. We made a humble attempt to categorize the biomedical wastes from Ayurvedic hospitals as the available data about its grouping is very scarce. Proper biomedical waste management is the mainstay of hospital cleanliness, hospital hygiene and maintenance activities. Current disposal techniques adopted for Ayurveda biomedical wastes are - sewage/drains, incineration and land fill. But these methods are having some merits as well as demerits. Our review has identified a number of interesting areas for future research such as the logical application of bioremediation techniques in biomedical waste management and the usage of effective micro-organisms and solar energy in waste disposal. Copyright © 2017 Transdisciplinary University, Bangalore and World Ayurveda Foundation. Published by Elsevier B.V. All rights reserved.

Neuroimaging in refractory epilepsy. Current practice and evolving trends

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Ramli, N. [Department of Biomedical Imaging, University Malaya Research Imaging Centre (Malaysia); Rahmat, K., E-mail: katt_xr2000@yahoo.com [Department of Biomedical Imaging, University Malaya Research Imaging Centre (Malaysia); Lim, K.S.; Tan, C.T. [Neurology Unit, Department of Medicine, University Malaya, Kuala Lumpur (Malaysia)

2015-09-15

Highlights: • Neuroimaging is imperative in diagnostic work up and therapeutic assessment of refractory epilepsy. • Identification of epileptogenic zone on EEG, MRI and functional imaging improves the success of surgery. • High performance MRI greatly enhanced metabolic information and elucidate brain functions. • Optimisation of epilepsy protocols in structural and functional MRI are presented in this article. - Abstract: Identification of the epileptogenic zone is of paramount importance in refractory epilepsy as the success of surgical treatment depends on complete resection of the epileptogenic zone. Imaging plays an important role in the locating and defining anatomic epileptogenic abnormalities in patients with medically refractory epilepsy. The aim of this article is to present an overview of the current MRI sequences used in epilepsy imaging with special emphasis of lesion seen in our practices. Optimisation of epilepsy imaging protocols are addressed and current trends in functional MRI sequences including MR spectroscopy, diffusion tensor imaging and fusion MR with PET and SPECT are discussed.

Neuroimaging in refractory epilepsy. Current practice and evolving trends

International Nuclear Information System (INIS)

Ramli, N.; Rahmat, K.; Lim, K.S.; Tan, C.T.

2015-01-01

Highlights: • Neuroimaging is imperative in diagnostic work up and therapeutic assessment of refractory epilepsy. • Identification of epileptogenic zone on EEG, MRI and functional imaging improves the success of surgery. • High performance MRI greatly enhanced metabolic information and elucidate brain functions. • Optimisation of epilepsy protocols in structural and functional MRI are presented in this article. - Abstract: Identification of the epileptogenic zone is of paramount importance in refractory epilepsy as the success of surgical treatment depends on complete resection of the epileptogenic zone. Imaging plays an important role in the locating and defining anatomic epileptogenic abnormalities in patients with medically refractory epilepsy. The aim of this article is to present an overview of the current MRI sequences used in epilepsy imaging with special emphasis of lesion seen in our practices. Optimisation of epilepsy imaging protocols are addressed and current trends in functional MRI sequences including MR spectroscopy, diffusion tensor imaging and fusion MR with PET and SPECT are discussed

Massive transfusion protocols: current best practice

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Hsu YM

2016-03-01

Full Text Available Yen-Michael S Hsu,1 Thorsten Haas,2 Melissa M Cushing1 1Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, NY, USA; 2Department of Anesthesia, University Children's Hospital Zurich, Zurich, Switzerland Abstract: Massive transfusion protocols (MTPs are established to provide rapid blood replacement in a setting of severe hemorrhage. Early optimal blood transfusion is essential to sustain organ perfusion and oxygenation. There are many variables to consider when establishing an MTP, and studies have prospectively evaluated different scenarios and patient populations to establish the best practices to attain improved patient outcomes. The establishment and utilization of an optimal MTP is challenging given the ever-changing patient status during resuscitation efforts. Much of the MTP literature comes from the trauma population, due to the fact that massive hemorrhage is the leading cause of preventable trauma-related death. As we come to further understand the positive and negative clinical impacts of transfusion-related factors, massive transfusion practice can be further refined. This article will first discuss specific MTPs targeting different patient populations and current relevant international guidelines. Then, we will examine a wide selection of therapeutic products to support MTPs, including newly available products and the most suitable of the traditional products. Lastly, we will discuss the best design for an MTP, including ratio-based MTPs and MTPs based on the use of point-of-care coagulation diagnostic tools. Keywords: hemorrhage, MTP, antifibrinolytics, coagulopathy, trauma, ratio, logistics, guidelines, hemostatic

21 CFR 120.5 - Current good manufacturing practice.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 2 2010-04-01 2010-04-01 false Current good manufacturing practice. 120.5 Section... Provisions § 120.5 Current good manufacturing practice. Part 110 of this chapter applies in determining whether the facilities, methods, practices, and controls used to process juice are safe, and whether the...

21 CFR 129.1 - Current good manufacturing practice.

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2010-04-01

... 21 Food and Drugs 2 2010-04-01 2010-04-01 false Current good manufacturing practice. 129.1 Section... Current good manufacturing practice. The applicable criteria in part 110 of this chapter, as well as the..., methods, practices, and controls used in the processing, bottling, holding, and shipping of bottled...

Is evidence-based medicine about democratizing medical practice?

DEFF Research Database (Denmark)

Thorgård, Keld

2014-01-01

The authoritarian standpoint in medicine has been under challenge by various groups and researchers since the 1980s. The challenges have been ethical, political and medical, with patient movements at the forefront. Over the past decade, however, a deep challenge has been posed by evidence......-based medicine (EBM), which has challenged the entire strategy of medical treatment from the point of view of a self-critical, anti-authoritarian and hereby also (it has been claimed) a more democratic medical practice. Previously, the challenges arose out of the patient rights perspective. EBM, by contrast......, was taken to challenge the way doctors consider their medical practice as a whole. The present paper puts this claim of democratization into a historical context. Two dimensions of the democratization hypothesis are discussed and it is argued that they are insufficient to capture the substantial changes...

Spirituality and medical practice: using the HOPE questions as a practical tool for spiritual assessment.

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Anandarajah, G; Hight, E

2001-01-01

The relationship between spirituality and medicine has been the focus of considerable interest in recent years. Studies suggest that many patients believe spirituality plays an important role in their lives, that there is a positive correlation between a patient's spirituality or religious commitment and health outcomes, and that patients would like physicians to consider these factors in their medical care. A spiritual assessment as part of a medical encounter is a practical first step in incorporating consideration of a patient's spirituality into medical practice. The HOPE questions provide a formal tool that may be used in this process. The HOPE concepts for discussion are as follows: H--sources of hope, strength, comfort, meaning, peace, love and connection; O--the role of organized religion for the patient; P--personal spirituality and practices; E--effects on medical care and end-of-life decisions.

American Medical Association

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... the Payment Process Physician Payment Resource Center Reinventing Medical Practice Managing Your Practice CPT® (Current Procedural Terminology) Medicare & Medicaid Private Payer Reform Claims Processing & Practice ...

21 CFR 113.5 - Current good manufacturing practice.

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2010-04-01

... 21 Food and Drugs 2 2010-04-01 2010-04-01 false Current good manufacturing practice. 113.5 Section... CONTAINERS General Provisions § 113.5 Current good manufacturing practice. The criteria in §§ 113.10, 113.40..., methods, practices, and controls used by the commercial processor in the manufacture, processing, or...

Medication management and practices in prison for people with mental health problems: a qualitative study

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Rogers Anne

2009-10-01

Full Text Available Abstract Background Common mental health problems are prevalent in prison and the quality of prison health care provision for prisoners with mental health problems has been a focus of critical scrutiny. Currently, health policy aims to align and integrate prison health services and practices with those of the National Health Service (NHS. Medication management is a key aspect of treatment for patients with a mental health problem. The medication practices of patients and staff are therefore a key marker of the extent to which the health practices in prison settings equate with those of the NHS. The research reported here considers the influences on medication management during the early stages of custody and the impact it has on prisoners. Methods The study employed a qualitative design incorporating semi-structured interviews with 39 prisoners and 71 staff at 4 prisons. Participant observation was carried out in key internal prison locations relevant to the management of vulnerable prisoners to support and inform the interview process. Thematic analysis of the interview data and interpretation of the observational field-notes were undertaken manually. Emergent themes included the impact that delays, changes to or the removal of medication have on prisoners on entry to prison, and the reasons that such events take place. Results and Discussion Inmates accounts suggested that psychotropic medication was found a key and valued form of support for people with mental health problems entering custody. Existing regimes of medication and the autonomy to self-medicate established in the community are disrupted and curtailed by the dominant practices and prison routines for the taking of prescribed medication. The continuity of mental health care is undermined by the removal or alteration of existing medication practice and changes on entry to prison which exacerbate prisoners' anxiety and sense of helplessness. Prisoners with a dual diagnosis are likely

South African medical schools: Current state of selection criteria and ...

African Journals Online (AJOL)

Selection of medical students at South African (SA) medical schools must promote ... groups, while ensuring optimal student throughput and success, and training future ... In keeping = with international practices, a variety of academic and ...

Transforming practice organizations to foster lifelong learning and commitment to medical professionalism.

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Frankford, D M; Patterson, M A; Konrad, T R

2000-07-01

Practice organizations will increasingly engage in activities that are the functional equivalents of continuing medical education. The authors maintain that if these activities are properly structured within practice organizations, they can become powerful engines of socialization to enhance physicians' lifelong learning and commitment to medical professionalism. They propose that this promise can be realized if new or reformed practice organizations combine education and service delivery and institutionalize processes of individual and collective reflection. The resulting "institutions of reflective practice" would be ones of collegial, experiential, reflective lifelong learning concerning the technical and normative aspects of medical work. They would extend recent methods of medical education such as problem-based learning into the practice setting and draw on extant methods used in complex organizations to maximize the advantages and minimize the disadvantages that practice organizations typically present for adult learning. As such, these institutions would balance the potentially conflicting organizational needs for, on the one hand, (1) self-direction, risk taking, and creativity; (2) specialization; and (3) collegiality; and, on the other hand, (4) organizational structure, (5) coordination of division of labor, and (6) hierarchy. Overall, this institutionalization of reflective practice would enrich practice with education and education with practice, and accomplish the ideals of what the authors call "responsive medical professionalism." The medical profession would both contribute and be responsive to social values, and medical work would be valued intrinsically and as central to practitioners' self-identity and as a contribution to the public good.

Consolidation of medical groups into physician practice management organizations.

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Robinson, J C

1998-01-14

Medical groups are growing and merging to improve efficiency and bargaining leverage in the competitive managed care environment. An increasing number are affiliating with physician practice management (PPM) firms that offer capital financing, expertise in utilization management, and global capitation contracts with health insurance entities. These physician organizations provide an alternative to affiliation with a hospital system and to individual physician contracting with health plans. To describe the growth, structure, and strategy of PPM organizations that coordinate medical groups in multiple markets and contract with health maintenance organizations (HMOs). Case studies, including interviews with administrative and clinical leaders, review of company documents, and analysis of documents from investment bankers, the Securities and Exchange Commission, and industry observers. Medical groups and independent practice associations (IPAs) in California and New Jersey affiliated with MedPartners, FPA Medical Management, and UniMed. Growth in number of primary care and specialty care physicians employed by and contracting with affiliated medical groups; growth in patient enrollment from commercial, Medicare, and Medicaid HMOs; growth in capitation and noncapitation revenues; structure and governance of affiliated management service organizations and professional corporations; and contracting strategies with HMOs. Between 1994 and 1996, medical groups and IPAs affiliated with 3 PPMs grew from 3787 to 25763 physicians; 65% of employed physicians provide primary care, while the majority of contracting physicians provide specialty care. Patient enrollment in HMOs grew from 285503 to 3028881. Annual capitation revenues grew from $190 million to $2.1 billion. Medical groups affiliated with PPMs are capitated for most professional, hospital, and ancillary clinical services and are increasingly delegated responsibility by HMOs for utilization management and quality

Developing role of short-lived radionuclides in nuclear medical practice. DOE symposium series; 56

International Nuclear Information System (INIS)

Paras, P.; Thiessen, J.W.

1985-01-01

The purpose was to define the developing role and state-of-the-art development of short-lived radionuclides (SLR's) in current nuclear medical practice. Special emphasis was placed on radionuclides with general-purpose labeling capabilities. The need for high-purity labeling-grade iodine-123 was emphasized in the program. Papers have been separately abstracted for the data base

The future of practical skills in undergraduate medical education – an explorative Delphi-Study

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Dannenberg, Katja Anne

2016-08-01

Full Text Available Background: 64% of young medical professionals in Germany do not feel adequately prepared for the practical requirements of the medical profession. The goal of “outcome-orientated training” is to structure medical curricula based on the skills needed when entering the workforce after completing undergraduate medical education, and thus to bridge the gap between the skills graduates have attained and those necessary for a career in the medical profession. Outcome frameworks (OFs are used for this purpose. In preparation for developing the National Competence-Based Catalogue of Learning Objectives for Medicine (NKLM – the German OF – the “Consensus Statement of Practical Skills in Undergraduate Medical Education” (which structures the teaching and acquisition of practical skills in Germany and which strongly influenced the “Clinical-Practical Skills” chapter of the NKLM was published in 2011.It is not uncommon for at least a decade to elapse between the definition and implementation of an OF and the students’ graduation, which can further increase the gap between necessary and acquired skills. Thus, the purpose of this paper is to posit theses for future development in healthcare and to apply these theses to a current OF. Methodology: Partially structured interviews with experts were used to generate theses pertaining to general, future development in healthcare. These theses were assessed by physician experts based on the likelihood of implementation by the year 2025. The 288 learning goals of the consensus statement were assessed for their relevance for medical education in the interim. Results: 11 theses were generated for the development of medicine, and these theses were assessed and discussed by 738 experts. These theses include the increase in diseases associated with old age, the increasing significance of interprofessional cooperation, and the growing prevalence of telemedicine applications. Of the 288 learning goals of

21 CFR 1271.150 - Current good tissue practice requirements.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Current good tissue practice requirements. 1271... HUMAN CELLS, TISSUES, AND CELLULAR AND TISSUE-BASED PRODUCTS Current Good Tissue Practice § 1271.150 Current good tissue practice requirements. (a) General. This subpart D and subpart C of this part set...

Undergraduate Training in Human Sexuality-Evaluation of the Impact on Medical Doctors' Practice Ten Years After Graduation.

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Clegg, Mary; Pye, Joanne; Wylie, Kevan R

2016-09-01

It has been suggested that an indicator of a doctor's ability to assess patients' sexual function relates to the level of earlier training. The amount and quality of training the doctor receives at the undergraduate level and beyond could contribute to the doctor's confidence and competence. To evaluate whether doctors found that the teaching in human sexuality received at medical school was sufficient for their future practice and whether their chosen medical specialty and exposure to issues related to sexual health affected this opinion. One hundred seventy doctors maintaining contact with the University of Sheffield Medical School Alumni Office after qualifying in 2004 were sent self-completion postal questionnaires. Space was allocated for supplementary comments to their answers. Self-completion postal questionnaire. Although the response rate was low, there appeared to be an impact of the teaching of human sexuality on the clinical practice of doctors. More than two-thirds of respondents rated the teaching as useful and more than 70% felt more confident in diagnosing and managing male and female sexual issues. The results show a link between the undergraduate teaching of sexual medicine and education and a subsequent proactive approach to sexuality issues; unfortunately, the study does not provide any information about the level of skills or ability in this field of medicine. We have confirmed that the Sheffield model might be suitable for teaching sexual medicine issues in the United Kingdom but cannot confirm that the current format is suitable for international undergraduate audiences. Future study could include other medical schools and a comparison of sexual medicine practice among physicians who received undergraduate medical education and overall numbers could be increased to compare current practice with the number of hours of sexual medicine education as a key parameter. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

[Health care waste management of potentially infectious medical waste by healthcare professionals in a private medical practice: a study of practices].

Science.gov (United States)

Brunot, Alain; Thompson, Céline

2010-01-01

A cross-sectional study was conducted with a sample of 278 health professionals (GPs and specialists, dentists, physical therapists and nurses) in a private medical practice in Paris to study the medical waste management practices related to the production and disposal of potentially hazardous health care waste. With the exception of physical therapists, most professionals produced medical waste (72% to 96,2% according to occupation), with a monthly median of 3 liters (inter-quartile range 1-15 liters). All sharp objects and needles were separated and 91% of them eliminated via a specific process for that sector. These percentages were respectively 84% and 69% concerning contaminated waste that was neither needles or used for cutting. 48% of the professionals reported the existence of documents that could track the disposal of their medical waste. To improve practice, professionals cited collection on-site at the office (74%) and reliability of the contracted service provider to collect the waste (59%). The study showed that health professionals need information on the regulations regarding potentially infectious medical waste, in particular on the traceability of its elimination. They also noted the lack of clarity and precision with regard to the definition of risk of infection: 31,7% of professionals only declare the production of sharp or cutting waste without having specified criteria for risk of infection.

Strengthening training in rural practice in Germany: new approach for undergraduate medical curriculum towards sustaining rural health care.

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Holst, Jens; Normann, Oliver; Herrmann, Markus

2015-01-01

After decades of providing a dense network of quality medical care, Germany is facing an increasing shortage of medical doctors in rural areas. Current graduation rates of generalists do not counterbalance the loss due to retirement. Informed by international evidence, different strategies to ensure rural medical care are under debate, including innovative teaching approaches during undergraduate training. The University of Magdeburg in Saxony-Anhalt was the first medical school in Germany to offer a rural elective for graduate students. During the 2014 summer semester, 14 medical students attended a two-weekend program in a small village in Northern Saxony-Anhalt that allowed them to become more familiar with a rural community and rural health issues. The elective course raised a series of relevant topics for setting up rural practice and provided students with helpful insight into living and working conditions in rural practice. Preliminary evaluations indicate that the rural medicine course allowed medical students to reduce pre-existing concerns and had positive impact on their willingness to set up a rural medical office after graduation. Even short-term courses in rural practice can help reduce training-related barriers that prevent young physicians from working in rural areas. Undergraduate medical training is promising to attenuate the emerging undersupply in rural areas.

Structuring group medical practices: tax planning aspects.

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Gassman, A S; Conetta, T F

1992-01-01

This article is the first in a series addressing the structuring of group medical practice entities, shareholder relationships, and general representation factors. In this article, a general background in federal tax planning is provided, including strategies for minimization of income tax payment and the potential problems that may be encountered when a group practice is not carefully structured.

Personalised Medical Reference to General Practice Notebook (GPnotebook - an evolutionary tale

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James McMorran

2002-09-01

What has happened to this resource now? This brief paper outlines how the developers of the reference resource have improved on the design and content of the medical database. Now the reference resource is an Internet-based resource called General Practice Notebook (www.gpnotebook.co.uk and is currently attracting 5000 to 9000 page views per day and containing over 30 000 index terms in a complex web structure of over 60 000 links. This paper describes the evolutionary process that has occurred over the last decade.

Cognitive bias in clinical practice – nurturing healthy skepticism among medical students

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Bhatti A

2018-04-01

Full Text Available Alysha Bhatti Faculty of Medicine, Imperial College London, London, UK Abstract: Errors in clinical reasoning, known as cognitive biases, are implicated in a significant proportion of diagnostic errors. Despite this knowledge, little emphasis is currently placed on teaching cognitive psychology in the undergraduate medical curriculum. Understanding the origin of these biases and their impact on clinical decision making helps stimulate reflective practice. This article outlines some of the common types of cognitive biases encountered in the clinical setting as well as cognitive debiasing strategies. Medical educators should nurture healthy skepticism among medical students by raising awareness of cognitive biases and equipping them with robust tools to circumvent such biases. This will enable tomorrow’s doctors to improve the quality of care delivered, thus optimizing patient outcomes. Keywords: cognitive bias, diagnostic error, clinical decision making

General Practice as a career choice among undergraduate medical students in Greece

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Stefanadis Christodoulos

2007-06-01

Full Text Available Abstract Background Although General Practice (GP was recognized as a medical specialty in Greece in 1986, the number of GPs is insufficient to cover needs and only few medical graduates choose GP as a career option. In the present study we investigated the profile of medical students in terms of their decisions regarding specialization and the possible association of career choices different from GP with the status of undergraduate training regarding GP. Methods The sample consisted of final year students in the Medical School of the University of Athens, Greece. Students filled in a self-reported questionnaire focusing on medical specialization, and GP in particular. Results Response rate was 82.5% with 1021 questionnaires collected, out of 1237 eligible medical students. Only 44 out of the 1021 (4.3% respondents stated that GP is -or could be- among their choices for specialty. The most popular medical specialty was General Surgery (10.9%, followed by Cardiology (9.6%, Endocrinology (8.7% and Obstetrics-Gynaecology (8.3%. The most common criterion for choosing GP was the guaranteed employment on completion of the residency (54.6% while a 56.6% of total respondents were positive to the introduction of GP/FM as a curriculum course during University studies. Conclusion Despite the great needs, GP specialty is currently not a career option among undergraduate students of the greater Medical University in Greece and is still held in low esteem. A university department responsible for undergraduate teaching, promotion and research in GP (where not available is essential; the status of undergraduate training in general practice/family medicine seems to be one of the most important factors that influence physician career choices regarding primary care specialties.

Current trend of robotics application in medical

International Nuclear Information System (INIS)

Olanrewaju, O A; Faieza, A A; Syakirah, K

2013-01-01

The applications of robotics in recent years has emerged beyond the field of manufacturing or industrial robots itself. Robotics applications are now widely used in medical, transport, underwater, entertainment and military sector. In medical field, these applications should be emphasized in view of the increasing challenges due to the variety of findings in the field of medicine which requires new inventions to ease work process. The objective of this review paper is to study and presents the past and on-going research in medical robotics with emphasis on rehabilitation (assistive care) and surgery robotics which are certainly the two main practical fields where robots application are commonly used presently. The study found that, rehabilitation and surgery robotics applications grow extensively with the finding of new invention, as well as research that is being undertaken and to be undertaken. The importance of medical robot in medical industry is intended to offer positive outcomes to assist human business through a complicated task that involves a long period, accuracy, focus and other routines that cannot be accomplished by human ability alone.

[Trends among medical students towards general practice or specialization].

Science.gov (United States)

Breinbauer K, Hayo; Fromm R, Germán; Fleck L, Daniela; Araya C, Luis

2009-07-01

A 60/40 ratio has been estimated as a country's ideal proportion between general practitioners and specialists. In Chile this proportion was 36/ 64 in 2004, exactly the opposite of the ideal. Trends towards specialization or general practice among medical students have not been thoughtfully studied. To assess trends among medical students towards becoming general practitioners or specialists, exploring associated factors. Descriptive survey of 822 first to seventh year medical students at the University of Chile, School of Medicine. Desired activity to pursue (general practice or specialization) after graduation and general orientations within clinical practice were explored. Fifty three percent of students desired to enter a specialization program. Only 20% would work as a general practitioner (27% were still indecisive). Furthermore, a trend in early years of medical training towards an integral medicine is gradually reversed within later years. Seventh year students give significantly more importance to specialization than to integral medicine (p specialized medicine in the teaching environment. Most students prefer to enter a specialization program immediately after finishing medical school. Moreover, there is a social trend, at least within the teacher-attending environment, promoting not only the desire to specialize, but a pro-specialist culture.

Protocol for audit of current Filipino practice in rehabilitation of stroke inpatients

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Gonzalez-Suarez CB

2015-03-01

Full Text Available Consuelo B Gonzalez-Suarez,1–3 Janine Margarita R Dizon,2,3 Karen Grimmer,3 Myrna S Estrada,4 Lauren Anne S Liao,1 Anne-Rochelle D Malleta,5 Ma Elena R Tan,6 Vero Marfil,6 Cristina S Versales,1 Jimah L Suarez,5 Kleon C So,1 Edgardo D Uyehara6 1University of Santo Tomas Hospital, University of Santo Tomas, 2University of Santo Tomas, Manila, Philippines; 3International Centre for Allied Health Evidence, University of South Australia, City East Campus, North Terrace, Adelaide, SA, Australia; 4De La Salle University Hospital, Cavite, Dasmariñas, 5Philippine Orthopedic Center, 6Veterans’ Memorial Medical Center, Quezon City, Philippines Background: Stroke is one of the leading medical conditions in the Philippines. Over 500,000 Filipinos suffer from stroke annually. Provision of evidence-based medical and rehabilitation management for stroke patients has been a challenge due to existing environmental, social, and local health system issues. Thus, existing western guidelines on stroke rehabilitation were contextualized to draft recommendations relevant to the local Philippine setting. Prior to fully implementing the guidelines, an audit of current practice needs to be undertaken, thus the purpose of this audit protocol.Methods: A clinical audit of current practices in stroke rehabilitation in the Philippines will be undertaken. A consensus list of data items to be captured was identified by the audit team during a 2-day meeting in 2012. These items, including patient demographics, type of stroke, time to referral for rehabilitation management, length of hospital stay, and other relevant descriptors of stroke management were included as part of the audit. Hospitals in the Philippines will be recruited to take part in the audit activity. Recruitment will be via the registry of the Philippine Academy of Rehabilitation Medicine, where 90% of physiatrists (medical doctors specialized in rehabilitation medicine are active members and are affiliated

Assessing the impact of a medical librarian on identification of valid and actionable practice gaps for a continuing medical education committee.

Science.gov (United States)

Bartkowiak, Barbara A; Safford, Lindsey A; Stratman, Erik J

2014-01-01

Identifying educational needs related to professional practice gaps can be a complex process for continuing medical education (CME) committees and for physicians who submit activity applications. Medical librarians possess unique skills that may be useful for identifying practice gaps relevant to CME committees. We assessed this assumption by assessing a medical librarian's contributions to practice gap identification for the Marshfield Clinic's CME Committee. We reviewed all locally relevant, locally actionable practice gaps identified annually by various stakeholders and presented to our CME Committee from 2010 to 2013. Total numbers of practice gaps identified, total categorized as actionable, and numbers of subsequent activities resulting from these gaps were calculated for each year. Medical librarian totals were compared to those of other CME committee stakeholders to determine the relative contribution. The medical librarian identified unique, actionable published practice gaps that directly contributed to CME activity planning. For each study year, contributions by the medical librarian grew, from 0 of 27 actionable gaps validated by CME Committee in 2010 to 49 of 108 (45.4%) in 2013. With the librarian's assistance, the number of valid practice gaps submitted between 2010 and 2013 by stakeholders climbed from 23 for 155 activities (14.8%) to 133 for 157 activities (84.7%). Medical librarians can provide a valuable service to CME committees by identifying valid professional practice gaps that inform decisions about educational activities aimed at improving clinical practice. Medical librarians bring into deliberations unique information, including national health policy priorities, practice gaps found in the literature, and point-of-care search engine statistics. © 2014 The Alliance for Continuing Education in the Health Professions, the Society for Academic Continuing Medical Education, and the Council on Continuing Medical Education, Association for

Debt on graduation, expected place of practice, and career aspirations of Auckland Medical School students.

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O'Grady, G; Fitzjohn, J

2001-10-26

To determine the debt level that current Auckland medical students expect to graduate with, and evaluate this debt in the context of their career aspirations and intended place of practice. Simple check-box and fill-in-the-blank surveys were distributed to Auckland University medical students in Years 1 through to 5 during their second week of scheduled lectures in March 2000. Students were asked to provide demographic details, then complete sections on debt and career aspirations. 70% of Auckland medical students participated. Average expected debt was between $60000 to $70000. Predicted size of graduation debt was significantly related with plans to practice medicine overseas, and this trend was especially strong among females. In addition, Maori and Polynesian students bear a disproportionate level of the student debt burden compared to Pakeha and Asian groups. 77% of students indicated a preference for working in private or hospital specialty work. Student debt will have major effects on the composition of the New Zealand medical workforce over coming years. More attention must be paid to the national picture of medical student indebtedness if adequate workforce planning is to be possible.

Time management tips, tricks, and exercises for busy medical practice employees.

Science.gov (United States)

Hills, Laura

2012-01-01

Working in a busy medical practice requires excellent time management skills and an ability to handle those unanticipated emergencies, urgencies, and monkey-wrenches that can and often do throw a well-planned day out of whack. This article offers busy medical practice employees 50 time management tips to help them manage their time well. It focuses specifically on eliminating time wasters, working more efficiently, and developing personal goals and habits that can increase productivity, reduce stress, and make working in the practice more enjoyable. This article also offers several hands-on time management exercises, including a time management self-assessment quiz, a multitasking exercise, and a time drain exercise. These can be completed individually or collaboratively with other members of the medical practice team. Finally, this article explores 12 popular time management myths and how a medical practice employee can increase his or her productivity by identifying and harnessing his or her productivity "happy hour(s)".

Insightful practice: a reliable measure for medical revalidation

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Guthrie, Bruce; Sullivan, Frank M; Mercer, Stewart W; Russell, Andrew; Bruce, David A

2012-01-01

Background Medical revalidation decisions need to be reliable if they are to reassure on the quality and safety of professional practice. This study tested an innovative method in which general practitioners (GPs) were assessed on their reflection and response to a set of externally specified feedback. Setting and participants 60 GPs and 12 GP appraisers in the Tayside region of Scotland, UK. Methods A feedback dataset was specified as (1) GP-specific data collected by GPs themselves (patient and colleague opinion; open book self-evaluated knowledge test; complaints) and (2) Externally collected practice-level data provided to GPs (clinical quality and prescribing safety). GPs' perceptions of whether the feedback covered UK General Medical Council specified attributes of a ‘good doctor’ were examined using a mapping exercise. GPs' professionalism was examined in terms of appraiser assessment of GPs' level of insightful practice, defined as: engagement with, insight into and appropriate action on feedback data. The reliability of assessment of insightful practice and subsequent recommendations on GPs' revalidation by face-to-face and anonymous assessors were investigated using Generalisability G-theory. Main outcome measures Coverage of General Medical Council attributes by specified feedback and reliability of assessor recommendations on doctors' suitability for revalidation. Results Face-to-face assessment proved unreliable. Anonymous global assessment by three appraisers of insightful practice was highly reliable (G=0.85), as were revalidation decisions using four anonymous assessors (G=0.83). Conclusions Unlike face-to-face appraisal, anonymous assessment of insightful practice offers a valid and reliable method to decide GP revalidation. Further validity studies are needed. PMID:22653078

Mission statements and vision documents in medical practices.

Science.gov (United States)

Drury, Ivo; Slomski, Carol

2006-01-01

Thoughtful, carefully constructed mission statements and vision documents serve both to signal the purpose of a medical practice to the public and other professional colleagues, and to keep the practice's providers focused on its key purposes. Practice culture is the primary driver ofmission and vision. We clarify the differences between mission statements and vision documents, and offer guidelines to aid in constructing them.

Narratives about illness and medication: a neglected theme/new methodology within pharmacy practice research. Part II: medication narratives in practice.

Science.gov (United States)

Ryan, Kath; Bissell, Paul; Morecroft, Charles

2007-08-01

Part 2 of this paper aims to provide a methodological framework for the study of medication narratives, including a semi-structured interview guide and suggested method of analysis, in an attempt to aid the development of narrative scholarship within pharmacy practice research. Examples of medication narratives are provided to illustrate their diversity and usefulness. The framework is derived from the work of other researchers and adapted for our specific purpose. It comes from social psychology, narrative psychology, narrative anthropology, sociology and critical theory and fits within the social constructionist paradigm. The suggested methods of analysis could broadly be described as narrative analysis and discourse analysis. Examples of medication narratives are chosen from a variety of sources and brief interpretations are presented by way of illustration. Narrative analysis, a neglected area of research in pharmacy practice, has the potential to provide new understanding about how people relate to their medicines, how pharmacists are engaged in producing narratives and the importance of narrative in the education of students. IMPACT OF THE ARTICLE: This article aims to have the following impact on pharmacy practice research: Innovative approach to researching and conceptualising the use of medicines. Introduction of a new theoretical perspective and methodology. Incorporation of social science research methods into pharmacy practice research. Development of narrative scholarship within pharmacy.

How to identify, assess and utilise mobile medical applications in clinical practice.

Science.gov (United States)

Aungst, T D; Clauson, K A; Misra, S; Lewis, T L; Husain, I

2014-02-01

There are thousands of medical applications for mobile devices targeting use by healthcare professionals. However, several factors related to the structure of the existing market for medical applications create significant barriers preventing practitioners from effectively identifying mobile medical applications for individual professional use. To define existing market factors relevant to selection of medical applications and describe a framework to empower clinicians to identify, assess and utilise mobile medical applications in their own practice. Resources available on the Internet regarding mobile medical applications, guidelines and published research on mobile medical applications. Mobile application stores (e.g. iTunes, Google Play) are not effective means of identifying mobile medical applications. Users of mobile devices that desire to implement mobile medical applications into practice need to carefully assess individual applications prior to utilisation. Searching and identifying mobile medical applications requires clinicians to utilise multiple references to determine what application is best for their individual practice methods. This can be done with a cursory exploration of mobile application stores and then moving onto other available resources published in the literature or through Internet resources (e.g. blogs, medical websites, social media). Clinicians must also take steps to ensure that an identified mobile application can be integrated into practice after carefully reviewing it themselves. Clinicians seeking to identify mobile medical application for use in their individual practice should use a combination of app stores, published literature, web-based resources, and personal review to ensure safe and appropriate use. © 2014 John Wiley & Sons Ltd.

Patients' view on medical students in dermatology practice

Directory of Open Access Journals (Sweden)

Seval Doğruk Kaçar

2014-12-01

Full Text Available Background and Design: Practical training of medical students, especially in specialties such as dermatology, is performed in outpatient clinics where mostly outpatients are encountered. The aim of this study was to compare patients’ perspectives on medical students in two university hospitals (X–Y situated in different regions of Turkey. Materials and Methods: A total of 250 patients, who visited outpatient clinics of X (group 1 and Y (group 2 university hospitals during practical training for fifth year medical students, were included in this study. A questionnaire composed of 16 items was filled by all patients. The first eight questions were about patients’ consent and preferences on the presence of medical students during their interview and the remaining eight questions inquired patients’ overall thoughts on medical students. Results: The patients in both groups were willing to be a part of the educational programme of medical students (39.8%, 53.5%, respectively. The patients were aware that they had the right to refuse the presence of medical students (61.0%, 62.3% and majority wanted to be informed on the presence of medical students during the interview (72.4%, 80.7%. While patients in group 1 evaluated being with medical students as pleasurable (43.1%, patients in group 2 did not agree (44.7%. In addition, both groups were not bothered to share personal information with medical students (50.4%, 44.7% and stated that they would recommend their friends and relatives to have a physical examination done by medical students (51.2%, 41.2%. Conclusion: The active role of medical students during dermatology training is positively viewed by patients in both western and eastern parts of our country. The patients’ request on being informed for the presence of medical students during clinical examination reveals the requirement of oral and written informed consent.

Melanoma and medical education: knowledge and sun safety practices amongst medical students

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Nicolina Smith

2018-02-01

Full Text Available Introduction: Melanoma has become a public health problem; however, with proper education and the use of sun safety techniques, most cases can be prevented. The purpose of this study is to determine if medical students have safer sun practices than the general population. Material and Methods: An online survey was sent to all students enrolled in the three medical schools in the Kansas City metropolitan area. Surveys were sent to 1200 medical students with a 39.25% response rate (n=471. Results: Most of the student population (n=436; 92.6% indicated that over the past year they had used one or more forms of sun protection. Of the respondents, 60.7% (n=286 indicated they had, to this point in their medical training, been educated counseling patients about the risk factors for prevention of skin cancer. Respondents who indicated that they had been educated on the steps/procedures of a complete skin exam were significantly more likely to indicate they had used sun protective equipment in the past year (P=.024. Conclusions: The general population is in need of dermatologic education on the basic risk factors of skin cancer as well as ways to prevent skin cancer. As education increases in the general population one would anticipate that these individuals would engage in safe sun practices as seen in the medical student community.

Cost of Transformation among Primary Care Practices Participating in a Medical Home Pilot.

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Martsolf, Grant R; Kandrack, Ryan; Gabbay, Robert A; Friedberg, Mark W

2016-07-01

Medical home initiatives encourage primary care practices to invest in new structural capabilities such as patient registries and information technology, but little is known about the costs of these investments. To estimate costs of transformation incurred by primary care practices participating in a medical home pilot. We interviewed practice leaders in order to identify changes practices had undertaken due to medical home transformation. Based on the principles of activity-based costing, we estimated the costs of additional personnel and other investments associated with these changes. The Pennsylvania Chronic Care Initiative (PACCI), a statewide multi-payer medical home pilot. Twelve practices that participated in the PACCI. One-time and ongoing yearly costs attributed to medical home transformation. Practices incurred median one-time transformation-associated costs of $30,991 per practice (range, $7694 to $117,810), equivalent to $9814 per clinician ($1497 to $57,476) and $8 per patient ($1 to $30). Median ongoing yearly costs associated with transformation were $147,573 per practice (range, $83,829 to $346,603), equivalent to $64,768 per clinician ($18,585 to $93,856) and $30 per patient ($8 to $136). Care management activities accounted for over 60% of practices' transformation-associated costs. Per-clinician and per-patient transformation costs were greater for small and independent practices than for large and system-affiliated practices. Error in interviewee recall could affect estimates. Transformation costs in other medical home interventions may be different. The costs of medical home transformation vary widely, creating potential financial challenges for primary care practices-especially those that are small and independent. Tailored subsidies from payers may help practices make these investments. Agency for Healthcare Research and Quality.

Medical Students’ View about the Effects of Practical Courses on Learning the General Theoretical Concepts of Basic Medical Sciences

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Leila Roshangar

2014-05-01

Full Text Available Introduction: The basic medical sciences section requires 2.5 years in the medical education curriculum. Practical courses complement theoretical knowledge in this period to improve their appreciation. Despite spending lots of disbursement and time, this period’s efficacy is not clearly known. Methods: One hundred thirty-three General Practitioner (GP students have been included in this descriptive cross-sectional study and were asked by questionnaire about the positive impact of practical courses on learning theoretical knowledge. Data were analyzed by descriptive statistics. Result: The agreement in “Practical Head and Neck Anatomy” was 40.91% ± 29.45, in “Practical Trunk Anatomy” was 63.62% ± 2.32 and in “Practical Anatomy of Extremities” was 56.16% ± 2.57. In “Practical Histology”, agreement was 69.50%±2.19; “Practical Biophysics” was 45.97%±2.25, “Practical Physiology” 61.75%±2.17; “Practical Biochemistry” 36.28%±2.42; “Practical Pathology” 59.80%±2.53; “Practical Immunology” 56.25%±26.40; “Practical Microbiology and Virology” 60.39%±2.27 and “Practical Mycology and Parasitology” 68.2%± 2.16.Conclusion: GP students in Tabriz University of Medical Sciences are not optimistic about the applicability of practical courses of basic medical sciences lessons.

Circulation Policies in Academic Medical Libraries: A Comparative Study of Allocation Strategies, Demographic Analysis, Service Offerings, and Implications for Practice

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Whitehead, Michele L.; Gutierrez, Laura; Miller, Melody

2014-01-01

The purpose of this study is to gain an understanding of current academic medical library circulation polices and examine methods libraries utilize to meet patron needs. Key informants were selected from five states. Statistics regarding financial practices, users, services, space access, and circulation practices were collected via survey…

Managing the culturally diverse medical practice team: twenty-five strategies.

Science.gov (United States)

Hills, Laura

2014-01-01

A common misconception is that the phrase workplace diversity means meeting certain quotas in employee race or gender categories. In fact, diversity is much more than that. This article explores the unique benefits and challenges of managing a culturally diverse medical practice team and offers practice managers 25 practical strategies. It describes the two types of diversity training that are beneficial to practice managers and the kinds of policies, practices, and procedures that foster and promote diversity. This article also explores ethnocentrism, racism, ageism, sexism, stereotyping, and other potentially divisive issues among a diverse medical practice team. It provides an assessment instrument practice managers can use to evaluate their own diversity management skills. Finally, this article defines specifically what is meant by the term diversity and explores the top 10 diversity issues in workplaces today.

Medical Residents’ and Practicing Physicians’ e-Cigarette Knowledge and Patient Screening Activities

OpenAIRE

Karen W. Geletko; Karen Myers; Naomi Brownstein; Breanna Jameson; Daniel Lopez; Alaine Sharpe; Gail R. Bellamy

2016-01-01

Purpose: The purpose of this study was to compare medical residents and practicing physicians in primary care specialties regarding their knowledge and beliefs about electronic cigarettes (e-cigarettes). We wanted to ascertain whether years removed from medical school had an effect on screening practices, recommendations given to patients, and the types of informational sources utilized. Methods: A statewide sample of Florida primary care medical residents (n = 61) and practicing physicians (...

Medical rosters and the Trade Practices Act.

Science.gov (United States)

Pengilley, Warren

2003-04-07

Medical rosters are not free of trade practices problems, notwithstanding assurances by the Australian Competition and Consumer Commission (ACCC). Neither the ACCC nor the recently convened Wilkinson Committee has applied rigorous legal principles in interpreting the Trade Practices Act 1974 (Cwlth) to reach its conclusions. The Australian law should be changed to bring it into line with that of the United States and New Zealand.

Choosing Your Medical Specialty

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... the Payment Process Physician Payment Resource Center Reinventing Medical Practice Managing Your Practice CPT® (Current Procedural Terminology) Medicare & Medicaid Private Payer Reform Claims Processing & Practice ...

Internet use by physicians and its impact on medical practice-an exploratory study.

Science.gov (United States)

Kwon, Ik-Whan G; Xie, Henry Yu

2003-01-01

Internet use by physicians has played a vital role in medical practices for many years. A number of related studies have emerged to examine the impact of Internet use on medical practice. However, there is yet to be a comprehensive study on the impact of Internet use by physicians on their medical practice. This study examines a preliminary step to explore the major implications of physicians' Internet use on the traditional areas, such as health education and learning, physician-patient relationship, and medical marketing. Barriers to Internet use are also investigated. Implication of use of the Internet in the medical practice and limitations of this study are discussed as well.

Attitudes of undergraduate medical students of Addis Ababa University towards medical practice and migration, Ethiopia

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Deressa Wakgari

2012-08-01

Full Text Available Abstract Background The health care system of Ethiopia is facing a serious shortage of health workforce. While a number of strategies have been developed to improve the training and retention of medical doctors in the country, understanding the perceptions and attitudes of medical students towards their training, future practice and intent to migrate can contribute in addressing the problem. This study was carried out to assess the attitudes of Ethiopian medical students towards their training and future practice of medicine, and to identify factors associated with the intent to practice in rural or urban settings, or to migrate abroad. Methods A cross-sectional study was conducted in June 2009 among 600 medical students (Year I to Internship program of the Faculty of Medicine at Addis Ababa University in Ethiopia. A pre-tested self-administered structured questionnaire was used for data collection. Descriptive statistics were used for data summarization and presentation. Degree of association was measured by Chi Square test, with significance level set at p  Results Only 20% of the students felt ‘excellent’ about studying medicine; followed by ‘very good’ (19%, ‘good’ (30%, ‘fair’ (21% and ‘bad’ (11%. About 35% of respondents responded they felt the standard of medical education was below their expectation. Only 30% of the students said they would like to initially practice medicine in rural settings in Ethiopia. However, students with rural backgrounds were more likely than those with urban backgrounds to say they intended to practice medicine in rural areas (adjusted OR = 2.50, 95% CI = 1.18-5.26. Similarly, students in clinical training program preferred to practice medicine in rural areas compared to pre-clinical students (adjusted OR = 1.83, 95% CI = 1.12-2.99. About 53% of the students (57% males vs. 46% females, p = 0.017 indicated aspiration to emigrate following graduation, particularly to the

A study to assess the knowledge and practice on bio-medical waste ...

African Journals Online (AJOL)

Background: The proper handling and disposal of bio-medical waste is very imperative. Unfortunately, laxity and lack of adequate knowledge and practice on bio-medical waste disposal leads to staid health and environment apprehension. Aim: To assess the knowledge and practice on bio-medical waste management ...

Internal medicine rounding practices and the Accreditation Council for Graduate Medical Education core competencies.

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Shoeb, Marwa; Khanna, Raman; Fang, Margaret; Sharpe, Brad; Finn, Kathleen; Ranji, Sumant; Monash, Brad

2014-04-01

The Accreditation Council for Graduate Medical Education (ACGME) has established the requirement for residency programs to assess trainees' competencies in 6 core domains (patient care, medical knowledge, practice-based learning, interpersonal skills, professionalism, and systems-based practice). As attending rounds serve as a primary means for educating trainees at academic medical centers, our study aimed to identify current rounding practices and attending physician perceived capacity of different rounding models to promote teaching within the ACGME core competencies. We disseminated a 24-question survey electronically using educational and hospital medicine leadership mailing lists. We assessed attending physician demographics and the frequency with which they used various rounding models, as defined by the location of the discussion of the patient and care plan: bedside rounds (BR), hallway rounds (HR), and card-flipping rounds (CFR). Using the ACGME framework, we assessed the perceived educational value of each model. We received 153 completed surveys from attending physicians representing 34 institutions. HR was used most frequently for both new and established patients (61% and 43%), followed by CFR for established patients (36%) and BR for new patients (22%). Most attending physicians indicated that BR and HR were superior to CFR in promoting the following ACGME competencies: patient care, systems-based practice, professionalism, and interpersonal skills. HR is the most commonly employed rounding model. BR and HR are perceived to be valuable for teaching patient care, systems-based practice, professionalism, and interpersonal skills. CFR remains prevalent despite its perceived inferiority in promoting teaching across most of the ACGME core competencies. © 2014 Society of Hospital Medicine.

Implications of current resident work-hour guidelines on the future practice of surgery in Canada.

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Maruscak, Adam A; VanderBeek, Laura; Ott, Michael C; Kelly, Stephen; Forbes, Thomas L

2012-01-01

Work-hour restrictions have had a profound impact on surgical training. However, little is known of how work-hour restrictions may affect the future practice patterns of current surgical residents. The purpose of this study is to compare the anticipated career practice patterns of surgical residents who are training within an environment of work-hour restrictions with the current practice of faculty surgeons. An electronic survey was sent to all surgery residents and faculty at 2 Canadian university-affiliated medical centers. The survey consisted of questions regarding expected (residents) or current (faculty) practice patterns. A total of 149 residents and 125 faculty members completed the survey (50.3% and 52.3% response rates, respectively). A greater proportion of males were in the faculty cohort than in the resident group (77.6% vs 62.4%, p = 0.0003). More faculty than residents believed that work-hour restrictions have a negative impact on both residency education (40.8% vs 20.8%, p = 0.008) and preparation for a surgical career (56.8% vs 19.5%, p implications and might require larger surgical groups and reconsideration of resource allocation. Copyright © 2012 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

21 CFR 123.5 - Current good manufacturing practice.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 2 2010-04-01 2010-04-01 false Current good manufacturing practice. 123.5 Section...) FOOD FOR HUMAN CONSUMPTION FISH AND FISHERY PRODUCTS General Provisions § 123.5 Current good manufacturing practice. (a) Part 110 of this chapter applies in determining whether the facilities, methods...

Teaching communications skills to medical students: Introducing the fine art of medical practice.

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Choudhary, Anjali; Gupta, Vineeta

2015-08-01

Like many other people based professions, communications skills are essential to medical practice also. Traditional medical teaching in India does not address communication skills which are most essential in dealing with patients. Communication skills can be taught to medical students to increase clinical competence. To teach basic communication and counseling skills to fourth-year undergraduate students to increase their clinical competence. A total of 48, fourth-year MBBS students participated in the study. They were given training in basic communication and counseling skills and taught the patient interview technique according to Calgary-Cambridge guide format. Improvement in communication was assessed by change in pre- and post-training multiple choice questions, clinical patient examination, and Standardized Patient Satisfaction Questionnaire (SPSQ) scores. About 88% of the students in the sample were convinced of the importance of learning communication skills for effective practice. Almost 90% students were communicating better after training, as tested by improved SPSQ. As judged by Communication Skill Attitude Scale, student's positive attitude toward learning communication skill indicated that there is a necessity of communication skill training during undergraduate years. The ability to communicate effectively is a core competency for medical practitioners. Inculcating habits of good communications skill during formative years will help the medical students and future practitioners. Regular courses on effective communication should be included in the medical school curriculum.

Big data in pharmacy practice: current use, challenges, and the future.

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Ma, Carolyn; Smith, Helen Wong; Chu, Cherie; Juarez, Deborah T

2015-01-01

Pharmacy informatics is defined as the use and integration of data, information, knowledge, technology, and automation in the medication-use process for the purpose of improving health outcomes. The term "big data" has been coined and is often defined in three V's: volume, velocity, and variety. This paper describes three major areas in which pharmacy utilizes big data, including: 1) informed decision making (clinical pathways and clinical practice guidelines); 2) improved care delivery in health care settings such as hospitals and community pharmacy practice settings; and 3) quality performance measurement for the Centers for Medicare and Medicaid and medication management activities such as tracking medication adherence and medication reconciliation.

A Review of Medical Emergencies in Dental Practice | Uyamadu ...

African Journals Online (AJOL)

A Review of Medical Emergencies in Dental Practice. ... are those adverse medical events that may present in the course of dental treatment. ... be available in a dental clinic, outline the prevention and management of such emergencies, ...

Nurses' experiences and perspectives on medication safety practices: an explorative qualitative study.

Science.gov (United States)

Smeulers, Marian; Onderwater, Astrid T; van Zwieten, Myra C B; Vermeulen, Hester

2014-04-01

To explore nurses' experiences with and perspectives on preventing medication administration errors. Insight into nurses' experiences with and perspectives on preventing medication administration errors is important and can be utilised to tailor and implement safety practices. A qualitative interview study of 20 nurses in an academic medical centre was conducted between March and December of 2011. Three themes emerged from this study: (1) nurses' roles and responsibilities in medication safety: aside from safe preparation and administration, the clinical reasoning of nurses is essential for medication safety; (2) nurses' ability to work safely: knowledge of risks and nurses' work circumstances influence their ability to work safely; and (3) nurses' acceptance of safety practices: advantages, feasibility and appropriateness are important incentives for acceptance of a safety practice. Nurses' experiences coincide with the assumption that they are in a pre-eminent position to enable safe medication management; however, their ability to adequately perform this role depends on sufficient knowledge to assess the risks of medication administration and on the circumstances in which they work. Safe medication management requires a learning climate and professional practice environment that enables further development of professional nursing skills and knowledge. © 2014 John Wiley & Sons Ltd.

Geographic Medical History: Advances in Geospatial Technology Present New Potentials in Medical Practice

Science.gov (United States)

Faruque, F. S.; Finley, R. W.

2016-06-01

Genes, behaviour, and the environment are known to be the major risk factors for common diseases. When the patient visits a physician, typical questions include family history (genes) and lifestyle of the patient (behaviour), but questions concerning environmental risk factors often remain unasked. It is ironic that 25 centuries ago Hippocrates, known as the father of medicine, noted the importance of environmental exposure in medical investigation as documented in his classic work, "Airs, Waters, Places", yet the practice of routinely incorporating environmental risk factors is still not in place. Modern epigenetic studies have found that unhealthy lifestyle and environmental factors can cause changes to our genes that can increase disease risk factors. Therefore, attempting to solve the puzzle of diseases using heredity and lifestyle alone will be incomplete without accounting for the environmental exposures. The primary reason why environmental exposure has not yet been a routine part of the patient's medical history is mostly due to our inability to provide clinicians useful measures of environmental exposures suitable for their clinical practices. This presentation will discuss advances in geospatial technology that show the potential to catalyse a paradigm shift in medical practice and health research by allowing environmental risk factors to be documented as the patient's "Geographic Medical History". In order to accomplish this we need information on: a) relevant spatiotemporal environmental variables, and b) location of the individual in that person's dynamic environment. Common environmental agents that are known to interact with genetic make-up include air pollutants, mold spores, pesticides, etc. Until recently, the other component, location of an individual was limited to a static representation such as residential or workplace location. Now, with the development of mobile technology, changes in an individual's location can be tracked in real time if

GEOGRAPHIC MEDICAL HISTORY: ADVANCES IN GEOSPATIAL TECHNOLOGY PRESENT NEW POTENTIALS IN MEDICAL PRACTICE

Directory of Open Access Journals (Sweden)

F. S. Faruque

2016-06-01

Full Text Available Genes, behaviour, and the environment are known to be the major risk factors for common diseases. When the patient visits a physician, typical questions include family history (genes and lifestyle of the patient (behaviour, but questions concerning environmental risk factors often remain unasked. It is ironic that 25 centuries ago Hippocrates, known as the father of medicine, noted the importance of environmental exposure in medical investigation as documented in his classic work, “Airs, Waters, Places”, yet the practice of routinely incorporating environmental risk factors is still not in place. Modern epigenetic studies have found that unhealthy lifestyle and environmental factors can cause changes to our genes that can increase disease risk factors. Therefore, attempting to solve the puzzle of diseases using heredity and lifestyle alone will be incomplete without accounting for the environmental exposures. The primary reason why environmental exposure has not yet been a routine part of the patient’s medical history is mostly due to our inability to provide clinicians useful measures of environmental exposures suitable for their clinical practices. This presentation will discuss advances in geospatial technology that show the potential to catalyse a paradigm shift in medical practice and health research by allowing environmental risk factors to be documented as the patient’s “Geographic Medical History”. In order to accomplish this we need information on: a relevant spatiotemporal environmental variables, and b location of the individual in that person’s dynamic environment. Common environmental agents that are known to interact with genetic make-up include air pollutants, mold spores, pesticides, etc. Until recently, the other component, location of an individual was limited to a static representation such as residential or workplace location. Now, with the development of mobile technology, changes in an individual’s location

Establishing advanced practice for medical imaging in New Zealand

International Nuclear Information System (INIS)

Yielder, Jill; Young, Adrienne; Park, Shelley; Coleman, Karen

2014-01-01

Introduction: This article presents the outcome and recommendations following the second stage of a role development project conducted on behalf of the New Zealand Institute of Medical Radiation Technology (NZIMRT). The study sought to support the development of profiles and criteria that may be used to formulate Advanced Scopes of Practice for the profession. It commenced in 2011, following on from initial research that occurred between 2005 and 2008 investigating role development and a possible career structure for medical radiation technologists (MRTs) in New Zealand (NZ). Methods: The study sought to support the development of profiles and criteria that could be used to develop Advanced Scopes of Practice for the profession through inviting 12 specialist medical imaging groups in NZ to participate in a survey. Results: Findings showed strong agreement on potential profiles and on generic criteria within them; however, there was less agreement on specific skills criteria within specialist areas. Conclusions: The authors recommend that one Advanced Scope of Practice be developed for Medical Imaging, with the establishment of generic and specialist criteria. Systems for approval of the overall criteria package for any individual Advanced Practitioner (AP) profile, audit and continuing professional development requirements need to be established by the Medical Radiation Technologists Board (MRTB) to meet the local needs of clinical departments. It is further recommended that the NZIMRT and MRTB promote and support the need for an AP pathway for medical imaging in NZ

Establishing advanced practice for medical imaging in New Zealand

Energy Technology Data Exchange (ETDEWEB)

Yielder, Jill, E-mail: j.yielder@auckland.ac.nz [University of Auckland, Auckland (New Zealand); Young, Adrienne; Park, Shelley; Coleman, Karen [University of Otago, Wellington (New Zealand); University of Auckland, Auckland (New Zealand)

2014-02-15

Introduction: This article presents the outcome and recommendations following the second stage of a role development project conducted on behalf of the New Zealand Institute of Medical Radiation Technology (NZIMRT). The study sought to support the development of profiles and criteria that may be used to formulate Advanced Scopes of Practice for the profession. It commenced in 2011, following on from initial research that occurred between 2005 and 2008 investigating role development and a possible career structure for medical radiation technologists (MRTs) in New Zealand (NZ). Methods: The study sought to support the development of profiles and criteria that could be used to develop Advanced Scopes of Practice for the profession through inviting 12 specialist medical imaging groups in NZ to participate in a survey. Results: Findings showed strong agreement on potential profiles and on generic criteria within them; however, there was less agreement on specific skills criteria within specialist areas. Conclusions: The authors recommend that one Advanced Scope of Practice be developed for Medical Imaging, with the establishment of generic and specialist criteria. Systems for approval of the overall criteria package for any individual Advanced Practitioner (AP) profile, audit and continuing professional development requirements need to be established by the Medical Radiation Technologists Board (MRTB) to meet the local needs of clinical departments. It is further recommended that the NZIMRT and MRTB promote and support the need for an AP pathway for medical imaging in NZ.

a worldwide assessment of medical journal editors' practices and ...

African Journals Online (AJOL)

responding editors reported having access to the Internet, making participation in ... of improving the quality of medical science and practice.! A critical activity of ... undertook a worldwide survey of medical editors to determine their interest in a ...

Sleep Hygiene Practices and Their Relation to Sleep Quality in Medical Students of Qazvin University of Medical Sciences

OpenAIRE

Yazdi, Zohreh; Loukzadeh, Ziba; Moghaddam, Parichehr; Jalilolghadr, Shabnam

2016-01-01

Introduction: Poor quality of sleep is a distressing and worrying condition that can disturb academic performance of medical students. Sleep hygiene practices are one of the important variables that affect sleep quality. The objective of this study was to assess association between sleep hygiene practices and sleep quality of medical students in Qazvin University of Medical Sciences. Methods: In this descriptive-correlational study, a total of 285 ...

Current Situation of Medication Adherence in Hypertension.

Science.gov (United States)

Vrijens, Bernard; Antoniou, Sotiris; Burnier, Michel; de la Sierra, Alejandro; Volpe, Massimo

2017-01-01

Despite increased awareness, poor adherence to treatments for chronic diseases remains a global problem. Adherence issues are common in patients taking antihypertensive therapy and associated with increased risks of coronary and cerebrovascular events. Whilst there has been a gradual trend toward improved control of hypertension, the number of patients with blood pressure values above goal has remained constant. This has both personal and economic consequences. Medication adherence is a multifaceted issue and consists of three components: initiation, implementation, and persistence. A combination of methods is recommended to measure adherence, with electronic monitoring and drug measurement being the most accurate. Pill burden, resulting from free combinations of blood pressure lowering treatments, makes the daily routine of medication taking complex, which can be a barrier to optimal adherence. Single-pill fixed-dose combinations simplify the habit of medication taking and improve medication adherence. Re-packing of medication is also being utilized as a method of improving adherence. This paper presents the outcomes of discussions by a European group of experts on the current situation of medication adherence in hypertension.

The Time Is Now: Using Graduates' Practice Data to Drive Medical Education Reform.

Science.gov (United States)

Triola, Marc M; Hawkins, Richard E; Skochelak, Susan E

2018-02-13

Medical educators are not yet taking full advantage of the publicly available clinical practice data published by federal, state, and local governments, which can be attributed to individual physicians and evaluated in the context of where they attended medical school and residency training. Understanding how graduates fare in actual practice, both in terms of the quality of the care they provide and the clinical challenges they face, can aid educators in taking an evidence-based approach to medical education. Although in their infancy, efforts to link clinical outcomes data to educational process data hold the potential to accelerate medical education research and innovation. This approach will enable unprecedented insight into the long-term impact of each stage of medical education on graduates' future practice. More work is needed to determine best practices, but the barrier to using these public data is low and the potential for early results is immediate. Using practice data to evaluate medical education programs can transform how the future physician workforce is trained and better align continuously learning medical education and health care systems.

Nurses who work in general medical practices: a Victorian survey.

Science.gov (United States)

Bonawit, V; Watson, L

1996-01-01

A questionnaire survey of 452 general medical practices in Victoria attracted responses from 277 practices, many of which did not employ nurses. The 93 respondents from 85 practices who were nurses reported that they enjoyed flexible working hours and stable employment. While their main reason for working in GPs' rooms was convenience, the most important aspect of their work was interaction with patients and fellow workers. Sixtyseven percent of nurses thought continuing education in specific skills was necessary for their work, 43% thought a post-registration qualification in community health nursing would be desirable and 47% thought a special interest group of nurses working in medical practices would be useful.

Choosing a New Telephone System for Your Medical Practice.

Science.gov (United States)

Metherell, Brian

2016-01-01

E-mail may rule the world in other types of businesses, but for medical practices, the telephone remains the primary mode of communication with patients, specialists, and pharmacies. From making appointments to calling in prescriptions, telephones are essential to patient care. With technology changing very quickly and new capabilities coming into the medical practice, such as telemedicine and Skype, you need to know your options when choosing a new telephone system. The possibilities include on-site, cloud, and hybrid networked solutions. A wide variety of features and capabilities are available, from dozens of vendors. Of course, no matter what telephone solution you choose, you must meet regulatory compliance, particularly HIPAA, and Payment Card Industry Data Security Standard if you take credit cards. And it has to be affordable, reliable, and long lasting. This article explores what medical practices need to know when choosing a new business telephone system in order to find the right solutions for their businesses.

A National Longitudinal Survey of Medical Students' Intentions to Practice Among the Underserved.

Science.gov (United States)

O'Connell, Thomas F; Ham, Sandra A; Hart, Theodore G; Curlin, Farr A; Yoon, John D

2018-01-01

To explore students' intentions to practice in medically underserved areas. In January 2011, 960 third-year medical students from 24 MD-granting U.S. medical schools were invited to participate in a survey on their intention to practice in a medically underserved area. A follow-up survey was sent to participants in September 2011. Covariates included student demographics, medical school characteristics, environmental exposures, work experiences, sense of calling, and religious characteristics. Adjusted response rates were 564/919 (61.4%, first survey) and 474/564 (84.0%, follow-up survey). Among fourth-year medical students, an estimated 34.3% had an intention to practice among the underserved. In multivariate logistic regression modeling, predictors for intentions to practice among the underserved included growing up in an underserved setting (odds ratio [OR] range: 2.96-4.81), very strong sense of calling (OR range: 1.86-3.89), and high medical school social mission score (in fourth year: OR = 2.34 [95% confidence interval (CI), 1.31-4.21]). International experience was associated with favorable change of mind in the fourth year (OR = 2.86 [95% CI, 1.13-7.24]). High intrinsic religiosity was associated with intentions to practice primary care in underserved settings (in fourth year: OR = 2.29 [95% CI = 1.13-4.64]). Growing up in medically underserved settings, work experience in religiously affiliated organizations, very strong sense of calling, and high medical school social mission score were associated with intentions to practice in underserved areas. Lack of formative educational experiences may dissuade students from considering underserved practice.

[Medical practice, magic and religion - conjunction and development before and after Reformation].

Science.gov (United States)

Thorvardardottir, Olina Kjerulf

2017-12-01

The conjunction between medical practice, religion and magic becomes rather visible when one peers into old scripts and ancient literature. Before the foundation and diffusion of universities of the continent, the european convents and cloisters were the centers of medical knowl-edge and -practice for centuries. Alongside the scholarly development of medical science, driven from the roots of the eldest scholarly medicial practice, the practice of folk-medicin flourished and thrived all over Europe, not least the herbal-medicine which is the original form and foundation for modern pharmacy. This article deals with the conjunction of religion, magic and medical practice in ancient Icelandic sources such as the Old-Norse literature, medical-scripts from the 12th - 15th century Iceland, and not least the Icelandic magical-scripts (galdrakver) of the 17th century. The last mentioned documents were used as evidence in several witch-trials that led convicted witches to suffer executions at the stake once the wave of European witch-persecutions had rushed ashore in 17th century Iceland. These sources indicate a decline of medical knowledge and science in the 16th and 17th century Iceland, the medical practice being rather undeveloped at the time - in Iceland as in other parts of Europe - there-fore a rather unclear margin between "the learned and the laymen". While common people and folk-healers were convicted as witches to suffer at the stake for possession of magical scripts and healing-books, some scholars of the state of Danmark were practicing healing-methods that deserve to be compared to the activities of the former ones. That comparison raises an inevitable question of where to draw the line between the learned medical man and the magician of 17th century Iceland, that is between Magic and Science.

Do Leadership Style, Unit Climate, and Safety Climate Contribute to Safe Medication Practices?

Science.gov (United States)

Farag, Amany; Tullai-McGuinness, Susan; Anthony, Mary K; Burant, Christopher

2017-01-01

This study aims at: examining if leadership style and unit climate predict safety climate; and testing the direct, indirect, and total effect of leadership style, unit climate, and safety climate on nurses' safe medication practices. The Institute of Medicine and nursing scholars propose that safety climate is a prerequisite to safety practices. However, there is limited empirical evidence about factors contributing to the development of safety climate and about the association with nurses' safe medication practices. This cross-sectional study used survey data from 246 RNs working in a Magnet® hospital. Leadership style and unit climate predicted 20% to 50% of variance on all safety climate dimensions. Model testing revealed the indirect impact of leadership style and unit climate on nurses' safe medication practices. Our hypothesized model explained small amount of the variance on nurses' safe medication practices. This finding suggests that nurses' safe medication practices are influenced by multiple contextual and personal factors that should be further examined.

Medizinbibliotheken: Innovativ denken, strategisch planen, praktisch umsetzen / Medical libraries: think innovative, plan strategically, implement in practice

Directory of Open Access Journals (Sweden)

Bauer, Bruno

2011-12-01

Full Text Available The focus of the current issue 3/2011 of GMS Medizin – Bibliothek – Information is the annual conference 2011 of the German Medical Libraries Association in Cologne. The motto of the conference was “Think innovative, plan strategically, implement in practice”. Focal points of the meeting were innovation management, marketing and new applications in medical libraries.The authors in this issue are Bruno Bauer, Daniel Formanek & Helmut Dollfuß (E-Books at medical libraries: They came to stay, Ursula Georgy (Systematic innovation management, Maurizio Grilli (New library portal at Province College for Health-Care Professions Claudiana, Bozen, Sabine Köhrer-Weisser (Marketing in One Person Libraries, Roland Mumenthaler (Innovation Management at ETH-Bibliothek, Markus Schmiel (Performance-related bonuses at Hannover Medical School: practical experience report of the library, Guus van den Brekel (Mobile Computing & Semantic Web in Health & Medicine, Iris Reimann & Sonja Fräntz (Think innovative, plan strategically, implement in practice – Annual Meeting 2011 of the German MLA, 19th to 21th September in Cologne and Eike Hentschel (Aus der AGMB.

Influences on final year medical students' attitudes to general practice as a career.

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Parker, Johanna E; Hudson, Ben; Wilkinson, Tim J

2014-03-01

General practice is under-represented in student career choices. This study aimed to identify and explore factors that influence the attitudes of final year medical students to general practice as a career. This qualitative study used semi-structured interviews of focus groups of final year undergraduate medical students at the University of Otago, Christchurch, New Zealand. Thematic analysis and grounded theory were used to interpret the data. General practitioners (GPs) play a key role in influencing medical students' attitudes to general practice as a career. Students identified their general practice placement during medical school training and personal contact with their own GP as principal factors. The media portrayal of general practice and the attitudes of friends and family were also influential. Students were positively influenced when they were made to feel part of the team, involved with consultations, allowed to carry out practical procedures under supervision, and witnessed what they perceived as good medical practice during clinical placements. Positive experiences often occurred later in training, when students felt more confident of their clinical abilities. While students reported occasional negative comments about general practice by some hospital doctors, these had a lesser role in influencing their perceptions of general practice compared with their own experiences, both as students and patients. GPs have a strong influence, positively and negatively, on the attitudes of medical students to general practice as a career. Effective influences include being made to feel welcome, involved, valued, and given legitimate roles during clinical placements.

Big data in pharmacy practice: current use, challenges, and the future

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Ma C

2015-08-01

Full Text Available Carolyn Ma, Helen Wong Smith, Cherie Chu, Deborah T JuarezDepartment of Pharmacy Practice, The Daniel K Inouye College of Pharmacy, University of Hawai'i at Hilo, Hilo, HI, USAAbstract: Pharmacy informatics is defined as the use and integration of data, information, knowledge, technology, and automation in the medication-use process for the purpose of improving health outcomes. The term “big data” has been coined and is often defined in three V's: volume, velocity, and variety. This paper describes three major areas in which pharmacy utilizes big data, including: 1 informed decision making (clinical pathways and clinical practice guidelines; 2 improved care delivery in health care settings such as hospitals and community pharmacy practice settings; and 3 quality performance measurement for the Centers for Medicare and Medicaid and medication management activities such as tracking medication adherence and medication reconciliation.Keywords: clinical pharmacy data base, pharmacy informatics, patient outcomes

Audit and feedback by medical students to improve the preventive care practices of general practice supervisors.

Science.gov (United States)

Gilkes, Lucy A; Liira, Helena; Emery, Jon

Medical students benefit from their contact with clinicians and patients in the clinical setting. However, little is known about whether patients and clinicians also benefit from medical students. We developed an audit and feedback intervention activity to be delivered by medical students to their general practice supervisors. We tested whether the repeated cycle of audit had an effect on the preventive care practices of general practitioners (GPs). The students performed an audit on topics of preventive medicine and gave feedback to their supervisors. Each supervisor in the study had more than one student performing the audit over the academic year. After repetitive cycles of audit and feedback, the recording of social history items by GPs improved. For example, recording alcohol history increased from 24% to 36%. This study shows that medical students can be effective auditors, and their repeated audits may improve their general practice supervisors' recording of some aspects of social history.

Marketing your medical practice with an effective web presence.

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Finch, Tammy

2004-01-01

The proliferation of the World Wide Web has provided an opportunity for medical practices to sell themselves through low-cost marketing on the Internet. A Web site is a quick and effective way to provide patients with up-to-date treatment and procedure information. This article provides suggestions on what to include on a medical practice's Web site, how the Web can assist office staff and physicians, and cost options for your Web site. The article also discusses design tips, such as Web-site optimization.

What do we do? Practices and learning strategies of medical education leaders.

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Lieff, Susan; Albert, Mathieu

2012-01-01

Continuous changes in undergraduate and postgraduate medical education require faculty to assume a variety of new leadership roles. While numerous faculty development programmes have been developed, there is little evidence about the specific practices of medical education leaders or their learning strategies to help inform their design. This study aimed to explore what medical education leaders' actually do, their learning strategies and recommendations for faculty development. A total of 16 medical education leaders from a variety of contexts within the faculty of medicine of a large North American medical school participated in semi-structured interviews to explore the nature of their work and the learning strategies they employ. Using thematic analysis, interview transcripts were coded inductively and then clustered into emergent themes. Findings clustered into four key themes of practice: (1) intrapersonal (e.g., self-awareness), (2) interpersonal (e.g., fostering informal networks), (3) organizational (e.g., creating a shared vision) and (4) systemic (e.g. strategic navigation). Learning strategies employed included learning from experience and example, reflective practice, strategic mentoring or advanced training. Our findings illuminate a four-domain framework for understanding medical education leader practices and their learning preferences. While some of these findings are not unknown in the general leadership literature, our understanding of their application in medical education is unique. These practices and preferences have a potential utility for conceptualizing a coherent and relevant approach to the design of faculty development strategies for medical education leadership.

The study of practices in planed diagnostic medical exposure

International Nuclear Information System (INIS)

Popescu, Irina-Anca; Perju, Nicoleta Ana-Maria; Cobzeanu, Camelia

2011-01-01

The exposure of population to ionizing radiations in medical diagnostic purposes represents a planed exposure procedure, medically justified, having a direct impact on patient health state. A justification of exposure, with a result that can confirm a clinical diagnostic, implies further important steps in treatment decisions. Optimization in patients radiological protection is the result of observing the reference levels recommendations, which maintains a reasonable individual exposure to ionizing radiation in medical purpose. In this paper we investigated the justification of 4189 exposures of patients who underwent planed diagnostic medical investigation over 36 months in a radiological unit. The most frequent investigation concerned the spinal column in 38.3% of total exposures-mainly at lumbar level (63.0% and 24.1%, respectively of total number of exposures), followed by limb bones (20.6%) and thorax (26.9%). Justification of practices included: rheumatic pains in 45.8% of exposures followed by traumatic injuries (20.6%), pleural and pulmonary pathology (19.3%), malignant processes (12.3%), ear-nose-throat investigations (1.1%) and car accidents (0.9%). The females over 40 years old were the group with the highest number of medical exposures, with 54.5% of total practices. This study revealed that the number of medical exposures justification is almost equal with non-justified examinations, confirming a not so good correlation between clinical diagnostic and the required radiological investigation. The percentages of justified versus non-justified practices indicated by specialist physicians and general practitioners were slightly equal - 59.3% vs. 40.7%, 56.9% vs. 43.1%, respectively. The analysis of data concluded that either specialist/general physicians must evaluate more rigorously the patients and all clinical signs in order to reduce as reasonable as possible the non-justified medical exposures to ionizing radiations, and thus to avoid financial and

21 CFR 114.5 - Current good manufacturing practice.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 2 2010-04-01 2010-04-01 false Current good manufacturing practice. 114.5 Section...) FOOD FOR HUMAN CONSUMPTION ACIDIFIED FOODS General Provisions § 114.5 Current good manufacturing practice. The criteria in §§ 114.10, 114.80, 114.83, 114.89, and 114.100, as well as the criteria in part...

Structuring group medical practices: shareholder and partnership agreements.

Science.gov (United States)

Gassman, A S

1992-01-01

This article is the second in a series addressing the structuring of group medical entities, shareholder relationships, and general representation factors. In this article, a number of the legal and business considerations for entering into shareholder and partnership agreements are discussed, and various types of practice structures and recommended group practice agreement provisions are described.

[Interculturality in the medical practice of Dr. Albert Schweitzer].

Science.gov (United States)

Campos-Navarro, Roberto; Ruiz-Llanos, Adriana

2004-01-01

Albert Schweitzer (1875-1965) was a young and promising German who at age 29 decided to undertake the profession of Medical Doctor at the University of Strassburg after finishing a career in musical studies in Paris (1899) and obtaining in Berlin a doctoral degree in Philosophy and Theology. Surprisingly, Albert Schweitzer, despite his comfortable life in Europe, decided in 1913 to practice his medical career in a remote and small Equatorial African country. He devoted nearly 50 years of his life caring for the Black population at Lamaberene, where he built a hospital. In this paper, we attempt to develop some theoretical aspects related with interculturality in the medical practice of Dr. Albert Schweitzer. We begin by considering certain sociocultural variables in hospitals that give care to patients with cultural characteristics that are substantially different from those of the health care personnel who organize, administer, and execute medical functions.

Current economic trends in equine practice.

Science.gov (United States)

Clark, Andrew R

2009-12-01

Current economic trends in equine practice are trends of weakness. Most practices, after a decade of double-digit growth, have migrated to survival mode within a few months. Understanding that all regions and disciplines are affected differently, using the Porter five forces model, we can identify changes that must be made in our business models first to survive and then to position ourselves to prosper when the recession ends. If we are to avoid long-term damage to our practices, we must use cost control and work efficiency in addition to price concessions.

Integrating Radiology and Anatomy Teaching in Medical Education in the UK--The Evidence, Current Trends, and Future Scope.

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Heptonstall, N B; Ali, T; Mankad, K

2016-04-01

This review article presents the current evidence of the importance of integrating radiology and anatomy in medical education in the UK, a recommendation by a number of key anatomy, education, and radiology organizations. Current evidence highlights that on average only 5% of total teaching time in medical education is dedicated to radiology. Often, radiology teaching does not adequately fulfill students' learning needs and potentially leaves them underprepared for medical practice. Benefits of integrating radiology and anatomy include improved clinical application of anatomy, an increase in student's interest in anatomy, and ultimately improved radiological interpretation. Various modalities exist for the integration of radiology and anatomy, facilitated by the vast portability of radiological images. It appears that combining radiological resources with traditional anatomy teaching methodology in a blended approach is most beneficial. Copyright © 2016 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

Factors Influencing Electronic Clinical Information Exchange in Small Medical Group Practices

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Kralewski, John E.; Zink, Therese; Boyle, Raymond

2012-01-01

Purpose: The purpose of this study was to identify the organizational factors that influence electronic health information exchange (HIE) by medical group practices in rural areas. Methods: A purposive sample of 8 small medical group practices in 3 experimental HIE regions were interviewed to determine the extent of clinical information exchange…

Unhealthy lifestyle practices and medical-care costs in the military

OpenAIRE

Weber, Timothy H.

1994-01-01

Approved for public release, distribution unlimited The majority of all medical illnesses, and associated costs. can be prevented through personal decisions not to use unhealthy lifest)·Je practices (e.g., smoking. not exercising). A statistical analysis was conducted to examine whether there was a cost impact on medical care as a result of military· personnel engaging in unhealthy lifestyle practices. The approach taken for this anal...

Medical Training Experience and Expectations Regarding Future Medical Practice of Medical Students at the University of Cape Verde.

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Delgado, Antonio Pedro; Soares Martins, Antonieta; Ferrinho, Paulo

2017-10-31

Cape Verde is a small insular developing state. Its first experience of undergraduate medical education began in October 2015. The purpose of this paper is to describe and analyze the professional expectations and profile of the first class of medical students at the University of Cape Verde. A piloted, standardized questionnaire, with closed and open-ended questions, was distributed to registered medical students attending classes on the day of the survey. All data were analyzed using SPSS. Students decided to study medicine in their mid-teens with relatives and friends having had significant influence over their decisions. Other major reasons for choosing medical training include "to take care of other people", "fascination for the subject matters of medicine" and "I have always wanted to". The degree of feminization of the student population is extremely high (20/25; 80.0%). Medical students are in general satisfied with the training program, and have expectations that the training received will allow them to be good professionals. Nevertheless, they consider the course too theoretical. Medical students know that this represents an opportunity for them to contribute to public welfare. Nonetheless, their expectations are to combine public sector practice with private work. Medical students come mostly from Santiago Island where the Capital of the Country is located. They still do not know about their future area of specialization. But all of those who want to specialize want to do so abroad. They mostly expect to follow hospital careers rather than health administration or family and community medicine. This study contributes to the growing body of knowledge about medical students' difficulties and expectations regarding medical schools or curriculums in lusophone countries. The decision to invest in the training of local physicians is justified by the need to be less dependent on foreigners. Local postgraduate medical training programs are already

Medical Physics Practice Guideline 4.a: Development, implementation, use and maintenance of safety checklists.

Science.gov (United States)

Fong de Los Santos, Luis E; Evans, Suzanne; Ford, Eric C; Gaiser, James E; Hayden, Sandra E; Huffman, Kristina E; Johnson, Jennifer L; Mechalakos, James G; Stern, Robin L; Terezakis, Stephanie; Thomadsen, Bruce R; Pronovost, Peter J; Fairobent, Lynne A

2015-05-08

The American Association of Physicists in Medicine (AAPM) is a nonprofit professional society whose primary purposes are to advance the science, education and professional practice of medical physics. The AAPM has more than 8,000 members and is the principal organization of medical physicists in the United States.The AAPM will periodically define new practice guidelines for medical physics practice to help advance the science of medical physics and to improve the quality of service to patients throughout the United States. Existing medical physics practice guidelines will be reviewed for the purpose of revision or renewal, as appropriate, on their fifth anniversary or sooner.Each medical physics practice guideline represents a policy statement by the AAPM, has undergone a thorough consensus process in which it has been subjected to extensive review, and requires the approval of the Professional Council. The medical physics practice guidelines recognize that the safe and effective use of diagnostic and therapeutic radiology requires specific training, skills, and techniques, as described in each document. Reproduction or modification of the published practice guidelines and technical standards by those entities not providing these services is not authorized.The following terms are used in the AAPM practice guidelines:Must and Must Not: Used to indicate that adherence to the recommendation is considered necessary to conform to this practice guideline.Should and Should Not: Used to indicate a prudent practice to which exceptions may occasionally be made in appropriate circumstances.

Practice of Regulatory Science (Development of Medical Devices).

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Niimi, Shingo

2017-01-01

Prototypes of medical devices are made in accordance with the needs of clinical practice, and for systems required during the initial process of medical device development for new surgical practices. Verification of whether these prototypes produce the intended performance specifications is conducted using basic tests such as mechanical and animal tests. The prototypes are then improved and modified until satisfactory results are obtained. After a prototype passes through a clinical trial process similar to that for new drugs, application for approval is made. In the approval application process, medical devices are divided into new, improved, and generic types. Reviewers judge the validity of intended use, indications, operation procedures, and precautions, and in addition evaluate the balance between risk and benefit in terms of efficacy and safety. Other characteristics of medical devices are the need for the user to attain proficiency in usage techniques to ensure efficacy and safety, and the existence of a variety of medical devices for which assessment strategies differ, including differences in impact on the body in cases in which a physical burden to the body or failure of a medical device develops. Regulatory science of medical devices involves prediction, judgment, and evaluation of efficacy, safety, and quality, from which data result which can become indices in the development stages from design to application for approval. A reduction in the number of animals used for testing, improvement in efficiency, reduction of the necessity for clinical trials, etc. are expected through rational setting of evaluation items.

Sleep Hygiene Practices and Their Relation to Sleep Quality in Medical Students of Qazvin University of Medical Sciences.

Science.gov (United States)

Yazdi, Zohreh; Loukzadeh, Ziba; Moghaddam, Parichehr; Jalilolghadr, Shabnam

2016-01-01

Poor quality of sleep is a distressing and worrying condition that can disturb academic performance of medical students. Sleep hygiene practices are one of the important variables that affect sleep quality. The objective of this study was to assess association between sleep hygiene practices and sleep quality of medical students in Qazvin University of Medical Sciences. In this descriptive-correlational study, a total of 285 medical students completed a self-administered questionnaire. Demographic data, sleep-wake schedule in weekday and weekend, and sleep duration were collected. Students' sleep quality was assessed by Pittsburg Sleep Quality Index (PSQI). Data were analyzed by SPSS Ver 13. Overall, 164 (57.5) of students had poor sleep quality. Mean global PSQI score and average score of four subscales were significantly higher in male than female. Regression analysis showed that male students (β=-0.85, Psleep hygiene practices slept worse. The findings of this study showed that the prevalence of poor sleep quality in medical students is high. Improper sleep hygiene behaviors might be a reason for poor quality of sleep in medical students.

Medical devices for the anesthetist: current perspectives

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Ingrande J

2014-03-01

Full Text Available Jerry Ingrande, Hendrikus JM LemmensDepartment of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA, USAAbstract: Anesthesiologists are unique among most physicians in that they routinely use technology and medical devices to carry out their daily activities. Recently, there have been significant advances in medical technology. These advances have increased the number and utility of medical devices available to the anesthesiologist. There is little doubt that these new tools have improved the practice of anesthesia. Monitoring has become more comprehensive and less invasive, airway management has become easier, and placement of central venous catheters and regional nerve blockade has become faster and safer. This review focuses on key medical devices such as cardiovascular monitors, airway equipment, neuromonitoring tools, ultrasound, and target controlled drug delivery software and hardware. This review demonstrates how advances in these areas have improved the safety and efficacy of anesthesia and facilitate its administration. When applicable, indications and contraindications to the use of these novel devices will be explored as well as the controversies surrounding their use.Keywords: catheters, echocardiography, ultrasound, fiberoptic bronchoscope, laryngeal mask airway, closed-loop anesthesia

An empirical analysis of public and private medical practice in Australia.

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Cheng, Terence C; Joyce, Catherine M; Scott, Anthony

2013-06-01

The combination of public and private medical practice is widespread in many health systems and has important consequences for health care cost and quality. However, its forms and prevalence vary widely and are poorly understood. This paper examines factors associated with public and private sector work by medical specialists using a nationally representative sample of Australian doctors. We find considerable variations in the practice patterns, remuneration contracts and professional arrangements across doctors in different work sectors. Both specialists in mixed practice and private practice differ from public sector specialists with regard to their annual earnings, sources of income, maternity and other leave taken and number of practice locations. Public sector specialists are likely to be younger, to be international medical graduates, devote a higher percentage of time to education and research, and are more likely to do after hours and on-call work compared with private sector specialists. Gender and total hours worked do not differ between doctors across the different practice types. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Participation and Progression: New Medical Graduates Entering Professional Practice

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Bearman, Margaret; Lawson, Mary; Jones, Alison

2011-01-01

The first year of practice after medical school is considered to be an essential part of becoming a medical practitioner in Australia. Previous qualitative investigations have investigated a number of significant aspects of this early stage of professional development. This qualitative study explores experiences and developing professional…

Medical Home Implementation Gaps for Seniors: Perceptions and Experiences of Primary Care Medical Practices.

Science.gov (United States)

Hoff, Timothy; DePuccio, Matthew

2018-07-01

The study objective was to better understand specific implementation gaps for various aspects of patient-centered medical home (PCMH) care delivered to seniors. The study illuminates the physician and staff experience by focusing on how individuals make sense of and respond behaviorally to aspects of PCMH implementation. Qualitative data from 51 in-depth, semi-structured interviews across six different National Committee for Quality Assurance (NCQA)-accredited primary care practices were collected and analyzed. Physicians and staff identified PCMH implementation gaps for their seniors: (a) performing in-depth clinical assessments, (b) identifying seniors' life needs and linking them with community resources, and (c) care management and coordination, in particular self-management support for seniors. Prior experiences trying to perform these aspects of PCMH care for older adults produced collective understandings that led to inaction and avoidance by medical practices around the first two gaps, and proactive behavior that took strategic advantage of external incentives for addressing the third gap. Greater understanding of physician and staff's PCMH implementation experiences, and the learning that accumulates from these experiences, allows for a deeper understanding of how primary care practices choose to enact the medical home model for seniors on an everyday basis.

Medication errors in anaesthetic practice: A report of two cases and ...

African Journals Online (AJOL)

Background: Mistakes in the identification and administration of drugs may be fatal. This is especially so in the practice of anaesthesia. This is a report of 2 cases of near fatality due to mistakes in drug administration from look-alike medications. Objective: To highlight the significance of medication errors in our practice and ...

Prevalence and pattern of self-medication practices in an urban area of Delhi, India

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Varun Kumar

2015-01-01

Full Text Available Background: Self-medication is one of the major health concerns worldwide and World Health Organization has laid emphasis on correctly investigating and controlling it. There is much public and professional concern regarding self-medication practices, which has dramatically increased in the last few decades, especially in the developing countries. Hence, this study was designed to study the prevalence and practice of self-medication practices in an urban area of Delhi, India. Materials and Methods: A cross-sectional study was conducted in March 2013 and data were collected by personal interviews using pretested questionnaires. An urban colony in the south district of Delhi was chosen and the eldest member of the family, present at the time of the visit was interviewed. Data were collected from 236 persons and analyzed using SPSS version 21. Results: The prevalence of self-medication was 92.8% (95 confidence interval: 66.5-79.4. 74.9% preferred allopathic medicines. Self-medication was found to be practiced more among younger persons than older age group persons (P = 0.000. Graduates and postgraduates practiced self-medication more than others (P = 0.002. Common cold (61.6% and fever (51.8% were the most common ailments for which self-medication were practiced. Paracetamol and cough syrups were the most commonly used class of drugs. Conclusion: The prevalence of self-medication in this study was high. Drugs especially antimicrobials were not taken for the proper length of time. Awareness regarding self-medication practices to help patients decide on the appropriateness of self-medication is required.

Current Cytology Practices in Korea: A Nationwide Survey by the Korean Society for Cytopathology

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Eun Ji Oh

2017-11-01

Full Text Available Background Limited data are available on the current status of cytology practices in Korea. This nationwide study presents Korean cytology statistics from 2015. Methods A nationwide survey was conducted in 2016 as a part of the mandatory quality-control program by the Korean Society for Cytopathology. The questionnaire was sent to 208 medical institutions performing cytopathologic examinations in Korea. Individual institutions were asked to submit their annual cytology statistical reports and gynecologic cytology-histology correlation data for 2015. Results Responses were obtained from 206 medical institutions including 83 university hospitals, 87 general hospitals, and 36 commercial laboratories. A total of 8,284,952 cytologic examinations were performed in 2015, primarily in commercial laboratories (74.9%. The most common cytology specimens were gynecologic samples (81.3%. Conventional smears and liquid-based cytology were performed in 6,190,526 (74.7% and 2,094,426 (25.3% cases, respectively. The overall diagnostic concordance rate between cytologic and histologic diagnoses of uterine cervical samples was 70.5%. Discordant cases were classified into three categories: category A (minimal clinical impact, 17.4%, category B (moderate clinical impact, 10.2%, and category C (major clinical impact, 1.9%. The ratio of atypical squamous cells of undetermined significance to squamous intraepithelial lesion was 1.6 in university hospitals, 2.9 in general hospitals, and 4.9 in commercial laboratories. Conclusions This survey reveals the current status and trend of cytology practices in Korea. The results of this study can serve as basic data for the establishment of nationwide cytopathology policies and quality improvement guidelines in Korean medical institutions.

Use of structured musculoskeletal examination routines in undergraduate medical education and postgraduate clinical practice - a UK survey.

Science.gov (United States)

Baker, Kenneth F; Jandial, Sharmila; Thompson, Ben; Walker, David; Taylor, Ken; Foster, Helen E

2016-10-21

Structured examination routines have been developed as educational resources for musculoskeletal clinical skills teaching, including Gait-Arms-Legs-Spine (GALS), Regional Examination of the Musculoskeletal System (REMS) and paediatric GALS (pGALS). In this study, we aimed to assess the awareness and use of these examination routines in undergraduate medical teaching in UK medical schools and UK postgraduate clinical practice. Electronic questionnaires were distributed to adult and paediatric musculoskeletal teaching leads at UK medical schools and current UK doctors in training. Responses were received from 67 tutors representing teaching at 22/33 [67 %] of all UK medical schools, and 70 trainee doctors across a range of postgraduate training specialities. There was widespread adoption, at responding medical schools, of the adult examination routines within musculoskeletal teaching (GALS: 14/16 [88 %]; REMS: 12/16 [75 %]) and assessment (GALS: 13/16 [81 %]; REMS: 12/16 [75 %]). More trainees were aware of GALS (64/70 [91 %]) than REMS (14/67 [21 %]). Of the 39 trainees who used GALS in their clinical practice, 35/39 [90 %] reported that it had improved their confidence in musculoskeletal examination. Of the 17/22 responding medical schools that included paediatric musculoskeletal examination within their curricula, 15/17 [88 %] used the pGALS approach and this was included within student assessment at 4 medical schools. We demonstrate the widespread adoption of these examination routines in undergraduate education and significant uptake in postgraduate clinical practice. Further study is required to understand their impact upon clinical performance.

Prescribing of pain medication in palliative care. A survey in general practice

NARCIS (Netherlands)

Borgsteede, Sander D.; Deliens, Luc; Zuurmond, Wouter W. A.; Schellevis, François G.; Willems, Dick L.; van der Wal, Gerrit; van Eijk, Jacques Th M.

2009-01-01

Purpose To examine what pain and adjuvant medication is prescribed in palliative care patients at home in The Netherlands. Methods In a nationwide, representative, prospective study in general practice in The Netherlands, prescribed medication was registered in 95 general practices with a listed

Prescribing of pain medication in palliative care: a survey in general practice.

NARCIS (Netherlands)

Borgsteede, S.D.; Deliens, L.; Zuurmond, W.W.A.; Schellevis, F.; Willems, D.L.; Wal, G. van der; Eijk, J.T.M. van

2009-01-01

PURPOSE: To examine what pain and adjuvant medication is prescribed in palliative care patients at home in The Netherlands. METHODS: In a nationwide, representative, prospective study in general practice in The Netherlands, prescribed medication was registered in 95 general practices with a listed

Medical students' experience in practical skills is far from stakeholders' expectations

DEFF Research Database (Denmark)

Ringsted, Charlotte; Schroeder, Torben V.; Henriksen, Jørgen

2001-01-01

This study compares medical graduates' experience in practical skills with a range of stakeholders' expectations. A questionnaire listing 58 practical skills was sent out to a group of graduating medical students. The medical students were asked to indicate their experience in each skill during...... medical school. A similar questionnaire was sent out to five groups of stakeholders asking for their expectations regarding graduates' experience. The stakeholders were: faculty members; consultants at clinical departments with interns in training; general practitioners; nurses; recently graduated junior...... doctors. A total of 472 questionnaires were sent out and 315 (67%) were returned. Medical graduates showed substantial variation in level of experience, and their experience was substantially lower than the expectations of the stakeholders. Nurses and junior doctors tended to have higher expectations...

Health Care Practices for Medical Textiles in Government Hospitals

Science.gov (United States)

Akubue, B. N.; Anikweze, G. U.

2015-01-01

The purpose of this study was to investigate the health care practices for medical textiles in government hospitals Enugu State, Nigeria. Specifically, the study determined the availability and maintenance of medical textiles in government hospitals in Enugu State, Nigeria. A sample of 1200 hospital personnel were studied. One thousand two hundred…

Implementing the patient-centered medical home model for chronic disease care in small medical practices: practice group characteristics and physician understanding.

Science.gov (United States)

Baxter, Louisa; Nash, David B

2013-01-01

Strengthening primary care may improve health outcomes and restrain spending. The patient-centered medical home (PCMH) model is endorsed as a tool to achieve this. Early evaluations in large group practices demonstrate improvements in some health outcomes. Evidence is lacking from small medical practices that deliver the majority of primary health care. This was a national survey of 200 physicians that explored perceptions of PCMH. There was considerable interest in adoption of the model; however, providing PCMH care was seen as an extension of traditional roles that requires additional reimbursement. No differentiation was made among a variety of payment models to do this. All joint principle components of the model were identified as important: extending access and information technology were the most contentious. There was consensus that PCMH might improve the quality of primary care; however, tension between wider societal benefits and rising costs for individual practices was a challenge to implementation.

Medical and dental students' attitude and practice of prevention ...

African Journals Online (AJOL)

... practiced universal standard precaution items. Conclusion: The uptake rate of HBV vaccination and practice of standard precaution among the students are commendable. However, there is need for improvement considering the level of HBV infection in Nigeria. Key words: Medical and dental students, hepatitis B vaccine ...

78 FR 4307 - Current Good Manufacturing Practice Requirements for Combination Products

Science.gov (United States)

2013-01-22

...-2009-N-0435] Current Good Manufacturing Practice Requirements for Combination Products AGENCY: Food and...) is issuing this regulation on the current good manufacturing practice (CGMP) requirements applicable... this subpart? (Sec. 4.2) D. What current good manufacturing practice requirements apply to my...

Theory-based practice in a major medical centre.

Science.gov (United States)

Alligood, Martha Raile

2011-11-01

This project was designed to improve care quality and nursing staff satisfaction. Nursing theory structures thought and action as demonstrated by evidence of improvement in complex health-care settings. Nursing administrators selected Modelling and Role-Modelling (MRM) for the theory-based practice goal in their strategic plan. An action research approach structured implementation of MRM in a 1-year consultation project in 2001-2002. Quality of health care improved according to national quality assessment ratings, as well as patient satisfaction and nurse satisfaction. Modelling and Role-Modelling demonstrated capacity to structure nursing thought and action in patient care in a major medical centre. Uniformity of patient care language was valued by nurses as well as by allied health providers who wished to learn the holistic MRM style of practice. The processes of MRM and action research contributed to project success. A positive health-care change project was carried out in a large medical centre with action research. Introducing MRM theory-based practice was a beneficial decision by nursing administration that improved care and nurse satisfaction. Attention to nursing practice stimulated career development among the nurses to pursue bachelors, masters, and doctoral degrees. © 2011 Blackwell Publishing Ltd.

A Constructive Reframing of Student Roles and Systems Learning in Medical Education Using a Communities of Practice Lens.

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Gonzalo, Jed D; Thompson, Britta M; Haidet, Paul; Mann, Karen; Wolpaw, Daniel R

2017-12-01

Health systems are in the midst of a transformation that is being driven by a variety of forces. This has important implications for medical educators because clinical practice environments play a key role in learning and professional development, and evolving health systems are beginning to demand that providers have "systems-ready" knowledge, attitudes, and skills. Such implications provide a clear mandate for medical schools to modify their goals and prepare physicians to practice flexibly within teams and effectively contribute to the improvement of health care delivery. In this context, the concepts of value-added medical education, authentic student roles, and health systems science are emerging as increasingly important. In this Article, the authors use a lens informed by communities of practice theory to explore these three concepts, examining the implications that the communities of practice theory has in the constructive reframing of educational practices-particularly common student roles and experiences-and charting future directions for medical education that better align with the needs of the health care system. The authors apply several key features of the communities of practice theory to current experiential roles for students, then propose a new approach to students' clinical experiences-value-added clinical systems learning roles-that provides students with opportunities to make meaningful contributions to patient care while learning health systems science at the patient and population level. Finally, the authors discuss implications for professional role formation and anticipated challenges to the design and implementation of value-added clinical systems learning roles.

Emotional Intelligence in medical practice

Directory of Open Access Journals (Sweden)

Abu Hasan Sarkar

2016-08-01

Full Text Available Emotional Intelligence is the ability to perceive, express, understand and regulate one’s inner emotions and the emotions of others. It is considered to be a ‘must have’ competence in the workplace. Several scientific studies have proven that the application of emotional intelligence is effective in improving the teaching-learning process and that it leads to organizational growth; however, only limited work has been carried out to assess its effectiveness in the practice of medicine, especially in India. Various scales have been developed to measure emotional intelligence but they are not universally applicable because emotional intelligence depends upon culture and personal background among other factors. In recent years in India, conflicts between patients and doctors have had serious, sometimes fatal, consequences for the physician. Behavior, when faced with a potential conflict-like situation, depends to a great extent on the emotional intelligence of the physician. Emotional intelligence of medical students and medical professionals can be honed through exposure to the medical humanities which are known to promote patient-centered care. Building better physician-patient relationships might help in averting doctor-patient conflict.

Implementation of Patient-Centered Medical Homes in Adult Primary Care Practices.

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Alexander, Jeffrey A; Markovitz, Amanda R; Paustian, Michael L; Wise, Christopher G; El Reda, Darline K; Green, Lee A; Fetters, Michael D

2015-08-01

There has been relatively little empirical evidence about the effects of patient-centered medical home (PCMH) implementation on patient-related outcomes and costs. Using a longitudinal design and a large study group of 2,218 Michigan adult primary care practices, our study examined the following research questions: Is the level of, and change in, implementation of PCMH associated with medical surgical cost, preventive services utilization, and quality of care in the following year? Results indicated that both level and amount of change in practice implementation of PCMH are independently and positively associated with measures of quality of care and use of preventive services, after controlling for a variety of practice, patient cohort, and practice environmental characteristics. Results also indicate that lower overall medical and surgical costs are associated with higher levels of PCMH implementation, although change in PCMH implementation did not achieve statistical significance. © The Author(s) 2015.

Teaching Laboratory Management Principles and Practices Through Mentorship and Graduated Responsibility: The Assistant Medical Directorship.

Science.gov (United States)

Hanley, Timothy; Sowder, Aleksandra M; Palmer, Cheryl Ann; Weiss, Ronald L

2016-01-01

With the changing landscape of medicine in general, and pathology in particular, a greater emphasis is being placed on laboratory management as a means of controlling spiraling medical costs and improving health-care efficiency. To meet this challenge, pathology residency programs have begun to incorporate formal laboratory management training into their curricula, using institutional curricula and/or online laboratory management courses offered by professional organizations. At the University of Utah, and its affiliated national reference laboratory, ARUP Laboratories, Inc, interested residents are able to supplement the departmental lecture-based and online laboratory management curriculum by participating in assistant medical directorship programs in one of several pathology subspecialty disciplines. The goals of many of the assistant medical directorship positions include the development of laboratory management skills and competencies. A survey of current and recent assistant medical directorship participants revealed that the assistant medical directorship program serves as an excellent means of improving laboratory management skills, as well as improving performance as a fellow and practicing pathologist.

Medical School Outcomes, Primary Care Specialty Choice, and Practice in Medically Underserved Areas by Physician Alumni of MEDPREP, a Postbaccalaureate Premedical Program for Underrepresented and Disadvantaged Students.

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Metz, Anneke M

2017-01-01

Minorities continue to be underrepresented as physicians in medicine, and the United States currently has a number of medically underserved communities. MEDPREP, a postbaccalaureate medical school preparatory program for socioeconomically disadvantaged or underrepresented in medicine students, has a stated mission to increase the numbers of physicians from minority or disadvantaged backgrounds and physicians working with underserved populations. This study aims to determine how MEDPREP enhances U.S. physician diversity and practice within underserved communities. MEDPREP recruits disadvantaged and underrepresented in medicine students to complete a 2-year academic enhancement program that includes science coursework, standardized test preparation, study/time management training, and emphasis on professional development. Five hundred twenty-five disadvantaged or underrepresented students over 15 years completed MEDPREP and were tracked through entry into medical practice. MEDPREP accepts up to 36 students per year, with two thirds coming from the Midwest region and another 20% from nearby states in the South. Students complete science, test preparation, academic enhancement, and professionalism coursework taught predominantly by MEDPREP faculty on the Southern Illinois University Carbondale campus. Students apply broadly to medical schools in the region and nation but are also offered direct entry into our School of Medicine upon meeting articulation program requirements. Seventy-nine percent of students completing MEDPREP became practicing physicians. Fifty-eight percent attended public medical schools, and 62% attended medical schools in the Midwest. Fifty-three percent of program alumni chose primary care specialties compared to 34% of U.S. physicians, and MEDPREP alumni were 2.7 times more likely to work in medically underserved areas than physicians nationally. MEDPREP increases the number of disadvantaged and underrepresented students entering and graduating

Artificial Intelligence in Medical Practice: The Question to the Answer?

Science.gov (United States)

Miller, D Douglas; Brown, Eric W

2018-02-01

Computer science advances and ultra-fast computing speeds find artificial intelligence (AI) broadly benefitting modern society-forecasting weather, recognizing faces, detecting fraud, and deciphering genomics. AI's future role in medical practice remains an unanswered question. Machines (computers) learn to detect patterns not decipherable using biostatistics by processing massive datasets (big data) through layered mathematical models (algorithms). Correcting algorithm mistakes (training) adds to AI predictive model confidence. AI is being successfully applied for image analysis in radiology, pathology, and dermatology, with diagnostic speed exceeding, and accuracy paralleling, medical experts. While diagnostic confidence never reaches 100%, combining machines plus physicians reliably enhances system performance. Cognitive programs are impacting medical practice by applying natural language processing to read the rapidly expanding scientific literature and collate years of diverse electronic medical records. In this and other ways, AI may optimize the care trajectory of chronic disease patients, suggest precision therapies for complex illnesses, reduce medical errors, and improve subject enrollment into clinical trials. Copyright © 2018 Elsevier Inc. All rights reserved.

Loneliness at the Top: Ten Ways Medical Practice Administrators Can Manage the Isolation of Leadership.

Science.gov (United States)

Hills, Laura

2016-01-01

Medical practice.managers spend their days surrounded by people, so the last thing they may expect to feel is lonely. Yet for many, being the manager of a medical practice can lead to feelings of isolation from the rest of the staff, and loneliness. This article explores the many reasons that managing a medical practice can be a lonely business. It considers the risks when a practice manager's loneliness goes unchecked, both to the individual and to the practice. It suggests 10 effective and healthy strategies for preventing and managing the leadership loneliness that medical practice managers sometimes experience. Next, this article argues that acceptance is the first step in overcoming loneliness in the workplace. It offers guidance for medical practice managers who wish to help lonely members of their teams. It describes the benefits of having a confidant to help support the medical practice manager, and the characteristics of an ideal confidant. Finally, this article suggests a strategy for combatting loneliness by interacting with the staff more frequently.

Empiricism Verses Rationalism: Matters Arising in Medical Practice ...

African Journals Online (AJOL)

Empiricism Verses Rationalism: Matters Arising in Medical Practice. ... AFRREV STECH: An International Journal of Science and Technology ... entirely antagonistic to one another, one favoring the senses and the other favoring the mind.

Indigenous Healing Practices and Self-Medication amongst ...

African Journals Online (AJOL)

Indigenous Healing Practices and Self-Medication amongst Pregnant Women in Cape Town, South Africa. Naeemah Abrahams, Rachel Jewkes, Zodumo Mvo. Abstract. This study was conducted in and around Cape Town, South Africa, at two primary obstetric facilities and in the antenatal clinics of two secondary hospitals.

Journal of Ethiopian Medical Practice: Editorial Policies

African Journals Online (AJOL)

... the health care delivery system. Most practicing physicians to this end should be widely encouraged to participate in medical researches in conjunction with their regular professional activities. Special efforts should be made to improve the opportunity, the inclination and talents of these professionals in research activities.

Mentoring medical students in your general practice.

Science.gov (United States)

Fraser, John

2016-05-01

Mentoring medical students in general practices is becoming more common in Australia due to formalised scholarship programs and informal approaches by students. This paper defines mentoring in Australian general practice. Practical suggestions are made on how to structure a mentorship program in your practice. Mentoring differs from leadership and teaching. It is a long-term relationship between a student and an experienced general practitioner. Avoiding summative assessment in mentorship is important to its success. Mentoring is about forming a safe place to confidentially discuss personal and professional issues between a mentor and student. This is based on defining roles and mutual trust. At the same time, students crave formative feedback. Unfortunately, present feedback models are based on teaching principles that can blur the differences between assessor, teacher and mentor. Mentorship can provide students with orientation and learning experiences so that they are prepared for practice as an intern.

Medical student selection criteria as predictors of intended rural practice following graduation.

Science.gov (United States)

Puddey, Ian B; Mercer, Annette; Playford, Denese E; Pougnault, Sue; Riley, Geoffrey J

2014-10-14

Recruiting medical students from a rural background, together with offering them opportunities for prolonged immersion in rural clinical training environments, both lead to increased participation in the rural workforce after graduation. We have now assessed the extent to which medical students' intentions to practice rurally may also be predicted by either medical school selection criteria and/or student socio-demographic profiles. The study cohort included 538 secondary school-leaver entrants to The University of Western Australia Medical School from 2006 to 2011. On entry they completed a questionnaire indicating intention for either urban or rural practice following graduation. Selection factors (standardised interview score, percentile score from the Undergraduate Medicine and Health Sciences Admission Test (UMAT) and prior academic performance (Australian Tertiary Admissions Rank), together with socio-demographic factors (age, gender, decile for the Index of Relative Socioeconomic Advantage and Disadvantage (IRSAD) and an index of rurality) were examined in relation to intended rural or urban destination of practice. In multivariate logistic regression, students from a rural background had a nearly 8-fold increase in the odds of intention to practice rurally after graduation compared to those from urban backgrounds (OR 7.84, 95% CI 4.10, 14.99, P practice rurally (OR 4.36, 95% CI 1.69, 11.22, P medical school entry may have the unintended consequence of selecting fewer graduates interested in a rural practice destination. Increased efforts to recruit students from lower socioeconomic backgrounds may be beneficial in terms of an ultimate intended rural practice destination.

Medical decision making and medical education: challenges and opportunities.

Science.gov (United States)

Schwartz, Alan

2011-01-01

The Flexner Report highlighted the importance of teaching medical students to reason about uncertainty. The science of medical decision making seeks to explain how medical judgments and decisions ought ideally to be made, how they are actually made in practice, and how they can be improved, given the constraints of medical practice. The field considers both clinical decisions by or for individual patients and societal decisions designed to benefit the public. Despite the relevance of decision making to medical practice, it currently receives little formal attention in the U.S. medical school curriculum. This article suggests three roles for medical decision making in medical education. First, basic decision science would be a valuable prerequisite to medical training. Second, several decision-related competencies would be important outcomes of medical education; these include the physician's own decision skills, the ability to guide patients in shared decisions, and knowledge of health policy decisions at the societal level. Finally, decision making could serve as a unifying principle in the design of the medical curriculum, integrating other curricular content around the need to create physicians who are competent and caring decision makers.

Self-reported tobacco smoking practices among medical students and their perceptions towards training about tobacco smoking in medical curricula: A cross-sectional, questionnaire survey in Malaysia, India, Pakistan, Nepal, and Bangladesh

Directory of Open Access Journals (Sweden)

Shah Mohsin

2010-11-01

Full Text Available Abstract Background Tobacco smoking issues in developing countries are usually taught non-systematically as and when the topic arose. The World Health Organisation and Global Health Professional Student Survey (GHPSS have suggested introducing a separate integrated tobacco module into medical school curricula. Our aim was to assess medical students' tobacco smoking habits, their practices towards patients' smoking habits and attitude towards teaching about smoking in medical schools. Methods A cross-sectional questionnaire survey was carried out among final year undergraduate medical students in Malaysia, India, Nepal, Pakistan, and Bangladesh. An anonymous, self-administered questionnaire included items on demographic information, students' current practices about patients' tobacco smoking habits, their perception towards tobacco education in medical schools on a five point Likert scale. Questions about tobacco smoking habits were adapted from GHPSS questionnaire. An 'ever smoker' was defined as one who had smoked during lifetime, even if had tried a few puffs once or twice. 'Current smoker' was defined as those who had smoked tobacco product on one or more days in the preceding month of the survey. Descriptive statistics were calculated. Results Overall response rate was 81.6% (922/1130. Median age was 22 years while 50.7% were males and 48.2% were females. The overall prevalence of 'ever smokers' and 'current smokers' was 31.7% and 13.1% respectively. A majority (> 80% of students asked the patients about their smoking habits during clinical postings/clerkships. Only a third of them did counselling, and assessed the patients' willingness to quit. Majority of the students agreed about doctors' role in tobacco control as being role models, competence in smoking cessation methods, counseling, and the need for training about tobacco cessation in medical schools. About 50% agreed that current curriculum teaches about tobacco smoking but not

Self-reported tobacco smoking practices among medical students and their perceptions towards training about tobacco smoking in medical curricula: A cross-sectional, questionnaire survey in Malaysia, India, Pakistan, Nepal, and Bangladesh.

Science.gov (United States)

Sreeramareddy, Chandrashekhar T; Suri, Sushil; Menezes, Ritesh G; Kumar, H N Harsha; Rahman, Mahbubur; Islam, Md R; Pereira, Xavier V; Shah, Mohsin; Sathian, Brijesh; Shetty, Ullasa; Vaswani, Vina R

2010-11-16

Tobacco smoking issues in developing countries are usually taught non-systematically as and when the topic arose. The World Health Organisation and Global Health Professional Student Survey (GHPSS) have suggested introducing a separate integrated tobacco module into medical school curricula. Our aim was to assess medical students' tobacco smoking habits, their practices towards patients' smoking habits and attitude towards teaching about smoking in medical schools. A cross-sectional questionnaire survey was carried out among final year undergraduate medical students in Malaysia, India, Nepal, Pakistan, and Bangladesh. An anonymous, self-administered questionnaire included items on demographic information, students' current practices about patients' tobacco smoking habits, their perception towards tobacco education in medical schools on a five point Likert scale. Questions about tobacco smoking habits were adapted from GHPSS questionnaire. An 'ever smoker' was defined as one who had smoked during lifetime, even if had tried a few puffs once or twice. 'Current smoker' was defined as those who had smoked tobacco product on one or more days in the preceding month of the survey. Descriptive statistics were calculated. Overall response rate was 81.6% (922/1130). Median age was 22 years while 50.7% were males and 48.2% were females. The overall prevalence of 'ever smokers' and 'current smokers' was 31.7% and 13.1% respectively. A majority (> 80%) of students asked the patients about their smoking habits during clinical postings/clerkships. Only a third of them did counselling, and assessed the patients' willingness to quit. Majority of the students agreed about doctors' role in tobacco control as being role models, competence in smoking cessation methods, counseling, and the need for training about tobacco cessation in medical schools. About 50% agreed that current curriculum teaches about tobacco smoking but not systematically and should be included as a separate module

Sleep practices among medical students in Pediatrics Department of ...

African Journals Online (AJOL)

Background: Medical students are a population who are at great risk of having bad sleep practice and hygiene due to demanding clinical and academic activities. Poor sleep practices are a disturbing and destabilizing phenomenon. It affects many people and can affect the quality of work, performance and education of ...

Medical students, early general practice placements and positive supervisor experiences.

Science.gov (United States)

Henderson, Margaret; Upham, Susan; King, David; Dick, Marie-Louise; van Driel, Mieke

2018-03-01

Introduction Community-based longitudinal clinical placements for medical students are becoming more common globally. The perspective of supervising clinicians about their experiences and processes involved in maximising these training experiences has received less attention than that of students. Aims This paper explores the general practitioner (GP) supervisor perspective of positive training experiences with medical students undertaking urban community-based, longitudinal clinical placements in the early years of medical training. Methods Year 2 medical students spent a half-day per week in general practice for either 13 or 26 weeks. Transcribed semi-structured interviews from a convenience sample of participating GPs were thematically analysed by two researchers, using a general inductive approach. Results Identified themes related to the attributes of participating persons and organisations: GPs, students, patients, practices and their supporting institution; GPs' perceptions of student development; and triggers enhancing the experience. A model was developed to reflect these themes. Conclusions Training experiences were enhanced for GPs supervising medical students in early longitudinal clinical placements by the synergy of motivated students and keen teachers with support from patients, practice staff and academic institutions. We developed an explanatory model to better understand the mechanism of positive experiences. Understanding the interaction of factors enhancing teaching satisfaction is important for clinical disciplines wishing to maintain sustainable, high quality teaching.

Determinants of physician empathy during medical education: hypothetical conclusions from an exploratory qualitative survey of practicing physicians

Science.gov (United States)

2014-01-01

Background Empathy is an outcome-relevant physician characteristic and thus a crucial component of high-quality communication in health care. However, the factors that promote and inhibit the development of empathy during medical education have not been extensively researched. Also, currently there is no explicit research on the perspective of practicing physicians on the subject. Therefore the aim of our study was to explore physicians’ views of the positive and negative influences on the development of empathy during their medical education, as well as in their everyday work as physicians. Method We administered a written Qualitative Short Survey to 63 physicians in seven specialties. They were able to respond anonymously. Our open-ended question was: “What educational content in the course of your studies and/or your specialist training had a positive or negative effect on your empathy?” We analyzed the data using thematic content analysis following Mayring’s approach. Results Forty-two physicians took part in our survey. All together, they mentioned 68 specific factors (37 positive, 29 negative, 2 neutral) from which six themes emerged: 1. In general, medical education does not promote the development of empathy. 2. Recognizing the psycho-social dimensions of care fosters empathy. 3. Interactions with patients in medical practice promote empathy. 4. Physicians’ active self-development through reflective practice helps the development of empathy. 5. Interactions with colleagues can both promote and inhibit empathy through their role modeling of empathic and non-empathic behavior. 6. Stress, time pressure, and adverse working conditions are detrimental to empathy development. Conclusions Our results provide an overview of what might influence the development of clinical empathy, as well as hypothetical conclusions about how to promote it. Reflective practice seems to be lacking in current medical curricula and could be incorporated. Raising physicians�

Medical social work practice in child protection in China: A multiple case study in Shanghai hospitals.

Science.gov (United States)

Zhao, Fang; Hämäläinen, Juha; Chen, Yu-Ting

2017-01-01

With the rapid development of the child welfare system in China over recent years, medical social work has been increasingly involved in providing child protection services in several hospitals in Shanghai. Focusing on five cases in this paper, the exploratory study aims to present a critical overview of current practices and effects of medical social work for child protection, based on a critical analysis of the multidimensional role of social work practitioners engaged in the provision of child protection services as well as potential challenges. Implications and suggestions for future improvements of China's child protection system are also discussed.

The pattern of trauma in private general medical practice set-up Port ...

African Journals Online (AJOL)

BACKGROUND: Private general medical practice establishments appear to be treating a significant number of trauma cases including more serious ones. Aim: To find out the extent of such treatment of trauma and what has made this possible. METHODS: All trauma cases treated in a private general medical practice set up ...

Sleep Hygiene Practices and Their Relation to Sleep Quality in Medical Students of Qazvin University of Medical Sciences

Directory of Open Access Journals (Sweden)

Zohreh Yazdi

2016-01-01

Full Text Available Introduction: Poor quality of sleep is a distressing and worrying condition that can disturb academic performance of medical students. Sleep hygiene practices are one of the important variables that affect sleep quality. The objective of this study was to assess association between sleep hygiene practices and sleep quality of medical students in Qazvin University of Medical Sciences. Methods: In this descriptive-correlational study, a total of 285 medical students completed a self-administered questionnaire. Demographic data, sleep-wake schedule in weekday and weekend, and sleep duration were collected. Students' sleep quality was assessed by Pittsburg Sleep Quality Index (PSQI. Data were analyzed by SPSS Ver 13. Results: Overall, 164 (57.5 of students had poor sleep quality. Mean global PSQI score and average score of four subscales were significantly higher in male than female. Regression analysis showed that male students (β=-0.85, P<0.05, students at senior level (β=-0.81, P<0.05, married students (β=-0.45, P<0.05, and those with improper sleep hygiene practices slept worse. Conclusion: The findings of this study showed that the prevalence of poor sleep quality in medical students is high. Improper sleep hygiene behaviors might be a reason for poor quality of sleep in medical students.

AAPM medical physics practice guideline 6.a.: Performance characteristics of radiation dose index monitoring systems.

Science.gov (United States)

Gress, Dustin A; Dickinson, Renee L; Erwin, William D; Jordan, David W; Kobistek, Robert J; Stevens, Donna M; Supanich, Mark P; Wang, Jia; Fairobent, Lynne A

2017-07-01

The American Association of Physicists in Medicine (AAPM) is a nonprofit professional society whose primary purposes are to advance the science, education and professional practice of medical physics. The AAPM has more than 8,000 members and is the principal organization of medical physicists in the United States. The AAPM will periodically define new practice guidelines for medical physics practice to help advance the science of medical physics and to improve the quality of service to patients throughout the United States. Existing medical physics practice guidelines will be reviewed for the purpose of revision or renewal, as appropriate, on their fifth anniversary or sooner. Each medical physics practice guideline represents a policy statement by the AAPM, has undergone a thorough consensus process in which it has been subjected to extensive review, and requires the approval of the Professional Council. The medical physics practice guidelines recognize that the safe and effective use of diagnostic and therapeutic radiology requires specific training, skills, and techniques, as described in each document. Reproduction or modification of the published practice guidelines and technical standards by those entities not providing these services is not authorized. The following terms are used in the AAPM practice guidelines: •Must and Must Not: Used to indicate that adherence to the recommendation is considered necessary to conform to this practice guideline. •Should and Should Not: Used to indicate a prudent practice to which exceptions may occasionally be made in appropriate circumstances. © 2017 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine.

Getting ready for identity theft rules: creating a prevention program for your medical practice.

Science.gov (United States)

Cascardo, Debra

2009-01-01

Identity theft worries have found their way into medical practices. By August 1, 2009, all "creditors" must have a written program to prevent, detect, and minimize damage from identity theft. Any medical practice that bills patients is considered a creditor. Like HIPAA, these new Red Flag guidelines will serve to protect your practice from lawsuits as well as protect your patients from identity theft of their financial, personal, and medical information.

Remediation in Canadian medical residency programs: Established and emerging best practices.

Science.gov (United States)

Shearer, Cindy; Bosma, Mark; Bergin, Fiona; Sargeant, Joan; Warren, Andrew

2018-02-23

Policies to guide remediation in postgraduate medical education exist in all Canadian medical schools. This study examines concordance between these policies and processes, and published "best practices" in remediation. We conducted a literature review to identify best practices in the area of remediation. We then reviewed remediation policies from all 13 English medical schools in Canada other than our own and conducted interviews with key informants from each institution. Each policy and interview transcript pair was then reviewed for evidence of pre-defined "best practices." Team members also noted additional potential policy or process enablers of successful remediation. Most policies and processes aligned with some but not all published best practices. For instance, all participating schools tailored remediation strategies to individual resident needs, and a majority encouraged faculty-student relationships during remediation. Conversely, few required the teaching of goal-setting, strategic planning, self-monitoring, and self-awareness. In addition, we identified avoidance of automatic training extension and the use of an educational review board to support the remediation process as enablers for success. Remediation policies and practices in Canada align well with published best practices in this area. Based on key informant opinions, flexibility to avoid training extension and use of an educational review board may also support optimal remediation outcomes.

Perspectives on the changing healthcare system: teaching systems-based practice to medical residents

Directory of Open Access Journals (Sweden)

Johanna Martinez

2013-09-01

Full Text Available Purpose: The Accreditation Council for Graduate Medical Education restructured its accreditation system to be based on educational outcomes in six core competencies. Systems-based practice is one of the six core competencies. The purpose of this report is to describe Weill Cornell Medical College's Internal Medicine Residency program curriculum for systems-based practice (SBP and its evaluation process. Methods: To examine potential outcomes of the POCHS curriculum, an evaluation was conducted, examining participants': (1 knowledge gain; (2 course ratings; and (3 qualitative feedback. Results: On average, there was a 19 percentage point increase in knowledge test scores for all three cohorts. The course was rated overall highly, receiving an average of 4.6 on a 1–5 scale. Lastly, the qualitative comments supported that the material is needed and valued. Conclusion: The course, entitled Perspectives on the Changing Healthcare System (POCHS and its evaluation process support that systems-based practice is crucial to residency education. The course is designed not only to educate residents about the current health care system but also to enable them to think critically about the risk and benefits of the changes. POCHS provides a framework for teaching and assessing this competency and can serve as a template for other residency programs looking to create or restructure their SBP curriculum.

Good Publication Practice for Communicating Company-Sponsored Medical Research: GPP3.

Science.gov (United States)

Battisti, Wendy P; Wager, Elizabeth; Baltzer, Lise; Bridges, Dan; Cairns, Angela; Carswell, Christopher I; Citrome, Leslie; Gurr, James A; Mooney, LaVerne A; Moore, B Jane; Peña, Teresa; Sanes-Miller, Carol H; Veitch, Keith; Woolley, Karen L; Yarker, Yvonne E

2015-09-15

This updated Good Publication Practice (GPP) guideline, known as GPP3, builds on earlier versions and provides recommendations for individuals and organizations that contribute to the publication of research results sponsored or supported by pharmaceutical, medical device, diagnostics, and biotechnology companies. The recommendations are designed to help individuals and organizations maintain ethical and transparent publication practices and comply with legal and regulatory requirements. These recommendations cover publications in peer-reviewed journals and presentations (oral or poster) at scientific congresses. The International Society for Medical Publication Professionals invited more than 3000 professionals worldwide to apply for a position on the steering committee, or as a reviewer, for this guideline. The GPP2 authors reviewed all applications (n = 241) and assembled an 18-member steering committee that represented 7 countries and a diversity of publication professions and institutions. From the 174 selected reviewers, 94 sent comments on the second draft, which steering committee members incorporated after discussion and consensus. The resulting guideline includes new sections (Principles of Good Publication Practice for Company-Sponsored Medical Research, Data Sharing, Studies That Should Be Published, and Plagiarism), expands guidance on the International Committee of Medical Journal Editors' authorship criteria and common authorship issues, improves clarity on appropriate author payment and reimbursement, and expands information on the role of medical writers. By following good publication practices (including GPP3), individuals and organizations will show integrity; accountability; and responsibility for accurate, complete, and transparent reporting in their publications and presentations.

[VR and AR Applications in Medical Practice and Education].

Science.gov (United States)

Hsieh, Min-Chai; Lin, Yu-Hsuan

2017-12-01

As technology advances, mobile devices have gradually turned into wearable devices. Furthermore, virtual reality (VR), augmented reality (AR), and mixed reality (MR) are being increasingly applied in medical fields such as medical education and training, surgical simulation, neurological rehabilitation, psychotherapy, and telemedicine. Research results demonstrate the ability of VR, AR, and MR to ameliorate the inconveniences that are often associated with traditional medical care, reduce incidents of medical malpractice caused by unskilled operations, and reduce the cost of medical education and training. What is more, the application of these technologies has enhanced the effectiveness of medical education and training, raised the level of diagnosis and treatment, improved the doctor-patient relationship, and boosted the efficiency of medical execution. The present study introduces VR, AR, and MR applications in medical practice and education with the aim of helping health professionals better understand the applications and use these technologies to improve the quality of medical care.

Medical homes: challenges in translating theory into practice.

Science.gov (United States)

Carrier, Emily; Gourevitch, Marc N; Shah, Nirav R

2009-07-01

The concept of the medical home has existed since the 1960s, but has recently become a focus for discussion and innovation in the health care system. The most prominent definitions of the medical home are those presented by the Patient-Centered Primary Care Collaborative, the National Committee for Quality Assurance, and the Commonwealth Fund. These definitions share: adoption of health information technology and decision support systems, modification of clinical practice patterns, and ensuring continuity of care. Each of these components is a complex undertaking, and there is scant evidence to guide assessment of diverse strategies for achieving their integration into a medical home. Without a shared vocabulary and common definitions, policy-makers seeking to encourage the development of medical homes, providers seeking to improve patient care, and payers seeking to develop appropriate systems of reimbursement will face challenges in evaluating and disseminating the medical home model.

Anaesthetic specialist registrars in Ireland: current teaching practices and perceptions of their role as undergraduate teachers.

LENUS (Irish Health Repository)

Walsh, K

2012-02-03

BACKGROUND AND OBJECTIVES: Teaching is an important responsibility of non-consultant hospital doctors. In Ireland, specialist registrars (SpRs) in anaesthesia are contractually obliged to teach medical students, other doctors and nurses. Both medical students and fellow non-consultant hospital doctors attribute between 30 and 40% of their knowledge gain to non-consultant hospital doctors. METHODS: We carried out a confidential telephone survey of anaesthetic SpRs in Ireland regarding their current teaching practices and the perceptions of their role as undergraduate teachers. All the SpRs currently working in clinical practice in Ireland were eligible. RESULTS: Fifty-five of the 79 (70%) SpRs responded to the questionnaire. Only 7 (12.7%) of the respondents said they had been well trained as a teacher. The majority of the respondents stated that they would attend a learning-to-teach course\\/workshop if one was available, and felt that such a course would improve their ability as a teacher. Only 8 (14.5%) agreed that adequate emphasis is placed on commitment to teaching in the assessment of SpRs, both by individual departments and by the College of Anaesthetists. Anaesthetic SpRs in Ireland spend a considerable amount of time each day teaching undergraduate medical students, the majority (68.9%) stated that they had inadequate time to prepare for teaching. CONCLUSION: The majority of the respondents stated that they enjoy teaching, feel that they play an important role in undergraduate teaching but have inadequate time to prepare for teaching. An adequate emphasis is not placed on their commitment to teaching.

Innovation in Indigenous Health and Medical Education: The Leaders in Indigenous Medical Education (LIME) Network as a Community of Practice.

Science.gov (United States)

Mazel, Odette; Ewen, Shaun

2015-01-01

The Leaders in Indigenous Medical Education (LIME) Network aims to improve the quality and effectiveness of Indigenous health in medical education as well as best practice in the recruitment, retention, and graduation of Indigenous medical students. In this article we explore the utility of Etienne Wenger's "communities of practice" (CoP) concept in providing a theoretical framework to better understand the LIME Network as a form of social infrastructure to further knowledge and innovation in this important area of health care education reform. The Network operates across all medical schools in Australia and New Zealand. Utilizing a model of evaluation of communities of practice developed by Fung-Kee-Fung et al., we seek to analyze the outcomes of the LIME Network as a CoP and assess its approach and contribution to improving the implementation of Indigenous health in the medical curriculum and the graduation of Indigenous medical students. By reflecting on the Network through a community of practice lens, this article highlights the synthesis between the LIME Network and Wenger's theory and provides a framework with which to measure Network outputs. It also posits an opportunity to better capture the impact of Network activities into the future to ensure that it remains a relevant and sustainable entity.

The Current Status of Medical Marijuana in the United States

OpenAIRE

McKenna, Gerald J

2014-01-01

Medical marijuana is currently a controversial issue in medicine. There are strong pro and con opinions but relatively little scientific data on which to base medical decisions. The unfortunate scheduling of marijuana in class I has limited research and only serves to fuel the controversy.

Current thinking in medical education research: an overview.

Science.gov (United States)

Elledge, R

2018-04-28

Medical education is fast becoming a separate focus, and together with their clinical commitments, many clinicians now seek higher qualifications and professional accreditation in the field. Research is also developing, and there is a need for evidence-based practice in education, just as in clinical work. This review gives an overview of research into medical education, and explains the fundamentals of educational theory and the specific considerations for the quantitative and qualitative research methods that pertain to it. It also explains the application of these methods to two growing areas of research: technology-enhanced learning (TEL) and normative ethics in training. Copyright © 2018 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Playing in the "Gutter": Cultivating Creativity in Medical Education and Practice.

Science.gov (United States)

Liou, Kevin T; Jamorabo, Daniel S; Dollase, Richard H; Dumenco, Luba; Schiffman, Fred J; Baruch, Jay M

2016-03-01

In comics, "gutters" are the empty spaces between panels that readers must navigate to weave disjointed visual sequences into coherent narratives. A gutter, however, is more than a blank space--it represents a creative zone for making connections and for constructing meaning from disparate ideas, values, and experiences. Over the course of medical training, learners encounter various "gutters" created by the disconnected subject blocks and learning experiences within the curriculum, the ambiguity and uncertainty of medical practice, and the conflicts and tensions within clinical encounters. Navigating these gutters requires not only medical knowledge and skills but also creativity, defined as the ability to make connections between disparate fragments to create meaningful, new configurations. To cultivate medical students' creative capacity, the authors developed the Integrated Clinical Arts (ICA) program, a required component of the first-year curriculum at the Warren Alpert Medical School of Brown University. ICA workshops are designed to place students in a metaphorical gutter, wherein they can practice making connections between medicine and arts-based disciplines. By playing in the gutter, students have opportunities to broaden their perspectives, gain new insights into both medical practice and themselves, and explore different ways of making meaning. Student feedback on the ICA program highlights an important role for creativity and the arts in medicine: to transform gutters from potential learning barriers into opportunities for discovery, self-reflection, and personal growth.

Current and future medical treatments for patients with acromegaly.

Science.gov (United States)

Maffezzoni, Filippo; Formenti, Anna Maria; Mazziotti, Gherardo; Frara, Stefano; Giustina, Andrea

2016-08-01

Acromegaly is a relatively rare condition of growth hormone (GH) excess associated with significant morbidity and, when left untreated, high mortality. Therapy for acromegaly is targeted at decreasing GH and insulin-like growth hormone 1 levels, ameliorating patients' symptoms and decreasing any local compressive effects of the pituitary adenoma. The therapeutic options for acromegaly include surgery, medical therapies (such as dopamine agonists, somatostatin receptor ligands and the GH receptor antagonist pegvisomant) and radiotherapy. However, despite all these treatments option, approximately 50% of patients are not adequately controlled. In this paper, the authors discuss: 1) efficacy and safety of current medical therapy 2) the efficacy and safety of the new multireceptor-targeted somatostatin ligand pasireotide 3) medical treatments currently under clinical investigation (oral octreotide, ITF2984, ATL1103), and 4) preliminary data on the use of new injectable and transdermal/transmucosal formulations of octreotide. This expert opinion supports the need for new therapeutic agents and modalities for patients with acromegaly.

[Birth and succession of a current of learning in Korean medicine: the supporting yang current of learning].

Science.gov (United States)

Oh, Chaekun

2014-04-01

In this study, I aim to reveal how Lee Gyoojoons medicine has given birth to a current of learning, the supporting yang current of learning, and describe its historical significance. Before anything, I'd like to throw the question of whether if there were any currents within the traditional Korean medicine. There are no records of medical currents being widely discussed until now in medical history of Korea; however, the current of Lee Jema's sasang medicine is the most noticeable one. Among the contemporaries of Lee Jema, during the late Chosun, there was also another famed medical practitioner called Lee Gyoojoon. Lee Gyoojoon mainly practiced his medicine within Pohang, Gyeongsangbuk-do area, his apprentices have formed a group and have succeeded his medical practice. Based on the analyses of Lee Gyoojoon's apprentices and the Somun Oriental Medical Society, which is known as a successor group to Lee Gyoojoon's medicine today, they are fully satisfying the five requirements to establish a medical current: first, they held Lee Gyoojoon as the first and foremost, representative practitioner of their current; second, they advocate the supporting yang theory suggested by Lee Gyoojoon, which is originated from his theory of Mind; third, books such as the Major Essentials of Huangdi's Internal Classic Plain Questions, and the Double Grinded Medical Mirror, were being used as the main textbooks to educate their students or to practice medicine. Fourth, Lee Gyoojoon's medical ideas were being transcended quite clearly within his group of apprentices, including Seo Byungoh, Lee Wonse, and the Somun Oriental Medical Society. Fifth, Lee Gyoojoon's apprentices were first produced through the Sukgok School, however, nowadays they are being produced through medical groups formed by Lee Wonse, the Somun Oriental Medical Society, regarding the propagation of medical theories, compilation of textbooks, publication of academic journals, etc. Then, what do the existence of the

[Medical professionals on the subject of their core values: the importance of practice-based stories and intrinsic motivation].

Science.gov (United States)

Witman, Yolande; van den Kerkhof, Peter C M; Braat, Didi D M

2013-01-01

In the current system for guaranteeing quality of care, emphasis is placed firmly on external control of professionals. We looked for a way to appeal to the intrinsic motivation of medical professionals and to discover what they mean by 'good work'. This was achieved with the aid of reflective sessions using the toolkit 'Good Work': in four sessions three different groups of medical professionals (medical department chairs, residents and interns) from a Dutch university hospital reflected on the topics 'excellence', 'moral responsibility' and 'personal engagement'. The participants exchanged practice-based stories during the sessions. The most important theme was moral responsibility, with its accompanying dilemmas. The sessions gave rise to feelings of mutual acknowledgement, recognition, inspiration and motivation. Sharing meaningful practice-based stories can be considered as a 'moment of learning', strengthening professional identity and stimulating intrinsic motivation. More space for this form of reflection might restore the balance with external control systems.

The integration of Information and Communication Technology into medical practice.

Science.gov (United States)

Lupiáñez-Villanueva, Francisco; Hardey, Michael; Torrent, Joan; Ficapal, Pilar

2010-07-01

To identify doctors' utilization of ICT; to develop and characterise a typology of doctors' utilization of ICT and to identify factors that can enhance or inhibit the use of these technologies within medical practice. An online survey of the 16,531 members of the Physicians Association of Barcelona who had a registered email account in 2006 was carried out. Factor analysis, cluster analysis and binomial logit model were undertaken. Multivariate statistics analysis of the 2199 responses obtained revealed two profiles of adoption of ICT. The first profile (38.61% of respondents) represents those doctors who place high emphasis on ICT within their practice. This group is thus referred to as 'integrated doctors'. The second profile (61.39% of respondents) represents those doctors who make less use of ICT so are consequently labelled 'non-integrated doctors'. From the statistical modelling, it was observed that an emphasis on international information; emphasis on ICT for research and medical practice; emphasis on information systems to consult and prescribe; undertaking teaching/research activities; a belief that the use of the Internet improved communication with patients and practice in both public and private health organizations play a positive and significant role in the probability of being an 'integrated doctor'. The integration of ICT within medical practice cannot be adequately understood and appreciated without examining how doctors are making use of ICT within their own practice, organizational contexts and the opportunities and constraints afforded by institutional, professional and patient expectations and demands. 2010 Elsevier Ireland Ltd. All rights reserved.

Assessing the Perceptions and Practice of Self-Medication among Bangladeshi Undergraduate Pharmacy Students

Directory of Open Access Journals (Sweden)

Md. Omar Reza Seam

2018-01-01

Full Text Available Objectives: To evaluate the perceptions and extent of practicing self-medication among undergraduate pharmacy students. Methods: This cross-sectional, questionnaire-based study was conducted over a six month period (January to June 2016 among undergraduate pharmacy students in five reputable public universities of Bangladesh. It involved face-to-face interviews regarding self-medication of 250 respondents selected by simple random sampling. Results: Self-medication was reported by 88.0% of students. Antipyretics (58.40% were mostly preferred for the treatment of fever and headaches. The major cause for self-medication was minor illness (59.60%, p = 0.73 while previous prescriptions were the main source of knowledge as well as the major factor (52.80%, p = 0.94 dominating the self-medication practice. The results also demonstrated 88.80% of students had previous knowledge on self-medication and 83.60% of students always checked the information on the label; mainly the expiry date before use (85.60%. A significant (p < 0.05 portion of the students (51% male and 43% female perceived it was an acceptable practice as they considered self-medication to be a segment of self-care. Furthermore, students demonstrated differences in their response level towards the adverse effect of drugs, the health hazard by a higher dose of drug, a physician’s help in case of side effects, taking medicine without proper knowledge, and stopping selling medicine without prescription. Conclusions: Self-medication was commonly used among pharmacy students primarily for minor illnesses using over-the-counter medications. Although it is an inevitable practice for them it should be considered an important public health problem as this practice may increase the misuse or irrational use of medicines.

Clinical exome sequencing reports: current informatics practice and future opportunities.

Science.gov (United States)

Swaminathan, Rajeswari; Huang, Yungui; Astbury, Caroline; Fitzgerald-Butt, Sara; Miller, Katherine; Cole, Justin; Bartlett, Christopher; Lin, Simon

2017-11-01

The increased adoption of clinical whole exome sequencing (WES) has improved the diagnostic yield for patients with complex genetic conditions. However, the informatics practice for handling information contained in whole exome reports is still in its infancy, as evidenced by the lack of a common vocabulary within clinical sequencing reports generated across genetic laboratories. Genetic testing results are mostly transmitted using portable document format, which can make secondary analysis and data extraction challenging. This paper reviews a sample of clinical exome reports generated by Clinical Laboratory Improvement Amendments-certified genetic testing laboratories at tertiary-care facilities to assess and identify common data elements. Like structured radiology reports, which enable faster information retrieval and reuse, structuring genetic information within clinical WES reports would help facilitate integration of genetic information into electronic health records and enable retrospective research on the clinical utility of WES. We identify elements listed as mandatory according to practice guidelines but are currently missing from some of the clinical reports, which might help to organize the data when stored within structured databases. We also highlight elements, such as patient consent, that, although they do not appear within any of the current reports, may help in interpreting some of the information within the reports. Integrating genetic and clinical information would assist the adoption of personalized medicine for improved patient care and outcomes. © The Author 2017. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Market factors and electronic medical record adoption in medical practices.

Science.gov (United States)

Menachemi, Nir; Mazurenko, Olena; Kazley, Abby Swanson; Diana, Mark L; Ford, Eric W

2012-01-01

Previous studies identified individual or practice factors that influence practice-based physicians' electronic medical record (EMR) adoption. Less is known about the market factors that influence physicians' EMR adoption. The aim of this study was to explore the relationship between environmental market characteristics and physicians' EMR adoption. The Health Tracking Physician Survey 2008 and Area Resource File (2008) were combined and analyzed. Binary logistic regression was used to examine the relationship between three dimensions of the market environment (munificence, dynamism, and complexity) and EMR adoption controlling for several physician and practice characteristics. In a nationally representative sample of 4,720 physicians, measures of market dynamism including increases in unemployment, odds ratio (OR) = 0.95, 95% confidence interval (CI) [0.91, 0.99], or poverty rates, OR = 0.93, 95% CI [0.89, 0.96], were negatively associated with EMR adoption. Health maintenance organization penetration, OR = 3.01, 95% CI [1.49, 6.05], another measure of dynamism, was positively associated with EMR adoption. Physicians practicing in areas with a malpractice crisis, OR = 0.82, 95% CI [0.71, 0.94], representing environmental complexity, had lower EMR adoption rates. Understanding how market factors relate to practice-based physicians' EMR adoption can assist policymakers to better target limited resources as they work to realize the national goal of universal EMR adoption and meaningful use.

Literary and Documentary Evidence for Lay Medical Practice in the Roman Republic and Empire.

Science.gov (United States)

Draycott, Jane

2016-01-01

The majority of surviving ancient medical literature was written by medical practitioners and produced for the purpose of ensuring the effective diagnosis and treatment of their patients, suggesting an audience of medical professionals ranging from instructors to students. This has led historians to concentrate on the professional medical practitioner and their theories, methods and practices, rather than on lay medical practitioners, or even patients themselves. This chapter seeks to redress this imbalance, and examine the ancient literary and documentary evidence for lay medical theories, methods and practices in the Roman Republic and Empire in an attempt to reconstruct the experiences of lay medical practitioners and their patients. The Roman agricultural treatises of Cato, Varro and Columella, papyri and ostraca from Egypt, and tablets from Britain are investigated, and it is established that the individual's personal acquisition of knowledge and expertise, not only from medical professionals and works of medical literature, but also from family members and friends, and through trial and error, was considered fundamental to domestic medical practice.

Perception and practice of self-medication with over-the-counter ...

African Journals Online (AJOL)

Background: Although over-the-counter (OTC) analgesics increase access to and ease of medication, they are a major contributor to irrational use of medicines worldwide.This study assessed perception and practice of self-medication with OTC analgesics among students of Federal College of Education,Zaria. Method: It ...

Factors that affect general practice as a choice of medical speciality: implications for policy development.

Science.gov (United States)

Vohra, Amit; Ladyshewsky, Richard; Trumble, Stephen

2017-11-28

Objective This article critically appraises the range of personal, professional and social factors that affect the choice of speciality across medical students, prevocational doctors, general practice registrars and general practitioners. Methods This qualitative study applied constructs from the fields of decision theory and career theory to better understand the complex nature of choosing a speciality. In all, 47 in-depth interviews were conducted with participants at different stages of their career cycle. The data was codified and analysed using NVivo to identify key factors that influenced speciality choice. Results The research identified 77 individual findings influencing general practice as a choice of medical speciality. These were distilled into a matrix to show that factors such as money, prestige and peer interaction did not have a compelling effect, whereas clinical and academic role models, flexibility, work-life balance, scope of practice, connection with patients, training environment and practical opportunities did. Conclusion The findings indicate that the decision in relation to the choice of medical speciality is a complex cognitive process that is undertaken within a personal, social and professional context particular to each individual. What is known about the topic? Current literature aims to quantify changes in attitudes towards choice of speciality or the effect of particular variables in isolation while ignoring the complexity of this decision process and how the numerous variables compare with each other. What does this paper add? The present study is the first intergenerational research on this topic in the Australian context and the paper dismisses the role of prestige and remuneration as key drivers of choice in picking general practice as a speciality, noting that money is merely a 'hygiene factor'. What are the implications for policy makers? A policy framework outlining 10 key principles is presented to assist policy makers seeking

First trimester medication abortion practice in the United States and Canada.

Directory of Open Access Journals (Sweden)

Heidi E Jones

Full Text Available We conducted a cross-sectional survey of abortion facilities from professional networks in the United States (US, n = 703 and Canada (n = 94 to estimate the prevalence of medication abortion practices in these settings and to look at regional differences. Administrators responded to questions on gestational limits, while up to five clinicians per facility reported on 2012 medication abortion practice. At the time of fielding, mifepristone was not approved in Canada. 383 (54.5% US and 78 (83.0% Canadian facilities participated. In the US, 95.3% offered first trimester medication abortion compared to 25.6% in Canada. While 100% of providers were physicians in Canada, just under half (49.4% were advanced practice clinicians in the US, which was more common in Eastern and Western states. All Canadian providers used misoprostol; 85.3% with methotrexate. 91.4% of US providers used 200 mg of mifepristone and 800 mcg of misoprostol, with 96.7% reporting home misoprostol administration. More than three-quarters of providers in both countries required an in-person follow-up visit, generally with ultrasound. 87.7% of US providers routinely prescribed antibiotics compared to 26.2% in Canada. Nonsteroidal anti-inflammatory drugs were the most commonly reported analgesic, with regional variation in opioid narcotic prescription. In conclusion, medication abortion practice follows evidence-based guidelines in the US and Canada. Efforts to update practice based on the latest evidence for reducing in-person visits and increasing provision by advanced practice clinicians could strengthen these services and reduce barriers to access. Research is needed on optimal antibiotic and analgesic use.

CORRUPTION IN MEDICAL PRACTICE: WHERE DO WE STAND?

Science.gov (United States)

Yousafzai, Abdul Wahab

2015-01-01

Corruption in health care sector affects all countries, including the United States, China and India. Pakistan is no exception. It is preventing people from having access to the quality medical care. Corruption in medical practice include ordering unnecessary investigations, and procedures for kickbacks and commissions; significant absenteeism, which adversely affects patient care; and the conflict of interest within the physician-pharmaceutical nexus, which exploits patients. To overcome corruption there is need to establish a framework for accountability, eliminating the physician-pharmaceutical nexus; and emphasizing medical ethics at the undergraduate and postgraduate levels. It is also important to open a dialogue amongst health care professionals and encourage the establishment of an ethical health care system in Pakistan.

The Institute for Safe Medication Practices and Poison Control Centers: Collaborating to Prevent Medication Errors and Unintentional Poisonings.

Science.gov (United States)

Vaida, Allen J

2015-06-01

This article provides an overview on the Institute for Safe Medication Practices (ISMP), the only independent nonprofit organization in the USA devoted to the prevention of medication errors. ISMP developed the national Medication Errors Reporting Program (MERP) and investigates and analyzes errors in order to formulate recommendations to prevent further occurrences. ISMP works closely with the US Food and Drug Administration (FDA), drug manufacturers, professional organizations, and others to promote changes in package design, practice standards, and healthcare practitioner and consumer education. By collaborating with ISMP to share and disseminate information, Poison Control centers, emergency departments, and toxicologists can help decrease unintentional and accidental poisonings.

ADHD medication prescription: effects of child, sibling, parent and general practice characteristics.

NARCIS (Netherlands)

Heins, M.J.; Bruggers, I.; Dijk, L. van; Korevaar, J.C.

2016-01-01

Many children receive attention-deficit hyperactivity disorder (ADHD) medication, but factors that determine medication prescription are largely unknown. This study aimed to determine the relative impact of factors on the child, family and general practitioner (GP) practice level on ADHD medication

Figures in clinical trial reports: current practice & scope for improvement.

Science.gov (United States)

Pocock, Stuart J; Travison, Thomas G; Wruck, Lisa M

2007-11-19

Most clinical trial publications include figures, but there is little guidance on what results should be displayed as figures and how. To evaluate the current use of figures in Trial reports, and to make constructive suggestions for future practice. We surveyed all 77 reports of randomised controlled trials in five general medical journals during November 2006 to January 2007. The numbers and types of figures were determined, and then each Figure was assessed for its style, content, clarity and suitability. As a consequence, guidelines are developed for presenting figures, both in general and for each specific common type of Figure. Most trial reports contained one to three figures, mean 2.3 per article. The four main types were flow diagram, Kaplan Meier plot, Forest plot (for subgroup analyses) and repeated measures over time: these accounted for 92% of all figures published. For each type of figure there is a considerable diversity of practice in both style and content which we illustrate with selected examples of both good and bad practice. Some pointers on what to do, and what to avoid, are derived from our critical evaluation of these articles' use of figures. There is considerable scope for authors to improve their use of figures in clinical trial reports, as regards which figures to choose, their style of presentation and labelling, and their specific content. Particular improvements are needed for the four main types of figures commonly used.

Figures in clinical trial reports: current practice & scope for improvement

Directory of Open Access Journals (Sweden)

Travison Thomas G

2007-11-01

Full Text Available Abstract Background Most clinical trial publications include figures, but there is little guidance on what results should be displayed as figures and how. Purpose To evaluate the current use of figures in Trial reports, and to make constructive suggestions for future practice. Methods We surveyed all 77 reports of randomised controlled trials in five general medical journals during November 2006 to January 2007. The numbers and types of figures were determined, and then each Figure was assessed for its style, content, clarity and suitability. As a consequence, guidelines are developed for presenting figures, both in general and for each specific common type of Figure. Results Most trial reports contained one to three figures, mean 2.3 per article. The four main types were flow diagram, Kaplan Meier plot, Forest plot (for subgroup analyses and repeated measures over time: these accounted for 92% of all figures published. For each type of figure there is a considerable diversity of practice in both style and content which we illustrate with selected examples of both good and bad practice. Some pointers on what to do, and what to avoid, are derived from our critical evaluation of these articles' use of figures. Conclusion There is considerable scope for authors to improve their use of figures in clinical trial reports, as regards which figures to choose, their style of presentation and labelling, and their specific content. Particular improvements are needed for the four main types of figures commonly used.

Assessment of Nature, Reasons, and Consequences of Self-medication Practice among General Population of Ras Al-Khaimah, UAE.

Science.gov (United States)

Sridhar, Sathvik B; Shariff, Atiqulla; Dallah, Lana; Anas, Doaa; Ayman, Maryam; Rao, Padma Gm

2018-01-01

The aim of this study is to assess the nature, reasons, and consequences of self-medication practice among the general population of Ras Al-Khaimah, UAE. This was a prospective, cross-sectional, survey-based study. Data with respect to knowledge, awareness, and practices regarding self-medication were collected through an interviewer-assisted questionnaire answered by the study participants. Thus, collected data from 413 survey respondents were analyzed using SPSS version 24.0. The prevalence of self-medication practices among our study respondents was 52.1%. A headache (155 [37.5%]) was the most common clinical condition treated through self-medication practice. Familiarity with the treatment/medication (198 [48%]) was the most common cited reasons, whereas the advertisement and friend's advice were the most (182 [44%]) cited sources of information for self-medication usage. The majority (265 [64.1%]) of the respondents were considered self-medication practice as safe. However, 19 respondents reported side-effects or complications during the due course of self-medication. It was observed that there is a statistically significant association ( P employment status of this study participants with self-medication practices. The data from this study show that the self-medication practice is very common among the study population. Variables such as younger age group and occupation status were significantly associated with self-medication practice. We emphasize the role of pharmacist in educating the community regarding safe medication practices such as harmful effects of self-medicating and inappropriate practices such as sharing the medications among family members and friends.

[A non-classical approach to medical practices: Michel Foucault and Actor-Network Theory].

Science.gov (United States)

Bińczyk, E

2001-01-01

The text presents an analysis of medical practices stemming from two sources: Michel Foucault's conception and the research of Annemarie Mol and John Law, representatives of a trend known as Actor-Network Theory. Both approaches reveal significant theoretical kinship: they can be successfully consigned to the framework of non-classical sociology of science. I initially refer to the cited conceptions as a version of non-classical sociology of medicine. The identity of non-classical sociology of medicine hinges on the fact that it undermines the possibility of objective definitions of disease, health and body. These are rather approached as variable social and historical phenomena, co-constituted by medical practices. To both Foucault and Mol the main object of interest was not medicine as such, but rather the network of medical practices. Mol and Law sketch a new theoretical perspective for the analysis of medical practices. They attempt to go beyond the dichotomous scheme of thinking about the human body as an object of medical research and the subject of private experience. Research on patients suffering blood-sugar deficiency provide the empirical background for the thesis of Actor-Network Theory representatives. Michel Foucault's conceptions are extremely critical of medical practices. The French researcher describes the processes of 'medicalising' Western society as the emergence of a new type of power. He attempts to sensitise the reader to the ethical dimension of the processes of medicalising society.

Clinical Practice Guideline: Safe Medication Use in the ICU.

Science.gov (United States)

Kane-Gill, Sandra L; Dasta, Joseph F; Buckley, Mitchell S; Devabhakthuni, Sandeep; Liu, Michael; Cohen, Henry; George, Elisabeth L; Pohlman, Anne S; Agarwal, Swati; Henneman, Elizabeth A; Bejian, Sharon M; Berenholtz, Sean M; Pepin, Jodie L; Scanlon, Mathew C; Smith, Brian S

2017-09-01

To provide ICU clinicians with evidence-based guidance on safe medication use practices for the critically ill. PubMed, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, CINAHL, Scopus, and ISI Web of Science for relevant material to December 2015. Based on three key components: 1) environment and patients, 2) the medication use process, and 3) the patient safety surveillance system. The committee collectively developed Population, Intervention, Comparator, Outcome questions and quality of evidence statements pertaining to medication errors and adverse drug events addressing the key components. A total of 34 Population, Intervention, Comparator, Outcome questions, five quality of evidence statements, and one commentary on disclosure was developed. Subcommittee members were assigned selected Population, Intervention, Comparator, Outcome questions or quality of evidence statements. Subcommittee members completed their Grading of Recommendations Assessment, Development, and Evaluation of the question with his/her quality of evidence assessment and proposed strength of recommendation, then the draft was reviewed by the relevant subcommittee. The subcommittee collectively reviewed the evidence profiles for each question they developed. After the draft was discussed and approved by the entire committee, then the document was circulated among all members for voting on the quality of evidence and strength of recommendation. The committee followed the principles of the Grading of Recommendations Assessment, Development, and Evaluation system to determine quality of evidence and strength of recommendations. This guideline evaluates the ICU environment as a risk for medication-related events and the environmental changes that are possible to improve safe medication use. Prevention strategies for medication-related events are reviewed by medication use process node (prescribing, distribution, administration, monitoring). Detailed

Osteopathic Medical Student Practice of Osteopathic Manipulative Treatment During School Break.

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Pierce-Talsma, Stacey; Hiserote, R Mitchell; Lund, Gregg

2017-03-01

Osteopathic manipulative treatment (OMT) is integral in osteopathic medical education. The timing of the loss of interest, leading to decreasing clinical use, is unclear. Osteopathic medical students' activities during laboratories or rotations are determined by laboratory or preceptor requirements and do not characterize students' interest in or how they value OMT. Students who practice OMT when they are not required to may demonstrate that they are interested in, perceive a positive value of, and have confidence in using OMT. To characterize preclinical students practicing OMT during their school break. First- and second-year students at the Touro University College of Osteopathic Medicine-CA and the University of New England College of Osteopathic Medicine were surveyed about whether they practiced OMT during winter break, types of conditions addressed, OMT technique(s) used, their practice partners' response to OMT, and reasons for not practicing OMT, if applicable. Students were also asked if they would have practiced more OMT if they had setups similar to those of the practice environment at school. Of the 499 surveys sent, 407 (81.6%) were returned. Of 407 students, 269 (66.1%) reported that they practiced OMT during winter break, and they used a full range of OMT techniques. Students reported a total of 551 practice partners and 602 complaints. Overall, 429 of 497 practice partners (86.3%) reported they were much improved or improved, and 6 of 497 (1.2%) felt worse or much worse. The most common reasons for not practicing OMT were that no one had complaints (56.3%) and that there was no place to practice (37.3%). More than half of surveyed students showed an interest in practicing OMT when it was not required of them. These findings may imply the need for curriculum changes at osteopathic medical schools to ensure student competency with using OMT techniques that take less time and can be done in a variety of settings and with discussing OMT with practice

Moral regulation and the presumption of guilt in Health Canada's medical cannabis policy and practice.

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Lucas, Philippe

2009-07-01

This paper is a sociological examination of policies and practices in Health Canada's Marihuana Medical Access Division (MMAD) that presume the illicit intentions and inherent "guilt" of medical cannabis users, hampering safe access to a medicine to which many are legally entitled, and raising doubts about this federal programme's overall effectiveness and constitutional legitimacy. Beginning with a brief historical overview of Canada's federal medical cannabis programme, this paper examines the failure of the MMAD to meet the needs of many sick and suffering Canadians through Hunt's [Hunt, A. (1999). Governing morals: A social history of moral regulation. Cambridge, UK: Cambridge University Press] work on moral regulation and Wodak's [Wodak, A. (2007). Ethics and drug policy. Psychiatry, 6(2), 59-62] critique of "deontological" drug policy strategies. I then cite Tupper's [Tupper, K. W. (2007). The globalization of ayahuasca: Harm reduction or benefit maximization? International Journal of Drug Policy, doi:10.1016/j.drugpo.2006.11.001] argument that shifting to a generative metaphor that constructs certain entheogenic substances as potentially useful "tools" rather than regulating them through inherently moralistic prohibitionist policies would better serve public health, and incorporate Young's [Young, I. M. (1990). Justice and the politics of difference. Princeton, New Jersey: Princeton University Press] theories of domination and oppression to examine the rise of community-base medical cannabis dispensaries as "new social movements". First-hand accounts by medical cannabis patients, federally funded studies, and internal Health Canada communication and documents suggest that current federal policies and practices are blocking safe access to this herbal medicine. The community-based dispensary model of medical cannabis access is a patient-centered "new social movement" that mitigates the stigmatization and moral regulation of their member-clients by creating

25 tips for working through language and cultural barriers in your medical practice.

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Hills, Laura Sachs

2009-01-01

The language and cultural barriers facing medical patients with limited English language proficiency pose tremendous challenges and risks. Moreover, medical practices today are more likely than ever to employ individuals whose first language is not English or who do not possess native-like knowledge of American culture. Knowing how to work through the language and cultural barriers you are likely to encounter in your medical practice has become increasingly more important. This article is written by a practice management consultant who has graduate-level linguistics training and second-language teaching credentials and experience. It offers 25 practical tips to help you communicate more effectively with individuals who are outside of your native culture and language. These include easy-to-implement tips about English language pronunciation, grammar, and word choice. This article also suggests what you can do personally to bridge the cultural divide with your patients and co-workers. Finally, this article includes a case study of one Virginia practice in which cultural differences interfered with the practice's smooth operation. It explains how the practice eventually worked through and overcame this cultural obstacle.

The experience of medical training and expectations regarding future medical practice of medical students in the Cuban-supported Medical School in Timor-Leste.

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Ferrinho, Paulo; Valdes, Ana C; Cabral, Jorge

2015-03-28

The purpose of this paper is to describe and analyse the professional expectations and profile of medical students at the Cuban-supported School of General Medicine, in the Faculty of Medicine and Health Sciences of the National University of Timor-Leste. A piloted, standardized questionnaire, with closed- and open-ended questions, was distributed to registered medical students attending classes on the day of the survey. All data were analysed using SPSS. The statistical analysis is mostly descriptive. Students decide to study medicine at an early age. Relatives and friends seem to have an especially important influence in encouraging, reinforcing and promoting the desire to be a doctor. The degree of feminization of the student population is high. Medical students are in general satisfied with the training received, though demanding improvements in terms of systems to support their studies and training (e.g. libraries, laboratories, access to computers and the Internet). Medical students know that they will be needed in the public sector and that it would represent their opportunity to contribute to the public's welfare. Nonetheless, they report that they expect to combine public sector practice with private work, probably, in order to improve their earnings. This may be explained by their expectations for salaries, which are much higher than the current level of public sector salaries. A significant proportion of students are unsure about their future area of specialization. Of those that have determined their desired specialization, most intend to train as hospital specialists and to follow a hospital-based career. For many, specialization is equated with migration to study abroad. There are important differences between students at the start of their training compared with more advanced students. This paper gives an overview of student expectations for alignment with stated national human resources for health priorities for Timor-Leste.

Curating research data a handbook of current practice

CERN Document Server

Johnston, Lisa R

2017-01-01

Curating Research Data, Volume Two: A Handbook of Current Practice guides you across the data lifecycle through the practical strategies and techniques for curating research data in a digital repository setting. The data curation steps for receiving, appraising, selecting, ingesting, transforming, describing, contextualizing, disseminating, and preserving digital research data are each explored, and then supplemented with detailed case studies written by more than forty international practitioners from national, disciplinary, and institutional data repositories. The steps in this volume detail the sequential actions that you might take to curate a data set from receiving the data (Step 1) to eventual reuse (Step 8). Data curators, archivists, research data management specialists, subject librarians, institutional repository managers, and digital library staff will benefit from these current and practical approaches to data curation.

CURRENT LEVELS OF MEDICAL EXPOSURE IN RUSSIA

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M. I. Balonov

2015-01-01

Full Text Available We considered conditions of patients’ medical radiation exposure in Russian diagnostic radiology and nuclear medicine basing on the data of our own research, of the Unified system of individual dose control and of some relevant literature. We analyzed the data on the number of diagnostic examinations, patients’ individual and collective doses and their distribution by examination types. Time trends of the studied parameters are presented for the period between 1999 and 2013. Current level of Russian patients’ medical exposure is the lowest over the whole observation period and one of the lowest among the developed countries. The annual number of X-ray diagnostic examinations is 1.8 per capita. In 2013 median effective dose of medical exposure per capita in Russia was 0.45 mSv and median dose per procedure was 0.25 mSv. The major contribution to collective dose of medical exposure was from computed tomography and radiography; the largest individual doses were caused by interventional radiology, computed X-Ray and nuclear medicine tomographic examinations. The range of median doses comprises about four orders of magnitude, i.e. from several microSv in dental X-ray examinations up to several tens of milliSv in interventional and multistage tomographic examinations. The median effective dose of adult patients increases by about an order of magnitude with each transition from dental X-ray examinations to conventional radiology and further to computed tomography and interventional radiology examinations. During interventional X-Ray examinations, absorbed skin doses at radiation beam entrance site may reach several Gray, which may lead to deterministic radiation effects in skin and subcutaneous tissues. Due to replacement of low-dose ‘functional’ nuclear medicine examinations with more informative modern scintigraphy and tomography examination, patient doses substantially increased over the last decade. With current trend for re-equipment of

A qualitative study of medical students in a rural track: views on eventual rural practice.

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Roseamelia, Carrie; Greenwald, James L; Bush, Tiffany; Pratte, Morgan; Wilcox, Jessica; Morley, Christopher P

2014-04-01

Rural tracks (RTs) exist within medical schools across the United States. These programs often target those students from rural areas and those with primary care career interests, given that these factors are robust predictors of eventual rural practice. However, only 26% to 64% of graduates from RTs enter eventual rural practice. We conducted a qualitative, exploratory study of medical students enrolled in one school's RT, examining their interests in rural training, specialization, and eventual rural practice, via open coding of transcripts from focus groups and in-depth individual interviews, leading to identification of emerging themes. A total of 16 out of 54 eligible first- and second-year preclinical medical students participated in focus group sessions, and a total of seven out of 17 eligible third- and fourth-year medical students participated in individual interviews. Analyses revealed the recognition of a "Rural Identity," typical characteristics, and the importance of "Program Fit" and "Intentions for Practice" that trended toward family medicine specialization and rural practice. However, nuances within the comments reveal incomplete commitment to rural practice. In many cases, student preference for rural practice was driven largely by a disinterest in urban practice. Students with rural and primary care practice interests are often not perfectly committed to rural practice. However, RTs may provide a haven for such students within medical school.

eMedOffice: A web-based collaborative serious game for teaching optimal design of a medical practice

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Hannig Andreas

2012-10-01

Full Text Available Abstract Background Preparing medical students for the takeover or the start-up of a medical practice is an important challenge in Germany today. Therefore, this paper presents a computer-aided serious game (eMedOffice developed and currently in use at the RWTH Aachen University Medical School. The game is part of the attempt to teach medical students the organizational and conceptual basics of the medical practice of a general practitioner in a problem-based learning environment. This paper introduces methods and concepts used to develop the serious game and describes the results of an evaluation of the game's application in curricular courses at the Medical School. Results Results of the conducted evaluation gave evidence of a positive learning effect of the serious game. Educational supervisors observed strong collaboration among the players inspired by the competitive gaming aspects. In addition, an increase in willingness to learn and the exploration of new self-invented ideas were observed and valuable proposals for further prospective enhancements were elicited. A statistical analysis of the results of an evaluation provided a clear indication of the positive learning effect of the game. A usability questionnaire survey revealed a very good overall score of 4.07 (5=best, 1=worst. Conclusions We consider web-based, collaborative serious games to be a promising means of improving medical education. The insights gained by the implementation of eMedOffice will promote the future development of more effective serious games for integration into curricular courses of the RWTH Aachen University Medical School.

Analysis of curricular reform practices at Chinese medical schools.

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Huang, Lei; Cai, Qiaoling; Cheng, Liming; Kosik, Russell; Mandell, Greg; Wang, Shuu-Jiun; Xu, Guo-Tong; Fan, Angela P

2014-01-01

A comprehensive search of the literature published between 2001 and 2010 was performed to gain a greater understanding of curricular reform practices at Chinese medical schools. There were 10,948 studies published between 2001 and 2010 that were retrieved from the database. Following preliminary screening, 76 publications from 49 different medical schools were selected. Thirty-one publications regarding clinical medicine curricular reforms were analyzed further. Of the 76 studies, 53 described curricular reforms that were instituted in theoretical courses, 22 described curricular reforms that were instituted in experimental courses, and 1 described curricular reforms that were instituted in a clinical skills training course. Of the 31 clinical medicine publications, 2 described reforms that were implemented for 3-year program medical students, 12 described reforms that were implemented for 5-year program medical students, 6 described reforms that were implemented for 7-year program medical students, and 2 described reforms that were implemented for 8-year program medical students. Currently, the majority of medical schools in China use the discipline-based curriculum model. Thirteen studies described transition to an organ-system-based curriculum model, 1 study described transition to a problem-based curriculum model, and 3 studies described transition to a clinical presentation-based curriculum model. In 7 studies educators decided to retain the discipline-based curriculum model while integrating 1 or several new courses to remedy the weaker aspects of the traditional curriculum, in 7 studies educators decided to integrate the preclinical courses with the clinical courses by using the systemic-integrating curricular system that dilutes classical disciplines and integrates material based on organ systems, and in 2 studies educators limited reforms to clinical courses only. Eight studies discussed the implementation of a formative evaluation system, 4 studies

Early Childhood Caries-Related Knowledge, Attitude, and Practice: Discordance between Pediatricians and Dentists toward Medical Office-Based Prevention in Taiwan.

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Dima, Shinechimeg; Chang, Wei-Jen; Chen, Jung-Wei; Teng, Nai-Chia

2018-05-24

The aim of this study was to assess the knowledge, attitude, and practice regarding early childhood caries (ECC) prevention and implementation of medical setting-based caries prevention among pediatricians and dentists in Taiwan. Data were collected from currently practicing pediatricians and general and pediatric dentists using self-administered questionnaires. A total of 301 questionnaires were completed by the pediatricians ( n = 105), general dentists ( n = 117), and pediatric dentists ( n = 79). The pediatric dentists obtained significantly higher knowledge and practice scores than the general dentists and pediatricians ( p < 0.0001). The pediatricians' attitude score related to engaging physicians in medical office-based caries prevention was significantly higher than the attitude scores of the general and pediatric dentists ( p < 0.05). A Spearman rank correlation analysis indicated a significant positive correlation between knowledge and practice among the general dentists (r s = 0.271, p < 0.01) and pediatricians (r s = 0.262, p < 0.01). The correlation between knowledge and attitude among the pediatricians was significantly positive (r s = 0.242, p < 0.05). Attitude and practice among the pediatricians were significantly positively correlated (r s = 0.271, p < 0.01). Pediatricians lacked ECC-related knowledge; however, they had a more positive attitude toward medical office-based prevention when they had a higher level of knowledge. Oral health-related education for pediatricians is necessary if such medical office-based caries prevention programs are to be implemented in Taiwan.

Mental health among currently enrolled medical students in Germany.

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Wege, N; Muth, T; Li, J; Angerer, P

2016-03-01

The study identifies the prevalence of common mental disorders according to the patient health questionnaire (PHQ) and the use of psychotropic substances in a sample of currently enrolled medical students. A cross-sectional survey with a self-administrated questionnaire. All newly enrolled medical students at the University of Dusseldorf, with study beginning either in 2012 or 2013, respectively, were invited to participate. The evaluation was based on 590 completed questionnaires. Mental health outcomes were measured by the PHQ, including major depression, other depressive symptoms (subthreshold depression), anxiety, panic disorders and psychosomatic complaints. Moreover, information about psychotropic substances use (including medication) was obtained. Multiple logistic regression analysis was used to estimate associations between sociodemographic and socio-economic factors and mental health outcomes. The prevalence rates, measured by the PHQ, were 4.7% for major depression, 5.8% for other depressive symptoms, 4.4% for anxiety, 1.9% for panic disorders, and 15.7% for psychosomatic complaints. These prevalence rates were higher than those reported in the general population, but lower than in medical students in the course of medical training. In all, 10.7% of the students reported regular psychotropic substance use: 5.1% of students used medication 'to calm down,' 4.6% 'to improve their sleep,' 4.4% 'to elevate mood,' and 3.1% 'to improve cognitive performance.' In the fully adjusted model, expected financial difficulties were significantly associated with poor mental health (odds ratio [OR]: 2.14; 95% confidence interval [CI]: 1.31-3.48), psychosomatic symptoms (OR:1.85; 95% CI: 1.11-3.09) and psychotropic substances use (OR: 2.68; 95% CI: 1.51-4.75). The high rates of mental disorders among currently enrolled medical students call for the promotion of mental health, with a special emphasis on vulnerable groups. Copyright © 2016 The Royal Society for Public

Collaboration with pharmacy services in a family practice for the medically underserved

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Campbell K

2009-12-01

Full Text Available Objectives: Pharmacist-managed collaborative services in a family practice setting are described, and diabetes and hypertension outcomes are assessed.Methods: Pharmacist-managed clinics, pharmacotherapy consultations, and drug information services are provided for a medically underserved, predominantly African American population. A pharmacy residency director, an ambulatory care pharmacy resident and three PharmD candidate student pharmacists work directly with physicians, nurse practitioners, nurses, and social workers to form an interdisciplinary health care team. Providers utilize pharmacy services through consultations and referrals. Collaboration outcomes were evaluated in twenty-two patients with diabetes and thirty hypertensive patients. Patients were retrospectively followed throughout their history with pharmacy service. Hemoglobin A1c (A1C was tracked before referral to pharmacy services, 3 to 6 months after, and as the most current measure after at least 6 months. Blood pressure (BP was observed before pharmacy involvement, 2 to 4 months later, and then currently for at least 4 months with the service. The mean of the most current markers was calculated, and the percent of patients at their goal marker was compared to national averages.Results: Fifty percent of pharmacy service patients met the American Diabetes Association hemoglobin A1c goal of less than 7% in our evaluation compared to the national mean of 49.8% overall and 44% in African Americans. Thirty percent of patients were at their BP goal while 33.1% of patients without diabetes and 33.2% of patients with diabetes nationally are at goal. Conclusion: The medically underserved patients under the care of pharmacy services achieved a higher percentage at their A1C goal than the national mean. The percentage of patients who achieved their BP goals was comparable to the national average. Increasing utilization of pharmacy services in the family practice setting allows for

Towards integration of health economics into medical education and clinical practice in Saudi Arabia.

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Da'ar, Omar B; Al Shehri, Ali M

2015-04-01

In an era of expanding health sectors and rising costs, doctors are expected to have a working knowledge of health economics to better use resources and improve outcomes and quality of health care. This article recognizes the dearth of knowledge and application of economic analyses in medical education and clinical practice in Saudi Arabia. In particular, it highlights the desirability of knowledge of health economics in ensuring certain competencies in medical education and the rationale for inviting doctors to apply knowledge of economics in Saudi Arabia. In addition, the article discusses challenges that hinder integrating health economics into clinical practice. Furthermore, the article typifies some of the important economic phenomena that physicians need to discern. Besides, the article provides implications for incorporating economic analysis into medical education and clinical practice in Saudi Arabia. Finally, the article concludes by demonstrating how health economics can enhance doctors' knowledge and recommends the country to move towards integrating health economics into medical education and clinical practice for best practice.

Toothache and Self‑Medication Practices: A Study of Patients ...

African Journals Online (AJOL)

assess the self‑medication practices among adult dental patients suffering from toothache. Subjects and ..... teeth whitening, preventing cavities and killing cariogenic bacteria ... soften the enamel on the teeth making them more susceptible.

[Internet presence of neurologists, psychiatrists and medical psychotherapists in private practice].

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Kuhnigk, Olaf; Ramuschkat, Meike; Schreiner, Julia; Anger, Anina; Reimer, Jens

2014-04-01

The world wide web provides new options to physicians in terms practice marketing, information brokerage, and process optimization. This study explores prevalence and content of homepages of neurologists, psychiatrists and medical psychotherapists in private practice. Through the legal bodies of physicians in private practice in six northern German states neurologists, psychiatrists and medical psychotherapists were identified. According to a standardized and operationalized criteria catalogue, homepages were rated. 1804 physicians were identified, 352 (19.5 %) had operated a homepage. Higher frequencies of homepages found for male physicians (vs. female physicians), practice centres (vs. single practices) and urban practices (vs. rural practices). In average, practices reached 18.8 (± 5.3) of 42 points; contact data and accessibility information were generally available; information as to qualification and specialization was provided more infrequently. Legal specifications were not considered in more than every second homepage, interactive elements like online appointment of follow-up prescription were only rarely offered. Only every fifth neurological or psychiatric practice operates an own homepage, higher competition (urban area) and higher professionalization (practice centres) seem to act as promotors. The legal framework has to be focused, and patient needs should be taken into account. © Georg Thieme Verlag KG Stuttgart · New York.

How can we assess the value of complex medical innovations in practice?

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Abrishami, Payam; Boer, Albert; Horstman, Klasien

2015-06-01

Rapid proliferation of medical innovations in the face of demographic changes and scarce resources is demanding a value-conscious entry of medical innovations into health care systems. An inquiry into value gains significance during the early diffusion phase of an innovation and becomes indispensable as the complexity of an innovation increases. In this editorial, we argue that a value assessment must pay attention to the social processes shaping the innovation's adoption and use, in particular, to the "promises" of the technology and actual "practices" with it. Promises and practices represent real-world value as they account for both outcomes and costs in practice. A systematic exploration of these loci of value, using insights from constructive technology assessment, enables us to make well-informed decisions on complex medical technologies.

Medical Training Experience and Expectations Regarding Future Medical Practice of Medical Students at the University of Cape Verde

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Antonio Pedro Delgado

2017-10-01

Conclusion: Cape Verde is pursuing a bold strategy to deal with a shortage of medical doctors. The problems experienced by medical students provide an important insight to help the new medical school to provide a better learning environment for students. The fact that students are not sure about their future area of specialization is an opportunity to guide them towards the areas of the health system with pressing needs. The current feminization of the medical workforce will be sustained with the profile of the present intake, hence the need to take this into account in workforce planning.

Medical students' attitudes and wishes towards extending an educational general practice app to be suitable for practice: A cross-sectional survey from Leipzig, Germany.

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Sandholzer, Maximilian; Deutsch, Tobias; Frese, Thomas; Winter, Alfred

2016-06-01

In medical education and practice, smartphone apps are increasingly becoming popular. In general practice, apps could play an important future role in supporting medical education and practice. To explore medical students' perceptions regarding the potential of a general practice app for training and subsequent work as a physician. Cross-sectional survey among Leipzig fourth-year medical students who were provided with an app prototype for a mandatory general practice course. Response rate was 99.3% (n = 305/307); 59.0% were female and mean age was 24.5 years. Students certified that the app had a higher potential than textbooks in both education (57.4% vs. 18.0%) and practice (47.1% vs. 22.8%). Students' most desired possible app extensions when anticipating its use for subsequent work as a physician were looking up information for diagnostics, therapy and prediction (85.1%), access to electronic patient files (48.1%), communication and networking (44.3%), organization of medical training (42.9%) and online monitoring of patients (38.1%). Students experienced with medical smartphone apps were more interested in app extensions. Consideration to use the app to support the opening of their own practice was significantly associated with higher interest in accessing electronic patient files, networking with colleagues and telemedicine. Fourth year medical students from Leipzig see a high potential in smartphone apps for education and practice and are interested in further using the technology after undergraduate education.

Medical Malpractice Implications of Clinical Practice Guidelines.

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Ruhl, Douglas S; Siegal, Gil

2017-08-01

Clinical practice guidelines aim to improve medical care by clarifying and making useful recommendations to providers. Although providers should account for patients' unique characteristics when determining a treatment plan, it is generally perceived as good practice to follow guidelines when applicable. This is of interest in malpractice litigation, where it is essential to establish a standard of care to evaluate the performances of providers. Although the opinions of expert witnesses are used to determine standards of care, guidelines are expected to play a leading role. Guidelines alone should not establish a legal standard but may help inform this discussion in the courtroom. Therefore, it is incumbent that excellent, practical, and timely guidelines are continually created and updated in a transparent way. These guidelines must be very clear and underscore the various strengths of recommendation based on the quality of available evidence.

The medical practice of euthanasia in Belgium and The Netherlands: legal notification, control and evaluation procedures.

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Smets, Tinne; Bilsen, Johan; Cohen, Joachim; Rurup, Mette L; De Keyser, Els; Deliens, Luc

2009-05-01

To describe and compare current legal procedures for notifying, controlling and evaluating (NCE-procedures) euthanasia in Belgium and the Netherlands, and to discuss the implications for a safe and controllable euthanasia practice. We systematically studied and compared official documents relating to the Belgian and the Dutch NCE-procedures for euthanasia. In both countries, physicians are required to notify their cases to a review Committee, stimulating them to safeguard the quality of their euthanasia practice and to make societal control over the practice of euthanasia possible. However, the procedures in both countries differ. The main differences are that the Dutch notification and control procedures are more elaborate and transparent than the Belgian, and that the Belgian procedures are primarily anonymous, whereas the Dutch are not. Societal evaluation is made in both countries through the Committees' summary reports to Parliament. Transparent procedures like the Dutch may better facilitate societal control. Informing physicians about the law and the due care requirements for euthanasia, and systematic feedback about their medical actions are both pivotal to achieving efficient societal control and engendering the level of care needed when performing such far-reaching medical acts.

Current state of information technology use in a US primary care practice-based research network.

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Andrews, James E; Pearce, Kevin A; Sydney, Carey; Ireson, Carol; Love, Margaret

2004-01-01

To examine the current levels of information technology (IT) use in a primary care practice-based research network (PBRN) in order to inform future development of its infrastructure. Every primary care practitioner who is a member of the Kentucky Ambulatory Network (KAN),as well as the office managers of each practice. Practitioners included family practitioners, general practitioners, nurse practitioners and physician assistants. A cross-sectional study using two survey instruments: one for office managers and one for practitioners. The office manager survey included questions related to the current state of IT within the practice, plans for enhancement and general IT issues from the perspective of managing a practice. The practitioner survey was designed to measure current IT use and attitudes of primary care practitioners. Response rates for the surveys were 46% (n = 68) for the office managers and 51% (n = 116) for practitioners. All but one practice had internet access; however, 43% had only dial-up service. Only 21% of practitioners use an electronic medical record (EMR), with dollar cost being the barrier reported most frequently (58%). More than half of the office managers were either 'somewhat interested' (45%) or 'very interested' (17%) in a low-cost, standardised EMR that was, at the time, to be sponsored by the American Academy of Family Physicians. For practitioners, 71% were either 'somewhat' or 'very' interested in such a system. Responses to other IT issues are reported. While interest in enabling information technologies was high in KAN, adoption was variable, with use of several key technologies reported as low.The results suggest that research in this network that would be dependent on or enhanced by IT might be impeded and, generally, greater attention should be given to enhancing the IT infrastructure in primary care.

Cancer pain management in China: current status and practice implications based on the ACHEON survey

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Xia Z

2017-08-01

Full Text Available Zhongjun Xia Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, ChinaPurpose: Cancer pain can seriously impact the quality of life (QoL of patients, and optimal management practices are therefore of paramount importance. The ACHEON survey queried physicians and patients from 10 Asian countries/regions to assess current clinical practices in cancer pain management in Asia. This study presents the data obtained for cancer pain management in mainland China, with an emphasis on practices related to opioid drugs.Materials and methods: In several tertiary hospitals across China, 250 patients experiencing cancer pain and 100 physicians were surveyed on questions designed to assess current cancer pain management practices and cancer pain impact on QoL.Results: The patient survey showed that 88% of patients reported moderate-to-severe cancer pain, with a median duration of 6 months. The physician survey showed that medical school/residency training with regard to cancer pain management was inadequate in ~80% of physicians. A total of 80% of physicians and 67.2% of patients reported that pain scale was used during pain assessment; 84% of physicians expressed that physician-perceived pain severity was not completely consistent with actual pain the patient experienced. Of the 147 patients who recalled the medication received, 83.7% were administered opioid prescriptions. Of the 240 patients who received treatment, 43.8% perceived the inadequacy of controlling pain. The primary barriers from physicians perceived to optimal pain management included patients’ fear of side effects (58%, patients’ fear of addiction (53%, patients’ reluctance to report pain (43%, physicians’ reluctance to prescribe (29%, physicians’ inadequacy of pain assessment (27% and excessive regulation of opioid analgesics (47%.Conclusion: Knowledge of cancer pain management should be strengthened among physicians. Quantitative pain assessment and principle-based pain

Kant, curves and medical learning practice: a reply to Le Morvan and Stock.

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Ives, J

2007-02-01

In a recent paper published in the Journal of Medical Ethics, Le Morvan and Stock claim that the kantian ideal of treating people always as ends in themselves and never merely as a means is in direct and insurmountable conflict with the current medical practice of allowing practitioners at the bottom of their "learning curve" to "practise their skills" on patients. In this response, I take up the challenge they issue [corrected] and try to reconcile this conflict. The kantian ideal offered in the paper is an incomplete characterisation of Kant's moral philosophy, and the formula of humanity is considered in isolation without taking into account other salient kantian principles. I also suggest that their argument based on "necessary for the patient" assumes too narrow a reading of "necessary". This reply is intended as an extension to, rather than a criticism of, their work.

International short-term medical missions: a systematic review of recommended practices.

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Roche, Stephanie D; Ketheeswaran, Pavinarmatha; Wirtz, Veronika J

2017-01-01

To identify practices for conducting international short-term medical missions (STMMs) recommended in the literature and examine how these link STMMs to recipient countries' existing health systems. Systematic review of PubMed-indexed articles on STMMs and their bibliographies using preferred reporting items for systematic reviews and meta-analyses guidelines. Recommendations were organized using the World Health Organization Health Systems Framework. In 92 publications, 67 % offered at least one recommendation that would link STMMs to the recipient country's health system. Among these recommendations, most focused on service delivery and few on health financing and governance. There is a lack of consensus around a proper standard of care, patient selection, and trip duration. Comprehensive global standards are needed for STMM work to ensure that services are beneficial both to patients and to the broader healthcare systems of recipient countries. By providing an overview of the current recommendations and important gaps where practice recommendations are needed, this study can provide relevant input into the development of global standards for STMMs.

EMOTIONAL BURNOUT SYNDROME: EFFECT ON CLINICAL INERTIA AND MEDICAL PRACTICE STEREOTYPES

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R. A. Khokhlov

2016-01-01

Full Text Available Aim. To estimate the prevalence of burnout in primary care physicians and its influence on medical practice stereotypes and on clinical inertia.Material and Methods. The anonymous single-stage poll was carried out among 184 primary care physicians. The questionnaire included information about sex, age, period and conditions of work, established stereotypes of practices. Burnout was evaluated by Russian analog of Maslach Burnout Inventory. It was defined in high level of emotional exhaustion and depersonalization and low level of personal accomplishment 11 questions were developed to reveal of suboptimal medical practice (for example, “I do not discuss treatment options with patient and do not give full answers to his questions” or “I make diagnostic and treatment errors despite of my professional knowledge and inexperience”.Results. The burnout syndrome (or extreme grade of emotional burnout occurs in 13,1% and high level of emotional burnout – in 49,7% of primary care physicians. Features of suboptimal medical practice are usually found in 24,2% of primary care physicians at least monthly. It expresses more often in improper attitude to paqtients and their problems associated with a disease. Thus, burnout contributes to improper attitude to patients. Professional burnout affects established work stereotypes and can promote development of physician’s clinical inertia.Conclusion. As the burnout is common among primary care physicians, an adequate monitoring and prevention of this state is necessary in medical labour management.

EMOTIONAL BURNOUT SYNDROME: EFFECT ON CLINICAL INERTIA AND MEDICAL PRACTICE STEREOTYPES

Directory of Open Access Journals (Sweden)

R. A. Khokhlov

2009-01-01

Full Text Available Aim. To estimate the prevalence of burnout in primary care physicians and its influence on medical practice stereotypes and on clinical inertia.Material and Methods. The anonymous single-stage poll was carried out among 184 primary care physicians. The questionnaire included information about sex, age, period and conditions of work, established stereotypes of practices. Burnout was evaluated by Russian analog of Maslach Burnout Inventory. It was defined in high level of emotional exhaustion and depersonalization and low level of personal accomplishment 11 questions were developed to reveal of suboptimal medical practice (for example, “I do not discuss treatment options with patient and do not give full answers to his questions” or “I make diagnostic and treatment errors despite of my professional knowledge and inexperience”.Results. The burnout syndrome (or extreme grade of emotional burnout occurs in 13,1% and high level of emotional burnout – in 49,7% of primary care physicians. Features of suboptimal medical practice are usually found in 24,2% of primary care physicians at least monthly. It expresses more often in improper attitude to paqtients and their problems associated with a disease. Thus, burnout contributes to improper attitude to patients. Professional burnout affects established work stereotypes and can promote development of physician’s clinical inertia.Conclusion. As the burnout is common among primary care physicians, an adequate monitoring and prevention of this state is necessary in medical labour management.

Gender matters in medical education.

Science.gov (United States)

Bleakley, Alan

2013-01-01

Women are in the majority in terms of entry to medical schools worldwide and will soon represent the majority of working doctors. This has been termed the 'feminising' of medicine. In medical education, such gender issues tend to be restricted to discussions of demographic changes and structural inequalities based on a biological reading of gender. However, in contemporary social sciences, gender theory has moved beyond both biology and demography to include cultural issues of gendered ways of thinking. Can contemporary feminist thought drawn from the social sciences help medical educators to widen their appreciation and understanding of the feminising of medicine? Post-structuralist feminist critique, drawn from the social sciences, focuses on cultural practices, such as language use, that support a dominant patriarchy. Such a critique is not exclusive to women, but may be described as supporting a tender-minded approach to practice that is shared by both women and men. The demographic feminising of medicine may have limited effect in terms of changing both medical culture and medical education practices without causing radical change to entrenched cultural habits that are best described as patriarchal. Medical education currently suffers from male biases, such as those imposed by 'andragogy', or adult learning theory, and these can be positively challenged through post-structuralist feminist critique. Women doctors entering the medical workforce can resist and reformulate the current dominant patriarchy rather than reproducing it, supported by male feminists. Such a feminising of medicine can extend to medical education, but will require an appropriate theoretical framework to make sense of the new territory. The feminising of medical education informed by post-structuralist frameworks may provide a platform for the democratisation of medical culture and practices, further informing authentic patient-centred practices of care. © Blackwell Publishing Ltd 2013.

Medical student attachments in private practice – The experience ...

African Journals Online (AJOL)

doctors in full-time governmental practice. However, since 2000, final year students spend one week of ... Background: Medical student attachments with family/general practitioners (GPs) in non-academic .... Giving the patient a free choice to.

Getting started on your research: practical advice for medical educators.

Science.gov (United States)

Markert, Ronald J

2010-10-01

Guidance and mentorship benefit faculty who having little or no background conducting research in medical education. From his experience the author suggests three characteristics that distinguish medical educators who are especially productive in their scholarly activities: intrinsic rather than extrinsic motivation, collaboration with colleagues, and the personal qualities of patience and organization. He then expands on these characteristics by offering practical advice in the form of eight tips for faculty seeking to acquire or improve their medical education research skills.

How to boost a low-morale medical practice team: twenty-five strategies.

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Hills, Laura

2014-01-01

Low morale can decrease productivity and cooperation among medical practice employees, and increase work errors, absenteeism, and turnover. That is why practice managers must be mindful of their employees' morale and develop a toolkit of strategies that they can use to assess and boost waning morale. This article suggests 25 practical and affordable strategies medical practice managers can use to increase their staffs' morale. It explores the high cost of low morale, including five invisible costs that are often overlooked but that nonetheless drain practice resources. Furthermore, this article suggests 25 warning signs of low morale and suggests 10 causes of low morale in the workplace. It also provides practice managers with a quick 10-question quiz to administer to their employees to help them assess employee morale. Finally, this article describes five easy and affordable games practice managers can play with their employees to build camaraderie and teamwork and to increase staff morale.

Medical Students’ View about the Effects of Practical Courses on Learning the General Theoretical Concepts of Basic Medical Sciences

OpenAIRE

Leila Roshangar; Fariba Salek Ranjbarzadeh; Reza Piri; Mahdi Karimi Shoar; Leila Rasi Marzabadi

2014-01-01

Introduction: The basic medical sciences section requires 2.5 years in the medical education curriculum. Practical courses complement theoretical knowledge in this period to improve their appreciation. Despite spending lots of disbursement and time, this period’s efficacy is not clearly known. Methods: One hundred thirty-three General Practitioner (GP) students have been included in this descriptive cross-sectional study and were asked by questionnaire about the positive impact of practical c...

A Pathophysiological Model-Driven Communication for Dynamic Distributed Medical Best Practice Guidance Systems.

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Hosseini, Mohammad; Jiang, Yu; Wu, Poliang; Berlin, Richard B; Ren, Shangping; Sha, Lui

2016-11-01

There is a great divide between rural and urban areas, particularly in medical emergency care. Although medical best practice guidelines exist and are in hospital handbooks, they are often lengthy and difficult to apply clinically. The challenges are exaggerated for doctors in rural areas and emergency medical technicians (EMT) during patient transport. In this paper, we propose the concept of distributed executable medical best practice guidance systems to assist adherence to best practice from the time that a patient first presents at a rural hospital, through diagnosis and ambulance transfer to arrival and treatment at a regional tertiary hospital center. We codify complex medical knowledge in the form of simplified distributed executable disease automata, from the thin automata at rural hospitals to the rich automata in the regional center hospitals. However, a main challenge is how to efficiently and safely synchronize distributed best practice models as the communication among medical facilities, devices, and professionals generates a large number of messages. This complex problem of patient diagnosis and transport from rural to center facility is also fraught with many uncertainties and changes resulting in a high degree of dynamism. A critically ill patient's medical conditions can change abruptly in addition to changes in the wireless bandwidth during the ambulance transfer. Such dynamics have yet to be addressed in existing literature on telemedicine. To address this situation, we propose a pathophysiological model-driven message exchange communication architecture that ensures the real-time and dynamic requirements of synchronization among distributed emergency best practice models are met in a reliable and safe manner. Taking the signs, symptoms, and progress of stroke patients transported across a geographically distributed healthcare network as the motivating use case, we implement our communication system and apply it to our developed best practice

Need of Department of General Practice / Family Medicine at AIIMS (All India Institute of Medical Sciences): Why the apex medical institute in India should also contribute towards training and education of general practitioners and family physicians.

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Pal, Ranabir; Kumar, Raman

2017-01-01

Family medicine or general practice is the practicing discipline of the majority doctors in India, however formal academic departments of general practice (or family medicine) do not exist in India, as it is not a mandatory requirement as prescribed by the Medical Council of India; the principal regulator of medical education. Currently India has capacity to produce more than 60,000 medical graduates per year, majority of whom are expected to become general practitoners or primary care doctors without under going any vocational training in general practice or family medicine. The 92 nd parliamentary standing committee report (on health and family welfare) of the Indian Parliament recommended that Government of India in coordination with State Governments should establish robust postgraduate programs in Family Medicine and facilitate introducing Family Medicine discipline in all medical colleges. This will not only minimize the need for frequent referrals to specialist and decrease the load on tertiary care but also provide continuous health care for the individuals and families. The authors concur with the parliament of India and strongly feel that "Family Medicine" (community-based comprehensive clinical practice) deserves dedicated and distinct department at all medical colleges in India in order to availability of qualified medical doctors in the community-based health system. AIIMS, New Delhi, along with other newly established AIIMS, should rise to their foundation mandate of supporting excellence in all disciplines of medical science and to this historic responsibility; and not just remain an ivory tower of tertiary care based fragmented (into sub specialties) hospital culture.

Knowledge, attitudes, and practice behaviors of medical specialists for the relationship between diabetes and periodontal disease: A questionnaire survey

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Vishnu Teja Obulareddy

2018-01-01

Full Text Available Introduction: Increased risk of periodontal disease has been associated with diabetes mellitus (DM and also periodontitis is considered as the sixth complication of DM. Medical physicians may have an advantageous position compared to the dentists to provide early patient counseling about oral health because patients attend medical offices more often than to dental offices and are more likely to be affiliated to medical than to dental insurance. Hence, the medical practitioners should have sufficient knowledge in this regard. The study aimed to assess the knowledge, attitudes, and practice behaviors of endocrinologists, general medicine practitioners, and diabetologists on the relationship between periodontal disease and DM. Materials and Methods: Data were collected from sixty participants practicing in Nellore, using a structured questionnaire survey. The obtained data were analyzed through percentages. Results: All the participants (100% were aware that there existed a relation between oral health and general health. However, only 17.8% (10 of the participants refer their patients to dentists without patients asking for referral. Conclusion: The endocrinologists were aware of the didactic relationship, whereas general medicine practitioners and diabetologists are not much well-equipped with the knowledge on relationship between DM and periodontitis. There exists a wide gap between their practice behaviors and current scientific evidence. Therefore, more emphasis must be made by medical practitioners for the diabetic patient toward periodontal health which is most important yet neglected aspect of comprehensive health care.

Current issues regarding radiation risk education in Medical Universities of Japan

International Nuclear Information System (INIS)

Tsuzuki, Teruhisa; Hosoi, Yoshio; Matsuda, Naoki; Kanda, Reiko; Hosoya, Noriko; Miyagawa, Kiyoshi; Awai, Kazuo; Kondo, Takashi

2017-01-01

The main purpose of radiation research is to understand the biological effects of radiation exposure to humans, the molecular mechanisms of biological response m organisms, and its sale application for medical and industrial use. In order to know the current state or education on fundamentals of radiology including radiation biology, a nation-wide questionnaire survey had been performed at medical schools and different co-medical courses in Japanese universities, during the period of 2004 and 2005. The survey results showed: (1) Difference in teaching hours for education on radiation between medical schools with and without department or division of radiation biology or radiation-related field. (2) Teaching hours for education on radiation in nursing course were very limited among the co-medical courses. Although, some improvement have been found about the state of education on radiation risk at medical schools, after the disaster of nuclear accident at Fukushima No.1 Nuclear Power Plant of TEPCO in March 2011. However, still much more effort t is needed to improve basic education on radiation. Science Council of Japan issued the recommendation on September 4, 2014 'Making radiation health risk education compulsory in medical education'. The working group for this purpose was set up under the Council of Head of National Medical Schools of Japan, on January 28, 2015. Here, we describe the details and current issues regarding radiation risk education in medical schools of Japan, as well as the efforts required for its betterment. (author)

Models for integrating medical acupuncture into practice: an exploratory qualitative study of physicians' experiences.

Science.gov (United States)

Crumley, Ellen T

2016-08-01

Internationally, physicians are integrating medical acupuncture into their practice. Although there are some informative surveys and reviews, there are few international, exploratory studies detailing how physicians have accommodated medical acupuncture (eg, by modifying schedules, space and processes). To examine how physicians integrate medical acupuncture into their practice. Semi-structured interviews and participant observations of physicians practising medical acupuncture were conducted using convenience and snowball sampling. Data were analysed in NVivo and themes were developed. Despite variation, three principal models were developed to summarise the different ways that physicians integrated medical acupuncture into their practice, using the core concept of 'helping'. Quotes were used to illustrate each model and its corresponding themes. There were 25 participants from 11 countries: 21 agreed to be interviewed and four engaged in participant observations. Seventy-two per cent were general practitioners. The three models were: (1) appointments (44%); (2) clinics (44%); and (3) full-time practice (24%). Some physicians held both appointments and regular clinics (models 1 and 2). Most full-time physicians initially tried appointments and/or clinics. Some physicians charged to offset administration costs or compensate for their time. Despite variation within each category, the three models encapsulated how physicians described their integration of medical acupuncture. Physicians varied in how often they administered medical acupuncture and the amount of time they spent with patients. Although 24% of physicians surveyed administered medical acupuncture full-time, most practised it part-time. Each individual physician incorporated medical acupuncture in the way that worked best for their practice. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Current Approaches of Regulating Radiological Safety of Medical and Industrial Practices in Romania

International Nuclear Information System (INIS)

Goicea, C.

2016-01-01

The principal document regulating the radiological safety of ionizing radiation application in Romania is the “Fundamental Norms for Radiological Safety”. These norms establish the requirements concerning the assurance of radiological safety of occupational exposed workers, population and environment, in accordance with the provisions of Law 111/1996 on the safe deployment of nuclear activities, republished. Justification of practices for all new practices which lead to exposure to ionizing radiation shall be justified in writing by their initiator, underlining their economic, social or other nature advantages, in comparison with the detriment which they could cause to health. CNCAN authorise these practices, provided that they consider the justification as being thorough. The applicant, respectively the authorisation holder, has to demonstrate that all actions to ensure radiation protection optimization are undertaken, with a view to ensure that all exposures, including the potential ones, within the framework of practice developed are maintained at the lowest reasonable achievable level, taking into account the economic and social factors: ALARA principle.

15 year experience of tacrolimus application in medical practice

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Y. S. Kondratyeva

2016-01-01

Full Text Available The review presents modern literature data on the use of tacrolimus in medical practice. The results of national and international research on the effectiveness and safety of the drug at various dermatoses are presented.

Codes of medical ethics: traditional foundations and contemporary practice.

Science.gov (United States)

Sohl, P; Bassford, H A

1986-01-01

The Hippocratic Coprus recognized the interaction of 'business' and patient-health moral considerations, and urged that the former be subordinated to the latter. During the 1800s with the growth of complexity in both scientific knowledge and the organization of health services, the medical ethical codes addressed themselves to elaborate rules of conduct to be followed by the members of the newly emerging national medical associations. After World War II the World Medical Association was established as an international forum where national medical associations could debate the ethical problems presented by modern medicine. The International Code of Medical ethics and the Declaration of Geneva were written as 20th century restatements of the medical profession's commitment to the sovereignty of the patient-care norm. Many ethical statements have been issued by the World Medical Association in the past 35 years; they show the variety and difficulties of contemporary medical practice. The newest revisions were approved by the General Assembly of the World Medical Association in Venice, Italy October 1983. Their content is examined and concern is voiced about the danger of falling into cultural relativism when questions about the methods of financing medical services are the subject of an ethical declaration which is arrived at by consensus in the W.M.A.

Learning the law: practical proposals for UK medical education.

Science.gov (United States)

Margetts, J K

2016-02-01

Ongoing serious breaches in medical professionalism might be avoided if UK doctors rethink their approach to law. UK medical education has a role in creating a climate of change by re-examining how law is taught to medical students. Adopting a more insightful approach in the UK to the impact of The Human Rights Act and learning to manipulate legal concepts, such as conflict of interest, need to be taught to medical students now if UK doctors are to manage complex decision-making in the NHS of the future. The literature is reviewed from a unique personal perspective of a doctor and lawyer, and practical proposals for developing medical education in law in the UK are suggested. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Medical physics 1981

International Nuclear Information System (INIS)

Bunde, E.

1982-01-01

This volume continues the series of congress publications with which the Deutsche Gesellschaft fuer Medizinische Physik has been completely documenting its annual meetings for some years. The meeting was aimed to show the complexity not only of the scientific specialty medical physics but also of the practical activities of medical physicists, or at least give some idea of it. The conference was centred on the following points: Possibilities of optimization and methods for re-examination of techniques used in X-ray diagnostics, nuclear diagnostics and ultrasonographic diagnostics; bases of dosimetry in practical radiotherapy, especially with a view to the plans to make gauging of therapeutical dosemeters compulsory; current state of neutron therapy and dosimetry; safety and constancy of irradiation devices in operation; planning and equipment of modern radiotherapy departments. Furthermore topics from medical optics and nuclearbiological research were dealt with. Reports were given on the clinical use of whole-body counters. Climatology and surgical research were marginally dealt with in two synoptical papers. Short reports on work currently under way completed the subject groups given and allowed insight into further topical fields of work of medical physicists in science and practice. Finally, the question of education received particular interest. (orig./MG) [de

Simulation of leakage current measurement on medical devices using helmholtz coil configuration with different current flow

Science.gov (United States)

Sutanto, E.; Chandra, F.; Dinata, R.

2017-05-01

Leakage current measurement which can follow IEC standard for medical device is one of many challenges to be answered. The IEC 60601-1 has defined that the limit for a leakage current for Medical Device can be as low as 10 µA and as high as 500 µA, depending on which type of contact (applied part) connected to the patient. Most people are using ELCB (Earth-leakage circuit breaker) for safety purpose as this is the most common and available safety device in market. One type of ELCB devices is RCD (Residual Current Device) and this RCD type can measure the leakage current directly. This work will show the possibility on how Helmholtz Coil Configuration can be made to be like the RCD. The possibility is explored by comparing the magnetic field formula from each device, then it proceeds with a simulation using software EJS (Easy Java Simulation). The simulation will make sure the concept of magnetic field current cancellation follows the RCD concept. Finally, the possibility of increasing the measurement’s sensitivity is also analyzed. The sensitivity is needed to see the possibility on reaching the minimum leakage current limit defined by IEC, 0.01mA.

Simulation of leakage current measurement on medical devices using helmholtz coil configuration with different current flow

International Nuclear Information System (INIS)

Sutanto, E; Chandra, F; Dinata, R

2017-01-01

Leakage current measurement which can follow IEC standard for medical device is one of many challenges to be answered. The IEC 60601-1 has defined that the limit for a leakage current for Medical Device can be as low as 10 µA and as high as 500 µA, depending on which type of contact (applied part) connected to the patient. Most people are using ELCB (Earth-leakage circuit breaker) for safety purpose as this is the most common and available safety device in market. One type of ELCB devices is RCD (Residual Current Device) and this RCD type can measure the leakage current directly. This work will show the possibility on how Helmholtz Coil Configuration can be made to be like the RCD. The possibility is explored by comparing the magnetic field formula from each device, then it proceeds with a simulation using software EJS (Easy Java Simulation). The simulation will make sure the concept of magnetic field current cancellation follows the RCD concept. Finally, the possibility of increasing the measurement’s sensitivity is also analyzed. The sensitivity is needed to see the possibility on reaching the minimum leakage current limit defined by IEC, 0.01mA. (paper)

Opting for rural practice: the influence of medical student origin, intention and immersion experience.

Science.gov (United States)

Playford, Denese; Ngo, Hanh; Gupta, Surabhi; Puddey, Ian B

2017-08-21

To compare the influence of rural background, rural intent at medical school entry, and Rural Clinical School (RCS) participation on the likelihood of later participation in rural practice. Analysis of linked data from the Medical School Outcomes Database Commencing Medical Students Questionnaire (CMSQ), routinely collected demographic information, and the Australian Health Practitioner Regulation Agency database on practice location. University of Western Australia medical students who completed the CMSQ during 2006-2010 and were practising medicine in 2016. Medical practice in rural areas (ASGC-RAs 2-5) during postgraduate years 2-5. Full data were available for 508 eligible medical graduates. Rural background (OR, 3.91; 95% CI, 2.12-7.21; P practice in the multivariate analysis of all potential factors. When interactions between intention, origin, and RCS experience were included, RCS participation significantly increased the likelihood of graduates with an initial rural intention practising in a rural location (OR, 3.57; 95% CI, 1.25-10.2; P = 0.017). The effect of RCS participation was not significant if there was no pre-existing intention to practise rurally (OR, 1.38; 95% CI, 0.61-3.16; P = 0.44). For students who entered medical school with the intention to later work in a rural location, RCS experience was the deciding factor for realising this intention. Background, intent and RCS participation should all be considered if medical schools are to increase the proportion of graduates working rurally.

Colostomy irrigation: current knowledge and practice of WOC nurses.

Science.gov (United States)

Cobb, Martha D; Grant, Marcia; Tallman, Nancy J; Wendel, Christopher S; Colwell, Janice; McCorkle, Ruth; Krouse, Robert S

2015-01-01

This study builds on the authors' previous studies that demonstrate that persons living with a colostomy who practice colostomy irrigation (CI) experience quality-of-life benefits. Studies also reveal that patients may not be taught about CI. The purpose of this study was to determine current knowledge, attitudes, and practices of WOC nurses on CI. The target population was ostomy nurses who were members of the Wound, Ostomy and Continence Nurse's Society. Nine hundred eighty-five nurses out of a possible pool of 4191 members responded, providing a response rate of 24%. Their average age was 53 years (range, 25-79 years). Respondents averaged 12 years' experience as a WOC nurse (range, 1-40 years) and 90% (n = 875) were certified. Participants practiced in a variety of settings, including acute and long-term care facilities, home health, and ambulatory clinics. They saw an average of 37 ± 60.5 (mean ± SD) ostomy patients per year (range, 0-1100). A 1-time online survey (SurveyMonkey) of members of the Wound, Ostomy and Continence Nurses (WOCN) Society was conducted. In addition to demographic and educational information, questions also included (1) CI advantages and disadvantages; (2) CI content routinely taught; (3) challenges in assisting patients to learn CI; and (4) where preparation was received for teaching this procedure. Nurses were asked whether they believe CI is evidence-based. More than half identified irrigation as an evidence-based practice (59%), but half indicated they do not routinely teach CI. Multiple factors correlated with nurses' decisions to teach CI, including years of experience (P = .03), specific CI education (P < .001), and considering the intervention evidence-based (P < .001). Factors influencing CI instruction are multifactorial; they include nurses' attitudes, experience base, education, medical indications, setting characteristics, and patient interest and physical abilities. Education on this procedure is urgently needed for

Medical negligence. An overview of legal theory and neurosurgical practice: duty of care.

Science.gov (United States)

Todd, Nicholas V

2014-04-01

A working knowledge of the legal principles of medical negligence is helpful to neurosurgeons. It helps them to act in a "reasonable, responsible and logical" manner, that is a practice that is consistent with the surgical practice of their peers. This article will review and explain the relevant medical law in relation to duty of care with illustrative neurosurgical cases.

Medical students’ perceptions and attitudes about family practice: a qualitative research synthesis

Directory of Open Access Journals (Sweden)

Selva Olid Anna

2012-08-01

Full Text Available Abstract Background During the last decade medical students from most Western countries have shown little interest in family practice. Understanding the factors that influence medical students to choose family medicine is crucial. Objective To systematically review and synthesize published evidence about medical students’ attitudes and perceptions towards family practice. Methods A qualitative systematic review. The literature search was undertaken in July 2010 in PubMed, EMBASE, Cumulative Index to Nursing and Allied Health Literature (CINAHL, Social Science Citation Index (SSCI, and ProQuest Dissertations & Theses. Two authors independently selected the studies for their inclusion and assessed their quality. The selected studies were thoroughly read. Key themes and categories were identified. A matrix was created for allowing the comparison of each theme across studies. Results Ten studies were finally included. Seven broad themes were identified across them: 1 Scope and context of practice was a broad theme comprising linked sub-themes: perception of a varied specialty, broad practice, holistic perspective and flexibility that allows having a family; 2 Lower interest or intellectually less challenging: treating common disease, repetitive, quasi administrative job; 3 Influence of role models, either positive and negative, and society: negative comments from other professionals, peers and family; 4 Lower prestige; 5 Poor remuneration; 6 Medical school influences, being important both the length and quality of the exposure; 7 Post graduate training, where the shorter duration and the lower intensity were perceived as positive aspects. After identifying these seven key themes, were also looked into patterns in the distribution of these themes among studies. Conclusions Our qualitative review provides a comprehensive picture of medical students’ attitudes towards family practice in the available literature. In general, although some students

What's the difference? Comparison of American and Japanese medical practice.

Science.gov (United States)

Kitano, Masami

2007-09-01

Medical systems in the USA such as EBM., DRG., Informed Consent and Second Opinion have already been introduced into the Japanese medical system. However, some of these systems have met resistance from a part of the population due to the differences of social structures, morals and customs between the two countries. Briefly, I described the medical education and licensure, the private practice and "open hospital system" of the USA. The following 4 topics which drew great interest in Japan will be discussed. 1) CEREBRAL DEATH AND BIOETHICS: Cerebral death has been restrictively accepted as human death since the 1980's only in terms of terminal cares in clinical medicine. The rather simplified current neurological criteria for death are approved in the USA. In order for an organ transplant to take place, a potential donor must be diagnosed as brain dead. However, Japanese society has not accepted the concept of cerebral death completely because of an accident in the 1960's where an organ was improperly removed when the donor who was not in the state of brain death. Recently, more people in Japan are showing interest in Dignity and Euthanasia from the point of view of "Right to die". 2) MALPRACTICE AND LITIGATION: "To err is human" was introduced by the Institute of Medicine for Risk Management. Accidental deaths of patients under medical care ranks No.8 in total number of deaths in the USA. There are 100,000 malpractice cases in the "Lawsuit Society" of America, which is 100 times that of Japan. Furthermore, the legal fees and insurance premiums are extremely high in the US as opposed to very low in Japan. 3) HEALTH CARE INSURANCE: To reduce medical costs, the insurance companies introduced "Competitive Managed Care" which resulted in the formation of "Health Maintenance Organizations" (HMO). Furthermore, when you compare the two countries in respect to those who have health insurance, 44 million in the USA carry no health insurance, whereas in Japan, the government

Drug choice in medical practice : rationales, routines and remedies

NARCIS (Netherlands)

Denig, Petra

1994-01-01

The aim of the studies presented in this dissertation is to describe and analyse drug choice in medical practice, and provide a better understanding of the possible shortcomings and the role of biomedical knowledge in the drug choice process.

Management of Pediatric Delirium in Pediatric Cardiac Intensive Care Patients: An International Survey of Current Practices.

Science.gov (United States)

Staveski, Sandra L; Pickler, Rita H; Lin, Li; Shaw, Richard J; Meinzen-Derr, Jareen; Redington, Andrew; Curley, Martha A Q

2018-06-01

The purpose of this study was to describe how pediatric cardiac intensive care clinicians assess and manage delirium in patients following cardiac surgery. Descriptive self-report survey. A web-based survey of pediatric cardiac intensive care clinicians who are members of the Pediatric Cardiac Intensive Care Society. Pediatric cardiac intensive care clinicians (physicians and nurses). None. One-hundred seventy-three clinicians practicing in 71 different institutions located in 13 countries completed the survey. Respondents described their clinical impression of the occurrence of delirium to be approximately 25%. Most respondents (75%) reported that their ICU does not routinely screen for delirium. Over half of the respondents (61%) have never attended a lecture on delirium. The majority of respondents (86%) were not satisfied with current delirium screening, diagnosis, and management practices. Promotion of day/night cycle, exposure to natural light, deintensification of care, sleep hygiene, and reorientation to prevent or manage delirium were among nonpharmacologic interventions reported along with the use of anxiolytic, antipsychotic, and medications for insomnia. Clinicians responding to the survey reported a range of delirium assessment and management practices in postoperative pediatric cardiac surgery patients. Study results highlight the need for improvement in delirium education for pediatric cardiac intensive care clinicians as well as the need for systematic evaluation of current delirium assessment and management practices.

Doctors' attitudes and confidence towards providing nutrition care in practice: Comparison of New Zealand medical students, general practice registrars and general practitioners.

Science.gov (United States)

Crowley, Jennifer; Ball, Lauren; Han, Dug Yeo; McGill, Anne-Thea; Arroll, Bruce; Leveritt, Michael; Wall, Clare

2015-09-01

Improvements in individuals' nutrition behaviour can improve risk factors and outcomes associated with lifestyle-related chronic diseases. This study describes and compares New Zealand medical students, general practice registrars and general practitioners' (GPs') attitudes towards incorporating nutrition care into practice, and self-perceived skills in providing nutrition care. A total of 183 New Zealand medical students, 51 general practice registrars and 57 GPs completed a 60-item questionnaire investigating attitudes towards incorporating nutrition care into practice and self-perceived skills in providing nutrition care. Items were scored using a 5-point Likert scale. Factor analysis was conducted to group questionnaire items and a generalised linear model compared differences between medical students, general practice registrars and GPs. All groups indicated that incorporating nutrition care into practice is important. GPs displayed more positive attitudes than students towards incorporating nutrition in routine care (ppractice registrars were more positive than students towards performing nutrition recommendations (p=0.004), specified practices (p=0.037), and eliciting behaviour change (p=0.024). All groups displayed moderate confidence towards providing nutrition care. GPs were more confident than students in areas relating to wellness and disease (pmedical students, general practice registrars and GPs have positive attitudes and moderate confidence towards incorporating nutrition care into practice. It is possible that GPs' experience providing nutrition care contributes to greater confidence. Strategies to facilitate medical students developing confidence in providing nutrition care are warranted.

[Problem areas and examples of best practice in intersectoral medication treatment--a literature review].

Science.gov (United States)

Mehrmann, Lena; Ollenschläger, Günter