Sample records for junior hospital doctors

  1. Junior doctor dementia champions in a district general hospital (innovative practice). (United States)

    Wilkinson, Iain; Coates, Anna; Merrick, Sophie; Lee, Chooi


    Dementia is a common condition in the UK with around 25% of patients in acute hospitals having dementia. In the UK, there is national guidance on the assessment of cognitive impairment in acute hospitals. This article is a qualitative study of junior doctors' experiences as part of a dementia and delirium team involved in changing the care of patients with dementia in a hospital in the UK. It draws on data from a focus group and follow-up questionnaire in two hospital trusts. We examine what drives doctors to become involved in such projects and the effects of this experience upon them. We suggest a typology for getting junior doctors involved in projects generating change when working with patients with dementia. Being more actively involved in caring for and developing services for patients with dementia may represent the crossing of an educational threshold for these junior doctors.

  2. Creativity in Medical Learning: A direction-finding study of junior hospital doctors

    Directory of Open Access Journals (Sweden)

    Martin Talbot


    Full Text Available In a questionnaire study of creativity, the author has assessed the teaching and clinical practice of medical teachers, as observed by their students. The study has taken some preliminary steps to assess the place of creativity in postgraduate medical learning in the United Kingdom. Junior doctors were asked to compare their ‘best’ teacher with their ‘worst’ utilising a semantic differential scale and questions derived from Torrance’s definitions of creativity. The response rate was 81 (56.25% of 144 junior hospital doctors, in whose view, ‘best’ teachers showed greater creative behaviour as evidenced by significantly higher creativity scores on the majority of parameters (p<0.0001.

  3. Do junior doctors take sick leave? (United States)

    Perkin, M R; Higton, A; Witcomb, M


    Nosocomial infections place a heavy burden on overstretched health services. An audit of junior doctors' sick leave behaviour was undertaken in 1993 and again in 2001. The object was to ascertain the level of common infectious illness and to investigate whether junior doctors were remaining at work inappropriately. The doctors were asked if any factors had influenced their decision to take sick leave or not. Between the two audits several initiatives have been introduced to improve the working conditions of junior doctors, including the New Deal to reduce hours of work. Eighty one junior doctors in a large teaching hospital participated in 1993 and 110 in 2001. The number reporting an infectious illness in the previous six months was similar (61.7% in 1993, 68.2% in 2001). There had been a significant increase in the percentage of infectious illness episodes for which the doctors took sick leave (15.1% in 1993, 36.8% in 2001, p work (72% in 1993, 68% in 2001). Consultant pressure was cited by 26% (1993) and 20% (2001). Use of the staff occupational health unit was minimal, with none of the ill doctors contacting the department in 1993 and only three in 2001. Overall, despite the reduction in the number of infectious doctors not taking sick leave, the majority remained at work. Fundamental changes are needed if potentially infected doctors are not to present a risk of iatrogenic infection.

  4. A mixed methods pilot study to investigate the impact of a hospital-specific iPhone application (iTreat) within a British junior doctor cohort. (United States)

    Payne, Karl Fb; Weeks, Lucy; Dunning, Paul


    We present a pilot study to investigate the impact of introducing a hospital-specific smartphone application into a cohort of British junior doctors. We created the iPhone application 'iTreat' that contained disease management and antibiotic dosing guidelines specific to our hospital, together with a postgraduate education department really simple syndication feed, a contact number phonebook and a favourites section. This intervention was trialled in a group of 39 foundation grade junior doctors, in a UK hospital, for a time period of 4 months. Mixed methods data capture, utilising survey and semi-structured interviews, was used to evaluate application usage patterns and potential barriers to endorsement of smartphone technology in the hospital setting. Sixty eight per cent of participants felt the application saved them time during clinical activities, with a decrease in the frequency of participants not referring to hospital clinical guidelines. The findings from this pilot study point towards the internal hospital environment as having a major impact upon smartphone usage. Participants viewed smartphone use as unprofessional in the ward-based setting, with a perceived negative attitude from other healthcare staff. An understanding of how healthcare staff choose to utilise smartphones in the clinical environment is crucial to enable the successful assimilation of smartphone technology into the hospital setting. This pilot study provides experience and parameters for future substantive studies being carried out by this group.

  5. A Survey on The Knowledge, Attitude and Confidence Level of Adult Cardiopulmonary Resuscitation Among Junior Doctors in Hospital Universiti Sains Malaysia and Hospital Raja Perempuan Zainab II, Kota Bharu, Kelantan, Malaysia. (United States)

    Chew F Z A W M N, K S; Mohd Hashairi, F; Ida Zarina, Z; Shaik Farid, A W; Abu Yazid, M N; Nik Hisamuddin, N A R


    Junior doctors are often the "first line" doctors called to attend to patients in cardiac arrest. We performed an anonymous questionnaire study from October 2008 to December 2008 to assess the knowledge, attitude and skill of cardiopulmonary resuscitation among junior doctors in Hospital Universiti Sains Malaysia and Hospital Raja Perempuan Zainab II. Out of the 100 questionnaire forms sent out, 70 were returned completed. The majority (85.8%) stated that they were not confident of managing a resuscitation case. There was a statistically significant (p<0.001) association between duration of clinical practice and confidence level. Up to 77.1% said that BLS should be re-certified every two years.

  6. Why are junior doctors reluctant to consult attending physicians? (United States)

    Swank, Otto H


    A physician performs two tasks: making diagnoses and determining treatments. To reduce medical error, junior doctors are supposed to consult their supervisors when they face uncommon circumstances. However, recent research shows that junior doctors are reluctant to do so. This paper presents a model that explains (i) which junior doctors shy away from consulting; (ii) when junior doctors are reluctant; (iii) the importance of protocols in the medical sector; and (iv) when consulting is a sign of strength or a sign of weakness. Furthermore, I show that encouraging junior doctors to consult by investigating mishaps leads to another distortion: they will give too much weight to own assessments.

  7. Junior doctors' knowledge of applied clinical anatomy. (United States)

    Gupta, Yuri; Morgan, Mia; Singh, Annika; Ellis, Harold


    This study examines the level of knowledge of applied clinical anatomy among junior doctors. A multiple-choice questionnaire was designed, which covered 15 areas of anatomical knowledge essential to clinical practice, for example, important surface landmarks and interpretation of radiographs. The questionnaire was completed by 128 individuals. They comprised anatomy demonstrators, preregistration house officers (PRHOs), senior house officers (SHOs) and specialist registrars (SpRs) across the range of medical and surgical specialities. Answers were scored and analyzed by group, allowing comparison not only between newly qualified PRHOs and more senior doctors, but also with anatomy demonstrators who had undergone more traditional anatomical training. The results reveal a wide variation of knowledge among junior doctors, with PRHOs scoring an average of 72.1%, SHOs 77.1%, SpRs 82.4%, and demonstrators 82.9%. This progression in knowledge up the clinical hierarchy may reflect clinical experience building upon the foundations laid in medical school, although with demonstrators topping the league table, it seems that intensive academic training is the most beneficial. With junior doctors' training in the UK currently in flux, these results highlight the need for training in clinical anatomy to hold an important place in the development of tomorrow's clinicians.

  8. "Junior Doctor Decision Making: Isn't that an Oxymoron?" A Qualitative Analysis of Junior Doctors' Ward-Based Decision-Making (United States)

    Bull, Stephanie; Mattick, Karen; Postlethwaite, Keith


    Unacceptable levels of adverse healthcare events, combined with changes to training, have put the spotlight on junior doctor decision-making. This study aimed to describe the decisions made by junior doctors and the contextual factors influencing how decisions were made and justified. Stimulated recall interviews with 20 junior doctors across five…

  9. "Junior Doctor Decision Making: Isn't that an Oxymoron?" A Qualitative Analysis of Junior Doctors' Ward-Based Decision-Making (United States)

    Bull, Stephanie; Mattick, Karen; Postlethwaite, Keith


    Unacceptable levels of adverse healthcare events, combined with changes to training, have put the spotlight on junior doctor decision-making. This study aimed to describe the decisions made by junior doctors and the contextual factors influencing how decisions were made and justified. Stimulated recall interviews with 20 junior doctors across five…

  10. Poor interpretation of chest X-rays by junior doctors

    DEFF Research Database (Denmark)

    Christiansen, Janus Mølgaard; Gerke, Oke; Karstoft, Jens;


    INTRODUCTION: Studies targeting medical students and junior doctors have shown that their radiological skills are insufficient. Despite the widespread use of chest X-ray; however, a study of Danish junior doctors' skills has not previously been performed. MATERIAL AND METHODS: A total of 22...... diagnosis, the participant's confidence in the diagnosis was assessed on a five-point Likert scale. The diagnoses were divided into four groups: normal findings, chronic diseases, acute diseases and hyperacute diseases or conditions. RESULTS: A total of 22 doctors receiving basic clinical education (BCE...

  11. Diagnosing the doctors' departure: survey on sources of dissatisfaction among Irish junior doctors.

    LENUS (Irish Health Repository)

    Bruce-Brand, R


    There has been a significant decline in the number of applications for non-consultant hospital doctor (NCHD) posts in Ireland over the last 18 months. We conducted an online, anonymous survey of Irish NCHDs to establish levels of satisfaction, sources of dissatisfaction and the major reasons for junior doctors seeking work abroad. 522 NCHDs took the survey, including 64 (12.3%) currently working outside of the Republic. 219 (45.8%) were slightly dissatisfied and 142 (29.7%) were extremely dissatisfied with practising medicine in Ireland. Major sources of dissatisfaction included the state of the health care system, staffing cover for leave and illness, the dearth of consultant posts and the need to move around Ireland. The most important reason for NCHDs wishing to leave was to seek better training and career opportunities abroad.

  12. Stress and burnout in junior doctors

    African Journals Online (AJOL)

    Wen discussing stress and burnour with doc- tors, I was ... of perceived stress and burnout in doctors who had recently graduated. ..... management. Poorly functioning doctors ... developing and maintaining human resources. The concepts of ...

  13. Career Calling as a Personal Resource Moderator between Environmental Demands and Burnout in Australian Junior Doctors (United States)

    Creed, Peter A.; Rogers, Mary E.; Praskova, Anna; Searle, Judy


    We surveyed 355 junior doctors (first 4 years of post-university training; 69% female, mean age = 28 years) from multiple hospital and practice locations and used an online questionnaire to assess their training-related demands (academic stress, concern about training debt, and hours worked), academic burnout, and personal resources…

  14. Professional approaches in clinical judgements among senior and junior doctors: implications for medical education

    Directory of Open Access Journals (Sweden)

    Pilhammar Ewa


    Full Text Available Abstract Background Clinical experience has traditionally been highly valued in medical education and clinical healthcare. On account of its multi-faceted nature, clinical experience is mostly difficult to articulate, and is mainly expressed in clinical situations as professional approaches. Due to retirement, hospitals in Scandinavia will soon face a substantial decrease in the number of senior specialist doctors, and it has been discussed whether healthcare will suffer an immense loss of experienced-based knowledge when this senior group leaves the organization. Both senior specialists and junior colleagues are often involved in clinical education, but the way in which these two groups vary in professional approaches and contributions to clinical education has not been so well described. Cognitive psychology has contributed to the understanding of how experience may influence professional approaches, but such studies have not included the effect of differences in position and responsibilities that junior and senior doctors hold in clinical healthcare. In the light of the discussion above, it is essential to describe the professional approaches of senior doctors in relation to those of their junior colleagues. This study therefore aims to describe and compare the professional approaches of junior and senior doctors when making clinical judgements. Methods Critical incident technique was used in interviews with nine senior doctors and nine junior doctors in internal medicine. The interviews were subjected to qualitative content analysis. Result Senior and junior doctors expressed a variety of professional approaches in clinical judgement as follows: use of theoretical knowledge, use of prior experience of cases and courses of events, use of ethical and moral values, meeting and communicating with the patient, focusing on available information, relying on their own ability, getting support and guidance from others and being directed by the

  15. Junior doctors' views on reporting concerns about patient safety: a qualitative study. (United States)

    Hooper, Patricia; Kocman, David; Carr, Sue; Tarrant, Carolyn


    Enabling healthcare staff to report concerns is critical for improving patient safety. Junior doctors are one of the groups least likely to engage in incident reporting. This matters both for the present and for the future, as many will eventually be in leadership positions. Little is known about junior doctors' attitudes towards formally reporting concerns. To explore the attitudes and barriers to junior doctors formally reporting concerns about patient safety to the organisations in which they are training. A qualitative study comprising three focus groups with 10 junior doctors at an Acute Teaching Hospital Trust in the Midlands, UK, conducted in 2013. Focus group discussions were transcribed verbatim and analysed using a thematic approach, facilitated by NVivo 10. Participants were supportive of the idea of playing a role in helping healthcare organisations become more aware of risks to patient safety, but identified that existing incident reporting systems could frustrate efforts to report concerns. They described barriers to reporting, including a lack of role modelling and senior leadership, a culture within medicine that was not conducive to reporting concerns, and a lack of feedback providing evidence that formal reporting was worthwhile. They reported a tendency to rely on informal ways of dealing with concerns as an alternative to engaging with formal reporting systems. If healthcare organisations are to be able to gather and learn from intelligence about risks to patient safety from junior doctors, this will require attention to the features of reporting systems, as well as the implications of hierarchies and the wider cultural context in which junior doctors work. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to

  16. Junior doctors and undergraduate teaching: the influence of gender on the provision of medical education.

    LENUS (Irish Health Repository)

    Prichard, David


    BACKGROUND: International experience has demonstrated that the medical profession is becoming less dominated by men. This "feminization of medicine" has been a topic of much debate in the medical literature. As the gender ratio in the profession changes, it is likely that a greater proportion of undergraduate education will be provided by women. Whether this shift away from the male-dominated provision of medical education will have an effect on undergraduate education is unknown. PURPOSE: The aim of this research was to clarify whether there are differences between the attitudes and practices of male and female junior doctors regarding the practice of undergraduate teaching. METHOD: A survey methodology among a cohort of nonconsultant hospital doctors in a major Irish teaching hospital was utilized. The overall response rate was 93%. The cohort held a positive attitude toward teaching undergraduates, and the majority were actively engaged in this activity. Doctors of both genders expressed a willingness to undertake teacher training. RESULTS: There were no significant differences between the genders regarding the self-reported quantity of teaching provided to undergraduates. Male doctors perceived themselves as more confident educators when compared to female doctors, but this is likely to reflect cohort demographics in which a greater proportion of male doctors were more senior. CONCLUSIONS: This study demonstrates that male and female doctors have similar attitudes toward, and practices in, voluntary undergraduate teaching. As a result, any gender shift in medicine is unlikely to result in a significant change in junior doctors\\' attitudes toward undergraduate medical education.

  17. Through doctors' eyes: A qualitative study of hospital doctor perspectives on their working conditions.

    LENUS (Irish Health Repository)

    McGowan, Yvonne


    BACKGROUND: Hospital doctors face significant challenges in the current health care environment, working with staff shortages and cutbacks to health care expenditure, alongside increased demand for health care and increased public expectations. OBJECTIVE: This article analyses challenges faced by junior hospital doctors, providing insight into the experiences of these frontline staff in delivering health services in recessionary times. DESIGN: A qualitative methodology was chosen. METHODS: Semi-structured in-depth interviews were conducted with 20 doctors from urban Irish hospitals. Interviews were recorded via note taking. Full transcripts were analysed thematically using NVivo software. RESULTS: Dominant themes included the following: (1) unrealistic workloads: characterised by staff shortages, extended working hours, irregular and frequently interrupted breaks; (2) fatigue and its impact: the quality of care provided to patients while doctors were sleep-deprived was questioned; however, little reflection was given to any impact this may have had on junior doctors own health; (3) undervalued and disillusioned: insufficient training, intensive workloads and a perceived lack of power to influence change resulted in a sense of detachment among junior doctors. They appeared immune to their surroundings. CONCLUSION: Respondents ascribed little importance to the impact of current working conditions on their own health. They felt their roles were underappreciated and undervalued by policy makers and hospital management. Respondents were concerned with the lack of time and opportunity for training. This study highlighted several \\'red flags\\

  18. Emotional Labour, Training Stress, Burnout, and Depressive Symptoms in Junior Doctors (United States)

    Rogers, Mary E.; Creed, Peter A.; Searle, Judy


    Junior doctors are at risk of work-related burnout and mental health problems due to training workload demands and responsibilities. This study investigated the predictors of work-related burnout and depressive symptoms in junior doctors. Participants were 349 Australian doctors in postgraduate years 1-4, who completed a web-based survey assessing…

  19. Emotional Labour, Training Stress, Burnout, and Depressive Symptoms in Junior Doctors (United States)

    Rogers, Mary E.; Creed, Peter A.; Searle, Judy


    Junior doctors are at risk of work-related burnout and mental health problems due to training workload demands and responsibilities. This study investigated the predictors of work-related burnout and depressive symptoms in junior doctors. Participants were 349 Australian doctors in postgraduate years 1-4, who completed a web-based survey assessing…

  20. Stick or twist? Career decision-making during contractual uncertainty for NHS junior doctors (United States)

    Gibson, Jon; Rigby, Dan; Sutton, Matt; Pearson, Emma; Checkland, Kath


    Objectives To examine the extent, and nature, of impact on junior doctors' career decisions, of a proposed new contract and the uncertainty surrounding it. Design Mixed methods. Online survey exploring: doctors' future training intentions; their preferred specialty training (ST) programmes; whether they intended to proceed immediately to ST; and other plans. Linked qualitative interviews to explore more fully how and why decisions were affected. Setting Doctors (F2s) in second year of Foundation School (FS) Programmes in England. Participants Invitations sent by FSs. Open to all F2s November 2015–February 2016. All FSs represented. Survey completed by 816 F2s. Sample characteristics broadly similar to national F2 cohort. Main outcome measures Proportions of doctors intending to proceed to ST posts in the UK, to defer or to exit UK medicine. Proportion of doctors indicating changes in training and career plans as a result of the contract and/or resulting uncertainty. Distribution of changes across training programmes. Explanations of these intentions from interviews and free text comments. Results Among the responding junior doctors, 20% indicated that issues related to the contract had prompted them to switch specialty and a further 20% had become uncertain about switching specialty. Switching specialty choice was more prevalent among those now choosing a community-based, rather than hospital-based specialty. 30% selecting general practice had switched choice because of the new contract. Interview data suggests that doctors felt they had become less valued or appreciated in the National Health Service and in society more broadly. Conclusions Doctors reported that contract-related issues have affected their career plans. The most notable effect is a move away from acute to community-based specialities, with the former perceived as more negatively affected by the proposed changes. It is concerning that young doctors feel undervalued, and this requires further

  1. A longitudinal study of well-being, confidence and competence in junior doctors and the impact of emergency medicine placements (United States)

    Mason, Suzanne; O'Keeffe, Colin; Carter, Angela; Stride, Chris


    Objectives To measure levels of, and change in junior doctor well-being, confidence and self-reported competence over their second postgraduate training year and the impact of emergency department (ED) placements on these outcomes. Design A longitudinal study using an online survey administered at four time points (2010–2011). Setting 28 Acute Hospital Trusts, drawn from nine participating Postgraduate Deaneries in England. Participants Junior doctors who had a placement in an ED as part of their second postgraduate training year. Main outcome measures Levels of anxiety, depression, motivation, job satisfaction, confidence and self-reported competence, collected at four time points spread over the period of the doctor's second training year (F2). Results 217 junior doctors were recruited to the study. Over the year there was a significant increase in their overall job satisfaction, confidence and self-reported competence. Junior doctors also reported significantly increased levels of motivation and anxiety, and significantly decreased levels of extrinsic job satisfaction when working in ED compared with other specialties. There were also significant increases in both junior doctor confidence and self-reported competence after their placement in ED relative to other specialties. Conclusions While elements of junior doctor well-being worsened in their ED placement compared with their time spent in other specialties, the increased levels of anxiety and reduced extrinsic job satisfaction were within the normal range for other healthcare workers. These deficits were also balanced by greater improvements in motivation, confidence in managing common acute clinical conditions and perceived competence in performing acute procedures compared with benefits offered by placements in other specialties. PMID:26338523

  2. A pilot survey of junior doctors' confidence in tasks related to broad aspects of competence

    DEFF Research Database (Denmark)

    Skaarup, Anne Marie; Davis, Deborah; Ringsted, Charlotte Vibeke


    The aim of this study was to survey junior doctors' growth in confidence in different physician roles. A total of 165 junior doctors in internal medicine completed a self-administered survey of confidence levels in physician roles. Confidence levels between training levels were compared....

  3. The value of the post-take ward round: are new working patterns compromising junior doctor education?

    National Research Council Canada - National Science Library

    Chaponda, M; Borra, M; Beeching, NJ; Almond, DS; Williams, PS; Hammond, MA; Price, VA; Tarry, L; Taegtmeyer, M


    This prospective observational study assessed the impact of the changes in junior doctors' working hours and waiting-time initiatives on teaching and learning opportunities for junior doctors in acute medicine...

  4. Developing a Platform for Learning from Mistakes: changing the culture of patient safety amongst junior doctors. (United States)

    Millwood, Sinead


    Junior doctors commonly make mistakes which may compromise patient safety. Despite the recent push by the NHS to encourage a "no blame" culture, mistakes are still viewed as shameful, embarrassing and demoralising events. The current model for learning from mistakes means that junior doctors only learn from their own errors. A survey was designed by the author for all the Foundation Year 1 doctors (FY1s) at Yeovil District Hospital to understand better the culture surrounding mistakes, and the types of mistakes that were being made. Using the results of the survey and the support of senior staff, a "Near misses" session has been introduced for FY1s once a month at which mistakes that have been made are discussed, with a consultant present to facilitate the proceedings. The aims of these sessions are to promote a culture of no blame, feedback information to clinical governance, and share learning experiences. 100% of the FY1s had made a mistake that could compromise patient safety. 63% discussed their mistakes with colleagues, 44% with seniors, and only 13% with their educational supervisor. Barriers to discussing mistakes included shame, embarrassment, fear of judgement, and unapproachable seniors. 94% thought a "Near misses" session would be useful. After the third session 100% of the FY1s agreed that the sessions were useful; 53% had changed their practice as a result of something they learned at the sessions. After discussing errors as a group we have worked with the clinical governance department, enacting strategies to avoid repetition of mistakes. Feedback from the junior doctors has been overwhelmingly positive and we have found these sessions to be a simple, inexpensive, and popular solution to cultural change in our organisation.

  5. Prevalence of stress in junior doctors during their internship training: a cross-sectional study of three Saudi medical colleges’ hospitals (United States)

    Abdulghani, Hamza Mohammad; Irshad, Mohammad; Al Zunitan, Mohammed A; Al Sulihem, Ali A; Al Dehaim, Muhammed A; Al Esefir, Waleed A; Al Rabiah, Abdulaziz M; Kameshki, Rashid N; Alrowais, Nourah Abdullah; Sebiany, Abdulaziz; Haque, Shafiul


    Background Medical science is perceived as a stressful educational career, and medical students experience monstrous stress during their undergraduate studies, internship, and residency training, which affects their cognitive function, practical life, and patient care. In the present study, an assessment of the prevalence of self-perceived stress among new medical graduates during their internship training has been performed, and correlations of self-perceived stress with sex, marital status, and clinical rotations have been evaluated. Patients and methods Interns of the King Khalid, King Abdulaziz, and King Fahd University hospitals in Saudi Arabia were invited to complete a stress inventory known as the Kessler 10, which is used for stress measurement. Apart from stress evaluation, the questionnaire collected personal data, such as age, sex, and marital status, in addition to information relevant to hospital training, assigned duties, and clinical training rotations. Results Our results showed that nearly 73.0% of interns were under stressed conditions. Most of the interns were affected by a severe level of stress (34.9%), followed by mild (19.3%) and moderate (18.8%) levels of stress. The stress level was significantly higher (84.0%) among female interns in comparison with male interns (66.5%) (odds ratio =2.64; confidence interval =1.59–4.39; P<0.0002). There were statistically significant differences between the percentages of male and female interns (P≤0.047) at mild, moderate, and severe stress levels. Marital status had no role in causing stress. The highest stress level was reported by interns during the clinical rotations of medicine (78.8%), followed by surgery (74.7%), pediatrics (72.4%), obstetrics and gynecology (70.1%), and emergency (58.3%). The prevalence of stress among the interns and their corresponding clinical rotations in all three hospitals had significant linear correlations (r≥0.829, P≤0.041). Conclusion We found a significantly

  6. Prevalence of stress in junior doctors during their internship training: a cross-sectional study of three Saudi medical colleges’ hospitals

    Directory of Open Access Journals (Sweden)

    Abdulghani HM


    Full Text Available Hamza Mohammad Abdulghani,1 Mohammad Irshad,1 Mohammed A Al Zunitan,1,2 Ali A Al Sulihem,1,2 Muhammed A Al Dehaim,1,2 Waleed A Al Esefir,1,2 Abdulaziz M Al Rabiah,1,2 Rashid N Kameshki,1,2 Nourah Abdullah Alrowais,2 Abdulaziz Sebiany,3 Shafiul Haque1 1Department of Medical Education, College of Medicine, King Saud University, Riyadh, Saudi Arabia; 2Department of Family and Community Medicine, King Saud University, Riyadh, Saudi Arabia; 3Department of Family and Community Medicine, University of  Dammam, Dammam, Saudi Arabia Background: Medical science is perceived as a stressful educational career, and medical students experience monstrous stress during their undergraduate studies, internship, and residency training, which affects their cognitive function, practical life, and patient care. In the present study, an assessment of the prevalence of self-perceived stress among new medical graduates during their internship training has been performed, and correlations of self-perceived stress with sex, marital status, and clinical rotations have been evaluated.Patients and methods: Interns of the King Khalid, King Abdulaziz, and King Fahd University hospitals in Saudi Arabia were invited to complete a stress inventory known as the Kessler 10, which is used for stress measurement. Apart from stress evaluation, the questionnaire collected personal data, such as age, sex, and marital status, in addition to information relevant to hospital training, assigned duties, and clinical training rotations.Results: Our results showed that nearly 73.0% of interns were under stressed conditions. Most of the interns were affected by a severe level of stress (34.9%, followed by mild (19.3% and moderate (18.8% levels of stress. The stress level was significantly higher (84.0% among female interns in comparison with male interns (66.5% (odds ratio =2.64; confidence interval =1.59–4.39; P<0.0002. There were statistically significant differences between the

  7. Is there a risk profile for the vulnerable junior doctor? (United States)

    Byrne, D; Buttrey, S; Carberry, C; Lydon, S; O'Connor, P


    Mental ill health is prevalent among doctors, especially those in the early stages of postgraduate training. However, a paucity of research has examined factors predictive of psychological distress in this population. To report the findings from a multi-centre survey of mental health among junior doctors in Ireland, and assess the extent to which moderator variables (e.g., age, academic performance, nationality, etc.) alter the levels of psychological distress caused by internship. An online, anonymous, questionnaire was distributed to all interns in the Republic of Ireland in January 2012. A total of 270 interns responded to the survey (45.0 % response rate), with 48.5 % of the respondents having a score indicative of psychological distress. A regression model found that nationality, academic performance, intern training network, rating of work stressors, home stressors, and work-life balance were associated with differing levels of mental health as measured by the General Health Questionnaire-12. There is a need to consider moderator variables when examining mental health in healthcare populations to avoid drawing overly simplistic conclusions. Interns in Ireland reported particularly high levels of psychological distress compared to other studies of mental health among healthcare populations.

  8. The impact of shift patterns on junior doctors' perceptions of fatigue, training, work/life balance and the role of social support. (United States)

    Brown, M; Tucker, P; Rapport, F; Hutchings, H; Dahlgren, A; Davies, G; Ebden, P


    The organisation of junior doctors' work hours has been radically altered following the partial implementation of the European Working Time Directive. Poorly designed shift schedules cause excessive disruption to shift workers' circadian rhythms. Interviews and focus groups were used to explore perceptions among junior doctors and hospital managers regarding the impact of the European Working Time Directive on patient care and doctors' well-being. Four main themes were identified. Under "Doctors shift rotas", doctors deliberated the merits and demerits of working seven nights in row. They also discussed the impact on fatigue of long sequences of day shifts. "Education and training" focused on concerns about reduced on-the-job learning opportunities under the new working time arrangements and also about the difficulties of finding time and energy to study. "Work/life balance" reflected the conflict between the positive aspects of working on-call or at night and the impact on life outside work. "Social support structures" focused on the role of morale and team spirit. Good support structures in the work place counteracted and compensated for the effects of negative role stressors, and arduous and unsocial work schedules. The impact of junior doctors' work schedules is influenced by the nature of specific shift sequences, educational considerations, issues of work/life balance and by social support systems. Poorly designed shift rotas can have negative impacts on junior doctors' professional performance and educational training, with implications for clinical practice, patient care and the welfare of junior doctors.

  9. Completion of Limitation of Medical Treatment forms by junior doctors for patients with dementia: clinical, medicolegal and education perspectives. (United States)

    Yoong, Jaclyn; MacPhail, Aleece; Trytel, Gael; Rajendram, Prashanti Yalini; Winbolt, Margaret; Ibrahim, Joseph E


    Objective Limitation of Medical Treatment (LMT) forms are an essential element of end-of-life care. Decision making around LMT is complex and often involves patients with dementia. Despite the complexity, junior doctors frequently play a central role in completing LMT forms. The present study sought perspectives from a range of stakeholders (hospital clinicians, medical education personnel, legal and advocacy staff) about junior doctors' roles in completing LMT forms in general and for patients with dementia.Methods Qualitative data were gathered in semi-structured interviews (SSI) and theoretical concepts were explored in roundtable discussion (RD). Participants were recruited through purposive and convenience sampling drawing on healthcare and legal personnel employed in the public hospital and aged care systems, selected from major metropolitan hospitals, healthcare and legal professional bodies and advocacy organisations in Victoria, Australia. The contents of the SSIs and RD were subject to thematic analysis using a framework approach. Data were indexed according to the topics established in the study aim; categories were systematically scrutinised, from which key themes were distilled.Results Stakeholders reported that completing LMT forms was difficult for junior doctors because of a lack of medical and legal knowledge, as well as clinical inexperience and inadequate training. Healthcare organisations (HCOs) either lacked policies about the role of junior doctors or had practices that were discordant with policy. In this process, there were substantial gaps pertaining to patients with dementia. Recommendations made by the study participants included the provision of supervised clinical exposure and additional training for junior doctors, strengthening HCO policies and explicit consideration of the needs of patients with dementia.Conclusions LMT forms should be designed for clarity and consistency across HCOs. Enhancing patient care requires appropriate and

  10. "A steep learning curve": junior doctor perspectives on the transition from medical student to the health-care workplace. (United States)

    Sturman, Nancy; Tan, Zachary; Turner, Jane


    The transition from medical student to hospital-based first year junior doctor (termed "intern" in Australia) is known to be challenging, and recent changes in clinical learning environments may reduce graduate preparedness for the intern workplace. Although manageable challenges and transitions are a stimulus to learning, levels of burnout in junior medical colleagues are concerning. In order to prepare and support medical graduates, educators need to understand contemporary junior doctor perspectives on this transition. Final-year University of Queensland medical students recruited junior doctors working in diverse hospital settings, and videorecorded individual semi-structured interviews about their transition from medical student to working as a junior doctor. Two clinical academics (NS and JT) and an intern (ZT) independently conducted a descriptive analysis of interview transcripts, and identified preliminary emerging concepts and themes, before reaching agreement by consensus on the major overarching themes. Three key themes emerged from the analysis of 15 interviews: internship as a "steep learning curve"; relationships and team; and seeking help. Participants described the intern transition as physically, mentally and emotionally exhausting. They learned to manage long days, administrative and clinical tasks, frequent interruptions and time pressures; identify priorities; deal with criticism without compromising key relationships; communicate succinctly; understand team roles (including their own status within hospital hierarchies); and negotiate conflict. Participants reported a drop in self-confidence, and difficulty maintaining self-care and social relationships. Although participants emphasised the importance of escalating concerns and seeking help to manage patients, they appeared more reluctant to seek help for personal issues and reported a number of barriers to doing so. Findings may assist educators in refining their intern preparation and intern

  11. Work Stressors, Social Support, and Burnout in Junior Doctors: Exploring Direct and Indirect Pathways (United States)

    Sochos, Antigonos; Bowers, Alexis; Kinman, Gail


    The study tested a pathway model linking different occupational stressors, different sources of social support, and burnout. A sample of 184 junior medical doctors was used. Pathway analysis suggested that doctors who experienced increased time demands, organizational constraints, and a lack of personal confidence perceived their consultants as…

  12. Introduction to teaching for junior doctors 2: collecting feedback and developing expertise. (United States)

    Cook, Vivien; Sharma, Anita; Alstead, Elspeth


    Doctors are likely to be involved in teaching activities and need to show evidence of their practice. For junior doctors this means gaining an understanding of educational principles and practice. This second of a two-part article focuses on how to collect feedback on teaching and develop educational expertise immediately and over the longer term.

  13. A pilot survey of junior doctors' confidence in tasks related to broad aspects of competence

    DEFF Research Database (Denmark)

    Davis, Deborah J; Skaarup, Anne Marie; Ringsted, Charlotte


    Medical authorities and society are recommending that postgraduate medical education prepare physicians for broad aspects of competence. The most effective ways to prepare physicians for these are not known. The aim of this pilot study was to survey junior doctors' growth in confidence in different...... physician roles. A total of 165 junior doctors in internal medicine completed a self-administered survey of confidence levels in physician roles. Confidence levels between training levels were compared. Confidence in the roles of medical expert, communicator and collaborator increased between PRHOs and SHOs...... tracking will be important to evaluate the effect of educational interventions on patient care. Udgivelsesdato: 2005-Sep...

  14. Junior doctors in their first year: mental health, quality of life, burnout and heart rate variability. (United States)

    Henning, Marcus A; Sollers, John; Strom, Joanna M; Hill, Andrew G; Lyndon, Mataroria P; Cumin, David; Hawken, Susan J


    There is a burgeoning interest in, and evidence of, quality of life and burnout issues among doctors. It was hypothesized that the junior doctors in this study would experience psychosocial and physiological changes over time, and that the obtained measures would indicate psychosocial and physiological anomalies. In addition, it was hypothesized that their psychosocial perceptions would be significantly associated with their physiological measures. A total sample of 17 junior doctors in their first year of training volunteered for this study. Over four time periods separated by 6 week phases, the doctors completed a set of quality of life and psychosocial inventories and wore a Polar RS800 Heart Rate Monitor over a day and night time interval. The findings showed that this sample of doctors did not report any problems associated with depression, anxiety, stress, burnout or quality of life (psychosocial measures). In addition, their heart rate variability scores (physiological measures) did not show any significant fluctuations. Furthermore, the responses from the self-report instruments measuring stress, anxiety, depression, quality of life and burnout did not consistently correlate with the HRV information suggesting a mind-body disconnection. More work needs to be done on larger samples to investigate these findings further given that the literature shows that junior doctors are likely to be stressed and working in stress-provoking environments.

  15. Assessment of Junior Doctors' Perceptions of Difficulty of Medical Specialty Training Programs (United States)

    Rogers, Mary E.; Creed, Peter A.; Searle, Judy


    The demands placed on medical trainees by the different specialty training programs are important considerations when choosing a medical specialty. To understand these demands, 193 junior doctors completed a web-based survey, and: (a) ranked medical specialties according to perceived level of training difficulty (incorporating entry difficulty,…

  16. What Should Junior Doctors Know about the Drugs they Frequently Prescribe? A Delphi Study among Physicians in the Netherlands. (United States)

    Brinkman, David; Disselhorst, Guus; Jansen, Bernard; Tichelaar, Jelle; van Agtmael, Michiel; de Vries, Theo; Richir, Milan


    The aim of this study was to identify the information about commonly prescribed drugs that junior doctors should know in order to prescribe rationally in daily practice, defined as essential drug knowledge (EDK). A two-round Internet Delphi study was carried out involving general practitioners from one practice cluster, and registrars and consultants from two Dutch academic and eight teaching hospitals. A preliminary list of 377 potential EDK items for three commonly prescribed drugs was assessed on a dichotomous scale; an item was considered EDK if at least 80% consensus was reached. The consensus list of EDK items was discussed by the research team to identify similarities between the three drugs, with a view to forming a list of general EDK items applicable to other commonly prescribed drugs. Sixty experts considered 93 of the 377 items (25%) as EDK. These items were then used to form a list of 10 general EDK items. The list of EDK items identified by primary and secondary care doctors could be used in medical curricula and training programmes and for assessing the prescribing competence of future junior doctors. Further research is needed to evaluate the generalizability of this list for other commonly prescribed drugs.

  17. Perceptions of junior doctors in the NHS about their training: results of a regional questionnaire. (United States)

    Gilbert, Alexandra; Hockey, Peter; Vaithianathan, Rhema; Curzen, Nick; Lees, Peter


    To explore the views of doctors in training about their current roles and their potential value to the National Health Service (NHS) in improving healthcare quality and productivity. Online questionnaire sent via email to 3766 junior doctors (foundation year one to specialist trainee year 3+) in the NHS South Central region. The response rate was 1479/3766 (39.3%). Respondents recognised the importance of leadership (89.7%), team working (89.2%) and professionalism (97%). Only 3.4% of junior doctors stated they have never acted in a leadership capacity. However, respondents reported a lack of receptivity from their organisations: the majority responded that they do not feel valued by managers (83.3%), the chief executive (77.7%), the organisation (77.3%), the NHS (79.3%) and consultants (58.2%). 91.2% of respondents have had ideas for improvement in their workplace; however, only 10.7% have had their ideas for change implemented. Respondents who had been on a NHS South Central leadership development course were significantly more likely to feel valued by all groups of staff in their organisation. They were also significantly more likely to report having their ideas implemented. Doctors in training have a desire and perceived ability to contribute to improvement in the NHS but do not perceive their working environment as receptive to their skills. Junior doctors who attend leadership training report higher levels of desire and ability to express these skills. This study suggests junior doctors are an untapped NHS resource and that they and their organisations would benefit from more formalised provision of training in leadership.

  18. An Investigation of Anatomical Competence in Junior Medical Doctors (United States)

    Vorstenbosch, Marc A. T. M.; Kooloos, Jan G. M.; Bolhuis, Sanneke M.; Laan, Roland F. J. M.


    Because of a decrease of the time available for anatomy education, decisions need to be made to reduce the relevant content of the anatomy curriculum. Several expert consensus initiatives resulted in lists of structures, lacking analysis of anatomical competence. This study aims to explore the use of anatomical knowledge by medical doctors in an…

  19. Improving acute medical management: Junior Doctor Emergency Prescription Cards. (United States)

    Hutton, Joe; Gingell, Megan; Hutchinson, Lisa


    Doctors commencing Foundation Year (FY) training face many stresses and challenges. FY doctors are often the first point of contact for acutely unwell and deteriorating patients. Trust guidelines are used to aid acute medical management. Accessing guidelines is often fraught with barriers. Evidence suggests aide-memoire cards can provide easier access to guidelines and management pathways. We aimed to improve prescribing accuracy and efficiency of FY doctors for acute medical conditions within Gloucestershire trust by improving access to and usability of trust guidelines. Questionnaires were distributed to FY doctors to identify acute medical conditions to include on the emergency prescription cards (EPCs). Two small double-sided cards were created containing bullet pointed trust guidelines for: hyper/hypokalaemia, status epilepticus, diabetic emergencies, arrhythmias, myocardial infarction, acute asthma, pulmonary oedema, anaphylaxis and a ward-round checklist. Feedback was used to improve EPCs prior to distribution. Pre (N=53) and post-intervention (N=46) written questionnaires were completed by FY doctors. These assessed acute clinical management including use of guidance, confidence in management, speed of prescribing and EPC "usability". To assess prescribing accuracy, prescriptions for acute medical conditions were reviewed pre (N=8) and post-intervention (N=12). The EPCs were well received (80% quite/very useful) and found "easy to use" (83%). The introduction of EPCs increased guidance use (pre-intervention 58.8%, post-intervention 71.7%), increased confidence (pre-intervention 79%, post-intervention 89%) and significantly improved prescribing speed (p=0.05). There was a significant correlation with confidence and prescribing speed (p = 0.023). The accuracy of prescribed doses improved (pre-intervention 62.5%, post-intervention 87.5% accurate) as did details regarding route / additional required information (pre-intervention 75%, post-intervention 97

  20. Awareness of ionizing radiation exposure among junior doctors and senior medical students in radiological investigations. (United States)

    Abuelhia, Elfatih


    The awareness and knowledge of ionizing radiation exposure in radiological investigations among junior doctors and medical students were studied. The participants were year four to year six senior medical students enrolled at University of Dammam and interns in King Fahad University Hospital. The survey consisted of 22 questions designed online using the software 'QuestionPro' licensed to the University of Dammam. 100 hard copies were also distributed manually and collected. A total of 221 (88.5%) questionnaires were completed. 213 participants viewed, 151 started and 128 (84.7%) completed online. 93% of the distributed samples were completed. Overall knowledge was poor; 44% and 19% of the respondents thought incorrectly that MRI and ultrasound emit ionizing radiation, respectively. Respondents (92%; n  =  203) underestimated the dose of abdominal spiral computed tomography (CT) and 4% thought no ionizing radiation involved in CT. 59% of respondents underestimated the radiation doses in nuclear medicine; bone scan 87%, PET/CT scan 67%, thyroid isotope scan 45% and PET scan 36%. 47% of the subjects had attended formal lectures, tutorials or workshops on radiation protection while 53% (n  =  119) had not. For future education the majority stated they would prefer tutorials or workshops (42.3%) or problem-based learning/case studies (32.4%), while web-based modules would be their last choice (8.1%).

  1. Harmonization of European neurology education: the junior doctor's perspective. (United States)

    Macerollo, Antonella; Struhal, Walter; Sellner, Johann


    The objective of this article, written by executives of the European Association of Young Neurologists and Trainees (EAYNT), is to illustrate the status quo of neurology training in Europe and give an outlook on ongoing efforts and prospects for junior neurologists. The European Union is an economic and political union that currently encompasses 27 member states with more than 500 million inhabitants (or 7.3% of the world population) (interested readers are referred to Countries of the European Union act as a single market with free movement of citizens, goods, services, and finances. As a consequence, a diploma and postgraduate training obtained in one EU country will be automatically recognized by all other EU member states. At the Lisbon European Council in March 2000, the Heads of State or Government signed a treaty that expresses their ambition of making Europe "the most competitive and dynamic knowledge-based economy in the world, capable of sustainable economic growth with more and better jobs and greater social cohesion" ( More than 1.6 million physicians in all the different medical specialties are represented by the European Union of Medical Specialists (UEMS). The UEMS was founded in 1958 and the objectives include the study, promotion, and harmonization of the highest level of training of medical specialists, medical practice, and health care within the European Union. The European Board of Neurology (UEMS-EBN; is in charge of the implementation of the UEMS policy regarding neurology.

  2. Do “trainee-centered ward rounds” help overcome barriers to learning and improve the learning satisfaction of junior doctors in the workplace?

    Directory of Open Access Journals (Sweden)

    Acharya V


    Full Text Available Vikas Acharya,1Amir Reyahi,2 Samuel M Amis,3 Sami Mansour2 1Department of Neurosurgery, University Hospitals Coventry and Warwickshire, Coventry, 2Luton and Dunstable University Hospital, Luton, 3Warwick Medical School, University of Warwick, Coventry, UK Abstract: Ward rounds are widely considered an underutilized resource with regard to medical education, and therefore, a project was undertaken to assess if the initiation of “trainee-centered ward rounds” would help improve the confidence, knowledge acquisition, and workplace satisfaction of junior doctors in the clinical environment. Data were collated from junior doctors, registrar grade doctors, and consultants working in the delivery suite at Luton and Dunstable University Hospital in Luton over a 4-week period in March–April 2013. A review of the relevant literature was also undertaken. This pilot study found that despite the reservations around time constraints held by both junior and senior clinicians alike, feedback following the intervention was largely positive. The junior doctors enjoyed having a defined role and responsibility during the ward round and felt they benefited from their senior colleagues’ feedback. Both seniors and junior colleagues agreed that discussing learning objectives prior to commencing the round was beneficial and made the round more learner-orientated; this enabled maximal learner-focused outcomes to be addressed and met. The juniors were generally encouraged to participate more during the round and the consultants endeavored to narrate their decision-making, both were measures that led to greater satisfaction of both parties. This was in keeping with the concept of “Legitimate peripheral participation” as described by Lave and Wenger. Overall, trainee-centered ward rounds did appear to be effective in overcoming some of the traditional barriers to teaching in the ward environment, although further work to formalize and quantify these findings

  3. Junior doctors' attitudes to opioids for refractory breathlessness in patients with advanced chronic obstructive pulmonary disease. (United States)

    Smallwood, Natasha; Gaffney, Nicole; Gorelik, Alexandra; Irving, Louis; Le, Brian; Philip, Jennifer


    Refractory breathlessness is a common, distressing symptom in patients with advanced chronic obstructive pulmonary disease (COPD). The judicious, off-licence prescription of opioids, together with other management strategies, can improve breathlessness, however, internationally there is profound reluctance to prescribe opioids for breathlessness in COPD. To understand Australian junior doctors' knowledge and attitudes regarding the management of refractory breathlessness and the role of opioids in COPD. All junior doctors undertaking basic training in internal medicine in Victoria were invited to complete an online survey. Knowledge, willingness, and experience prescribing opioids to COPD patients with refractory breathlessness, were examined. Of the 243 responses received, most trainees (193, 86.5%) believed opioids have a role in treating refractory breathlessness in stable COPD outpatients, with 143 (64.1%) recommending morphine as first line treatment for refractory breathlessness. One quarter (55, 24.7%) reported having themselves initiated an opioid and 102 (45.7%) had prescribed an opioid under senior supervision for management of breathlessness in COPD. Concern regarding adverse opioid effects was low, with 58 (26.0%) having no concerns prescribing an opioid to COPD patients. This is the first study of doctors to demonstrate high awareness, confidence, willingness and experience in prescribing opioids for the off-licence indication of refractory breathlessness in COPD. These findings differ significantly from attitudes reported overseas and are unexpected given the doctors surveyed were recently qualified. The low awareness of possible adverse events and limited insight regarding knowledge gaps is concerning and highlights the significant need for greater education in palliative care. This article is protected by copyright. All rights reserved.

  4. Smartphone and medical related App use among medical students and junior doctors in the United Kingdom (UK: a regional survey

    Directory of Open Access Journals (Sweden)

    Payne Karl Frederick


    Full Text Available Abstract Background Smartphone usage has spread to many settings including that of healthcare with numerous potential and realised benefits. The ability to download custom-built software applications (apps has created a new wealth of clinical resources available to healthcare staff, providing evidence-based decisional tools to reduce medical errors. Previous literature has examined how smartphones can be utilised by both medical student and doctor populations, to enhance educational and workplace activities, with the potential to improve overall patient care. However, this literature has not examined smartphone acceptance and patterns of medical app usage within the student and junior doctor populations. Methods An online survey of medical student and foundation level junior doctor cohorts was undertaken within one United Kingdom healthcare region. Participants were asked whether they owned a Smartphone and if they used apps on their Smartphones to support their education and practice activities. Frequency of use and type of app used was also investigated. Open response questions explored participants’ views on apps that were desired or recommended and the characteristics of apps that were useful. Results 257 medical students and 131 junior doctors responded, equating to a response rate of 15.0% and 21.8% respectively. 79.0% (n=203/257 of medical students and 74.8% (n=98/131 of junior doctors owned a smartphone, with 56.6% (n=115/203 of students and 68.4% (n=67/98 of doctors owning an iPhone. The majority of students and doctors owned 1–5 medical related applications, with very few owning more than 10, and iPhone owners significantly more likely to own apps (Chi sq, p Conclusions This study found a high level of smartphone ownership and usage among medical students and junior doctors. Both groups endorse the development of more apps to support their education and clinical practice.

  5. "The people not the policy": quality improvement, junior doctors, and cultural change. (United States)

    Grant, Paul


    Health care is a highly regulated environment. This has driven what could be characterized as a paper-safe approach, whereby organizations are required to demonstrate to a multiplicity of regulators, inspectorates, and accrediting bodies that they are paper safe. However, for many organizations, this has not produced a system that is actually patient safe; rather, it has in practice operated as a parallel system that does not reflect the true state of safety. This project looks at a quality improvement and patient safety program and critically asks the question of whether it is flawed because of failure to address issues surrounding doctors and cultural change. Johnson & Schole's cultural web framework was used to explore the attitudes of junior doctors toward a patient safety and quality improvement program. Data collection was through the use of focus groups backed up with quantitative data from a web based questionnaire survey. It has been demonstrated that doctors represent a dominant subculture within the National Health Service and their beliefs, attitudes, and value are often at odds or unrecognized by senior health care managers. Unless the cultural differences are adequately addressed, transformational change projects such as "Best & Safest Care" are unlikely to succeed. A better understanding of the organizational context allows for more appropriate change interventions to be developed.

  6. Views of junior doctors about whether their medical school prepared them well for work: questionnaire surveys

    Directory of Open Access Journals (Sweden)

    Taylor Kathryn


    Full Text Available Abstract Background The transition from medical student to junior doctor in postgraduate training is a critical stage in career progression. We report junior doctors' views about the extent to which their medical school prepared them for their work in clinical practice. Methods Postal questionnaires were used to survey the medical graduates of 1999, 2000, 2002 and 2005, from all UK medical schools, one year after graduation, and graduates of 2000, 2002 and 2005 three years after graduation. Summary statistics, chi-squared tests, and binary logistic regression were used to analyse the results. The main outcome measure was the level of agreement that medical school had prepared the responder well for work. Results Response rate was 63.7% (11610/18216 in year one and 60.2% (8427/13997 in year three. One year after graduation, 36.3% (95% CI: 34.6, 38.0 of 1999/2000 graduates, 50.3% (48.5, 52.2 of 2002 graduates, and 58.2% (56.5, 59.9 of 2005 graduates agreed their medical school had prepared them well. Conversely, in year three agreement fell from 48.9% (47.1, 50.7 to 38.0% (36.0, 40.0 to 28.0% (26.2, 29.7. Combining cohorts at year one, percentages who agreed that they had been well prepared ranged from 82% (95% CI: 79-87 at the medical school with the highest level of agreement to 30% (25-35 at the lowest. At year three the range was 70% to 27%. Ethnicity and sex were partial predictors of doctors' level of agreement; following adjustment for them, substantial differences between schools remained. In years one and three, 30% and 34% of doctors specified that feeling unprepared had been a serious or medium-sized problem for them (only 3% in each year regarded it as serious. Conclusions The vast knowledge base of clinical practice makes full preparation impossible. Our statement about feeling prepared is simple yet discriminating and identified some substantial differences between medical schools. Medical schools need feedback from graduates about

  7. Smartphone and medical related App use among medical students and junior doctors in the United Kingdom (UK): a regional survey (United States)


    Background Smartphone usage has spread to many settings including that of healthcare with numerous potential and realised benefits. The ability to download custom-built software applications (apps) has created a new wealth of clinical resources available to healthcare staff, providing evidence-based decisional tools to reduce medical errors. Previous literature has examined how smartphones can be utilised by both medical student and doctor populations, to enhance educational and workplace activities, with the potential to improve overall patient care. However, this literature has not examined smartphone acceptance and patterns of medical app usage within the student and junior doctor populations. Methods An online survey of medical student and foundation level junior doctor cohorts was undertaken within one United Kingdom healthcare region. Participants were asked whether they owned a Smartphone and if they used apps on their Smartphones to support their education and practice activities. Frequency of use and type of app used was also investigated. Open response questions explored participants’ views on apps that were desired or recommended and the characteristics of apps that were useful. Results 257 medical students and 131 junior doctors responded, equating to a response rate of 15.0% and 21.8% respectively. 79.0% (n=203/257) of medical students and 74.8% (n=98/131) of junior doctors owned a smartphone, with 56.6% (n=115/203) of students and 68.4% (n=67/98) of doctors owning an iPhone. The majority of students and doctors owned 1–5 medical related applications, with very few owning more than 10, and iPhone owners significantly more likely to own apps (Chi sq, papp usage of several times a day. Over 24hours apps were used for between 1–30 minutes for students and 1–20 minutes for doctors, students used disease diagnosis/management and drug reference apps, with doctors favouring clinical score/calculator apps. Conclusions This study found a high level of

  8. Variation in duration of hospital stay between hospitals and between doctors within hospitals

    NARCIS (Netherlands)

    Westert, Gert P.; Nieboer, Anna P.; Groenewegen, Peter P.


    Whether one examines the average length of hospital stay at the level of geographic areas, at the level of hospitals, or at the level of doctors, length-of-stay figures are known to vary widely. Even for hospital admissions for comparable surgical procedures among comparable groups of patients, sign

  9. Variation in duration in hospital stay between hospitals and between doctors within hospitals.

    NARCIS (Netherlands)

    Westert, G.P.; Nieboer, A.P.; Groenewegen, P.P.


    Whether one examines the average length of hospital stay at the level of geographic areas, at the level of hospitals, or at the level of doctors, length-of-stay figures are known to vary widely. Even for hospital admissions for comparable surgical procedures among comparable groups of patients, sign


    NARCIS (Netherlands)



    Whether one examines the average length of hospital stay at the level of geographic areas, at the level of hospitals, or at the level of doctors, length-of-stay figures are known to vary widely. Even for hospital admissions for comparable surgical procedures among comparable groups of patients, sign

  11. Choosing a doctor and hospital for your cancer treatment (United States)

    ... htm Choosing a doctor and hospital for your cancer treatment To use the sharing features on this page, please enable JavaScript. When you seek cancer treatment, you want to find the best care possible. ...

  12. Temporal and spatial organization of doctors' computer usage in a UK hospital department. (United States)

    Martins, H M G; Nightingale, P; Jones, M R


    This paper describes the use of an application accessible via distributed desktop computing and wireless mobile devices in a specialist department of a UK acute hospital. Data (application logs, in-depth interviews, and ethnographic observation) were simultaneously collected to study doctors' work via this application, when and where they accessed different areas of it, and from what computing devices. These show that the application is widely used, but in significantly different ways over time and space. For example, physicians and surgeons differ in how they use the application and in their choice of mobile or desktop computing. Consultants and junior doctors in the same teams also seem to access different sources of patient information, at different times, and from different locations. Mobile technology was used almost exclusively during the morning by groups of clinicians, predominantly for ward rounds.

  13. Establishing a generic training programme for future junior doctors: a role for neurosurgery within the framework of clinical neurosciences.


    Nadarajah, Ramesh; Amin, Amit; Aldlyami, Ehabb; Kang, Niel; Wong, James Min-Leong; Selway, Richard; Gullan, Richard


    INTRODUCTION: To describe the opinion of junior doctors in neurosurgery in the UK and Eire about future reforms to training, and to relate this to the establishment of a generic neurosciences training programme. METHODS: A postal questionnaire survey of neurosurgery units in UK and Eire (36 units). All senior house officers (SHOs) taking part in a neurosurgery on-call rota during the 6 months between February and August 2003 (n=236); 190 respondents (response rate 81% overall, 90% neurosurger...

  14. An audit cycle of consent form completion: A useful tool to improve junior doctor training

    Directory of Open Access Journals (Sweden)

    Catherine Leng


    Full Text Available Background: Consent for surgical procedures is an essential part of the patient's pathway. Junior doctors are often expected to do this, especially in the emergency setting. As a result, the aim of our audit was to assess our practice in consenting and institute changes within our department to maintain best medical practice. Methods: An audit of consent form completion was conducted in March 2013. Standards were taken from Good Surgical Practice (2008 and General Medical Council guidelines. Inclusion of consent teaching at a formal consultant delivered orientation programme was then instituted. A re-audit was completed to reassess compliance. Results: Thirty-seven consent forms were analysed. The re-audit demonstrated an improvement in documentation of benefits (91–100% and additional procedures (0–7.5%. Additional areas for improvement such as offering a copy of the consent form to the patient and confirmation of consent if a delay occurred between consenting and the procedure were identified. Conclusion: The re-audit demonstrated an improvement in the consent process. It also identified new areas of emphasis that were addressed in formal teaching sessions. The audit cycle can be a useful tool in monitoring, assessing and improving clinical practice to ensure the provision of best patient care.

  15. Factors influencing performance of cardiopulmonary resuscitation (CPR) by Foundation Year 1 hospital doctors. (United States)

    Sayee, Nicole; McCluskey, David


    Foundation Year One (FY1) doctors are often the first medical staff responders at in-hospital cardiac arrests. The study objectives were to assess the cardiopulmonary resuscitation (CPR) skills of FY1 doctors at a Belfast teaching hospital and to highlight factors that influence their performance. A group of FY1 doctors working in a Belfast teaching hospital were asked to participate in this study. These junior doctors were regularly on-call for acute medical emergencies including cardiac arrest. Participants were instructed to perform two, 3 minute sessions of CPR on a skills reporter manikin. Each session was separated by a 5 minute rest period, one session using a compression-to-ventilation ratio of 15:2 and the other using a ratio of 30:2. Performance was gauged both objectively, by measuring the depth of chest compressions, and subjectively by a panel of 5 Advanced Life Support (ALS) instructors who reviewed the tracings of each CPR session. Overall, 85% of medical FY1's working in the hospital participated in the study. Objective results determined that males performed significantly better than their female counterparts using both the 15:2 and 30:2 ratios. The male FY1 doctors performed equally well using both 15:2 and 30:2 ratios, in comparison to female doctors who were noted to be better using the 15:2 ratio. Individuals with a Body mass index (BMI) greater than the mean for the group, performed significantly better than those with a lower BMI when using the 30:2 ratio. BMI was an important factor and correlated with chest compression depth. Females with a low BMI performed less well when using a ratio of 30:2. Overall, expert opinion significantly favoured the 15:2 ratio for the FY1 doctor group. CPR performance can be influenced by factors such as gender and BMI, as such the individual rescuer should take these into account when determining which compression to ventilation ration to perform in order to maximise patient outcome. This study showed that

  16. Factors influencing junior doctors' choices of future specialty: trends over time and demographics based on results from UK national surveys. (United States)

    Smith, Fay; Lambert, Trevor W; Goldacre, Michael J


    To study trends in factors influencing junior doctors' choice of future specialty. Respondents were asked whether each of 15 factors had a great deal of influence on their career choice, a little influence or no influence on it. Percentages are reported of those who specified that a factor had a great deal of influence on their career choice. UK. A total of 15,765 UK-trained doctors who graduated between 1999 and 2012. Questions about career choices and factors which may have influenced those choices, in particular comparing doctors who qualified in 2008-2012 with those who qualified in 1999-2002. Enthusiasm for and commitment to the specialty was a greater influence on career choice in the 2008-2012 qualifiers (81%) than those of 1999-2002 (64%), as was consideration of their domestic circumstances (43% compared with 20%). Prospects for promotion were less important to recent cohorts (16%) than older cohorts (21%), as were financial prospects (respectively, 10% and 14%). Domestic circumstances and working hours were considered more important, and financial prospects less important, by women than men. Inclination before medical school was rated as important by 41% of doctors who were over 30 years old, compared with 13% of doctors who were under 21, at the time of starting medical school. The increasing importance of both domestic circumstances and enthusiasm for their specialty choice in recent cohorts suggest that today's young doctors prize both work-life balance and personal fulfilment at work more highly than did their predecessors. The differences in motivations of older and younger generations of doctors, men and women, and doctors who start medical school relatively late are worthy of note. © The Royal Society of Medicine.

  17. Teamwork and collaboration among doctors and nurses in two public hospitals in China


    Li, F; Xu, H.; Johnston, JM


    The Work-related Collaboration among Doctor-Nurse Scale (WCDNS) was ad-ministered to 398 doctors and nurses working in one of two hospitals in Guangzhou to assess 1) inter professional (doctor-nurse) differences in collaboration and teamwork and 2) inter hospital (general-specialist) differences in doctor nurse collaboration. Significant between profession and hospital differences were observed. Implications for future studies in doctor-nurse collaboration are discussed.

  18. A survey of how and why medical students and junior doctors choose a career in ENT surgery. (United States)

    Bhutta, M; Mandavia, R; Syed, I; Qureshi, A; Hettige, R; Wong, B Y W; Saeed, S; Cartledge, J


    To ascertain determinants of an interest in a career in ENT surgery through a survey of medical students and junior doctors. A survey was administered, comprising Likert scales, forced response and single option questions, and free text responses, at five different courses or events for those interested in a career in ENT. The survey had an 87 per cent response rate; respondents consisted of 43 applicants for national selection, 15 foundation doctors and 23 medical students. The most important factors that encourage ENT as a career included: the variety of operative procedures, work-life balance, inherent interest in this clinical area and inspirational senior role models. Exposure to ENT in undergraduate or post-graduate training is critical in deciding to pursue this specialty. It is important to promote those aspects of ENT surgery that attract people to it, and to argue for greater exposure to ENT during undergraduate and post-graduate training.

  19. Junior Doctor (CERN Fellows Programme) in the CERN Medical Service (HSE-ME)

    CERN Document Server

    Fassnacht, Veronique


    The CERN Medical Service is seeking to reinforce its medical team through the recruitment, for two (or three) years, of a doctor specialised in occupational medicine, who will also take part in the Service's exciting new projects.

  20. Medical Student and Junior Doctors' Tolerance of Ambiguity: Development of a New Scale (United States)

    Hancock, Jason; Roberts, Martin; Monrouxe, Lynn; Mattick, Karen


    The practice of medicine involves inherent ambiguity, arising from limitations of knowledge, diagnostic problems, complexities of treatment and outcome and unpredictability of patient response. Research into doctors' tolerance of ambiguity is hampered by poor conceptual clarity and inadequate measurement scales. We aimed to create and pilot a…

  1. Undergraduate and foundation training in trauma and orthopaedics: junior doctors have their say. (United States)

    Ghani, Yaser; Thakrar, Raj R; Palmer, Jon; Konan, Sujith; Donaldson, James; Olivier, Andre; Gikas, Panos; Briggs, Tim


    Undergraduate education in musculoskeletal health is currently insufficient in most medical schools worldwide, in both basic sciences and clinical training. A national survey was carried out to obtain views of current doctors from various specialties about undergraduate and foundation training in trauma and orthopaedics.

  2. How do patients define "good" and "bad" doctors? - Qualitative approach to the representations of hospital patients

    NARCIS (Netherlands)

    Luthy, C; Cedraschi, C; Perrin, E; Allaz, AF


    Questions under study: Knowledge of hospital patients' perceptions of doctors' qualities is limited. The purpose of this study was to explore hospital patients' definitions of "good" and "bad" doctors. Methods: Semi-structured interviews conducted with 68 consecutive hospital patients. The questions

  3. Cutaneous larva migrans in Hospital Kuala Lumpur, Malaysia: rate of correct diagnosis made by the referring primary care doctors. (United States)

    Yap, Felix Boon-Bin


    A retrospective study was undertaken to determine the clinical features of cutaneous larva migrans (CLM) seen in the Department of Dermatology, Hospital Kuala Lumpur (Kuala Lumpur, Malaysia) and to assess the rate of correct diagnosis made by the referring primary care doctors. Clinical records of all 31 patients with CLM seen between January 2006 and June 2010 were retrieved. The majority of patients were male. The mean age was 32.2 years. Pruritus was reported in 83.9% of cases and serpiginous tracts in 100%. The mean lesion count was 4.4 and the mean duration of disease before presentation was 3.1 weeks. The majority of skin lesions were on the buttock and lower extremities. Only 45.2% of patients had the correct diagnosis made by the referring primary care doctors. Older age of patients and lower number of lesions were associated with a higher rate of correct diagnosis. The low rate of correct diagnosis made by the referring primary care doctors to the dermatologists in this study warrants the need for education of not only primary care doctors but also future primary care providers, consisting of medical students, house officers and junior medical officers.

  4. Assessment of the knowledge and attitudes of intern doctors to medication prescribing errors in a Nigeria tertiary hospital. (United States)

    Ajemigbitse, Adetutu A; Omole, Moses Kayode; Ezike, Nnamdi Chika; Erhun, Wilson O


    Junior doctors are reported to make most of the prescribing errors in the hospital setting. The aim of the following study is to determine the knowledge intern doctors have about prescribing errors and circumstances contributing to making them. A structured questionnaire was distributed to intern doctors in National Hospital Abuja Nigeria. Respondents gave information about their experience with prescribing medicines, the extent to which they agreed with the definition of a clinically meaningful prescribing error and events that constituted such. Their experience with prescribing certain categories of medicines was also sought. Data was analyzed with Statistical Package for the Social Sciences (SPSS) software version 17 (SPSS Inc Chicago, Ill, USA). Chi-squared analysis contrasted differences in proportions; P Interns were least confident prescribing antibiotics (12, 25.5%), opioid analgesics (12, 25.5%) cytotoxics (10, 21.3%) and antipsychotics (9, 19.1%) unsupervised. Respondents seemed to have a low awareness of making prescribing errors. Principles of rational prescribing and events that constitute prescribing errors should be taught in the practice setting.

  5. Conceptualisation of socio-technical integrated information technology solutions to improve incident reporting through Maslow's hierarchy of needs: a qualitative study of junior doctors. (United States)

    Yee, Kwang Chien


    Medical errors are common, especially within the acute healthcare delivery. The identification of systemic factors associated with adverse events and the construction of models to improve the safety of the healthcare system seems straightforward, this process has been proven to be much more difficult in the realism of medical practice due to the failure of the incident reporting system to capture the essential information, especially from the perspective of junior doctors. The failure of incidence reporting system has been related to the lack of socio-technical consideration for both system designs and system implementations. The main reason of non-reporting can be conceptualised through the motivation psychology model: Maslow's hierarchy of needs; in order to achieve a change in the socio-cultural domain for incident reporting. This paper presents a qualitative research methodology approach to generate contextual-rich insights into the socio-cultural and technological factors of incident reporting among junior doctors. The research illuminates the guiding principles for future socio-technical integrated information communication technology designs and implementations. Using Maslow's hierarchy of needs as the conceptual framework, the guiding principles aim to design electronic incident reporting systems which will motivate junior doctors to participate in the process. This research paper aims to make a significant contribution to the fields of socio-technical systems and medical errors management. The design and implementation of the new incident reporting system has great potential to motivate junior doctors to change the culture of incident reporting and to work towards a safer future healthcare system.

  6. Clinical utility and impact of autopsies on clinical practice among doctors in a large teaching hospital in Ghana

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    Edem Tette


    : Strengthening the interaction between doctors and pathologists is essential in improving the autopsy process and utilization in the hospital. KBTH should create opportunities for doctors to attend autopsy demonstrations and for pathologists to attend clinicopathological meetings in the hospital.

  7. Effectiveness of mask ventilation performed by hospital doctors in an Irish tertiary referral teaching hospital.

    LENUS (Irish Health Repository)

    Walsh, K


    The objective of this study was to assess the effectiveness of mask ventilation performed by 112 doctors with clinical responsibilities at a tertiary referral teaching hospital. Participant doctors were asked to perform mask ventilation for three minutes on a Resusci Anne mannequin using a facemask and a two litre self inflating bag. The tidal volumes generated were quantified using a Laerdal skillmeter computer as grades 0-5, corresponding to 0, 334, 434, 561, 673 and > 800 ml respectively. The effectiveness of mask ventilation (i.e. the proportion of ventilation attempts which achieved a volume delivery of > 434 mls) was greater for anaesthetists [78.0 (29.5)%] than for non anaesthetists [54.6 (40.0)%] (P = 0.012). Doctors who had attended one or more resuscitation courses where no more effective at mask ventilation than their colleagues who had not undertaken such courses. It is likely that first responders to in-hospital cardiac arrests are commonly unable to perform adequate mask ventilation.

  8. A time and motion study of junior doctor work patterns on the weekend: a potential contributor to the weekend effect? (United States)

    Richardson, L C; Lehnbom, E C; Baysari, M T; Walter, S R; Day, R O; Westbrook, J I


    Patients admitted to hospital on weekends have a greater risk of mortality compared to patients admitted on weekdays. Junior medical officers (JMO) make up the majority of medical staff on weekends. No previous study has quantified JMO work patterns on weekends. To describe and quantify JMO work patterns on weekends and compare them with patterns previously observed during the week. Observational time and motion study of JMO working weekends using the Work Observation Method by Activity Timing (WOMBAT; Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, Australia) software. Descriptive statistics were used to determine the proportion of total observed time spent in tasks. Weekend JMO predominately spent time in indirect care (32.0%), direct care (23.0%) and professional communication (22.1%). JMO spent 20.9% of time multitasking and were interrupted, on average, every 9 min. Weekend JMO spent significantly more time in direct care compared with weekdays (13.0%; P pattern of JMO work could be a potential contributing factor to the weekend effect in terms of JMO abilities to respond safely and adequately to care demands. © 2016 Royal Australasian College of Physicians.

  9. Sticking with One Doctor May Help Keep Seniors Out of the Hospital (United States)

    ... a senior research associate, and Chris Salisbury, a professor of primary health care. Not only would it benefit patients, it would improve doctors' job satisfaction and likely reduce pressure on hospitals, they ...

  10. Questionnaire survey of working relationships between nurses and doctors in University Teaching Hospitals in Southern Nigeria

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    Adebamowo Clement A


    Full Text Available Abstract Background Smooth working relationships between nurses and doctors are necessary for efficient health care delivery. However, previous studies have shown that this is often absent with negative impact on the quality of health care delivery. In 2002, we studied factors that affect nurse-doctor working relationships in University Teaching Hospitals (UTH in Southern Nigeria in order to characterize it and identify managerial and training needs that might be used to improve it. Method Questionnaire survey of doctors and nurses working in four UTH in Southern Nigeria was done in 2002. The setting and subjects were selected by random sampling procedures. Information on factors in domains of work, union activities, personnel and hospital management were studied using closed and open-ended questionnaires. Results Nurse-doctor working relationships were statistically significantly affected by poor after-work social interaction, staff shortages, activist unionism, disregard for one's profession, and hospital management and government policies. In general, nurses had better opinion of doctors' work than doctors had about nurses' work. Conclusion Working relationships between doctors and nurses need to be improved through improved training and better working conditions, creation of better working environment, use of alternative methods of conflict resolution and balanced hospital management and government policies. This will improve the retention of staff, job satisfaction and efficiency of health care delivery in Nigeria.

  11. Job Satisfaction Analysis in Rural China: A Qualitative Study of Doctors in a Township Hospital

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    Qiwei Chen


    Full Text Available Background. Township hospitals in China provide rural communities with basic but much needed critical health care services. The doctors working in these hospitals often feel unsatisfied when considering their work schedules and financial rewards. Method. To explore job satisfaction of health workers in a township hospital, a qualitative study was conducted of 39 doctors from five township hospitals in Guangxi Zhuang Autonomous Region. The goal was to understand the level of job satisfaction of doctors and to make recommendations for improvements. Results. About 75% (28/39 of the doctors expressed negative attitudes related to their work conditions. Slightly more than half (22/39 mentioned they should receive greater compensation for their work and more than one were seriously considering other options. Many participants (35/39 showed their satisfaction about the achievement of serving as a doctor. Conclusion. Their main concerns related to job satisfaction included working conditions, financial rewards, and the doctor’s relationships with patients. Increasing the incomes and fringe benefits of healthcare workers, improving their work conditions, and providing training and continuing education opportunities would help rural clinics retain doctors and eliminate the current unsatisfactory conditions. The findings also highlight the need for the government to increase financial support of township hospitals.

  12. Basic life support knowledge, self-reported skills and fears in Danish high school students and effect of a single 45-min training session run by junior doctors; a prospective cohort study (United States)


    Background Early recognition and immediate bystander cardiopulmonary resuscitation are critical determinants of survival after out-of-hospital cardiac arrest (OHCA). Our aim was to evaluate current knowledge on basic life support (BLS) in Danish high school students and benefits of a single training session run by junior doctors. Methods Six-hundred-fifty-one students were included. They underwent one 45-minute BLS training session including theoretical aspects and hands-on training with mannequins. The students completed a baseline questionnaire before the training session and a follow-up questionnaire one week later. The questionnaire consisted of an eight item multiple-choice test on BLS knowledge, a four-level evaluation of self-assessed BLS skills and evaluation of fear based on a qualitative description and visual analog scale from 0 to 10 for being first responder. Results Sixty-three percent of the students (413/651) had participated in prior BLS training. Only 28% (179/651) knew how to correctly recognize normal breathing. The majority was afraid of exacerbating the condition or causing death by intervening as first responder. The response rate at follow-up was 61% (399/651). There was a significant improvement in correct answers on the multiple-choice test (p first responder was decreased 6.8 ± 2.2 to 5.5 ± 2.4 (p < .001). Conclusion Knowledge of key areas of BLS is poor among high school students. One hands-on training session run by junior doctors seems to be efficient to empower the students to be first responders to OHCA. PMID:24731392

  13. MedlinePlus FAQ: Information on Doctors or Hospitals (United States)

    ... this page, please enable JavaScript. Answer: Many health topic pages in MedlinePlus contain a section which lists directories of doctors and services relevant to the topic. The Directories page lists many sources of information about physicians, other ...

  14. Understanding doctors' ethical challenges as role virtue conflicts. (United States)

    McDougall, Rosalind


    This paper argues that doctors' ethical challenges can be usefully conceptualised as role virtue conflicts. The hospital environment requires doctors to be simultaneously good doctors, good team members, good learners and good employees. I articulate a possible set of role virtues for each of these four roles, as a basis for a virtue ethics approach to analysing doctors' ethical challenges. Using one junior doctor's story, I argue that understanding doctors' ethical challenges as role virtue conflicts enables recognition of important moral considerations that are overlooked by other approaches to ethical analysis.

  15. Burnout among doctors in residency training in a tertiary hospital. (United States)

    Ogundipe, O A; Olagunju, A T; Lasebikan, V O; Coker, A O


    The mental health of doctors is an issue of growing concern all over the world as it frequently interplays with their professional trainings and responsibilities. This study was done to determine the pattern and correlates of burnout among 204 doctors undergoing residency training. Eligible participants were interviewed using designed questionnaire, General Health Questionnaire (GHQ-12) and Maslach Burnout Inventory (MBI). The mean age of participants was 33.44±4.50. Ninety-three (45.6%) respondents reported burnout in the dimension of emotional exhaustion (EE), 118 (57.8%) in the dimension of depersonalization (D), and 126 (61.8%) in the dimension of reduced personal accomplishment (RPA). Factors that were significantly associated with all the dimensions of burnout were perceived heavy workload and presence of emotional distress (based on GHQ score of ≥3). The perception of call duty as being not stressful was negatively predictive of burnout in the emotional exhaustion subscale (odds ratio [OR]=0.52; 95%confidence interval [CI]=0.29-0.97; p=0.03), while emotional distress was a positive predictor (OR=6.97; 95%CI=3.28-14.81; pburnout in the depersonalization subscale (OR=0.36; 95%CI=0.17-0.76); pburnout in the reduced personal accomplishment subscale. Burnout is highly prevalent among resident doctors. Evolvement of comprehensive mental health services, training supports, conflict de-escalation/resolution mechanisms, and periodic assessment are indicated to mitigate work related distress with burn out among resident doctors, while improving their productivity.

  16. Cost awareness among doctors in an Irish university-affiliated teaching hospital

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    William H.C. Tiong


    Full Text Available Previous studies in USA and Canada have found that physicians and physicians in training have a limited understanding of medical care costs. In this study, we set out to survey all grades of doctors in the surgical department, emergency department, and anaesthetic department in a university-affiliated, Irish teaching hospital. Open-ended questionnaires on cost of 25 routinely used items in the hospital were sent to each department. The aims of the study were to assess the present knowledge of cost among the various grades of doctors, and to evaluate the level of professional experience on cost awareness and their confidence in their estimates. We had an overall response rate of 56.8% with 68.5% of doctors admitted to have estimated more than 90% of their responses. Ninety three percent of doctors have no confidence in their estimates on cost of listed items. We found that the lack of cost awareness was universal among doctors of all grades (P = 0.236. The doctors in our study population showed a high level of inaccuracy on their estimates of cost of routinely used items with 84% of the items overestimated. Our results were discouraging and demonstrated that considerable educational activity will be necessary if doctors are to be more cost effective in meeting the national health care budget.

  17. Pain issues from the palliative perspective: a survey among doctors in Hospital Melaka. (United States)

    Taye, G A W C


    This survey was intended to gauge the management of pain in palliative cancer patients by the doctors in Melaka Hospital. It also sought to identify possible barriers to adequate pain management among doctors and gauge their response to the adequacy of medical school teaching on cancer pain issues. A 39 item survey was used to cover the issues involved. Overall, the doctors displayed a lack of systematic approach to cancer pain management with inadequate knowledge of analgesia handling. Medical school exposure to cancer pain issues was lacking. Formulation of accepted clinical practice guidelines and new education strategies can improve cancer pain management.

  18. Medical restrictions to driving: the awareness of patients and doctors


    Kelly, R; Warke, T.; Steele, I.


    The study was set up to investigate the awareness of elderly patients and medical doctors of medical restrictions to driving. Separate questionnaires were completed by patients and doctors. All were interviewed face-to-face, without prior warning and their immediate answers were recorded. In total, 150 elderly patients from the acute elderly care wards, rehabilitation wards and day hospital, and 50 doctors (including all grades from consultant to junior house officer) were interviewed. The ma...

  19. Job satisfaction among hospital doctors in Norway and Germany. A comparative study on national samples. (United States)

    Rosta, Judith; Nylenna, Magne; Aasland, Olaf G


    To compare German and Norwegian hospital doctors on 10 different aspects of job satisfaction and general life satisfaction. The study population consisted of a representative sample of 1,448 German and 484 Norwegian hospital doctors aged 33-65 years (n = 1,932), selected from nationwide postal surveys in 2006. The questionnaires contained items on subjective life satisfaction and the validated 10-item Job Satisfaction Scale. Each item was scored on a seven-point Likert scale from 1 (very dissatisfied) to 7 (very satisfied). A mean sum score was calculated, ranging from 1 to 7. Regression analyses and generalized-linear-model-estimated means controlled for age and gender with 95% confidence intervals were used for comparison. Norwegian hospital doctors had significantly higher life satisfaction (mean 5.31 vs. 5.15) and job satisfaction (mean 5.09 vs. 4.55) than their German colleagues. Item by item, doctors in Norway were significantly more content with seven aspects of their work: "Freedom to choose your own methods of working'' (mean 5.00 vs. 4.72), "opportunities to use your skills'' (mean 5.49 vs. 5.01), "physical working conditions'' (mean 4.62 vs. 4.08), "recognition you get for good achievements'' (mean 4.83 vs. 4.26), "overall job situation'' (mean 5.57 vs. 4.64), "work hours'' (mean 4.39 vs. 3.39), "ate of pay'' (mean 4.70 vs. 3.70). General life satisfaction and age, but not gender, were positively associated with job satisfaction in both countries. Norwegian hospital doctors enjoy a higher level of life and job satisfaction than German hospital doctors. The most likely reasons for this are more acceptable work hours, salary and control over clinical work in Norway.

  20. Submerged discontent and patterns of accommodation: a case study of doctors' pay in two public hospitals in China. (United States)

    Cao, Xuebing


    The article evaluates submerged discontent among Chinese public hospital doctors (Note1) regarding their pay and patterns of accommodation, including doctors' responses through formal and informal actions in the context of health service marketization. On the basis of a case study of two public hospitals, the article illustrates the dynamical impact of marketization on Chinese doctors' pay-related dissatisfaction and health service employment relationship. Because of the authoritarian management and compliant trade unions, the conflict between doctors and hospitals is unable to be accommodated through collective methods. Instead, doctors' discontent is often channelled through informal, individual and subtle activities. Meanwhile, doctors' professional society is gradually influential, showing its potential of developing doctors' group identity and protecting members' interests in future.

  1. Mobile learning devices in the workplace: 'as much a part of the junior doctors' kit as a stethoscope'? (United States)

    Dimond, Rebecca; Bullock, Alison; Lovatt, Joseph; Stacey, Mark


    Smartphones are ubiquitous and commonly used as a learning and information resource. They have potential to revolutionize medical education and medical practice. The iDoc project provides a medical textbook smartphone app to newly-qualified doctors working in Wales. The project was designed to assist doctors in their transition from medical school to workplace, a period associated with high levels of cognitive demand and stress. Newly qualified doctors submitted case reports (n = 293) which detail specific instances of how the textbook app was used. Case reports were submitted via a structured online form (using Bristol Online Surveys - BOS) which gave participants headings to elicit a description of: the setting/context; the problem/issue addressed; what happened; any obstacles involved; and their reflections on the event. Case reports were categorised by the purpose of use, and by elements of the quality improvement framework (IoM 2001). They were then analysed thematically to identify challenges of use. Analysis of the case reports revealed how smartphones are a viable tool to address clinical questions and support mobile learning. They contribute to novice doctors' provision of safe, effective, timely, efficient and patient-centred care. The case reports also revealed considerable challenges for doctors using mobile technology within the workplace. Participants reported concern that using a mobile phone in front of patients and staff might appear unprofessional. Mobile phones blur boundaries between the public and private, and the personal and professional. In contrast to using a mobile as a communication device, using a smartphone as an information resource in the workplace requires different rituals. Uncertain etiquette of mobile use may reduce the capacity of smartphone technology to improve the learning experience of newly qualified doctors.

  2. A Failure to Communicate? Doctors and Nurses in American Hospitals. (United States)

    Michel, Lucie


    This article showcases the realities and challenges of teamwork in American hospitals based on the in situ comparison with France. Drawing on observation of nurse-physician interactions in hospitals in the two nations, this article highlights a troubling conflict between teamwork rhetoric and realities on the ward. Although the use of informatics systems such as electronic health records is supposed to increase cooperation, the observations presented here show that on the contrary, it inhibits communication that is becoming mainly virtual. While the nursing profession is more developed and provides stronger education in the United States, this story highlights the challenges in creating a shared environment of work and suggests the importance of balancing professional autonomy and effective teamwork. Copyright © 2017 by Duke University Press.

  3. A study of needle stick injuries among non-consultant hospital doctors in Ireland.

    LENUS (Irish Health Repository)

    O'Connor, M B


    NCHDs are exposed to a great number of blood-borne infections. Needle stick injuries are possibly the main route of acquiring such infections from a non-consultant hospital doctors (NCHDs) perspective. This study examines NCHDs experiences surrounding needle stick injuries.


    Directory of Open Access Journals (Sweden)

    Amit A.


    Full Text Available BACKGROUND: Monitoring and evaluation of adverse drug reactions (ADRs through a well - organized pharmacovigilance system is vital for safe use of medicines. ADR reporting by healthcare professionals forms the backbone of pharmacovigilance system. AIM: To assess the awareness of pharmacovigilance among resident doctors in a tertiary care hospital. MATERIAL AND METHODS: This is a cross sectional descriptive study, carried out in a total 160 resident doctors from various specialities in a government run tertiary care teaching hospital were administered a questionnaire to evaluate knowledge, attitude and practice of pharmacovigilance. The questionnaire consisted of open and closed ended questions. The study was conducted in January/ February 2012. RESULTS: Most of the residents had heard the term ‘pharmacovigilance’ but only 25% knew the actual meaning of it. About 84% of the residents did not know about Pharmacovigilance Programme of India ( PvPI, 68% did not know about existence of any ADR reporting centers in the country. Most of them (75% agreed that ADR reporting is responsibility of the doctors. So far none of the residents have reported an ADR under PvPI. CONCLUSION: The awareness of pharmacovigilance among resident doctors in teaching hospitals is very low. There is an urgent need to train health professionals in pharmacovigilance to improve the current sorry state.

  5. New drug prescribing by hospital doctors: the nature and meaning of knowledge. (United States)

    Prosser, Helen; Walley, Tom


    In the UK the high cost of new drugs is partly accountable for the growth in spending on prescription drugs. Most prescribing takes place in general practice and the influence of secondary care prescribing on primary care prescribing is well recognized; yet the factors that influence hospital prescribing have been little researched. Drawing on accounts of actual prescribing events from hospital doctors from a range of specialties, we investigated the processes by which new drugs come into practice, from hospital doctors' awareness of new drugs to the assimilation and interpretation of evidential sources. The determinants of new drug prescribing were interconnected within four forms of knowledge: scientific knowledge, social knowledge, patient knowledge and experiential knowledge. Furthermore, the nature of knowledge could only be understood within its situated context. The revelation of multiple and contingent forms of knowledge highlights the problematic nature of knowledge construction within the approaches of evidence-based medicine.

  6. Continuing professional development and Irish hospital doctors: a survey of current use and future needs. (United States)

    Maher, Bridget; Faruqui, Adnan; Horgan, Mary; Bergin, Colm; Tuathaigh, Colm O; Bennett, Deirdre


    Doctors rate clinical relevance and applicability as the most important determinants of continuing professional development (CPD) course selection. This study examined patterns of current CPD practice and perceived CPD needs among hospital doctors in Ireland across various clinical specialties. A cross-sectional survey was administered to doctors, focusing on the areas of training needs analysis, CPD course content and preferred course format. In total, 547 doctors identified doctor-patient communication as the skill ranked highest for importance and level of current performance. Workload/time organisation and stress management were areas where a skills deficiency was identified. Non-clinical CPD topics, including resilience training, management and communication skills, were preferred areas for future CPD offerings. All respondents favoured interactive, hands-on sessions. CPD course completion and preference patterns differed significantly across clinical specialties. These results highlight the importance of considering the individual needs and preferences of clinicians across clinical specialties to facilitate more effective CPD programmes. © Royal College of Physicians 2017. All rights reserved.

  7. Intergroup communication between hospital doctors: implications for quality of patient care. (United States)

    Hewett, David G; Watson, Bernadette M; Gallois, Cindy; Ward, Michael; Leggett, Barbara A


    Hospitals involve a complex socio-technical health system, where communication failures influence the quality of patient care. Research indicates the importance of social identity and intergroup relationships articulated through power, control, status and competition. This study focused on interspecialty communication among doctors for patients requiring the involvement of multiple specialist departments. The paper reports on an interview study in Australia, framed by social identity and communication accommodation theories of doctors' experiences of managing such patients, to explore the impact of communication. Interviews were undertaken with 45 doctors working in a large metropolitan hospital, and were analysed using Leximancer (text mining software) and interpretation of major themes. Findings indicated that intergroup conflict is a central influence on communication. Contested responsibilities emerged from a model of care driven by single-specialty ownership of the patient, with doctors allowed to evade responsibility for patients over whom they had no sense of ownership. Counter-accommodative communication, particularly involving interpersonal control, appeared as important for reinforcing social identity and winning conflicts. Strategies to resolve intergroup conflict must address structural issues generating an intergroup climate and evoke interpersonal salience to moderate their effect.

  8. [Supervision of junior doctors and allocation of work tasks regarding admissions and further treatment of acute admitted patients.

    DEFF Research Database (Denmark)

    Folkestad, Lars; Brabrand, Mikkel; Hallas, Peter


    -up of patients with clinical deterioration at the wards. RESULTS: A total of 88 interns with an average of 2.8 months of experience were included in the survey. Sixty percent of the interns answered that they initially dealt with acute admissions. During the day, patients with clinical deterioration......INTRODUCTION: It is being debated whether medical staff working at the emergency departments with acute admission services dealing with medical patients have the required professional competence level. It has not previously been documented which doctors see the acute admissions initially...... are the responsibility of the physicians doing their rounds at the ward. During evening and night hours, 80% of interns say that patients with clinical deterioration are their responsibility. Fifty four percent of participants care for medical patients as they initially arrive at the emergency room. The interns consult...

  9. Evidence-based information-seeking skills of junior doctors entering the workforce: an evaluation of the impact of information literacy training during pre-clinical years. (United States)

    Cullen, Rowena; Clark, Megan; Esson, Rachel


    To investigate the extent to which junior doctors in their first clinical positions retained information literacy skills taught as part of their undergraduate education. Participants drawn from different training cohorts were interviewed about their recall of the instruction they had received, and their confidence in retrieving and evaluating information for clinical decision making. They completed a search based on a scenario related to their specialty. Their self-assessment of their competency in conducting and evaluating a search was compared with an evaluation of their skills by an experienced observer. Most participants recalled the training they received but had not retained high-level search skills, and lacked skills in identifying and applying best evidence. There was no apparent link between the type of training given and subsequent skill level. Those whose postgraduate education required these skills were more successful in retrieving and appraising information. Commitment to evidence-based medicine from clinicians at all levels in the profession is needed to increase the information seeking skills of clinicians entering the work force. © 2011 The authors. Health Information and Libraries Journal © 2011 Health Libraries Group.

  10. Junior Doctors of Health©: an interprofessional service-learning project addressing childhood obesity and encouraging health care career choices. (United States)

    Buff, Scotty M; Gibbs, Pamella Y; Oubré, O'karsamaa L; Ariail, Jane C; Blue, Amy V; Greenberg, Raymond S


    While much literature describes programmatic success of clinical service-learning opportunities, this initiative integrates student learning across a comprehensive discipline set (Dental Medicine, Graduate Studies, Health Administration, Medicine, Nursing, Occupational Therapy, Pharmacy, Physical Therapy, and Physician Assistant), providing preventive health education and role modeling to low-income elementary-school children. Junior Doctors of Health© (JDOH), a health education curriculum taught by Medical University of South Carolina students, addresses childhood obesity and encourages child interest in health professional (HP) and biomedical science (BS) careers. Of the 78 surveyed HP/BS students, over 80% agreed JDOH was worthwhile for their professional development, increased their appreciation and ability as an interprofessional team member, improved their understanding and interest in underserved communities, and provided them with valuable childhood-obesity prevention information. With the increased need for childhood-obesity prevention and team building among students of various health and science professions, recommendations are offered to others interested in creating or collaborating to build similar service-learning initiatives.

  11. An Overview of the Opportunities the Presence of Specialist Doctors Resident in Hospitals

    Directory of Open Access Journals (Sweden)

    Reza Moradi


    Full Text Available Attention to the functions and pattern organized staff are important to achieve organizational goals, especially for hospitals that are one of the important components into account a element in improving the health system and providing a fair field of utilization of health intervention. So this study was to review the opportunities of presence resident doctors in hospitals based on the instructions of the health system reform plan. This is a narrative review that returning to the site of the Persian (Magiran, Irandoc, Google Scholar, Iranmedex, SID and English (PubMed, Scopus, EMBASE and Sciencedirect and also library studies with keywords (physicians, resident physicians, health equity, project development, opportunity specialist and human resources and the English word for them in this area and the 30 related articles was extracted. Given the evidence may not be fully implemented in all government hospitals because of problems such as the lack of doctors in public hospitals or other administrative problems, but it can be said that is one of the best model to achieve better clinical outcomes in hospitals. In order to solve problems, there is the need to design and create the appropriate environment for the successful implementation plan, or create an ideal environment for the implementation of evidence-based medicine moved.

  12. A Study of Power Relations in Doctor-Patient Interactions in Selected Hospitals in Lagos State, Nigeria (United States)

    Adam, Qasim


    This paper explores power relations in clinical interactions in Nigeria. It seeks to investigate the use of power between doctors and patients during consultations on patient-centred approach to medicine in selected public and private hospitals in Lagos State, Nigeria. The objective is to establish how doctors' projection of power, using the…

  13. Why are hospital doctors not referring to Consultation-Liaison Psychiatry? - a systemic review. (United States)

    Chen, Kai Yang; Evans, Rebecca; Larkins, Sarah


    Consultation-Liaison Psychiatry (CLP) is a subspecialty of psychiatry that provides care to inpatients under non-psychiatric care. Despite evidence of benefits of CLP for inpatients with psychiatric comorbidities, referral rates from hospital doctors remain low. This review aims to understand barriers to CLP inpatient referral as described in the literature. We searched on Medline, PsychINFO, CINAHL and SCOPUS, using MESH and the following keywords: 1) Consultation-Liaison Psychiatry, Consultation Liaison Psychiatry, Consultation Psychiatry, Liaison Psychiatry, Hospital Psychiatry, Psychosomatic Medicine, the 2) Referral, Consultation, Consultancy and 3) Inpatient, Hospitalized patient, Hospitalized patient. We considered papers published between 1 Jan 1965 and 30 Sep 2015 and all articles written in English that contribute to understanding of barriers to CLP referral were included. Thirty-five eligible articles were found and they were grouped thematically into three categories: (1) Systemic factors; (2) Referrer factors; (3) Patient factors. Systemic factors that improves referrals include a dedicated CLP service, active CLP consultant and collaborative screening of patients. Referrer factors that increases referrals include doctors of internal medicine specialty and comfortable with CLP. Patients more likely to be referred tend to be young, has psychiatric history, live in an urban setting or has functional psychosis. This is the first systematic review that examines factors that influence CLP inpatient referrals. Although there is research in this area, it is of limited quality. Education could be provided to hospital doctors to better recognise mental illness. Collaborative screening of vulnerable groups could prevent inpatients from missing out on psychiatric care. CLP clinicians should use the knowledge gained in this review to provide quality engagement with referrers.

  14. Awareness and attitude of doctors and nurses at a teaching hospital to skin donation and banking. (United States)

    Michael, A I; Ademola, S A; Olawoye, O A; Iyun, A O; Oluwatosin, O M


    This study sought to determine the awareness and attitude of doctors and nurses in a teaching hospital to skin donation and banking, and to identify needs for personnel educational programmes. A cross sectional survey on doctors and nurses was carried out using a 44-item questionnaire that included a Likert scale on attitudes. Predictors of favourable attitudes were determined. Eighty (49.7%) doctors and 81 (50.3%) nurses participated in the study. Many participants, 126 (78.3%), knew that skin could be donated, but only 96 (59.6%) participants were aware of skin banking. The main source of information was during professional training (17.4%). Only 41 (25.5%) participants were willing to donate skin after death. Body disfigurement was the major reason (20.5%) against skin donation. Participants who were doctors, were aware of skin banking, and who were previous blood donors had higher attitudes scores (pbanking were predictors of favourable attitudes to skin donation and banking. Knowledge transfer during health professional training on the usefulness of banked skin in patients with major burns may lead to improved attitude of health professionals and acceptance of this modality of burn management. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

  15. Practise what you preach: health behaviours and stress among non-consultant hospital doctors.

    LENUS (Irish Health Repository)

    Feeney, Sinéad


    High rates of psychological distress, depression and suicide have been reported among doctors. Furthermore, many doctors do not access healthcare by conventional means. This study aimed to increase understanding regarding non-consultant hospital doctors\\' (NCHDs\\') response to stress and barriers to accessing supports, and identify possible solutions. Medical manpower departments in 58 hospitals distributed a 25-item questionnaire to 4,074 NCHDs; we received 707 responses (response rate, 17.4%). 60% of NCHDs were unable to take time off work when unwell; \\'letting teammates down\\' (90.8%) and \\'difficulty covering call\\' (85.9%) were the leading reasons. \\'Being too busy\\' (85%), \\'self-prescription\\' (66.6%) and \\'self-management\\' (53.1%) were ranked highest in deterring NCHDs from visiting a general practitioner (GP). 22.9% of NCHDs would not attend a GP with anxiety or depression until they began to feel hopeless, helpless or suicidal. 12.2% would not seek help at all. 55% of respondents (n = 330) had to move away from partners or dependants due to work, negatively affecting the social supports of 82.9%. Possible practical solutions were explored. NCHDS are a vulnerable population and have a particularly challenging lifestyle. Key recommendations include improved GP and counselling access for NCHDs, and addressing the culture of self-treatment and poor health behaviours through undergraduate and postgraduate education.

  16. Founding an adverse drug reaction (ADR) network: a method for improving doctors spontaneous ADR reporting in a general hospital. (United States)

    Goldstein, Lee Hilary; Berlin, Maya; Saliba, Walid; Elias, Mazen; Berkovitch, Matitiyahu


    Adverse drug reactions (ADR) are underreported by doctors despite numerous efforts. We aimed to determine if establishing an "ADR reporting doctor's network" within a hospital would increase the quantity of ADRs reported by hospital doctors. One hundred hospital doctors joined the network. Email reminders were sent to network members during the 1 year study period, conveying information about ADRs reported, amusingly and pleasantly reminding them to report ADRs in minimal detail, by phone, email, text message or mail to the Clinical Pharmacology Unit, who would further complete the report. A total of 114 ADRs were reported during the study period in comparison to 48, 26, and 17 in the previous 3 years (2008, 2009, 2010, respectively). In the 3 years prior, doctors reported 41.7% of the reported ADRs whereas in the study period, doctors reported 74.3% of ADRs (P reports. Ninety seven percent of doctors' reports were of ADR network members. Thirty-four (34%) network members reported an ADR during the study period and 31 of the 34 reporters had never reported ADRs before becoming network members. Establishing an ADR network of doctors substantially increases ADR reporting amongst its members.

  17. Can the transition process from foundation doctor to neurosurgical specialty trainee be improved through “learner-centered induction programs”?

    Directory of Open Access Journals (Sweden)

    Acharya V


    Full Text Available Vikas Acharya,1 Sami Mansour,2 Samuel M Amis,3 Amir Reyahi3 1Department of Neurosurgery, University Hospitals Coventry and Warwickshire, 2Warwick Medical School, University of Warwick, Coventry, 3Luton and Dunstable University Hospital, Luton, UK Abstract: The transition period from foundation program doctor to specialty trainee can be difficult for junior doctors. This difficult period often acts as a major obstacle for learning in the workplace. Existing induction programs are commonly seen as inadequate at easing this transition, and therefore, a pilot study intervention was undertaken to assess if the initiation of “learner-centered induction programs” could help improve the confidence, knowledge acquisition, and satisfaction of junior doctors as they begin specialty training in neurosurgery. Ethnographic and anecdotal evidences were collated from junior doctors, specialty trainees, and consultants in order to investigate if further work on this subject would be beneficial. All participants were working in the Department of Neurosurgery at University Hospital Coventry and Warwickshire, Coventry, UK, over a 4-week period in March/April 2015. A review of the relevant literature was also undertaken. This report found that despite the reservations around the increased organizational demands of induction programs of this nature, as well as concerns around a single junior doctor covering the ward alone during the induction period, feedback following the intervention was largely positive. Junior doctors appreciated being taught about their roles and responsibilities from their predecessors as well as deciding among themselves what topics they wanted covering. As a result, the induction sessions tended to focus on clinical skills rather than theoretical knowledge, which most of the junior doctors believed they could cover adequately in their own time. The junior doctors felt that they benefited from learning/refreshing their relevant practical

  18. Doctors' perspectives on the barriers to appropriate prescribing in older hospitalized patients: A qualitative study.

    LENUS (Irish Health Repository)

    Cullinan, S


    Older patients commonly suffer from multimorbidites and take multiple medications. As a result, these patients are more vulnerable to potentially inappropriate prescribing (PIP). PIP in older patients may result in adverse drug events and hospitalisations. However, little has been done to identify why PIP occurs. The objectives of this study were; (1) to identify hospital doctors\\' perceptions as to why PIP occurs, (2) to identify the barriers to addressing the issues identified, and (3) to determine which intervention types would be best suited to improving prescribing.

  19. Supervisory needs of research doctoral students in a university teaching hospital setting. (United States)

    Caldwell, Patrina Hy; Oldmeadow, Wendy; Jones, Cheryl A


    Teaching hospitals affiliated with universities are now common sites for research higher degree supervision. We hypothesised that the hospital environment poses unique challenges to supervision compared with the traditional university research institute setting. This study aimed to identify and rank important supervision issues in a clinical setting from the students' perspective. Using the Delphi method to explore issues and facilitate consensus, small group discussions were conducted with 10 research doctoral students from a tertiary teaching hospital. We identified supervision issues that are unique to the hospital-based context. These include the demands placed on supervisors combining clinical and supervisory roles, the challenges of academic medical/scientific writing and career issues for students who are already established in their professions. Other issues identified, common to all doctoral students, include differing expectations between students and supervisors (with students wanting support for their career plans, training in research skills and increasing autonomy and responsibility), supervisor access, quality and frequency of meetings, lack of training in writing and dealing with conflicts. Our research identified that postgraduate students of supervisors who combine clinical and supervisory roles report significant issues with supervision, some of which are unique to the clinical setting. Clinician researchers who supervise postgraduate students need to balance clinical and supervisory responsibilities, identify and negotiate student expectations early in candidature and provide career counselling to students who are already highly experienced. Furthermore, clinician supervisors should undertake postgraduate supervisor training programme tailored to the hospital setting to better support their students. © 2012 The Authors. Journal of Paediatrics and Child Health © 2012 Paediatrics and Child Health Division (Royal Australasian College of

  20. Improving computer-mediated synchronous communication of doctors in rural communities through cloud computing: A case study of rural hospitals in South Africa

    CSIR Research Space (South Africa)

    Coleman, A


    Full Text Available This paper investigated how doctors in remote rural hospitals in South Africa use computer-mediated tool to communicate with experienced and specialist doctors for professional advice to improve on their clinical practices. A case study approach...

  1. How do hospital doctors manage patients with medically unexplained symptoms: a qualitative study of physicians. (United States)

    Warner, Alex; Walters, Kate; Lamahewa, Kethakie; Buszewicz, Marta


    Objective Medically unexplained symptoms are a common presentation in medical practice and are associated with significant morbidity and high levels of service use. Most research exploring the attitudes and training of doctors in treating patients with unexplained symptoms has been conducted in primary care. This study aims to explore the ways in which doctors working in secondary care approach and manage patients with medically unexplained symptoms. Design A qualitative study using in-depth interviews and thematic analysis. Setting Three hospitals in the North Thames area. Participants Twenty consultant and training-grade physicians working in cardiology, gastroenterology, rheumatology and neurology. Main outcome measure Physicians' approach to patients with medically unexplained symptoms and their views on managing these patients. Results There was considerable variation in how the physicians approached patients who presented with medically unexplained symptoms. Investigations were often ordered without a clear rationale and the explanations given to patients when results of investigations were normal were highly variable, both within and across specialties. The doctor's level of experience appeared to be a more important factor in their investigation and management strategies than their medical specialty. Physicians reported little or no formal training in how to manage such presentations, with no apparent consistency in how they had developed their approach. Doctors described learning from their own experience and from senior role models. Organisational barriers were identified to the effective management of these patients, particularly in terms of continuity of care. Conclusions Given the importance of this topic, there is a need for serious consideration as to how the management of patients with medically unexplained symptoms is included in medical training and in the planning and delivery of services.

  2. Mobile and fixed computer use by doctors and nurses on hospital wards

    DEFF Research Database (Denmark)

    Andersen, Pia; Lindgaard, Anne-Mette; Prgomet, M.


    , computers on wheels (COWs) and tablet PCs-was made. Two types of COWs were available on the wards: generic COWs (laptops mounted on trolleys) and ergonomic COWs (an integrated computer and cart device). Heuristic evaluation of the user interfaces was also carried out. RESULTS: The majority (93......BACKGROUND: Selecting the right mix of stationary and mobile computing devices is a significant challenge for system planners and implementers. There is very limited research evidence upon which to base such decisions. OBJECTIVE: We aimed to investigate the relationships between clinician role......, clinical task, and selection of a computer hardware device in hospital wards. METHODS: Twenty-seven nurses and eight doctors were observed for a total of 80 hours as they used a range of computing devices to access a computerized provider order entry system on two wards at a major Sydney teaching hospital...

  3. A study of needle stick injuries among non-consultant hospital doctors in Ireland.

    LENUS (Irish Health Repository)

    O'Connor, M B


    INTRODUCTION: NCHDs are exposed to a great number of blood-borne infections. Needle stick injuries are possibly the main route of acquiring such infections from a non-consultant hospital doctors (NCHDs) perspective. This study examines NCHDs experiences surrounding needle stick injuries. METHODS: A cross-sectional self-administered anonymous questionnaire survey was conducted on 185 NCHDs working in a clinical setting among seven teaching hospitals in Ireland. Implied consent was obtained. The data was analysed using Excel spreadsheets. Ethical approval was received. RESULTS: A response rate of 85.4% (158\\/185) was achieved. Findings of the study are shown in the manuscript table. CONCLUSIONS: A needle stick injury (NI) history is greater among surgical NCHDs than medical NCHDs. The level of disposable glove usage is worryingly poor. Training in sharps handling and dealing with a NI needs to be addressed. HIV is the blood-borne infection most fear of being contracting as a consequence of a NI.

  4. The effect of performance-related pay of hospital doctors on hospital behaviour: a case study from Shandong, China

    Directory of Open Access Journals (Sweden)

    Mills Anne


    Full Text Available Abstract Background With the recognition that public hospitals are often productively inefficient, reforms have taken place worldwide to increase their administrative autonomy and financial responsibility. Reforms in China have been some of the most radical: the government budget for public hospitals was fixed, and hospitals had to rely on charges to fill their financing gap. Accompanying these changes was the widespread introduction of performance-related pay for hospital doctors – termed the "bonus" system. While the policy objective was to improve productivity and cost recovery, it is likely that the incentive to increase the quantity of care provided would operate regardless of whether the care was medically necessary. Methods The primary concerns of this study were to assess the effects of the bonus system on hospital revenue, cost recovery and productivity, and to explore whether various forms of bonus pay were associated with the provision of unnecessary care. The study drew on longitudinal data on revenue and productivity from six panel hospitals, and a detailed record review of 2303 tracer disease patients (1161 appendicitis patients and 1142 pneumonia patients was used to identify unnecessary care. Results The study found that bonus system change over time contributed significantly to the increase in hospital service revenue and hospital cost recovery. There was an increase in unnecessary care and in the probability of admission when the bonus system switched from one with a weaker incentive to increase services to one with a stronger incentive, suggesting that improvement in the financial health of public hospitals was achieved at least in part through the provision of more unnecessary care and drugs and through admitting more patients. Conclusion There was little evidence that the performance-related pay system as designed by the sample of Chinese public hospitals was socially desirable. Hospitals should be monitored more closely

  5. Doctors' knowledge of patients' rights at King Fahd Hospital of the University. (United States)

    Al-Muammar, Sarah A; Gari, Danya M K


    To assess the level of physicians' knowledge about the contents of patients' bill of rights (PBR) and its implementation. This cross-sectional study was carried out at a university hospital in the Eastern Province of Saudi Arabia. All physicians working in the hospital received a self-administered questionnaire to measure their level of knowledge of PBR. Scoring was done to determine the knowledge of the details. The study was approved by the Institutional Review Board of the University Hospital and permission sought from the administration. Data analysis performed with SPSS; descriptive analyses included frequency and percentages for categorical variables, and mean and standard deviations for continuous variables. Bivariate analyses were carried out to determine association between sociodemographic variables and the level of knowledge (adequate/inadequate). Logistic regression analysis were performed to calculate adjusted odds ratio at 0.05 significance level. Most (52.7%) of the physicians were females, were aged between 25 and 30 years (58.5%), and Saudi (80.2%). The majority of the physicians belonged to the residency program (44.9%) and had work experience of 1-5 years (45.4%). About 44% physicians had adequate knowledge about PBR and 55.56% had inadequate knowledge. Regarding physician's response to each item of PBR, the majority (98.1%) gave correct answer to Item 2: "Patients should know the identity and professional status of the healthcare providers responsible for their treatment" (98.1%). Item 25: "Doctors are entitled to withhold any procedures related to a patient's condition if the patient refuses their choice of treatment" was the item with the least correct response (15.5%). Reinforcement and strict implementation of PBR are necessary. The institution should provide training and motivate physicians, especially younger doctors regarding PBR to ensure good health for all and safeguard the integrity of both the physician and the hospital.

  6. Harm to patients and others caused by impaired junior doctors compelled to work 30-hour shifts or longer: Can the minister of health, provincial MECs for health and public health officials be held liable?

    Directory of Open Access Journals (Sweden)

    David Jan McQuoid-Mason


    Full Text Available Junior doctors in most provinces in South Africa are compelled to work 30-hour shifts without a break. Shifts in excess of 24 hours can result in serious bodily harm to patients, third parties and the doctors themselves. These risks have been drawn to the attention of the health authorities but the 30-hour policy continues to be implemented in all provinces, except recently in the Western Cape. Public health officials may be held directly liable for the harm caused to patients, third parties or the junior doctors themselves, if it can be shown that they are at fault and are acting unlawfully in violation of the Constitution. Where officials carry out the unlawful orders of senior officials, including the minister of health and provincial members of the executive council (MECs for health, they may not raise the defence of ‘obedience to orders’ and may be held directly liable for harm caused. Superior officials issuing such orders will also be held directly liable for harm caused.

  7. Doctors as street-level bureaucrats in a rural hospital in South Africa. (United States)

    Gaede, Bernhard M


    In the perspectives of implementation of policy, the top-down and bottom-up perspectives of policy-making dominate the discourse. However, service delivery and therefore the experience of the policy by the citizen ultimately depend on the civil servant at the front line to implement the policy. Lipsky named this street-level bureaucracy, which has been used to understand professionals working in the public sector throughout the world. The public sector in South Africa has undergone a number of changes in the transition to a democratic state, post 1994. This needs to be understood in public administration developments throughout the world. At the time of the study, the public sector was characterized by considerable inefficiencies and system failures as well as inequitable distribution of resources. The context of the study was a rural hospital serving a population of approximately 150 000. An insider-ethnography over a period of 13 months explored the challenges of being a professional within the public sector in a rural hospital in South Africa. Data collection included participant observation, field notes of events and meetings, and documentation review supplemented with in-depth interviews of doctors working at a rural hospital. Street-level bureaucracy was used as a framework to understand the challenges of being a professional and civil servant in the public sector. The context of a resource-constrained setting was seen as a major limitation to delivering a quality service. Yet considerable evidence pointed to doctors (both individually and collectively) being active in managing the services in the context and aiming to achieve optimal health service coverage for the population. In the daily routine of the work, doctors often advocated for patients and went beyond the narrow definitions of the guidelines. They compensated for failing systems, beyond a local interpretation of policy. However, doctors also at times used their discretion negatively, to avoid work

  8. [How to make regional medicine revive from the medical crisis or collapse due to the severe paucity of medical doctors: a plan with "the magnet hospital"]. (United States)

    Itoh, Tsunetoshi


    In 2002-2003, the practice of doctors lending their names to appear as "staff" of hospitals became known. Problems regarding funds from public hospitals were also revealed. Tohoku University asked regional societies how to improve the medical situation, and redefined its responsibilities. The Educational Development Center for Local Medicine and Department of Local Medical Service System were set up (2005-2008). A severe shortage of medical doctors prevails in Japan: the number of doctors per population is at the 4th lowest among OECD countries, and the number per hospital bed is the lowest. We have no nursing homes whose beds are not counted as hospital beds. The number of faculty staff in Japanese medical schools is 1/3 to those of Western countries. The reported number of doctors working in hospitals and offices surpasses that by census for medical doctors by >40,000. Japanese doctors work for >60 hours per week. I propose essential plans to improve Japanese situation for medical service: 1. Immediately increase the number of doctors by at least 50%. Based on our calculation, we need 450,000 doctors. 2. When the shortage of doctors is severe, establish a magnet hospital with c.a. 500 beds for every 200,000 population, capable of treating highly emergency patients and attracting doctors who need medical training. Hospitals should not belong to each city or town. 3. Establish a comprehensive organization to nurture doctors on a long-term basis. It should consist of a medical school, hospitals, and the prefectural government. It should help doctors to move between hospitals, and be responsible both for designing doctors' career paths and for allocating them appropriately.

  9. Doctor-Patient Communication In An Out-Patient Clinic Of A Teaching Hospital

    Directory of Open Access Journals (Sweden)

    Amir Ali


    Full Text Available Research question: What is the degree of satisfaction of patient with doctor-patient communication? Objective: To study the degree of satisfaction with doctor-patient communication. Study design: Cross-sectional Setting & participants: Patient attending department of Medicine, J.N.M.C. Hospital, A.M.U., Aligarh. Study period: April 1977 to March 1998. Sample size: 4460 urban male patients aged 18 years and above. Study variables: Age, no of clinic visits. Statistical analysis: Chi-Square test. Results: 38.34% patients received satisfactory answers to their questions. The proportion of dissatisfaction was (70.31% among elderly patients. The patients who visited clinic on more than 4 occasions were relatively more satisfied (43.83%. Majority of the patients received information on nature of investigation (30.71% and about treatment (26.63% but only 6.07% received information on prognosis and 18.92% about nature of the disease. Majority of the patients (82.62% preferred verbal information.

  10. The Impact of Learning Natural Dialectics on Junior Doctors' Engaging in Medical Research Activities%学习自然辩证法对初级医生从事医疗科研活动的影响

    Institute of Scientific and Technical Information of China (English)



    The study of natural dialectics is of great value and practical significance. Based on the science view and sci-entific method theory of Dialectics of nature, from the actual situation of medical and scientific research activities of the ju-nior doctors, this article respectively discusses the dialectical requirements of training medical scientific spirit, the important idea of the view of dialectical materialism in the diagnosis and treatment,the principles of scientific research closely linked to the topic to carry out, and systematically analyses the influence of learning natural dialectics of junior doctors engaged in medical research.%自然辩证法的学习具有较强的时代价值和现实意义。该研究基于自然辩证法的科学观与科学方法论,从初级医生医疗科研活动实际出发,分别论述了培养医学科研精神的辩证要求,辩证唯物诊治观的重要理念,紧扣选题开展科研的方法原则,较为系统分析了学习自然辩证法对初级医生从事医疗科研活动的影响。

  11. The CLAS App A mobile training tool to improve handover procedures between hospital interface and family doctors

    NARCIS (Netherlands)

    Maher, Bridget; Drachsler, Hendrik; Kalz, Marco; Specht, Marcus


    Maher, B., Drachsler, H., Kalz, M., & Specht, M. (2012). The CLAS App - A mobile training tool to improve handover procedures between hospital interface and family doctors. In M. Specht, J. Multisilta, & M. Sharples (Eds.), Proceedings of the 11th World Conference on Mobile and Contextual Learning 2

  12. Hospital doctors' self-rated skills in and use of evidence-based medicine - a questionnaire survey

    DEFF Research Database (Denmark)

    Oliveri, Roberto S; Gluud, Christian; Wille-Jørgensen, Peer A


    Problems in understanding basic aspects of evidence-based medicine (EBM) may form barriers to its implementation into clinical practice. We examined hospital doctors' skills in EBM terms and related these skills to their use of information sources, critical appraisal, and implementation of EBM...

  13. Assessing the functional performance of post-call hospital doctors using a Nintendo Wii.

    LENUS (Irish Health Repository)

    Clancy, K


    Sleep deprivation is an established part of the working life for Non-Consultant Hospital Doctors (NCHDs) in Ireland. Concern exists about the effect of extended NCHD work hours. We utilised a Nintendo Wii to evaluate motor function of NCHDs both prior to their on-call shift and the day afterwards. Data was exported to SPSS ver. 15 for statistical analysis with p < 0.05 considered significant. A total of 72 NCHDs were invited to participate in this study. There was a 62.5% (45) rate of follow-up. Overall 27 (60%) NCHDs were on medical call, with 18 (40%) on surgical call. There was no statistically significant difference between NCHDs pre-and post-call motor assessment scores. The majority of study participants (75.5%, n = 34) had four or more hours sleep. On-call duty allows for a greater than anticipated amount of sleep per on-call shift and therefore has a negligible effect on the motor skills of medical staff.

  14. Smoking behaviour among young doctors of a tertiary care hospital in North India

    Directory of Open Access Journals (Sweden)

    Muneer A. Bhat


    Full Text Available Background: Tobacco use is one of the biggest public health threats the world has ever faced. There are more than one billion smokers in the world. Almost half of the worlds children breathe air polluted by tobacco. Aim of current study was to study the smoking trends among young doctors in a tertiary care institute in north India. Methods: A descriptive observational cross-sectional epidemiological study was conducted among 250 doctors of a tertiary care Hospital in Jammu and Kashmir (Sheri Kashmir Institute of Medical Sciences, SKIMS during the two months of February-March, 2014. The predesigned tool adopted during data collection was a questionnaire that was developed at the institute with the assistance from the faculty members and other experts. Results: Among 250 participants, (20% were smokers; among smokers, (76% were regular smokers and (24% were occasional smokers. Majority of smokers were in the age group of 21-30 years (80% and started smoking between 11-20 years (70%. All of them were male (100%. No significant difference was observed among urban and rural students. Among smokers, majority (60% was in the practice of smoking for last 6 months to 1 year and 26% smoked for <6 months; and (14% smoked for more than 5 years .It was found more than half of the responding (60% students used to smoke 5-9 cigarettes per day; 14% is <5 and 26% consumed 10 or more per day .Among smokers, peer pressure was found in 80% cases. ( and #967;2 = 107, P <0.001. Among smokers, almost 20% had other addiction and among non-smokers only 5% had .Effect of parental smoking was significantly higher in smokers than non-smoker ( and #967;2 = 66.2, P <0.001 .It was seen that peer pressure was the most important risk factor (60% of initiation of smoking habit followed by parental influence (20%. Majority (78.4% had no intention to quit in the next 6 months. Lack of Incentive (36.36% and Addiction (27.27% were the main reasons for not quitting. Conclusion: We

  15. A Survey of Knowledge and Practices of Transfusion Medicine Among Post Intern Doctors in Specialized Hospital in Sri Lanka. (United States)

    Kumarage, Samantha; Fernando, Rahal; Gunasekara, Lanka


    Knowledge of transfusion medicine is the key element of better transfusion practices. This deficit observed at the blood bank end on daily basis exposing the patients for redundant risk. We assessed the knowledge of transfusion medicine among post intern doctors. To assess the knowledge of transfusion medicine among post intern doctors in working in our hospital. Self administrated questionnaire was used. 45 questions of transfusion medicine included in the questioner. A total 57 post internship doctors participated in the survey. Statistical analysis was done using SPSS. In overall survey average score was 41.45%. Lowest score 19.8% was for the area of lab result interpretation. Highest score 56.63% obtained for the administration of blood component. Differences among the medical officers of various specialties were not statistically significant. Transfusion medicine knowledge among post internship doctors in our hospital need to be upgraded. © American Society for Clinical Pathology, 2016. All rights reserved. For permissions, please e-mail:

  16. The involvement of medical doctors in hospital governance and implications for quality management: a quick scan in 19 and an in depth study in 7 OECD countries. (United States)

    Rotar, A M; Botje, D; Klazinga, N S; Lombarts, K M; Groene, O; Sunol, R; Plochg, T


    Hospital governance is broadening its orientation from cost and production controls towards 'improving performance on clinical outcomes'. Given this new focus one might assume that doctors are drawn into hospital management across OECD countries. Hospital performance in terms of patient health, quality of care and efficiency outcomes is supposed to benefit from their involvement. However, international comparative evidence supporting this idea is limited. Just a few studies indicate that there may be a positive relationship between medical doctors being part of hospital boards, and overall hospital performance. More importantly, the assumed relationship between these so-called doctor managers and hospital performance has remained a 'black-box' thus far. However, there is an increasing literature on the implementation of quality management systems in hospitals and their relation with improved performance. It seems therefore fair to assume that the relation between the involvement of doctors in hospital management and improved hospital performance is partly mediated via quality management systems. The threefold aim of this paper is to 1) perform a quick scan of the current situation with regard to doctor managers in hospital management in 19 OECD countries, 2) explore the phenomenon of doctor managers in depth in 7 OECD countries, and 3) investigate whether doctor involvement in hospital management is associated with more advanced implementation of quality management systems. This study draws both on a quick scan amongst country coordinators in OECD's Health Care Quality Indicator program, and on the DUQuE project which focused on the implementation of quality management systems in European hospitals. This paper reports two main findings. First, medical doctors fulfil a broad scope of managerial roles at departmental and hospital level but only partly accompanied by formal decision making responsibilities. Second, doctor managers having more formal decision making

  17. Medical leadership, a systematic narrative review: do hospitals and healthcare organisations perform better when led by doctors? (United States)

    Clay-Williams, Robyn; Ludlow, Kristiana; Testa, Luke; Li, Zhicheng; Braithwaite, Jeffrey


    Despite common assumptions that doctors are well placed to lead hospitals and healthcare organisations, the peer-reviewed literature contains little evidence on the performance of doctors in leadership roles in comparison with that of non-medical managers. To determine whether there is an association between the leader's medical background and management performance in terms of organisational performance or patient outcomes. We searched for peer-reviewed, English language studies using Medline, Embase and Emerald Management between 2005 and 2017. We included quantitative, qualitative and mixed method empirical studies on the performance of senior healthcare managers where participants were described as doctors or leaders and where comparative performance data were provided on non-medical leaders. Studies without full text available, or no organisational, leadership behaviour or patient measures, were excluded. The search, conducted in Medline (n=3395), Embase (n=1913) and Emerald Management (n=454) databases, yielded 3926 entries. After the application of inclusion and exclusion criteria, 16 studies remained. Twelve studies found that there were positive differences between medical and non-medical leaders, and eight studies correlated those findings with hospital performance or patient outcomes. Six studies examined the composition of boards of directors; otherwise, there were few common areas of investigation. Five inter-related themes emerged from a narrative analysis: the impact of medical leadership on outcomes; doctors on boards; contribution of qualifications and experience; the medical leader as an individual or part of a team and doctors transitioning into the medical leadership role. A modest body of evidence supports the importance of including doctors on organisational governing boards. Despite many published articles on the topic of whether hospitals and healthcare organisations perform better when led by doctors, there were few empirical studies that

  18. Knowledge, awareness and practice of ethics among doctors in tertiary care hospital. (United States)

    Singh, Surjit; Sharma, Pramod Kumar; Bhandari, Bharti; Kaur, Rimplejeet


    With the advancement of healthcare and medical research, doctors need to be aware of the basic ethical principles. This cross-sectional study is an attempt to assess the knowledge, awareness, and practice of health-care ethics among health-care professionals. After taking written informed consent, a standard questionnaire was administered to 117 doctors. No personal information was recorded on the questionnaire so as to ensure the confidentiality and anonymity of participants. Data analysis was done using SPSS version 21 (IBM Corp., Armonk, NY, USA). Statistically significant difference observed between the opinions of consultant and senior resident (SRs) on issues like, adherence to confidentiality; paternalistic attitude of doctors (doctors should do their best for the patient irrespective of patient's opinion); doctor's decision should be final in case of disagreement and interest in learning ethics (P ethics. Surprisingly, the response of clinical and nonclinical faculty did not differ as far as awareness and practice of ethics were concerned. The significant difference is observed in the knowledge, awareness, and practice of ethics among consultants and SRs. Conferences, symposium, and workshops, on health-care ethics, may act as a means of sensitizing doctors and thus will help to bridge this gap and protect the well-being and confidentiality of the patients. Such an effort may bring about harmonious change in the doctor-patient relationship.

  19. Effects of coaching supervision, mentoring supervision and abusive supervision on talent development among trainee doctors in public hospitals: moderating role of clinical learning environment. (United States)

    Subramaniam, Anusuiya; Silong, Abu Daud; Uli, Jegak; Ismail, Ismi Arif


    Effective talent development requires robust supervision. However, the effects of supervisory styles (coaching, mentoring and abusive supervision) on talent development and the moderating effects of clinical learning environment in the relationship between supervisory styles and talent development among public hospital trainee doctors have not been thoroughly researched. In this study, we aim to achieve the following, (1) identify the extent to which supervisory styles (coaching, mentoring and abusive supervision) can facilitate talent development among trainee doctors in public hospital and (2) examine whether coaching, mentoring and abusive supervision are moderated by clinical learning environment in predicting talent development among trainee doctors in public hospital. A questionnaire-based critical survey was conducted among trainee doctors undergoing housemanship at six public hospitals in the Klang Valley, Malaysia. Prior permission was obtained from the Ministry of Health Malaysia to conduct the research in the identified public hospitals. The survey yielded 355 responses. The results were analysed using SPSS 20.0 and SEM with AMOS 20.0. The findings of this research indicate that coaching and mentoring supervision are positively associated with talent development, and that there is no significant relationship between abusive supervision and talent development. The findings also support the moderating role of clinical learning environment on the relationships between coaching supervision-talent development, mentoring supervision-talent development and abusive supervision-talent development among public hospital trainee doctors. Overall, the proposed model indicates a 26 % variance in talent development. This study provides an improved understanding on the role of the supervisory styles (coaching and mentoring supervision) on facilitating talent development among public hospital trainee doctors. Furthermore, this study extends the literature to better

  20. Barriers to healthy eating by National Health Service (NHS hospital doctors in the hospital setting: results of a cross-sectional survey

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    Wilson Sue


    Full Text Available Abstract Background With high levels of obesity and related illness, improving the health of the nation is a major public health concern. This study aimed to identify factors that prevent healthy eating among doctors, and that are associated with satisfaction with catering services. Findings Methods: Cross-sectional survey of 328 NHS doctors working in two NHS Trusts with on-site hospital canteen. Questionnaire to establish perceived barriers to healthy eating, weekly use and satisfaction with the hospital canteen, lifestyle and dietary habits, gender, age, height, weight, job details, and affect. Results: 70% of doctors reported using their hospital canteen each week, with 2 visits per week on average. Canteen opening times, lack of selection and lack of breaks were the most commonly perceived barriers to healthy eating. Availability of healthy options caused the most dissatisfaction. Only 12% felt the NHS was supportive of healthy eating. 74% did not feel their canteen advocated healthy eating. Canteen use is associated with younger age (r = -0.254, p Conclusion Interventions to encourage regular meal breaks, eating breakfast and drinking more water each day need developing. Improved canteen accessibility and availability of healthy options at evenings and weekends may be beneficial.

  1. Mobile and fixed computer use by doctors and nurses on hospital wards

    DEFF Research Database (Denmark)

    Andersen, Pia; Lindgaard, Anne-Mette; Prgomet, M.


    and doctors were observed performing workarounds, such as transcribing medication orders from the computer to paper. CONCLUSIONS: The choice of device was related to clinical role, nature of the clinical task, degree of mobility required, including where task completion occurs, and device design. Nurses' work......, and clinical tasks performed by doctors during ward rounds, require highly mobile computer devices. Nurses and doctors on ward rounds showed a strong preference for generic COWs over all other devices. Tablet PCs were selected by doctors for only a small proportion of clinical tasks. Even when using mobile......BACKGROUND: Selecting the right mix of stationary and mobile computing devices is a significant challenge for system planners and implementers. There is very limited research evidence upon which to base such decisions. OBJECTIVE: We aimed to investigate the relationships between clinician role...

  2. Do you agree with the doctor's decision to continue treatment?: A scenario-based study of hospital nurses in Italy

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    Francesca Ingravallo


    Full Text Available INTRODUCTION: A lack of social consensus on the duty to comply with a patient's request to forgo treatment was reported in Italy, but little is known about the nurses' attitudes regarding this issue. MATERIALS AND METHODS: Questionnaire including two clinical scenarios regarding doctor's decision to not comply with a competent patient's request to forgo treatment was administered to all nurses (n = 487 of an Italian medium-sized hospital. RESULTS: Eighty-five percent of nurses completed the study. Although 83% of participants supported a general right to self-determination, around 40% of them agreed with the doctor's decision in both scenarios. The multivariate analyses adjusted for gender, age, length of professional experience, and care setting showed that the agreement with the doctor's decision was significantly associated with nurses' personal background beliefs about self-determination and quality of life. DISCUSSION AND CONCLUSIONS: Many nurses have difficulty in accepting a patient's request to forgo treatment. Increasing ethical reflection and discussion at both educational and professional level, and introducing ethical consultation services would be essential to develop a consistent approach to end-of-life decisions in Italian hospitals.

  3. Explaining medical disputes in Chinese public hospitals: the doctor-patient relationship and its implications for health policy reforms. (United States)

    He, Alex Jingwei; Qian, Jiwei


    In recent years China has witnessed a surge in medical disputes, including many widely reported violent riots, attacks, and protests in hospitals. This is the result of a confluence of inappropriate incentives in the health system, the consequent distorted behaviors of physicians, mounting social distrust of the medical profession, and institutional failures of the legal framework. The detrimental effects of the damaged doctor-patient relationship have begun to emerge, calling for rigorous study and serious policy intervention. Using a sequential exploratory design, this article seeks to explain medical disputes in Chinese public hospitals with primary data collected from Shenzhen City. The analysis finds that medical disputes of various forms are disturbingly widespread and reveals that inappropriate internal incentives in hospitals and the heavy workload of physicians undermine the quality of clinical encounters, which easily triggers disputes. Empirically, a heavy workload is associated with a larger number of disputes. A greater number of disputes are associated with higher-level hospitals, which can afford larger financial settlements. The resolution of disputes via the legal channel appears to be unpopular. This article argues that restoring a healthy doctor-patient relationship is no less important than other institutional aspects of health care reform.


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    Avtar Singh


    Full Text Available BACKGROUND : Disruptive behavior in a medical setting is defined as objectionable or offensive interpersonal behavior that leads to disruption of professional activities in the workplace. 1 It has been observed that majority of doctors do not show disruptive behavior in their day today conduct and only few doctors are identified for their disruptive behavior . Special commi ttee on professional conduct and ethics defines disruptive behavior in physicians as aberrant behavior manifested through personal interaction with physicians , hospital personnel , health care professionals , patients , family members or others which interferes with patient care or could reasonably be expected to interfere with the process of delivering quality care. 2 Common forms of disruptive behaviors generally seen amongst young doctors are use of abusive language , yelling or shouting at patients , colleagues and subordinate staff , showing in disciplined behavior and at times indulging in physical abuse. 3 - 4 STUDY DESIGN : Study was conducted at a tertiary care hospital where 614 health care professionals participated which included 108 doctors 432 nurs ing staff and 74 paramedical staff METHOD : Data collection was done by semi structured pretested questionnaire and was entered in Microsoft Excel and analyzed for frequency and percentages . RESULTS : 64 % doctor , 66% nursing staff and 50% of the paramedicals answered that they have seen doctors showing disruptive behavior at one time or the other . Not all the doctors show disruptive behavior but this type of aberrant behavior is seen mainly in2 - 3 percent of doctors only. While answering to the que stion as to the type of disruptive behavior , 57% health care professionals reported that commonest form of disruptive behavior noticed by them amongst doctors was yelling or shouting on junior staff , patients and colleagues . 47% answered that doctors with disruptive behavior do not follow laid down orders or

  5. Knowledge and attitudes of doctors on medical ethics in a teaching hospital, Manipur. (United States)

    Brogen, Akoijam S; Rajkumari, Bishwalata; Laishram, Jalina; Joy, Akoijam


    This study aimed to assess the knowledge of and attitudes to, medical ethics among doctors in the Regional Institute of Medical Sciences (RIMS), Imphal, Manipur. It also looked at the association between levels of knowledge and selected variables. A self-administered structured questionnaire was distributed to all doctors working in RIMS, Imphal between September and October 2007. 315 of 440 (71.6%) doctors contacted, responded. 62.2% of respondents (196) were below 35 years of age. 22.5% (71) were faculty members. 98.7% (311) had heard of the Code of Medical Ethics but only 188 (59.7%) had read it, even in part. 69.2% (218) felt that the undergraduate curriculum on medical ethics was not adequate. 10.5% (33) could describe what medical professionalism meant. Knowledge of medical ethics was higher among those who were over 35 years of age, those who graduated before 1999 and those having higher educational qualifications. The doctors in this survey lacked adequate and detailed knowledge on the code of ethics, though most of them had read it once. There is a need to sensitise doctors on medical ethics and professionalism.

  6. Quality care, public perception and quick-fix service management: a Delphi study on stressors of hospital doctors in Ireland (United States)

    Hayes, Blanaid; Fitzgerald, Deirdre; Doherty, Sally; Walsh, Gillian


    Objectives To identify and rank the most significant workplace stressors to which consultants and trainees are exposed within the publicly funded health sector in Ireland. Design Following a preliminary semistructured telephone interview, a Delphi technique with 3 rounds of reiterative questionnaires was used to obtain consensus. Conducted in Spring 2014, doctors were purposively selected by their college faculty or specialty training body. Setting Consultants and higher specialist trainees who were engaged at a collegiate level with their faculty or professional training body. All were employed in the Irish publicly funded health sector by the Health Services Executive. Participants 49 doctors: 30 consultants (13 male, 17 female) and 19 trainees (7 male, 12 female). Consultants and trainees were from a wide range of hospital specialties including anaesthetics, radiology and psychiatry. Results Consultants are most concerned with the quality of healthcare management and its impact on service. They are also concerned about the quality of care they provide. They feel undervalued within the negative sociocultural environment that they work. Trainees also feel undervalued with an uncertain future and they also perceive their sociocultural environment as negative. They echo concerns regarding the quality of care they provide. They struggle with the interface between career demands and personal life. Conclusions This Delphi study sought to explore the working life of doctors in Irish hospitals at a time when resources are scarce. It identified both common and distinct concerns regarding sources of stress for 2 groups of doctors. Its identification of key stressors should guide managers and clinicians towards solutions for improving the quality of patient care and the health of care providers. PMID:26700286

  7. The effectiveness of a 'train the trainer' model of resuscitation education for rural peripheral hospital doctors in Sri Lanka.

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    Bishan N Rajapakse

    Full Text Available BACKGROUND: Sri Lankan rural doctors based in isolated peripheral hospitals routinely resuscitate critically ill patients but have difficulty accessing training. We tested a train-the-trainer model that could be utilised in isolated rural hospitals. METHODS: Eight selected rural hospital non-specialist doctors attended a 2-day instructor course. These "trained trainers" educated their colleagues in advanced cardiac life support at peripheral hospital workshops and we tested their students in resuscitation knowledge and skills pre and post training, and at 6- and 12-weeks. Knowledge was assessed through 30 multiple choice questions (MCQ, and resuscitation skills were assessed by performance in a video recorded simulated scenario of a cardiac arrest using a Resuci Anne Skill Trainer mannequin. RESULTS/DISCUSSION/CONCLUSION: Fifty seven doctors were trained. Pre and post training assessment was possible in 51 participants, and 6-week and 12-week follow up was possible for 43, and 38 participants respectively. Mean MCQ scores significantly improved over time (p<0.001, and a significant improvement was noted in "average ventilation volume", "compression count", and "compressions with no error", "adequate depth", "average depth", and "compression rate" (p<0.01. The proportion of participants with compression depth ≥40mm increased post intervention (p<0.05 and at 12-week follow up (p<0.05, and proportion of ventilation volumes between 400-1000mls increased post intervention (p<0.001. A significant increase in the proportion of participants who "checked for responsiveness", "opened the airway", "performed a breathing check", who used the "correct compression ratio", and who used an "appropriate facemask technique" was also noted (p<0.001. A train-the-trainer model of resuscitation education was effective in improving resuscitation knowledge and skills in Sri Lankan rural peripheral hospital doctors. Improvement was sustained to 12 weeks for most

  8. Perceptions of doctors and nurses at a Ugandan hospital regarding the introduction and use of the South African Triage Scale

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    Francis Mulindwa


    Full Text Available Background: International Hospital Kampala (IHK experienced a challenge with how to standardise the triaging and sorting of patients. There was no triage tool to help to prioritise which patients to attend to first, with very sick patient often being missed.Aim and setting: To explore whether the introduction of the South African Triage Scale (SATS was seen as valuable and sustainable by the IHK’s outpatient department and emergency unit (OPD and EU staff.Methods: The study used qualitative methods to introduce SATS in the OPD and EU at IHK and to obtain the perceptions of doctors and nurses who had used it for 3–6 months on its applicability and sustainability. Specific questions about challenges faced prior to its introduction, strengths and weaknesses of the triage tool, the impact it had on staff practices, and their recommendations on the continued use of the tool were asked. In-depth interviews were conducted with 4 doctors and 12 nurses.Results: SATS was found to be necessary, applicable and recommended for use in the IHK setting. It improved the sorting of patients, as well as nurse-patient and nurse-doctor communication.The IHK OPD & EU staff attained new skills, with nurses becoming more involved in-patient care. It is possibly also useful in telephone triaging and planning of hospital staffing.Conclusion: Adequate nurse staffing, a computer application for automated coding of patients, and regular training would encourage consistent use and sustainability of SATS. Setting up a hospital committee to review signs and symptoms would increase acceptability and sustainability. SATS is valuable in the IHK setting because it improved overall efficiency of triaging and care, with significantly more strengths than weaknesses.Keywords: South African Triage Scale; Perceptions

  9. A study on the interactions of doctors with medical representatives of pharmaceutical companies in a Tertiary Care Teaching Hospital of South India

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    Sandeep Kumar Gupta


    Full Text Available Background: The promotional activities by medical representatives (MRs of the pharmaceutical companies can impact the prescribing pattern of doctors. Hence, the interaction between doctors and the pharmaceutical industry is coming under increasing scrutiny. Objective: The primary objective was to assess the attitude of the doctors toward the interaction with the MRs of the pharmaceutical company. The secondary objective was to assess the awareness of the doctors about regulations governing their interaction with the pharmaceutical company. Materials and Methods: This was a cross-sectional study. This study was carried out using a pretested questionnaire containing 10 questions between June and September 2014. The doctors working in the Dhanalakshmi Srinivasan Medical College and Hospital, Perambalur (Tamil Nadu during the study period was included. Results: A total of 100 pretested questionnaires were distributed, and 81 doctors responded (response rate 81%. 37% doctors responded that they interacted with MR once a week whereas 25.9% told that they interact with MRs twice a month. About 69.1% doctors think that MR exaggerate the benefits of medicines and downplays the risks and contraindications of medicine(P = 0.000. 61.7% doctors think that MR has an impact on their prescribing (P = 0.000. 63% doctors stated that they had received promotional tools such as stationery items, drug sample, textbooks or journal reprints from MR in last 12 months (P = 0.0012. Unfortunately, 70.4% doctors have not read the guidelines about interacting with the pharmaceutical industry or its representative (P = 0.000. Conclusion: Rather than forbidding any connection between doctors and industry, it is better to establish ethical guidelines. The Medical Council of India code is a step in the right direction, but the majority of doctors in this study have not read the guidelines about interacting with the pharmaceutical industry or its representative.

  10. A Study Of Power Relations In Doctor-Patient Interactions In Selected Hospitals In Lagos State, Nigeria

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    Qasim Adam


    Full Text Available This paper explores power relations in clinical interactions in Nigeria. It seeks to investigate the use of power between doctors and patients during consultations on patient-centred approach to medicine in selected public and private hospitals in Lagos State, Nigeria. The objective is to establish how doctors' projection of power, using the discourse resources of transitivity, affects positively or negatively their relationship with patients. This study employs triangulation as its methodology. A judicious mix of quantitative and qualitative methods has been utilized to give the  study a scientific shape. Proportionate stratified random sampling and purposive sampling procedures were employed. The study employs the theoretical and analytical paradigms of Systemic Functional Linguistics and Critical Discourse Analysis. The findings revealed that doctors predominantly use this process to the benefit of the patients. Minimal level of intrusive and cooperative interruptions was also observed. It is expected that this study will give more visibility on the best way patients can be empowered by lessening doctors’ use of polar interrogatives and completely avoiding interruptive discourse in clinical interactions

  11. General self-efficacy and the effect of hospital workplace violence on doctors' stress and job satisfaction in China. (United States)

    Yao, Yongcheng; Wang, Wei; Wang, Faxuan; Yao, Wu


    This study aims at exploring associations of general self-efficacy (GSE), workplace violence and doctors' work-related attitudes. In this study a cross-sectional survey design was applied. Questionnaires were administrated to 758 doctors working in 9 hospitals of Zhengzhou, Henan province, China, between June and October 2010. General information on age, gender, and years of working was collected, and the doctors' experience and witnessing workplace violence, job satisfaction, job initiative, occupational stress as well as GSE were measured. General linear regression analysis was performed in association analyses. Both experiencing and witnessing workplace violence were significantly positively correlated with the level of occupational stress but significantly negatively correlated with job satisfaction, job initiative, and GSE. General self-efficacy significantly modified relationships between both experiencing and witnessing workplace violence with occupational stress (β = 0.49 for experiencing violence; β = 0.43 for witnessing violence; p 0.05). The levels of occupational stress declined significantly with the increase of GSE, while job satisfaction increased significantly along with its increase. The effects of GSE on occupational stress and job satisfaction weakened as the frequency of violence increased. The findings suggest that GSE can modify effects of workplace violence on health care workers' stress and job satisfaction. Enhancing GSE in combination with stress reduction may lead to facilitating health care workers' recovery from workplace violence, and thereby improving their work-related attitudes.

  12. Sources of drug information and their influence on the prescribing behaviour of doctors in a teaching hospital in Ibadan, Nigeria. (United States)

    Oshikoya, Kazeem Adeola; Oreagba, Ibrahim; Adeyemi, Olayinka


    Pharmaceutical drug promotion is a means of informing health professionals about new drugs. The approach is often times unethical and inappropriate and may promote irrational prescribing. Dearth of information on impact of pharmaceutical drug promotion on prescribing behaviour of doctors in developing African countries has necessitated this study. We therefore aimed to determine the sources of drug information for doctors working in a teaching hospital in Nigeria and to assess the self-reported impact of the sources on their prescribing behaviour. A total of 163 doctors working at the University College Hospital (UCH), Ibadan in Nigeria were evaluated with a questionnaire for their demographics and sources of drug information. For doctors who relied on drug promotion, they were asked to self-report and self-rate their opinion on extent of interactions with pharmaceutical companies as well as how such interactions had impacted on their prescribing behaviour. Apart from the demographics, each question was evaluated with a typical five-level Likert item. Data analyses were with simple descriptive statistics. Of the 400 doctors working at UCH, only 40.8% participated in the study. Drug information was sourced from colleagues (161, 98.8%), reference books (158, 96.9%), pharmaceutical sales representatives-PSRs (152, 93.2%), promotion materials (151, 92.6%), scientific papers/journals/internet (149, 91.4%), and drug promotion forum/product launches (144, 88.3%). Each source was highly utilized but there was no wide variation in their pattern of use. According to the self-report of over a half of the respondents, PSRs was an accurate and reliable drug information resource; PSRs increased their awareness of the promoted drugs; and their prescribing behaviours were influenced by information from PSRs. Respondents tend to rely on a broad range of drug information resources which include potentially inappropriate resources such as PSRs. Since this study was based on self

  13. Knowledge gaps about smoking cessation in hospitalized patients and their doctors.


    Raupach, Tobias; Merker, Jacqueline; Hasenfuß, Gerd; Andreas, Stefan; Pipe, Andrew


    BACKGROUND: Hospitalization is an opportune time for smoking cessation support; cessation interventions delivered by hospital physicians are effective. While general practitioners' and outpatients' knowledge and attitudes towards smoking cessation have been studied in great detail, in-patient cessation programmes have received less attention. DESIGN: Questionnaire-based survey of a convenience sample of hospital physicians and in-patients at Göttingen University Hospital, Germany. M...

  14. [The use of benzodiazepines and Z-drugs for patients with sleeping problems - A survey among hospital doctors and nurses]. (United States)

    Weiß, V; Heinemann, S; Himmel, W; Nau, R; Hummers-Pradier, E


    Aim | Benzodiazepines and Z-drugs are frequently prescribed sleep medications in spite of their poor risk-benefit ratio when used over a longer period of time. The aim of the study was to find out how the medical and nursing staff in a general hospital estimated the frequency of use for these drugs, and the risk-benefit ratio for elderly patients as well as the factors which positively influence the perceived use of these drugs. Methods | All members of the medical and nursing staff of a hospital received a questionnaire about their use of, and attitudes towards, benzodiazepines and Z-drugs. Absolute and relative frequencies were calculated to estimate the perceived frequency of use and the risk-benefit ratio. Multiple logistic regressions were used to analyze which factors are associated with a perceived high use of benzodiazepines or Z-drugs for insomnia. Results | More nurses than hospital doctors believed that they dispensed benzodiazepines often or always (57 % vs. 29 %) to patients with insomnia; this was also the case for Z-drugs (66 % vs. 29 %). Nearly half of the hospital doctors and 29 % of the nurses perceived more harms than benefits for benzodiazepines in the elderly. The following factors were associated with a high perceived usage of Z-drugs: working as a nurse (OR: 13,95; 95%-CI: 3,87-50,28), working in a non-surgical department (5,41; 2,00-14,61), having benzodiazepines, only the perceived positive risk-benefit ratio had an influence on the perceived use (3,35; 1,28-8.79). Conclusion | The medical and nursing staff perceived the frequency of prescription of benzodiazepines and Z-drugs and the risk-benefit ratio in different ways. Other aspects, such as working in a non-surgical department or having a smaller amount of working experience may also influence the decision to use Z-drugs.

  15. [Frequency and assessment of symptoms in hospitalized patient with advanced chronic diseases: is there concordance among patients and doctors?]. (United States)

    Palma, Alejandra; Del Río, Ignacia; Bonati, Pilar; Tupper, Laura; Villarroel, Luis; Olivares, Patricia; Nervi, Flavio


    Physicians tend to over or underestimate symptoms reported by patients. Therefore standardized symptom scoring systems have been proposed to overcome this drawback. To estimate the prevalence and the diagnostic accuracy of physical and psychological symptoms and delirium in patients admitted to an internal medicine service at a university hospital. We studied 58 patients, 45 with metastasic cancer and 13 with other advanced chronic diseases. The following scales were used: the Confusion Assessment Method for the diagnosis of delirium; the Edmonton Symptom Assessment Scale (ESAS) for pain and other physical symptoms; the Hospital Anxiety and Depression Scale to assess anxiety and depression. The ESAS was simultaneously applied to patients without delirium and their doctors to assess the level of diagnostic concordance. Twenty two percent of patients had delirium. Among the 45 patients without delirium, 11 (25%) had at least eight symptoms and 39 (88.6%) had four symptoms. The prevalence of symptoms was very high, ranging from 22 to 78%. Pain, restlessness, anorexia and sleep disorders were the most common. The concordance between symptoms reported by patients and those recorded by doctor was very low, with a Kappa index between 0.001 and 0.334. In our sample of chronic patients, there is a very high frequency of psychological and physical symptoms that are insufficiently recorded by the medical team.

  16. Clinical supervision by consultants in teaching hospitals. (United States)

    Hore, Craig T; Lancashire, William; Fassett, Robert G


    Clinical supervision is a vital part of postgraduate medical education. Without it, trainees may not learn effectively from their experiences; this may lead to acceptance by registrars and junior doctors of lower standards of care. Currently, supervision is provided by consultants to registrars and junior doctors, and by registrars to junior doctors. Evidence suggests that the clinical supervision provided to postgraduate doctors is inadequate. Registrars and juniors doctors have the right to expect supervision in the workplace. Impediments to the provision of clinical supervision include competing demands of hospital service provision on trainees and supervisors, lack of clarity of job descriptions, private versus public commitments of supervisors and lack of interest. Supervisors should be trained in the process of supervision and provided with the time and resources to conduct it. Those being supervised should be provided with clear expectations of the process. We need to create and develop systems, environments and cultures that support high standards of conduct and effective clinical supervision. These systems must ensure the right to supervision, feedback, support, decent working conditions and respect for both trainees and their supervisors.

  17. Improving Computer-Mediated Synchronous Communication of Doctors in Rural Communities Through Cloud Computing: A Case Study of Rural Hospitals in South Africa

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    Alfred Coleman


    Full Text Available This paper investigated how doctors in remote rural hospitals in South Africa use computer-mediated toolto communicate with experienced and specialist doctors for professional advice to improve on their clinicalpractices. A case study approach was used. Ten doctors were purposively selected from ten hospitals in theNorth West Province. Data was collected using semi-structured open ended interview questions. Theinterviewees were asked to tell in their own words the average number of patients served per week,processes used in consultation with other doctors, communication practices using computer-mediated tool,transmission speed of the computer-mediated tool and satisfaction in using the computer-mediatedcommunication tool. The findings revealed that an average of 15 consultations per doctor to a specialistdoctor per week was done through face to face or through telephone conversation instead of using acomputer-mediated tool. Participants cited reasons for not using computer-mediated tool forcommunication due to slow transmission speed of the Internet and regular down turn of the Internetconnectivity, constant electricity power outages and lack of e-health application software to support realtime computer-mediated communication. The results led to the recommendation of a hybrid cloudcomputing architecture for improving communication between doctors in hospitals.

  18. Doctor--how do I use my EpiPen? (United States)

    Mehr, Sam; Robinson, Marnie; Tang, Mimi


    Parents and children who have been prescribed an Epipen are often unable to demonstrate its correct administration. One contributory factor may be that doctors are unfamiliar with the EpiPen and are unable to demonstrate the correct administration of the pen to the family. The aim of this study was to determine the rate of correct EpiPen demonstration by junior and Senior Medical Staff at a major tertiary paediatric Hospital. Junior and Senior medical staff were scored on their ability to correctly use the EpiPen trainer. A 6 step scoring system was used. One-hundred doctors were recruited (Residents n = 31, Senior Residents n = 39, Fellow/Consultants n = 30). Junior and Senior Medical staff had similar scores for EpiPen demonstration, the number that needed to read the EpiPen instructions prior to use and the frequancy of accidental self-injection into the thumb. Only two doctors (2%) demonstrated all 6 administration steps correctly. The most frequent errors made were not holding the pen in place for >5 seconds (57%), failure to apply pressure to activate (21%), and self-injection into the thumb (16%). Ninety five doctors needed to read the instructions, and of these, only 39 (41%) then proceeded to correctly demonstrate the remaining 5 steps. Forty-five doctors had previously dispensed an EpiPen, but only three demonstrated its use to parents/children with a trainer. The majority of doctors do not know how to use an Epipen and are unable to provide appropriate education to parents/children. In 37% of cases, the demonstration would not have delivered adrenaline to a patient.

  19. The validity of the Annual Review of Competence Progression: a qualitative interview study of the perceptions of junior doctors and their trainers. (United States)

    Viney, Rowena; Rich, Antonia; Needleman, Sarah; Griffin, Ann; Woolf, Katherine


    Objective To investigate trainee doctors' and trainers' perceptions of the validity of the Annual Review of Competence Progression (ARCP) using Messick's conceptualisation of construct validity. Design Qualitative semi-structured focus groups and interviews with trainees and trainers. Setting Postgraduate medical training in London, Kent Surrey and Sussex, Yorkshire and Humber, and Wales in November/December 2015. Part of a larger study about the fairness of postgraduate medical training. Participants Ninety-six trainees and 41 trainers, comprising UK and international medical graduates from Foundation, General Practice, Medicine, Obstetrics and Gynaecology, Psychiatry, Radiology, and Surgery, at all levels of training. Main outcome measures Trainee and trainer perceptions of the validity of the ARCP as an assessment tool. Results Participants recognised the need for assessment, but were generally dissatisfied with ARCPs, especially UK graduate trainees. Participants criticised the perceived tick-box nature of ARCPs as measuring clerical rather than clinical ability, and which they found detrimental to learning. Trainees described being able to populate their e-portfolios with just positive feedback; they also experienced difficulty getting assessments signed off by supervisors. ARCPs were perceived as poor at identifying struggling trainees and/or as discouraging excellence by focussing on minimal competency. Positive experiences of ARCPs arose when trainees could discuss their progress with interested supervisors. Conclusions Trainee and trainer criticisms of ARCPs can be conceptualised as evidence that ARCPs lack validity as an assessment tool. Ongoing reforms to workplace-based assessments could address negative perceptions of the 'tick-box' elements, encourage constructive input from seniors and allow trainees to demonstrate excellence as well as minimal competency, while keeping patients safe.

  20. Determining the agent factors related with time management of responsible doctors and nurses in clinics at Ankara University hospitals. (United States)

    Acuner, Ahmet Munir; Nilgun, Sarp; Cifteli, F Gulay


    This research has been planned and conducted as a descriptive scanning model field study in order to determine the agent factors related with time management of doctors and nurses in positions of responsibility at Ankara University hospitals. As data collection instruments; the "Personal Information Form" which has been developed to determine the socio-demographical characteristics of the research group, the questionnaire of "Determining the Time Management Attitudes and Behaviour of Managers, Time Management Opportunities of the Managers, Prodcutive Working Times of the Managers and the Factors Causing Them to Lose Time", developed by Erdem has been used. It has been determined that the time management attitudes and behaviour of doctors, nurses and nurse assistants responsible for clinics are all different. It was found that nurse assistants graduated from pre-undergraduate or high schools are the least conscious of time management. In particular, nurse assistants of 36 years old and over with 21 years of work experience and 11 years of management experience show little awareness of time management. The time losing factors of the research group were found to be unnecessary visitors, lack of materials and the excessive amount of time spent on obtaining the necessary equipment.

  1. Procedural confidence in hospital based practitioners: implications for the training and practice of doctors at all grades

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    Tsagkaraki Petroula A


    Full Text Available Abstract Background Medical doctors routinely undertake a number of practical procedures and these should be performed competently. The UK Postgraduate Medical Education and Training Board (PMETB curriculum lists the procedures trainees should be competent in. We aimed to describe medical practitioner's confidence in their procedural skills, and to define which practical procedures are important in current medical practice. Methods A cross sectional observational study was performed measuring procedural confidence in 181 hospital practitioners at all grades from 2 centres in East Anglia, England. Results Both trainees and consultants provide significant service provision. SpR level doctors perform the widest range and the highest median number of procedures per year. Most consultants perform few if any procedures, however some perform a narrow range at high volume. Cumulative confidence for the procedures tested peaks in the SpR grade. Five key procedures (central line insertion, lumbar puncture, pleural aspiration, ascitic aspiration, and intercostal drain insertion are the most commonly performed, are seen as important generic skills, and correspond to the total number of procedures for which confidence can be maintained. Key determinants of confidence are gender, number of procedures performed in the previous year and total number of procedures performed. Conclusion The highest volume of service requirement is for six procedures. The procedural confidence is dependent upon gender, number of procedures performed in the previous year and total number of procedures performed. This has implications for those designing the training curriculum and with regards the move to shorten the duration of training.

  2. Attitudes Toward Euthanasia Among Doctors in a Tertiary Care Hospital in South India: A Cross Sectional study. (United States)

    Kamath, Sneha; Bhate, Priya; Mathew, Ginu; Sashidharan, Srijith; Daniel, Anjali B


    Advances in expertise and equipment have enabled the medical profession to exercise more control over the processes of life and death, creating a number of moral and ethical dilemmas. People may live for extended periods with chronic painful or debilitating conditions that may be incurable. This study attempts to study the attitudes of doctors toward euthanasia and the possible factors responsible for these attitudes. A cross-sectional survey of 213 doctors working at a tertiary care hospital was conducted to determine their attitudes toward euthanasia. A self-administered questionnaire was used to assess attitudes and personal perceptions about euthanasia. The Chi square test was used to assess factors influencing attitudes toward euthanasia. A majority of the respondents (69.3%) supported the concept of euthanasia. Relief from unbearable pain and suffering was the most commonly (80.3%) cited reason for being willing to consider the option of euthanasia. Majority of those who were against euthanasia (66.2%) felt that the freedom to perform euthanasia could easily be misused. Disapproval of euthanasia was associated with religious affiliation (Peuthanasia for the relief of unbearable pain and suffering. Religion and speciality appear to be significant in determining attitudes toward euthanasia.

  3. [Successful patient-activated help call for a doctor during in-hospital stay]. (United States)

    Hansen, Mette Mejlby; Hasselkvist, Birgith; Thordal, Sofie; Riiskjær, Erik; Kelsen, Jens


    Department of Medicine, Randers Regional Hospital, conducted a study of patient-activated help call, involving 1,050 patients with nearly 3,700 days in-hospital stay. Patients were encou-raged to bypass traditional clinical hierarchy of communication when they felt, that their concern was not met by the staff. Three help calls were related to the management of pain. In two cases it resulted in a surgical procedure. A survey including 104 patients revealed that one third reported that patient safety was improved by the initiative and nearly three quarters re-ported that they would be willing to activate the call.

  4. Hospital doctors behave differently, and only by respecting the fundamentals of professional organizations will managers be able to create common goals with professionals. (United States)

    Van Dijck, H


    Hospital doctors behave differently from other hospital workers. The general and specific characteristics of the doctors' behavior are described. As professionals, doctors want to make autonomous decisions and more specifically, they negotiate differently. The best description of their negotiation style is one that features multi-actor, multi-issue characteristics. They behave as actors in a network in never-ending rounds of negotiations with variable issues up for discussion: one time you lose, the next you win. A doctor's career starts with a long residency period in which he or she absorbs professional habits. His or her knowledge and way of organizing are implicit. It is hard for him or her to explicitly describe what he or she is doing. This makes it difficult for managers to discuss quality issues with doctors. Dealing with disruptive behavior is not easy either. The difficult tasks of the chief medical officer, who acts as a go-between, are highlighted. Only when managers respect the fundamentals of the professional organization will they be able to create common goals with the professionals. Common goals bring about better care in hospitals.

  5. Medical restrictions to driving: the awareness of patients and doctors. (United States)

    Kelly, R; Warke, T; Steele, I


    The study was set up to investigate the awareness of elderly patients and medical doctors of medical restrictions to driving. Separate questionnaires were completed by patients and doctors. All were interviewed face-to-face, without prior warning and their immediate answers were recorded. In total, 150 elderly patients from the acute elderly care wards, rehabilitation wards and day hospital, and 50 doctors (including all grades from consultant to junior house officer) were interviewed. The main outcome measures were numbers of patients currently driving and previously driving; patients' awareness of how their medical condition affected their ability to drive; doctors' spontaneous knowledge of medical conditions which restrict driving, current licensing policy, and restrictions for five specific medical conditions (epilepsy, myocardial infarction, stroke, 5-cm abdominal aortic aneurysm, and diabetes). Only 21 patients were current drivers, and six of these should not have been driving. While 103 perceived themselves eligible to drive, 46 had medical restrictions to driving. Seventeen of the 47 patients who perceived themselves not eligible to drive possibly did not have restrictions to driving. Doctors' knowledge of the current licensing policy and action to be taken if a patient was not eligible to drive was very poor. Knowledge of medical restrictions to driving was scanty, with few doctors giving the correct driving restrictions for the five specific conditions. We recommend that education of doctors regarding medical restrictions to driving should begin at an undergraduate level and be continued throughout their postgraduate career.

  6. [Hospital Doctors Should Receive Lecture for Sedation According to Joint Commission International]. (United States)

    Ueshima, Hironobu; Komasawa, Nobuyasu; Kitamura, Akira


    At our hospital, intending to obtaining an approval from the Joint Commission International (JCI), we conducted a workshop on sedation for all staff physicians. A sedation instructor authorized by the Japanese Association for Medical Simulation gave a lecture using the "practice guidelines for sedation and administration of analgesics for non-anesthesiologists", revised in 2002 by the American Society of Anesthesiologists, following which, a test using 10 true-false questions was conducted, while before and after the lecture a questionnaire survey on the sedation lecture was carried out Among 191 physicians attending the lecture, except for one person, 7 or more questions were answered correctly. From the questionnaires, the sedation lectures were also generally accepted favourably. In the test of understanding, the mistakes were mostly in the sections on "sedation evaluation" "intraoperative monitoring" "pharmaceutical knowledge" and "airway management methods". The sedation lecture in the hospital was effective.

  7. Doctors as managers: moving towards general management? The case of unitary management reform in Norwegian hospitals. (United States)

    Mo, Tone Opdahl


    The paper seeks to explore whether the development in department management in Norwegian hospitals after the unitary management reform in 2001 constitutes a development in the direction of general management. Interviews were conducted with ten managers from different levels in a large Norwegian university hospital in 2001-2002, as a unitary management model was implemented. There is an emerging change of practice among the physician managers according to this study. The manager function is more explicit and takes a more general responsibility for the department and the professions. However, the managerial function is substantiated by conditions related to the professional field of knowledge, which gives legitimacy within a medical logic. Contact with the clinic is stressed as important, but it is possible to adjust both amount and content of a clinical engagement to the demands of the new manager position. This has both a symbolic and a practical significance, as it involves both legitimacy and identity issues. The paper shows that the institutionalised medical understanding of management has a bearing on managerial reforms. Managerial changes need to relate to this if they are to have consequences for the managerial roles and structures on department level in hospitals. The paper suggests that the future development of this role will depend on the way the collectivist and individualist aspects of responsibility are handled, as well as on the further development of managerial knowledge of physicians.

  8. Mandatory notification of impaired doctors. (United States)

    Beran, R G


    Mandatory reporting of impaired doctors is compulsory in Australasia. Australian Health Practitioner Regulation Agency guidelines for notification claim high benchmark though the Royal Australasian College of Surgeons and the Royal Australasian College of Physicians suggest they still obstruct doctors seeking help. Western Australia excludes mandatory reporting of practitioner-patients. This study examines reporting, consequences and international experiences with notification. Depressed doctors avoid diagnosis and treatment, fearing consequences, yet are more prone to marital problems, substance dependence and needing psychotherapy. South African research confirms isolation of impaired doctors and delayed seeking help with definable characteristics of those at risk. New Zealand data acknowledge: errors occur; questionable contribution from mandatory reporting; issues concerning competence assessment; favouring reporting to senior colleagues or self-intervention to compliance with mandatory reporting. UK found an anaesthetist guilty of professional misconduct for not reporting and sanctioned doctors regarding Harold Shipman. Australians are reluctant to report, fearing legalistic intrusion into care. Australian research confirmed definable characteristics for doctors with psychiatric illness or alcohol abuse. Exposure to legal medicine evokes personal disenchantment for doctors involved. Medicine poses barriers for impaired doctors. Spanish and UK doctors do not use general practitioners and may have suboptimal care. US and European doctors self-medicate using samples. US drug-dependent doctors also prescribe for spouses. Junior doctors are losing empathy with the profession. UK doctors favour private care, avoiding public scrutiny. NZ and Brazil created specific services for doctors, which appear effective. Mandatory reporting may be counterproductive requiring reappraisal.

  9. 基于医方访谈的乡镇卫生院医患信任研究%Study of Doctor-patient Trust in Township Hospitals Based on Doctors' Interview

    Institute of Scientific and Technical Information of China (English)

    刘一; 王晓燕; 于鲁明; 彭迎春; 周慧姊


    Objective To describe the trust status of doctor-patient relationship in township hospitals as well as the influencing factors,then put forward to relevant countermeasures. Methods Purpose sampling method was used to select three towns B,Q and C from a distant outskirt in Beijing as the observation places,according to geographical positions of the township hospitals,town population and cultural level,where the township hospitals were subjected to 3 d spot research by not participato-ry observation method. Besides 12 doctors chosen by purpose sampling method received personal interview. Results The mean score of the doctor-patient relationship evaluation by township doctors was ( 3. 83 ± 0. 58 ) with 5 as the full mark. 9 doctors thought the trust type largely belonged to operational relationship. In terms of trust degree of the patients,6 in 12 doctors thought" so-so",5 doctors thought" high"and 1 was not clear about it. The doctors in township hospitals thought the trust was mainly built on competence(10 persons),on medical ethics(10 persons),on service attitude(4 persons),on genetic relationship (2 persons),on geo-relationship(1 person),on responsibility(1 person). Conclusion Doctors in township hospitals con-clude that patient trust township hospitals more than county doctors,but less than big city hospitals. The trust type toward town-ship hospitals belongs to relationship trust and doctor's competence,moral and attitude are the influencing factors for doctor-pa-tient relationship. Therefore the doctor-patient relationship can be improved by advancing medical technology,increasing public health personnel,strengthening the doctor-patient communication,escalating equipment levels and adding drug types etc.%目的:了解乡镇卫生院医患信任现状及存在的问题,并提出相关对策建议。方法选取北京市北部某远郊区作为研究现场,采用目的抽样法,在综合考虑乡镇卫生院地理位置、乡镇人口及文化发展水

  10. All in a day's work: an observational study to quantify how and with whom doctors on hospital wards spend their time. (United States)

    Westbrook, Johanna I; Ampt, Amanda; Kearney, Leanne; Rob, Marilyn I


    To quantify time doctors in hospital wards spend on specific work tasks, and with health professionals and patients. Observational time and motion study. 400-bed teaching hospital in Sydney. 19 doctors (seven registrars, five residents, seven interns) in four wards were observed between 08:30 and 19:00 for a total of 151 hours between July and December 2006. Proportions of time in categories of work; proportions of tasks performed with health professionals and patients; proportions of tasks using specific information tools; rates of multitasking and interruptions. The greatest proportions of doctors' time were in professional communication (33%; 95% CI, 29%-38%); social activities, such as non-work communication and meal breaks (17%; 95% CI, 13%-21%), and indirect care, such as planning care (17%; 95% CI, 15%-19%). Multitasking involved 20% of time, and on average, doctors were interrupted every 21 minutes. Most tasks were completed with another doctor (56%; 95% CI, 55%-57%), while 24% (95% CI, 23%-25%) were undertaken alone and 15% (95% CI, 15%-16%) with a patient. Interns spent more time completing documentation and administrative tasks, and less time in direct care than residents and registrars. The time interns spent documenting (22%) was almost double the time they were engaged in direct patient care. Two-thirds of doctors' time was consumed by three work categories: professional communication, social activities and indirect care. Doctors on wards are interrupted at considerably lower rates than those in emergency and intensive care units. The results confirm interns' previously reported dissatisfaction with their level of administrative work and documentation.

  11. The well-being and mental health of male and female hospital doctors in Germany. (United States)

    Mache, Stefanie; Klapp, Burghard F; Groneberg, David A


    This study focuses on the associations between subjective well-being and mental health. In addition, gender differences are evaluated. The research was conducted as a cross-sectional online survey using a standardized questionnaire to assess physicians' mental health and well-being. Results have shown moderate scores for mental health and well-being in physicians. In general, male physicians perceive a better well-being and higher mental health score than female physicians. Well-being and mental health should be improved to increase physicians' work ability and subsequently, the quality of treatment and patient satisfaction. Mental health prevention should be more widely implemented in hospitals, and its awareness and early treatment should be encouraged. Mental health interventions might include modifying physicians' daily work schedules, providing curricula on mental health and offering training on the awareness of distress and well-being.

  12. Sticks and stones: investigating rude, dismissive and aggressive communication between doctors. (United States)

    Bradley, Victoria; Liddle, Samuel; Shaw, Robert; Savage, Emily; Rabbitts, Roberta; Trim, Corinne; Lasoye, Tunji A; Whitelaw, Benjamin C


    Destructive communication is a problem within the NHS; however previous research has focused on bullying. Rude, dismissive and aggressive (RDA) communication between doctors is a more widespread problem and underinvestigated. We conducted a mixed method study combining a survey and focus groups to describe the extent of RDA communication between doctors, its context and subsequent impact. In total, 606 doctors were surveyed across three teaching hospitals in England. Two structured focus groups were held with doctors at one teaching hospital. 31% of doctors described being subject to RDA communication multiple times per week or more often, with junior and registrar doctors affected twice as often as consultants. Rudeness was more commonly experienced from specific specialties: radiology, general surgery, neurosurgery and cardiology. 40% of respondents described that RDA moderately or severely affected their working day. The context for RDA communication was described in five themes: workload, lack of support, patient safety, hierarchy and culture. Impact of RDA communication was described as personal, including emotional distress and substance abuse, and professional, including demotivation. RDA communication between doctors is a widespread and damaging behaviour, occurring in contexts common in healthcare. Recognition of the impact on doctors and potentially patients is key to change.

  13. Leveraging on information technology to enhance patient care: a doctor's perspective of implementation in a Singapore academic hospital. (United States)

    Ong, B K C


    Information technology (IT) can improve the safety of patient care by minimising prescribing errors and organising patient-specific information from diverse databases. Apart from legibility, prescribing safety is enhanced as online access to databases carrying patient drug history, scientific drug information and guideline reference, and patient-specific information is available to the physician. Such specific information includes discharge summaries, surgical procedure summaries, laboratory data and investigation reports. In addition, decision support and prompts can be built in to catch errant orders. For such system implementations to work, the IT backbone must be fast, reliable and simple to use. End-user involvement and ownership of all aspects of development are key to a usable system. However, the hospital leadership must also have the will to mandate and support these development efforts. With such support, the design and implementation team can then map out a strategy where the greatest impact is achieved in both safety and enhanced information flow. The system should not be considered a finished work, but a continual work in progress. The National University Hospital's continuously updated Computerised Patient Support System (CPSS) is an example of an IT system designed to manage information and facilitate prescribing. It is a client-server based, one-point ordering and information access portal for doctors that has widespread adoption for drug prescription at outpatient and discharge medication usage areas. This system has built in safety prompts and rudimentary decision support. It has also become the choice means of accessing patient-related databases that impact on diagnoses and management.

  14. A survey of the attitude and practice of research among doctors in Riyadh Military Hospital primary care centers, Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Saad H Al-Abdullateef


    Full Text Available Objectives: To assess the attitude and practice of doctors in the Military Hospital Primary Care Centers in Riyadh (RMH toward research and to identify the main barriers to conduct research. Materials and Methods: A cross-sectional study was conducted from March to April, 2010, at RMH primary care centers. The sample included all general practitioners (GPs working in primary healthcare centers. A self-administered questionnaire was formulated from different sources and used as a tool for data collection. Results: The response rate was 75%. Among the respondents 96.9% agreed that research in primary care was important for different reasons. Most of the GPs had a positive attitude toward research: 68% had been influenced by research in their clinical practice and 66% had an interest in conducting research, and74.2% of the respondents had plans to do research in the future. Insufficient time was the most frequently cited barrier (83.5% for participating in research, followed by the lack of support (58.8%. Conclusions: Many of the GPs had a positive attitude toward research, but had no publications or plan for new research. Lack of time, support, and money were the main constraints for carrying out research.

  15. Creating opportunities for interdisciplinary collaboration and patient-centred care: how nurses, doctors, pharmacists and patients use communication strategies when managing medications in an acute hospital setting. (United States)

    Liu, Wei; Gerdtz, Marie; Manias, Elizabeth


    This paper examines the communication strategies that nurses, doctors, pharmacists and patients use when managing medications. Patient-centred medication management is best accomplished through interdisciplinary practice. Effective communication about managing medications between clinicians and patients has a direct influence on patient outcomes. There is a lack of research that adopts a multidisciplinary approach and involves critical in-depth analysis of medication interactions among nurses, doctors, pharmacists and patients. A critical ethnographic approach with video reflexivity was adopted to capture communication strategies during medication activities in two general medical wards of an acute care hospital in Melbourne, Australia. A mixed ethnographic approach combining participant observations, field interviews, video recordings and video reflexive focus groups and interviews was employed. Seventy-six nurses, 31 doctors, 1 pharmacist and 27 patients gave written consent to participate in the study. Data analysis was informed by Fairclough's critical discourse analytic framework. Clinicians' use of communication strategies was demonstrated in their interpersonal, authoritative and instructive talk with patients. Doctors adopted the language discourse of normalisation to standardise patients' illness experiences. Nurses and pharmacists employed the language discourses of preparedness and scrutiny to ensure that patient safety was maintained. Patients took up the discourse of politeness to raise medication concerns and question treatment decisions made by doctors, in their attempts to challenge decision-making about their health care treatment. In addition, the video method revealed clinicians' extensive use of body language in communication processes for medication management. The use of communication strategies by nurses, doctors, pharmacists and patients created opportunities for improved interdisciplinary collaboration and patient-centred medication

  16. Awareness of HIV testing guidelines is low among Swiss emergency doctors: a survey of five teaching hospitals in French-speaking Switzerland.

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    Katharine E A Darling

    Full Text Available BACKGROUND: In Switzerland, 30% of HIV-infected individuals are diagnosed late. To optimize HIV testing, the Swiss Federal Office of Public Health (FOPH updated 'Provider Induced Counseling and Testing' (PICT recommendations in 2010. These permit doctors to test patients if HIV infection is suspected, without explicit consent or pre-test counseling; patients should nonetheless be informed that testing will be performed. We examined awareness of these updated recommendations among emergency department (ED doctors. METHODS: We conducted a questionnaire-based survey among 167 ED doctors at five teaching hospitals in French-Speaking Switzerland between 1(st May and 31(st July 2011. For 25 clinical scenarios, participants had to state whether HIV testing was indicated or whether patient consent or pre-test counseling was required. We asked how many HIV tests participants had requested in the previous month, and whether they were aware of the FOPH testing recommendations. RESULTS: 144/167 doctors (88% returned the questionnaire. Median postgraduate experience was 6.5 years (interquartile range [IQR] 3; 12. Mean percentage of correct answers was 59 ± 11%, senior doctors scoring higher (P=0.001. Lowest-scoring questions pertained to acute HIV infection and scenarios where patient consent was not required. Median number of test requests was 1 (IQR 0-2, range 0-10. Only 26/144 (18% of participants were aware of the updated FOPH recommendations. Those aware had higher scores (P=0.001 but did not perform more HIV tests. CONCLUSIONS: Swiss ED doctors are not aware of the national HIV testing recommendations and rarely perform HIV tests. Improved recommendation dissemination and adherence is required if ED doctors are to contribute to earlier HIV diagnoses.

  17. Exposure to coughed airborne pathogens in a double bed hospital patient room with overhead mixing ventilation: impact of posture of coughing patient and location of doctor

    DEFF Research Database (Denmark)

    Kierat, W.; Bolashikov, Zhecho Dimitrov; Melikov, Arsen Krikor


    The exposure of a doctor and a patient to air coughed by a second infected patient was studied in a mock-up of two-bed hospital infectious ward with mixing ventilation at 22oC (71.6 F) room air temperature. The effect of posture of the coughing patient lying sideways or on back), position...... with a cough generator. Another heated dummy was used to simulate the second patient in the second bed. The cough consisted of 100% CO2. The Peak Cough Time was 4 s, when the doctor was close to coughing patient and increased more than twice for the exposed patient. The level of exposure (Peak Concentration...... Level) depends on the positioning relative to the cough direction: lying or standing still, facing or turned sideways and changed varied 194 to 10228 ppm. Ventilation rates of 12 h-1 (recommended by present hospital standards) resulted in increased background exposure levels and may suggest risk from...

  18. A Study of Workplace Violence Experienced by Doctors and Associated Risk Factors in a Tertiary Care Hospital of South Delhi, India (United States)

    Kumar, Mukesh; Das, Timiresh; Pardeshi, Geeta; Kishore, Jugal; Padmanandan, Arun


    Introduction The increasing incidences of violence against doctors in their workplaces are an important reason for stress among these healthcare workers. Many incidences of workplace violence against doctors have been reported in the past and are also being continuously reported from different parts of the country as well as the world. Aim To determine the prevalence of workplace violence among doctors and to study the associated risk factors in a tertiary care hospital of Delhi, India. Material and Methods A cross-sectional study was conducted using a self-administered semi-structured questionnaire. The contents were: data related to the workplace, incidences at work, violence prevention policy of the institution, reporting of incidences and follow-up, education and training for violence management. A total of 151 doctors participated in the study. Results Total participants in the study were 151. The mean age of study participants was 26.73±4.24 years. Almost half (47.02%; 44.56% of males and 50.84% of females) of the doctors reported having an experience of violence during work hours in past 12 months. Among the cases, 39.4% were reported from Department of Obstetrics and Gynaecology while Surgery, Medicine and other departments reported 29.6%, 26.8% and 4.2% respectively. Patients or their relatives were perpetrators in most of the cases. Maximum (87.3%) of the reported cases were of verbal violence while 8.6% of the cases were of physical violence. Younger doctors with less work experience were more prone to physical violence. Regarding the time of violence, 35.1% of such cases occurred during afternoon while 30.1% of them took place at night. Conclusion A large number of doctors had experienced violence in past 12 months in a tertiary care hospital of South Delhi, India. Verbal violence came out to be most common form of violence experienced by the doctors. Afternoon or night hours were the timings when majority of such cases were reported. PMID:28050406

  19. Assessment of junior doctors’ admission notes: do they follow what they learn? (United States)

    Ghurab, Abdulaziz M.; Balubaid, Hassan K.; Alfaer, Sultan S.; Hanbazazah, Kamal A.; Bukhari, Mohammed F.; Hamed, Omayma A.; Bakhsh, Talal M.


    Objectives To assess the completeness of history-taking and physical-examination notes of junior doctors at King Abdulaziz University Hospital per the approach they learned in medical school. Methods In this retrospective study, we reviewed 860 admission notes written by 269 junior doctors (interns and residents) in an academic tertiary-care medical centre in Jeddah, Saudi Arabia, over a two-month period. Notes were evaluated for completeness using a checklist developed with reference to relevant medical textbooks. The checklist included 32 items related to history-taking and physical examination. Based on the review of the notes, checklist items were evaluated as complete, incomplete, not present, or not applicable according to set criteria. Data were analysed and summarised for information on the frequency and relative frequency of these types. Results The history items varied in completeness. At the high end, asking about chief complaint and duration, associated symptoms, aggravating and relieving factors, and conducting systemic review were marked ‘complete’ in 74.2%, 81.7%, 80.4%, and 79.7% of notes, respectively. At the low end, asking about previous episodes, allergies, medications, and family history were complete in 5.3%, 1.9%, 4.8%, and 2.9% of notes, respectively. All physical examination items were poorly documented, especially breast examination, which was ‘not present’ in 95.8% of the notes. Conclusions Junior doctors’ history and physical-examination notes are often incomplete and do not follow the approach taught in medical school. The reasons for this must be studied via focus-group discussions with junior doctors. PMID:28285275

  20. Evaluation of the Patients, Doctors and Nurses View Points about Patient Bill of Rights in Rasht Public Hospitals

    Directory of Open Access Journals (Sweden)

    Zahra Bostani Khalesi


    Full Text Available Background & Objective: With the aim to clarify the rights of the patients on the basis of medical ethic norms, Patient Bill of Rights in five categories was developed in Iran for the first time, during 2002. The main objective of this study was to determine the views of patients, physicians and nurses about this aspect of medical ethics and its necessary to comply in Rasht public hospitals. Materials &Methods: In this cross-sectional study the data were collected by filling a reliable and validated questionnaire consisting of demographic part and 25 specific questions about the rights of patients, these questions were answered By 185 patients, 22 nurses and 14 doctors. Each of the criteria necessary to use was measured by the Likert scale from zero (completely disagree to five (fully agree. SPSS software 16 and one way ANOVA tests were used for data analysis. Result: The results showed that all groups were agreeing with the necessity to have a bill and consider the patient's rights during treatment (P<0.05. But the most controversial point were related to the rights of patient to have access to their information and the right to choose and decide (P<0.05. However, 68.2 percent of physicians, 80.05 percent of nurses, and 93 percent of patients were agreed with the Bill of Rights. Conclusion: Although all the groups were agreed with the patient's Bill of rights (P<0.05, It seems it is necessary to reconsider the issue of providing the necessary information to the patient and give attention to their choices and decisions by the medical health service providers.

  1. Attitudes toward euthanasia among doctors in a tertiary care hospital in South India: A cross sectional study

    Directory of Open Access Journals (Sweden)

    Sneha Kamath


    Conclusions: A majority of the doctors in this study supported euthanasia for the relief of unbearable pain and suffering. Religion and speciality appear to be significant in determining attitudes toward euthanasia.

  2. Relação entre enfermeiros e médicos em hospital escola: a perspectiva dos médicos Professional relationship between nurses and doctors at the hospital of medical school: the view of doctors

    Directory of Open Access Journals (Sweden)

    Ana Maria de Oliveira


    determine, in the view of physicians, the existence of conflict in the relationship between them and nurses at the Hospital das Clinicas, Universidade Federal de Goiás (HC / UFG and what factors are associated with it. To this goal, 30 doctors completed a questionnaire with demographic data and questions about the variables that affect the relationship, using a Lickert scale. Among the results, the average of age is 42.7 years, 50% of participants are female and 93.3% of the respondents worked elsewhere. The average of years of working in the HC is 16.3. Concerning to the conflict, we highlighted four factors of conflict prevention (Pc, with Middle Ranking (RM greater than 3.0, and two others generators of conflict (2Gc. These factors are: Interprofessional Communication (RM=3.03; Autonomy in Team (RM=3.63; Interprofessional Relationship (RM=3.36; Working Conditions (RM=2.26, Influence of Hospital as a School (RM=2.83 and Patient Benefits (RM = 3,93. We concluded that in the analyzed reality the conflict is considered non-existent, because there is a favorable ratio of protective factors (4Pc:2Gc, but it is imminent, due to the persistence of factors that can unleash it ("Working Conditions" and "Influence of Hospital as a School ". Moreover, there is power struggle with nursing, which can unbalance the situation and create ethical problems.

  3. Expo Junior

    CERN Multimedia

    Staff Association


    Fort de son succès Expo Juniors revient du 22 au 23 novembre 2014 - Papa & Maman Noël seront présents ! Nous avons le plaisir de  proposer à nos membres des billets d'entrées  à un tarif préférentiel, au prix de CHF 10.- l'unité au lieu de CHF 18.- (gratuit pour les enfants de 0 à 4 ans). Des centaines d’ateliers répartis en 3 villages : Sports & Loisirs, Jeux & Jouets, Éducation & Vie pratique. Cet événement propose aux familles aussi d'autres thèmes : tourisme, idées cadeaux, mode, bien-être, beauté, décoration, ainsi que des services destinés aux familles. Parades, attractions, castings, défilés de mode, dédicaces, séances photos avec Papa Noël, ainsi que de nombre...

  4. Undergraduate Information Literacy Instruction Is Not Enough to Prepare Junior Doctors for Evidence Based Practice. A Review of: Cullen, R., Clark, M., & Esson, R. (2011. Evidence-based information-seeking skills of junior doctors entering the workforce: An evaluation of the impact of information literacy training during pre-clinical years. Health Information & Libraries Journal, 28(2, 119-129. doi:10.1111/j.1471-1842.2011.00933.x

    Directory of Open Access Journals (Sweden)

    Carol D. Howe


    Full Text Available Objective – To determine if junior doctorsentering the workforce retain the informationliteracy skills they learned as undergraduates.Design – Structured interviews andobservations.Setting – Wellington Medical School of theUniversity of Otago in New Zealand. Medicinein New Zealand is an undergraduate program.Subjects – Thirty-eight University of Otagostudents who were starting their fourth year ofundergraduate medical training between 1994and 2004. At the time of this study, thestudents had graduated and were a number ofyears into advanced training for theirspeciality, i.e., junior doctors. The participantsrepresented five cohorts, each having receiveda different level of information literacyinstruction as undergraduates. Cohort 1, withthe most years in clinical practice at the time ofthe study, received no formal informationliteracy instruction as undergraduates. Cohorts2 to 5 received information literacy instructionin their fourth undergraduate year. The focusof instruction for cohorts 2 and 3 was ondeveloping an effective search strategy,whereas the instruction for cohorts 4 and 5focused more on the critical appraisal ofarticles. Methods – In 2008 and 2009, the authors contacted cohort graduates. Two medical librarians from the Wellington Medical Library interviewed and observed participants to establish their level of information literacy. The librarians asked an initial six questions to determine how much participants remembered of their undergraduate information literacy instruction, how they search for clinical information, what databases they use, how they evaluate information, and if they have had any formal or informal information literacy instruction since graduating. For question seven, participants described a recent situation in which they searched for clinical information relating to a given patient. For question eight, participants rated their own skill level as “no skills”, “some skills”, or “highly skilled

  5. Exposure to Exhaled Air from a Sick Occupant in a Two-Bed Hospital Room with Mixing Ventilation: Effect of Posture of Doctor and Air Change Rate

    DEFF Research Database (Denmark)

    Bolashikov, Zhecho Dimitrov; Melikov, Arsen Krikor; Barova, Mariya


    Full-scale measurements were performed in a climate chamber set as a two-bed hospital room, ventilated at 3, 6 and 12 ACH with overhead mixing ventilation. Air temperature was kept constant at 22 °C. Two breathing thermal manikins were used to mimic a sick patient lying on one side in one...... of the beds and a doctor. A thermal dummy mimicked an exposed patient lying in the second bed. The doctor either stood up or sat in a chair 0.55 m facing the sick patient. The ‘sick patient’ was exhaling through the mouth and inhaling from the nose. Tracer gas (R 134A) was mixed with the exhaled air to mimic...

  6. 公立医院医生心理资本特征研究%Research on characteristic psychological capital of doctors in public hospitals

    Institute of Scientific and Technical Information of China (English)

    任桂芳; 尹文强; 黄冬梅; 孙葵; 李伟


    目的 了解医生心理资本现状,并分析其特点,以使医院管理更加具有针对性.方法 运用定量与定性相结合的方法,对公立医院医生进行心理资本状况的研究.结果 医生事务型心理资本得分4.25分,人际型心理资本得分4.41分;医生心理资本各维度得分最高的是“谦虚沉稳”,得分最低的是“乐观希望”;医生心理资本在性别、年龄、工作总年限、月均收入等方面存在差异,而在职称、医院级别、聘用形式等方面无差异.结论 医生具有较强的心理资本以应对压力.增强医生心理资本,对提高医疗服务质量具有重要的实践意义.%Objective To study the state of doctors' psychological capital in public hospitals,and to analyze the characteristics of such capital,so as to better leverage the capital as a hospital management tool.Methods A quantitative and qualitative research was made on the state of doctors' psychological capital.Results The doctors' task-oriented psychological capital scored 4.25,and guanxi-oriented psychological capital 4.41; “modesty and prudence”scored the highest in all dimensions of the doctors' psychological capital,“optimism and hope”lowest; the doctors with different genders,ages,seniority,and monthly average income have a difference in psychological capital.However,no significant difference was found with varying titles,hospital levels,and employment models.Conclusion The doctors were found with a strong psychological capital to cope with stress.Better psychological capital will raise quality of care in practice.

  7. Prevalence of stress in junior doctors during their internship training: a cross-sectional study of three Saudi medical colleges’ hospitals


    Abdulghani HM; Irshad M; Al Zunitan MA; Al Sulihem AA; Al Dehaim MA; Al Esefir WA; Al Rabiah AM; Kameshki RN; Alrowais NA; Sebiany A; Haque S


    Hamza Mohammad Abdulghani,1 Mohammad Irshad,1 Mohammed A Al Zunitan,1,2 Ali A Al Sulihem,1,2 Muhammed A Al Dehaim,1,2 Waleed A Al Esefir,1,2 Abdulaziz M Al Rabiah,1,2 Rashid N Kameshki,1,2 Nourah Abdullah Alrowais,2 Abdulaziz Sebiany,3 Shafiul Haque1 1Department of Medical Education, College of Medicine, King Saud University, Riyadh, Saudi Arabia; 2Department of Family and Community Medicine, King Saud University, Riyadh, Saudi Arabia; 3Department of Family and Community Medicine, Universit...

  8. 二级医院医生工作满意度研究%The study of job satisfaction of secondary hospital doctors

    Institute of Scientific and Technical Information of China (English)

    孟梦; 尹文强; 李丹; 王青


    目的 了解二级医院医生工作满意度水平,研究其主要影响因素,并提出相应对策.方法 采用自制的问卷以多阶段分层随机抽样的方法调查了2066名二级医院医生,运用方差分析、相关、非条件logistic回归等方法进行分析.结果 二级医院医生总体工作满意度的平均得分为(3.44±0.95)分.其中57.6%的医生对当前的工作表示满意;工作本身满意度分量表的得分最高,为(3.91±0.79)分,工作回报满意度分量表的得分最低,仅(2.85±1.16)分;非条件Logistic回归分析表明,领导行为对医生工作满意度的决定作用最大(β=0.7,P<0.01).结论 二级医院医生总体工作满意度处于中等偏上水平,医生最不满意的方面集中在工作回报和执业环境方面.%Objective To realize job satisfaction of doctors from the secondary hospital and its influencing factors and put forward countermeasures for doctor job satisfaction.Methods 2066 doctors from the secondary hospital were investigated by self-made scale,and analyzed by analysis of variance,non-conditional logistic regression analysis and other methods.Results The average score of total job satisfaction of doctors was (3.44±0.95),in which about 57.6% of doctors expressed satisfaction with the current work.The scale of job itself satisfaction had the hisheet score,that was (3.91±0.79),while the scale of job retum satisfaction had the lowest score,that was (2.85±1.16).Leadership behavior played the most decisive role in doctors job satisfaction(sβ=0.7,P<0.01).Condusion The total job satisfaction of secondary hospital doctors is just above the average and doctors are most dissatisfied with the work concentrated in the areas of return and the practice environment.

  9. Incidence and risk factors of occupational blood exposure: a nation-wide survey among Danish doctors

    DEFF Research Database (Denmark)

    Nelsing, S; Nielsen, T L; Brønnum-Hansen, H;


    Occupational blood exposures involves a risk of transmission of serious infections. We performed a nation-wide survey, to describe the incidence and risk factors of percutaneous (PCE) and mucocutaneous (MCE) blood exposures among hospital employed doctors in Denmark. Of 9,374 questionnaires, 6.......6-3.1 PCE/pry and 6.0-6.9 MCE/pry). Finally Pathology, Internal medicine, Radiology and Paediatrics had a considerable risk (0.8-1.3 PCE/pry and 1.3-2.9 MCE/pry). Potential risk factors were examined by Poisson regression. Employment as senior as compared to junior doctor was associated with a higher risk...... doctors. Non-compliance with UP was associated with an increased risk of exposure and efforts to improve compliance with UP as well as implementation and evaluation of other preventive measures are needed....

  10. Awareness about medical research among resident doctors in a tertiary care hospital: A cross-sectional survey

    Directory of Open Access Journals (Sweden)

    Dattatray B Pawar


    Full Text Available Context: Every medical practitioner should strive to contribute to the generation of evidence by conducting research. For carrying out research, adequate knowledge, practical skills, and development of the right attitude are crucial. A literature review shows that data regarding knowledge, attitude, and practices toward medical research, among resident doctors in India, is lacking. Aims: This study was conducted to assess research-related knowledge, attitude, and practices among resident doctors. Settings and Design: A cross-sectional survey was conducted using a pretested, structured, and pre-validated questionnaire. Materials and Methods: With approval of the Institutional Ethics Committee and a verbal consent, a cross-sectional survey among 100 resident doctors pursuing their second and third years in the MD and MS courses was conducted using a structured and pre-validated questionnaire. Statistical Analysis: Descriptive statistics were used to analyze the results. Results: The concept of research hypothesis was known to 58% of the residents. Ninety-eight percent of the residents were aware of the procedure to obtain informed consent. Seventy-six percent agreed that research training should be mandatory. Although 88% of the residents were interested in conducting research in future, 50% had participated in research other than a dissertation project, 28% had made scientific presentations, and only 4% had publications. Lack of time (74%, lack of research curriculum (42%, and inadequate facilities (38% were stated as major obstacles for pursuing research. Conclusions: Although resident doctors demonstrated a fairly good knowledge and positive attitude toward research, it did not translate into practice for most of them. There is a need to improve the existing medical education system to foster research culture among resident doctors




  12. Arab doctors, evolving society and corruption: a medical student's perspective. (United States)

    Alamri, Yassar


    Doctors, especially junior doctors, face immense pressure in their day-to-day work. As a result, the rates of depression and anxiety are particularly high in this demanding profession. The pressure, which is compounded by constantly being under societal scrutiny, can unfortunately drive the doctor to breaking point. However, we can help doctors deal with these pressures in a more meaningful way if we make them aware of their wider environment (within a social paradigm) and the implications of their actions.

  13. Attitudes Toward Euthanasia Among Doctors in a Tertiary Care Hospital in South India: A Cross Sectional study


    Sneha Kamath; Priya Bhate; Ginu Mathew; Srijith Sashidharan; Daniel, Anjali B


    Context: Advances in expertise and equipment have enabled the medical profession to exercise more control over the processes of life and death, creating a number of moral and ethical dilemmas. People may live for extended periods with chronic painful or debilitating conditions that may be incurable. Aim: This study attempts to study the attitudes of doctors toward euthanasia and the possible factors responsible for these attitudes. Settings and Design: A cross-sectional survey of 213 ...

  14. Simplifying trauma airway management in South African rural hospitals. (United States)

    Berry, Michael; Wood, Darryl


    South African emergency centres witness high levels of trauma. Successfully managing a compromised trauma airway requires considerable skill and expertise. In the rural healthcare setting, clinics and hospitals are often staffed by junior doctors without formal advanced airway training. Current airway management algorithms tend to ignore lack of resources and skill. We therefore propose a simplified guideline for the rural hospital practitioner. Our algorithm offers a step-by-step approach, with the aim of providing an easy sequence to follow that will ensure successful airway management and patient safety. The lack of advanced airway equipment in most rural hospitals is taken into consideration.

  15. Longer pre-hospital delay in acute myocardial infarction in women because of longer doctor decision time

    NARCIS (Netherlands)

    Bouma, J; Broer, J; Bleeker, J; van Sonderen, E; Meyboom-de Jong, B; DeJongste, MJL


    Study objective-To measure the prehospital delay times in patients with proven acute myocardial infarction (AMI) and to identify possibilities for reduction of treatment delay. Design-Descriptive three centre study. Setting-One university teaching hospital and two regional hospitals in Groningen, th

  16. Analysis of inpatient dermatologic referrals: insight into the educational needs of trainee doctors.

    LENUS (Irish Health Repository)

    Ahmad, K


    AIM: To analyse inpatient consultation referrals to the Dermatology Department and to identify the educational needs of junior\\/trainee doctors. METHODS: Consultation data of inpatients referred to the Dermatology Department between 2001 and 2006 was reviewed. RESULTS: There were 703 referrals identified. Patients were referred from all wards in the hospital. There were a total of 113 different dermatological diagnoses in the group. One-fifth (22%) consultations were for skin infections, 12% had atopic dermatitis, 8% had psoriasis and 8% had clear or suspected drug cause for their rash. In 391 cases, the Consultant Dermatologist\\'s diagnosis was different to the inpatient referral diagnosis on the consultation referral form. CONCLUSIONS: Our results emphasise the need for junior dermatology trainees to undertake extra training in both the dermatologic conditions. This data supports the need for expansion of service provision of dermatology in the region.

  17. Student assistantships: bridging the gap between student and doctor

    Directory of Open Access Journals (Sweden)

    Crossley JGM


    Full Text Available James GM Crossley,1,2 Pirashanthie Vivekananda-Schmidt1 1University of Sheffield School of Medicine, Sheffield, 2Chesterfield Royal Hospital NHS Foundation Trust, Chesterfield, UK Abstract: In 2009, the General Medical Council UK (GMC published its updated guidance on medical education for the UK medical schools – Tomorrow's Doctors 2009. The Council recommended that the UK medical schools introduce, for the first time, a clinical placement in which a senior medical student, “assisting a junior doctor and under supervision, undertakes most of the duties of an F1 doctor”. In the UK, an F1 doctor is a postgraduation year 1 (PGY1 doctor. This new kind of placement was called a student assistantship. The recommendation was considered necessary because conventional UK clinical placements rarely provided medical students with opportunities to take responsibility for patients – even under supervision. This is in spite of good evidence that higher levels of learning, and the acquisition of essential clinical and nontechnical skills, depend on students participating in health care delivery and gradually assuming responsibility under supervision. This review discusses the gap between student and doctor, and the impact of the student assistantship policy. Early evaluation indicates substantial variation in the clarity of purpose, setting, length, and scope of existing assistantships. In particular, few models are explicit on the most critical issue: exactly how the student participates in care and how supervision is deployed to optimize learning and patient safety. Surveys indicate that these issues are central to students' perceptions of the assistantship. They know when they have experienced real responsibility and when they have not. This lack of clarity and variation has limited the impact of student assistantships. We also consider other important approaches to bridging the gap between student and doctor. These include supporting the

  18. Attitude and perception of junior resident doctors’ regarding antibiotic resistance - A pilot study

    Institute of Scientific and Technical Information of China (English)

    Sourabh Aggarwal; Jesna Mathew; Harkirat Singh; Vishal Sharma


    Objective:To analyze the attitude and perception of junior resident doctors’ regarding antibiotic resistance and prescribing.Methods:This cross-sectional study was conducted in two tertiary care centres in theNewDelhi during the months ofMay-June2012.An email based questionnaire was emailed to all the junior residents(JRs) working in the clinical setting and all the responses obtained within2 months were included in the study.Statistical analysis was done usingSPSS v.17. Results:This email based questionnaire was forwarded to80JRs.53 responses were deemed appropriate for analysis with response rate of66.25%.Forty-nineJRs(92.45%) believed that antibiotic resistance is a problem inIndia while38JRs(71.7%) believed it is a problem in their hospital.28JRs(52.83%) had received training regarding antibiotic prescription in last6 months while25(47.17%) had not received any training.47JRs(88.7%) believed thatMedicalCouncil should take strict actions prohibiting irrational use of antibiotics.Only18JRs(33.96%) said thatGovernment ofIndia should go ahead with proposed plan of restricting junior doctors from prescribing third and fourth generation antibiotics withoutHead ofDepartment's permission. Conclusions:Most of the junior residents believe that antibiotic resistance is an emerging problem in their hospital as also nationally.There is a large unmet need of providing education to these residents.

  19. The near-peer tutoring programme: embracing the ‘doctors-to-teach’ philosophy – a comparison of the effects of participation between the senior and junior near-peer tutors

    Directory of Open Access Journals (Sweden)

    Siaw-Cheok Liew


    Full Text Available Background: While there is an increasing pool of literature documenting the benefits of near-peer tutoring programme, little is known about the benefits for junior and senior peer tutors. Knowledge of the peer tutors’ perceived benefits at different levels of seniority will aid in the development of a near-peer tutoring programme that will better fulfil both curricula and personal aspirations of near-peer tutors. We, therefore, investigated the perceived benefits of participation in a near-peer tutoring programme for junior as well as senior near-peer tutors. Methods: Pre- and post-participation questionnaires were distributed to near-peer tutors after their clinical skills teaching sessions with Phase I undergraduate medical students. The Peer Tutor Assessment Instrument questionnaires were distributed to the 1 students, and to the 2 near-peer tutors (junior and senior after each teaching and learning session for self-evaluation. Results: The senior near-peer tutors felt that their participation in the programme had enhanced their skills (p=0.03. As a whole, the near-peer tutors were more motivated (Pre 5.32±0.46; Post 5.47±0.50; p=0.210 to participate in future teaching sessions but did not expect that having teaching experiences would make teaching as their major career path in the future (Pre 4.63±1.07; Post 4.54±0.98; p=0.701. The senior near-peer tutors were evaluated significantly higher by the students (p=0.0001. Students’ evaluations of near-peer tutors on the domain of critical analysis was higher than self-evaluations (p=0.003. Conclusions: Generally, the near-peer tutors perceived that they have benefited most in their skills enhancement and these near-peer tutors were scored highly by the students. However, senior near-peer tutors do not perceive that the programme has a lasting impact on their choice of career path.

  20. A Case of Blunt Traumatic Cardiac Tamponade Successfully Treated by Out-of-hospital Pericardial Drainage in a "Doctor-helicopter" Ambulance Staffed by Skilled Emergency Physicians. (United States)

    Otsuka, Hiroyuki; Sato, Toshiki; Morita, Seiji; Nakagawa, Yoshihide; Inokuchi, Sadaki


    We report a 55-year-old man who relapsed into a state of shock in an ambulance before arriving at our critical care center after a fall injury. The diagnosis of cardiac tamponade was made by portable ultrasound, and immediate pericardiocentesis and drainage were performed at the heliport. He was then transported immediately to our hospital with continuous drainage and surgery was performed. After surgery, the patient was transferred to the intensive care unit in stable condition. After undergoing rehabilitation, he made a full recovery and was discharged. This case illustrates that such patients can be treated reliably by pericardial drainage performed by skilled emergency physicians in the field by making use of the "doctor-helicopter" ambulance transportation system, followed by emergency surgery in a critical care center.




  2. Smartphone apps to support hospital prescribing and pharmacology education: a review of current provision


    Haffey, Faye; Brady, Richard R W; Maxwell, Simon


    Junior doctors write the majority of hospital prescriptions but many indicate they feel underprepared to assume this responsibility and around 10% of prescriptions contain errors. Medical smartphone apps are now widely used in clinical practice and present an opportunity to provide support to inexperienced prescribers. This study assesses the contemporary range of smartphone apps with prescribing or related content. Six smartphone app stores were searched for apps aimed at the healthcare prof...

  3. 'I used to fight with them but now I have stopped!': conflict and doctor-nurse anaesthetists' motivation in maternal and neonatal care provision in a specialist referral hospital

    NARCIS (Netherlands)

    Aberese-Ako, M.; Agyepong, I.A.; Gerrits, T.; van Dijk, H.


    Background and Objectives: This paper analyses why and how conflicts occur and their influence on doctors and nurse-anaesthetists' motivation in the provision of maternal and neonatal health care in a specialist hospital. Methodology: The study used ethnographic methods including participant observa

  4. From Dissertation to Publication: Converting Doctoral Research into a Peer-Reviewed Journal Article (United States)

    Rodriquez-Kiino, Diane


    "The Journal of Applied Research in the Community College" (JARCC) actively seeks scholarly submissions on community colleges that originate from doctoral dissertations. Understanding the scope and complexity of community and junior colleges nationally requires multiple vantage points. Newly minted doctorates and doctoral candidates can provide a…

  5. From Dissertation to Publication: Converting Doctoral Research into a Peer-Reviewed Journal Article (United States)

    Rodriquez-Kiino, Diane


    "The Journal of Applied Research in the Community College" (JARCC) actively seeks scholarly submissions on community colleges that originate from doctoral dissertations. Understanding the scope and complexity of community and junior colleges nationally requires multiple vantage points. Newly minted doctorates and doctoral candidates can provide a…

  6. APPENDIX:A Doctor's Confession

    Institute of Scientific and Technical Information of China (English)


    Not long ago, Xinhua News Agency reported on a confession by Xiao Qiwei regarding corruption in medicine purchases at a hospital in Sichuan. Excerpts follow: I have been working as a doctor for 35 years. As far as I know, corruption in medicine purchases dates from the 1990s. After 1998, all kinds of medicine salespersons surged into hospitals and talked to doctors face to face, stating clearly that they

  7. Investiagation of the core competency of junior nurses in cancer specialized hospital%肿瘤专科医院低年资护士核心能力调查

    Institute of Scientific and Technical Information of China (English)

    苏伟才; 路虹; 耿敬芝


    Objective To understand the overall situation and influence factors of core competence of junior nurses to provide the reference for the next nurse training .Methods Ninety-five junior nurses with nurse occupation qualification certificate ( nursing age was no more than 3 years ) in Cancer Institute & Hospital Chinese Academy of Medical Sciences were chosen and were surveyed by the competency inventory for registered nurses.Results The total score of the core competency of junior nurses was (173.05 ±27.21), and the average score of dimension was (2.98 ±0.47), and was in upper middle level.The average score of dimension showed that the score of legal and ethical practice was the highest score (3.25 ±0.52) and the score of education/counseling was the lowest score (2.74 ±0.59).No differences were found in the average score of core competence of junior nurses who were different gender (t=-0.063), working years (F=1.306), title (t=0.01), education (t=-0.463), department (t=-0.463), the appointment way (t=-1.492), the only child (t=0.301) and the job satisfaction (F=1.063) and so on (P>0.05).Conclusions The core competence of junior nurses should be strengthened , especially in the education/counseling and the critical thinking/scientific research etc .%目的:了解低年资护士核心能力总体情况及影响因素,为下一步培训提供参考依据。方法对中国医学科学院肿瘤医院已考取护士职业资格证书的95名低年资(护龄≤3年)护士进行中国注册护士核心能力量表问卷调查。结果肿瘤医院低年资护士核心能力总分为(173.05±27.21)分,维度总均分为(2.98±0.47)分,属于中等偏上水平;各维度条目均分显示,法律/伦理实践得分最高,为(3.25±0.52)分;教育/咨询得分最低,为(2.74±0.59)分;不同性别、工作年限、职称、学历、工作科室、聘任方式、是否独生子以及对工作满意度评价不同的低

  8. Public hospitals in China: privatisation, the demise of universal health care and the rise of patient-doctor violence. (United States)

    Zheng, Pingan; Faunce, Thomas; Johnston, Kellie


    Ensuring the safety of staff and patients has become a major problem for hospitals in China. This article examines whether one of the reasons for this violence may be the emerging injustice and inequality that have manifested in the Chinese health care system as a result of privatisation reforms since the early 1980s. It considers approaches to these issues that may assist the Chinese Government, and other nations contemplating similar policy changes, to create efficient but equity-based health care systems that minimise collateral trauma to patients and their families.

  9. A survey-based cross-sectional study of doctors' expectations and experiences of non-technical skills for Out of Hours work. (United States)

    Brown, Michael; Shaw, Dominick; Sharples, Sarah; Jeune, Ivan Le; Blakey, John


    The skill set required for junior doctors to work efficiently and safely Out of Hours (OoH) in hospitals has not been established. This is despite the OoH period representing 75% of the year and it being the time of highest mortality. We set out to explore the expectations of medical students and experiences of junior doctors of the non-technical skills needed to work OoH. Survey-based cross-sectional study informed by focus groups. Online survey with participants from five large teaching hospitals across the UK. 300 Medical Students and Doctors Participants ranked the importance of non-technical skills, as identified by literature review and focus groups, needed for OoH care. The focus groups revealed a total of eight non-technical skills deemed to be important. In the survey 'Task Prioritisation' (mean rank 1.617) was consistently identified as the most important non-technical skill. Stage of training affected the ranking of skills, with significant differences for 'Communication with Senior Doctors', 'Dealing with Clinical Isolation', 'Task Prioritisation' and 'Communication with Patients'. Importantly, there was a significant discrepancy between the medical student expectations and experiences of doctors undertaking work. Our findings suggest that medical staff particularly value task prioritisation skills; however, these are not routinely taught in medical schools. The discrepancy between expectations of students and experience of doctors reinforces the idea that there is a gap in training. Doctors of different grades place different importance on specific non-technical skills with implications for postgraduate training. There is a pressing need for medical schools and deaneries to review non-technical training to include more than communication skills. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to

  10. On the Relationship between the Hospital and the Doctor-Patient Harmo-nious Cultural Archives%浅谈医院文化档案与医患和谐的关系

    Institute of Scientific and Technical Information of China (English)

    张男; 耿志伟; 田云峰; 杨金红; 王姣云


    医院文化档案是医院行政机构中重要的组成部分,是对医院过去的历史事件等一系列发展历程的真实记录,并且文化档案也是医院精神文化的载体与传承,其肩负着医院文化特色的延续以及精神文明的传播责任。同时医院文化档案的创立以及加强对医患和谐的关系也具有重要的作用,在医患关系不断恶化,医患矛盾频繁发生的今天,加强医院文化档案的管理工作,对于改善医患关系,创建医患和谐具有重要作用。%Hospital culture archives hospital administration an important part of the hospital is a series of past historical events of the real course of development records,archives and cultural heritage is also the support and spiritual culture of the hospital, which shoulders the hospital cultural characteristics continuation and spread of spiritual responsibility.At the same time the creation of the hospital culture archives and strengthen the doctor-patient rapport also has an important role in the deteriorating relationship between doctors and patients, patient conflicts frequently occurring today,strengthening the management of the hospital culture archives,to improve doctor-patient relationship, create harmonious doctor-patient plays an important role.

  11. 精神科专科医院与综合医院医师工作倦怠及相关因素分析%Analysis on occupational burnout of psychiatrists in psychiatry hospitals and doctors in general hospitals

    Institute of Scientific and Technical Information of China (English)

    杨程甲; 张胜军; 钟天平; 许明智


    Objective To investigate the characteristics of occupational burnout of psychiatrists in psychiatry hos-pitals and doctors in general hospitals, and to explore the association between work stress and somatization, as well as health-related behaviors.Methods A cross-sectional study was implemented.121 psychiatrists and 121 doctors filled out the Maslach Burnout lnventory-General Survey (MBI-GS) and Patient Health Questionnaire(PHQ-15) to explore the level of job burnout and somatic complains.Results There were 89.3%of psychiatrists and 99.2%of doctors suffer-ing from burnout.Doctors in general hospitals yielded higher scores of burnout, exhaustion and reduced personal accom-plishment ( P<0.001) .Psychiatrists more often engaged in physical exercise, smoke less, and kept a better dietary rou-tine than doctors in general hospitals (P<0.05 or P<0.001).The PHQ-15 total scores, stomach pain, back pain, pain in arms/legs/joints, chest pain, palpitation, shortness of breath, sexual problems, abnormal bowel movement, diges-tive discomfort, tiredness and sleep difficulties were notably higher in doctors in general hospital(P<0.05 or P<0.001). Engagement in physical exercise was negatively correlated with exhaustion, while overall PHQ score was positively correla-ted with exhaustion.Results from multiple linear regression showed that MBI-GS score (β=0.375, 95%CI:2.85 -3.09), exhaustion(β=0.273,95%CI:3.11-3.47) and gender (β=0.218,95%CI:1.38-1.51) were potential risk factors of somatic complains(R2 =0.102).Conclusion There are higher burnout level and more somatic complains in doctors in general hospitals.Exhaustion is a predictive factor of somatic symptoms, and a healthy lifestyle may have some effects on reducing burnout.%目的:调查精神科专科医院及综合医院医务人员工作压力状况,并探讨不同专科医师工作压力与功能性躯体不适及健康相关行为的关系。方法应用Maslach工作倦怠量表通用版( MBI-GS

  12. 三所精神病院间医护人员对精神疾病态度的比较%Comparison of Attitudes on Mental Illness among Doctors and Nurses of Three Psychiatric Hospitals

    Institute of Scientific and Technical Information of China (English)

    徐东; 费立鹏; 许德广; 邵贵忠; 曾闽风


    Objective: To compare the attitudes of doctors and nurses from different psychiatric hospitals on mental illness and its stigma experienced by mentally ill patients and their family members. Methods: A questionnaire was administered to 102 doctors and 116 nurses from three psychiatric hospitals in Beijing with different mean lengths of admission and different proportions of chronic patients. Results: There was relatively little difference in the attitudes of nurses among the three hospitals, but doctors from the three centers differed significantly in their beliefs about the social worth of psychiatric patients, patients' level of violence and the need to restrict patients' social activities, as well as the effect of stigma on patients and their family members. These differences among physicians remained after adjusting for gender, age and level of education; this suggests that their attitudes were related to the types of patients they treated.Conclusion: The attitudes of doctors and to a lesser extent nurses on mental illness are affected by the duration of illness and level of social disability of the psychiatric patients they treat.

  13. Doctors Today

    LENUS (Irish Health Repository)

    Murphy, JFA


    Doctors’ relationship with patients and their role in society is changing. Until the 1960s doctors concentrated on the welfare of patients with less emphasis placed on patients’ rights1. Over recent decades there has been increasing empowerment of the individual across all facets of society including health care. Doctors continue to be perceived as having expertise and authority over medical science. Patients, however, now hold sway over questions of values or preferences. We all must be aware of this change in the doctor- patient interaction. We need to be more aware of the outcomes that patients view as important. The concept of shared decision-making with the patient is now widely appreciated. The process involves a change in mind set particularly for doctors who trained in an earlier era.

  14. Doctor Shopping (United States)

    Sansone, Lori A.


    Doctor shopping is defined as seeing multiple treatment providers, either during a single illness episode or to procure prescription medications illicitly. According to the available literature, prevalence rates of doctor shopping vary widely, from 6.3 to 56 percent. However, this variability is partially attributable to research methodology, including the study definition of doctor shopping as well as the patient sample. The reasons for doctor shopping are varied. Some patient explanations for this phenomenon relate to clinician factors, such as inconvenient office hours or locations, long waiting times, personal characteristics or qualities of the provider, and/or insufficient communication time between the patient and clinician. Some patient explanations relate to personal factors and include both illness factors (e.g., symptom persistence, lack of understanding or nonacceptance of the diagnosis or treatment) as well as psychological factors (e.g., somatization, prescription drug-seeking). Importantly, not all doctor shopping is driven by suspect motivations. Being aware of these various patient justifications for doctor shopping is important in understanding and managing these challenging patients in the clinical setting, whether they emerge in psychiatric or primary care environments. PMID:23346518

  15. Compulsory removal to and detention in hospital in the case of notifiable disease: a survey of public health doctors. (United States)

    Kaur, B; Bingham, P


    Compulsory detention of an individual in hospital, because they have a notifiable disease, is controversial. Difficulties experienced by the authors in applying Sections 37 and 38 of the Public Health (Control of Disease) Act 1984 led them to conduct a postal survey of the experience of Consultants in Communicable Disease Control/Medical Officers of Environmental Health (CCDC/MOEH) currently in post in England. Out of 138 respondents (80% response rate), 48 respondents (34.8%) had dealt with 'non-compliant' individuals posing an infectious risk to the community. Of the 48, 13 respondents achieved compliance by threatening to use Section 37/38 and only 6 respondents resorted to using Section 37/38, equivalent to less than one use of the sections for every hundred years of CCDC/MOEH experience. In most cases the notifiable disease in question was tuberculosis. In contrast to our experience and previously reported cases, the survey suggests generally satisfactory experience of Section 37/38 amongst CCDC/MOEH currently in post. Recommended guidelines for the use of Section 37/38 are given.

  16. Dangerous liaisons: doctors-in-training and the pharmaceutical industry. (United States)

    Pokorny, A M J; Gittins, C B


    Interaction between doctors and the pharmaceutical industry is long-standing and ingrained in modern practice. Doctors-in-training are at a vulnerable stage of their careers, both in requiring knowledge and forming lasting relationships. There is evidence that limiting contact between industry and junior doctors has a positive effect on subsequent clinical behaviour. Currently in Australia, there is no limitation on pharmaceutical representatives approaching doctors-in-training, and the majority of education sessions are sponsored by pharmaceutical companies. This purposefully creates a sense of reciprocity, which may have adverse long-term consequences on attitudes, behaviours and patient care. Several guidelines exist that may assist junior doctors in navigating these potential interactions, most notably the Royal Australasian College of Physicians' own Guidelines for Ethical Relationships between Physicians and Industry. Despite this, there is no reflection of its importance or necessity within subspecialty curricula. This should be rectified, to the benefit of both the profession and public.

  17. 北京地区三级医院医生职业幸福感现状及影响因素%Occupational well-being status and influence factors of doctors in third class hospitals in Beijing area

    Institute of Scientific and Technical Information of China (English)

    马妮娜; 张曼华; 朱洁; 刘婷


    Objective To understand the current status of doctors' occupational well-being in three class general hospi-tals in Beijing, and discuss its influencing factors, then may provide a reference for the promotion strategies later. Methods Combined purpose sampling and convenience sampling method were used, and semi-structured interview method was used to do the individual in-depth interviews with 30 doctors from four three class general hospitals in Beijing area, understand the status of their occupational well-being and influencing factors. Results The average of doctors' occupational well-being was (6.03±1.43) points (out of 10 points), overall the doctors' occupational well-being was lower. Doctors believed that the maln factors influenced on their occupational well-being including excessive work pressure (27 people), disproportionate pay (23 people), poor doctor-patient relationship (18 people), hospital manage-ment issues (17 people). Conclusion Doctors' occupational well-being is lower in the three class general hospital in Beijing. The maln factors influenced on doctors' occupational well-being are workload, long working hours, dispropor-tionately individuals pay and reward and doctor-patient relationship disharmony. In order to enhance the doctors' oc-cupational well-being, improving diagnosis and treatment system, optimizing hospitals resource allocation, building de-partment subculture, communication skills tralning for doctors and other channels are better ways.%目的:了解目前北京地区三级综合医院医生的职业幸福感现状,并对其影响因素进行探讨,为后期可能的提升策略提供参考。方法采用目的抽样与便利抽样相结合、半结构化访谈的方法,对北京地区4所三级综合医院中30名医生进行个人深入访谈,了解其职业幸福感现状及影响因素。结果医生的职业幸福感平均得分为(6.03±1.43)分(满分为10分),医生总体职

  18. Supervision and feedback for junior medical staff in Australian emergency departments: findings from the emergency medicine capacity assessment study

    Directory of Open Access Journals (Sweden)

    Weiland Tracey J


    Full Text Available Abstract Background Clinical supervision and feedback are important for the development of competency in junior doctors. This study aimed to determine the adequacy of supervision of junior medical staff in Australian emergency departments (EDs and perceived feedback provided. Methods Semi-structured telephone surveys sought quantitative and qualitative data from ED Directors, Directors of Emergency Medicine Training, registrars and interns in 37 representative Australian hospitals; quantitative data were analysed with SPSS 15.0 and qualitative data subjected to content analysis identifying themes. Results Thirty six of 37 hospitals took part. Of 233 potential interviewees, 95 (40.1% granted interviews including 100% (36/36 of ED Directors, and 96.2% (25/26 of eligible DEMTs, 24% (19/81 of advanced trainee/registrars, and 17% (15/90 of interns. Most participants (61% felt the ED was adequately supervised in general and (64.2% that medical staff were adequately supervised. Consultants and registrars were felt to provide most intern supervision, but this varied depending on shift times, with registrars more likely to provide supervision on night shift and at weekends. Senior ED medical staff (64% and junior staff (79% agreed that interns received adequate clinical supervision. Qualitative analysis revealed that good processes were in place to ensure adequate supervision, but that service demands, particularly related to access block and overcrowding, had detrimental effects on both supervision and feedback. Conclusions Consultants appear to provide the majority of supervision of junior medical staff in Australian EDs. Supervision and feedback are generally felt to be adequate, but are threatened by service demands, particularly related to access block and ED overcrowding.

  19. Analysis of Doctors' Resignation in Public Hospital and its Influential Factors%某公立医院医生离职情况分析及影响因素研究

    Institute of Scientific and Technical Information of China (English)

    张冬娟; 张春芳; 王晶桐


    目的探讨某公立医院医生离职的特点及相关因素,为医院的人力资源管理提供依据。方法以我院2009至2014年间72名离职医生为研究对象,收集其基本信息进行回顾性分析,并结合深度访谈、问卷调查等明确医生离职的原因和去向,进行描述性分析。结果医生离职受个人因素、家庭因素、工作因素和外部就业机会等多种因素的影响,不同职称级别的医生离职的主要影响因素存在差异。结论医院要改进绩效工资分配制度,保证医生获得公平合理的收入,提高医生的职业安全感,加强对年轻医生的关心与培养,建立科学合理的人才梯队,保证人力资源的良性发展。%Objective To explore the characteristics and related factors of doctors' resignation in a public hospital and to provide evidences for the management of human resources in hospitals.Methods In total of 72 doctors who resigned from our hospital from 2009 to 2014 were included in our study, and there basic information was collected to conduct retrospective analysis. In-depth interview and questionnaire were adopted to find out each doctor's resignation reason and new job after resignation so as to conduct descriptive analysis.Results Doctors' resignation was influenced by many different factors including personal factors, family factors, job satisfaction, and external career opportunities. There were differences of resignation reasons among doctors at different professional ranks and levels.Conclusion It is necessary to improve the performance salary distribution system in order to ensure doctors maintain a fair and reasonable income level, to increase the job security by improving the job environment, to improve the training and welfare for young doctors, and to establish a beneficial and reasonable recruiting and promotion system to ensure the healthy career and skill development as well as fair opportunity for doctors.

  20. Going to the Doctor (United States)

    ... Happens in the Operating Room? Going to the Doctor KidsHealth > For Kids > Going to the Doctor A ... it's time to meet the doctor. continue Hello, Doctor The doctor will come in and say hello, ...


    African Journals Online (AJOL)

    Methods: This was a cross-sectional questionnaire based study involving medical doctors working at the .... Set up pharmacovigilance team in hospital and clinical presentation of ... of functional pharmacovigilance committee in the hospitals.

  2. [Job satisfaction among Norwegian doctors]. (United States)

    Nylenna, Magne; Aasland, Olaf Gjerløw


    Doctors' job satisfaction has been discussed internationally in recent years based on reports of increasing professional dissatisfaction. We have studied Norwegian doctors' job satisfaction and their general satisfaction with life. A survey was conducted among a representative sample of practicing Norwegian doctors in 2008. The validated 10-item Job Satisfaction Scale was used to assess job satisfaction. 1,072 (65 %) doctors responded. They reported a mean job satisfaction of 5.3 on a scale from 1 (very dissatisfied) to 7 (very satisfied). Job satisfaction increased with increasing age. Private practice specialists reported the highest level of job satisfaction (5.8), and general practitioners reported higher job satisfaction (5.5) than hospital doctors (5.1). Among specialty groups, community doctors scored highest (5.6) and doctors in surgical disciplines lowest (5.0). While long working hours was negatively correlated with job satisfaction, the perception of being professionally updated and having part-time affiliation(s) in addition to a regular job were positively correlated with job satisfaction. 52.9 % of doctors reported a very high general satisfaction. Norwegian doctors have a high level of job satisfaction. Satisfaction with life in general is also high and at least in line with that in the Norwegian population.

  3. Communications between professional groups in an NHS trust hospital. (United States)

    Smith, A J; Preston, D


    Discusses an audit of communications between doctors and other professional groups in a National Health Services trust hospital. The project was undertaken as a result of senior management's perception that there were problems regarding the interface between professionals and junior doctors particularly, and that these have a potentially detrimental impact on patient care. The aim of the study was to improve the work environment of medical practitioners and professional staff by researching the factors affecting communication and the sources of conflict which exist between the groups. Describes the methodology and provides an overview of the main findings grouped into themes. A large number of recommendations for change have been made to the hospital concerning systems, procedures, structures, training and inter-professional boundaries. Implementation of some of these recommendations has taken place already. Full evaluation of their impact is yet to be determined.

  4. Instigating change: trainee doctors' perspective. (United States)

    Parvizi, Nassim; Shahaney, Sumera; Martin, Guy; Ahmad, Ahmir; Moghul, Masood


    In the 21st century, the core skills of trainee doctors are evolving as clinicians, leaders and innovators. Leadership skills are an essential tool for all doctors and need to be an integral part of their training and learning as set out in the General Medical Council's Good Medical Practice. It is essential to develop these skills at an early stage and continually improve them. A group of junior doctors participated in a pilot programme for leadership with the aim of executing a quality improvement (QI) project. This article describes our experiences of both the course itself and the project undertaken by our group. As part of the process of implementing change, we faced a number of challenges which contributed to our learning. These have been explored as well as potential ways to overcome them to enable the swift and smooth development of future QI projects. Using an example of a QI project looking at handover, this article demonstrates how a trainee doctor can implement their project for both professional and institutional improvement.

  5. Research on the"Green Hospital"from the Perspective of the Doctor of Humane care Quality%“绿色医院”视角下的医生人文关怀品质研究

    Institute of Scientific and Technical Information of China (English)

    兰利莹; 熊伟


    Objective To understand the factors of humanistic caring ability and its effect of doctors, to explore the humanistic care for patients in a hospital doctor significance.Methods Use the convenient sampling method,the management staf of the Jinlin Medical col ege at al levels of doctors,hospital administrators and higher medical institutions to consult the experts.Results Resident and attending the humanistic caring ability was significantly higher than that of the chief physician,and hospital management personnel of humanistic caring ability of different level were signify-cantly lower than those of physicians caring ability,the difference had statistical significance(P<0.05). Conclusion The doctor of humane care of patients,can reduce medical disputes,improve patient satisfaction.%目的:了解医生的人文关怀能力及其影响因素,探讨医生人文关怀对患者的意义。方法利用方便抽样的方法,对吉林医药学院的各级医生、医院管理人员及上级医疗机构管理人员进行专家咨询。结果住院医生及主治医师的人文关怀能力明显高于主任医生,且医院管理人员的人文关怀能力均明显低于不同等级医师的关怀能力,差异均有统计学意义(均P<0.05)。结论通过医生对患者的人文关怀,可减少医患纠纷,提高患者的满意度。

  6. Doctoral Education

    DEFF Research Database (Denmark)

    Ridder, Hanne Mette Ochsner


    Doctoral education covers the “third cycle” of degrees following the bachelor’s and the master’s degree. The education of researchers is necessary for developing music therapy as a scientific discipline and calls for a certain research culture that not only brings knowledge on research...... with an integration of science and practice. This leads to a description of the principles of problem-based learning as a social constructive approach, problematization, self-directed learning and learning community. The chapter is concluded with an example of a model of doctoral education, the Aalborg model, where...... the coursework, supervision, and curriculum is based on problem-based learning. About the book: 'International Perspectives in Music Therapy Education and Training: Adapting to a Changing World,' the first anthology of its kind, edited by Professor Karen Goodman, brings noted educators from Brazil, Canada...

  7. Doctoral Education

    DEFF Research Database (Denmark)

    Ridder, Hanne Mette Ochsner


    Doctoral education covers the “third cycle” of degrees following the bachelor’s and the master’s degree. The education of researchers is necessary for developing music therapy as a scientific discipline and calls for a certain research culture that not only brings knowledge on research...... with an integration of science and practice. This leads to a description of the principles of problem-based learning as a social constructive approach, problematization, self-directed learning and learning community. The chapter is concluded with an example of a model of doctoral education, the Aalborg model, where...... the coursework, supervision, and curriculum is based on problem-based learning. About the book: 'International Perspectives in Music Therapy Education and Training: Adapting to a Changing World,' the first anthology of its kind, edited by Professor Karen Goodman, brings noted educators from Brazil, Canada...

  8. Doctors' views about training and future careers expressed one year after graduation by UK-trained doctors: questionnaire surveys undertaken in 2009 and 2010. (United States)

    Maisonneuve, Jenny J; Lambert, Trevor W; Goldacre, Michael J


    The UK medical graduates of 2008 and 2009 were among the first to experience a fully implemented, new, UK training programme, called the Foundation Training Programme, for junior doctors. We report doctors' views of the first Foundation year, based on comments made as part of a questionnaire survey covering career choices, plans, and experiences. Postal and email based questionnaires about career intentions, destinations and views were sent in 2009 and 2010 to all UK medical graduates of 2008 and 2009. This paper is a qualitative study of 'free-text' comments made by first-year doctors when invited to comment, if they wished, on any aspect of their work, education, training, and future. The response rate to the surveys was 48% (6220/12952); and 1616 doctors volunteered comments. Of these, 61% wrote about their first year of training, 35% about the working conditions they had experienced, 33% about how well their medical school had prepared them for work, 29% about their future career, 25% about support from peers and colleagues, 22% about working in medicine, and 15% about lifestyle issues. When concerns were expressed, they were commonly about the balance between service provision, administrative work, and training and education, with the latter often suffering when it conflicted with the needs of medical service provision. They also wrote that the quality of a training post often depended on the commitment of an individual senior doctor. Service support from seniors was variable and some respondents complained of a lack of team work and team ethic. Excessive hours and the lack of time for reflection and career planning before choices about the future had to be made were also mentioned. Some doctors wrote that their views were not sought by their hospital and that NHS management structures did not lend themselves to efficiency. UK graduates from non-UK homes felt insecure about their future career prospects in the UK. There were positive comments about

  9. Talking to Your Doctor (United States)

    ... Doctor Research Underway Plain Language Talking to Your Doctor Preparing for Your Medical Appointment (4:37) Understanding ... sources of information. How to Talk to your Doctor Talking With Your Doctor , NIH News in Health ...

  10. The Effect of Out-Patient Doctor Workstation in Improving the Level of Hospital Services%门诊医生工作站在提升医院服务水平中的作用

    Institute of Scientific and Technical Information of China (English)

    孟晓阳; 宋忠良


    The clinical information system is an important guarantee to support the normal functioning of the hospital; outpatient doctor workstation is the core of the clinical information system. Through comparison of the outpatient medical services before and after the application of the outpatient doctor services, the paper discussed the effect of outpatient doctor workstation in improving the level of hospital services from five aspects; work efficiency, quality of care, treatment processes 9 medical management y and health care policy.%门诊信息系统是支撑医院正常运转的重要保障,门诊医生工作站是门诊信息系统的核心.通过对比门诊医生工作站上线前后门诊医疗业务的变化,从工作效率、医疗质量、就诊流程、医疗管理、医保政策5方面阐述了门诊医生工作站在提升医院服务水平中的重要作用.

  11. 医院管理人员与医护人员对医患关系评价的差异性分析%Analysis of Evaluation Difference between Hospital Administrator and Medical Personnel on Doctor-patient Relationship

    Institute of Scientific and Technical Information of China (English)

    汉业旭; 王晓燕; 张建; 梁立智; 关丽征; 宋晓霞; 焦峰


    Objective To know about evaluation difference and the cause of it between hospital administrator and medical personnel on doctor-patient relationship. Methods Questionnaire survey was used to investigate 114 hospital administrators and 378 medical personnel, and the result was analyzed by statistical techniques. Results There are statistical significance between hospital administrator and medical personnel in terms of their evaluation difference on doctor-patient relationship, and the evaluation difference is relevant to their life satisfaction and work experience. Conclusion The difference in working principle between hospital administrator and medical personnel is the key issue in the evaluation difference on doctor-patient relationship; hospital administrator needs to strengthen the management theory of humanism, manage the hospitar scientifically , as well as pursue high medical quality, and build up a strong foundation for hospital, construct a harmonious relationship between doctors and patients.%目的 了解医院行政管理人员与医护人员对医患关系的总体评价,探究其差异产生的原因.方法 对北京市5家三级甲等医院114名医院行政管理人员和378名医护人员进行问卷调查,运用秩和检验、Logistic回归等方法对其结果进行统计学分析.结果 医院行政管理人员与医务人员对医患关系的评价存在差异,具有统计学意义;差异产生的原因与他们的生活满意度和工作总体感受相关.结论 医院行政管理人员与医护人员对医患关系评价的差异与其各自的岗位特点有直接关系;医院行政管理需加强人本管理理念,科学管理医院,同时追求更高的医疗质量,打造坚实的医院品牌,构建和谐的医患关系.

  12. Bullying among trainee doctors in Southern India: A questionnaire study

    Directory of Open Access Journals (Sweden)

    Bairy K


    Full Text Available Background: Workplace bullying is an important and serious issue in a healthcare setting because of its potential impact on the welfare of care-providers as well as the consumers. Aims: To gauge the extent of bullying among the medical community in India; as a subsidiary objective, to assess the personality trait of the bullying victims. Settings and Design: A cross-sectional, anonymous, self-reported questionnaire survey was undertaken among a convenient sample of all the trainee doctors at a Government Medical College in Tamil Nadu, India. Materials and Methods: A questionnaire, in English with standard written explanation of bullying was used. Basic information like age, sex, job grade and the specialty in case of Postgraduates (PGs were also collected. Statistical Analysis: The results were subjected to descriptive statistical analysis and Chi-square test for comparison of frequencies. Results: A total of 174 doctors (115 PGs and 59 junior doctors, took part in the study with a cent percent response. Nearly half of the surveyed population reported being subjected to bullying. Nearly 54 (53% of the men and 35 (48% of women were subjected to bullying. Significant proportions ( P < 0.0001 of medical personnel and paramedical staff bullied the PGs and junior doctors, respectively. More than 85 (90% of bullying incidents went unreported. A significant ( P < 0.0001 percentage of PGs and junior doctors revealed a personality trait towards bully. Conclusions: Workplace bullying is common among trainee doctors and usually goes unreported.

  13. Knowledge, attitudes and practice of healthcare ethics and law among doctors and nurses in Barbados

    Directory of Open Access Journals (Sweden)

    Walrond Errol


    Full Text Available Abstract Background The aim of the study is to assess the knowledge, attitudes and practices among healthcare professionals in Barbados in relation to healthcare ethics and law in an attempt to assist in guiding their professional conduct and aid in curriculum development. Methods A self-administered structured questionnaire about knowledge of healthcare ethics, law and the role of an Ethics Committee in the healthcare system was devised, tested and distributed to all levels of staff at the Queen Elizabeth Hospital in Barbados (a tertiary care teaching hospital during April and May 2003. Results The paper analyses 159 responses from doctors and nurses comprising junior doctors, consultants, staff nurses and sisters-in-charge. The frequency with which the respondents encountered ethical or legal problems varied widely from 'daily' to 'yearly'. 52% of senior medical staff and 20% of senior nursing staff knew little of the law pertinent to their work. 11% of the doctors did not know the contents of the Hippocratic Oath whilst a quarter of nurses did not know the Nurses Code. Nuremberg Code and Helsinki Code were known only to a few individuals. 29% of doctors and 37% of nurses had no knowledge of an existing hospital ethics committee. Physicians had a stronger opinion than nurses regarding practice of ethics such as adherence to patients' wishes, confidentiality, paternalism, consent for procedures and treating violent/non-compliant patients (p = 0.01 Conclusion The study highlights the need to identify professionals in the workforce who appear to be indifferent to ethical and legal issues, to devise means to sensitize them to these issues and appropriately training them.

  14. Perspectives of Patients, Doctors and Medical Students at a Public University Hospital in Rio de Janeiro Regarding Tuberculosis and Therapeutic Adherence.

    Directory of Open Access Journals (Sweden)

    Elizabeth da Trindade de Andrade

    Full Text Available The World Health Organization (WHO identifies 8.7 million new cases of tuberculosis (TB annually around the world. The unfavorable outcomes of TB treatment prevent the achievement of the WHO's cure target.To evaluate existing intersections in the conceptions relative to the knowledge of TB, the experience of the illness and the treatment.Doctors, medical students and patients were selected from a public university in Rio de Janeiro, Brazil, from 2011 to 2013. The data were obtained by semi-structured individual and focus group interviews, participant observation and a field journal. The inclusion of patients was interrupted due to saturation, and the inclusion of doctors and medical students stopped due to exhaustion. The theoretical background included symbolic Interactionism, and the analysis used rounded Theory. The analysis prioritized the actions/interactions axis.Twenty-three patients with pulmonary TB, seven doctors and 15 medical students were included. In the interviews, themes such as stigma, self-segregation, and difficulties in assistance emerged, in addition to defense mechanisms such as denial, rationalization, isolation and other mental mechanisms, including guilt, accountability and concealment of the disease. Aspects related to the assistance strategy, the social support network, bonding with the healthcare staff and the doctor-patient relationship were highlighted as adherence enablers. Doctors and students recommended an expansion of the theoretical and practical instruction on TB during medical students' education. The existence of health programs and policies was mentioned as a potential enabler of adherence.The main concepts identified were the stigma, self-segregation, guilt, responsibility, concealment and emotional repercussions. In relation to the facilitation of therapeutic adherence, the concepts identified were the bonds with healthcare staff, the doctor-patient relationship, assistance and educational health

  15. Medical literature search practice in paediatric junior medical staff: a questionnaire survey. (United States)

    Shirkhedkar, P; Day, A S


    With increasing medical knowledge and emphasis upon evidence-based medicine, it is essential for practitioners to have optimal literature searching skills. There are limited data regarding the use of online information retrieval (IR) systems by paediatric junior medical officers (JMO). The aims of this questionnaire-based study of a group of JMO were to assess the accessibility, frequency of use and preferences for electronic information resources, and to ascertain their perceived adequacy of training and expertise in online searching. Questionnaires were distributed to 319 JMO at two Australian children's hospitals. A total of 106 questionnaires were returned (33.2% response rate). Twenty-four-hour access to electronic medical databases was available to almost 90% of respondents at work or home. Five or less online searches per month were performed by 53.7% of respondents. Previous formal training in database searching was reported by 72.4% of respondents, but over half felt it had been inadequate. Most JMO (91.5%) acknowledged a need for further training in search skills. In spite of widespread availability of online resources, use of these resources was sub-optimal in this group of trainee doctors. Most respondents reported a need for further training in electronic searching. Continuing targeted education in electronic database searching is required to ensure that future doctors develop skills to ensure optimal use of medical literature.

  16. Evaluation of the knowledge, attitude and the practice of pharmacovigilance among the interns and doctors in a tertiary level care teaching hospital in Northern India

    Directory of Open Access Journals (Sweden)

    Manreet Singh Sekhon


    Conclusions: There is a great need to create awareness and to promote the reporting of ADR amongst interns and doctors, which will lay a solid foundation for these healthcare professionals to be involved in quality pharmacovigilance. [Int J Basic Clin Pharmacol 2016; 5(3.000: 1068-1074

  17. 浅谈医院在营造良好医患关系中的作用%The Roles of Hospital in Building Harmonious Doctor-Patient Relationship

    Institute of Scientific and Technical Information of China (English)

    季学磊; 葛艺东; 程结南; 姜兰兰; 朱苏月; 徐明亮; 崔人喜; 王谊雯; 何思忠


    随着卫生医疗服务水平的提高,医患矛盾却呈现日益加重的趋势。作为医患关系发生的主要场所,医院在营造良好医患关系方面有着不可替代的作用。本文将从医院管理层面来探讨如何建构良好的医患关系。%With the development of social economy and socioculture,health service in China has made great improve.However,the doctor-patient contradiction has been undergoing a severe trial. As the main venue where the doctor-patient relationship occurred,the hospital plays an impotent role in establishment of a good rapport between physicians and patients.The aim of this article is to discuss how to establish a harmonious doctor-patient relationship on a management level.

  18. Did the Olympics need more drugs? a doctor's reflection on providing medical care during Op OLYMPICS. (United States)

    Monteiro de Barros, James; Ross, D A


    This paper examines some of the medical problems arising from the successful deployment of Defence Medical Services personnel to Op OLYMPICS (mid-June 2012-September 2012). It does not aim to be all encompassing in its scope, but focuses on the most pressing issues affecting a junior military doctor's ability to work effectively under field conditions. This will entail a discussion about whether in a deployment such as Op OLYMPICS medical care should be based upon offering solely primary healthcare in medical centres or using Role 1 medical treatment facilities, which include primary healthcare and pre-hospital emergency care. The main recommendations arising from the deployment are: clinicians should deploy with a minimum of basic emergency drugs and equipment; a medical facility treating a large population at risk for a prolonged period should have a broad stock of medications available on site; and medical risk assessments must be performed on all Reservists during mobilisation.

  19. Empirical analysis on the job satisfaction of doctors in public hospitals%公立医院医生工作本身满意度实证分析

    Institute of Scientific and Technical Information of China (English)

    张宜民; 尹文强; 孙葵; 黄冬梅; 赵延奎; 李艳丽


    目的 了解我国公立医院医生工作本身满意度的现状和人口学特征差异,并识别其内部决定因素,为改善公立医院管理体制提供科学依据.方法 自行设计量表,按照多阶段分层抽样的方法,从全国4个省区抽取公立医院医生5 677名,对所获样本数据进行实证分析.结果 量表信度和效度良好;公立医院医生工作本身满意度的平均得分较高,表示"较满意"及以上的人群占样本总量的78.20%;在是否带教及不同级别医院、年龄、工作年限、职称、科室等变量上,差异有统计学意义;主要受专业兴趣、性格适合、医疗保险自主及工作胜任等因素的影响.结论 注意不同医生群体间的差异,积极发挥主要决定因素的内在激励作用,提高公立医院医生对工作本身的满意程度,可有效改善医疗服务质量.%Objective To understand the current status and demographic differences in job satisfaction of doctors in public hospitals and find out the internal determinants, with the aim of providing scientific basis for improving the management mechanism of public hospitals. Methods A total of 5 677 doctors in public hospitals from four provinces were enrolled by method of multi-stage stratifiedsampling, and they were tested by the self-designed scale. Empirical analysis was conducted on the acquired data. Results The reliability and validity of the self-designed scale were good. Most doctors in public hospitals were highly satisfied with their job, with the population being 78.20% of the total. The differences were significant on partial demographic variables, including whether teaching, grade of hospital, age, length of service, professional title, department, etc. The job satisfaction was mainly determined by such factors as interest on speciality, whether in suit with character, medical autonomy, job competence, etc. Conclusion The quality of medical services can be improved by attaching importance to the

  20. Hospitals (United States)

    Department of Homeland Security — This database contains locations of Hospitals for 50 states and Washington D.C. , Puerto Rico and US territories. The dataset only includes hospital facilities and...

  1. Choosing a Family Doctor (United States)

    ... nav nav, .header-9#header-section #main-nav, #overlay-menu nav, #mobile-menu, #one-page-nav li . ... editorial staff Home Your Health Resources Doctor Visit Preparation Choosing a Family Doctor Choosing a Family Doctor ...

  2. Impact of New Shift Models for Doctors Working at a German University Hospital for Gynaecology and Obstetrics Four Years After Implementation. Can They Meet the European Working Time Directive Without Increasing Costs? (United States)

    Maschmann, J; Holderried, M; Blumenstock, G; Bamberg, M; Rieger, M A; Wallwiener, D; Brucker, S


    Background: The impact of the European Working Time Directive and subsequent collective wage agreements for doctors from 2006 onwards were substantial. So far, no systematic evaluation of their application in Germany has been performed. We evaluated the impact four years after implementation of new shift models in a University Hospital for Gynaecology and Obstetrics (UHGO). Methods: A new shift model was created together with doctors of Tübingen UHOG in 2007 and implemented in 2008. Documentation of working hours has hence been done electronically. Adherence to the average weekly working time limit (AWTL) and the maximum of 10 h daily working time (10 h-dwt) was evaluated, as well as staffing costs in relation to case-weight points gathered within the German DRG (diagnosis related groups) System. Results: Staff increased from a mean of 44.7 full time equivalent (FTE) doctors in 2007 to 52.5 FTE in 2009, 50.8 in 2010, and 54.5 in 2011. There was no statistically significant difference of the monthly staff expenditures per case-weight between the years 2009 or 2010 vs. 2007. 2011, however, was significantly more expensive than 2007 (p = 0.02). The internal control group (five other departments of the university hospital) did not show an increase during the same period. AWTL were respected by 90, 96, and 98 % in 2009, 2010, and 2011, respectively. Of all shifts 10 h-dwt was exceeded by 7.4 % in 2009, 1.3 % in 2010, and 2.6 % in 2011, with significant differences between 2009 and both, 2010 and 2011 (p implementation of the new shift model without increasing the cost/earnings ratio for the first two years. However, in 2011 the ratio increased significantly (p = 0.02).

  3. The research of Chinese medical students′understanding current of China's doctor-patient relationship in teaching hospital%教学医院医学生对我国医患关系现状认知的研究

    Institute of Scientific and Technical Information of China (English)

    蒋晓敏; 孙忠河


    As contradictions and disputes of doctor-patient relationship are increasingly intensified, Chinese medical students have faced big challenge of it. This paper recognizes the importance of solutions. With reference to some surveys of medical residents in school and hospital, the authors emphasize that strong clinical skills, patient-centered model, good communication and optimistic attitude are the keys to improving doctor-patient relationship, so that to guide the medical students in teaching hospitals to get better learning and clinical practicing.%我国医患关系日益紧张,医学生如临深渊.本文运用文献总结、学生采访等手段,通过探究医患关系现状、原因以及医学生对现状的认识,力求深化医患沟通知识及技巧,得出改善医患关系的启示,以指导教学医院医学生更好地学习和实习.

  4. 医患关系视角下的医院管理者角色期待%Expectations of the Role of Hospital Administrators to Harmonize the Doctor-Patient Relationship

    Institute of Scientific and Technical Information of China (English)

    王倩云; 郑龙; 吕书革


    医院管理者在构建和谐医患关系中发挥着重要作用,是组织架构的优化者、环境变化的调适者、决策执行的督导者、和谐人际的引领者。本文通过对医院管理者角色定位、履职影响因素的分析,提出管理者应做好“五个关注”,推动医患关系趋于和谐稳定。%Hospital Administrators play an important role in building a harmonious doctor -patient rela-tionship.They will make the crucial function in the organizational structure , regulation of circumstance changes , and supervision of decision -making executive , and leading the construction of harmonious interpersonal .In this paper, the roles of the hospital administrators and influence factors to fulfill the roles were analyzed , and then five issues were put forward to promote the doctor -patient relationship .

  5. Patient-Related Factors Influencing Satisfaction in the Patient-Doctor Encounters at the General Outpatient Clinic of the University of Calabar Teaching Hospital, Calabar, Nigeria

    Directory of Open Access Journals (Sweden)

    Ndifreke E. Udonwa


    Full Text Available Medical consultation is at the centre of clinical practice. Satisfaction of a patient with this process is a major determinant of the clinical outcome. This study sought to determine the proportion of patients who were satisfied with their doctor-patient encounter and the patient-related factors that affected patients’ satisfaction with the consultation process. A clinic-based, cross-sectional study using a modified version of the General Practice Assessment Questionnaire (GPAQ, which employed a systematic sampling technique, was used. The questionnaires were administered on 430 patients within the ages of 18 years and 65 years. Among the 430 subjects within the ages of 18 years and 65 years studied, 200 (46.5% were males and 230 (53.5% were females. Only 59.3% were satisfied with their patient-doctor encounter. The patient’s perception of time spent in the consultation, illness understanding after the visit, ability to cope with the illness after the visit, and ability to maintain health after visit were the only factors that affected patient’s satisfaction with the consultation. In our environment, nonsatisfaction with the patient-doctor encounter is high. Only few factors considered to encourage a patients satisfaction at primary care consultation contributed to end-of-consultation satisfaction. This calls for refocusing so as to improve the overall patient care in our cultural context and meet the patient needs in our environment.

  6. Field trials of the Baby Check score card in hospital. (United States)

    Thornton, A J; Morley, C J; Cole, T J; Green, S J; Walker, K A; Rennie, J M


    The Baby Check score card was used by junior paediatric doctors to assess 262 babies under 6 months old presenting to hospital. The duty registrar and two consultants independently graded the severity of each baby's illness without knowledge of the Baby Check score. The registrars assessed the babies at presentation while the consultants reviewed the notes. The consultants and registrars agreed about the need for hospital admission only about 75% of the time. The score's sensitivity and predictive values were similar to those of the registrars' grading. The score's specificity was 87%. Babies with serious diagnosis scored high, while minor illnesses scored low. The predictive value for requiring hospital admission increased with the score, rising to 100% for scores of 20 or more. The appropriate use of Baby Check should improve the detection of serious illness. It could also reduce the number of babies admitted with minor illness, without putting them at increased risk.

  7. Positioning doctors for convenience medicine. (United States)

    Haley, M


    Faced with an increasingly competitive environment, physicians must learn to organize themselves into group practices positioned to perform as the customer expects. To be successful, these new group practices must recruit the kind of physician who will meet the consumer's demands for quality care: convenience, continuity of care, and confidence in the doctor's competence. This article describes how doctors can become more competitive based on my observations as a former consultant with such healthcare companies as Cigna Healthplan, the largest for-profit HMO, and as the current vice president of Operations Planning and Development with Republic Health Corporation, a Dallas-based hospital management company. These observations should help hospital managers learn how to organize their medical staffs to better serve the patient's needs. By repositioning their physician services, hospitals should become better positioned to compete for new patients.

  8. 'I Used to Fight with Them but Now I Have Stopped!': Conflict and Doctor-Nurse-Anaesthetists' Motivation in Maternal and Neonatal Care Provision in a Specialist Referral Hospital.

    Directory of Open Access Journals (Sweden)

    Matilda Aberese-Ako

    Full Text Available This paper analyses why and how conflicts occur and their influence on doctors and nurse-anaesthetists' motivation in the provision of maternal and neonatal health care in a specialist hospital.The study used ethnographic methods including participant observation, conversation and in-depth interviews over eleven months in a specialist referral hospital in Ghana. Qualitative analysis software Nvivo 8 was used for coding and analysis of data. Main themes identified in the analysis form the basis for interpreting and reporting study findings.Ethical clearance was obtained from the Ghana Health Service Ethics Review board (approval number GHS-ERC:06/01/12 and from the University of Wageningen. Written consent was obtained from interview participants, while verbal consent was obtained for conversations. To protect the identity of the hospital and research participants pseudonyms are used in the article and the part of Ghana in which the study was conducted is not mentioned.Individual characteristics, interpersonal and organisational factors contributed to conflicts. Unequal power relations and distrust relations among doctors and nurse-anaesthetists affected how they responded to conflicts. Responses to conflicts including forcing, avoiding, accommodating and compromising contributed to persistent conflicts, which frustrated and demotivated doctors and nurse-anaesthetists. Demotivated workers exhibited poor attitudes in collaborating with co-workers in the provision of maternal and neonatal care, which sometimes led to poor health worker response to client care, consequently compromising the hospital's goal of providing quality health care to clients.To improve health care delivery in health facilities in Ghana, health managers and supervisors need to identify conflicts as an important phenomenon that should be addressed whenever they occur. Effective mechanisms including training managers and health workers on conflict management should be put in

  9. 三甲儿童医院门诊护理细节管理对医患关系的影响%Affect Tertiary Level Children's Hospital Outpatient Care Details of the Management of the Doctor-patient Relationship

    Institute of Scientific and Technical Information of China (English)



    Objective Investigate the ef ect of a large children's hospital outpatient care and management of the doctor-patient relationship details. Methods This study used self-made questionnaire on 625 cases of children or their families were anonymous survey. The questionnaire mainly related to nurses, family members and hospital three children, a total of 11 questions. Results Patient identity details of outpatient care af ect patient relationship before six were ranked poor at itude of nurses (97%), basic nursing skil s unskil ed technical operations (94.9%), lack of communication skil s (91.5%), professionalism is not high (81.9%), lack of humane care (75%), poor mental quality (60%) ,Families of children with pediatric medical knowledge of the relevant legal knowledge and understanding is not enough, hospital outpatient department of the hospital environment factors such as poor doctor-patient relationship is af ected. Conclusion Strengthen management can improve patient care details of the families of children with satisfaction, Improve the doctor-patient relationship, Reduce the occur ence of medical disputes.%目的:探讨大型儿童医院门诊护理细节管理对医患关系的影响。方法本研究采用自制调查问卷对625例患儿或家属进行无记名调查。调查问卷主要涉及护理人员、患儿家属及医院三个方面,共11个问题。结果患者认同门诊护理细节影响医患关系排名前六的分别是护理人员的服务态度恶劣(97%)、基础护理技术操作技巧不熟练(94.9%)、缺乏沟通技巧(91.5%)、专业素养不高(81.9%)、缺乏人文关怀(75%)、心理素质较差(60%),患儿家属对相关儿科医学知识和法律知识了解不够,医院门诊部的就医环境较差等也是影响医患关系因素。结论加强门诊护理细节管理可以提高患儿家属满意度,改善医患关系,减少医疗纠纷的发生。

  10. Are doctor's hands contributing in spreading nosocomial pathogens? Rapid appraisal from a tertiary care health center of Northern India

    Directory of Open Access Journals (Sweden)

    Shewtank Goel


    Full Text Available Background: Clinical white coats have very long history of being a symbol of hope and healing for medical professionals; however there has been a concern that white coats may play a big role in transmitting infections within and outside hospital settings. Aim of the study was to assess pattern of pathogenic bacteria on the hands of doctors of a tertiary care hospital along with effect of hand wash on reduction of contamination. Methods: The present study was a hospital based, cross sectional type. Eighty-six doctors of all designations (Junior doctors, n=51; and senior doctors, n=35 were included in this study. The swabs were taken at entry in the wards and also at exit from the wards without washing the hands. Then, swabs were taken after hand washing with tap water and subsequently after alcohol swabs. A total of four wards (2 General Medicine and Surgery wards each included in the study. Isolated microorganisms were identified using Gram's stain, hemolysis patterns and colony morphology. The data were analyzed using MedCalc statistical software. Results: Staphylococcus aureus was isolated in 24.41% at entry and in 52.33% at exit. Similarly Pseudomonas aeruginosa and Klebsiella pneumonia were not present on the hands of doctors at entry but isolated in 5.81% and 10.46% of doctors at exit. Pseudomonas aeruginosa and Klebsiella pneumonia were not present on the hands of doctors at entry in both medicine and surgery wards but isolated at exit. Complete removal/reduction of microorganism (100% was recorded in Escherichia coli and Candida sp after tap water wash. Decrease in count of Pseudomonas aeruginosa up to 80.00% after tap water wash. 88.89 % decrease in microorganism after subsequent alcohol wash was seen in Staphylococcus aureus, Coagulase-negative Staphylococci and Klebsiella pneumonia. Conclusions: It has been observed that simple hand washing (first with water and then with alcohol is an effective tool to reduce the contamination

  11. How does a doctor study other doctors being doctors?

    DEFF Research Database (Denmark)

    Risør, Torsten

    The intension of this presentation is to encourage debate on auto-ethnography in medical systems. The empirical starting point will be my present study of how young doctors learn to make decisions about diagnosis and treatment of the individual patient. The study is an ethnographic field study...... involving participant observation and individual interviews with nine newly graduated doctors for a period of 18 months. The background of the ethnographer who is also the author of the present abstract poses a few interesting challenges to the study. I am a doctor doing fieldwork in my own medical culture......, among other doctors, at departments where I have worked. My parents, my sister and my grandfather are doctors. So reflections and experiences concerning medicine and being a doctor are integrated parts of my personal history and identity. Will I be capable of critical reflection on something...

  12. Media Coping Strategy for Doctor-patient Dispute Processing in Hospital%医院在医患纠纷处理中的媒体应对策略

    Institute of Scientific and Technical Information of China (English)



    阐述了医患纠纷中媒体介入的影响及媒体应对在医院医患纠纷处理中的重要性,讨论了目前医院媒体应对中存在的主要问题,并提出医院在医患纠纷中的媒体应对策略,主要有:迅速查明真相,积极配合媒体报道;发布权威消息,还原事件真相;监督媒体报道,严惩侵权行为;开通医院官方微博、微信公众平台。%This paper expounded the influences of the doctor -patient dispute media intervention and media re-sponse in the importance of the hospital medical disputes processing , discusses the media response to the main problems existing in the hospital , and put forward hospital in media strategies of medical disputes , mainly include:quickly find out the truth , actively cooperate with media;Release authoritative information , restore the truth;Su-pervision and media reports , punish infringement behavior;Opened a hospital official weibo , WeChat public plat-form.

  13. Doctors' involvement in torture

    DEFF Research Database (Denmark)

    Sonntag, Jesper


    Doctors from both non-democratic and democratic countries are involved in torture. The majority of doctors involved in torture are doctors at risk. Doctors at risk might compromise their ethical duty towards patients for the following possible reasons: individual factors (such as career, economic...


    CERN Multimedia

    Medical Service


    IN URGENT NEED OF A DOCTOR GENEVA EMERGENCY SERVICES GENEVA AND VAUD 144 FIRE BRIGAD 118 POLICE 117 CERN FIREMEN 767-44-44 ANTI-POISONS CENTRE Open 24h/24h 01-251-51-51 Patient not fit to be moved, call family doctor, or: GP AT HOME, open 24h/24h 748-49-50 Association Of Geneva Doctors Emergency Doctors at home 07h-23h 322 20 20 Patient fit to be moved: HOPITAL CANTONAL CENTRAL 24 Micheli-du-Crest 372-33-11 ou 382-33-11 EMERGENCIES 382-33-11 ou 372-33-11 CHILDREN'S HOSPITAL 6 rue Willy-Donzé 372-33-11 MATERNITY 32 la Cluse 382-68-16 ou 382-33-11 OPHTHALMOLOGY 22 Alcide Jentzer 382-33-11 ou 372-33-11 MEDICAL CENTRE CORNAVIN 1-3 rue du Jura 345 45 50 HOPITAL DE LA TOUR Meyrin EMERGENCIES 719-61-11 URGENCES PEDIATRIQUES 719-61-00 LA TOUR MEDICAL CENTRE 719-74-00 European EmergencyCall 112 FRANCE EMERGENCY SERVICES 15 FIRE BRIGADE 18 POLICE 17 CERN FIREMEN AT HOME 00-41-22-767-44-44 ANTI-POISONS CENTRE Open 24h/24h 04-72-11-69-11 All doctors will...

  15. 湖北省部分医院创伤急救颈椎保护技能现状调查%Present status of cervical immobilization skills for trauma of some hospital doctors of Hubei Province

    Institute of Scientific and Technical Information of China (English)

    杨奇盛; 赵剡; 王翔; 宋小兵; 潘正启


    Retrospective analysis was conducted for the results of first-aid competitions so as to understand the present status of how emergency doctors of Hubei Province grasp the skills and consciousnesses of cervical immobilization.From 6 out of 19 teams,38 participating doctors from grade 3A hospitals provided patient cervical immobilization while 2 teams offered no cervical protection.It is necessary to intensify the skills and consciousnesses of cervical immobilization in clinical practice.%回顾分析湖北省急救医师技能竞赛中创伤急救颈椎保护比赛结果,了解全省急救医师保护颈椎的意识、手法等基本技能掌握情况.全省19支三级甲等医院(含市州级急救中心)代表队的38人参赛,6支队实施了颈椎保护动作,2支队未对颈椎进行任何保护.提示在临床工作中要不断强化保护颈椎意识、规范保护颈椎手法和正确放置颈托的方法.

  16. Survey of the current situation of job burnout of junior nurses in the hospitals at the level of gradeⅢ class A in Beijing city and analysis of the related factors%北京市三甲医院低年资护士职业倦怠现状调查及相关因素分析

    Institute of Scientific and Technical Information of China (English)

    许亚红; 张茜; 陈英


    目的:了解北京市三甲医院低年资护士职业倦怠的状况,探讨影响低年资护士职业倦怠的相关因素。方法:应用一般资料问卷、MBI - GS 工作倦怠量表对北京市3所三级甲等综合医院的100名低年资护士进行调查。结果:北京市三甲医院低年资护士存在较严重职业倦怠,50%存在情感耗竭;去个性化者占60%;成就感低落占49%。护龄2~4年的护士职业倦怠最重,是否参加科室轮转培养会影响护士的职业倦怠水平。结论:北京市三甲医院低年资护士存在较高的职业倦怠,护理管理者重视低年资护士规范化培训,以便降低护士职业倦怠。%Objective:To investigate the current situation of job burnout of junior nurses in the hospitals at the level of grade Ⅲclass A in Beijing city and analyze the related factors. Methods:The general information questionnaire and MBI - GS job burnout scale were used to conduct a survey on 100 junior nurses of 3 hospitals at the level of grade Ⅲclass A in Beijing city. Results:The job burnout existed in these junior nurses,50% of them had emotional exhaustion,60% had depersonalization and 49% had low personal accomplishment. The most serious job burnout existed in the nurses with nursing age of 2 to 4 years. Conclusion:The nursing managers should pay attention to stand-ardized training for junior nurses so as to reduce their job burnout.

  17. Personality differences among junior postgraduate trainees in the United Kingdom. (United States)

    Martinou, Eirini; Allan, Hayley; Vig, Stella


    An early understanding of the personality profiles of junior trainees may be valuable for supporting the professional and educational development of tomorrow's doctors. This study aims to describe the personality profile of junior trainees and to explore whether the personality profiles differed according to the level of training, specialty choice, or gender. The Mental Muscle Diagram Indicator was distributed electronically. South West London, Health Education England South London. A total of 157 junior trainees completed the personality questionnaire. Specifically, there were core surgical (n = 40), core medical (n = 24), and foundation trainees (n = 93). The preferential profile across all groups was Extroversion (E), Sensing (S), Feeling (F), and Perception (P). More foundation doctors favored an extrovert and sensing personality when compared with core trainees (72% vs 60.4% and 77.4% vs 57.5%, respectively). More core surgical trainees appeared to prefer Extroversion when compared with their medical counterparts (66.7% vs 54.2%). More core medical trainees favored an intuitive behavior when compared with their surgical colleagues (50% vs 35%). Significantly, more female trainees (83.3%) displayed an extrovert personality than male trainees (66.7%) did. According to the Mental Muscle Diagram Indicator analysis, this work shows that the more junior the trainees are in their career, the more they tend to enjoy human interaction and to favor acting before thinking. The most junior trainees tend to be slightly more interested in dealing with facts rather than ideas and favor a flexible approach of life. The reducing ratio of Extroversion and Sensing in the core trainees when compared with foundation doctors may suggest that clinical experience has an effect on personality. As trainees begin to progress, they may tend to reflect more on their practice and to start thinking about more long term. These results suggest that a greater understanding of their personality

  18. hospital

    African Journals Online (AJOL)

    Pattern of congenital orthopaedic malformations in an African teaching hospital ... malformation in this environment while congenital hip dislocation (CDH) is rare when .... malformations of radial dysplasia and other congenital malformations.

  19. Freeman Hospital: the will to survive. (United States)

    Kingman, S


    The future looks uncertain for the Freeman Hospital trust in Newcastle upon Tyne. There are plans to rationalise the health service in Newcastle by shifting resources from secondary to primary care, and by providing more services locally for people who live in the region but outside Newcastle. These could reduce the level of contracts that purchasers place with the trust in the future. Staff at the trust say the service they provide is good value for money, but purchasers do not seem to take this into account. Instead of choosing from a "shopping list" of priced procedures, purchasers are forcing the trust to dovetail its prices to meet their budgets. There is also concern at the potential impact on the trust's financial situation of reduced working hours for junior doctors and the Calman proposals on training.

  20. Doctoral specialization in nursing informatics.


    Gassert, C. A.; Mills, M. E.; Heller, B R


    A prototype program of doctoral study has been developed at the University of Maryland School of Nursing to prepare students with nursing expertise in the conceptualization and research of computer based information systems in hospitals, industry and other health care organizations. The graduate will be prepared to design effective nursing information systems; create innovative information technology; conduct research regarding integration of technology with nursing practice, administration, ...

  1. 三级医院医师临床能力评价方法的研究%Research on evaluation methods of doctor clinical competence in tertiary hospital

    Institute of Scientific and Technical Information of China (English)

    符晓婷; 袁蕙芸


    目的适应三级医院医师临床能力科学评价、人才招聘与培养和确保医院医疗质量的需要,开展医师临床能力评价必要性、评价原则、主体、内容、方法等方面的研究,为完善医师临床能力的评价方法提供建议.方法综合运用文献检索、专家咨询、问卷调查等方式,对三级医院医师临床能力评价方法进行探讨,采用SPSS17.0统计软件包进行统计和分析.结果三级医院医师临床能力评价应注重定性定量相结合、主观客观相结合的评价原则,评价主体以上级医师为主体,多方共同参与评价,从临床工作能力、绩效与态度三方面内容进行评价,以考核评价为主、考试评价为辅,评价结果可应用于职称晋升、岗位配置、招聘等多项人力资源管理领域.结论建议从六方面优化三级医院医师临床能力评价方法.%Objectives: To meet the need of scientific evaluation of doctors' clinical competence, talents recruits and quality of medical treatment in tertiary hospital, the research on evaluation necessary, principle, evaluator, contents and methods aims to provide advice on the improvement of doctors' clinical competence evaluation. Methods: The study explored the status and trends of the evaluation method of clinical competence through documentation retrieval, questionnaire and expert interviews, and used SPSS 17.0 in data analysis. Results: The evaluation of doctors' clinical competence in tertiary hospitals should combine the qualitative method with the quantitative method and the subjective method with the objective method. Depend on participating with all parts like peers,inferiors, patients and oneself,the main body of evaluation should be superior doctors. The evaluation results should be based on the aspects of clinical capabilities, performance and attitude.The evaluation manner should be based on the performance appraisal and the subjective judgments with examination as a

  2. Cost incentives for doctors

    DEFF Research Database (Denmark)

    Schottmüller, Christoph


    If doctors take the costs of treatment into account when prescribing medication, their objectives differ from their patients' objectives because the patients are insured. This misalignment of interests hampers communication between patient and doctor. Giving cost incentives to doctors increases...... welfare if (i) the doctor's examination technology is sufficiently good or (ii) (marginal) costs of treatment are high enough. If the planner can costlessly choose the extent to which doctors take costs into account, he will opt for less than 100%. Optimal health care systems should implement different...... degrees of cost incentives depending on type of disease and/or doctor....

  3. Hospital Medicine (Part 1): what is wrong with acute hospital care?

    LENUS (Irish Health Repository)

    Kellett, John


    Modern hospitals are facing several challenges and, over the last decade in particular, many of these institutions have become dysfunctional. Paradoxically as medicine has become more successful the demand for acute hospital care has increased, yet there is no consensus on what conditions or complaints require hospital admission and there is wide variation in the mortality rates, length of stay and possibly standards of care between different units. Most acutely ill patients are elderly and instead of one straightforward diagnosis are more likely to have a complex combination of multiple co-morbid conditions. Any elderly patient admitted to hospital is at considerable risk which must be balanced against the possible benefits. Although most of the patients in hospital die from only approximately ten diagnoses, obvious life saving treatment is often delayed by a junior doctor in-training first performing an exhaustive complete history and physical, and then ordering a number of investigations before consulting a senior colleague. Following this traditional hierarchy delays care with several "futile cycles" of clinical activity thoughtlessly directed at the patient without any benefit being delivered. If acute hospital medicine is to be improved changes in traditional assumptions, attitudes, beliefs and practices are needed.

  4. Individual performance review in hospital practice: the development of a framework and evaluation of doctors' attitudes to its value and implementation. (United States)

    Trebble, T M; Cruickshank, L; Hockey, P M; Heyworth, N; Powell, T; Clarke, N


    Appraisal, or independent performance review (IPR) is used in human resources management in the commercial and public sectors to evaluate the performance of an employee against agreed local organisational expectations and objectives, and to identify their requirements for development and effective management. IPR for NHS consultants may provide essential information for job planning, contribute towards medical appraisal for revalidation, and facilitate productivity and quality improvement. To develop a framework for IPR for consultants, and to determine attitudes on its value, process and content. Information from commercial, public and voluntary sector models and published and other literature sources were used to develop an IPR framework. This was assessed through a three-cycle action research methodology involving qualitative interviews with 22 consultants (predominantly with medical management roles). The domains of the IPR framework included: (1) performance against objectives; (2) behaviour and leadership; (3) talent management; (4) agreed future objectives. A number of themes were identified from the consultant interviews including: ineffective current appraisal systems reflecting a lack of valid performance data and allotted time; a lack of empowerment of medical managers to address performance issues; IPR as a more explicit system, offering value in evaluating doctors performance; and the dependence of successful implementation on the engagement of the Trust executive. IPR may have value for performance evaluation of consultants, contributing toward job planning and complementing medical appraisal. Support by their employing organisation and engagement with medical managers in design and implementation is likely to be essential.

  5. Find a Cancer Doctor (United States)

    ... Home > Find a Cancer Doctor Find a Cancer Doctor Status message Locating you... The Find an Oncologist ... and caregivers. The database includes the names of physicians and other health professionals from certain ASCO membership ...

  6. Coaching doctoral students

    DEFF Research Database (Denmark)

    Godskesen, Mirjam Irene; Kobayashi, Sofie


    In this paper we focus on individual coaching carried out by an external coach as a new pedagogical element that can impact doctoral students’ sense of progress in doctoral education. The study used a mixed methods approach in that we draw on quantitative and qualitative data from the evaluation......-reported gains from coaching show that doctoral students experience coaching as an effective method to support the doctoral study process. This study also provides preliminary empirical evidence that coaching of doctoral students can facilitate the doctoral study process so that the doctoral students experience...... an enhanced feeling of progress and that they can change their study behaviour in a positive direction. The study discusses the difference between coaching and supervision, for instance power imbalances and contrary to earlier research into coaching of doctoral students this study indicates that coaching can...

  7. Republished: instigating change: trainee doctors' perspective. (United States)

    Parvizi, Nassim; Shahaney, Sumera; Martin, Guy; Ahmad, Ahmir; Moghul, Masood


    In the 21st century, the core skills of trainee doctors are evolving as clinicians, leaders and innovators. Leadership skills are an essential tool for all doctors and need to be an integral part of their training and learning as set out in the General Medical Council's Good Medical Practice. It is essential to develop these skills at an early stage and continually improve them. A group of junior doctors participated in a pilot programme for leadership with the aim of executing a quality improvement (QI) project. This article describes our experiences of both the course itself and the project undertaken by our group. As part of the process of implementing change, we faced a number of challenges which contributed to our learning. These have been explored as well as potential ways to overcome them to enable the swift and smooth development of future QI projects. Using an example of a QI project looking at handover, this article demonstrates how a trainee doctor can implement their project for both professional and institutional improvement.

  8. Strains in the nurse-doctor relationship. (United States)

    Selmanoff, E D


    Many problems and conflicts between nurses and doctors in the hospital stem from the organizational structure of the hospital rather than from the personalities of the individuals involved. Nurses often assert the latter. Understanding these conflicts requires that they be examined in terms of the organizational context within which they occur. To understand the modern American hospital it is useful to view its development. Private practitioners who at one time had cared for patients in their homes shifted the locus of care to the hospital as medical care became more complex in the latter half of the nineteenth century. Three selected aspects of hospital structure that are seen as sources of strain for nurses in their relationship with doctors are: (1) Doctors do not see themselves as full-fledged members of the hospital organization. While nurses, who do, feel bound by the operating rules of the hospital, doctors tend to operate as free agents. There is probably little that nurses can do to reduce this source of strain. (2) The hospital has two lines of authority, administrative and medical, unlike most large-scale organizations which have only one. Nurses are in the former while doctors are in the latter hierarchy. The "influence relationship" between nurses and doctors is largely unarticulated; informally "negotiated" patterns prevail. Nurses can be more aggressive in attempting to develop institutional patterns that are mutually satisfactory to themselves and to doctors and that meet the needs of the hospital as a whole. (3) In the absence of a functioning health team nurses have assumed responsibility, without the requisite authority, for the coordination of patient care. Although this action is for the immediate benefit of patients nurses should realize that it also tends to retard the development of needed organizational changes in the hospital. Nurses generally accept the possibility of changing the personality structure of an individual. They should be

  9. 提升医院管理水平的数字化无线医护管理系统%Digital wireless doctor-nurse management system to upgrade hospital management

    Institute of Scientific and Technical Information of China (English)



    介绍了数字化医院框架的设计,并在此基础上研究开发了无线医护管理系统.阐述了无线医护管理系统的总体架构,探讨了无线医护管理系统整体建设中的关键技术:移动计算和EDA技术,无线局域网技术,中间件技术和条码和RFID技术,为医院信息化的建设提供参考.%This paper introduced the framework designs of digitalized hospitals,and developed the wireless doctor-nurse management system on such a framework.It described the overall structure of this wireless system,and probed into key technologies in overall construction of the system;mobile computing and EDA technologies,wireless LAN technology,mid-ware technology and RFID technologies.All these aimed at providing references for digitalized hospitals.Even more important,this paper has introduced the concept of overall system and key technologies.

  10. Impact of Doctor-patient Relationship in Guangzhou on Hospital Crisis Management%广州地区医患关系状况对医院危机管理的影响分析

    Institute of Scientific and Technical Information of China (English)

    林凯程; 耿仁文; 田柯; 周梅芳


    目的:对广州地区医院患者进行调查,了解患者对目前医患关系状况的评价、对医疗危机事件发生的态度及行为选择,分析医患关系状况对医院危机管理的影响.方法:采用自设问卷进行调查和访谈.结果:55.4%的患者认为目前医患关系状况好或较好;66.0%的患者认为诊疗中的医患沟通效果较好;63.9%的患者对医患沟通状况比较满意;大多数医务人员未能主动履行告知义务;72.8%的患者对医生开药或作检查有过疑问;72.8%的患者遇到医疗纠纷会首先找院方投诉;认为诊疗过失和对事件处理不够及时最易引发医疗危机事件,56.8%的患者认为危机事件会影响其选择.结论:采取多种方式加强医患沟通,预防危机事件的发生;加强医疗服务的质量管理,建立高效的危机处理机制,提高患者满意度;重视医疗危机事件的善后管理.树立新形象.%Objective To investigate patients of hospitals in Guangzhou and understand the relationship between patients on the current status of patient evaluation, medical crisis occurred choice attitudes and behavior, and to analyze crisis management of doctor-patient relationship. Methods Using self-based questionnaire and interview. Results 55.4% patients think that current state of physician-patient relationship is good or better; 66.0% patients think that communication between doctors and patients in clinics is better, and 63.9% patients is relatively satisfied with communication between doctors and patients; the majority of medical staff fail to fulfill this obligation initiatively; 72.8% patients are doubt of doctors' prescription and examination; 72.8% patients will complain to hospitals in medical disputes; 56.8% patients think that crisis events will affect their choice, because they think that the clinics on how to deal with negligence and lack of timely medicine are likely to trigger a crisis. Conclusion A variety of ways should be

  11. Talking to Your Child's Doctor (United States)

    ... to 2-Year-Old Talking to Your Child's Doctor KidsHealth > For Parents > Talking to Your Child's Doctor ... an important role in your child's health? The Doctor-Patient Relationship Today, doctors are pressured to see ...

  12. Working with doctors and nurses (United States)

    ... doctor Working with doctors and nurses Working with doctors and nurses Answering questions, filling out papers, getting ... my ability to pay? What questions will the doctor or nurse ask? top It’s a good idea ...

  13. Doctors in Balzac's work. (United States)

    Moulin, Thierry


    Balzac wrote his novels during a time of great literary and scientific change. Romanticism gave way to the school of realism, of which Balzac could be considered the founder. It was via realism, where both the positive and negative aspects of life were depicted, that doctors naturally gained a much more active role in novels. In conjunction with this was the development of science and medicine, which fascinated Balzac, also leading to the significant and prevalent role of doctors in his works. His fascination with the sciences led to him to gain many acquaintances and much knowledge in the medical domain, especially in neuropsychiatry and physiology. His fictional doctors, such as Desplein and Bianchon, thus demonstrate considerable knowledge of pathology, physiology, and neuropsychiatry. The doctors in Balzac's novels can be grouped into four categories: provincial doctors, Parisian doctors, country doctors, and military doctors. They were most often fictitious representations of real individuals (e.g. Guillaume Dupuytren), and often symbolize schools of thought which were in vogue at the time. In addition to the accurate scientific depiction of doctors, it must be noted that his doctors not only played an active role in clinically assessing their patients, but also had a sociological role in assessing society; it is through his doctors that Balzac gave his opinion of the world in which he lived.

  14. Bare Below the Elbows: A comparative study of a tertiary and district general hospital. (United States)

    Collins, A M; Connaughton, J; Ridgway, P F


    A 'Bare Below the Elbows' (BBTE) dress code policy has been introduced by the majority of NHS trusts in the UK. The aim of this Irish study was to evaluate the impact of an educational intervention on perception of medical attire. The study was carried out in two centres: a tertiary referral centre (Beaumont Hospital) and a district hospital (MRH, Portlaoise). Two questionnaires, incorporating photographic evaluation of appropriate attire for consultants and junior doctors, were completed pre and post BBTE education. One hundred and five patients participated. Analysis pre BBTE education indicated patients considered formal attire and white coats most appropriate for consultants and junior doctors respectively. Post-intervention analysis revealed a significant reduction in the popularity of both (p <0.001), with scrubs and smart casual attire gaining significant support in both cohorts (p <0.001). Our findings demonstrated that patient opinion on medical attire is malleable. The support of such a policy may be achieved if patients are informed that the aim is to reduce the spread of healthcare-associated infections.

  15. Factors associated with doctors' knowledge on antibiotic use in China. (United States)

    Bai, Yu; Wang, Sijie; Yin, Xiaoxv; Bai, Jigeng; Gong, Yanhong; Lu, Zuxun


    Misuse of antibiotics by the medical profession is a global concern. Examining doctors' knowledge about antimicrobials will be important in developing strategies to improve antibiotic use. The aim of the study was to survey Chinese doctors' knowledge on antibiotics and reveal the factors associated with their level of knowledge. A cross-sectional survey was conducted in Shanxi in central China. A total of 761 physicians were surveyed using a structured self-administered questionnaire. A generalized linear regression model was used to identify the factors associated with doctors' knowledge on antibiotic. Based on a full score of 10, the average score for doctors' knowledge on antibiotics was 6.29 (SD = 1.79). Generalized linear regression analysis indicated that doctors who either worked in the internal medicine department, who were chief doctors or who received continuing education on antibiotic, had better knowledge of antibiotics. Compared with doctors working in tertiary hospitals, doctors working in secondary hospitals or primary healthcare facilities had poorer knowledge about antibiotics. Chinese doctors have suboptimal knowledge about antimicrobials. Ongoing education is effective to enhance doctors' knowledge, but the effect remains to be further improved. More targeted interventions and education programs should improve knowledge about antimicrobials, especially for doctors working in primary healthcare institutions.

  16. How does a doctor study other doctors being doctors?

    DEFF Research Database (Denmark)

    Risør, Torsten

    The intension of this presentation is to encourage debate on auto-ethnography in medical systems. The empirical starting point will be my present study of how young doctors learn to make decisions about diagnosis and treatment of the individual patient. The study is an ethnographic field study...... that is a part of me? How can I represent the experience and learning of my informants without simply reproducing my own experience? This makes the project both anthropology-at-home and auto-ethnography. I will present an example from the field work to illustrate the many ways in which the auto- part...... involving participant observation and individual interviews with nine newly graduated doctors for a period of 18 months. The background of the ethnographer who is also the author of the present abstract poses a few interesting challenges to the study. I am a doctor doing fieldwork in my own medical culture...

  17. Perceptions and attitudes of hospital staff toward paging system and the use of mobile phones.

    LENUS (Irish Health Repository)

    Haroon, Muhammad


    OBJECTIVES: Our objective was to document the pattern of mobile phone usage by medical staff in a hospital setting, and to explore any perceived benefits (such as improved communications) associated with mobile phones. METHODS: This cross-sectional survey was conducted in Waterford Regional Hospital, Ireland, where bleep is the official system of communication. All non-consultant hospital doctors, of medical disciplines only, were asked to participate. The questionnaire was designed to explore the pattern and different aspects of mobile phone usage. RESULTS: At the time of study, there were sixty medical junior doctors, and the response rate was 100 percent. All participants used mobile phones while at work, and also for hospital-related work. For 98.3 percent the mobile phone was their main mode of communication while in the hospital. Sixty-two percent (n = 37) made 6-10 calls daily purely for work-related business, and this comprised of >\\/= 80 percent of their daily usage of mobile phones. For 98 percent of participants, most phone calls were work-related. Regarding reasons for using mobile phones, all reported that using mobile phone is quicker for communication.Conclusions: Mobile phone usage is very common among the medical personnel, and this is regarded as a more efficient means of communication for mobile staff than the hospital paging system.

  18. Junior Professors Question Job Policies (United States)

    Smith, Lauren


    Female and minority faculty members rated their institutions less positively as places for junior professors to work than did their male and white counterparts, according to a new report. Young professors said institutional policies designed to help them succeed were important, but they were less satisfied that those policies were effective. Women…

  19. Improving Junior High Classroom Management. (United States)

    Emmer, Edmund T.; And Others

    A field experiment was conducted to determine whether descriptive-correlational results from classroom management research could be implemented by junior high school teachers, and whether such implementation would result in improved classroom management. An experimental group (18 teachers) received management manuals developed by researchers, and…

  20. Holography in the Junior High. (United States)

    Tomaszkiewicz, Frank


    Examines the use of holography in the art technology program of a junior high school. Characterizing holography as a valuable artistic experience and discovery experience and stressing the importance of student interest and involvement, the author discusses the necessary equipment for the project and includes two diagrams of a holographic setup.…

  1. Doctors and pharmaceutical industry. (United States)

    Beran, Roy G


    The pharmaceutical industry is seen as seducing doctors by providing expensive gifts, subsidising travel and underwriting practice expenses in return for those doctors prescribing products that otherwise they would not use. This paints doctors in a very negative light; suggests doctors are available to the highest bidder; implies doctors do not adequately act as independent agents; and that doctors are driven more by self-interest than by patient needs. Similar practices, in other industries, are accepted as normal business behaviour but it is automatically assumed to be improper if the pharmaceutical industry supports doctors. Should the pharmaceutical industry withdraw educational grants then there would be: fewer scientific meetings; reduced attendance at conferences; limited post graduate education; and a depreciated level of maintenance of professional standards. To suggest that doctors prescribe inappropriately in return for largesse maligns their integrity but where there is no scientific reason to choose between different treatments then there can be little argument against selecting the product manufactured by a company that has invested in the doctor and the question arises as to whether this represents bad medicine? This paper will examine what constitutes non-professional conduct in response to inducements by the pharmaceutical industry. It will review: conflict of interest; relationships between doctors and pharma and the consequences for patients; and the need for critical appraisal before automatically decrying this relationship while accepting that there remain those who do not practice ethical medicine.

  2. 双因素理论在我院医师临床技能考核中的运用%Two-factor Theory Application in Clinical Skills Assessment for Doctors in the Hospital

    Institute of Scientific and Technical Information of China (English)

    孟文娟; 王文娟; 王宝; 杜慧杰; 田秋野; 赵鹏军; 施梅


    To introduce clinical skills assessment into the assessment and appointment on professional titles as a new factor is a creative advance. A series of supporting policies according two-factor theory is introduced when managing the clinical skills assessment, which stimulated the employees to improve their professional skills while continuously guarantee their basic interest at the same time in order to improve management level, and to strengthen doctors' team building of the hospital.%将临床技能考核引入到专业技术职务评聘中是职称评聘工作的一个创新.文章介绍了运用“双因素理论”制定实施医师临床技能考核的一系列配套政策,在保障职工利益的同时激励其不断提高技术水平和职业水准,使技能考核在顺利引入的同时又达到了提高医院管理水平、加强医师队伍建设的目的.

  3. How Six Sigma Methodology Improved Doctors' Performance (United States)

    Zafiropoulos, George


    Six Sigma methodology was used in a District General Hospital to assess the effect of the introduction of an educational programme to limit unnecessary admissions. The performance of the doctors involved in the programme was assessed. Ishikawa Fishbone and 5 S's were initially used and Pareto analysis of their findings was performed. The results…

  4. Bacterial contamination of the hands of doctors: A study in the medicine and dermatology wards

    Directory of Open Access Journals (Sweden)

    Rudrajit Paul


    Full Text Available Background: Doctors′ hands are a common source of bacterial contamination. Often, these organisms are found to be virulent species with multidrug-resistance patterns. These are the sources of nosocomial infections in many patients. Aims: The present study was undertaken to find out the prevalence of bacterial contamination in the hands of doctors in the Medicine and Dermatology wards of a tertiary care hospital. Methods: The hands of 44 doctors were swabbed and cultured at entry to ward and at exit. Then, tap water and alcohol swab wash techniques were used and further swabs were done at each step. Thus, each doctor was sampled four-times for the study. The antibiotic-sensitivity pattern of the organisms was determined by the disc-diffusion method. Results: There was a significant contamination of the doctors′ hands at entry (59.1% and at exit (90.9%. Overall, Staphylococcus was the predominant organism (59% at entry and 85% at exit; coagulase-negative ones were more prevalent at entry (32% and coagulase-positive ones were more prevalent at exit (54%. There was no difference in the hand contamination rates of junior and senior doctors. Also, the contamination rates were similar in the Medicine and Dermatology wards. Among the Gram negative organisms, Escherichia coli (4.5%, Pseudomonas (4.5%, Enterococci (13.6% and Klebsiella (9% were the main ones isolated. Gram negative organisms were significantly more prevalent at exit (P = 0.009 compared with their numbers at entry. Hand washing techniques reduced the contamination rates significantly, 76% with tap water wash and further 16.5% with alcohol swab. The removal rate for both groups of organisms was similar. Also, coagulase-positive and -negative Staphylococci showed equal rates of removal with hand washing (P = 0.9793. The organisms were found to be resistant to most of the commonly used antibiotics; the beta-lactam group was especially largely resistant both for Gram positive and Gram

  5. Countermeasures on promoting doctor in public hospitals to apply for multi-sited license in private hospitals%推动公立医院医生到民营医院多点执业的对策分析

    Institute of Scientific and Technical Information of China (English)

    吴敏; 刘岩; 李晓冰


    The obstacles in the implementation of Doctor’s Multi-sited License were analyzed from three aspects including physician, administrator in public hospitals, and specific support for the policy. The government is considered to encourage private hospital and public hospitals which met certain requirements to conduct cooperation, develop multi-sited license research, issue policy to guide duty, right and benefit for multi-sited license, develop and spread medical liability insurance to share medical risk in multi-sited license, strengthen the monitoring on consultation and operation without permission.%  从医生、医院管理者、配套支持等层面梳理分析了医师多点执业实践中存在的障碍和瓶颈,提出政府应牵头鼓励和促成民营医院与有条件的公立医院建立合作,开展多点执业调查研究,制订多点执业责、权、利分配指导政策,建立和推行医疗责任保险,分担医师多点执业中的医疗风险,加强对医生私自外出会诊、手术现象的监管等促进公立医院医生到民营医院多点执业的对策建议。

  6. 精神病专科医院441名医护人员职业暴露现状调查及对策%Investigation and countermeasures of occupation exposure status of 441 doctors and nurses in psychiatric hospital

    Institute of Scientific and Technical Information of China (English)

    秦轶灵; 梁忠新; 梁淑敏


    目的:分析精神病专科医院医护人员发生职业暴露的常见危险因素,并提出有效防护措施。方法:对精神病医院医护人员进行职业暴露调查,并对职业暴露者相关资料进行分析。结果:441名医护人员中共有18名工作人员发生职业暴露,全部为护理人员。其中职业暴露地点全部在病房;部位有14例在手指、3例在手臂、1例在眼睛;类别有锐器伤14例(输液针10例、注射针3例、缝针1例),患者咬伤3例,血液喷溅1例;暴露环节为输液过程针刺伤8例,其中因患者兴奋不合作导致的针刺伤4例;清理用物6例;护理过程咬伤3例;输液过程血液喷溅1例。暴露源中有3例乙肝病毒阳性;无丙肝、梅毒和HIV病毒阳性。结论:加强职业暴露防护知识培训,落实标准预防措施和规范操作流程,能有效减少职业暴露的发生。%Objective:To analyze the risk factors of occupational exposure among common psychiatric hospital medical staff,and to propose effective protective measures.Methods:We investigated the occupation exposure status of doctors and nurses in psychiatric hospital,and analyzed the relevant information of occupational exposure.Results:In the 441 doctors and nurses,18 workers occurred occupational exposure,and they were all nurses.All of the occupational exposure locations were in the ward.The position of 14 cases was at the fingers,three cases were at the arm,one case was at the eye.14 patients were sharp injury(10 cases of transfusion needle,3 cases of injection needle,1 case of suture needle),3 cases were bite by the patients,1 case was blood splashes.8 cases were exposed on the infusion process with needle stick injuries,including 4 cases of needle stick injuries because of noncooperation and excitement of patients;6 cases occurred on the process of cleaning materials;3 cases with bite occurred on the nursing process;1 case with blood splashing occurred on the

  7. [The happy doctor]. (United States)

    van Dongen, Christel M P; van der Graaf, Yolanda


    Descriptive, questionnaire-based. To study what makes doctors and medical students happy: Descriptive, questionnaire-based. Descriptive, questionnaire-based. For the purposes of this study, doctors and medical students completed an online questionnaire in the summer of 2012. They were presented with questions enquiring into general characteristics and into happiness. We asked them to define happiness, and to describe their happiest moments. The results were interpreted with the aid of simple statistics. 401 doctors, registrars and medical students took part in the study. 41% of the respondents were male and 59% female. Average age was 40 years. Students, GPs, anaesthesiologists and internists were the best represented. On average, the participants gave their 'happiness' a score of 7.6. The younger doctors ( 48 years (7.8), which also explains the relatively low scores for students (7.1). GPs were the happiest, with an average score of 7.9, closely followed by the 'other doctors', with an average score of 7.8, and the medical specialists (7.6). Within the specialties, bearing in mind that the low numbers means that results should be interpreted with some caution, the doctors with 'minority specialties' were the happiest, followed by internists and the supporting specialties. Psychiatrists and surgical colleagues can be found at the bottom of the list. The determinants 'love and relationships' and 'family' contribute the most to feeling happy. Older doctors are happier than younger doctors and GPs are generally happier than medical specialists. The determinants 'love and relationships' and family' are the most important for doctors' happiness.


    African Journals Online (AJOL)

    Design. A descriptive study combining quantitative and qualitative methods: a quantitative audit of operating theatre ... type of anaesthetic, type of procedure, and whether a .... Furthermore, the issue of observer bias in qualitative research.

  9. Assessment of behavioral risk factors of medical workers at multidisciplinary hospital

    Directory of Open Access Journals (Sweden)

    E.V. Dubel


    Full Text Available The prevalence of behavioural risk factors among health professionals at the multidisciplinary hospital was the aim of the present research. The study included a questionnaire of the WHO International Programme of Integrated Prevention of Noncommunicable Diseases “Countrywide Integrated Noncommunicable Disease Intervention Programme” (CINDI. The survey involved 333 health professionals: doctors – 14.1 %, mid-level and junior medical personnel – 62.2 % and 23.7 %, respectively. The average age of the respondents was 42.5 years. The proportion of males and females was 8.4 % and 91.6 %, respectively. It was found that a significant proportion of respondents has overweight (34.4 % and obesity (17.5 %, hypertension (31.1 %. The prevailing part of the hospital medical staff has an average and a high level of physical activity. The eating behaviour of 80 % of health workers is characterized by low consumption of fruit and vegetables. Doctors tend to drink alcohol more frequently than the mid-level and junior medical personnel, at that the consumption of alcohol for the vast majority of persons who participated in the study is moderate. Tobacco consumption is typical for a significant proportion of the respondents (32 %, more common among nurses than among doctors and mid-level medical staff. Health workers of 40–60 years have a high individual risk of coronary heart disease associated with smoking (1.3•10 –4 – 1.6•10 –3 . Persons older than 50 years revealed an unacceptable risk of lung cancer pathology (4.7•10 –4 , stomach (1.4•10 –4 , bladder (1.5•10 –4 , cerebrovascular disease (2.5•10 –4 at the effects of smoking.

  10. Patient-doctor relationship: the practice orientation of doctors in Kano. (United States)

    Abiola, T; Udofia, O; Abdullahi, A T


    Attitude and orientation of doctors to the doctor-patient relationship has a direct influence on delivery of high quality health- care. No study to the knowledge of these researchers has so far examined the practice orientation of doctors in Nigeria to this phenomenon. The aims of this study were to determine the orientation of Kano doctors to the practice of doctor-patient relationship and physicians' related-factors. Participants were doctors working in four major hospitals (i.e., two federal-owned and two state-owned) servicing Kano State and its environs. The Patient-Practitioner Orientation Scale (PPOS) and a socio-demographic questionnaire were completed by the 214 participants. The PPOS has 18 items and measures three parameters of a total score and two dimension of "sharing" and "caring". The mean age of participants was 31.72 years (standard deviation = 0.87), with 22% being females, 40.7% have been practicing for ≥ 6 years and about two-third working in federal-owned health institution. The Cronbach's alpha of total PPOS scores was 0.733 and that of two sub-scale scores of "sharing" and "caring" were 0.659 and 0.546 respectively. Most of the doctors' orientation (92.5%) was towards doctor-centered (i.e., paternalistic) care, majority (75.2%) upheld the view of not sharing much information and control with patients, and showing little interest in psychosocial concerns of patients (i.e., 'caring'=93.0%). Respondents' characteristics that were significantly associated with high doctor 'caring' relationship orientation were being ≥ 30-year-old and practicing for ≥ 6 years. Working in State-owned hospitals was also significantly associated with high doctor "sharing" orientation. This paper demonstrated why patient-centered medical interviewing should be given top priority in medical training in Nigeria, and particularly for federal health institutions saddled with production of new doctors and further training for practicing doctors.

  11. Doctor of osteopathic medicine (United States)

    ... and Wilkins; 2010. Gevitz N. The "doctor of osteopathy": expanding the scope of practice. J Am Osteopath ... 6):ES28-S38. Moore WJ. The eccentricities of osteopathy. BMJ . 2012;345:e5890. Stark J. A degree ...

  12. Going to the Doctor (United States)

    ... time they go to the doctor, but the truth is that kids don't need many shots ... The Nemours Foundation, iStock, Getty Images, Corbis, Veer, Science Photo Library, Science Source Images, Shutterstock, and Clipart. ...

  13. Talking to Your Doctor

    Medline Plus

    Full Text Available ... Trials and You Talking to Your Doctor Science Education Resources Community Resources Clear Health A–Z Publications ... Research & Training Medical Research Initiatives Science Highlights Science Education Research in NIH Labs & Clinics Training Opportunities Library ...

  14. Finding the Right Doctor (United States)

    ... you meet someone that doesn’t match your communication style, you should switch,” Dr. Krumholz said. Another part ... for looking around: When you feel that the communication style is not matching your own If your doctor ...

  15. Talking to Your Doctor

    Medline Plus

    Full Text Available ... your appointment. Consider bringing a close friend or family member with you. Take notes about what the doctor says, or ask a friend or family member to take notes for you. Learn how ...

  16. Talking to Your Doctor

    Medline Plus

    Full Text Available ... Simple Clear Health from NIH Cultural Respect Language Access Talking to Your Doctor Research Underway Plain Language ... to take notes for you. Learn how to access your medical records, so you can keep track ...

  17. 上海某三级医院医师膳食模式及其与慢性病的关系%Dietary patterns and risk of chronic diseases in doctors of a tertiary hospital in Shanghai

    Institute of Scientific and Technical Information of China (English)

    周丽; 程蓁; 陈科


    目的 研究上海某三级医院医师的膳食模式及其与慢性病的关系.方法 对118例样本采集一般情况、食物频率、慢性病等信息,经前处理后用SPSS提供的因子分析获得膳食模式,描述膳食模式、分布及其与慢性痛的关系.调查的118例对象中男性44例,女性74例,平均年龄(38.4±10.8)岁,平均体质量(62.6±10.0)kg.结果 高血压患者20例(16.9%),血脂异常患者17例(14.4%),糖尿病患者0例.33项食物频率经前处理后转变为9大类食物频率并换算成单位体质量的食物频率,再经因子分析获得“水产果蔬”、“优质蛋白”、“传统主食”三种膳食模式,膳食模式标化因子得分以三等分(T1 ~T3)方式描述.男性更易接受水产果蔬和优质蛋白模式,年龄越小越易接受水产果蔬模式.控制性别、年龄后,传统主食模式(T3拟合度)为高血压的保护因素,优质蛋白模式(T3拟合度)为血脂异常的保护因素.结论 该三级医院男医师更易接受水产果蔬和优质蛋白的膳食模式,传统主食模式与高血之间有良性关系,优质蛋白模式与血脂异常之间有良性关系.横断面调查中可能包含的局限性有待于在进一步研究中证实与解决.%Objective To survey dietary patterns and risk of chronic diseases in doctors of a tertiary hospital in Shanghai.Methods The dietary pattern and prevalence of chronic disease were surveyed in 118 doctors including 44 males and 74 females with the average age of 38.4 ± 10.8.The distribution of dietary pattern and its correlation with chronic diseases was analyzed with SPSS software.Results The prevalence of hypertension,dyslipidemia and diabetes were 16.9%,14.4% and 0,respectively.The frequency of 33 food items of 9 types were surveyed and transformed into 3 dietary patterns:aquatic-fruit-vegetable pattern,protein pattern and traditional pattern.Patterns were described with tertiled factor scores (T1 ~ T3).Males

  18. University strategy for doctoral training: the Ghent University Doctoral Schools. (United States)

    Bracke, N; Moens, L


    The Doctoral Schools at Ghent University have a three-fold mission: (1) to provide support to doctoral students during their doctoral research, (2) to foster a quality culture in (doctoral) research, (3) to promote the international and social stature and prestige of the doctorate vis-a-vis potential researchers and the potential labour market. The Doctoral Schools offer top-level specialized courses and transferable skills training to doctoral students as part of their doctoral training programme. They establish mechanisms of quality assurance in doctoral research. The Doctoral Schools initialize and support initiatives of internationalization. They also organize information sessions, promotional events and interaction with the labour market, and as such keep a finger on the pulse of external stakeholders.

  19. The role ofprivate hospitals in South Africa

    African Journals Online (AJOL)

    DepartInent ofConnnunity Health, University ofthe. Witwatersrand, Johannesburg ... ing the efficiency of the private hospital sector, ... mended that a system of hospital accreditation be developed to .... in the case of academic hospitals. Doctors' ...

  20. Teaching History in the Junior College. (United States)

    Ediger, Marlow


    Recommends techniques for teaching history in the junior college. Discusses subject matter to be taught, the psychology of learning, and the philosophy of teaching history. Addresses the special needs of the junior college classroom. Outlines criteria to be followed in teaching history. (RW)

  1. Junior High Career Planning: What Students Want (United States)

    Bardick, Angela D.; Bernes, Kerry B.; Magnusson, Kris C.; Witko, Kim D.


    This research used "The Comprehensive Career Needs Survey" to assess the career counselling needs of 3,562 junior high students in Southern Alberta. This article examines junior high students' responses regarding their perceptions of (a) the relevance of career planning, (b) who they would approach for help with career planning, and (c)…

  2. Junior High Norms for the Bender Gestalt. (United States)

    Grow, Richard T.


    Junior high students were tested to supply normative data supporting the Bender Gestalt. Subject's performance was not significantly related to sex or occupation of the family bread winner. These variables do not have to be controlled for in norming visual motor tests at the junior high level. (Author)

  3. Effective Management in Junior High Mathematics Classrooms. (United States)

    Emmer, Edmund T.

    Reporting on part of the data collected in the Junior High Classroom Organization Study, this document focuses on the mathematics subsample. Twenty-six mathematics teachers in 11 junior high schools were observed in two classes. The major purpose of this paper is to describe the classroom procedures and behaviors of teachers identified as…

  4. Controle de infecção oral em pacientes internados: uma abordagem direcionada aos médicos intensivistas e cardiologistas Oral infection control in hospitalized patients: an approach to cardiologist and intensive care units doctors

    Directory of Open Access Journals (Sweden)

    Sérgio Kahn


    Full Text Available O objetivo do presente estudo foi verificar o grau de conhecimento médico sobre medicina periodontal e verificar a existência de algum protocolo de controle de infecção da cavidade oral em pacientes internados em hospitais. Para tal, 110 médicos cardiologistas e intensivistas lotados em cinco hospitais no município do Rio de Janeiro foram entrevistados. Dentre os indivíduos, 75,4% afirmaram ter conhecimento sobre o termo medicina periodontal; entretanto, apenas 30% declararam já ter lido algo a respeito. Apenas 2,7% dos médicos possuem o hábito de coletar informações sobre a história odontológica de seus pacientes e 58,2% afirmaram que essa conduta é condicional ao quadro apresentado pelo paciente. Com base nos dados obtidos, pode-se concluir que o conhecimento sobre medicina periodontal e, consequentemente, sobre a importância do controle do biofilme oral na manutenção da saúde sistêmica, apresenta-se pouco difundido entre a classe médica. Verificou-se não haver setor ou pessoa responsável pelo controle de infecção oral dentro dos hospitais avaliados e, consequentemente, a não existência de qualquer protocolo, eficaz ou não, de controle de infecção oral nessas unidades.This paper aims to find the current level of periodontal med-care knowledge, as well as the possible existence of some oral infection control protocol regarding hospitalized patients. Our sample gathered 110 cardiologists and intensive care units doctors selected from medical teams of five Rio de Janeiro hospitals. Preliminary numbers: 75.4% said to have heard something about Periodontal Medicine, although only 30% out of this group admitted to have read something concerning such subject. On the other side, only 2.7% of the sample informed to do consistent information searching along their patients anamnese, while 58.2% out of this group admitted such procedure conditional to the patient's general state at the due moment. Through such numbers, we

  5. Vocabulary Development of Junior Teens

    Directory of Open Access Journals (Sweden)

    L. V. Nikonova


    Full Text Available The article deals with the communicative competence formation of young adolescents in the secondary school at the Russian language lessons. The author maintains that the key element of the above problem is the vocabulary development guaranteeing both comprehension and verbal expression formation – oral and written. The theoretical part of the research explores different word functions: nominal, communicative, text generating and semantic. The correlation between the mental development level and lexical semantic system formation is emphasized. The age specific features of junior teens are listed: rising interest to various life spheres and activi- ties, capability of formulating opinions and judgments, self-awareness, formation of values. The relationship complexity stimulates vocabulary development of 10 to 12 year-old children; however, the process requires peda- gogical facilitation.The monitoring of speech development proves the necessity of commutative competence formation of the fifth- and sixth-year pupils. The paper presents the model of communicative competence development and its approbation results received for the junior adolescents. 

  6. Vocabulary Development of Junior Teens

    Directory of Open Access Journals (Sweden)

    L. V. Nikonova


    Full Text Available The article deals with the communicative competence formation of young adolescents in the secondary school at the Russian language lessons. The author maintains that the key element of the above problem is the vocabulary development guaranteeing both comprehension and verbal expression formation – oral and written. The theoretical part of the research explores different word functions: nominal, communicative, text generating and semantic. The correlation between the mental development level and lexical semantic system formation is emphasized. The age specific features of junior teens are listed: rising interest to various life spheres and activi- ties, capability of formulating opinions and judgments, self-awareness, formation of values. The relationship complexity stimulates vocabulary development of 10 to 12 year-old children; however, the process requires peda- gogical facilitation.The monitoring of speech development proves the necessity of commutative competence formation of the fifth- and sixth-year pupils. The paper presents the model of communicative competence development and its approbation results received for the junior adolescents. 

  7. The effect of effort-reward imbalance at work on the professional attitude of doctors in public hospitals%工作付出—回报失衡对公立医院医生职业心态的影响

    Institute of Scientific and Technical Information of China (English)

    孙葵; 尹文强; 黄冬梅; 于倩倩; 赵延奎; 陈钟鸣; 李云伟


    Objective: To explore the effects of effort-reward imbalance (ERI) at work on the occupational burnout, job satisfaction and turnover intention of doctors in public hospitals. Methods: By using self-designed questionnaires to in-vestigate job attitude, this paper adopts a stratified random sampling method to select 1910 doctors from public hospitals in Jinan, Weifang and Dezhou cities based on the level of economic development in Shandong province. The data are ana-lyzed using descriptive analysis, correlation analysis, hierarchical regression analysis, etc. Results: The effort-reward imbal-ance at work exists in the surveyed public hospitals. The job effort of doctors is 1. 39 ± 0. 37 times higher than job reward. The effort-reward imbalance at work has positive predictive effects on occupational burnout, negative predictive effects on job satis-faction, and positive predictive effects on turnover intention. Conclusions:Public hospital administrators should improve the ef-fort-reward ratio of doctors in order to stabilize doctors' professional attitude at work and enhance their morale.%目的:探讨付出—回报失衡对公立医院医生职业倦怠、工作满意度和离职意向的影响. 方法:利用课题组编制的医生工作感受量表,按照分层随机抽样原则,根据经济发展水平从山东省抽取济南、潍坊、德州3市的1 910名公立医院医生进行调查,采用描述性统计分析、相关分析、分层回归分析等分析方法. 结果:医生工作付出—回报失衡,工作付出是工作回报的1. 54 ± 0. 74倍. 工作付出—回报失衡对职业倦怠有正向预测作用,对工作满意度有负向预测作用,对离职意向有正向预测作用. 结论:管理者应从改善医生付出—回报比例入手,以稳定医生职业心态,提升其工作积极性.

  8. Medical thrillers: doctored fiction for future doctors? (United States)

    Charpy, Jean-Pierre


    Medical thrillers have been a mainstay of popular fiction since the late 1970s and still attract a wide readership today. This article examines this specialized genre and its core conventions within the context of professionally-based fiction, i.e. the class of thrillers written by professionals or former professionals. The author maps this largely unchartered territory and analyzes the fictional representations of doctors and medicine provided in such novels. He argues that medical thrillers, which are not originally aimed at specialized readers and sometimes project a flawed image of medicine, may be used as a pedagogical tool with non-native learners of medical English.


    CERN Multimedia

    Medical Service


    IN URGENT NEED OF A DOCTOR GENEVA EMERGENCY SERVICES GENEVA AND VAUD 144 FIRE BRIGADE 118 POLICE 117 CERN FIREMEN 767-44-44 ANTI-POISONS CENTRE Open 24h/24h 01-251-51-51 Patient not fit to be moved, call family doctor, or: GP AT HOME, open 24h/24h 748-49-50 Association Of Geneva Doctors Emergency Doctors at home 07h-23h 322 20 20 Patient fit to be moved: HOPITAL CANTONAL CENTRAL 24 Micheli-du-Crest 372-33-11 ou 382-33-11 EMERGENCIES 382-33-11 ou 372-33-11 CHILDREN'S HOSPITAL 6 rue Willy-Donzé 372-33-11 MATERNITY 32 la Cluse 382-68-16 ou 382-33-11 OPHTHALMOLOGY 22 Alcide Jentzer 382-33-11 ou 372-33-11 MEDICAL CENTRE CORNAVIN 1-3 rue du Jura 345 45 50 HOPITAL DE LA TOUR Meyrin EMERGENCIES 719-61-11 URGENCES PEDIATRIQUES 719-61-00 LA TOUR MEDICAL CENTRE 719-74-00 European Emergency Call 112 FRANCE EMERGENCY SERVICES 15 FIRE BRIGADE 18 POLICE 17 CERN FIREMEN AT HOME 00-41-22-767-44-44 ANTI-POISONS CENTRE Open 24h/24h 04-72-11-69-11 All doctors ...

  10. Is it fair for a junior doctor’s deanery to be largely based on one test: a student’s perspective (United States)

    Singagireson, Shawmian; Ramjeeawon, Natalie; Ravindra, Saranya; Shah, Neil; Singh, Bharpoor


    The manner in which UK medical students are allocated foundation jobs is a controversial system. As medical students in the UK, we are subject to this system and have found students and junior doctors have varying opinions on it. Ultimately this led us to question, is this is a fair system? PMID:26257529

  11. Learning Dynamics in Doctoral Supervision

    DEFF Research Database (Denmark)

    Kobayashi, Sofie

    This doctoral research explores doctoral supervision within life science research in a Danish university. From one angle it investigates doctoral students’ experiences with strengthening the relationship with their supervisors through a structured meeting with the supervisor, prepared as part...... of an introduction course for new doctoral students. This study showed how the course provides an effective way build supervisee agency and strengthening supervisory relationships through clarification and alignment of expectations and sharing goals about doctoral studies. From the other angle the research...

  12. Are doctors altruistic? (United States)

    Glannon, W; Ross, L F


    There is a growing belief in the US that medicine is an altruistic profession, and that physicians display altruism in their daily work. We argue that one of the most fundamental features of medical professionalism is a fiduciary responsibility to patients, which implies a duty or obligation to act in patients' best medical interests. The term that best captures this sense of obligation is "beneficence", which contrasts with "altruism" because the latter act is supererogatory and is beyond obligation. On the other hand, we offer several examples in which patients act altruistically. If it is patients and not the doctors who are altruistic, then the patients are the gift-bearers and to that extent doctors owe them gratitude and respect for their many contributions to medicine. Recognising this might help us better understand the moral significance of the doctor-patient relationship in modern medicine.

  13. Should Doctors Be Allowed to Impose Operations on Patients?

    Institute of Scientific and Technical Information of China (English)


    Li Liyun,a 22-year-old who was in her ninth month of pregnancy,died of serious pneumonia at Chaoyang Hospital in west Beijing on November 21,after her husband refused to let doctors perform a Caesarean sec- tion.The hospital had offered to do the operation free of charge but the husband did not believe it.


    Directory of Open Access Journals (Sweden)

    S.К. Matelo


    Full Text Available Biennial program of controlled tooth brushing performed econdary school among junior schoolchildren from Minsk secondary school № 166 proved to be highly effective. Decrease in caries increment has been shown on the average up to 50%. No credible differences between remineralising defluorinated toothpastes or pastes enriched with aminofluoride (F = 500 ppm and sodium fluoride  (F = 1000 ppm efficacy were found in this study. Credibility of the results was determined by comparison with similar study conducted on a bigger population of children. Though anti-caries effect of the same tooth-pastes in a bigger-scale study was lower — within 30%. Such difference can be explained by a different level of motivation and discipline of participants.Key words: schoolchildren, dental caries prevention, toothpastes. (Voprosy sovremennoi pediatrii — Current Pediatrics. — 2011; 10 (6: 48–51

  15. Influence of different nursing models on doctor-patient relationship in the department of radiology in a hospital%某医院放射科不同护理模式对医患关系的影响

    Institute of Scientific and Technical Information of China (English)

    钞俊; 邹文远; 朱新枝; 顾永丽; 李胜; 石思李


    目的 探讨放射科不同护理模式对医患关系的影响,旨在提高服务质量.方法 对某医院放射科护理工作模式改革效果进行回顾性评价.改革前采用传统护理方法,在传统的放射科窗口内护理;改革后在传统护理方法的基础上增没放射科窗口外护理,主要为患者行放射线检查前提供各项服务及健康咨询工作.两组通过年度统计的对比剂渗漏、碘过敏不良反应及其他不良事件和患者满意度调查等项目进行效果评价.结果 改革前后总碘过敏反应发生率(x2=0.58,P>0.05)及对比剂渗漏发生率(x2=0.33,P>0.05)两组间比较差异无统计学意义;不良事件两组间比较,差异具有统计学意义(x2 =310.8,P<0.01);患者满意度由改制前的81.74%上升至91.81%,二者组间比较,差异具有统计学意义(x2 =52.7,P<0.01).结论 该医院增设放射科窗口外护理对对比剂渗漏及碘过敏反应的控制帮助不大,对不良事件和患者满意度影响大,该模式的运行有助于减少放射科不良事件的发生率和提高患者满意度,对缓解紧张的医患关系意义重大.%[Objective] To explore the influence of different nursing models on doctor-patient relationship in the department of radiology, improve the quality of medical service. [ Methods ] The effect of nursing model reformation in the department of radiology in a hospital was evaluated retrospectively. Before reformation, the patients were given the traditional nursing service at the window of the department of radiology. After reformation, patients received the nursing service outside the window on the basis of traditional nursing service, which included the nursing services before radiographie examination and health consulting. The incidence rates of contrast agent extravasation, iodine allergy and other adverse events, as well as patient satisfaction in two groups were evaluated. [Results]There was no significant difference in

  16. Women Doctors in 1914

    Institute of Scientific and Technical Information of China (English)


    THE five women shown here are doctors. Eighty-four years ago, they sat for this photographic portrait. The photo depicts the tasteful combination of East and West. While the photographic studio was decorated in the European style, the women doctors were dressed in traditional Chinese fashion with their hair coiled in Japanese style. We can also see that though the ladies were in vogue for their time, they still displayed shyness facing a male photographer, as most can be observed shifting their eyesight away from the lens.

  17. Surviving the Doctoral Years

    Directory of Open Access Journals (Sweden)

    Scott P. Kerlin


    Full Text Available This article probes the implications of neo-conservative public education policies for the future of the academic profession through a detailed examination of critical issues shaping contemporary doctoral education in U.S. and Canadian universities. Institutional and social factors such as financial retrenchment, declining support for affirmative action, downward economic mobility, a weak academic labor market for tenure-track faculty, professional ethics in graduate education, and backlash against women's progress form the backdrop for analysis of the author's survey of current doctoral students' opinions about funding, support, the job market, and quality of learning experiences.

  18. Changing doctor prescribing behaviour

    DEFF Research Database (Denmark)

    Gill, P.S.; Mäkelä, M.; Vermeulen, K.M.


    The aim of this overview was to identify interventions that change doctor prescribing behaviour and to derive conclusions for practice and further research. Relevant studies (indicating prescribing as a behaviour change) were located from a database of studies maintained by the Cochrane Collabora......The aim of this overview was to identify interventions that change doctor prescribing behaviour and to derive conclusions for practice and further research. Relevant studies (indicating prescribing as a behaviour change) were located from a database of studies maintained by the Cochrane...

  19. How doctors search

    DEFF Research Database (Denmark)

    Lykke, Marianne; Price, Susan; Delcambre, Lois


    to context-specific aspects of the main topic of the documents. We have tested the model in an interactive searching study with family doctors with the purpose to explore doctors’ querying behaviour, how they applied the means for specifying a search, and how these features contributed to the search outcome...

  20. Fourth Doctoral Student Assembly

    CERN Multimedia

    Ingrid Haug


    On 10 May, over 130 PhD students and their supervisors, from both CERN and partner universities, gathered for the 4th Doctoral Student Assembly in the Council Chamber.   The assembly was followed by a poster session, at which eighteen doctoral students presented the outcome of their scientific work. The CERN Doctoral Student Programme currently hosts just over 200 students in applied physics, engineering, computing and science communication/education. The programme has been in place since 1985. It enables students to do their research at CERN for a maximum of three years and to work on a PhD thesis, which they defend at their University. The programme is steered by the TSC committee, which holds two selection committees per year, in June and December. The Doctoral Student Assembly was opened by the Director-General, Fabiola Gianotti, who stressed the importance of the programme in the scientific environment at CERN, emphasising that there is no more rewarding activity than lear...

  1. Penumbra: Doctoral support as drama

    DEFF Research Database (Denmark)

    Wisker, Gina; Robinson, Gill; Bengtsen, Søren Smedegaard


    Much international doctoral learning research focuses on personal, institutional and learning support provided by supervisors, managed relationships,‘nudging’ robust, conceptual, critical, creative work. Other work focuses on stresses experienced in supervisor-student relationships and doctoral j...

  2. Reinventing The Doctor

    Directory of Open Access Journals (Sweden)

    Moyez Jiwa


    Full Text Available There has been a seismic shift in the lives of people because of technology. People are far better informed than they were in the 1980s and 1990s. Much of this information is available through the media but even more is available and archived on the internet. The forces pushing the internet into health and health care are strong and unstoppable, ensuring that the internet and the choices it offers must be part of the design of our future health care system. We are no longer content to wait in queues as we live at a faster pace than earlier generations — we don’t not have time to wait for appointments months, weeks or even days in advance. The internet offers the prospect of online consultations in the comfort of your own home. The physical examination will change as new devices are developed to allow the necessary sounds and signals emitted by our malfunctioning bodies to be recorded, interpreted and captured at a remote location. Meanwhile, for those who prefer to see a health care practitioner in person the options to consult practitioners other than doctors who can advise on our health is expanding. The reality is we can’t afford to train or pay for all the doctors we need under the current “doctor-knows-best” system of health care. Patients no longer believe the rhetoric and are already voting with their feet. Pharmacists, nurses and other allied health professionals are beginning to play a much greater role in offering relief from symptoms and monitoring of chronic diseases. Of course, the doctor of the future will still need to offer face-to-face consultations to some people most of the time or most people some of the time. The social role doctors play will continue to be important as humans will always need other humans to personally respond to their distress. As doctors reinvent themselves, the internet and the value of time with patients will be the driving forces that move us into a more sustainable future in health care.

  3. Entrepreneurship and UK Doctoral Graduates (United States)

    Hooley, Tristram; Bentley, Kieran; Marriott, John


    This paper discusses the experience of UK doctoral graduates in pursuing entrepreneurial careers: there is evidence that this applies to a substantial number--about 10%--of doctoral graduates. The nature of their experience was explored using 37 interviews with doctoral entrepreneurs. The research was funded by Vitae (, an…

  4. Doctorateness as a Threshold Concept (United States)

    Trafford, Vernon; Leshem, Shosh


    Achieving a doctorate presents candidates with certain challenges--undertaking the research, writing the thesis and defending both at their viva. Throughout that doctoral journey, candidates are expected to display doctorateness in their thesis via the characteristics of high-quality scholarly research. The blockages that occur and prevent…

  5. Doctorateness as a Threshold Concept (United States)

    Trafford, Vernon; Leshem, Shosh


    Achieving a doctorate presents candidates with certain challenges--undertaking the research, writing the thesis and defending both at their viva. Throughout that doctoral journey, candidates are expected to display doctorateness in their thesis via the characteristics of high-quality scholarly research. The blockages that occur and prevent…

  6. Educating sexologists in a Danish university hospital in accordance with a Nordic educational programme

    DEFF Research Database (Denmark)

    Rischel, Karen; Kristensen, Ellids


    The establishment of an educational programme in sexology in a Danish university hospital is described and an overview of the historical background of the Nordic Association for Clinical Sexology (NACS) and the Nordic educational programme is presented. The Nordic Association for Clinical Sexology...... was founded in 1978. In 2000, agreement was reached on a three-level educational programme for sexologists and identical rules for authorization in the Nordic countries. After analysis of the Nordic educational programme, curricula on levels 1 and 2 as well as logbooks were designed. Employees of the clinic...... with relevant clinical work could enter the programme. Twelve employees entered the programme at different points; one junior doctor graduated in March 2004. The NACS curricula secure a similar standard of authorized Nordic sexologists. The use of specialist teachers from non-Nordic countries links the Nordic...


    CERN Multimedia

    Medical Service


    GENEVA EMERGENCY SERVICES GENEVA AND VAUD 144 FIRE BRIGADE 118 POLICE 117 CERN FIREMEN 767-44-44 ANTI-POISONS CENTRE Open 24h/24h 01-251-51-51 Patient not fit to be moved, call family doctor, or: GP AT HOME, open 24h/24h 748-49-50 Association Of Geneva Doctors Emergency Doctors at home 07h-23h 322 20 20 Patient fit to be moved: HOPITAL CANTONAL CENTRAL 24 Micheli-du-Crest 372-33-11 ou 382-33-11 EMERGENCIES 382-33-11 ou 372-33-11 CHILDREN'S HOSPITAL 6 rue Willy-Donzé 372-33-11 MATERNITY 32 la Cluse 382-68-16 ou 382-33-11 OPHTHALMOLOGY 22 Alcide Jentzer 382-33-11 ou 372-33-11 MEDICAL CENTRE CORNAVIN 1-3 rue du Jura 345 45 50 HOPITAL DE LA TOUR Meyrin EMERGENCIES 719-61-11 URGENCES PEDIATRIQUES 719-61-00 LA TOUR MEDICAL CENTRE 719-74-00 European Emergency Call 112 FRANCE EMERGENCY SERVICES 15 FIRE BRIGADE 18 POLICE 17 CERN FIREMEN AT HOME 00-41-22-767-44-44 ANTI-POISONS CENTRE Open 24h/24h 04-72-11-69-11 All doctors will come to your home. Cal...

  8. Doctors and romance: not only of interest to Mills and Boon readers. (United States)

    Callister, Paul; Badkar, Juthika; Didham, Robert


    media coverage, the NZ public is well aware of local and national doctor shortages. There is also awareness, often through personal visits to a GP or hospital, of the significant rise in number of female and of foreign-born doctors. The choices doctors are making in living arrangements need to be taken into account when considering both national and international recruitment of medical staff. Researchers and policy makers may need to consider family migration issues more than they have in the past for doctors as well as for other migrant groups.

  9. Find a Doctor - American Optometric Association (United States)

    ... Doctor Login Join Find a Doctor Find a Doctor Search our database of 28,417 Optometrists. 1 ... Guidelines Evidence-based Optometry Marketplace Home > Find a Doctor Basic Search Advanced Search Fine Tune Your Results ...

  10. Contextual dynamics in clinical workplaces: learning from doctor-doctor consultations. (United States)

    Pimmer, Christoph; Pachler, Norbert; Genewein, Urs


    Some studies have explored the role of learning context in clerkships and in clinical teams. Very little is known, however, about the relationship between context and competence development in more loosely framed, day-to-day practices such as doctor-doctor consultations, although such interactions are frequent and typical in clinical work. To address this gap in the literature, a study was conducted using semi-structured interviews in four different hospitals and participant observation at one site. Inductive content analysis was used to develop a framework. Special reference was made to the principles of situated cognition. The framework illustrates how different situational, personal and organisational factors interact in every learning situation. The interplay manifests in three different roles that doctors assume in highly dynamic ways: doctors learn as 'actors' (being responsible), as 'participants' (being involved) and as 'students' (being taught); contextual influences also impact on the quality of learning within these roles. The findings add to the current literature on clinical workplace learning and to the conceptualisation of context in the field of education. The practical contribution of the research lies in disentangling the complex dynamics of learning in clinical environments and in helping doctors and medical educators to increase their responsiveness to contextual factors. © Blackwell Publishing Ltd 2013.

  11. Doctoral education from a distance. (United States)

    Effken, Judith A


    This article describes the environmental factors that have contributed to the recent rapid growth of nursing doctoral education at a distance. Early and recent efforts to deliver distance doctoral education are discussed, using The University of Arizona College of Nursing experience as the key exemplar. The Community of Inquiry model is introduced as an appropriate model for doctoral education and then used as a framework to evaluate the current state of the art in distance doctoral nursing education. Successes and challenges in delivering doctoral education from a distance are described.

  12. Obstetric anaesthesia at district and regional hospitals in KwaZulu ...

    African Journals Online (AJOL)

    ... in KwaZulu-Natal: human resources, caseloads and the experience of doctors. ... Only 3% of responding doctors working in rural hospitals had a Diploma in ... in obstetric anaesthesia and documents workload patterns at district hospitals.

  13. 加强医院宣传工作对构建和谐医患关系的作用%Enhance the hospital propaganda work and build a harmonious doctor-patient relationship

    Institute of Scientific and Technical Information of China (English)



    Objective: With the development of China's society and economy, Chinese people's materialandculturallifeandhealthservicedemandimprovesfast.Meanwhile,medicaldisputesriserapidlyanddoctor-patientcontradictions are growing. For this reason, hospitals should pay attention to the important role of propaganda inimproving the doctor-patient relationship and build a harmonious doctor-patient relationship by providing goodmethodstohelpdoctorsandpatientscommunicatewellwitheachother.%随着人民群众对医疗卫生服务的需求日益增长,医患间的矛盾日益突出,医疗纠纷呈现上升趋势。医院在开展宣传工作时,应重视发挥宣传工作在改善医患关系中的重要作用,为医患的沟通了解提供途径和帮助,该文对此进行了初步探讨。

  14. Survey among doctors related with bronchial asthma patients in central hospitals of region level cities in Shaanxi province%陕西省地区级城市中心医院支气管哮喘相关科室医师的调查分析

    Institute of Scientific and Technical Information of China (English)

    宋立强; 吴昌归; 呼彩莲; 李海东; 李文革; 何小鹏; 张和平


    表示为每位接诊的哮喘患者制定了长期用药方案及随访计划.结论 通过调查了解了陕西省地区级城市中心医院医师对哮喘知识的掌握程度.总体来看,呼吸内科医师的掌握程度高于其他专科,但距离普及规范化治疗理念还任重而道远.这些资料将为联盟在西部地区的医师教育工作提供参考.%Objective To evaluate the situation of grasping bronchial asthma(asthma) knowledge ofdoctors related with asthma patients in central hospitals of region level cities in Shaanxi province, and toappraise the effect of doctor education in order to provide evidence for the next step of education. MethodsSix hospitals were selected from six region level cities, where questionnaire survey was completed in thedorctors from the department of respiratory medicine, internal medicine, emergency or pediatrics. Thequestionnaire involved pathogenesy, prevention, treatment and advencement of global initiative for asthma(GINA). Results 187 doctors completed the qusetionnaire,and the ratio of every speciality was 29.9%,23.0%,26.7% and 20.3%, respectively. 58.9%-62.5% dorctors in respiratory knew the organization ofasthma clearly and the ratio was very higher than that in other spciality. But 10.7% dorctors did not knowthe significance of GINA. World Asthma Day was known in 87.6%. 69.9% doctors understood thepathogenesy of slow airway inflammation, while the highest ratio was 78.6% in repiralogy and the lowestone was 55.8% in internal medcine. Repiratory doctor knew the classification of asthma according tocontroled level most clearly in all people. 54.8%-75.0% doctors knew the importance of inhaledcorticosteroid (ICS)in therapy. But the effect of asthma control test and stort-acting β2-agonist wasunderstood only by 7.1% and 42.9% respiratory doctors. 37.8% doctors knew the use of long-actingβ2-agonist should be combined with ICS. 52.0%-76.4% doctors knew the blocker of leukotriene receptorwas control medcine. 51

  15. Electronic Printed Ward Round Proformas: Freeing Up Doctors' Time (United States)

    Fernandes, Darren; Eneje, Philip


    The role of a junior doctor involves preparing for the morning ward round. At a time when there are gaps on rotas and doctors' time is more stretched, this can be a source of significant delay and thus a loss of working time. We therefore looked at ways in which we could make the ward round a more efficient place by introducing specific electronic, printed ward round proformas. We used the average time taken to write proformas per patient and the average time taken per patient on the ward round. This would then enable us to make fair comparisons with future changes that were made using the plan, do, study, and act principles of quality improvement. Our baseline measurement found that the average time taken to write up the proforma for each patient was 1 minute 9 seconds and that the average time taken per patient on the ward round was 8 minutes 30 seconds. With the changes we made during our 3 PDSA cycles and the implementation of an electronic, printed ward round proforma, we found that we were able to reduce the average time spent per patient on the ward round to 6 minutes 32 seconds, an improvement of 1 min 58 seconds per patient. The project has thus enabled us to reduce the time taken per patient during the ward round. This improved efficiency will enable patients to be identified earlier for discharge. It will also aid in freeing up the time of junior doctors, allowing them to complete discharge letters sooner, order investigations earlier and enable them to complete their allocated tasks within contracted hours. PMID:28352467

  16. 口腔专科医院医护合作水平对护士工作满意度及离职意愿的影响研究%Impact of doctor-nurse collaboration on job satisfaction and turnover intention among nurses in stomatological hospital

    Institute of Scientific and Technical Information of China (English)

    张琳; 刘萌; 严红; 李秀娥


    Objective To explore the influences of doctor-nurse collaboration on job satisfaction and turnover intention among nurses in stomatological hospital. Methods A total of 545 nurses from grade Ⅲ-A stomatological hospital were investigated by convenience sampling method from January 2015 to February 2015 using general data questionnaire, doctor-nurse collaboration scale, nurses′ job satisfaction scale and turnover intention questionnaire. Results The scores of doctor-nurse collaboration scale, job satisfaction and turnover intention were (86. 46 ± 14. 52), (136. 08 ± 14. 88) and (20. 31 ± 3. 67). The doctor-nurse collaboration level was positively correlated with job satisfaction (r=0. 328, P<0. 01) and negatively correlated with turnover intention (r= -0. 220, P<0. 01). Doctor-nurse collaboration level could be positive to predict the situation of job satisfaction (t=2. 871, P <0. 01), and negative to predict the possibility of quitting current job (t =-6. 209, P < 0. 01). Conclusions The situation of nurse job satisfaction and turnover intention is not optimistic in stomatological hospital. Improving the level of doctor-nurse collaboration can help to improve job satisfaction and reduce turnover intention.%目的 探讨口腔专科医院医护合作水平对护士工作满意度及离职意愿的影响. 方法 采用一般资料问卷、医护合作量表、工作满意指数量表和离职意愿量表,于2015年1-2月方便取样选择某三级甲等口腔专科医院545 名护士进行调查. 结果 口腔专科医院护士医护合作水平为(86. 46 ± 14. 52)分,工作满意度水平为(136. 08 ± 14. 88)分,离职意愿水平为(20. 31 ± 3. 67)分;医护合作水平与工作满意度呈正相关(r=0. 328,P<0. 01),与离职意愿呈负相关(r= -0. 220,P<0. 01);医护合作水平能正向预测工作满意度(t=2. 871,P<0. 01),负向预测离职意愿中辞去目前工作的可能性(t= -6. 209, P<0. 01). 结论 口腔专科医院护士工作满意度

  17. Does obesity preclude lumbar puncture with a standard spinal needle? The use of computed tomography to measure the skin to lumbar subarachnoid space distance in the general hospital population.

    LENUS (Irish Health Repository)

    Halpenny, Darragh


    OBJECTIVES: Failed lumbar puncture (LP) is a common indication for referral for radiologically guided LP. This study aims to evaluate what percentage of the hospital population would fail an LP using a standard 9-cm needle because of obesity and a skin to subarachnoid space distance greater than 9 cm. METHODS: Images of 402 consecutive patients undergoing computed tomography of the abdomen and pelvis were reviewed. Skin to subarachnoid space distance was calculated using sagittal images. A survey was conducted among junior hospital doctors to assess their experience of performing lumbar puncture in obese patients. RESULTS: Four hundred patients were included. Fifty-five patients (13.8 %) had a skin to subarachnoid space distance greater than 9 cm. Intra-abdominal fat, subcutaneous fat and abdominal girth correlated with distance between the skin and subarachnoid space. Among junior doctors, 68.3 % (n = 41) reported LP failure on an obese patient; 78.4 % (n = 47) were unaware of the existence of a longer needle and 13.3 % (n = 8) had experience using a longer needle. CONCLUSIONS: A significant proportion of the hospital population will fail LP with a standard length spinal needle. Selecting a longer needle may be sufficient to successfully complete LP in obese patients. KEY POINTS : • Lumbar puncture failure commonly leads to referral for an image-guided procedure • Standard lumbar puncture may fail in 13.8 % of patients due to obesity • 78.4 % of trainee doctors are unaware of the existence of longer spinal-needles • Using longer spinal needles may allow successful LP in obese patients.

  18. [Compliance on hand-hygiene among healthcare providers working at secondary and tertiary general hospitals in Chengdu]. (United States)

    Han, Ke; Dou, Feng-man; Zhang, Li-jie; Zhu, Bao-ping


    To evaluate the compliance on hand-hygiene and related factors among healthcare providers working at secondary and tertiary hospitals in Chengdu. On-site observations regarding hand-hygiene compliance and facilities were conducted in 6 hospitals in Chengdu. Doctors and nurses were asked and recorded about their knowledge regarding hand-hygiene. Of 1535 activities where hand-hygiene was deemed necessary, under observating healthcare providers would perform hand-hygiene procedures 17.8% of the time (12.8% of the time before touching a patient, 21.0% of the time before touching objects around a patient, 27.3% of the time after touching a patient, and 31.5% of the time after removing gloves). Only 2.2% of the treating rooms were equipped with foot-operated or automatic faucets;of these only 24.5% had soap or alcohol-based hand-sanitizer, and 6.3% had paper towel or other hand-drying equipment. 92.8% of the healthcare providers knew of the six-step method on hand-washing. More than 90.0% of the healthcare providers knew that both palm and back of the hands as well as the front and back of the fingers should be washed. However, only 22.8% knew that the hand-washing procedure should last ≥ 15 seconds. Rates on hand hygiene among chief or more senior physicians (14.6%), attending physicians (9.2%) and junior doctors (15.6%), nurses in chief (25.0%), senior nurses (26.3%) and junior nurses (20.5%) showed no significant differences (P > 0.05). Similarly, scores on related knowledge between chief or senior physicians (12.4 ± 3.2), attending physicians (13.6 ± 3.3) and junior doctors (13.4 ± 2.9), nurses in charge (15.2 ± 2.0), senior nurses (14.8 ± 2.1) and junior nurses (14.3 ± 2.6) also showed no significant differences (P > 0.05). Rate on hand hygiene among nurses (22.7%) was significantly higher than that of the doctors (13.6%). Rate of hand hygiene among 50 - 59 years old healthcare providers (7.4%) was significantly lower than those of all the other age groups

  19. Doctor Alberto Zabaleta Lombana



    El Doctor Alberto Zabaleta Lombana nació en la población de Turbaco, Bolívar, el nueve de Abril de 1923. Toda su formación intelectual transcurrió en los claustros de la Universidad de Cartagena. En 1936 ingresó a la Facultad de Filosofía y Letras (Bachillerato), luego pasó a la Facultad de Medicina hasta obtener su grado de Médico en 1953. Posteriormente en 1959 inició la Jefatura de Clínica Obstetricia (Residencia como se denominan en el presente) en la Universidad de Cartagena y en la Clín...

  20. Learner Reading Problems: A Case of Khoe Learners at Junior ...

    African Journals Online (AJOL)

    Learner Reading Problems: A Case of Khoe Learners at Junior Secondary School. ... learners' reading ability of English at junior secondary school in Botswana. ... teachers' schemes and records of work to explore the subjects' reading skills.

  1. 县级医疗和谐医患关系的构建路径%Routes of Constructing Harmonious Doctor-Patient Relationship in County-Level Hospitals

    Institute of Scientific and Technical Information of China (English)



    Medical service condition is relatively backward in mid-western counties,and medical disputes occur frequently there.From the perspective of patients,three factors causing doctor-patient disputes are patients' dissatisfaction with medical process,result and cost.The roots can be found both in medical service suppliers and consumers.In order to achieve harmonious doctor-patient relationship,the reform in medical service supply should be carried out to improve medical services,enhance doctors-patient communication,resolve medical disputes and strengthen medical law construction.%中西部县级医疗条件较为落后,医疗纠纷多发、易发。县级医患纠纷有三种主要类型,即对医疗过程不满意的医患纠纷、对医疗结果不满意的医患纠纷和对医疗费用不满意的医患纠纷,而医患纠纷的产生则可以从供给和需求两侧寻找原因。县级和谐医患关系构建需要县级医疗的供给侧改革,即从改善医疗服务、医患沟通、医疗纠纷化解、医疗法治建设等方面来营造和谐医患关系的条件。

  2. [The birth of the hospital]. (United States)

    Le Coz, R


    Hospitals were founded as early as the forth century, by the Church in the Byzantine Empire. However, it was not before the sixth century, with the Reform of Justinian, that the hospital got its definitive organization. In Bagdad, as soon as the eight century, the christian-nestorian doctors organized the first hospitals in the Arab-Muslim world.

  3. The Impact of Information on Doctors' Attitudes Toward Generic Drugs. (United States)

    Tsaprantzi, Aggeliki V; Kostagiolas, Petros; Platis, Charalampos; Aggelidis, Vassilios P; Niakas, Dimitris


    The objective of this study is to assess the impact of information on doctors' attitudes and perceptions toward generics. A cross-sectional survey based on a specially designed 21-item questionnaire was conducted. The survey involved doctors of different specialties working in a public hospital in Greece. The analysis includes descriptive and inferential statistics, reliability and validity tests, as well as structural equation modeling to evaluate the causal model. Statistical analysis was accomplished by using SPSS 20 and Amos 20. A total of 134 questionnaires out of 162 were received, providing a response rate of 82.71%. A number of significant associations were found between information and perceptions about generic medicines with demographic characteristics. It seems that the provision of quality information on generic drugs influences doctors' attitudes and prescription practices toward generic drugs. This is not a static process but a rather dynamic issue involving information provision policies for strengthening the proper doctors' attitudes toward generic drugs.

  4. Secondary postpartum haemorrhage - a underappreciated danger. A retrospective review of the incidence of hysterectomy for the 37 years at Holles St Hospital

    LENUS (Irish Health Repository)


    Institute of Obstetricians & Gynaecologists, RCPI Four Provinces Meeting, Junior Obstetrics & Gynaecology Society Annual Scientific Meeting, Royal Academy of Medicine in Ireland Dublin Maternity Hospitals Reports Meeting, Nov 2010

  5. More than just clowns--Clown doctor rounds and their impact for children, families and staff. (United States)

    Ford, Karen; Courtney-Pratt, Helen; Tesch, Leigh; Johnson, Caddi


    Admission to hospital is recognised as a difficult time for children and families. This study explored clown doctor activities in an acute paediatric setting and the impact their activities have on children, their families, other health professionals and clown doctors themselves. We used observation, semi-structured interviews and focus groups with children and parents and staff and clown doctors and results provide a rich description of the work of clown doctors. The major themes were 'the encounter - in the moment' of the interaction of the child and the clown doctor and 'beyond the encounter'. The findings show that the impact of clown doctor visits is experienced beyond the immediate interaction, and this has not been clearly articulated in previous studies. This study highlights the multifaceted and complex nature of the work of the clown doctors and the high level of skill required as they modify and interpret play, activities and environment based on individual need and response.

  6. Insufficient knowledge about battered child syndrome among doctors in the emergency department

    DEFF Research Database (Denmark)

    Villadsen, Jenny Korsgaard; Bersang, Ann Buhl; Thorninger, Rikke;


    The aim of the study was to determine the present knowledge regarding battered child syndrome (BCS) among doctors in the emergency department. Nineteen doctors with different educational levels from seven hospitals in Denmark were interviewed. For children younger than 18 months, 68%, 65% and 25......% of the participants related femur-, collum costae- and corner fractures to BCS respectively. We found that more than one third of the 19 doctors did not know which fractures to look for when suspecting BCS....

  7. Language of the doctorate: Doctorateness as a threshold concept in doctoral literacy

    Directory of Open Access Journals (Sweden)

    Bitzer, Eli


    Full Text Available In academia, the definition of literacy has evolved from a focus on reading and writing to encompass more inclusive and expansive perspectives. Such perspectives have come from researchers involved in exploring literacy among diverse populations and across traditional divides such as cultural, political and socioeconomic boundaries. Changing definitions of literacy include usage in expressions such as ‘computer literacy’, ‘civic literacy’, ‘health literacy’, ‘cultural literacy’ and others. Recently, new directions in literacy research were foregrounded by critical questions that seek to discover how literacy functions in doctoral studies and within research communities. For instance, what does it mean to be ‘literate’ as a doctoral member of a research culture, within a field of research, within the academic profession and so on? In addition, doctoral candidates often grapple with what may be termed ‘threshold concepts’. Such concepts include the meaning of the doctorate as a qualification, its aims, its narrative and the level of literacy required to succeed with a doctorate. Against this background the article explores firstly how the concept of being literate has been broadened to include literacy for doctoral learning; secondly, it explains why doctorateness remains a threshold concept for many doctoral candidates and supervisors, and thirdly it provides some evidence from at least five years of working with doctoral education and doctoral supervisor development workshops to support an argument for doctoral literacy. Finally, the article provides some implications which emerged from a better understanding of the language and requirements of doctorateness as an essential literacy requirement for doctoral candidates and their supervisors.

  8. 42 CFR 21.25 - Eligibility; junior assistant grade. (United States)


    ... 42 Public Health 1 2010-10-01 2010-10-01 false Eligibility; junior assistant grade. 21.25 Section... COMMISSIONED OFFICERS Appointment § 21.25 Eligibility; junior assistant grade. (a) Requirements; all candidates... for appointment in the grade of junior assistant: (1) Shall be a citizen of the United States; (2...

  9. Doctor Gonzalo Esguerra Gómez


    Academia Nacional de Medicina


    Nació en Bogotá (Colombia) el 24 de enero de 1902
    Bachiller de la Escuela Nacional de Comercio (Bogotá), diciembre de 1919.
    Ayudante del Laboratorio de Radiología del Hospital de San Juan de Dios (Facultad de Medicina de Bogotá), 1920-1922.
    Jefe de trabajos del mismo laboratorio (1926-1928).
    Doctor en medicina y cirugía de la Universidad Nacional de Colombia. (Bogotá 19 de noviembre de 1927).<...

  10. Quality of Plaster Molding for Distal Radius Fractures Is Improved Through Focused Tuition of Junior Surgeons. (United States)

    Ramoutar, Darryl N; Silk, Robert; Rodrigues, Jeremy N; Hatton, Mark


    Successful nonoperative management of distal radius fractures requires an adequately reduced fracture held in a well-molded cast. The purpose of this study was to determine whether a targeted teaching session to the same group of junior doctors led to objective improvement in fracture reduction and plaster molding and hence a decrease in the redisplacement of these fractures. Retrospective review. Level I academic trauma center. A retrospective review of all dorsally angulated distal radius fractures treated in plaster that presented to our plaster room over a 4-week period (group 1, n = 52). This was followed by the intervention and a subsequent 4-week prospective review (group 2, n = 36). Radiographs were reviewed before manipulation, after manipulation, and at follow-up by a single senior orthopaedic trainee using predetermined criteria. A targeted teaching session on fracture reduction and cast molding to the same group of junior doctors involved in managing all these cases. Adequate fracture reduction, plaster molding, redisplacement, and further intervention before and after the targeted intervention. In group 1, 85% had adequate fracture reduction but only 36% showed adequate molding. This was improved in group 2%-94% adequate reduction and 65% adequate molding (P = 0.022). The rate of redisplacement was improved from 65% to 44% in group 2. In both groups, the rate of redisplacement was around 20% for adequately reduced and molded fractures, compared with around 90% for adequately reduced but inadequately molded cases (P < 0.001). The rate of further intervention improved from 27% to 8% (P = 0.052). We recommend that specific teaching focusing on fracture reduction and molding techniques is included in orthopaedic juniors' induction teaching or as a separate session. Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

  11. Transfers from rural hospitals in New Zealand. (United States)

    Lloyd, Trevor; Blattner, Katharina; Nixon, Garry


    To canvass the experience of a group of New Zealand rural hospital doctors of transfers from their hospitals. Ten rural hospital doctors were required to write an assignment on patient transfer as part of their assessment for a postgraduate diploma. The information from the completed assignments was grouped into themes for analysis. The responses from the ten doctors could be grouped into six themes: resources at the rural hospital, clinical conditions, mode of transfer, communication, issues during transfer, and health system issues. The experience of this group of doctors is consistent with the available published information. Transfer of patients is an inevitable part of rural hospital practice. The outcome for patients could be improved through better resourcing of rural hospitals and education for staff, improved communication with transport services and with base hospital specialists, and involvement in the development of regionalised transport protocols.

  12. Re-Imagining Doctoral Education: Professional Doctorates and beyond (United States)

    Lee, Alison; Brennan, Marie; Green, Bill


    Portents of the demise of the Professional Doctorate have emerged in some recent policy and institutional circles in Australia, raising questions about the meaning and relevance of the Professional Doctorate in an era of "league tables" and research assessment in Australia. This article argues that such portents, based largely on narrow…

  13. Professionalism for future humanistic doctors

    Directory of Open Access Journals (Sweden)



    Full Text Available Dear editor Clinical environments encounter is an important part of studying medicine (1. Patient contact as an integral part of medical education occurs in various formats in the clinical settings (2, 3. During clinical training, medical students may experience high levels of stress, and some may not deal with it well. The abruptness of students’ transition to the clinical setting generated positive and negative emotions. Due to being a novice, they did not receive adequate training on how to get emotionally prepared for meeting seriously ill people. In such circumstances, the shortage of training will have predictably crucial consequences. Early clinical contact has been suggested to reduce these stresses and help the students adapt effectively to changes in the hospital climate (2. Patient contact creates an environment where each student appreciates cultural diversity and reinforces the development of clinical professional interpersonal skills through social, emotional and cognitive experiences (4, 5. It encourages validating of the relationship between patients and doctors and allows students to experience a more personal relationship with patients and nurture the ability to empathize with them, providing considerable benefits for trainees and patients. In this way, the social emotions that students experience when empathizing with a patient represent a uniquely human achievement. By internalizing their subjective interpretations of patient’s beliefs and feelings, the student’s body, brain and mind come together to produce cognition and emotion . They construct culturally relevant knowledge and make decisions about how to act and think about the patient’s problems as if they were their own. On the other hand, patient interaction in undergraduate education offers students a valuable early insight into the day-to-day role of a doctor and the patients’ perspective on specific conditions. Early experience provides a greater knowledge

  14. Accounting Boot Camp for College Juniors (United States)

    Myring, Mark; Wrege, William; Van Alst, Lucinda


    We describe a day-long introduction to new accounting majors, which we call a boot camp. Boot camp it is an effort to make juniors more aware of their identity, career purposes and learning resources that are now parts of their world, much of which is not covered explicitly in the accounting curriculum. This paper provides an overview of the…

  15. 7 CFR 765.206 - Junior liens. (United States)


    ... 7 Agriculture 7 2010-01-01 2010-01-01 false Junior liens. 765.206 Section 765.206 Agriculture Regulations of the Department of Agriculture (Continued) FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE... determinations for future requests for assistance and may adversely impact such requests. (b) Conditions...

  16. Pygmalion Effect on Junior English Teaching

    National Research Council Canada - National Science Library

    Yurong Wang; Li Lin


    .... This thesis mainly focuses on the application of Pygmalion effect in English teaching, especially junior English teaching in China. If we can make good use of the Pygmalion Effect to conduct teaching and have positive expectations to students, it will improve teaching greatly.

  17. Organizing and Managing the Junior High Classroom. (United States)

    Emmer, Edmund T.; And Others

    This manual provides guidelines and activities for organizing and managing junior high school classes. The first five chapters are devoted to the topic of getting ready for the beginning of the school year; the last four chapters suggest guidelines and activities that are helpful in maintaining a management system. Chapter 1 deals with organizing…

  18. A Senior Partner in the Junior College. (United States)

    Santa Fe Community Coll., Gainesville, FL.

    The development and current status of the student personnel program at Sante Fe Junior College is described. Statements of purpose and philosophy are amplified through an outline of the needs and characteristics of Santa Fe students and a description of the elements of the program as they relate to specific needs and characteristics. The elements…

  19. Mathematics for Junior High School. Supplementary Units. (United States)

    Anderson, R. D.; And Others

    This is a supplementary SMSG mathematics text for junior high school students. Key ideas emphasized are structure of arithmetic from an algebraic viewpoint, the real number system as a progressing development, and metric and non-metric relations in geometry. Chapter topics include sets, projective geometry, open and closed paths, finite…


    Institute of Scientific and Technical Information of China (English)

    Duan Bixi


    In This Article, the writer focus on an over- all analysis of the present situation of the students' reading activities in junior middle school in the countryside and put forward some suggestions on improving the teaching arts to enhance the students' fast reading abilities . It provided some theoretical basis on the further improcement of students' reading abilities in the school

  1. Foreign Languages at Tarrant County Junior College. (United States)

    Harper, Jane

    Even during the 1970's when diminished national interest in foreign language study was reflected in declining enrollments at most colleges, Tarrant County Junior College (TCJC) was able to maintain a vigorous language program by emphasizing oral communication and developing a flexible curriculum. Since 1975, the college has offered its preparatory…

  2. Curriculum Reviews: Middle/Junior High Science. (United States)

    Faller, Richard


    Reviews "Pathways in Science" (Globe Book Company), designed as a complete middle/junior high school science program. Strengths (including sixth-grade readability) and weaknesses (indicating that limited process skill development may not challenge more capable students). Limited process skill development and the possibility for the program…

  3. Theme: Junior High and Middle School Programs. (United States)

    Hillison, John; And Others


    On the topic of agricultural education programs in middle/junior high schools, nine articles address developing self-concept, selecting materials, the benefits of agriscience contests, adopting new curricula, the role of Future Farmers of America in the development of adolescents, teaming science and agriculture, and the rationale for middle…

  4. Santa Fe Junior College, Gainesville, Florida. (United States)

    Caudill, Rowlett and Scott, Architects, Houston, TX.

    The design of Santa Fe Junior College is examined, beginning with the development of an educational philosophy. Subsequent design decisions are based largely upon this philosophy which emphasizes the development of the individual student and the fulfillment of his needs. Further, the need for flexibility is recognized and is an important aspect of…

  5. Redskin Images. Roy Junior High School. (United States)

    Reese, William M.

    The school and self-improvement programs instituted at Roy Junior High School include the development of a self-performance evaluative instrument, the incorporation of a daily 15-minute reading session, the encouragement of dance and movement education through use of visiting professionals, and implementation of a self-esteem improvement mechanism…

  6. Public Relations for Community/Junior Colleges. (United States)

    Woodress, Fred A.

    This monograph is a practical manual on public relations (PR) for community and junior colleges, containing numerous suggestions and recommendations for establishing and operating an effective public relations effort while avoiding PR pitfalls. An overview of the history of public relations in academe, the rationale underlying today's PR programs…

  7. India's Doctor Shortage Reflects Problems in Medical Education (United States)

    Neelakantan, Shailaja


    This article reports that India's medical profession is in a crisis. For every 10,000 people in India there are only six doctors, compared with nearly 55 in the United States and nearly 21 in Canada. The problem is likely to get worse before it gets better. Professors are leaving medical schools for better-paying jobs in private hospitals and in…

  8. Patient-doctor communication. (United States)

    Teutsch, Carol


    Communication is an important component of patient care. Traditionally, communication in medical school curricula was incorporated informally as part of rounds and faculty feedback, but without a specific or intense focus on skills of communicating per se. The reliability and consistency of this teaching method left gaps, which are currently getting increased attention from medical schools and accreditation organizations. There is also increased interest in researching patient-doctor communication and recognizing the need to teach and measure this specific clinical skill. In 1999, the Accreditation of Council for Graduate Medical Education implemented a requirement for accreditation for residency programs that focuses on "interpersonal and communications skills that result in effective information exchange and teaming with patients, their families, and other health professionals." The National Board of Medical Examiners, Federation of State Medical Boards. and the Educational Commission for Foreign Medical Graduates have proposed an examination between the. third and fourth year of medical school that "requires students to demonstrate they can gather information from patients, perform a physical examination, and communicate their findings to patients and colleagues" using standardized patients. One's efficiency and effectiveness in communication can be improved through training, but it is unlikely that any future advances will negate the need and value of compassionate and empathetic two-way communication between clinician and patient. The published literature also expresses belief in the essential role of communication. "It has long been recognized that difficulties in the effective delivery of health care can arise from problems in communication between patient and provider rather than from any failing in the technical aspects of medical care. Improvements in provider-patient communication can have beneficial effects on health outcomes". A systematic review of

  9. Investigation and research of the reasonable use of antibiotics in treating respiratory infections by young doctors in primary hospitals%基层医院中青年医师对呼吸道感染性疾病抗菌药物合理应用的调查研究

    Institute of Scientific and Technical Information of China (English)

    周九洲; 马媛; 韦霖


    OBJECTIVE To investigate the condition of rational use of antibiotics in treating respiratory tract infec‐tions by young doctors in primary hospitals ,so as to provide the basis for the rational use of antimicrobial drugs for young doctors in primary hospitals .METHODS Stratified sampling was used to research young doctors from 5 primary hospitals in Beijing .Totally 411 valid questionnaires were collected .The questionnaires were designed to investigate how well the young doctors knew about rational use of antibiotics .And medical records and prescrip‐tions of the 400 patients underwent respiratory tract infections were retrospectively analyzed .All data were ana‐lyzed by SPSS 19 .0 software .RESULTS The young doctors in primary hospitals knew little about precaution and combined use of antibiotics with the cognitive rate of only 30 .09% and 32 .85% .The cognition of drug sensitivity proved to be better with the rate of 77 .61% .About 70 .07% of them thought the reason of poor antibiotic efficacy was antibiotics and 52 .80% thought the antibiotic resistance of bacteria .Among the 400 prescriptions for respira‐tory tract infections ,about 86 .75% of them used antibiotics .Unreasonable application of antibiotics mainly con‐tained :the use of super expensive antibiotics ,unreasonable combination therapy ,over‐course drug use ,pharma‐cological antagonism , inappropriate solvent and repeated use of antibiotics and so on . CONCLUSION Young doctors in primary hospitals lack the knowledge about the use of antibiotics ,and unreasonable use of antibiotics is common to see .Young doctors should strengthen their professional ethics education and improve their professional knowledge level so that they can use antibiotics normatively and rationally .%目的:调查分析基层医院中青年医师对呼吸道感染性疾病抗菌药物合理应用情况,为提高基层医院中青年医师抗菌药物合理应用提供依据。方法采取分层抽样

  10. The Social Work Practice Doctorate (United States)

    Hartocollis, Lina; Cnaan, Ram A.; Ledwith, Kate


    This article provides a systematic review of the emerging practice doctorate in social work. Based on the experience of the first such Doctor of Social Work (DSW) program, we provide information regarding the program origins and rationale, development, current structure, and future direction. Such information will enrich the discussion on the role…

  11. Will Medical Technology Deskill Doctors? (United States)

    Lu, Jingyan


    This paper discusses the impact of medical technology on health care in light of the fact that doctors are becoming more reliant on technology for obtaining patient information, making diagnoses and in carrying out treatments. Evidence has shown that technology can negatively affect doctor-patient communications, physical examination skills, and…

  12. Talking to Your Child's Doctor (United States)

    ... a Better Relationship en español Cómo conversar con el médico de su hijo Your child's doctor can ... don't be afraid to give the doctor feedback about your office visit experience, such as whether ...

  13. 教学医院医患关系与医德医风评价研析%Analysis of Doctor-patient Relationship and Appraisal of Medical Ethics in Teaching Hospitals

    Institute of Scientific and Technical Information of China (English)



    Objective To research appraisal of medical ethics from medical personnel and patients. Methods Questionnaires are done to survey 306 patients and 266 doctors and patients through investigation by Epidata and statistical description and analysis by SPSS13.0. Results There are differences in medical personnel's service attitude, medical personnel's response to patients' needs, right of informed consent of respecting patients, medical cost, patients' respect and doctor-patient communication, etc. Conclusion Several aspects should be improved from the following aspects: improving the management system of medical ethics; focusing on education to enhance medical personnel's overall quality; focusing on the belief of medical ethics for medical students; changing medical ethics education mode; and improving the remuneration of medical personnel.%目的 调查医护人员医德自我评价和患者对医护人员医德评价.方法 对某教学医院306名患者、266名医护人员进行问卷调查,调查信息通过Epidata录入,使用SPSS13.0软件进行统计描述和分析.结果 在医护人员的服务态度、医护人员对患者需求的反应、尊重患者的知情同意权、医药费用问题、患者的信任、医患沟通等方面存在差异.结论 主要从以下几方面进行改善:完善医德医风管理制度;提高医护人员整体素质:注重对医学生医德信念的培养;转变医德医风的教育方式:提高医务人员的待遇.

  14. The perceptions of rural women doctors about their work | De Vries ...

    African Journals Online (AJOL)

    The perceptions of rural women doctors about their work. ... Results: The main theme was balance. ... reason for working at a rural hospital, attitudes to rural life, opportunities for personal and professional growth, the feeling of being needed in ...

  15. 英文医学试题选%Questions to Junior Doctors

    Institute of Scientific and Technical Information of China (English)



    @@ 1.A 63-year-old woman complains of abdominal discomfort,anorexia,and a 10-1b weight loss over a 3-month period.Endoscopy reveals a polypoid lesion in the gastric antrum.She is informed that she has "early gastric cancer":

  16. prevalence and correlates of job stress among junior doctors in the ...

    African Journals Online (AJOL)

    physical and emotional responses that occur when the requirements of the job do not ... settings reward long hours and self-neglect.5 Physicians ... There is growing interest in and awareness of the ..... Peter W, John C, Toby W. Scales for the.

  17. [Civil, criminal and ethical liability of medical doctors]. (United States)

    Udelsmann, Artur


    In the last years doctors have been the target of a growing number of civil, criminal law suits, as well as ethical procedures. Medicine is a widely targeted career, not only owing to its inherent risks, but also owing to a mistaken approach of the Judiciary Power about the obligations of medical doctors. Decisions of the Medical Board in ethical procedures have an impact in civil and criminal justice and therefore should be followed closely. The purpose of this review is to provide a wide view from a doctor-lawyer perspective of cases involving civil, criminal liability of anesthesiologists as well as ethical procedures against them, in an effort to make them comprehensible to doctors. After a brief historical introduction civil liability foundations and legal articles are examined. Responsibilities of doctors, hospitals and health insurance providers are discussed separately, as well as reparation mechanisms. Crimes possible to occur during medical practice and respective penalties are described; the direct relationship between crime and civil reparation is demonstrated. The administrative nature of ethical procedure is described, emphasizing that the legal character of its penalties often serve as grounds for civil and criminal justice decisions. Prevention is still the best medicine. Good medical practice and a good medical-patient relationship are still the best ways to minimize lawsuits and their repercussions. Doctors should have some knowledge of juridical mechanisms in lawsuits and ethical procedures, but should not take defense initiatives without prior consultation of an attorney. Civil, criminal and ethical liability of physicians.

  18. Ethical erosion in newly qualified doctors: perceptions of empathy decline. (United States)

    Stratta, Emily C; Riding, David M; Baker, Paul


    This study sought to understand whether UK Foundation doctors perceived the phenomena of ethical erosion and empathy decline during their initial period of clinical practice, and if so, why this occurred. This qualitative study used semi-structured interviews with nine doctors in their first year of clinical practice at Royal Bolton Hospital, UK. Participants were invited to discuss the definition of empathy, how individuals acquire and maintain empathic ability, perceptions of ethical erosion in the self and others, and how clinical experiences have influenced their empathic ability. The interviews were transcribed, and analysed to identify emergent themes. Each participant reported a conscious acknowledgement of empathy decline in their own and their colleagues' early clinical experiences as doctors. Stressful working environments, the prioritisation of patients' physical rather than psychological well-being, and the attitudes of senior colleagues were all suggested as possible causes. Some doctors believed that specialties with reduced patient contact had a culture which precluded empathy, and influenced their own practice. In addition, some described how their value judgements of patients had affected their ability to empathise. However, all doctors perceived that empathy skills were desirable in senior clinicians, and some believed that educational interventions may be useful in arresting ethical erosion. Newly qualified doctors are aware of ethical erosion in themselves and their colleagues as they begin clinical practice. This has serious implications for patient care. Improving working conditions may reverse this trend. Empathy skills training within undergraduate and postgraduate curricula may be a useful intervention.

  19. Dementia - what to ask your doctor (United States)

    What to ask your doctor about dementia; Alzheimer disease - what to ask your doctor; Cognitive impairment - what to ask your doctor ... who is losing or has lost their memory? What type of words should I use? What is ...

  20. Epilepsy - what to ask your doctor - adult (United States)

    What to ask your doctor about epilepsy - adult; Seizures - what to ask your doctor - adult; Seizure - what to ask your doctor ... call to find more information about driving and epilepsy? What should I discuss with my boss at ...

  1. Relative age effect in junior tennis (male

    Directory of Open Access Journals (Sweden)

    Adrián Agricola


    Full Text Available BACKGROUND: The issues of the age effect (the theory of the age influence have been shown in sport sciences since the 1980s. The theory of age effect works on the assumption that athletes born in the beginning of a calendar year are, particularly in children’s and junior age, more successful than athletes born in the end of the year. This fact has been proved by a number of research studies, mainly in ice hockey, soccer, and tennis but also in other sports. OBJECTIVE: The submitted contribution is aimed at verifying of the age effect in junior tennis. The research objective was to find out the distribution of birth date frequencies in a population of tennis players’ in individual months, quarters, and half-years in the observed period 2007–2011 and to check the significance of differences. METHODS: The research was conducted on male tennis players aged 13–14 (N = 239, participants of the World Junior Tennis Finals. From the methodological point of view, it was an intentional selection. The birth dates of individual tennis players were taken from official materials of the ITF, the research data were processed using Microsoft Excel. The personal data were processed with the approval of players and the hosting organization (ITF. RESULTS: Testing of the hypothesis on the significance of differences in the distribution of frequencies between individual quarters (Q1–Q4 has proved statistically relevant differences between Q1 and Q3, Q1 and Q4, Q2 and Q3, and Q2 and Q4; a statistically relevant difference has been also found in the distribution of frequencies between the first and second half of the year. On the basis of the results of the presented research, the age effect in the studied population of junior male tennis players can be regarded as significant. CONCLUSIONS: The results of the analysis of the research data confirm the conclusions of similar studies in other sports and prove that in the population of elite junior players

  2. Masculinity in the doctor's office: Masculinity, gendered doctor preference and doctor-patient communication. (United States)

    Himmelstein, Mary S; Sanchez, Diana T


    Mortality and morbidity data suggest that men have shorter life expectancies than women and outrank women on several leading causes of death. These gendered disparities may be influenced by psychosocial factors like masculinity. Three studies (Total N=546) examined the role of masculinity in men's doctor choices and doctor-patient interactions. In Studies 1 and 2, men completed measures of masculinity, gender bias, and doctor preference. Using structural equation modeling, we tested the direct relationship between masculinity and male doctor preference and the indirect relationship of masculinity on male doctor preference through an association with gendered competence stereotypes. Participants in Study 3 disclosed symptoms in private followed by disclosure to a male or female interviewer in a clinical setting. Using repeated measures analysis of variance (ANOVA), we examined the interaction among symptom reporting, masculinity and doctor gender, controlling for participant comfort. In Study 1, results suggested that masculinity encouraged choice of a male doctor directly and indirectly via beliefs that men make more competent doctors than women; Study 2 directly replicated the results of Study 1. In Study 3, independent of participant comfort, an interaction between interviewer gender and masculinity emerged such that men scoring higher on masculinity reported symptoms less consistently to male interviewers (relative to higher scoring men reporting to female interviewers); the reverse was found for men scoring low on masculinity. Taken together these studies suggest that masculinity may affect men's health by encouraging choice of a male doctor with whom doctor-patient communication may be impaired. Copyright © 2015 Elsevier Inc. All rights reserved.

  3. 湖南省乡镇卫生院精神疾病防治人员精神卫生知识知晓情况调查%Mental health knowledge among the mental disorders prevention and control doctors in township hospitals of Hunan Province

    Institute of Scientific and Technical Information of China (English)

    付文彬; 罗邦安; 刘学军; 谌良民


    目的:调查湖南省乡镇卫生院精神疾病防治人员的精神卫生知识知晓情况,为采取措施进一步提高其精神卫生服务能力提供科学参考依据。方法以参加培训班的乡镇卫生院精神疾病防治人员为研究对象,共发放问卷1700份,得到有效问卷1447份。采用卫生部推荐的精神卫生与心理保健知识问卷进行评估。结果湖南省乡镇卫生院精神疾病防治人员精神卫生知识总体知晓率为81.9%,平均得分为(16.40±2.13)分;错误率排在前3位的条目分别为“精神疾病就是思想上出了问题”(32.6%)、“有些人的性格不好,比较容易出现心理问题”(30.0%)、“绝大多数精神疾病是治不好的”(24.0%);4个国际节日中,世界预防自杀日和世界睡眠日的知晓率分别为30.1%、42.2%;不同性别、文化程度、职称、工作年限组之间的得分差异无统计学意义。结论湖南省乡镇卫生院精神疾病防治人员的精神卫生知识总体知晓率较高,但对部分条目的知晓率还需要进一步提高。%Objective To investigate mental health knowledge among the mental disorders preven‐tion and control doctors in township hospitals in Hunan ,and provide evidence for taking measures to im‐prove the mental health service ability .Methods The Mental Health Knowledge Questionnaire (MH‐KQ) was used to measure mental health knowledge among the mental disorders prevention doctors in township hospitals . A total of 1 447 doctors who participated training classes were assessed . Results The correct rate of mental health knowledge was 81 .9% ,the average score was (16 .40 ± 2 .13);er‐ror rate about items in the top three were“Is mental health a problem on the thought”(32 .6% );“Bad-tempered people are more likely to experience mental disorders (30 .0% )” ;“Most of mental disorders cannot be cured(24 .0% )” .The correct rate about

  4. Digital Curation and Doctoral Research

    Directory of Open Access Journals (Sweden)

    Daisy Abbott


    Full Text Available This article considers digital curation in doctoral study and the role of the doctoral supervisor and institution in facilitating students’ acquisition of digital curation skills, including some of the potentially problematic expectations of the supervisory relationship with regards to digital curation. Research took the form of an analysis of the current digital curation training landscape, focussing on doctoral study and supervision. This was followed by a survey (n=116 investigating attitudes towards importance, expertise, and responsibilities regarding digital curation. This research confirms that digital curation is considered to be very important within doctoral study but that doctoral supervisors and particularly students consider themselves to be largely unskilled at curation tasks. It provides a detailed picture of curation activity within doctoral study and identifies the areas of most concern. A detailed analysis demonstrates that most of the responsibility for curation is thought to lie with students and that institutions are perceived to have very low responsibility and that individuals tend to over-assign responsibility to themselves. Finally, the research identifies which types of support system for curation are most used and makes suggestions for ways in which students, supervisors, institutions, and others can effectively and efficiently address problematic areas and improve digital curation within doctoral study.

  5. Turning Doctors Into Employees

    Directory of Open Access Journals (Sweden)

    Matthew Anderson


    Full Text Available Background: Much of the contentious debate surrounding the Patient Protection and Affordable Care Act (“Obamacare” concerned its financing and its attempt to guarantee (near universal access to healthcare through the private insurance market.  Aside from sensationalist stories of “death panels,” much less attention went to implications of the bill for the actual provision of healthcare. Methodology: This paper examines the "patient-centered medical home" (PCMH model which has been widely promoted as a means of reviving and improving primary care (i.e. general internal medicine, family medicine, and pediatrics. Argument: The PCMH and many of its components (e.g pay-for-performance, electronic medical records were interventions that were implemented on a massive basis without any evidence of benefit. Recent research has not generally supported clinical benefits with the PCMH model. Instead it seems to designed to de-professionalize (make proletarians of health care workers and enforce corporate models of health. The core values of professional work are undermined while the PCMH does nothing to address the structural marginalization of primary care within US health care. Conclusions: The development of alternative models will require political changes. Both doctors and teachers are in a position of advocate for more progressive systems of care and education.

  6. Doctor-patient relationships (DPR) in China. (United States)

    Ma, Shaozhuang; Xu, Xuehu; Trigo, Virginia; Ramalho, Nelson J C


    Purpose The purpose of this paper is twofold: first, to develop and test theory on how commitment human resource (HR) practices affect hospital professionals' job satisfaction that motivates them to generate desirable patient care and subsequently improve doctor-patient relationships (DPR) and second, to examine how commitment HR practices influence hospital managers and clinicians in different ways. Design/methodology/approach Using a cross-sectional survey, the authors collected data from 508 clinicians and hospital managers from 33 tertiary public hospitals in China. Structural equation model was employed to test the relationships of the variables in the study. Findings Commitment HR practices positively affect the job satisfaction of the healthcare professionals surveyed and a positive relationship is perceived between job satisfaction and DPR. Overall, the model shows a reversal on the strongest path linking job satisfaction and DPR whereby managers' main association operates through extrinsic job satisfaction while for clinicians it occurs through intrinsic satisfaction only. Practical implications DPR might be improved by applying commitment HR practices to increase healthcare professional's intrinsic and extrinsic satisfaction. In addition, while recognizing the importance of compensation and benefits to address the underpayment issue of Chinese healthcare professionals, empowerment and autonomy in work, and the use of subjects' expertise and skills may serve as stronger motivators for clinicians rather than hard economic incentives in achieving DPR improvements. Originality/value This study contributes to the small but growing body of research on human resource management (HRM) in the healthcare sector with new evidence supporting the link between commitment HR practice and work attitudes, as well as work attitudes and patient care from the perspective of clinicians and hospital managers. This study represents an initial attempt to examine the associations

  7. [Academician Li Lianda talking about doctors doing scientific research]. (United States)

    He, Ping; Li, Yi-kui


    At present, Chinese medical field faces with an important problem of how to correctly handle the relationship between medical and scientific research. Academician Li Lianda advocates doctors doing scientific research under the premise of putting the medical work first. He points out that there are many problems in the process of doctors doing scientific research at present such as paying more attention to scientific research than medical care, excessively promoting building scientific research hospital, only paying attention to training scientific talents, research direction be flashy without substance, the medical evaluation system should be improved and so on. Medical, scientific research and teaching are inseparable because improving medical standards depends on scientific research and personnel training. But not all doctors need to take into account of medical treatment, scientific research and teaching in the same degree while not all hospitals need to turn into three-in-one hospital, scientific research hospital or teaching hospital. It must be treated differently according to the actual situation.

  8. Cultures of resistance? A Bourdieusian analysis of doctors' antibiotic prescribing. (United States)

    Broom, Alex; Broom, Jennifer; Kirby, Emma


    The prospect of an 'antimicrobial perfect storm' in the coming decades through the emergence and proliferation of multi-resistant organisms has become an urgent public health concern. With limited drug discovery solutions foreseeable in the immediate future, and with evidence that resistance can be ameliorated by optimisation of prescribing, focus currently centres on antibiotic use. In hospitals, this is manifest in the development of stewardship programs that aim to alter doctors' prescribing behaviour. Yet, in many clinical contexts, doctors' antibiotic prescribing continues to elude best practice. In this paper, drawing on qualitative interviews with 30 Australian hospital-based doctors in mid-2013, we draw on Bourdieu's theory of practice to illustrate that 'sub-optimal' antibiotic prescribing is a logical choice within the habitus of the social world of the hospital. That is, the rules of the game within the field are heavily weighted in favour of the management of immediate clinical risks, reputation and concordance with peer practice vis-à-vis longer-term population consequences. Antimicrobial resistance is thus a principal of limited significance in the hospital. We conclude that understanding the habitus of the hospital and the logics underpinning practice is a critical step toward developing governance practices that can respond to clinically 'sub-optimal' antibiotic use.

  9. Dating With Super Junior-M

    Institute of Scientific and Technical Information of China (English)


    担心情人节没人陪?还在幻想能与谁约会?2009年2月14日,梦想照进现实,SJ-M将在上海举办“情人Superman-Super Junior-M 2009上海歌会”,化身你的甜蜜情人,与你一起共度浪漫情人节。

  10. Doctor, Clinic, and Dental Visits (United States)

    ... Viral Suppression Doctor, Clinical & Dental Visits Treatment Adherence Mental Health Substance Abuse Issues Sexual Health Nutrition & Food Safety Exercise Immunizations Aging with HIV/AIDS Women’s Health Housing ...

  11. Questions to Ask Your Doctor (United States)

    ... to MBCN Contact Us Questions to ask your doctor Medical appointments can be stressful. To better deal ... for you. If diagnosed by your primary care physician Where do you send your metastatic patients for ...

  12. Moral distress among Norwegian doctors. (United States)

    Førde, R; Aasland, O G


    Medicine is full of value conflicts. Limited resources and legal regulations may place doctors in difficult ethical dilemmas and cause moral distress. Research on moral distress has so far been mainly studied in nurses. To describe whether Norwegian doctors experience stress related to ethical dilemmas and lack of resources, and to explore whether the doctors feel that they have good strategies for the resolution of ethical dilemmas. Postal survey of a representative sample of 1497 Norwegian doctors in 2004, presenting statements about different ethical dilemmas, values and goals at their workplace. The response rate was 67%. 57% admitted that it is difficult to criticize a colleague for professional misconduct and 51% for ethical misconduct. 51% described sometimes having to act against own conscience as distressing. 66% of the doctors experienced distress related to long waiting lists for treatment and to impaired patient care due to time constraints. 55% reported that time spent on administration and documentation is distressing. Female doctors experienced more stress that their male colleagues. 44% reported that their workplace lacked strategies for dealing with ethical dilemmas. Lack of resources creates moral dilemmas for physicians. Moral distress varies with specialty and gender. Lack of strategies to solve ethical dilemmas and low tolerance for conflict and critique from colleagues may obstruct important and necessary ethical dialogues and lead to suboptimal solutions of difficult ethical problems.

  13. Healthy Doctors – Sick Medicine

    Directory of Open Access Journals (Sweden)

    Olaf Gjerløw Aasland


    Full Text Available Doctors are among the healthiest segments of the population in western countries. Nevertheless, they complain strongly of stress and burnout. Their own explanation is deprofessionalisation: The honourable art of doctoring has been replaced by standardised interventions and production lines; professional autonomy has withered. This view is shared by many medical sociologists who have identified a “golden age of medicine,” or “golden age of doctoring,” starting after World War II and declining around 1970. This article looks at some of the central sociological literature on deprofessionalisation, particularly in a perspective of countervailing powers. It also looks into another rise-and-fall model, proposed by the medical profession itself, where the fall in professional power was generated by the notion that there are no more white spots to explore on the map of medicine. Contemporary doctoring is a case of cognitive dissonance, where the traditional doctor role seems incompatible with modern health care.Keywords: deprofessionalisation, professional autonomy, cognitive dissonance, golden age of doctoring

  14. Ethics and professional development: a primer for doctors in training

    Directory of Open Access Journals (Sweden)

    Jammula P. Patro


    Full Text Available While dealing with colleagues, patients and relatives of patients, doctors have to practice ethical behavior. This paper describes some basics on etiquette, ethics, people management skills, team work, politeness, etc which will give doctors 3 C's: Competence, Confidence and Compassion, which in turn will enable doctors ascend rapidly in health care organizations. It is suggested that principles of etiquette and ethics be acquired by medical students while in training itself so that they can implement them and use them from day one in the hospital they join. Whether these principles should be part of medical curriculum is a matter to be decided by appropriate authorities. [Int J Res Med Sci 2016; 4(5.000: 1778-1782

  15. A Study of the 1968 Graduates of Manatee Junior College. (United States)

    Stivers, Earl R.

    This study of the 1968 graduates of Manatee Junior College, Florida, showed that: (1) it is not necessary to be in the top 40% of grade 12 to succeed in junior college, (2) students in the lowest percentiles at entrance can earn a degree, (3) the average candidate for a degree should expect to spend more than four terms at the junior college, (4)…

  16. Fully leverage the role of hospital journal, establish a bridge between patients and doctors%充分发挥院报作用建立医患沟通桥梁

    Institute of Scientific and Technical Information of China (English)

    陈秀春; 刘丽娜; 吴鹏; 杨蕊; 刘斯; 周蕊


    This article gives an introduction of the hospital’s experiences and methods in issuing its journals. A corresponding team is organized to actively retrieve information, thus ensuring the sufifciency of journal article resource;Emphasis is laid on layout design to create a popular journal in the public;opinions and suggestions from different levels are taken seriously as to raise the quality of the journal;the latest situation is highlighted in each journal’s planning;publishing of the journal is carried out in a multi-channel way to widely propagandize the image of the hospital and disseminate health knowledge;positive and upward spirit is carried forward through the inclusion of humanity essays. The hospital has promoted its culture establishment and development though the publishing of hospital journals.%介绍了该院创办院报的经验及其做法,即通过组建通讯员队伍动态地获取信息并保证稿源充足;重视其版面设计从而打造老百姓喜闻乐见的健康读物;倾听不同层面的意见和建议提高了办报质量;每期都结合形势进行重点策划;多渠道开展院报发行工作,从而广泛宣传医院形象及传播健康知识;通过推出人文精品文章以弘扬积极向上的精神,该院通过创办院报促进了其医院文化的建设和发展。

  17. [Contamination of workwear in medical doctors and nursing stuff]. (United States)

    Lenski, M; Scherer, M A


    The hands of medical stuff are the most important vectors for the transmission of pathogens in the hospital. Furthermore a "bare below the elbows dress code" has been introduced in Great Britain. Aim of this study was to investigate whether workwear contamination of the medical stuff by pathogens is similar to the contamination of their hands and whether wearing workwear is associated with increased transmission risk. In total 54 swabs were collected from nursing stuff, medical doctors, patients and hospital work material. Patients had a statistically significant more dense colonization with bacteria (median = 73 colony-forming units (CFU)), than the sleeves of the doctor's coat (median = 36 CFU, p = 0,005), followed by workwear of the nursing stuff at the end of a shift (median = 23 CFU, p < 0,001) and the hospital work material (median = 15 CFU, p < 0,001). Isolated pathogens were coagulase-negative staphylococci, Staphylococcus aureus, Enterobacter cloacae and Acinetobacter species. Contaminated work wear presents a relevant risk for the transmission of pathogens. A "bare below the elbow dress-code" or the daily change of the doctor's coat appear both to represent reasonable measures to reduce the transmission risk of pathogens in hospitals.

  18. Cruise ship's doctors - company employees or independent contractors? (United States)

    Dahl, Eilif


    Traditionally, cruise companies have stated that they are in the transport business but not in the business of providing medical services to passengers. They have claimed not to be able to supervise or control the ship's medical personnel and cruise ship's doctors have therefore mostly been signed on as independent contractors, not employees. A United States court decision from 1988, Barbetta versus S/S Bermuda Star, supported this view and ruled that a ship's owner cannot be held vicariously liable for the negligence of the ship's doctor directed at the ship's passengers. Some years ago a cruise passenger fell and hit his head while boarding a trolley ashore. Hours later he was seen aboard by the ship's doctor, who sent him to a local hospital. He died 1 week later, and his daughter filed a complaint alleging the cruise company was vicariously liable for the purported negligence of the ship's doctor and nurse, under actual or apparent agency theories. A United States district court initially dismissed the case, but in November 2014 the United States Court of Appeals for the Eleventh Circuit disagreed and reversed. From then on independently contracted ship's doctors may be considered de facto employees of the cruise line. The author discusses the employment status of physicians working on cruise ships and reviews arguments for and against the Appellate Court's decision.

  19. Doctors' strikes and mortality: a review. (United States)

    Cunningham, Solveig Argeseanu; Mitchell, Kristina; Narayan, K M; Yusuf, Salim


    A paradoxical pattern has been suggested in the literature on doctors' strikes: when health workers go on strike, mortality stays level or decreases. We performed a review of the literature during the past forty years to assess this paradox. We used PubMed, EconLit and Jstor to locate all peer-reviewed English-language articles presenting data analysis on mortality associated with doctors' strikes. We identified 156 articles, seven of which met our search criteria. The articles analyzed five strikes around the world, all between 1976 and 2003. The strikes lasted between nine days and seventeen weeks. All reported that mortality either stayed the same or decreased during, and in some cases, after the strike. None found that mortality increased during the weeks of the strikes compared to other time periods. The paradoxical finding that physician strikes are associated with reduced mortality may be explained by several factors. Most importantly, elective surgeries are curtailed during strikes. Further, hospitals often re-assign scarce staff and emergency care was available during all of the strikes. Finally, none of the strikes may have lasted long enough to assess the effects of long-term reduced access to a physician. Nonetheless, the literature suggests that reductions in mortality may result from these strikes.

  20. Study on value of Extended-Focused Abdominal Scan For Trauma (e-FAST performed by non-radiologist emergency care doctors in Management of Trauma at Emergency Trauma Centre, Teaching Hospital, Karapitiya,Galle, Sri Lanka

    Directory of Open Access Journals (Sweden)

    Seneviratne RW


    Full Text Available Background This study was designed to evaluate the accuracy and usefulness of ultrasound in the hands of emergency physicians and medical officers who are non-radiologistsin assessing Trauma patients at Emergency Trauma Centre(ETC at Teaching Hospital, Karapitiya, Galle, Sri Lanka Methodology We performed an observational study on Trauma patients admitted to Emergency Department at Teaching Hospital, Karapitiya from 1.12.2014 to 31.12.2014 who fulfilled indications for e-FAST using a specially designed performa. Accuracy of eFAST was tested by comparing the original with subsequent imaging, clinical decision by surgeons, findings at surgery or more than one of the above. Results 69 patients fulfilled the entry criteria.Nineteen of the scans were performed by consultants while rest was done by senior medical officers. All of them were trained in eFAST. Of the 20 scans which were positive there were four pneumothoraxes and one haemothorax. 15 scans which were positive for intraperitoneal free fluid were later. Out of 49 Patients who had negative scans 47 did not require surgery or any interventions. Other two required laparotomy later. Sensitivity and specificity ofeFast was 90.4% and 97.9% respectively. Positive predictive value was 95.0% while Negative predictive value was at 95.9% . Conclusions eFAST is a rapidand reliable alternative in detecting free intra-abdominal fluid as well as pneumotorax and haemothorax. It is a safe decision making tool which can be used with confidence and accuracy after brief training and experience by non radiologists which will reduce morbidity and mortality in trauma patients of Sri Lanka.

  1. Learning through inter- and intradisciplinary problem solving: using cognitive apprenticeship to analyse doctor-to-doctor consultation. (United States)

    Pimmer, Christoph; Pachler, Norbert; Nierle, Julia; Genewein, Urs


    Today's healthcare can be characterised by the increasing importance of specialisation that requires cooperation across disciplines and specialities. In view of the number of educational programmes for interdisciplinary cooperation, surprisingly little is known on how learning arises from interdisciplinary work. In order to analyse the learning and teaching practices of interdisciplinary cooperation, a multiple case study research focused on how consults, i.e., doctor-to-doctor consultations between medical doctors from different disciplines were carried out: semi-structured interviews with doctors of all levels of seniority from two hospital sites in Switzerland were conducted. Starting with a priori constructs based on the 'methods' underpinning cognitive apprenticeship (CA), the transcribed interviews were analysed according to the principles of qualitative content analysis. The research contributes to three debates: (1) socio-cognitive and situated learning, (2) intra- and interdisciplinary learning in clinical settings, and (3), more generally, to cooperation and problem solving. Patient cases, which necessitate the cooperation of doctors in consults across boundaries of clinical specialisms, trigger intra- as well as interdisciplinary learning and offer numerous and varied opportunities for learning by requesting doctors as well as for on-call doctors, in particular those in residence. The relevance of consults for learning can also be verified from the perspective of CA which is commonly used by experts, albeit in varying forms, degrees of frequency and quality, and valued by learners. Through data analysis a model for collaborative problem-solving and help-seeking was developed which shows the interplay of pedagogical 'methods' of CA in informal clinical learning contexts.

  2. Clown doctors: shaman healers of Western medicine. (United States)

    Van Blerkom, L M


    The Big Apple Circus Clown Care Unit, which entertains children in New York City hospitals, is compared with non-Western healers, especially shamans. There is not only superficial resemblance--weird costumes, music, sleight of hand, puppet/spirit helpers, and ventriloquism--but also similarity in the meanings and functions of their performances. Both clown and shaman violate natural and cultural rules in their performances. Both help patient and family deal with illness. Both use suggestion and manipulation of medical symbols in attempting to alleviate their patients' distress. Just as traditional ethnomedical systems have been integrated with Western medicine in other societies, clown doctors can provide complementary therapy that may enhance the efficacy of medical treatment in developed nations, particularly for children.

  3. Differentiated correction of junior school age children’s posture at physical culture trainings

    Directory of Open Access Journals (Sweden)

    Razumeiko N.S.


    Full Text Available Purpose: to show peculiarities of differentiated correction of junior school age children’s posture, considering tonic vibration reflex. Material: the research was conducted with participation of 62 junior school age children (7-10 years old boys and girls. All children have no sport training experience. All children were preliminary examined by qualified medical doctors. Tonic vibration reflex of lumbar spine was registered. Children fulfilled test exercises, which characterized power endurance of abdomen muscles, side of torso and back muscles. Results: external signs of posture disorders were absent in frontal plane. In 35 persons (65.8% we registered one-side increased reflex excitability of nervous centers: from right side of backbone - in 28 children (72%; from the left side in 17 children (28%. Correction of posture with the help of correcting exercises can give steady effect only with simultaneous formation of correct posture habit. For this purpose it is necessary to create muscular-joint sense of separate body parts’ position. Conclusions: for determination of functional potentials of in-born muscular corset it is recommended to fulfill special test exercises. For local influence on lumbar spine muscles it is recommended to use exercise of asymmetric character.

  4. Training generalist doctors for rural practice in New Zealand. (United States)

    Nixon, Garry; Blattner, Katharina; Williamson, Martyn; McHugh, Patrick; Reid, James


    Targeted postgraduate training increases the likelihood young doctors will take up careers in rural generalist medicine. This article describes the postgraduate pathways that have evolved for these doctors in New Zealand. The Cairns consensus statement 2014 defined rural medical generalism as a scope of practice that encompasses primary care, hospital or secondary care, emergency care, advanced skill sets and a population-based approach to the health needs of rural communities. Even as work goes on to define this role different jurisdictions have developed their own training pathways for these important members of the rural healthcare workforce. In 2002 the University of Otago developed a distance-taught postgraduate diploma aimed at the extended practice of rural general practitioners (GPs) and rural hospital medical officers. This qualification has evolved into a 4-year vocational training program in rural hospital medicine, with the university diploma retained as the academic component. The intentionally flexible and modular nature of the rural hospital training program and university diploma allow for a range of training options. The majority of trainees are taking advantage of this by combining general practice and rural hospital training. Although structured quite differently the components of this combined pathway looks similar to the Australian rural generalist pathways. There is evidence that the program has had a positive impact on the New Zealand rural hospital medical workforce.

  5. Knowledge of medical doctors in Turkey about the relationship between periodontal disease and systemic health. (United States)

    Taşdemir, Zekeriya; Alkan, Banu Arzu


    Understanding the relationship between periodontal disease (PD) and systemic health (SH) is necessary for the accurate diagnosis and treatment of both. The aim of this study was to evaluate the knowledge of medical doctors in Turkey with regard to the association between PD and SH. This study was carried out using self-reported questionnaires that were sent to medical doctors who work at various universities and public and private hospitals in different cities in Turkey. The questionnaires consisted of questions about the demographic information of the medical doctors, as well as the knowledge of those doctors about the relationship between PD and SH. In total, 1,766 responses were received and 90.8% of the participants agreed that there was a relationship between PD and SH. Diabetes mellitus was the most frequent systemic disease (66.8%) known to be related to PD. Of the participants, 56.5% of the medical doctors referred their patients to periodontists for different reasons. Gingival bleeding was the most frequent reason for patient referrals, with 44% of doctors giving such referrals. Doctors who worked in basic medical sciences were significantly less aware of the relationship between PD and SH than the doctors in other specialties. Although the vast majority of the medical doctors reported that they knew the relationship between PD and SH, the findings of this study showed that this awareness was not supported by precise knowledge, and often failed to translate into appropriate clinical practice.

  6. Teaching Prescribing: Just What the Doctor Ordered? A Thematic Analysis of the Views of Newly Qualified Doctors

    Directory of Open Access Journals (Sweden)

    Christina R. Hansen


    Full Text Available Undergraduate medical education has been criticised for failing to adequately prepare doctors for the task of prescribing. Pharmacists have been shown to improve medication use in hospitals. This study aims to elicit the views of intern doctors on the challenges of prescribing, and to suggest changes in education to enhance prescribing practice and potential role of the pharmacist. Semi-structured, qualitative interviews were conducted with intern doctors in their first year post qualification in an Irish hospital. Data collection was conducted until no new themes emerged and thematic analysis was performed. Thirteen interviews took place. Interns described training in practical prescribing as limited and felt the curriculum failed to convey the reality of actual prescribing. Pharmacists were perceived to be a useful, but underutilised, information source in the prescribing process. They requested an earlier introduction, and repeated exposure, to prescribing, and suggested the involvement of peers and pharmacists in this teaching. Intern doctors reported difficulties in applying knowledge gained in medical school to clinical practice. New strategies are needed to enhance the clinical relevance of the medical curriculum by rethinking the learning outcomes regarding prescribing practice and the involvement of pharmacists in prescribing education.


    Osuoji, Roland I; Adebanji, Atinuke; Abdulsalam, Moruf A; Oludara, Mobolaji A; Abolarinwa, Abimbola A


    This study examined medical specialty selection by Nigerian resident doctors using a marketing research approach to determine the selection criteria and the role of perceptions, expected remuneration, and job placement prospects of various specialties in the selection process. Data were from the Community of residents from April 2014 to July 2014. The cohort included 200 residents, but only 171 had complete information. Data were obtained from a cross section of resident doctors in the Lagos State University Teaching Hospital and at the 2014 Ordinary General Meeting of the National Association of Resident Doctors(NARD) where representatives from over 50 Teaching hospitals in Nigeria attended. Using a client behaviour model as a framework, a tripartite questionnaire was designed and administered to residents to deduce information on their knowledge about and interests in various specialties, their opinions of sixteen specialties, and the criteria they used in specialty selection. A total of 171 (85.5%) questionnaires were returned. ln many instances, consistency between selection criteria and perceptions of a specialty were accompanied by interest in pursuing the specialty. Job security, job availability on completion of programme, duration of training and qualifying examinations were highly correlated with p value training and practice related variables loaded on it while the second component was loaded with job security and financial remuneration related variables. Using marketing research concepts for medical specialty selection (Weissmanet al 2012) stipulates that choice of speciality is influenced by criteria and perception. This study shows that job security expected financial remuneration, and examination requirements for qualification are major determinants of the choice of speciality for residents.

  8. Doctoral research on cadastral development

    DEFF Research Database (Denmark)

    Cagdas, Volkan; Stubkjær, Erik


    . The article focuses on the methodological aspect of doctoral research by analyzing ten doctoral dissertations. Our analysis is based on a taxonomy of methodological elements and aims at identifying commonalities and differences among the dissertations in the use of concepts and methods. Having completed......The multitude of rights in land and the recording of these rights are addressed by a number of studies, yet a recognized paradigm for such studies seems missing. Rights in land are recorded and managed through either cadastral systems or land administration systems depending on the legal system...... of cadastral development. This research is multi-disciplinary and draws on elements of theories and methodologies from the natural, the social, the behavioral, and the formal sciences. During the last decade or so, doctoral dissertations have come to constitute a substantial part of this research effort...

  9. [The clown doctor: an introduction]. (United States)

    Rösner, M


    In the literature, increasing numbers of practitioners have reported their experience using clown doctors in geriatric settings. The reports agree on the positive effects on persons with dementia and also on their caregivers. However, empirical studies on its effectiveness are rare. This article presents the field of activity of a clown doctor in geriatric settings as well as an overview of current scientific research on the topic and the effects on persons with dementia and nursing staff. It will be become clear that the clown doctor is a supporting therapeutic intervention. Through the clown representation, it is possible to obtain access to and interact with a person with dementia, thus, maintaining social contact of the patient with his/her environment. This effect leads to an increase of well-being and contributes to a reduction of problematic behavior. In addition to reduced workload and relief for the nursing staff, it has a positive effect on the working atmosphere.

  10. Learning Dynamics in Doctoral Supervision

    DEFF Research Database (Denmark)

    Kobayashi, Sofie

    This doctoral research explores doctoral supervision within life science research in a Danish university. From one angle it investigates doctoral students’ experiences with strengthening the relationship with their supervisors through a structured meeting with the supervisor, prepared as part...... investigates learning opportunities in supervision with multiple supervisors. This was investigated through observations and recording of supervision, and subsequent analysis of transcripts. The analyses used different perspectives on learning; learning as participation, positioning theory and variation theory....... The research illuminates how learning opportunities are created in the interaction through the scientific discussions. It also shows how multiple supervisors can contribute to supervision by providing new perspectives and opinions that have a potential for creating new understandings. The combination...

  11. Solo doctors and ethical isolation. (United States)

    Cooper, R J


    This paper uses the case of solo doctors to explore whether working in relative isolation from one's peers may be detrimental to ethical decision-making. Drawing upon the relevance of communication and interaction for ethical decision-making in the ethical theories of Habermas, Mead and Gadamer, it is argued that doctors benefit from ethical discussion with their peers and that solo practice may make this more difficult. The paper identifies a paucity of empirical research related to solo practice and ethics but draws upon more general medical ethics research and a study that identified ethical isolation among community pharmacists to support the theoretical claims made. The paper concludes by using the literary analogy of Soderberg's Doctor Glas to illustrate the issues raised and how ethical decision-making in relative isolation may be problematical.

  12. Research on the relationship for perceptions of payment fairness to job satisfaction and turnover intention of ;doctors in public hospitals%公立医院医师薪酬公平感与工作满意度、离职倾向的关系研究

    Institute of Scientific and Technical Information of China (English)

    于倩倩; 尹文强; 黄冬梅; 孙葵; 魏艳


    目的:分析不同级别公立医院、不同收入医师的工作满意度、离职倾向及收入分配现状,探讨薪酬公平感对医师工作满意度、离职倾向的预测能力。方法:利用医师薪酬公平感量表、工作满意度量表及离职倾向量表,对山东省三地市1910名公立医院医师实施调查,采用描述、相关分析及层次回归分析等分析资料。结果:医师薪酬公平感均分(2.75±1.10)分;工作满意度均分(3.12±0.85)分;离职倾向均分(2.23±1.03)分。薪酬公平感对医师工作满意度、离职倾向分别具有明显的正负向预测作用,分别解释变异的26.3%和11.6%。结论:薪酬公平感是医师工作满意度和稳定性的重要影响因素,但目前基层医疗机构、低收入医师薪酬公平感较低。设计医师薪酬制度时需了解医师报酬与付出的职业心态,体现其技术劳务价值。%Objective:To analyze the job satisfaction,turnover intention and the current situation of doctors’ income distribution of different hospitals and at different income levels,and to explore predictive ability of perceptions of payment fairness to doctors’ job satisfaction and turnover intention. Methods:Perceptions of payment scale,job satisfaction scale and turnover intention scale were used and 1 910 doctors from three cities in Shandong Province were investigated. Descriptive analysis,correlation analysis and hierarchical regression analysis were used to analyze the data. Results:The average score of fairness payment perceptions was(2.75±1.10)points;the average score of job satisfaction was(3.12±0.85)points;the average score of turnover intention was(2.23±1.03)points. Perceptions of payment fairness for doctors to job satisfaction and turnover intention were obvious positive and negative predictive;the explained variance was 26.3%and 11.6%,respectively. Conclusion:Perceptions of payment fairness is an important factor of job

  13. 海南三甲医院医护人员慢性疲劳与睡眠质量相关分析%Correlation analysis on chronic fatigue and sleep quality of doctors and nurses in third-grade class-A hospital of Hainan Province

    Institute of Scientific and Technical Information of China (English)

    高允锁; 王小丹; 杨威科


    目的 了解海南省三甲医院医护人员慢性疲劳现况及其与睡眠质量的关系,为早期诊断慢性疲劳和寻找有效的预防措施提供科学依据.方法 采用横断面研究的方法,用多级随机抽样的方法抽取1 042名医护人员,用疲劳量表14(FS-14)和睡眠质量量表(PSQI)进行测评.结果 FS-14总平均得分为(7.43±3.04)分,慢性疲劳的发生率为38.77%(404/1042),躯体疲劳得分(4.79±2.31)分,脑力疲劳得分(2.63±1.40)分;躯体疲劳、脑力疲劳、疲劳总分与PSQI各因子分的相关分析表明,均呈正相关,其差异有统计学意义(r=0.22~0.43,P<0.05);多重线回归分析表明,日间功能障碍、睡眠障碍、睡眠效率、睡眠质量与疲劳呈正相关.结论 医护人员慢性疲劳与睡眠质量有关,睡眠质量越低,慢性疲劳程度越高.所以应保证医护人员的充足睡眠,以提高工作效率.%[Objective] To understand the relationship between chronic fatigue and sleep quality of doctors and nurses in thirdgrade class-A hospital of Hainan Province,provide scientific basis for the early diagnosis and effective prevention of chronic fatigue.[Methods] With the cross-sectional study,1042 doctors and nurses were collected by the multistage random sampling,and were assessed by the Fatigue scale-14 (FS-14) and Pittsburgh sleep quality index (PSQI).[Results] The total scores of FS-14 was (7.43±3.04),the incidence of chronic fatigue was 38.77% (404/1 042),and the scores of body fatigue and mental fatigue was (4.79±2.31) and (2.63±1.40) respectively.The body fatigue scores,mental fatigue scores and total scores of FS-14 were positively correlated with the PSQI factor scores,and the differences were statistically significant (r=0.22-0.43,P<0.05).The multiple linear regression analysis showed that the daytime dysfunction,sleep disorders,sleep efficiency,sleep quality were positively correlated with the fatigue.[Conclusion] The chronic fatigue is correlated

  14. [Analyzing the attributes of surgeons and working environment required for a successful career path and work-life balance: results of a survey administered to doctors working at Kyoto University Hospital]. (United States)

    Okoshi, Kae; Tanabe, Tomoko; Hisamoto, Norio; Sakai, Yoshiharu


    We conducted a survey in March 2010 of all physicians at Kyoto University Hospital on working environments, levels of satisfaction, and level of exhaustion. A comparison of surgeons with other physicians showed tendencies among surgeons toward longer working hours and lower income. The findings indicated that surgeons experienced satisfaction from teamwork with fellow physicians, opportunities to manage interesting cases, and patient gratitude. Surgeons tended to have low fatigue level and were satisfied with their working environments, despite their low wages and long working hours. Although surgical treatment is currently built upon the feelings of accomplishment and satisfaction of individual surgeons, there is always a limit to his/her psychological strength. Indeed, the number of young surgeons is not increasing. In the future, efforts must be taken to prevent the departure of currently practicing surgeons. Consideration must also be given to reducing nonsurgical duties by increasing the numbers of medical staff, and making work conditions more appealing to young surgeons by guaranteeing income and prohibiting long working hours, particularly consecutive working hours.

  15. Multiple Intelligences Profiles of Junior Secondary School Students in Indonesia (United States)

    Emmiyati, Nuri; Rasyid, Muhammad Amin; Rahman, M. Asfah; Arsyad, Azhar; Dirawan, Gufran Darma


    This study aimed to investigate the Multiple Intelligences profiles of the students at junior secondary school in Makassar. The Multiple Intelligences Inventory was used to identify the dominant intelligence among the students. The sample of this research was 302 junior secondary schools students in Makassar Indonesia who willing to participated…

  16. Sexuality Education in Junior High Schools in Japan (United States)

    Hashimoto, N.; Shinohara, H.; Tashiro, M.; Suzuki, S.; Hirose, H.; Ikeya, H.; Ushitora, K.; Komiya, A.; Watanabe, M.; Motegi, T.; Morioka, M.


    This paper aims to determine via responses to three questionnaire surveys how sexuality education programs are conducted at junior high schools in Japan. Study 1 examined the practice of sexuality education in schools, Study 2 investigated junior high school students' (age 12-13 and 14-15 years) knowledge of sexuality, and Study 3 examined…

  17. Interest Learning about English in Junior Middle School

    Institute of Scientific and Technical Information of China (English)

    XU Shi-qin


    In modern time, interest learning play a more and more important role in the children’study. So the paper plays a key on the interest learning in junior middle school. And the paper mainly explores theoretical research, the reason of interest learning and the way to motivate junior middle students’interest learning in English learning.

  18. General Education in Occupational Education Programs Offered by Junior Colleges. (United States)

    Wiegman, Robert R.

    This report, directed toward junior college board members, presidents, deans, department heads, and teachers, as well as legislators, attempts to stimulate thought and action to improve general education in occupational programs offered by junior colleges. Following a review of the unsatisfactory status of present curricula, a rationale and…

  19. Practices and attitudes of doctors and patients to downward referral in Shanghai, China (United States)

    Yu, Wenya; Li, Meina; Nong, Xin; Ding, Tao; Ye, Feng; Liu, Jiazhen; Dai, Zhixing; Zhang, Lulu


    Objectives In China, the rate of downward referral is relatively low, as most people are unwilling to be referred from hospitals to community health systems (CHSs). The aim of this study was to explore the effect of doctors' and patients' practices and attitudes on their willingness for downward referral and the relationship between downward referral and sociodemographic characteristics. Methods Doctors and patients of 13 tertiary hospitals in Shanghai were stratified through random sampling. The questionnaire surveyed their sociodemographic characteristics, attitudes towards CHSs and hospitals, understanding of downward referral, recognition of the community first treatment system, and downward referral practices and willingness. Descriptive statistics, χ2 test and stepwise logistic regression analysis were employed for statistical analysis. Results Only 20.8% (161/773) of doctors were willing to accept downward referrals, although this proportion was higher among patients (37.6%, 326/866). Doctors' willingness was influenced by education, understanding of downward referral, and perception of health resources in hospitals. Patients' willingness was influenced by marital status, economic factors and recognition of the community first treatment system. Well-educated doctors who do not consider downward referral would increase their workloads and those with a more comprehensive understanding of hospitals and downward referral process were more likely to make a downward referral decision. Single-injury patients fully recognising the community first treatment system were more willing to accept downward referral. Patients' willingness was significantly increased if downward referral was cost-saving. A better medical insurance system was another key factor for patients to accept downward referral decisions, especially for the floating population. Conclusions To increase the rate of downward referral, the Chinese government should optimise the current referral system and

  20. 从美国医师、医院、医保机构的制约关系探讨我国医药费用控制%Discussion on Medical Costs Control in China from the Perspective of the Relationship among Doctors, Hospitals and Health Insurance Institutions in the United States

    Institute of Scientific and Technical Information of China (English)

    宗毛毛; 尤晓敏; 赵瑞; 袁丽; 杨悦


    目的:为我国医药费用的控制提供参考。方法:运用信息不对称与委托代理、弗里德曼的消费理论,结合美国医疗卫生服务体系的主要特点,分析美国医师、医院、医保机构三者之间均衡的制约关系在控制医药费用和提高诊疗质量方面的优势;同时比较我国与美国在医药费用增长率、药占比等方面的差异,论证上述制约关系对医药费用控制的作用。结果与结论:美国的医疗服务实行分级诊疗与双向转诊制度、盈利性医院与非盈利性医院相互补充、不同性质的医保体系并存、实行不同的付费方式、实行严格的商业贿赂监管制度,其医师、医院、医保机构三者之间形成的是一种相互制约的均衡关系。其不仅在理论上存在诸多优势,在实际控制费用增长率、药占比等方面也优于我国,在一定程度上控制了医疗费用的快速增长。结合我国国情,有必要借鉴美国的经验,从降低信息不对称与规范支付审核、建立科学的混合型支付方式、加强医保机构对医师和医院的间接影响等方面,构建我国医师、医院、医保机构三者之间的均衡制约关系,从而有效控制我国医药费用的增长。%OBJECTIVE:To provide reference for medical costs control in China. METHODS:Based on main characteristics of the United States health service system,information asymmetry,principal-agent theory and Freedman’s consumption theory were used to analyze the advantages of restrictive relationship among doctors,hospitals and health insurance institutions in control-ling medical costs and improving the quality of diagnosis and treatment. The growth rate of medical cost,the percentage of drug ex-penditure and other aspects were compared between China and the United States;the effect of restrictive relationship on medical cost control was demonstrated. RESULTS & CONCLUSIONS:In the United States,there are

  1. Critical Reflection as Doctoral Education (United States)

    Brookfield, Stephen D.


    This chapter considers how doctoral education, particularly in applied settings such as education, social work, counseling, and health care, could be reimagined if it was organized around the idea and process of critical reflection: of helping students to better understand how power operates in educational environments and how students' sense of…

  2. Industry-Oriented Doctorate Established. (United States)

    Chemical and Engineering News, 1982


    Describes an industry-related program at the University of Texas (Arlington) leading to a Doctorate of Science in Applied Chemistry. The program requires an industrial internship and a dissertation based on research involving both the university's chemistry faculty and chemists in industry. (SK)

  3. Robert Paine Doctor Honoris Causa

    Directory of Open Access Journals (Sweden)

    Per Mathiesen


    Full Text Available Professor Emeritus Dr. Robert Paine was conferred the degree of Doctor Honoris Causa at the University of Tromsø on August 27 1998 as a recognition of his long lasting and continuing influence on the anthropological study of modern society, and in particular his many contributions to the understanding of Sami reindeer husbandry and the Sami culture in general.

  4. Doctoral Students' Conceptions of Research (United States)

    Pitcher, Rod


    In this paper I report a study of the conceptions of research held by a sample of doctoral students at an Australian research-intensive university. I take a unique approach by using metaphor analysis to study the students' conceptions. The students in this study were recruited for an on-line survey in which they answered questions relating to…

  5. Literature Reviews: Advising Doctoral Students (United States)

    Muirhead, Brent


    The rapid expansion of available information has created new opportunities and challenges for today's research students. Academic and public libraries have developed sophisticated electronic databases to better manage knowledge to make it more accessible to researchers. Literature reviews are a major challenge for doctoral students. The focus of…

  6. Moral distress and professional freedom of speech among doctors. (United States)

    Førde, Reidun; Aasland, Olaf Gjerløw


    Previous studies indicate that Norwegian doctors experience distress in their encounter with differing and partly contradictory ideals, such as the obligation to criticise unethical and inappropriate practices. The objective of this study was to investigate the perception of moral distress and professional freedom of speech among Norwegian doctors as of today, as well as identify changes that have occurred since the previous study undertaken in 2004. A total of 1,522 economically active doctors received a questionnaire listing various statements describing the perception of moral distress and professional freedom of speech. The responses were compared to responses to the 2004 study. Altogether 67% of the doctors responded to the questionnaire. The proportion who reported «fairly strong» or «strong» moral distress varied from 24% to 70% among the different statements. On the whole, the «rank and file» hospital doctors reported the highest degree of moral distress. Nevertheless, a decrease in the scores for moral distress could be observed from 2004 to 2010. During the same period, the perception of professional freedom of speech increased slightly. A reduced level of distress associated with ethical conflicts in working life may be due to improved methods for handling distressing situations, or because the consequences of the health services reorganisations are perceived as less threatening now than in 2004, immediately after the introduction of the hospital reform. However, the perceived lower distress level may also be due to professional and ethical resignation. These findings should be followed up by a qualitative study.

  7. Attitude and practice of patients and doctors towards complementary and alternative medicine. (United States)

    Junaid, Rabyyan; Abaas, Mustafa; Fatima, Batool; Anis, Irma; Hussain, Mehwish


    To determine the attitude towards complementary and alternative medicine among the doctors and patients. The study was carried out at Civil Hospital Karachi and Liaquat National University Hospital, Karachi during April to September 2010. Two sets of questionnaires were developed separately for doctors and patients. Each set consisted of queries regarding demographic data of patients and doctors. The questionnaire for the patients contained questions reflecting the general attitude, mode of complimentary and alternative medicine usage, disease referred and the underlined reasons behind pricking the options. The questionnaires for doctors in general laid focus on the personal opinion about the practice not only for their own use, but also related to their concern towards those patients who used complimentary and alternative medicine. Predictive analysis software statistics 18 was used for statistical analysis. Of the patients, 237 (59.3%) used complimentary and alternative medicine. Herbal medicine followed by homeopathic medicine were the most commonly used therapies. Fever and cough were the most common diseases for which patients used the options. The preference was mainly based on inter-personal communications, reliance on complimentary and alternative medicine, and financial restriction. Concealing from the doctors was common in patients. Only 62 (34.4%) out of 180 doctors used complimentary and alternative medicine themselves. Refusal by other doctors was because they considered the option ineffective, obsolete and unsatisfactory. About half of the doctors forbade the patients to use such therapies, but 31% (n=73) patients ignored the doctor's advice. The use of complimentary and alternative medicine is highly prevalent in our society by patients irrespective of their social class. Preference for such therapies, on the other hand, is quite low among medical doctors as they consider allopathic medicine to be effective.

  8. Knowledge and attitude of medical resident doctors toward antihistamines

    Directory of Open Access Journals (Sweden)

    Esha Chainani


    Full Text Available Background: Allergic rhinitis and urticaria are chronic persistent allergic conditions that need proper management as they significantly reduce quality of life measures. Of the many pharmacological options of allergic rhinitis and urticaria, second-generation antihistamines are the mainstay of therapy. Aims: This review focuses on the knowledge of medical residents toward prescribing antihistamines, according to the new ARIA and GA2LEN guidelines for allergic rhinitis and urticaria, attempting to find the cause of less prescription of newer second-generation antihistamines by finding out the knowledge and attitude of the doctors prescribing them to the patients. Materials and Methods: The study was carried out among resident doctors at a tertiary care teaching hospital. Primary data from 100 resident doctors, who gave their informed consent, was collected. A prevalidated questionnaire regarding knowledge, attitude and prescribing practice of antihistamines was filled up. The data was then analyzed with suitable statistical tests. Every question was first validated using the Chi-square test, and significance was below 10% hence proving validity of the questions. Results: Out of the doctors surveyed, 82% of doctors said they prescribed second-generation antihistamines, while 18% still prescribed first-generation antihistamines. Out of the 82% that prescribed second-generation antihistamines, 8.9% also prescribed first-generation antihistamines as well. 23% of doctors surveyed had heard about the ARIA and GAL2EN guidelines and their recommendations for prescribing second-generation antihistamines over the older first-generation antihistamines, while 77% of them had not heard of these position papers. Conclusion: First-generation or classic antihistamines are still overused due to the lack of knowledge of various guidelines that have been published. The main reason for not prescribing the second-generation antihistamines was due to the increased

  9. Statistics teaching in medical school: opinions of practising doctors. (United States)

    Miles, Susan; Price, Gill M; Swift, Louise; Shepstone, Lee; Leinster, Sam J


    The General Medical Council expects UK medical graduates to gain some statistical knowledge during their undergraduate education; but provides no specific guidance as to amount, content or teaching method. Published work on statistics teaching for medical undergraduates has been dominated by medical statisticians, with little input from the doctors who will actually be using this knowledge and these skills after graduation. Furthermore, doctor's statistical training needs may have changed due to advances in information technology and the increasing importance of evidence-based medicine. Thus there exists a need to investigate the views of practising medical doctors as to the statistical training required for undergraduate medical students, based on their own use of these skills in daily practice. A questionnaire was designed to investigate doctors' views about undergraduate training in statistics and the need for these skills in daily practice, with a view to informing future teaching. The questionnaire was emailed to all clinicians with a link to the University of East Anglia Medical School. Open ended questions were included to elicit doctors' opinions about both their own undergraduate training in statistics and recommendations for the training of current medical students. Content analysis was performed by two of the authors to systematically categorize and describe all the responses provided by participants. 130 doctors responded, including both hospital consultants and general practitioners. The findings indicated that most had not recognised the value of their undergraduate teaching in statistics and probability at the time, but had subsequently found the skills relevant to their career. Suggestions for improving undergraduate teaching in these areas included referring to actual research and ensuring relevance to, and integration with, clinical practice. Grounding the teaching of statistics in the context of real research studies and including examples of

  10. Statistics teaching in medical school: Opinions of practising doctors

    Directory of Open Access Journals (Sweden)

    Shepstone Lee


    Full Text Available Abstract Background The General Medical Council expects UK medical graduates to gain some statistical knowledge during their undergraduate education; but provides no specific guidance as to amount, content or teaching method. Published work on statistics teaching for medical undergraduates has been dominated by medical statisticians, with little input from the doctors who will actually be using this knowledge and these skills after graduation. Furthermore, doctor's statistical training needs may have changed due to advances in information technology and the increasing importance of evidence-based medicine. Thus there exists a need to investigate the views of practising medical doctors as to the statistical training required for undergraduate medical students, based on their own use of these skills in daily practice. Methods A questionnaire was designed to investigate doctors' views about undergraduate training in statistics and the need for these skills in daily practice, with a view to informing future teaching. The questionnaire was emailed to all clinicians with a link to the University of East Anglia Medical School. Open ended questions were included to elicit doctors' opinions about both their own undergraduate training in statistics and recommendations for the training of current medical students. Content analysis was performed by two of the authors to systematically categorise and describe all the responses provided by participants. Results 130 doctors responded, including both hospital consultants and general practitioners. The findings indicated that most had not recognised the value of their undergraduate teaching in statistics and probability at the time, but had subsequently found the skills relevant to their career. Suggestions for improving undergraduate teaching in these areas included referring to actual research and ensuring relevance to, and integration with, clinical practice. Conclusions Grounding the teaching of statistics

  11. Lyme disease - what to ask your doctor (United States)

    What to ask your doctor about Lyme disease; Lyme borreliosis - questions; Bannwarth syndrome - questions ... I am treated with antibiotics? How can my doctor diagnose me with Lyme disease? Can I be ...

  12. Concussion - what to ask your doctor - child (United States)

    What to ask your doctor about concussion - child; Mild brain injury - what to ask your doctor - child ... school people I should tell about my child's concussion? Can my child stay for a full day? ...

  13. Cholesterol - what to ask your doctor (United States)

    ... your doctor; What to ask your doctor about cholesterol ... What is my cholesterol level? What should my cholesterol level be? What are HDL ("good") cholesterol and LDL ("bad") cholesterol? Does my cholesterol ...

  14. Enlarged prostate - what to ask your doctor (United States)

    What to ask your doctor about enlarged prostate; Benign prostatic hypertrophy - what to ask your doctor; BPH - what to ... . Roehrborn CG. Benign prostatic hyperplasia: Etiology, pathophysiology, epidemiology, and natural history. In: Wein ...

  15. Doctor Roberto Serpa Novoa

    Directory of Open Access Journals (Sweden)

    Hernando Groot


    complacencia, ya enfrentando problemas dramáticos como la alta mortalidad infantil, la fiebre amarilla y la lepra, ya apersonándose para dirigir la solución de graves problemas de salud pública desde posiciones tan importantes como la de Secretario de Salud de Bogotá, Director de la Compañía Antileprosa y Secretario General del Ministerio de Salud.

    Estas actividades y otras muchas, todas de especial relevancia, fueron complementadas con su vida académicas en el Hospital San Juan de Dios y más tarde en esta misma Academia Nacional de Medicina donde sus lúcidas intervenciones fueron recibidas siempre con profundo respeto. Entendiendo su papel como líder de la medicina en un país donde había, como las hay hoy, toda suerte de necesidades en materia de salud, tuvo por fuerza que intervenir en política, no como escalón para alcanzar preeminencia y poder sino para lograr oportunidades de servicio mejor a su pueblo, haciendo gala siempre de su gran sensibilidad social, de su profundo sentido liberal y democrático, y de su enorme preocupación por toda clase de injusticias. Aún le puedó tiempo para la literatura y fueron muchos los periódicos y revistas que guardan sus escritos y sus cuentos.

    De sus múltiples actividades médicas habré de referirme esta noche -por razones elementales de tiempo- sólo a su contribución al estudio de la fiebre amarilla en Santander, enfermedad que ha sido y debería seguir siendo motivo de preocupación permanente para la medicina nacional, no sin antes hacer una breve descripción de los antecedentes y del ambiente que en este cam po le tocó afrontar a Serpa.

    En efecto, entre las muchas epidemias que han azotado la patria tiene un puesto especial esta grave dolencia. Por ejemplo, ya casi no nos acordamos de la viruela que diezmó a la población indígena y que era frecuente en Bogotá hasta hace cuarenta años, todo gracias a esa maravillosa hazaña de la medicina preventiva que es haberla borrado de la faz del

  16. From Doctors' Stories to Doctors' Stories, and Back Again. (United States)

    Childress, Marcia Day


    Stories have always been central to medicine, but during the twentieth century bioscience all but eclipsed narrative's presence in medical practice. In Doctors' Stories, published in 1991, Kathryn Montgomery excavated medicine's narrative foundations and functions to reveal new possibilities for how to conceive and characterize medicine. Physicians' engagement with stories has since flourished, especially through the narrative medicine movement, although in the twenty-first century this has been challenged by the health care industry's business-minded and data-driven clinical systems. But doctors' stories-and Montgomery's text-remain crucial, schooling clinicians in reflection, ethical awareness, and resilience. Physicians who write even short, 55-word reflective stories can hold to humanistic and ethical understandings of patient care and of themselves as healers even as they practice in systematized settings and employ evidence-based expertise. © 2017 American Medical Association. All Rights Reserved.

  17. Should doctors inform terminally ill patients? The opinions of nationals and doctors in the United Arab Emirates. (United States)

    Harrison, A; al-Saadi, A M; al-Kaabi, A S; al-Kaabi, M R; al-Bedwawi, S S; al-Kaabi, S O; al-Neaimi, S B


    OBJECTIVES: To study the opinions of nationals (Emiratis) and doctors practising in the United Arab Emirates (UAE) with regard to informing terminally ill patients. DESIGN: Structured questionnaires administered during January 1995. SETTING: The UAE, a federation of small, rich, developing Arabian Gulf states. PARTICIPANTS: Convenience samples of 100 Emiratis (minimum age 15 years) and of 50 doctors practising in government hospitals and clinics. RESULTS: Doctors emerged as consistently less in favour of informing than the Emiratis were, whether the patient was described as almost certain to die during the next six months or as having a 50% chance of surviving, and even when it was specified that the patient was requesting information. In the latter situation, a third of doctors maintained that the patient should not be told. Increasing survival odds reduced the number of doctors selecting to inform; but it had no significant impact on Emiratis' choices. When Emiratis were asked whether they would personally want to be informed if they had only a short time to live, less than half responded in the way they had done to the in principle question. CONCLUSIONS: The doctors' responses are of concern because of the lack of reference to ethical principles or dilemmas, the disregard of patients' wishes and dependency on survival odds. The heterogeneity of Emiratis' responses calls into question the usefulness of invoking norms to explain inter-society differences. In the current study, people's in principle choices did not provide a useful guide to how they said they would personally wish to be treated. PMID:9134491

  18. The doctor-patient relationship as a toolkit for uncertain clinical decisions. (United States)

    Diamond-Brown, Lauren


    Medical uncertainty is a well-recognized problem in healthcare, yet how doctors make decisions in the face of uncertainty remains to be understood. This article draws on interdisciplinary literature on uncertainty and physician decision-making to examine a specific physician response to uncertainty: using the doctor-patient relationship as a toolkit. Additionally, I ask what happens to this process when the doctor-patient relationship becomes fragmented. I answer these questions by examining obstetrician-gynecologists' narratives regarding how they make decisions when faced with uncertainty in childbirth. Between 2013 and 2014, I performed 21 semi-structured interviews with obstetricians in the United States. Obstetricians were selected to maximize variation in relevant physician, hospital, and practice characteristics. I began with grounded theory and moved to analytical coding of themes in relation to relevant literature. My analysis renders it evident that some physicians use the doctor-patient relationship as a toolkit for dealing with uncertainty. I analyze how this process varies for physicians in different models of care by comparing doctors' experiences in models with continuous versus fragmented doctor-patient relationships. My key findings are that obstetricians in both models appealed to the ideal of patient-centered decision-making to cope with uncertain decisions, but in practice physicians in fragmented care faced a number of challenges to using the doctor-patient relationship as a toolkit for decision-making. These challenges led to additional uncertainties and in some cases to poor outcomes for doctors and/or patients; they also raised concerns about the reproduction of inequality. Thus organization of care delivery mitigates the efficacy of doctors' use of the doctor-patient relationship toolkit for uncertain decisions. These findings have implications for theorizing about decision-making under conditions of medical uncertainty, for understanding

  19. Pygmalion Effect on Junior English Teaching

    Directory of Open Access Journals (Sweden)

    Yurong Wang


    Full Text Available Pygmalion Effect, or Robert Rosenthal Effect, was proved by the famous American psychologist Robert Rosenthal and Jacobson in 1968. Pygmalion Effect, as a matter of fact, is a psychological suggestion, which believes that people can accept the influence and suggestion given by the people whom very much they admire, like, believe, and respect. This effect was first applied in the field of management and medication. What’s more, remarkable achievements have been accomplished on human resource management. Robert Rosenthal put it into education through an experiment called Pygmalion in the Classroom, which aroused widely attention in the education sector. This thesis mainly focuses on the application of Pygmalion effect in English teaching, especially junior English teaching in China. If we can make good use of the Pygmalion Effect to conduct teaching and have positive expectations to students, it will improve teaching greatly.

  20. PIXE technique applied to Almeida Junior materials

    Energy Technology Data Exchange (ETDEWEB)

    Pascholati, Paulo R.; Rizzutto, Marcia A.; Neves, Graziela; Tabacniks, Manfredo H.; Moleiro, Guilherme F.; Dias, Flavia A. [Universidade de Sao Paulo (USP), SP (Brazil). Inst. de Fisica]. E-mails:;;;;;; Mendonca, Valeria de [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil); Pinacoteca do Estado de Sao Paulo, Sao Paulo, SP (Brazil); E-mail:


    The Institute of Physics University of Sao Paulo in collaboration with the Pinacoteca do Estado of the State of Sao Paulo has a project to develop a data bank with information about the elementary composition of pigments of paintings and materials of its collection for future application as conservation and restoration as well as authenticity,. The project is beginning with the materials (palette, paint box and paint tubes) belonging to the painter Almeida Junior. Twenty-three spots on the palette were chosen with determined colors, and also the paint tubes present in the paint box. The PIXE (Particle Induced X-ray Emission) analysis of the spectra enabled to conclude that the red colors have predominant Hg and S suggesting Vermellion and the white one are consisted of Pb (Lead White). The analyzed tubes of same colors confirm the elements pigment present in the palette. (author)

  1. Career Progression of Junior Professional Officers

    Energy Technology Data Exchange (ETDEWEB)

    Pepper S. E.; Carbonaro J.; Hoffheins, B; Collins, T.


    The U.S. Support Program to IAEA Safeguards (USSP) has funded more than 25 Junior Professional Officer (JPO) positions in the IAEA Department of Safeguards since 2005. JPOs are college graduates with zero to two years’ work experience who work alongside experienced IAEA staff members for one to two years and assist with basic, yet essential work while obtaining valuable experience. They contribute to equipment development, testing, integration, open source information collection and analysis, and software and database development. This paper will study the trends in career progression for the JPOs who have completed assignments with the IAEA in the Department of Safeguards. Brookhaven National Laboratory, in its role in managing the USSP, has compiled information that can be analyzed for this purpose.

  2. Politeness in Doctor-Potient Diolog

    Institute of Scientific and Technical Information of China (English)



    In our everyday communication, we often use Euphemism to express our thought indirectly, for example, doctors usually do not tell the patients the truth when treating serious patients. This paper aims at exploring the nature of euphemism in doctor-patient interactions and how do doctors use euphemism to attain the goal of politeness on the basis of the Face Theory and Politeness theory.

  3. An Exploration of Darkness within Doctoral Education

    DEFF Research Database (Denmark)

    Bengtsen, Søren Smedegaard


    In doctoral education, the formal structures include the Graduate School system, PhD courses, and supervision contracts, etc. Doctoral education also takes place on informal and tacit levels, where doctoral students learn about the institutional regulations, the research field, academic craftsman...

  4. The Learning Alliance: Ethics in Doctoral Supervision (United States)

    Halse, Christine; Bansel, Peter


    This paper is concerned with the ethics of relationships in doctoral supervision. We give an overview of four paradigms of doctoral supervision that have endured over the past 25 years and elucidate some of their strengths and limitations, contextualise them historically and consider their implications for doctoral supervision in the contemporary…

  5. Asthma - what to ask the doctor - adult (United States)

    What to ask your doctor about asthma - adult ... For what side effects should I call the doctor? How will I know when my inhalers are ... worse and that I need to call the doctor? What should I do when I feel short ...

  6. Asthma - what to ask your doctor - child (United States)

    What to ask your doctor about asthma - child ... For what side effects should I call the doctor? How will I know when the inhalers are ... worse and that I need to call the doctor? What should I do when my child feels ...

  7. Invisible Roles of Doctoral Program Specialists (United States)

    Bachman, Eva Burns; Grady, Marilyn L.


    The purpose of this study was to investigate the roles of doctoral program specialists in Big Ten universities. Face-to-face interviews with 20 doctoral program specialists employed in institutions in the Big Ten were conducted. Participants were asked to describe their roles within their work place. The doctoral program specialists reported their…

  8. Hybrid Doctoral Program: Innovative Practices and Partnerships (United States)

    Alvich, Dori; Manning, JoAnn; McCormick, Kathy; Campbell, Robert


    This paper reflects on how one mid-Atlantic University innovatively incorporated technology into the development of a hybrid doctoral program in educational leadership. The paper describes a hybrid doctoral degree program using a rigorous design; challenges of reworking a traditional syllabus of record to a hybrid doctoral program; the perceptions…

  9. Knowledge, attitude and practice of healthcare ethics among resident doctors and ward nurses from a resource poor setting, Nepal. (United States)

    Adhikari, Samaj; Paudel, Kumar; Aro, Arja R; Adhikari, Tara Ballav; Adhikari, Bipin; Mishra, Shiva Raj


    Healthcare ethics is neglected in clinical practice in LMICs (Low and Middle Income Countries) such as Nepal. The main objective of this study was to assess the current status of knowledge, attitude and practice of healthcare ethics among resident doctors and ward nurses in a tertiary teaching hospital in Nepal. This was a cross sectional study conducted among resident doctors (n = 118) and ward nurses (n = 86) in the largest tertiary care teaching hospital of Nepal during January- February 2016 with a self-administered questionnaire. A Cramer's V value was assessed to ascertain the strength of the differences in the variables between doctors and nurses. Association of variables were determined by Chi square and statistical significance was considered if p value was less than 0.05. Our study demonstrated that a significant proportion of the doctors and nurses were unaware of major documents of healthcare ethics: Hippocratic Oath (33 % of doctors and 51 % of nurses were unaware), Nuremberg code (90 % of both groups were unaware) and Helsinki Declaration (85 % of doctors and 88 % of nurses were unaware). A high percentage of respondents said that their major source of information on healthcare ethics were lectures (67.5 % doctors versus 56.6 % nurses), books (62.4 % doctors versus 89.2 % nurses), and journals (59 % doctors versus 89.2 % nurses). Attitude of doctors and nurses were significantly different (p ethics. More nurses had agreement than doctors on the tested statements pertaining to different aspects of healthcare ethics except for need of integration of medical ethics in ungraduate curricula (97.4 % doctors versus 81.3 % nurses),paternalistic attitude of doctor was disagreed more by doctors (20.3 % doctors versus 9.3 % nurses). Notably, only few (9.3 % doctors versus 14.0 % nurses) doctors stood in support of physician-assisted dying. Significant proportion of doctors and nurses were unaware of three major documents on


    Directory of Open Access Journals (Sweden)

    Rahul Sanjeev Chaudhary


    Full Text Available BACKGROUND Hand hygiene practices of health care workers has been shown to be an effective measure in preventing hospital acquired infections. This concept has been aptly used to improve understanding, training, monitoring, and reporting hand hygiene among healthcare workers. We conducted this study to assess the knowledge of doctors and health care workers regarding hand scrub. METHODS A study was conducted among doctors and health care workers in a tertiary care hospital. Knowledge was evaluated by using self-structured questionnaire based on the guidelines of hand hygiene prescribed by WHO. RESULTS The awareness and knowledge of preoperative surgical hand scrubbing was moderate in doctors, but unfortunately poor in HCWs. CONCLUSION Our study highlights the need for introducing measures in order to increase the knowledge of preoperative hand scrub in teaching hospital which may translate into good practices.

  11. 南通市5家三级医院青年医师思想状况调查分析%An investigation and analysis of the ideological situation among young doctors in the third-grade hospitals in Nantong City

    Institute of Scientific and Technical Information of China (English)

    王建军; 陈建荣; 何书; 陆洁玉; 陈卫军; 缪旭东; 黄宇


    Objective:To understand the current ideological situation among young doctors and to provide empirical evidences for improving the pertinence of the ideological and political education and the sound development of young doc-tors. Methods:A self-designed questionnaire was applied to survey 356 clinical doctors under the age of 40 years old from five third-grade hospitals in Nantong City, and the statistical analysis of the investigation was made. Results: Young doc-tors adopted proper mainstream values and good professional ethics with relatively stronger sense of belonging to their pro-fession, but there were also noteworthy ideological conditions: high working pressure, financial pressure in living, profes-sional disappointment, solely professional skills-centered tendency, and potential moral cognition problems, and so on. Conclusion: Guiding their enthusiasms for career development in the right direction and correcting their unhealthy views and values to reduce harmful influence are the key points of the ideological and political work among young doctors. Sug-gestions made here include:enhancing ideological education and guidance, providing guarantee for career development, re-inforcing professionalism construction, and bettering psychological support system.%目的:了解青年医师思想现状,为加强思想政治教育针对性、促进青年医师健康成长提供依据。方法:采用自制问卷系统抽样调查的方法,对南通市5家三级医院356名40岁以下临床医师进行调查和统计分析。结果:(1)生活压力首要来源占45.7%的是经济负担过重,超过住房紧张、家庭矛盾等因素。面对医疗改革深化,担心收入下降占33.5%。社会压力、经济压力太大,“啃老”难以避免占35.1%;变换工作与收入福利待遇有关占42.0%。(2)热爱本职工作占47.6%,工作繁忙但仍有自己目标占34.0%。在工作取得重大业绩时,能得到激励和发展机会占50

  12. Another successful Doctoral Student Assembly

    CERN Multimedia

    Katarina Anthony


    On Wednesday 2 April, CERN hosted its third Doctoral Student Assembly in the Council Chamber.   CERN PhD students show off their posters in CERN's Main Building. Speaking to a packed house, Director-General Rolf Heuer gave the assembly's opening speech and introduced the poster session that followed. Seventeen CERN PhD students presented posters on their work, and were greeted by their CERN and University supervisors. It was a very successful event!

  13. Mastectomy and breast reconstruction - what to ask your doctor (United States)

    Mastectomy - what to ask your doctor; Breast reconstruction - what to ask your doctor; TRAM flap - what to ... your doctor; What to ask your doctor about mastectomy and breast reconstruction; Breast cancer - mastectomy - what to ...

  14. Brazilian doctors' perspective on the second opinion strategy before a C-section. (United States)

    Osis, Maria José Duarte; Cecatti, José Guilherme; de Pádua, Karla Simônia; Faúndes, Anibal


    To describe the opinion of doctors who participated in the Latin American Study on Cesarean section in Brazil regarding the second opinion strategy when faced with the decision of performing a C-section. Seventy-two doctors from the hospitals where the study took place (where the second opinion was routinely sought) and 70 from the control group answered a pre-tested self-administered structured questionnaire. Descriptive tables were prepared based on the frequency of relevant variables on opinion of physicians regarding: effectiveness of the application of the second opinion strategy; on whether they would recommend implementation of this strategy and reasons for not recommending it in private institutions; feasibility of the strategy implementation and reasons for not considering this implementation feasible in private institutions. Half of the doctors from the intervention hospitals (50%) and about two thirds of those in the control group (65%) evaluated the second opinion as being or having the potential of being effective/very effective in their institutions. The great majority of those interviewed from both intervention and control hospitals considered this strategy feasible in public (87% and 95% respectively) but not in private hospitals (64% and 70% respectively), mainly because in the latter the doctors would not accept interference from a colleague in their decision-making process. Although the second opinion strategy was perceived as effective in reducing C-section rates, doctors did not regard it feasible outside the public health system in Brazil.

  15. Fever as a predictor of doctor shopping in the paediatric population. (United States)

    Hariman, Keith W; Lam, Stacey C; Lam, Yvette W S; Luk, Karen H K; Poon, K K; Li, Albert M


    To estimate prevalence and assess factors associated with doctor shopping among caregivers of children acutely admitted to a hospital in Hong Kong, and examine the reasons for such behaviour and caregivers' awareness of its possible dangers. Cross-sectional study with face-to-face surveys. A paediatric unit in a teaching hospital in Hong Kong. Caregivers of children admitted to acute paediatric wards between April and July 2011. MAIN OUTCOME MEASURES; Socio-demographic characteristics of the interviewee, personal history and clinical data of the patient, presence of doctor shopping (consulting more than one doctor for medical advice without referral) for each episode, the reasons behind such behaviour, and awareness of potential dangers. Data retrieved were analysed to estimate the prevalence and logistic regression was used to assess factors associated with doctor shopping. In all, 649 such patients were admitted into hospital during the study period, of which 336 were recruited, with about a half being absent or given home leave. Thirty-four patients were excluded due to absent caregivers or refusal, and 302 were included in the study. More than half (79.5%) were female and the caregivers' monthly household incomes were between HK$10 001 and HK$15 000 (21.2%), similar to the median household income in Hong Kong. The prevalence of doctor shopping was 53%. The only significant clinical parameter associated with doctor shopping was presence of fever (odds ratio=2.4; 95% confidence interval, 1.4-3.9). Persistence of symptoms was the commonest reason given by interviewees for doctor shopping, and the majority (75.5%) were unaware of the possible dangers of this behaviour. Doctor shopping is highly prevalent among caregivers of children with acute paediatric conditions. Most caregivers do not know the potential complications of this behaviour. Further measures should be taken to educate subjects on the associated dangers of this behaviour and the natural course of

  16. The Status of Basic Technology in Cross River State Junior ...

    African Journals Online (AJOL)


    Copyright © IAARR, 2007-2016: Indexed African ... instructional materials for teaching basic technology in junior secondary school in. Cross River State and .... resource utilization. Conference paper, Nigeria Audio – visual.

  17. Variables that influence junior secondary school students‟ attitude ...

    African Journals Online (AJOL)

    Variables that influence junior secondary school students‟ attitude to agricultural ... and cluster) sampling techniques was employed to select a sample of 254 students. ... It was recommended that efforts be geared towards implementation of ...

  18. Strategies for Teaching Elementary and Junior High Students. (United States)

    Consuegra, Gerard F.


    Discusses the applications of Piaget's theory of cognitive development to elementary and junior high school science teaching. Topics include planning concrete experiences, inductive and hypothetical deductive reasoning, measurement concepts, combinatorial logic, scientific experimentation and reflexive thinking. (SA)

  19. Teaching Human Sexuality in Junior High School: An Interdisciplinary Approach. (United States)

    Kapp, Lucy; And Others


    An experimental sex education program designed for the junior high school adolescent is described. The program's goal is to affect primary prevention of adolescent pregnancy and other problems related to adolescent sexuality. (Author/JMF)

  20. PSI for Low-Enrollment Junior-Senior Physics Courses (United States)

    Frahm, Charles P.; Young, Robert D.


    The administration of a Personalized System of Instruction (PSI) for junior-senior level courses in mechanics, electricity and magneturn, atomic physics, mathematical physics, physics and computers, astrophysics, and relativity is described. (CP)

  1. Profiles Junior high School West Java in Education Learning Environment

    Directory of Open Access Journals (Sweden)

    NFN Nahadi


    Full Text Available Descriptive studies have been conducted on the existing junior high profile in West Java on Education Learning Environment. The study was conducted by purposive sampling and descriptive done to get an idea about the profile of SMP in West Java implementation of the learning environment. in junior high school in West Java. Research conducted by distributing questionnaires, and observations based on the indicators developed. Based on this research, it is known that, PLH learning in junior high school in West Java has been in force since 2007 after the enactment of the Governor of West Java on environmental education for junior high school students in West Java. Learning that lasts generally implemented in conventional teacher, and it is without any innovations. It has made learning the essential condition runs well, but has not lasted optimally.

  2. John Brozovsky appointed Wayne E. Leininger Junior Faculty Fellow


    Owczarski, Mark


    John Brozovsky, associate professor of accounting and information systems in the Pamplin College of Business at Virginia Tech, has been appointed the Wayne E. Leininger Junior Faculty Fellow by the Virginia Tech Board of Visitors.

  3. Effects of Cloze Instructional Approach on Junior Secondary School ...

    African Journals Online (AJOL)

    Effects of Cloze Instructional Approach on Junior Secondary School Students' ... comprehension achievement in English language using Owerri Educational Zone. ... basis for incorporating the cloze approach as a method of teaching reading ...

  4. Academic achievement of junior high school students with sleep disorders

    National Research Council Canada - National Science Library

    Auliyanti, Fijri; Sekartini, Rini; Mangunatmadja, Irawan


    ... status, family structure, after-hours education program, presence of TV/computer in the bedroom, sleep duration during school days, as well as bedtime and wakeup time difference in junior high school...

  5. A Study of Junior Students'Cross- Culture Obstacles in English Reading Comprehension%A Study of Junior Students' Cross-Culture Obstacles in English Reading Comprehension

    Institute of Scientific and Technical Information of China (English)



    This paper will research Junior students' cross-cultural obstacles in English reading from the perspective of culture background,Eliminating Junior students'cross-cultural barriers can improve intercultural communication competent.

  6. Errors in Junior English Writing:Resources and Strategies

    Institute of Scientific and Technical Information of China (English)

    XU Shu-ling


    The research on the common errors in junior English writings reflects the categories of errors, resources of errors, and how to do with errors in effective ways. Errors are divided into two types:intralingual errors and interlingual errors. The research finds that Chinese junior students depend heavily on their native language in English writing and finds out some effective strate-gies avoiding errors in writing.

  7. What makes work experience program in junior high school effective?


    五島, 萌子; 重川, 純子


    Recently, the work experience program in junior high schools is spreading all over Japan in order that students get views on occupation and works. The purpose of this study is to clarify the value of this program and its determinants of effectiveness. We conducted interview survey to informantswho experienced the work experience programs in junior high school from 2000 to 2004. We have found that the followings are important to make the program more effective: adequacy interm and difficulty, ...

  8. Obesity prevention for junior high school students: An intervention programme


    Topalidou,Anastasia; Dafopoulou, GM


    Background: Generally, schools are an important setting to provide programmes for obesity prevention for children because the vast majority of children attend school. This study investigates how an intervention programme in the school subject of Physical Education can help reduce obesity for junior high school students in combination with information on dietary and health matters in school and family. Materials and Methods: A quantitative study for junior high school students (N = 250) and a ...

  9. Perfectionism and attitudes towards doping in junior athletes


    Madigan, Daniel J.; Stoeber, Joachim; Passfield, Louis


    Recent theory and research suggest that perfectionism is a personal factor contributing to athletes’ vulnerability to doping (using banned substances/drugs to enhance sporting performance). So far, however, no study has examined what aspects of perfectionism suggest a vulnerability in junior athletes. Employing a cross-sectional design, this study examined perfectionism and attitudes towards doping in 129 male junior athletes (mean age 17.3 years) differentiating four aspects of perfectionism...

  10. Stress among medical doctors working in public hospitals of the ...

    African Journals Online (AJOL)

    situation to another.4 For the purpose of this study, work stress is ... and Primary Health Care, Faculty of Health Science, University of Limpopo (Medunsa Campus), Pretoria ... problems, which sometimes end in divorce,10,12 physical illness,.

  11. Knowledge and utilization amongst Doctors in Government hospitals ...

    African Journals Online (AJOL)


    Mar 17, 2015 ... procedures being undertaken, medico‑legal and safety aspects as well ... The patient is at the center of any discussion on the benefits of POCT. ... specimen, proper interpretation and documentation of .... Medical officer. 9. 5.1.

  12. Adverse effects on health and wellbeing of working as a doctor: views of the UK medical graduates of 1974 and 1977 surveyed in 2014. (United States)

    Smith, Fay; Goldacre, Michael J; Lambert, Trevor W


    Objective To report on any adverse effects on health and wellbeing of working as a doctor, as described by senior doctors. Design Questionnaires sent in 2014 to all medical graduates of 1974 and 1977. Participants 3695 UK medical graduates. Setting United Kingdom. Main outcome measures Statements about adverse effects upon health, wellbeing and career. Results The aggregated response rate from contactable doctors was 84.6% (3695/4369). In response to the question 'Do you feel that working as a doctor has had any adverse effects on your own health or wellbeing?', 44% of doctors answered 'yes'. More GPs (47%) than hospital doctors (42%) specified that this was the case. Three-quarters of doctors who answered 'yes' cited 'stress/work-life balance/workload' as an adverse effect, and 45% mentioned illness. In response to the statement 'The NHS of today is a good employer when doctors become ill themselves', 28% of doctors agreed, 29% neither agreed nor disagreed and 43% disagreed. More women doctors (49%) than men doctors (40%) disagreed with this statement. More general practitioners (49%) disagreed than hospital doctors (37%). Conclusions Chronic stress and illness, which these doctors attributed to their work, were widely reported. Although recent changes may have alleviated some of these issues, there are lessons for the present and future if the NHS is to ensure that its medical workforce receives the support which enables current doctors to enjoy a full and satisfying career and to contribute fully to health service provision in the UK. Older doctors, in particular, need support to be able to continue successfully in their careers.

  13. Doctors' use of mobile devices in the clinical setting: a mixed methods study. (United States)

    Nerminathan, Arany; Harrison, Amanda; Phelps, Megan; Scott, Karen M; Alexander, Shirley


    Mobile device use has become almost ubiquitous in daily life and therefore includes use by doctors in clinical settings. There has been little study as to the patterns of use and impact this has on doctors in the workplace and how negatively or positively it impacts at the point of care. To explore how doctors use mobile devices in the clinical setting and understand drivers for use. A mixed methods study was used with doctors in a paediatric and adult teaching hospital in 2013. A paper-based survey examined mobile device usage data by doctors in the clinical setting. Focus groups explored doctors' reasons for using or refraining from using mobile devices in the clinical setting, and their attitudes about others' use. The survey, completed by 109 doctors, showed that 91% owned a smartphone and 88% used their mobile devices frequently in the clinical setting. Trainees were more likely than consultants to use their mobile devices for learning and accessing information related to patient care, as well as for personal communication unrelated to work. Focus group data highlighted a range of factors that influenced doctors to use personal mobile devices in the clinical setting, including convenience for medical photography, and factors that limited use. Distraction in the clinical setting due to use of mobile devices was a key issue. Personal experience and confidence in using mobile devices affected their use, and was guided by role modelling and expectations within a medical team. Doctors use mobile devices to enhance efficiency in the workplace. In the current environment, doctors are making their own decisions based on balancing the risks and benefits of using mobile devices in the clinical setting. There is a need for guidelines around acceptable and ethical use that is patient-centred and that respects patient privacy. © 2016 Royal Australasian College of Physicians.

  14. Improving Emergency Department Door to Doctor Time and Process Reliability (United States)

    El Sayed, Mazen J.; El-Eid, Ghada R.; Saliba, Miriam; Jabbour, Rima; Hitti, Eveline A.


    Abstract The aim of this study is to determine the effectiveness of using lean management methods on improving emergency department door to doctor times at a tertiary care hospital. We performed a before and after study at an academic urban emergency department with 49,000 annual visits after implementing a series of lean driven interventions over a 20 month period. The primary outcome was mean door to doctor time and the secondary outcome was length of stay of both admitted and discharged patients. A convenience sample from the preintervention phase (February 2012) was compared to another from the postintervention phase (mid-October to mid-November 2013). Individual control charts were used to assess process stability. Postintervention there was a statistically significant decrease in the mean door to doctor time measure (40.0 minutes ± 53.44 vs 25.3 minutes ± 15.93 P < 0.001). The postintervention process was more statistically in control with a drop in the upper control limits from 148.8 to 72.9 minutes. Length of stay of both admitted and discharged patients dropped from 2.6 to 2.0 hours and 9.0 to 5.5 hours, respectively. All other variables including emergency department visit daily volumes, hospital occupancy, and left without being seen rates were comparable. Using lean change management techniques can be effective in reducing door to doctor time in the Emergency Department and improving process reliability. PMID:26496278

  15. Protest of doctors: a basic human right or an ethical dilemma. (United States)

    Abbasi, Imran Naeem


    Peaceful protests and strikes are a basic human right as stated in the United Nations' universal declaration on human rights. But for doctors, their proximity to life and death and the social contract between a doctor and a patient are stated as the reasons why doctors are valued more than the ordinary beings. In Pakistan, strikes by doctors were carried out to protest against lack of service structure, security and low pay. This paper discusses the moral and ethical concerns pertaining to the strikes by medical doctors in the context of Pakistan. The author has carefully tried to balance the discussion about moral repercussions of strikes on patients versus the circumstances of doctors working in public sector hospitals of a developing country that may lead to strikes. Doctors are envisaged as highly respectable due to their direct link with human lives. Under Hippocrates oath, care of the patient is a contractual obligation for the doctors and is superior to all other responsibilities. From utilitarian perspective, doctors' strikes are justifiable only if there is evidence of long term benefits to the doctors, patients and an improvement in service delivery. Despite that, it is hard to justify such benefits against the risks to the patients. Harms that may incur to the patients include: prolongation of sufferings, irreversible damage to health, delay in treatment, death, loss of work and waste of financial resources.In a system of socialized medicine, government owing to greater control over resources and important managerial decisions should assume greater responsibility and do justice to all stakeholders including doctors as well as patients. If a doctor is underpaid, has limited options for career growth and is forced to work excessively, then not only quality of medical care and ability to act in the best interests of patients is adversely affected, it may also lead to brain drain. There is no single best answer against or in favor of doctors' industrial

  16. Towards a doctorate in physics

    CSIR Research Space (South Africa)

    Greeff, M


    Full Text Available 2009 1990’s and the 21st Century are more likely to be supporting children, spouses, aging parents or extended families [8] [5] D. J. Grayson, A Baseline Study of Women Physics Graduates, Report to DST, 2008 [8] M.A. Hellberg et al... myself and function independently I need to support my family I am not interested in research I want to change my career I will earn more money in industry I am considering relocating to another country Lysko et al., Towards a Doctorate in Physics...

  17. What Makes a Good Doctor?

    Institute of Scientific and Technical Information of China (English)

    C. Richard Coati


    @@ Introduction In the United States and I suspect in all parts of the world, a good doctor is an individual who, in addition to training in their area of interest, i.e., family practice, internal medicine, or a subspecialty area, has participated actively in the educational programs relating to their training which make them eligible to take examinations in those areas (if they are available) and pass them.All physicians generally like to have some procedural skills,but the most important part of their skills relate to their cognitive knowledge which in the long term insures optimal patient care.



    Revista Ciencias Biomedicas


    El doctor Jaime Antonio Barrios Amaya, nació en Cartagena de Indias, Colombia, el 4 de noviembre de 1935. Realizó estudios de primaria en el colegio Fernández Baena y de secundaria en el Liceo de Bolívar, donde se graduó de Bachiller superior en 1956. Inmediatamente ingresó a la Universidad de Cartagena, adelantando estudios médicos y egresó en 1963 con el título de Médico Cirujano. Poco tiempo después regresó a la Universidad de Cartagena e ...

  19. Prescribing patterns of antibiotics and sensitivity patterns of common microorganisms in the Internal Medicine ward of a teaching hospital in Western Nepal: a prospective study

    Directory of Open Access Journals (Sweden)

    Easow Joshy


    Full Text Available Abstract Background Information about antibiotic use and resistance patterns of common microorganisms are lacking in hospitals in Western Nepal. Excessive and inappropriate use of antibiotics contributes to the development of bacterial resistance. The parameter: Defined daily dose/100 bed-days, provides an estimate of consumption of drugs among hospital in-patients. This study was carried out to collect relevant demographic information, antibiotic prescribing patterns and the common organisms isolated including their antibiotic sensitivity patterns. Methods The study was carried out over a 3-month period (01.04.2002 to 30.06.2002 at the Manipal Teaching Hospital, Western Nepal. The median number of days of hospitalization and mean ± SD cost of antibiotics prescribed during hospital stay were calculated. The use of antibiotics was classified for prophylaxis, bacteriologically proven infection or non-bacteriologically proven infection. Sensitivity patterns of the common organisms were determined. Defined daily dose/100 bed-days of the ten most commonly prescribed antibiotics were calculated. Results 203 patients were prescribed antibiotics; 112 were male. Median duration of hospitalization was 5 days. 347 antibiotics were prescribed. The most common were ampicillin, amoxicillin, metronidazole, ciprofloxacin and benzylpenicillin. Mean ± SD cost of antibiotics was 16.5 ± 13.4 US$. Culture and sensitivity testing was carried out in 141 patients. The common organisms isolated were H. influenzae, E. coli, K. pneumoniae and S. aureus. Conclusions Antibiotic resistance is becoming a problem in the Internal Medicine ward. Formulation of a policy for hospital antibiotic use and an educational programme especially for junior doctors is required.

  20. Breakfast Composition in Junior High School Students

    Directory of Open Access Journals (Sweden)

    Sheila Devi


    Full Text Available Background: Adolescence is a time of rapid development that requires higher nutrient intake levels than in adulthood. However the habit of skipping breakfast has become very popular among adolescents. Skipping breakfast has negative effects such as difficulty in concentrating, growth impairment and decrease academic performance. Therefore, this study was conducted to identify the breakfast composisition of early adolescents in Jatinangor, Sumedang, Indonesia. Methods: A cross sectional study with non-probability sampling method, was conducted in a junior high school Jatinangor during the month of July 2013. Ninety six participants were included in this study. All the participants underwent an interview about the food intake for breakfast in seven days using eating pattern recall guidelines. Results: Overall, 37% of the respondents skipped breakfast. The mean of total calories among the adolescents who consumed breakfast was 286.06 (187.89 kcal. The amount of carbohydrate, fat and protein consumed was 29.23 (19.93 gram, 13.93 (13.29 gram and 8.78 (6.11 gram accordingly. The main reason for adolescent to skip breakfast was lack of time. Conclusions: Majority of the respondents have their breakfast before they go to school. Overall, the total calories comsumed is sufficient however the amount of protein consumed is low.

  1. Family Doctors Seen through the Eyes of Specialists: A Qualitative Study

    Directory of Open Access Journals (Sweden)

    Anna Probst


    Full Text Available Germany is facing a shortage of young family doctors. In search of possible reasons the aim of this study was to explore the perception of specialists on family doctors. Within a qualitative study 16 medical specialists from different fields in hospital and outpatient care setting were interviewed. Interviews were analysed using qualitative content analysis according to Mayring. Most of the interviewed specialists have a positive view on family doctors although a certain depreciative assumption is resonated in a number of statements. According to the specialists, family doctors enjoy a high status in public, even if social processes of change may have a negative influence on their rather old-fashioned image. Specialists find that family medicine is underrepresented in university education suffering from an upgrading of specialized disciplines. Altogether the majority of the interviewed specialists certify family doctors in Germany a positive image. Lecturer in medical education and training should be aware of their key role in the career choices of young trainees and avoid degradation or upgrading of certain medical disciplines. Interlinked measures on different levels focusing on the improvement of working conditions and representation at the universities would be needed to regain attractiveness for the family doctor's profession as a career choice for young doctors.

  2. Women Doctors and Lady Nurses: Class, Education, and the Professional Victorian Woman. (United States)

    Heggie, Vanessa


    The lives of the first women doctors in Britain have been well studied by historians, as have the many debates about the right of women to train and practice as doctors. Yet the relationship between these women and their most obvious comparators and competitors-the newly professionalized hospital nurses-has not been explored. This article makes use of a wide range of sources to explore the ways in which the first lady doctors created "clear water" between themselves and the nurses with whom they worked and trained. In doing so, it reveals an identity that may seem at odds with some of the clichés of Victorian femininity, namely that of the intelligent and ambitious lady doctor.

  3. A survey on the attitudes of doctors towards health insurance payment in the medical consortium

    Institute of Scientific and Technical Information of China (English)

    SHI Ge; WU Tao; XU Wei-guo


    Background Medical consortium is a specific vertical integration model of regional medical resources.To improve medical resources utilization and control the health insurance costs by fee-for-service plans (FFS),capitation fee and diagnosis-related groups (DRGs),it is important to explore the attitudes of doctors towards the different health insurance payment in the medical consortium in Shanghai.Methods A questionnaire survey was carried out randomly on 50 doctors respectively in 3 different levels medical institutes.Results The statistical results showed that 90% of doctors in tertiary hospitals had the tendency towards FFS,whereas 78% in secondary hospitals towards DRGs and 84% in community health centers towards capitation fee.Conclusions There are some obvious differences on doctors' attitudes towards health insurance payment in 3 different levels hospitals.Thus,it is feasible that health insurance payment should be supposed to the doctors' attitudes using the bundled payments along with the third-party payment as a supervisor within consortium.

  4. Documentation of clinical care in hospital patients' medical records: A qualitative study of medical students' perspectives on clinical documentation education. (United States)

    Rowlands, Stella; Coverdale, Steven; Callen, Joanne


    Clinical documentation is essential for communication between health professionals and the provision of quality care to patients. To examine medical students' perspectives of their education in documentation of clinical care in hospital patients' medical records. A qualitative design using semi-structured interviews with fourth-year medical students was undertaken at a hospital-based clinical school in an Australian university. Several themes reflecting medical students' clinical documentation education emerged from the data: formal clinical documentation education using lectures and tutorials was minimal; most education occurred on the job by junior doctors and student's expressed concerns regarding variation in education between teams and receiving limited feedback on performance. Respondents reported on the importance of feedback for their learning of disease processes and treatments. They suggested that improvements could be made in the timing of clinical documentation education and they stressed the importance of training on the job. On-the-job education with feedback in clinical documentation provides a learning opportunity for medical students and is essential in order to ensure accurate, safe, succinct and timely clinical notes. © The Author(s) 2016.

  5. Doctoral education in a successful ecological niche

    DEFF Research Database (Denmark)

    Christensen, Mette Krogh; Lund, Ole


    explore the microclimate in an ecological niche of doctoral education. Based on a theoretical definition of microclimate as the emotional atmosphere that ties group members together and affects their actions, we conducted a case study that aimed to describe the key features of the microclimate...... in a successful ecological niche of doctoral education, and the ways in which the microclimate support the doctoral students’ learning. The methods we applied in the case study were based on short-term ethnographic fieldwork. The results reveal four key features of the emotional atmosphere in the microclimate...... successful doctoral education because it: 1) fleshes out the professional attitude that is necessary for becoming a successful researcher in the department, 2) shapes and adapts the doctoral students’ desires to grasp and identify with the department’s practices, and 3) provides the doctoral students...

  6. Women who doctor shop for prescription drugs. (United States)

    Worley, Julie; Thomas, Sandra P


    Doctor shopping is a term used to describe a form of diversion of prescription drugs when patients visit numerous prescribers to obtain controlled drugs for illicit use. Gender differences exist in regard to prescription drug abuse and methods of diversion. The purpose of this phenomenological study guided by the existential philosophy of Merleau-Ponty was to understand the lived experience of female doctor shoppers. Interviews were conducted with 14 women, which were recorded, transcribed, and analyzed. Included in the findings are figural aspects of the participants' experience of doctor shopping related to the existential grounds of world, time, body, and others. Four themes emerged from the data: (a) feeding the addiction, (b) networking with addicts, (c) playing the system, and (d) baiting the doctors. The findings suggest several measures that nurses can take to reduce the incidence of doctor shopping and to provide better care for female doctor shoppers.

  7. Attempt to promote hospital management by IM Public Platform

    Directory of Open Access Journals (Sweden)

    Hui CHEN


    Full Text Available Thisarticle has analyzed the contribution of modern IT to hospital management: using public platform of IM (instant message/communication will make it more convenient and efficient to conduct communication with (prior to the treatment, conduct treatment, and provide post-treatment service for patients and their family; withthe set-up of a smooth and efficient information channel set up, the relationship between patients and doctors will be greatly improved ,thus reputation and credibility of the hospital and its doctors will be promoted; when the public has better received the hospital and its doctors, social harmony will be achieved. 


    CERN Multimedia


    GENEVA PATIENT NOT FIT TO BE MOVED: Call your family doctor  Or SOS MEDECINS (24H/24H) Or ASSOC. MEDECINS DE GENEVE (7H-23H) 022 748-49-50 022 322-20-20 PATIENT CAN BE MOVED: HOPITAL CANTONAL 24 Micheli du Crest  022 372-33-11 / 022 382-33-11 URGENCES PEDIATRIQUES  30 Bd de la Cluse  022 382-45-55  MATERNITY 24 Micheli du Crest  022 382-68-16 / 022 382-33-11 CLINIQUE OPHTALMOLOGIQUE 22 Alcide Jentzer  022 382-84-00 HOPITAL DE LA TOUR  Meyrin  022 719-61-11 URGENCES ADULTES  Meyrin  022 719-66-80  URGENCES : AMBULANCE (GENEVE ET VAUD) : 144 FIRE BRIGADE CERN 767-44-44  FIRE BRIGADE 118 POLICE 117 CENTRE ANTI-POISON 24H/24H  01-251-51-510 APPEL D'URGENCE EUROPEEN 112 FRANCE PATIENT NOT FIT TO BE MOVED: Call your family doctor (ou­or 15) PATIENT CAN BE MOVED: HOPITAL DE ST. JULIEN  Rue Amédée VIII de Savoie&a...

  9. Urgent Need of a Doctor

    CERN Multimedia


    GENEVE PATIENT NOT FIT TO BE MOVED: Call your family doctor Or: SOS MEDECINS (24H/24H) 022 748-49-50 Or: ASSOC. MEDECINS DE GENEVE (07H-23H) 022 322-20-20 PATIENT CAN BE MOVED: • HOPITAL CANTONAL 24 Micheli du Crest 022 372-33-11 / 022 382-33-11 PAEDIATRIC EMERGENCIES 30 Bd de la Cluse 022 382-45-55 MATERNITY 24 Micheli du Crest 022 382-68-16 / 022 382-33-11 CLINIQUE OPHTALMOLOGY 22 Alcide Jentzer 022 382-84-00 • HOPITAL DE LA TOUR Meyrin 022 719-61-11 EMERGENCIES ADULTS Meyrin 022 719-66-80 EMERGENCIES: AMBULANCE (GENEVE AND VAUD) 144 FIRE BRIGADE 118 FIRE BRIGADE CERN 022 767-44-44 POLICE 117 ANTI POISON CENTRE (24H/24H) 01-251-51-51 EUROPEAN EMERGENCY CALL  112 FRANCE PATIENT NOT FIT TO BE MOVED: Call your family doctor (or 15) PATIENT CAN BE MOVED: • HOPITAL DE ST. JULIEN Rue Amédée VIII de Savoie 04-50-49-65-65 EMERGENCIES Rue Amédée VIII de Savoie 04.50-49-65-83 MATERNITY Rue Am&...


    CERN Multimedia


    GENEVE PATIENT NOT FIT TO BE MOVED: Call your family doctor Or: SOS MEDECINS (24H/24H) 022 748-49-50 Or: ASSOC. MEDECINS DE GENEVE (07H-23H) 022 322-20-20 PATIENT CAN BE MOVED: HOPITAL CANTONAL 24 Micheli du Crest 022 372-33-11 / 022 382-33-11 EMERGENCIES PEDIATRIQUES 30 Bd de la Cluse 022 382-45-55 MATERNITY 24 Micheli du Crest 022 382-68-16 / 022 382-33-11 CLINIQUE OPHTALMOLOGIQUE 22 Alcide Jentzer 022 382-84-00 HOPITAL DE LA TOUR Meyrin 022 719-61-11 EMERGENCIES ADULTES Meyrin 022 719-66-80 EMERGENCIES: AMBULANCES (GENEVE ET VAUD) 144 FIRE BRIGADE CERN 022 767-44-44 FIRE BRIGADE 118 POLICE 117 CENTRE ANTI-POISON: 24H/24H 01-251-51-51 EUROPEAN EMERGENCY CALL: 112 FRANCE PATIENT NOT FIT TO BE MOVED: Call your family doctor (or 15) PATIENT CAN BE MOVED: HOPITAL DE ST. JULIEN rue Amédée VIII de Savoie 04-50-49-65-65 EMERGENCIES rue Amédée VIII de Savoie 04-50-49-65-83 MATERNITY rue Amédée VIII de Savoie 04-50-49-66-07 HOPITAL D'ANNEMASSE 17 r...

  11. Urgent need of a doctor

    CERN Multimedia


    GENEVE PATIENT NOT FIT TO BE MOVED: Call your family doctor Or : SOS MEDECINS (24H/24H) 022 748-49-50 Or : ASSOC. MEDECINS DE GENEVE (07H-23H) 022 322-20-20 PATIENT CAN BE MOVED: HOPITAL CANTONAL 24 Micheli du Crest 022 372-33-11 / 022 382-33-11 EMERGENCIES PEDIATRIQUES 30 Bd de la Cluse 022 382-45-55 MATERNITY 24 Micheli du Crest 022 382-68-16 / 022 382-33-11 CLINIQUE OPHTALMOLOGIQUE 22 Alcide Jentzer 022 382-84-00 HOPITAL DE LA TOUR Meyrin 022 719-61-11 EMERGENCIES ADULTS Meyrin 022 719-66-80 EMERGENCIES: AMBULANCES (GENEVE ET VAUD) 144 FIRE BRIGADE CERN 022 767-44-44 FIRE BRIGADE 118 POLICE 117 CENTRE ANTI-POISON 24H/24H: 01-251-51-51 EUROPEAN EMERGENCY CALL : 112 FRANCE PATIENT NOT FIT TO BE MOVED: Call your family doctor (or 15) PATIENT CAN BE MOVED: HOPITAL DE ST. JULIEN rue Amédée VIII de Savoie 04-50-49-65-65 EMERGENCIES rue Amédée VIII de Savoie 04-50-49-65-83 MATERNITY rue Amédée VIII de Savoie 04-50-49-66-07 HOPITAL D'ANNEMASSE 1...

  12. Urgent Need of a Doctor

    CERN Multimedia


    GENEVE PATIENT NOT FIT TO BE MOVED: Call your family doctor Or: SOS MEDECINS (24H/24H) 022 748-49-50 Or: ASSOC. MEDECINS DE GENEVE (07H-23H) 022 322-20-20 PATIENT CAN BE MOVED: • HOPITAL CANTONAL 24 Micheli du Crest 022 372-33-11 / 022 382-33-11 PAEDIATRIC EMERGENCIES 30 Bd de la Cluse 022 382-45-55 MATERNITY 24 Micheli du Crest 022 382-68-16 / 022 382-33-11 CLINIQUE OPHTALMOLOGY 22 Alcide Jentzer 022 382-84-00 • HOPITAL DE LA TOUR Meyrin 022 719-61-11 EMERGENCIES ADULTS Meyrin 022 719-66-80 EMERGENCIES: AMBULANCE (GENEVE AND VAUD) 144 FIRE BRIGADE 118 FIRE BRIGADE CERN 022 767-44-44 POLICE 117 ANTI POISON CENTRE (24H/24H) 01-251-51-51 EUROPEAN EMERGENCY CALL  112 FRANCE PATIENT NOT FIT TO BE MOVED: Call your family doctor (or 15) PATIENT CAN BE MOVED: • HOPITAL DE ST. JULIEN Rue Amédée VIII de Savoie 04-50-49-65-65 EMERGENCIES Rue Amédée VIII de Savoie 04.50-49-65-83 MATERNITY Rue Am...

  13. Urgent need of a doctor

    CERN Multimedia


    GENEVE PATIENT NOT FIT TO BE MOVED: Call your family doctor Or: SOS MEDECINS (24H/24H) 022 748-49-50 Or: ASSOC. MEDECINS DE GENEVE (07H-23H) 022 322-20-20 PATIENT CAN BE MOVED: • HOPITAL CANTONAL 24 Micheli du Crest 022 372-33-11 / 022 382-33-11 URGENCES PEDIATRIQUES 30 Bd de la Cluse 022 382-45-55 MATERNITY 24 Micheli du Crest 022 382-68-16 / 022 382-33-11 CLINIQUE OPHTALMOLOGIQUE 22 Alcide Jentzer 022 382-84-00 • HOPITAL DE LA TOUR Meyrin 022 719-61-11 EMERGENCIES ADULTES Meyrin 022 719-66-80 EMERGENCIES: AMBULANCES (GENEVE AND VAUD) 144 FIRE BRIGADE CERN 022 767-44-44 FIRE BRIGADE 118 POLICE 117 CENTRE ANTI-POISON (24H/24H): 01-251-51-51 EUROPEAN EMERGENCY CALL: 112 FRANCE PATIENT NOT FIT TO BE MOVED: Call your family doctor (or 15) PATIENT CAN BE MOVED: • HOPITAL DE ST. JULIEN rue Amédée VIII de Savoie 04-50-49-65-65 EMERGENCIES rue Amédée VIII de Savoie 04-50-49-65-83 MATERNITY r...


    CERN Multimedia


    GENEVE PATIENT NOT FIT TO BE MOVED: Call your family doctor Or : SOS MEDECINS (24H/24H) 022 748-49-50 Or : ASSOC. MEDECINS DE GENEVE (07H-23H) 022 322-20-20 PATIENT CAN BE MOVED: HOPITAL CANTONAL 24 Micheli du Crest 022 372-33-11 / 022 382-33-11 EMERGENCIES PEDIATRIQUES 30 Bd de la Cluse 022 382-45-55 MATERNITY 24 Micheli du Crest 022 382-68-16 / 022 382-33-11 CLINIQUE OPHTALMOLOGIQUE 22 Alcide Jentzer 022 382-84-00 HOPITAL DE LA TOUR Meyrin 022 719-61-11 EMERGENCIES ADULTES Meyrin 022 719-66-80 EMERGENCIES: AMBULANCES (GENEVE ET VAUD) 144 FIRE BRIGADE CERN 022 767-44-44 FIRE BRIGADE 118 POLICE 117 CENTRE ANTI-POISON: 24H/24H 01-251-51-51 EUROPEAN EMERGENCY CALL: 112 FRANCE PATIENT NOT FIT TO BE MOVED: Call your family doctor (or 15) PATIENT CAN BE MOVED: HOPITAL DE ST. JULIEN rue Amédée VIII de Savoie 04-50-49-65-65 EMERGENCIES rue Amédée VIII de Savoie 04-50-49-65-83 MATERNITY rue Amédée VIII de Savoie 04-50-49-66-07 HOPITAL D'ANNEMASSE 17 rue du Jura, Ambilly 04-50-87-47-47 EMERGENCIES 17 rue...

  15. Junior empresa: un modelo empresarial diferente = Junior enterprise: a different business model

    Directory of Open Access Journals (Sweden)

    Javier Jiménez


    Full Text Available Resumen¿Quién no está harto ya de oír cómo está el mercado laboral? Nos bombardean con un ruido de fondo incesante, como si graduarnos no fuese suficiente reto. Bueno, ¿y qué? Un grupo de estudiantes de la Escuela Técnica Superior de Ingeniería y Diseño Industrial de la Universidad Politécnica de Madrid (ETSIDI-UPM nos hemos unido y hemos creado nuestra propia Junior Empresa, un modelo empresarial diferente, innovador, que nos permite revertir todos los beneficios en aprendizaje. ¿Quién ha dicho que tengamos que dejarnos vencer por un sistema laboral obsoleto?AbstractAre you tired of hearing how difficult it is to get a job? They are filling our minds with a non-stop background noise, as if getting a degree was an insufficient challenge. So what? Well, some students from the Superior Technical School of Engineering and Industrial Design from the Technical University of Madrid (ETSIDIUPM have come together and created our own Junior Enterprise, a different business model, an innovative canvas, which allows us to transform all the benefits into learning. Who said our destiny is being crushed by an obsolete labour market?

  16. Investjgatjon of Professjonal Abjljty of Rural Doctor jn Western Chjna%中国西部地区农村医师岗位职业能力调查研究

    Institute of Scientific and Technical Information of China (English)

    何坪; 张冬青; 邓宇; 潘伦; 肖文冲; 易敏春; 董萱; 邹利


    Objectjve To learn the professional ability of rural doctor in western China,and provide scientific reference for the improvement of professional competence training and junior - college clinical medicine education on rural doctor. Methods 36 rural grassroots health institutions from Chongqing City,Tongren City of Guizhou Province,Chuxiong City of Yunnan Province,were included by multi - stage stratified sampling from September 2012 to February 2013. A self - made questionnaire included general situation and vocational ability adaption ( the ability to adapt to the work environment, interpersonal communication skills,clinical diagnosis - treatment capacity and operational capability of medical equipments), was performed in rural doctors from the 36 rural grassroots health institutions. 580 doctors were investigated,498 of which responded,and the rate of response was 85. 9% . Results 10. 4%(52 / 498)of respondents had no any qualification. Only 43. 9%(208 / 473)of respondents choosed the option 〞 maintaining good or very good relationship with patients〞 . Data showed 79. 6%(393 / 494)of respondents ever transfered patients to higher hospital mainly due to the lack of medical equipments,and 35. 9% (141 / 393)of respondents done referral due to lack of medical technology. Phygmomanometer,stethoscope,body mass meter and blood glucose meter were often and proper used by investigated rural doctors,but few rural doctors could use other conventional medical equipments properly. 67. 3% (335 / 498)of respondents used auxiliary diagnosis instrument frequently, while 32. 7%(163 / 498)occasionally or never used auxiliary diagnosis instrument. After a comprehensive evaluation,the work environment adaptability score of investigated rural doctor was 74. 2,interpersonal communication skills score was 74. 0,clinical diagnosis - treatment capacity score was 69. 6,operational capability of medical equipments score was 31. 8. Conclusjon The educational background of rural doctors

  17. Consultation behaviour of doctor-shopping patients and factors that reduce shopping. (United States)

    Ohira, Yoshiyuki; Ikusaka, Masatomi; Noda, Kazutaka; Tsukamoto, Tomoko; Takada, Toshihiko; Miyahara, Masahito; Funakoshi, Hiraku; Basugi, Ayako; Keira, Katsunori; Uehara, Takanori


    To investigate the subsequent behaviour of doctor-shopping patients (defined as those attending multiple hospitals for the same complaint) who consulted our department and factors related to cessation of doctor shopping. Patients who presented without referral to the Department of General Medicine at Chiba University Hospital in Japan (our department) completed a questionnaire at their first visit. A follow-up questionnaire was also sent to them in order to assess doctor shopping after 3 months. Then items in the questionnaires were investigated for significant differences between patients who continued or stopped doctor shopping. Logistic regression analysis was performed with items showing a significant difference between patients who stopped doctor shopping and those who continued it, in order to identify independent determinants of the cessation of shopping. A total of 978 patients who presented spontaneously to our department consented to this study, and 929 patients (95.0%) completed questionnaires correctly. Among them, 203 patients (21.9%) were identified as doctor shoppers. The follow-up survey was completed correctly by 138 patients (68.0%). Among them, 25 patients (18.1%) were found to have continued doctor shopping, which was a significantly lower rate than before (P shopping: 'confirmation of the diagnosis' (odds ratio: 8.12, 95% confidence interval: 1.46-45.26), and 'satisfaction with consultation' (odds ratio: 2.07, 95% confidence interval: 1.42-3.01). Doctor shopping decreased significantly after patients consulted our department, with 'confirmation of the diagnosis' and 'satisfaction with consultation' being identified as contributing factors. © 2010 Blackwell Publishing Ltd.

  18. Psychiatric Prescribers' Experiences With Doctor Shoppers. (United States)

    Worley, Julie; Johnson, Mary; Karnik, Niranjan


    Doctor shopping is a primary method of prescription medication diversion. After opioids, benzodiazepines and stimulants are the next most common prescription medications used nonmedically. Studies have shown that patients who engage in doctor shopping find it fun, exciting, and easy to do. There is a lack of research on the prescriber's perspective on the phenomenon of doctor shopping. This study investigates the experiences of prescribers in psychiatry with patients who engage in doctor shopping. Fifteen prescribers including psychiatrists and psychiatric nurse practitioners working in outpatient psychiatry were interviewed to elicit detailed information about their experiences with patients who engage in doctor shopping. Themes found throughout the interview were that psychiatric prescribers' experience with patients who engage in doctor shopping includes (a) detecting red flags, (b) negative emotional responding, (c) addressing the patient and the problem, and (d) inconsistently implementing precautions. When red flags were detected when prescribing controlled drugs, prescribers in psychiatry experienced both their own negative emotional responses such as disappointment and resentment as well as the negative emotions of the patients such as anger and other extreme emotional responses. Psychiatric prescribers responded to patient's doctor shopping in a variety of ways such as changing their practice, discharging the patients or taking steps to not accept certain patients identified as being at risk for doctor shopping, as well as by talking to the patient and trying to offer them help. Despite experiencing doctor shopping, the prescribers inconsistently implemented precautionary measures such as checking prescription drug monitoring programs.

  19. Doctors' attitudes about prescribing and knowledge of the costs of common medications.

    LENUS (Irish Health Repository)

    McGuire, C


    INTRODUCTION: Compliance with medical therapy may be compromised because of the affordability of medications. Inadequate physician knowledge of drug costs may unwittingly contribute to this problem. METHODS: We measured attitudes about prescribing and knowledge of medication costs by written survey of medical and surgical non consultant hospital doctors and consultants in two University teaching hospitals (n = 102). Sixty-eight percent felt the cost of medicines was an important consideration in the prescribing decision, however, 88% often felt unaware of the actual costs. Only 33% had easy access to drug cost data, and only 3% had been formally educated about drug costs. Doctors\\' estimates of the cost of a supply of ten commonly used medications were accurate in only 12% of cases, too low for 50%, and too high for 38%. CONCLUSIONS: Interventions are needed to educate doctors about drug costs and provide them with reliable, easily accessible cost information in real-world practice.

  20. Acute hormonal responses in elite junior weightlifters. (United States)

    Kraemer, W J; Fry, A C; Warren, B J; Stone, M H; Fleck, S J; Kearney, J T; Conroy, B P; Maresh, C M; Weseman, C A; Triplett, N T


    To date, no published studies have demonstrated resistance exercise-induced increases in serum testosterone in adolescent males. Furthermore, few data are available on the effects of training experience and lifting performance on acute hormonal responses to weightlifting in young males. Twenty-eight junior elite male Olympic-style weightlifters (17.3 +/- 1.4 yrs) volunteered for the study. An acute weightlifting exercise protocol using moderate to high intensity loads and low volume, characteristic of many weightlifting training sessions, was examined. The exercise protocol was directed toward the training associated with the snatch lift weightlifting exercise. Blood samples were obtained from a superficial arm vein at 7 a.m. (for baseline measurements), and again at pre-exercise, 5 min post-, and 15 min post-exercise time points for determination of serum testosterone, cortisol, growth hormone, plasma beta-endorphin, and whole blood lactate. The exercise protocol elicited significant (p less than or equal to 0.05) increases in each of the hormones and whole blood lactate compared to pre-exercise measures. While not being significantly older, subsequent analysis revealed that subjects with greater than 2 years training experience exhibited significant exercise-induced increases in serum testosterone from pre-exercise to 5 min post-exercise (16.2 +/- 6.2 to 21.4 +/- 7.9 nmol.l-1), while those with less than or equal to 2 years training showed no significant serum testosterone differences. None of the other hormones or whole blood lactate appear to be influenced by training experience.(ABSTRACT TRUNCATED AT 250 WORDS)

  1. Truth telling in Taiwanese cancer care: patients' and families' preferences and their experiences of doctors' practices. (United States)

    Tang, Woung-Ru; Hong, Ji-Hong; Rau, Kun-Ming; Wang, Cheng-Hsu; Juang, Yeong-Yuh; Lai, Chien-Hong; Fujimori, Maiko; Fang, Chun-Kai


    Despite the significant role played by cancer patients' families in medical decision-making in Asian countries, inconsistencies have hitherto not been evaluated between patients' and families' preferences and doctors' actual practices with regard to cancer truth telling. For this quantitative comparative study of cancer patients' and families' truth-telling preferences and their experiences of doctors' practices, 532 patients, 551 family members, and 127 doctors (N = 1 210) were enrolled from five hospitals across Taiwan over 2 years. Truth telling was assessed using the Taiwanese version of a modified Japanese truth-telling scale. Patients' truth-telling preferences and their experiences of doctors' truth-telling practices differed significantly in scores on the overall truth-telling scale and each subscale, including method of disclosure, emotional support, additional information, and setting (P truth-telling preference scores were higher than doctors' actual practice scores. Multiple regression analysis revealed a dose-dependent effect of doctors' monthly truth-telling frequency on their truth-telling preferences, but this effect was only borderline significant (P = .08). This multiple regression model explained 30% of the total variance in doctors' truth-telling preferences (F = 1.38, P = .22). Taiwanese medical educational policies need to be revised to better equip doctors to practice truth telling in accordance with the preferences of cancer patients and families. Communication skills training should be prioritized for doctors who refrain from truth telling in actual practice. Copyright © 2016 John Wiley & Sons, Ltd.

  2. Value-meaning Barriers in Research Activity of Junior Scientists

    Directory of Open Access Journals (Sweden)

    Shabalovskaya M.V.


    Full Text Available Contents of value-meaning barriers are covered that acquire certain specifics in research activity and influence formation of meaning-forming research motivation of junior scientists. Such barriers were assumed to be conditioned by dissonance between dominating values and degree of their realization in junior researchers. Sample of respondents included 88 beginners: postgraduate students (n=65 and masters (n=23 of Tomsk high schools aged between 21 and 35 years. As research methods the expanded version of technique by M. Rokeach (proposed by M.S. Yanitsky and A.V. Seryy, methods of statistical analysis of results (frequency analysis, Mann-Whitney test were used. Relevant value orientations of junior scientists are presented. Gender differences in value-meaning domain are revealed. Differences in values in postgraduate students and masters were found. Dissonance in degree of fulfillment of terminal and instrumental values has been established that indicates disturbances of value-meaning domain of the personality of junior scientists. Results add to scientific ideas about value-meaning barriers in research activity of junior scientists.

  3. Perceived Injury Risk among Junior Cricketers: A Cross Sectional Survey

    Directory of Open Access Journals (Sweden)

    Prasanna J. Gamage


    Full Text Available Understanding how junior athletes perceive injury risks when participating in sport and the environment they play in is an important component of injury prevention. This study investigates how Sri Lankan junior cricketers (n = 365, aged 11–14 years, boys perceive injury risks associated with playing cricket. The study used a Sri Lankan modification of an Australian junior cricket injury risk perception survey that considered playing cricket versus other sports, different cricket playing positions and roles, and different ground conditions. The risk of playing cricket was considered to be greater than that for cycling, but lower than that for rugby and soccer. Fast-bowlers, batters facing fast-bowlers, fielding close in the field, and wicket-keeping without a helmet were perceived to pose greater risks of injury than other scenarios. Playing on hard, bumpy and/or wet ground conditions were perceived to have a high risk opposed to playing on a grass field. Fielding in the outfield and wicket-keeping to fast-bowlers whilst wearing a helmet were perceived as low risk actions. The risk perceptions of junior cricketers identified in this study, do not necessarily reflect the true injury risk in some instances. This information will inform the development of injury prevention education interventions to address these risk perceptions in junior cricketers.

  4. Effects of Clown Doctors on Child and Caregiver Anxiety at the Entrance to the Surgery Care Unit and Separation from Caregivers (United States)

    Arriaga, Patrícia; Pacheco, Catarina


    This study investigated the effects of hospital Clown Doctors intervention on child and caregiver preoperative anxiety at the entrance to the surgery care unit and separation from caregivers. A total of 88 children (aged 4-12 years) were assigned to one of the following two groups: Clown Doctors intervention or control group (standard care).…

  5. Knowing Laughter: What Do Clown-Doctors Know and How Do They Learn To Do What They Do? NALL Working Paper. (United States)

    Warren, Bernie

    A research project was conducted to determine how and what clown-doctors know on entry to the profession and how and what they learn both formally and informally in a hospital environment; the linkages between informal and formal learning in clown-doctor training and practice in Canada; and "best practices." Information was gathered…

  6. Doctoral Studies in Romania: Admission Procedures, Social, and Legal Aspects of Doctoral Training (United States)

    Miclea, Mircea


    This contribution presents a concise and up-to-date report of doctoral studies in Romania, with a special emphasis on legal and social aspects. The author also argues that in order to be sustainable, the reform of doctoral studies should be substantiated by the differentiation of universities, reliable post-doctoral programmes, and a substantive…

  7. Challenges to the Doctoral Journey: A Case of Female Doctoral Students from Ethiopia (United States)

    Bireda, Asamenew Demessie


    This study aimed to investigate some challenges female doctoral students experience in their doctoral journey. The study used a qualitative design and structured interviews. The theoretical framework that guided the study was that of Urie Bronfenbrenner's ecosystemic theory. A purposely selected sample of five female doctoral students from the…

  8. What Disengages Doctoral Students in the Biological and Environmental Sciences from Their Doctoral Studies? (United States)

    Virtanen, V.; Taina, J.; Pyhältö, K.


    This study explored the causes of student disengagement from their doctoral studies in the biological and environmental sciences. The data came from interviews of 40 doctoral students (male = 15, female = 25) and underwent qualitative analysis for content. Our results showed that doctoral studies provide multiple contexts for disengagement, such…

  9. A Qualitative Examination of Challenges Influencing Doctoral Students in an Online Doctoral Program (United States)

    Deshpande, Anant


    The main purpose of the study was to investigate the challenges faced by students in completion of an online doctoral program at the University of Liverpool, Online Doctoral Business Administration program. We analyse the responses of 91 doctoral students in an online DBA program. Based on the exploratory qualitative study themes were developed…

  10. On Doctoral Student Development: Exploring Faculty Mentoring in the Shaping of African American Doctoral Student Success (United States)

    Felder, Pamela


    This study examines the influence of faculty mentorship in the shaping of African American doctoral student success. A case analysis framework is used to investigate the belief systems that doctoral students held about their doctoral experience. Data collection involved a one-phase semi-structured interview protocol used to gather information…

  11. Sensitising intern doctors to ethical issues in a doctor-patient relationship. (United States)

    Shah, Nilima D; Mehta, Ritambhara Y; Dave, Kamlesh R


    There is a felt need in India to influence the ethical behaviour of doctors by giving students formal education in ethics in medical colleges. Since internship is the interface between learning and independent practice, it is important to sensitise intern doctors to ethical issues in a doctor-patient relationship at this stage.

  12. Inequality and Doctoral Education: Exploring the "Rules" of Doctoral Study through Bourdieu's Notion of Field (United States)

    Gopaul, Bryan


    While studies have examined a myriad of issues in doctoral study, much of this research has not employed the tools of major social and cultural thinkers to the dynamics of doctoral education. This paper explores the use of Bourdieu's notion of field to render visible the practices and contexts of doctoral education that produce inequalities across…

  13. What Disengages Doctoral Students in the Biological and Environmental Sciences from Their Doctoral Studies? (United States)

    Virtanen, V.; Taina, J.; Pyhältö, K.


    This study explored the causes of student disengagement from their doctoral studies in the biological and environmental sciences. The data came from interviews of 40 doctoral students (male = 15, female = 25) and underwent qualitative analysis for content. Our results showed that doctoral studies provide multiple contexts for disengagement, such…

  14. The Association of Types of Training and Practice Settings with Doctors' Empathy and Patient Enablement among Patients with Chronic Illness in Hong Kong.

    Directory of Open Access Journals (Sweden)

    Frances S K Yu

    Full Text Available The increase in non-communicable disease (NCD is becoming a global health problem and there is an increasing need for primary care doctors to look after these patients although whether family doctors are adequately trained and prepared is unknown.This study aimed to determine if doctors with family medicine (FM training are associated with enhanced empathy in consultation and enablement for patients with chronic illness as compared to doctors with internal medicine training or without any postgraduate training in different clinic settings.This was a cross-sectional questionnaire survey using the validated Chinese version of the Consultation and Relational Empathy (CARE Measure as well as Patient Enablement Instrument (PEI for evaluation of quality and outcome of care. 14 doctors from hospital specialist clinics (7 with family medicine training, and 7 with internal medicine training and 13 doctors from primary care clinics (7 with family medicine training, and 6 without specialist training were recruited. In total, they consulted 823 patients with chronic illness. The CARE Measure and PEI scores were compared amongst doctors in these clinics with different training background: family medicine training, internal medicine training and those without specialist training. Generalized estimation equation (GEE was used to account for cluster effects of patients nested with doctors.Within similar clinic settings, FM trained doctors had higher CARE score than doctors with no FM training. In hospital clinics, the difference of the mean CARE score for doctors who had family medicine training (39.2, SD = 7.04 and internal medicine training (35.5, SD = 8.92 was statistically significant after adjusting for consultation time and gender of the patient. In the community care clinics, the mean CARE score for doctors with family medicine training and those without specialist training were 32.1 (SD = 7.95 and 29.2 (SD = 7.43 respectively, but the difference was not

  15. Doctors in a Southeast Asian country communicate sub-optimally regardless of patients' educational background.

    NARCIS (Netherlands)

    Claramita, M.; Dalen, J.V.; Vleuten, C.P.M. van der


    OBJECTIVE: To explore the relationship between the style of doctor-patient communication and patients' educational background in a Southeast Asian teaching hospital setting using the Roter Interaction Analysis System (RIAS). METHODS: We analyzed a total of 245 audio-taped consultations involving 30

  16. Doctors in a Southeast Asian country communicate sub-optimally regardless of patients' educational background.

    NARCIS (Netherlands)

    Claramita, M.; Dalen, J.V.; Vleuten, C.P.M. van der


    OBJECTIVE: To explore the relationship between the style of doctor-patient communication and patients' educational background in a Southeast Asian teaching hospital setting using the Roter Interaction Analysis System (RIAS). METHODS: We analyzed a total of 245 audio-taped consultations involving 30

  17. [Priest-doctors in Russia]. (United States)

    Berlan, Hélène; Triaire, Dominique


    Jean Pierre Frank offers in the early nineteenth century a revolution in medical Russian Empire. Indeed, Russia is in an emergency situation where the lack of practitioners is obvious. The imperial project is inspired by past practices in some European countries. Frank fits these transfers and implements a unique model where the priest-doctor stands out as the solution to overcome the lack of medicalization of the Empire. Even if the attempt was a failure, it remains that the proposals were part of Frank in both an ancient tradition that priests and physicians providing care for souls and bodies, but also showed that called his wishes the advent of "public health" in this country disinherited.

  18. The Doctor and the Charlatan

    Directory of Open Access Journals (Sweden)

    Isabelle Stengers


    Full Text Available We all know, in fact we are sure, that our medical practices are very different from those in the times of Molière or of Louis XVI. In one way or another medicine has today become ‘modern’ in the same way as the whole set of knowledges and practices that call themselves rational. This is obvious, but I would like to interrogate this obviousness. Not to debunk it so as to show that beyond these appearances nothing has changed, but in order to focus in a slightly clearer way on ‘what’ has changed. To be even more precise, I would like to focus on ‘what’ has changed for the doctor, the one who practises medicine.

  19. [Patients' rights--doctors' duties]. (United States)

    Jaeger, L; Bertram, E; Grate, S; Mischkowsky, T; Paul, D; Probst, J; Scala, E; Wbllenweber, H D


    On 26 February 2013 the new "Law on Patients' Rights" (hereinafter also the "Law") became effective. This Law strengthens patients' rights vis-à-vis the insurdnce company and also regulates patients' rights regarding their relation to the doctor. This has consequences for the laws on medical liability all doctors must consider. The doctor's performance is and remains a service and such service does not hold any guarantee of success. Nevertheless, this Law primarily reads as a "law on the duties of physicians". To duly take into account these duties and to avoid mistakes and misinterpretation of the Law, the Ethics Committee of the Consortium of Osteosynthesis Trauma Germany (AOTRAUMA-D) has drafted comments on the Law. Brief summaries of its effects are to be found at the end of the respective comment under the heading "Consequences for Practice". The text of the law was influenced particularly by case law, as continuously developed by the German Federal Court of Justice ("BGH"). The implementation of the Law on Patients' Rights was effected by the newly inserted sections 630a to 630h of the German Civil Code (the "BGB"), which are analysed below. The following comments are addressed to physicians only and do not deal with the specific requirements and particularities of the other medical professions such as physiotherapy, midwifery and others so on. Special attention should be paid to the comments on the newly inserted Duty to inform, which has to be fullfilled prior to any diagnostic or therapeutic procedure (sec. 630c para 2 sentence 1 BGB). Under certain conditions the doctor also has to inform the patient about the circumstances that lead to the presumed occurance of a therapeutic or diagnostic malpractice (sec. 630c para. 2 sentence 2 BGB), based on the manifestation of an undesired event or an undesired outcome. As before, the patient's valid consent to any procedure (sec. 630d BGB) is directly linked to the comprehensive and timely provision of information

  20. Developing a Peer Mentorship Program to Increase Competence in Clinical Supervision in Clinical Psychology Doctoral Training Programs. (United States)

    Foxwell, Aleksandra A; Kennard, Beth D; Rodgers, Cynthia; Wolfe, Kristin L; Cassedy, Hannah F; Thomas, Anna


    Supervision has recently been recognized as a core competency for clinical psychologists. This recognition of supervision as a distinct competency has evolved in the context of an overall focus on competency-based education and training in health service psychology, and has recently gained momentum. Few clinical psychology doctoral programs offer formal training experiences in providing supervision. A pilot peer mentorship program (PMP) where graduate students were trained in the knowledge and practice of supervision was developed. The focus of the PMP was to develop basic supervision skills in advanced clinical psychology graduate students, as well as to train junior doctoral students in fundamental clinical and practical skills. Advanced doctoral students were matched to junior doctoral students to gain experience in and increase knowledge base in best practices of supervision skills. The 9-month program consisted of monthly mentorship meetings and three training sessions. The results suggested that mentors reported a 30% or more shift from the category of not competent to needs improvement or competent, in the following supervision competencies: theories of supervision, improved skill in supervision modalities, acquired knowledge in supervision, and supervision experience. Furthermore, 50% of the mentors reported that they were not competent in supervision experience at baseline and only 10% reported that they were not competent at the end of the program. Satisfaction data suggested that satisfaction with the program was high, with 75% of participants indicating increased knowledge base in supervision, and 90% indicating that it was a positive addition to their training program. This program was feasible and acceptable and appears to have had a positive impact on the graduate students who participated. Students reported both high satisfaction with the program as well as an increase in knowledge base and experience in supervision skills.