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Sample records for medical leadership doctors

  1. From medical doctor to medical director: leadership style matters.

    Williams, Geraint; Wood, Edward V; Ibram, Ferda

    2015-07-01

    Leadership is a skill to be developed by all doctors from the foundation trainee to the director of the board. This article explores the impact of leadership style on performance and considers techniques to develop doctors' leadership skills and personal effectiveness.

  2. Medical doctors in healthcare leadership: theoretical and practical challenges.

    Denis, Jean-Louis; van Gestel, Nicolette

    2016-05-24

    While healthcare systems vary in their structure and available resources, it is widely recognized that medical doctors play a key role in their adaptation and performance. In this article, we examine recent government and organizational policies in two different health systems that aim to develop clinical leadership among the medical profession. Clinical leadership refers to the engagement and guiding role of physicians in health system improvement. Three dimensions are defined to conduct our analysis of engaging medical doctors in healthcare leadership: the position and status of medical doctors within the system; the broader institutional context of governmental and organizational policies to engage medical doctors in clinical leadership roles; and the main factors that may facilitate or limit achievements. Our aim in this study is exploratory. We selected two contrasting cases according to their level of institutional pluralism: one national health insurance system, Canada, and one etatist social insurance system, the Netherlands. We documented the institutional dynamics of medical doctors' engagement and leadership through secondary sources, such as government websites, key policy reports, and scholarly literature on health policies in both countries. Initiatives across Canadian provinces signal that the medical profession and governments search for alternatives to involve doctors in health system improvement beyond the limitations imposed by their fundamental social contract and formal labour relations. These initiatives suggest an emerging trend toward more joint collaboration between governments and medical associations. In the Dutch system, organizational and legal attempts for integration over the past decades do not yet fit well with the ideas and interests of medical doctors. The engagement of medical doctors requires additional initiatives that are closer to their professional values and interests and that depart from an overly focus on top down

  3. [Unravelling medical leadership].

    Voogt, Judith J; van Rensen, Elizabeth L J; Noordegraaf, Mirko; Schneider, Margriet M E

    2015-01-01

    Medical leadership is a popular topic in the Netherlands, and several interest groups now incorporate medical leadership into postgraduate medical education. However, there is no consensus on what this concept entails. By conducting a discourse analysis, a qualitative method which uses language and text to reveal existing viewpoints, this article reveals three perspectives on medical leadership: administrative leadership, leadership within organisations and leadership within each doctor's daily practice. Text analysis shows that the first two perspectives refer to medical leadership mainly in a defensive manner: by demonstrating medical leadership doctors could 'take the lead' once again; patient care only seems to play a small part in the process. These perspectives are not free of consequences, they will determine how the medical profession is constructed. For this reason, it is argued that there should be more emphasis on the third perspective, in which the quality of care for patients is of primary importance.

  4. Medical leadership, a systematic narrative review: do hospitals and healthcare organisations perform better when led by doctors?

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

    2017-09-24

    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

  5. Misconceiving medical leadership.

    Parker, Malcolm

    2013-01-01

    Medical leadership and leadership education have recently emerged as subjects of an expanding though as yet uncritical literature. Considerable attention is being given to the development of courses and electives, together with some proposals for generalizing these offerings to all medical students and doctors. This article briefly sketches this development and its derivation from business and corporate leadership models and accompanying literature, and subjects its adoption by medicine to critical scrutiny. Putative motivations for these developments are discussed, and an alternative explanation is offered, tied to the loss of physician status. The nature of leadership as complex, emergent, and unpredictable has been ignored in the promotion of medical leadership and leadership training, and this is reflected in the false assumption that leadership in medicine is something that can be taught. Although the leadership literature is beginning to recognize these complex aspects of leadership, so far their implications have not been acknowledged. This article aims to stimulate further analytic discussion of this under-theorized aspect of medicine.

  6. Encouraging formative assessments of leadership for foundation doctors.

    Hadley, Lindsay; Black, David; Welch, Jan; Reynolds, Peter; Penlington, Clare

    2015-08-01

    Clinical leadership is considered essential for maintaining and improving patient care and safety in the UK, and is incorporated in the curriculum for all trainee doctors. Despite the growing focus on the importance of leadership, and the introduction of the Medical Leadership Competency Framework (MLCF) in the UK, leadership education for doctors in training is still in its infancy. Assessment is focused on clinical skills, and trainee doctors receive very little formal feedback on their leadership competencies. In this article we describe the approach taken by Health Education Kent, Sussex and Surrey (HEKSS) to raise the profile of leadership amongst doctors in training in the South Thames Foundation School (STFS). An annual structured formative assessment in leadership for each trainee has been introduced, supported by leadership education for both trainees and their supervisors in HEKSS trusts. We analysed over 500 of these assessments from the academic year 2012/13 for foundation doctors in HEKSS trusts, in order to assess the quality of the feedback. From the analysis, potential indicators of more effective formative assessments were identified. These may be helpful in improving the leadership education programme for future years. There is a wealth of evidence to highlight the importance and value of formative assessments; however, particularly for foundation doctors, these have typically been focused on assessing clinical capabilities. This HEKSS initiative encourages doctors to recognise leadership opportunities at the beginning of their careers, seeks to help them understand the importance of acquiring leadership skills and provides structured feedback to help them improve. Leadership education for doctors in training is still in its infancy. © 2015 John Wiley & Sons Ltd.

  7. Leadership Preparation in an Education Doctorate Program

    Ryerson, Dean

    2011-01-01

    This was a study of an education doctorate program at a small, private college. It examined the following nine components: theory of leadership for school improvement; candidate recruitment and selection based on leadership; coherent curriculum; use of active learning strategies; knowledgeable faculty; high quality internships; social and…

  8. Power, leadership and transformation: the doctor's potential for influence.

    Gabel, Stewart

    2012-12-01

    Power and leadership are concepts that are linked. Both are studied too infrequently in medical and health care settings, given the responsibilities and opportunities doctors and other health care personnel have to exert leadership and power appropriately to foster patient-centred and health care organisational goals. This paper reviews Raven's concept of power, clarifies the bases of power that are available to doctors in different roles and provides illustrations of the application of the bases of power in medical practice. The relationship between power and leadership is explored, with an emphasis on how power and leadership are linked through the personal characteristics and competencies of the leader.   Transformational leadership illustrates the incorporation and elaboration of power strategies into a principles-driven, relationship-oriented and empirically grounded form of leadership. Illustrations of the appropriate and inappropriate use of power and leadership in health care settings are provided. The study of power, the study of leadership and their linkage should be incorporated to a greater degree into medical education at all levels. Strategies to achieve this end are suggested. © Blackwell Publishing Ltd 2012.

  9. Medical thrillers: doctored fiction for future doctors?

    Charpy, Jean-Pierre

    2014-12-01

    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.

  10. Promoting Team Leadership Skills in Doctoral Candidates

    Suleiman, Mahmoud; Whetton, Danny

    2014-01-01

    Doctoral programs can serve as an optimal opportunity for candidates to engage in tasks and activities to transform them and their schools. The paradigm shifts in such preparation involve moving from sitting and getting to making and taking. Most importantly, it requires building leadership skills and styles necessary to bring about desired change…

  11. Will Medical Technology Deskill Doctors?

    Lu, Jingyan

    2016-01-01

    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. Exploring a shared leadership perspective for NHS doctors.

    Willcocks, Stephen George; Wibberley, Gemma

    2015-01-01

    The purpose of this paper is to explore involving doctors in shared leadership. It examines the policies that have led to the focus on shared leadership and the implications for practice. This is a conceptual paper, examining policy developments and key literature to understand the move towards shared leadership. It focuses on UK NHS, and in particular doctors, although the concepts will be relevant to other disciplines in healthcare, and healthcare systems in other countries. This paper suggests that the shared-leadership approach for doctors has potential given the nature of clinical practice, the inherently collaborative nature of healthcare and the demands of new healthcare organisations. Health policy reform, generally, will mean that all doctors need to be engaged with leadership, albeit, perhaps, at different levels, and with different degrees of formality. Leadership will remain an important precondition for the success of the reforms. This is likely to be the case for other countries involved in healthcare reform. To highlight the benefits and barriers to shared leadership for doctors. Offers an alternative to traditional approaches to leadership.

  13. Cultural initiation of medical doctors.

    Zsinkó-Szabó, Zoltán; Lázár, Imre

    2013-12-01

    Eighteen years experience of teaching medical anthropology at a Hungarian medical school offers insight into the dynamics of interference between the rationalist epistemological tradition of biomedicine as one of the central paradigms of modernism and the cultural relativism of medical anthropology, as cultural anthropology is considered to be one of the generators of postmodern thinking. Tracing back the informal "prehistory" of our Institute, we can reveal its psychosomatic, humanistic commitment and critical basis as having represented a kind of counterculture compared with the technocrats of state-socialist Hungary's health ideology. The historical change and socio-cultural transition in Hungary after 1989 was accompanied by changes in the medical system as well as in philosophy and in the structure of the teaching of social sciences. The developing pluralism in the medical system together with the pluralism of social ideologies allowed the substitution of the dogmatic Marxist-Leninist framework with the more pragmatic and empiricist behavioral sciences including medical sociology and medical anthropology. The conflict between the initiation function of the hard preclinical training of the first two years, and the reflective, relativistic and critical narrative on "biomedicine as culture bound entity" constructed by medical anthropology during the second year of medical training is discussed. We also submit our fieldwork data gained as a result of a two year investigation period focusing on diverse initiation types of "would be" physicians. The main proportion of our data derives from individual semi structured deep interviews together with focus group interviews carried out with medical students of upper years. Finally, the role of medical anthropology in the "rite of passage" of becoming a medical doctor is summarized, paying attention to their field work reports and the risks and gains in this process.

  14. Cultural Complementarity : Reshaping Professional and Organizational Logics in Developing Frontline Medical Leadership

    Noordegraaf, Mirko; Schneider, Magriet; Boselie, Paul; van Rensen, E.L.J.

    2016-01-01

    With the rise of clinical management, new skills of medical doctors stand out, including leadership skills. Medical doctors organize medical work and improve patient care. The training of frontline leadership skills, however, is weakly developed in residency programmes. Medical professional cultures

  15. Doctor's dilemma (medical decision making)

    Ganatra, R.D.

    2003-01-01

    Disagreement between experts is presumed to be uncommon in medical diagnosis. Radiology is considered to be a particularly objective means of diagnosis and expert radiographic interpretation is expected to be infallible. Five military radiologists were made to review independently chest radiographs of 1256 patients recorded in four image formats and interpret each as positive or negative for tuberculosis. The results were unexpected. Ability to detect tuberculosis varied little between various image formats but the extent of disagreement between doctors was remarkable. The number of cases judged positive varied from 56 to 100 among the five readers. Of cases judged positive at least once, the mean rate of disagreement between pairs of readers was 19%. The validity of these findings have been confirmed repeatedly in several subsequent trials. Other diagnostic modalities show equally surprising rates of diagnostic dissonance. Extensive observer disagreement was found to be a universal problem in medical diagnosis, giving credence to the proverbial adage that 'no two doctors agree'. The magnitude of disagreement between experts is the principal theoretic problem of diagnosis. Even a stochastic theory of diagnosis is devised which accounts for the disagreement between experts, where the disagreement approaches a theoretic maximum even for ideal diagnosticians

  16. Transformational Leadership in the Planning of a Doctoral Program.

    Martinez, Bobby J.; Slater, Charles L.

    2000-01-01

    The process of developing a doctoral program at the University of the Incarnate Word demonstrates the use of both transformational leadership (empowerment, advocacy, reconciliation) and transactional leadership (power brokering, making legitimate decisions). The contemporary environment needs multiple leaders who exercise different types of…

  17. Training of Leadership Skills in Medical Education

    Kiesewetter, Jan; Schmidt-Huber, Marion; Netzel, Janine; Krohn, Alexandra C.; Angstwurm, Matthias; Fischer, Martin R.

    2013-01-01

    Background: Effective team performance is essential in the delivery of high-quality health-care. Leadership skills therefore are an important part of physicians’ everyday clinical life. To date, the development of leadership skills are underrepresented in medical curricula. Appropriate training methods for equipping doctors with these leadership skills are highly desirable. Objective: The review aims to summarize the findings in the current literature regarding training in leadership skills in medicine and tries to integrate the findings to guide future research and training development. Method: The PubMED, ERIC, and PsycArticles, PsycINFO, PSYNDEX and Academic search complete of EBSCOhost were searched for training of leadership skills in medicine in German and English. Relevant articles were identified and findings were integrated and consolidated regarding the leadership principles, target group of training and number of participants, temporal resources of the training, training content and methods, the evaluation design and trainings effects. Results: Eight studies met all inclusion criteria and no exclusion criteria. The range of training programs is very broad and leadership skill components are diverse. Training designs implied theoretical reflections of leadership phenomena as well as discussions of case studies from practice. The duration of training ranged from several hours to years. Reactions of participants to trainings were positive, yet no behavioral changes through training were examined. Conclusions: More research is needed to understand the factors critical to success in the development of leadership skills in medical education and to adapt goal-oriented training methods. Requirements analysis might help to gain knowledge about the nature of leadership skills in medicine. The authors propose a stronger focus on behavioral training methods like simulation-based training for leadership skills in medical education. PMID:24282452

  18. Training of leadership skills in medical education.

    Kiesewetter, Jan; Schmidt-Huber, Marion; Netzel, Janine; Krohn, Alexandra C; Angstwurm, Matthias; Fischer, Martin R

    2013-01-01

    Effective team performance is essential in the delivery of high-quality health-care. Leadership skills therefore are an important part of physicians' everyday clinical life. To date, the development of leadership skills are underrepresented in medical curricula. Appropriate training methods for equipping doctors with these leadership skills are highly desirable. The review aims to summarize the findings in the current literature regarding training in leadership skills in medicine and tries to integrate the findings to guide future research and training development. The PubMED, ERIC, and PsycArticles, PsycINFO, PSYNDEX and Academic search complete of EBSCOhost were searched for training of leadership skills in medicine in German and English. Relevant articles were identified and findings were integrated and consolidated regarding the leadership principles, target group of training and number of participants, temporal resources of the training, training content and methods, the evaluation design and trainings effects. Eight studies met all inclusion criteria and no exclusion criteria. The range of training programs is very broad and leadership skill components are diverse. Training designs implied theoretical reflections of leadership phenomena as well as discussions of case studies from practice. The duration of training ranged from several hours to years. Reactions of participants to trainings were positive, yet no behavioral changes through training were examined. More research is needed to understand the factors critical to success in the development of leadership skills in medical education and to adapt goal-oriented training methods. Requirements analysis might help to gain knowledge about the nature of leadership skills in medicine. The authors propose a stronger focus on behavioral training methods like simulation-based training for leadership skills in medical education.

  19. Teaching leadership: the medical student society model.

    Matthews, Jacob H; Morley, Gabriella L; Crossley, Eleanor; Bhanderi, Shivam

    2018-04-01

    All health care professionals in the UK are expected to have the medical leadership and management (MLM) skills necessary for improving patient care, as stipulated by the UK General Medical Council (GMC). Newly graduated doctors reported insufficient knowledge about leadership and quality improvement skills, despite all UK medical schools reporting that MLM is taught within their curriculum. A medical student society organised a series of extracurricular educational events focusing on leadership topics. The society recognised that the events needed to be useful and interesting to attract audiences. Therefore, clinical leaders in exciting fields were invited to talk about their experiences and case studies of personal leadership challenges. The emphasis on personal stories, from respected leaders, was a deliberate strategy to attract students and enhance learning. Evaluation data were collected from the audiences to improve the quality of the events and to support a business case for an intercalated degree in MLM. When leadership and management concepts are taught through personal stories, students find it interesting and are prepared to give up their leisure time to engage with the subject. Students appear to recognise the importance of MLM knowledge to their future careers, and are able to organise their own, and their peers', learning and development. Organising these events and collecting feedback can provide students with opportunities to practise leadership, management and quality improvement skills. These extracurricular events, delivered through a student society, allow for subjects to be discussed in more depth and can complement an already crowded undergraduate curriculum. Newly graduated doctors reported insufficient knowledge about leadership and quality improvement skills. © 2017 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

  20. Impressions of Action and Critical Action Learning: Exploring the Leadership Development of Senior Doctors in an English Healthcare Organization

    McCray, Janet; Warwick, Rob; Palmer, Adam

    2018-01-01

    This paper aims to explore the influence of one cycle of a learning set experience in a postgraduate medical leadership development programme. It does so from two perspectives: first, from the self-reports of nine senior doctors working in leadership roles in England in the National Health Service; and second from a researcher perspective as we…

  1. Leadership in Doctoral Dissertations of Educational Sciences in Turkey

    Yardibi, Nursel

    2014-01-01

    The purpose of the study is to determine tendencies in educational sciences doctoral dissertations according to divisions, research methods and desings, data collection tools, data analysis techniques, and leadership levels in Turkey. This content analysis study has been desinged with qualitative research methods. This research has been limited by…

  2. Self-determining medical leadership needs of occupational health physicians.

    Giri, Prosenjit; Aylott, Jill; Kilner, Karen

    2017-10-02

    Purpose The purpose of this study was to explore which factors motivate doctors to engage in leadership roles and to frame an inquiry of self-assessment within Self-Determination Theory (SDT) to identify the extent to which a group of occupational health physicians (OHPs) was able to self-determine their leadership needs, using a National Health Service (NHS) England competency approach promoted by the NHS England Leadership Academy as a self-assessment leadership diagnostic. Medical leadership is seen as crucial to the transformation of health-care services, yet leadership programmes are often designed with a top-down and centrally commissioned "one-size-fits-all" approach. In the UK, the Smith Review (2015) concluded that more decentralised and locally designed leadership development programmes were needed to meet the health-care challenges of the future. However, there is an absence of empirical research to inform the design of effective strategies that will engage and motivate doctors to take up leadership roles, while at the same time, health-care organisations continue to develop formal leadership roles as a way to secure medical leadership engagement. The problem is further compounded by a lack of validated leadership qualities assessment instruments which support researching this problem. Design/Methodology/approach The analysis draws on a sample of about 25 per cent of the total population size of the Faculty of Occupational Medicine ( n = 1,000). The questionnaire used was the Leadership Qualities Framework tool as a form of online self-assessment ( NHS Leadership Academy, 2012 ). The data were analysed using descriptive statistics and simple inferential methods. Findings OHPs are open about reporting their leadership strengths and leadership development needs and recognise leadership learning as an ongoing development need regardless of their level of personal competence. This study found that the single most important factor to affect a doctor

  3. Teaching doctors to treat doctors: medical student peer counselling.

    Spiro, J H; Roenneburg, M; Maly, B J

    1980-01-01

    Physicians' emotional problems need to be recognized and treated. Intervention and prevention in this problem area have been attempted at the Medical College of Wisconsin through a programme of peer counselling designed to teach student physicians how to recognize and treat emotional difficulties faced by their peers. During the 18 months that the programme has been in operation, 20 peer counsellors reported a total 1,185 hours spent in counselling their peers, lending credence to the speculation that doctors will turn to their peers for help if, in medical school, there is acceptance of fallibility and responsiveness on the part of peers.

  4. Working better together: joint leadership development for doctors and managers.

    Kelly, Nicola

    2014-01-01

    Traditionally, there have been tensions between frontline healthcare professionals and managers, with well-known stereotypes of difficult consultants and pen-pushing managers. Many junior doctors have limited management experience and have often never even met a manager prior to taking on a consultant role. Based on a successful programme pioneered by Dr Robert Klaber (Imperial, London) we have set-up an innovative scheme for Birmingham Children's Hospital, pairing junior doctors and managers to learn and work together. Our aim was to cultivate positive attitudes and understanding between the two groups, break down inter-professional barriers, and to provide practical leadership experience and education. We recruited 60 managers and doctors to participate in shadowing, conversation, and quality improvement projects. Thought-provoking online materials, blogs, socials, and popular monthly workshops consisting of patient-focused debate and discussion around key leadership themes, have helped to support learning and cement shared values. Formal evaluation has demonstrated an improvement in how participants perceive their knowledge and ability based on key NHS Leadership Framework competencies. Participant feedback has been extremely positive, and everyone plans to continue to incorporate Paired Learning into their continuing professional development. We are now embedding Paired Learning in the on-going educational programme offered at Birmingham Children's Hospital, whilst looking at extending the scheme to include different professional groups and other trusts across the region and nationally.

  5. Doctor's dilemma: Medical decision making

    Ganatra, R.D.

    1992-01-01

    How a doctor arrives at a decision is of interest to both the developed and the developing countries. The developed and the developing want to walk on the same road but from different directions: one wants to develop a little more and the other wants to develop a little less for cost containment. To justify nuclear medicine in a developing country we have to see nuclear medicine in a new role. It is not for putting the diagnostic labels, not for differential diagnosis as we have been conditioned to think so far. In a developing country it should be for differential management, How does it alter the management decision in respect to a particular patient? If management outcomes are restricted, there is no need for an investigation which does not help in any way the management of the patient. If there is no bypass surgery, what use is the thallium perfusion? Although primarily a diagnostic discipline for its justification and survival in the developing country it should lead to a sensible differential management

  6. Medical humanities: a resident doctor's perspective.

    Pauranik, Anvita

    2012-01-01

    The barrage of competitive examinations, overwork, sleep deprivation, and the pressure of expectations all combine to destroy the dreams that resident doctors have when they start medical school. The empathy they had before entering this field fades away, and they eventually become insensitive to their patients. Medical humanities may be the means to halt this trend. Sensitising young minds, using the arts, literature, history and lessons on social issues, may bring about a paradigm shift in these doctors' outlook towards their patients. However, for the humanities to be integrated into medical education, the current curriculum must be modified and made more clinically and socially relevant. Further, the humanities cannot be taught in lecture halls; they need to be integrated into all aspects of medical school. For this, the medical school faculty should be sensitised to, and trained in, humanities education.

  7. Medical Doctors Perceptions of Genetically Modified Foods

    Hasan Savas

    2014-12-01

    Full Text Available Aim: Recombinant DNA and with similar technical changes made on genes or transferred isolated gene the living organisms have been named genetically modified organisms (GMOs. Thanks to advances in genetic technology, the advancement of enzyme and fermentation techniques result obtained by the use of GMOs in food industry products of genetically modified (GM foods are named. In this study, GM foods about the possible harmful effects have information and community advice on this matter to be medical doctors on this issue perceptions, knowledge, attitudes and behaviors aimed to measure.Material and Method: The study was made on including 200 medical doctors aged 23-65, 118 men (59%, 82 women (41%. In the statistical analysis based on the responses of medical doctors, against GM food risk perception, knowledge, attitudes and behaviors were assessed. Results: 80.5% of the participants’ think that GM foods are harmful. 22% of the participants were expressed that their knowledge are ‘’good’’ and ‘’very good’’ about GM food. While 38% of the participants use internet and 23.5% of the participants  use media, only 4.5% of the participants use medical schools as a source of sufficient information about GM foods. Discussion: While the risk perception of medical doctors about GM foods is high, the knowledge on this issue is observed low. Though the consumption and the prevelance of GM foods are increasing, medical doctors should have more information about this issue to enlighten and guide the community.

  8. Leadership and power in medical imaging

    Yielder, Jill [School of Health and Community Studies, Unitec New Zealand, Private Bag 92 025, Mt Albert, Auckland (New Zealand)]. E-mail: jyielder@unitec.ac.nz

    2006-11-15

    This article examines the concept of professional leadership in medical imaging. It explores the context of power issues in which such leadership is located, the differences between leadership and management, the qualities needed for effective leadership and how an individual's psychology may affect it. The article concludes that in the current climate of change and development, the medical imaging profession needs strong and appropriate leadership to profile the profession effectively and to lead it through to a more autonomous future.

  9. Leadership and power in medical imaging

    Yielder, Jill

    2006-01-01

    This article examines the concept of professional leadership in medical imaging. It explores the context of power issues in which such leadership is located, the differences between leadership and management, the qualities needed for effective leadership and how an individual's psychology may affect it. The article concludes that in the current climate of change and development, the medical imaging profession needs strong and appropriate leadership to profile the profession effectively and to lead it through to a more autonomous future

  10. Knowledge of medical ethics among Nigerian medical doctors ...

    Background: The knowledge of medical ethics is essential for health care practitioners worldwide. The main objective of this study was to evaluate the knowledge of medical doctors in a tertiary care hospital in Nigeria in the area of medical ethics. Materials and Methods: A cross– sectional questionnaire‑based study ...

  11. Medical leadership and management in the United Kingdom.

    Kyratsis, Yiannis; Armit, Kirsten; Zyada, Azra; Lees, Peter

    2016-06-01

    This article aims to outline the historical development of medical leadership in the United Kingdom (UK), present recent advances, and discuss professional development and future prospects. With increasing involvement of medical professionals in top managerial roles in the UK over the last 30 years, leadership development initiatives have been growing steadily and there is increasing recognition of the need for leadership and management skills for doctors. Such skills can help to greatly improve patient care as well as enhance organisational effectiveness and productivity. The central involvement of professional bodies such as the UK Faculty of Medical Leadership and Management, and the establishment of medical fellowship schemes, have provided a solid foundation for a new generation of aspiring medical leaders but there is still a long way to go to achieve a higher degree of professionalism for clinical leadership in the UK. The evidence base is weak such that integrated efforts by clinicians and management academics have much to offer in achieving the vision of socially responsible, clinically relevant and research informed medical leadership training. © The Royal Australian and New Zealand College of Psychiatrists 2016.

  12. Exploring UK health-care providers' engagement of trainee doctors in leadership.

    Miller, Christopher J; Till, Alex; McKimm, Judy

    2018-05-02

    The need for doctors at all levels to undergo some form of leadership development is well evidenced, but provision remains patchy and models underpinning such development are often inconsistent. This article sets out the findings of a literature review into leadership development opportunities for doctors in training in the UK.

  13. The Doctoral Student Leadership Institute: Learning to Lead for the Future

    Terry, Helen; Liller, Karen D.

    2014-01-01

    The purpose of this article is to describe the Doctoral Student Leadership Institute, an initiative developed to hone the leadership skills of doctoral students from a wide range of disciplines. The components of the Institute and preliminary assessment measures with findings are discussed. We particularly were pleased with the outcomes of the…

  14. Migration of doctors for undergraduate medical education.

    Hallock, James A; McKinley, Danette W; Boulet, John R

    2007-03-01

    Global shortages of healthcare workers in both developed and developing countries are of great concern. Research on physician migration typically focuses on medical school graduates, most often those seeking postgraduate training opportunities elsewhere. An overview of medical school migration patterns is presented in this paper. To put this phenomenon into the broader context of global physician migration, data is also presented on the distribution of medical schools, physician density, the flow of international medical graduates to the US, and the present composition of the US physician workforce. Results of the study indicate that many individuals leave their home country for undergraduate medical education. Given the movement of students and physicians, both for medical school and for advanced training opportunities, it is evident that some medical schools in the world are training doctors for their home country as well as for the international labor market. Overall, given the internationalization of medical education, collaborative efforts will be needed to develop an adequate, balanced, and well-trained global physician workforce.

  15. Towards a Marketing Communication Recruitment Plan for the Rowan University Educational Leadership Doctoral Program

    Kanyi, Titus Kamau

    2009-01-01

    Doctoral studies are at the apex of the education system. Attracting, recruiting, enrolling, and graduating the best suited students in doctoral education is, therefore, critical in ensuring the highest academic standards and service to society. Focusing on Rowan University's Doctor of Education (Ed.D.) in Educational Leadership program, this…

  16. Knowledge and awareness of medical doctors, medical students ...

    Introduction: Various studies have reported poor awareness and knowledge of dentistry in the Nigerian population. There is, however, paucity of information assessing the knowledge and awareness of medical doctors/students and nurses about dentistry. The present study is aimed at determining the knowledge and ...

  17. Medical leadership and management: An international revolution

    Alex Till

    2015-01-01

    Full Text Available Medical leadership and management are increasingly receiving widespread attention internationally. Significant focus has been paid as to the style of leadership within healthcare and how to develop both leadership and management skills and competencies (the two are inseparable yet distinct throughout the careers of all healthcare professionals. This article discusses how leadership and management development is being considered internationally, both at an organisational and personal level, helpful models and frameworks and challenges and opportunities.

  18. A systematic review of leadership training for medical students.

    Lyons, Oscar; Su'a, Bruce; Locke, Michelle; Hill, Andrew

    2018-01-19

    Leadership is increasingly being recognised as an essential requirement for doctors. Many medical schools are in the process of developing formal leadership training programmes, but it remains to be elucidated what characteristics make such programmes effective, and to what extent current programmes are effective, beyond merely positive learner reactions. This review's objective was to investigate the effectiveness of undergraduate medical leadership curricula and to explore common features of effective curricula. A systematic literature search was conducted. Articles describing and evaluating undergraduate medical leadership curricula were included. Outcomes were stratified and analysed according to a modified Kirkpatrick's model for evaluating educational outcomes. Eleven studies met inclusion criteria. Leadership curricula evaluated were markedly heterogeneous in their duration and composition. The majority of studies utilised pre- and post- intervention questionnaires for evaluation. Two studies described randomised controlled trials with objective measures. Outcomes were broadly positive. Only one study reported neutral outcomes. A wide range of leadership curricula have shown subjective effectiveness, including short interventions. There is limited objective evidence however, and few studies have measured effectiveness at the system and patient levels. Further research is needed investigating objective and downstream outcomes, and use of standard frameworks for evaluation will facilitate effective comparison of initiatives.

  19. Attitudes of medical students to medical leadership and management: a systematic review to inform curriculum development.

    Abbas, Mark R; Quince, Thelma A; Wood, Diana F; Benson, John A

    2011-11-14

    There is a growing acknowledgement that doctors need to develop leadership and management competences to become more actively involved in the planning, delivery and transformation of patient services. We undertook a systematic review of what is known concerning the knowledge, skills and attitudes of medical students regarding leadership and management. Here we report the results pertaining to the attitudes of students to provide evidence to inform curriculum development in this developing field of medical education. We searched major electronic databases and citation indexes within the disciplines of medicine, education, social science and management. We undertook hand searching of major journals, and reference and citation tracking. We accessed websites of UK medical institutions and contacted individuals working within the field. 26 studies were included. Most were conducted in the USA, using mainly quantitative methods. We used inductive analysis of the topics addressed by each study to identity five main content areas: Quality Improvement; Managed Care, Use of Resources and Costs; General Leadership and Management; Role of the Doctor, and Patient Safety. Students have positive attitudes to clinical practice guidelines, quality improvement techniques and multidisciplinary teamwork, but mixed attitudes to managed care, cost containment and medical error. Education interventions had variable effects on students' attitudes. Medical students perceive a need for leadership and management education but identified lack of curriculum time and disinterest in some activities as potential barriers to implementation. The findings from our review may reflect the relatively little emphasis given to leadership and management in medical curricula. However, students recognise a need to develop leadership and management competences. Although further work needs to be undertaken, using rigorous methods, to identify the most effective and cost-effective curriculum innovations, this

  20. Preparing medical physicists for future leadership roles

    Caruana, Carmel J.

    2017-01-01

    In today's rapidly changing and highly competitive world, being a good scientist is not sufficient for a professional to prosper; good leadership, managerial and strategic planning skills have become essential. The issue of authentic leadership has become of central concern to all healthcare professions, but it is even more crucial for small professions such as Medical Physics. Preparing future leaders should be done in two ways: first by direct interaction with established and successful leaders who would share their experiences (role modelling) and secondly through a formal leadership course in Medical Physics leadership

  1. Leadership Competence Educational Model for a Twenty-First Century Nursing Doctoral Education in Contemporary Turkey

    Terzioglu, Fusun

    2011-01-01

    In this article, the author proposes a nursing education model about leadership that can be used to improve the leadership skills of nursing doctoral students. This model is developed at the University of Michigan School of Nursing. In developing this model, the author had the opportunity to observe the University of Michigan, School of Nursing…

  2. "Con todo mi corazón": Mentoring Latinas in Educational Leadership Doctoral Programs

    Rodríguez, Mariela A.

    2016-01-01

    Personal narrative essays were used to analyze the experiences of four Latina doctoral students who completed their first year in an educational leadership doctoral program in a Hispanic-Serving Institution (HSI) in the southwestern U.S. Four themes emerged from their "testimonios" 1) "Con todo el corazón"; 2) "Somos como…

  3. Mentoring Matters: An Exploratory Survey of Educational Leadership Doctoral Students' Perspectives

    Welton, Anjalé D.; Mansfield, Katherine Cumings; Lee, Pei-Ling

    2014-01-01

    There is limited research on quantitative differences between men and women's experiences in doctoral programs. We aim to fill that gap by sharing findings from a web-based exploratory survey of perceived gender differences on quality mentoring in educational leadership doctoral programs. According to survey results, there is limited…

  4. Medical leadership arrangements in English healthcare organisations: findings from a national survey and case studies of NHS trusts.

    Dickinson, Helen; Ham, Chris; Snelling, Iain; Spurgeon, Peter

    2013-11-01

    This project sought to describe the involvement of doctors in leadership roles in the NHS and the organisational structures and management processes in use in NHS trusts. A mixed methods approach was adopted combining a questionnaire survey of English NHS trusts and in-depth case studies of nine organisations who responded to the survey. Respondents identified a number of challenges in the development of medical leadership, and there was often perceived to be an engagement gap between medical leaders and doctors in clinical roles. While some progress has been made in the development of medical leadership in the NHS in England, much remains to be done to complete the journey that started with the Griffiths Report in 1983. We conclude that a greater degree of professionalism needs to be brought to bear in the development of medical leadership. This includes developing career structures to make it easier for doctors to take on leadership roles; providing training, development and support in management and leadership at different stages of doctors' careers; and ensuring that pay and other rewards are commensurate with the responsibilities of medical leaders. The time commitment of medical leaders and the proportion of doctors in leadership roles both need to increase. The paper concludes considering the implications of these findings for other health systems. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  5. Bacterial contamination of medical doctors' white coats as ...

    Keywords: Medical doctors, White coats, Bacteria, Hospital, Infection, Healthcare. INTRODUCTION. Hospital environment have been reported to be strong ... the hospital environment to the perception of a .... impact on the number of isolates present on the sleeve. ..... healthcare setting to safeguard both the doctors and their ...

  6. The Lived Experiences of Female Educational Leadership Doctoral Students

    Mansfield, Katherine Cumings; Welton, Anjale; Lee, Pei-Ling; Young, Michelle D.

    2010-01-01

    Purpose: There is a meager body of research addressing the role educational leadership preparation programs in colleges and universities play in preparing women leaders. Also educational leadership preparation research has yet to explore ways in which mentorship provides additional capital for female graduate students. This study seeks to…

  7. The prevalence of burnout and depression in medical doctors ...

    The prevalence of burnout and depression in medical doctors working in the Cape Town Metropolitan Municipality community healthcare clinics and district hospitals of the Provincial Government of the Western Cape: a cross-sectional study.

  8. Importance and benefits of the doctoral thesis for medical graduates.

    Giesler, Marianne; Boeker, Martin; Fabry, Götz; Biller, Silke

    2016-01-01

    The majority of medical graduates in Germany complete a doctorate, even though a doctoral degree is not necessary for the practice of medicine. So far, little is known about doctoral candidates' view on the individual benefit a doctoral thesis has for them. Consequently, this is the subject of the present investigation. Data from surveys with graduates of the five medical faculties of Baden-Württemberg from the graduation years 2007/2008 (N=514) and 2010/2011 (N=598) were analysed. One and a half years after graduating 53% of those interviewed had completed their doctorate. When asked about their motivation for writing a doctoral thesis, participants answered most frequently "a doctorate is usual" (85%) and "improvement of job opportunities" (75%), 36% said that an academic career has been their primary motive. Less than 10% responded that they used their doctoral thesis as a means to apply for a job. The proportion of graduates working in health care is equally large among those who have completed a thesis and those who have not. Graduates who pursued a thesis due to scientific interest are also currently more interested in an academic career and recognise more opportunities for research. An implicit benefit of a medical thesis emerged with regard to the self-assessment of scientific competences as those who completed a doctorate rated their scientific competencies higher than those who have not. Although for the majority of physicians research interest is not the primary motivation for completing a doctorate, they might nevertheless achieve some academic competencies. For graduates pursuing an academic career the benefit of completing a medical thesis is more obvious.

  9. Importance and benefits of the doctoral thesis for medical graduates

    Giesler, Marianne

    2016-02-01

    Full Text Available Introduction: The majority of medical graduates in Germany complete a doctorate, even though a doctoral degree is not necessary for the practice of medicine. So far, little is known about doctoral candidates’ view on the individual benefit a doctoral thesis has for them. Consequently, this is the subject of the present investigation.Method: Data from surveys with graduates of the five medical faculties of Baden-Württemberg from the graduation years 2007/2008 (N=514 and 2010/2011 (N=598 were analysed.Results: One and a half years after graduating 53% of those interviewed had completed their doctorate. When asked about their motivation for writing a doctoral thesis, participants answered most frequently “a doctorate is usual” (85% and “improvement of job opportunities” (75%, 36% said that an academic career has been their primary motive. Less than 10% responded that they used their doctoral thesis as a means to apply for a job. The proportion of graduates working in health care is equally large among those who have completed a thesis and those who have not. Graduates who pursued a thesis due to scientific interest are also currently more interested in an academic career and recognise more opportunities for research. An implicit benefit of a medical thesis emerged with regard to the self-assessment of scientific competences as those who completed a doctorate rated their scientific competencies higher than those who have not.Discussion: Although for the majority of physicians research interest is not the primary motivation for completing a doctorate, they might nevertheless achieve some academic competencies. For graduates pursuing an academic career the benefit of completing a medical thesis is more obvious.

  10. Importance and benefits of the doctoral thesis for medical graduates

    Giesler, Marianne; Boeker, Martin; Fabry, Götz; Biller, Silke

    2016-01-01

    Introduction: The majority of medical graduates in Germany complete a doctorate, even though a doctoral degree is not necessary for the practice of medicine. So far, little is known about doctoral candidates’ view on the individual benefit a doctoral thesis has for them. Consequently, this is the subject of the present investigation. Method: Data from surveys with graduates of the five medical faculties of Baden-Württemberg from the graduation years 2007/2008 (N=514) and 2010/2011 (N=598) were analysed. Results: One and a half years after graduating 53% of those interviewed had completed their doctorate. When asked about their motivation for writing a doctoral thesis, participants answered most frequently “a doctorate is usual” (85%) and “improvement of job opportunities” (75%), 36% said that an academic career has been their primary motive. Less than 10% responded that they used their doctoral thesis as a means to apply for a job. The proportion of graduates working in health care is equally large among those who have completed a thesis and those who have not. Graduates who pursued a thesis due to scientific interest are also currently more interested in an academic career and recognise more opportunities for research. An implicit benefit of a medical thesis emerged with regard to the self-assessment of scientific competences as those who completed a doctorate rated their scientific competencies higher than those who have not. Discussion: Although for the majority of physicians research interest is not the primary motivation for completing a doctorate, they might nevertheless achieve some academic competencies. For graduates pursuing an academic career the benefit of completing a medical thesis is more obvious. PMID:26958656

  11. What do doctors and nurses think about development of clinical leadership?

    Lo, David; Till, Alex; McKimm, Judy

    2017-09-02

    Leadership development for health-care professionals is a priority within the NHS. Training is generally targeted at individual staff groups in isolation, even though contemporary leadership thinking recognizes the benefits of collaborative leadership between different clinical disciplines. Focussing on the attitudes and perceived training needs of undergraduate and qualified medical and nursing professionals, this article highlights the similarities and differences and will help to inform the design of existing and future leadership programmes.

  12. Do Doctors differ from Medical Laboratory Scientists?

    Background: Doctors and laboratory scientists are at risk of infection from blood borne pathogens during routine clinical duties. After over 20 years of standard precautions, health care workers knowledge and compliance is not adequate. Aim: This study is aimed at comparing adherence and knowledge of standard ...

  13. Medical leadership: why it's important, what is required, and how we develop it.

    Warren, Oliver J; Carnall, Ruth

    2011-01-01

    Good medical leadership is vital in delivering high-quality healthcare, and yet medical career progression has traditionally seen leadership lack credence in comparison with technical and academic ability. Individual standards have varied, leading to variations in the quality of medical leadership between different organisations and, on occasions, catastrophic lapses in the standard of care provided to patients. These high-profile events, plus increasing evidence linking clinical leadership to performance of units, has led recently to more focus on leadership development for all doctors, starting earlier and continuing throughout their careers. There is also an increased drive to see doctors take on more significant leadership roles throughout the healthcare system. The achievement of these aims will require doctors to develop strong personal and professional values, a range of non-technical skills that allow them to lead across professional boundaries, and an understanding of the increasingly complex environment in which 21st century healthcare is delivered. Developing these attributes will require dedicated resources and the sophisticated application of a variety of different learning methodologies such as mentoring, coaching, action learning and networking.

  14. Toxoplasmosis - Awareness and knowledge among medical doctors in Nigeria.

    Efunshile, Akinwale Michael; Elikwu, Charles John; Jokelainen, Pikka

    2017-01-01

    Toxoplasma gondii is a zoonotic parasite causing high disease burden worldwide. A One Health approach is needed to understand, prevent, and control toxoplasmosis, while knowledge gaps in the One Health aspects have been identified among medical professionals in earlier studies. As a One Health collaboration between veterinary and medical fields, we surveyed the knowledge on toxoplasmosis among medical doctors in Nigeria. The knowledge questions, which the participants answered without consulting literature and colleagues, covered epidemiological One Health aspects as well as clinical interspecialty aspects of T. gondii infections. Altogether 522 medical doctors from four tertiary hospitals completed the questionnaire. The mean number of correct answers in the knowledge questions was 7.5, and 8.4% of the participants selected at least 12 of the 17 correct answers. The proportion of medical doctors scoring such a high score was significantly higher among those who reported having seen a case of clinical toxoplasmosis than in those who did not. While 62% of the medical doctors participating in our study knew that cats can shed T. gondii in their feces, 36% incorrectly suggested that humans could do that too. That T. gondii infection can be meatborne was known by 69%, but that it can be also waterborne only by 28% of the medical doctors participating in our study. Most of the medical doctors, 78%, knew that clinical toxoplasmosis may involve the central nervous system, while only 37% answered that it can involve the eyes. Our results suggested knowledge gaps, which need to be addressed in Continuous Medical Education. The identified gaps included both intersectoral One Health aspects and interspecialty aspects: For prevention and management of toxoplasmosis, knowing the main transmission routes and that the parasite can affect several organs is relevant.

  15. Exploring the Relationship between Cultural Intelligence, Transformational Leadership, and Burnout in Doctorate of Education Students

    Stokes, D. Michelle.

    2013-01-01

    This correlational study used standard multiple regression to determine if there was a relationship between the factors of cultural intelligence (metacognitive CQ, cognitive CQ, motivational CQ, and behavioral CQ) and transformational leadership in doctoral students. This study also sought to determine the best predictor of burnout by using a…

  16. Experiential Workshop with Educational Leadership Doctoral Students: Managing Affective Reactions to Organizational Change

    Falls, Leigh; Jara, Teresa; Sever, Tim

    2009-01-01

    Managing change processes, resistance to change, and organizational members' emotional reactions to change are crucial skills for future educational leaders to learn. Our case study is based on a workshop conducted using two experiential exercises to facilitate current educational leadership doctoral students' reflections on their own reactions to…

  17. Female medical leadership: cross sectional study.

    Kvaerner, K J; Aasland, O G; Botten, G S

    1999-01-09

    To assess the relation between male and female medical leadership. Cross sectional study on predictive factors for female medical leadership with data on sex, age, specialty, and occupational status of Norwegian physicians. Oslo, Norway. 13 844 non-retired Norwegian physicians. Medical leaders, defined as physicians holding a leading position in hospital medicine, public health, academic medicine, or private health care. 14.6% (95% confidence interval 14.0% to 15.4%) of the men were leaders compared with 5.1% (4.4% to 5.9%) of the women. Adjusted for age men had a higher estimated probability of leadership in all categories of age and job, the highest being in academic medicine with 0.57 (0.42 to 0.72) for men aged over 54 years compared with 0.39 (0.21 to 0.63) for women in the same category. Among female hospital physicians there was a positive relation between the proportion of women in their specialty and the probability of leadership. Women do not reach senior positions as easily as men. Medical specialties with high proportions of women have more female leaders.

  18. Do medical doctors respond to economic incentives?

    Andreassen, Leif; Di Tommaso, Maria Laura; Strøm, Steinar

    2013-03-01

    A longitudinal analysis of married physicians labor supply is carried out on Norwegian data from 1997 to 1999. The model utilized for estimation implies that physicians can choose among 10 different job packages which are a combination of part time/full time, hospital/primary care, private/public sector, and not working. Their current choice is influenced by past available options due to a habit persistence parameter in the utility function. In the estimation we take into account the budget constraint, including all features of the tax system. Our results imply that an overall wage increase or less progressive taxation moves married physicians toward full time job packages, in particular to full time jobs in the private sector. But the overall and aggregate labor supply elasticities in the population of employed doctors are rather low compared to previous estimates. Copyright © 2012 Elsevier B.V. All rights reserved.

  19. Gender contentedness in aspirations to become engineers or medical doctors

    Koul, Ravinder; Lerdpornkulrat, Thanita; Poondej, Chanut

    2017-11-01

    Medical doctor and engineer are highly esteemed STEM professions. This study investigates academic and motivational characteristics of a sample of high school students in Thailand who aspire to become medical doctors or engineers. We used logistic regression to compare maths performance, gender typicality, gender contentedness, and maths and physics self-concepts among students with aspirations for these two professions. We found that high levels of felt gender contentedness in men had positive association with aspirations for engineering irrespective of the levels of maths or physics self-concept. We found that high levels of felt gender contentedness combined with high levels of maths or physics self-concept in women had positive associations with aspirations to become a medical doctor. These findings are evidence that student views of self are associated with uneven gendered patterns in career aspirations and have implications for the potential for future participation.

  20. [The motivation to become a medical doctor - doctoral students in a formal academic study program compared with those pursuing their doctorate independently].

    Pfeiffer, M; Dimitriadis, K; Holzer, M; Reincke, M; Fischer, M R

    2011-04-01

    Weight and quality of medical doctoral theses have been discussed in Germany for years. Doctoral study programs in various graduate schools offer opportunities to improve quality of medical doctoral theses. The purpose of this study was to demonstrate distinctions and differences concerning motivation, choice of subject and the dissertation process between doctoral candidates completing the doctoral seminar for doctoral students in the Ludwig-Maximilians-University (LMU) Munich and doctoral candidates doing their doctorate individually. All 4000 medical students of the LMU obtained an online-questionnaire which was completed by 767 students (19 % response rate). The theoretical framework of this study was based upon the Self-Determination-Theory by Deci and Ryan. Doctoral candidates completing the doctoral study program were more intrinsically motivated than doctoral candidates doing their doctorate individually; no difference was found in their extrinsic motivation. In regard to choice of subject and dissertation process the doctoral students in the seminar were distinguished from the individual group by having chosen a more challenging project. They anticipated a demanding dissertation process including conference participation, publishing of papers, etc. Intrinsic motivation correlates positively with choosing a challenging project and a demanding dissertation process. High intrinsic motivation seems to be very important for autonomous scholarly practice. Our results suggest that doctoral study programs have a positive impact on intrinsic motivation and interest in research. © Georg Thieme Verlag KG Stuttgart · New York.

  1. Shining the light on the dark side of medical leadership - a qualitative study in Australia.

    Loh, Erwin; Morris, Jennifer; Thomas, Laura; Bismark, Marie Magdaleen; Phelps, Grant; Dickinson, Helen

    2016-07-04

    Purpose The paper aims to explore the beliefs of doctors in leadership roles of the concept of "the dark side", using data collected from interviews carried out with 45 doctors in medical leadership roles across Australia. The paper looks at the beliefs from the perspectives of doctors who are already in leadership roles themselves; to identify potential barriers they might have encountered and to arrive at better-informed strategies to engage more doctors in the leadership of the Australian health system. The research question is: "What are the beliefs of medical leaders that form the key themes or dimensions of the negative perception of the 'dark side'?". Design/methodology/approach The paper analysed data from two similar qualitative studies examining medical leadership and engagement in Australia by the same author, in collaboration with other researchers, which used in-depth semi-structured interviews with 45 purposively sampled senior medical leaders in leadership roles across Australia in health services, private and public hospitals, professional associations and health departments. The data were analysed using deductive and inductive approaches through a coding framework based on the interview data and literature review, with all sections of coded data grouped into themes. Findings Medical leaders had four key beliefs about the "dark side" as perceived through the eyes of their own past clinical experience and/or their clinical colleagues. These four beliefs or dimensions of the negative perception colloquially known as "the dark side" are the belief that they lack both managerial and clinical credibility, they have confused identities, they may be in conflict with clinicians, their clinical colleagues lack insight into the complexities of medical leadership and, as a result, doctors are actively discouraged from making the transition from clinical practice to medical leadership roles in the first place. Research limitations/implications This research was

  2. Doctor-patient dialogue--basic aspect of medical consultation.

    Murariu-Brujbu, Isabella Cristina; Macovei, Luana Andreea

    2013-01-01

    Family medicine is the specialty that provides ongoing primary medical care and improves the health status of the individual, of the family and of the community through preventive, educational, therapeutic and rehabilitation measures. The family doctor often makes the interdisciplinary synthesis, in a flexible manner, either alone or in most cases with interdisciplinary consultation. In the latter case, the family doctor initiates the team work and makes the final evaluation by using the longitudinal follow-up of the disease. The doctor-patient encounter represents the "confrontation" with the greatest moral weight, due to the complexity of the values involved, the status of the doctor in a society, and patient's involvement in decision making. The patient is a person who should be treated with respect, honesty, professionalism and loyalty, whatever the clinical status, severity of illness, mental competence or incompetence. A focus, on an international scale, is represented by the characteristics of a good doctor, family physician included, as the latter is the first link in the network of health services. Each model of consultation varies in a more or less subtle way in priorities assignment, and suggests slight differences regarding the role played by doctor and patient in their collaboration. The qualities of a good family physician include not only the strictly professional competences, that also apply to other medical specialties, but also duties, such as, clearly explaining to patients issues concerning their health, informing them about all the possible preventive measures of diseases, making a diagnosis, initiating and supervising a therapy. Medical responsibility lies at the crossroads between medical science and the conscience of the doctor.

  3. [When state authorisation was introduced for medical doctors in Norway].

    Haave, Per

    2007-12-13

    In 1927, a law was implemented in Norway that for the first time required medical students to be state authorised before they could practice medicine and use the title medical doctor. The question of authorisation split the professional elite, both the Norwegian Medical Association and the Medical Faculty at the University of Oslo. Those very few members of the professional elite that advocated authorisation did, however, convince the government as well as the parliament that authorisation should be given and recalled by the state. State authorisation was first of all aimed at protecting the medical profession against "unfit" members; it was not a question of monopolising medical work or preventing other groups from working within the healthcare services. To put this into context, one should know that there had been a transition from a bureaucratic to a free labour market and most doctors were no longer engaged by the State, but had to practise in a private market. One feared that this would undermine the doctors' authority and status. In this situation, authorisation by the state was considered necessary to safeguard the public's confidence in doctors and their work.

  4. Does leadership effectiveness correlates with leadership styles in healthcare executives of Iran University of Medical Sciences.

    Ebadifard Azar, Farbod; Sarabi Asiabar, Ali

    2015-01-01

    Effective leadership is essential to passing through obstacles facing the health field.The current health care system in Iran has major problems and gaps in the field of effective leadership. The aim of this study was to evaluate hospital managers' leadership style through selfassessment and to determine the correlation between leadership styles with healthcare executives' leadership readiness and leadership effectiveness. In this cross-sectional study a self-administered questionnaire completed by all internal healthcare executives of all teaching and non-teaching hospitals affiliated to Iran University of Medical Sciences. Questionnaire was composed to determine demographic information, leadership style questions, leadership effectiveness and leadership readiness. Descriptive statistics and Pearson correlation coefficient were used for data analysis. According to the findings, the dominant style of healthcare executives was transformational leadership style (with a score of 4.34). The leadership effectiveness was estimated at about 4.36 that shows the appropriate level of leadership effectiveness. There was a significant correlation (correlation coefficient of 0.244) between leadership readiness and transformational leadership style (pleadership effectiveness with transformational (0.051) and transactional (0.216) styles. There was a correlation between leadership readiness and leadership effectiveness with leadership styles. Application of this research will be crucial to universities and healthcare executives. This study suggests that strengthening the scientific basis is essential for leadership readiness and leadership effectiveness in healthcare system.

  5. The leadership crisis of medical profession in India: ongoing impact on the health system

    Raman Kumar

    2015-01-01

    Full Text Available By 2030 India will have one million additional MBBS doctors; currently being produced @50,000 per year. Contrary to perception of scarcity of medical doctors, a large section of newly qualified physicians are spending considerable years in dysfunctional status due to mismanagement in human resource in health in India. There are very few employment opportunities for qualified doctors in public sector; at the same time the average salary of MBBS doctors in urban private hospitals is very low. Paradoxically, in a country of 1.3 billion populations there is no actual demand for medical professionals. While the popular perception is that young doctors are not willing for community service, a reality check is required on the count of intent and capacity of public sector as well as industry towards engagement of medical doctors in the process of service delivery. The visible leaders of medical profession are unable to reflect the ground reality. There is a leadership crisis among medical doctors in India.

  6. Exploring female GPs' perceptions about medical leadership.

    Price, Karen; Clearihan, Lynette

    2015-06-01

    Women are increasingly entering the Australian general practice workforce. This study aims to explore female general practitioners' (GPs') perceptions of possible barriers to leadership and professional roles in the workforce. A purposive, convenience sample of 30 female GPs in active practice was approached in February, 2012. An anonymous, pa-per-based, semi-quantitative survey sought to identify participation and leadership confidence within general practice in a number of professional roles. The top two barriers participants identified for after-hours medical meetings were energy to attend and geographical location. For after-hours care, the top two barriers identified were energy and self-motivation. Few participants aspired to 'leadership' activities. 'Medical mentoring' was most likely to attract them into leadership. It is important female GPs' perspectives are explored in general practice. This small survey suggests further studies are needed in the importance of energy limitations and lack of self-confidence in restricting female GPs' capacity to fully engage in professional roles.

  7. Medical professionalism: a tale of two doctors.

    Gorrindo, Tristan; Groves, James E

    2011-01-01

    The AMA's social media guidelines provide physicians with some basic rules for maintaining professional boundaries when engaging in online activities. Left unanswered are questions about how these guidelines are to be implemented by physicians of different generations. By examining the issues of privacy and technological skill through the eyes of digital natives and digital immigrants, the challenges associated with medical e-professionalism become clear.

  8. Tuberculosis in medical doctors – a study of personal experiences ...

    Background. The concurrent TB and HIV epidemics in sub-Saharan Africa place all healthcare workers (HCWs) at increased risk of exposure to Mycobacterium tuberculosis. Aim. This study explores personal experiences, attitudes and perceptions of medical doctors following treatment for TB within the healthcare system.

  9. "Doctor Jazz": Lessons that medical professionals can learn from jazz musicians.

    van Ark, Allard E; Wijnen-Meijer, Marjo

    2018-04-24

    The worlds of a physician and a jazz musician seem entirely different. Various studies, however, relating the concepts behind jazz music to medical practice and education, have been published. The aim of this essayistic review is to summarize previously described concepts behind jazz music and its required artistic skills that could be translated to medicine, encouraging doctors, medical students and medical educators to see their professional environment from a different perspective. A systematic search was conducted using PubMed, Embase, and ERIC databases, combining keywords with regard to jazz, medicine and medical education. Background information concerning jazz music and several jazz musicians was retrieved through an additional nonsystematic search using Google Scholar. Lessons with regard to improvisational skills, both in communication with patients and in a technical context, communication skills, leadership, interprofessional teamwork and coping with errors are presented. Doctors and medical students could learn various lessons from jazz music performance and jazz musicians. The potential and the possibilities of implementing jazz into the medical curriculum, in order to contribute to the development of professional skills and attitudes of medical students, could be explored further.

  10. [Knowledge of medical doctors about health economics].

    Rodríguez-Ledesma, María de Los Angeles; Constantino-Casas, Patricia; García-Contreras, Fernando; Garduño-Espinosa, Juan

    2007-01-01

    To identify the level of knowledge about health economics of physicians with different academic degree, working place and medical activities. A questionnaire with 24 items about commonly used health economics concepts was applied. Face validity, content, construct, and consistency of the questionnaire were assessed. 523 Mexican physicians from public and private health institutions in Sinaloa and Distrito Federal were interviewed. The average general score was 4.1 +/- 2.1 (0 to 10 scale), for physicians at the IMSS was 4.1 +/- 2.1, SSA 4.3 +/- 2.5, ISSSTE 3.3 +/- 2; SEDENA 3.9 +/- 2.3 and in private medical services 4.4 +/- 2.2 (p = 0.001). Interns scored 3.7 +/- 2.1; physicians with specialties different from family medicine 4.3 +/- 2.2 and family physicians 4 +/- 2 (p = 0.05). The question that got the most correct answers was the definition of direct costs (82%) and the one with fewest was the percentage of the gross national product recommended by the World Health Organization for the health sector (11%). Interviewed physicians had poor knowledge about health economics. Academic degree and institutional work were factors related to that knowledge.

  11. Leadership and Ethics: A Pragmatic Exploration among Candidates in a Doctoral Leadership Program

    Hatfield, Jennifer Marie

    2011-01-01

    The study of leadership and ethics, in the context of ethical behavior, is an area of concern, yet interest in an ever changing multicultural society of social norms and values. The magnitude of success has been and can be attributed to thriving and flourishing leadership exhibited by those parties involved. However, the behaviors exhibited by…

  12. Knowledge of medical imaging radiation dose and risk among doctors

    Brown, Nicholas; Jones, Lee

    2013-01-01

    The growth of computed tomography (CT) and nuclear medicine (NM) scans has revolutionised healthcare but also greatly increased population radiation doses. Overuse of diagnostic radiation is becoming a feature of medical practice, leading to possible unnecessary radiation exposures and lifetime-risks of developing cancer. Doctors across all medical specialties and experience levels were surveyed to determine their knowledge of radiation doses and potential risks associated with some diagnostic imaging. A survey relating to knowledge and understanding of medical imaging radiation was distributed to doctors at 14 major Queensland public hospitals, as well as fellows and trainees in radiology, emergency medicine and general practice. From 608 valid responses, only 17.3% correctly estimated the radiation dose from CT scans and almost 1 in 10 incorrectly believed that CT radiation is not associated with any increased lifetime risk of developing cancer. There is a strong inverse relationship between a clinician's experience and their knowledge of CT radiation dose and risks, even among radiologists. More than a third (35.7%) of doctors incorrectly believed that typical NM imaging either does not use ionising radiation or emits doses equal to or less than a standard chest radiograph. Knowledge of CT and NM radiation doses is poor across all specialties, and there is a significant inverse relationship between experience and awareness of CT dose and risk. Despite having a poor understanding of these concepts, most doctors claim to consider them prior to requesting scans and when discussing potential risks with patients.

  13. [Significance of the doctorate in scientific medical education].

    Frosch, Matthias

    2018-02-01

    According to European and German law, the medical education of physicians must take place in a scientific degree program at a university or under the supervision of a university. To keep up the ideal of a scientific degree program, various organizations and associations, such as the German Research Foundation, the German Council of Science and Humanities and the German Medical Faculty Association, see the need for an even stronger anchoring of academic learning content in the course of study. Traditionally, a scientific project, which is carried out during the studies, provides the basis for the Doctor of Medicine (Dr. med.) after graduation, although the research projects as a basis for medical degrees are currently not obligatory parts of the curricula. The number of medical students performing such research projects is significantly decreasing, thus they are missing major skills for working in science. To counteract these developments, faculties of medicine are currently developing model curricula including deepened scientific education. Despite these efforts, the German Association of Faculties of Medicine argues that the performance of research projects leading to the doctoral degree is most suitable for obtaining expertise in scientific work. According to recommendations by the German Council of Science on the requirements for quality assurance of graduation doctoral degree programs have been introduced. This and further measures, like MD/PhD programs or research-based additional study programs serving the scientific qualification of medical students, are the subject of this article.

  14. The geographical mobility of recently graduated medical doctors

    Drejer, Ina; Holm, Jacob Rubæk; Petersen, Karin Dam

    specialize to become general practitioners (GPs). Access to medical services is included among the services important for ensuring the basics in a welfare society. The analysis is limited to general practitioners (GPs), although access to other types of medical professionals is also an important aspect......University graduates are not evenly distributed geographically, and attraction and retention of university graduates is high on the agenda in many regional development strategies. In this paper we study the geographical mobility of a particular type of university graduates: medical doctors who...... of local access to medical services. We have chosen GPs because they – except in cases of emergency – are the main entrance to medical services in Denmark. We study how different factors may influence where GPs choose to set up medical practice. We pay particular attention to the importance of local...

  15. Helping doctors in training to STEP-UP: A leadership and quality improvement programme in the Belfast Health and Social Care Trust.

    Donaghy, Grainne; McKeever, Kris; Flanagan, Catherine; O'Kane, Donal; McQuillan, Bernie; Cash, Johnny; Jack, Cathy; Lundy, Claire

    2018-05-01

    Medical engagement in healthcare organisations can improve service development and patient experience. Doctors in training have limited opportunities to engage in service improvement work and develop leadership skills. We describe the Specialist Trainees Engaged in Leadership Programme (STEP) , a programme developed to introduce concepts of medical leadership and quality improvement skills in the Belfast Trust. STEP started in 2013 and over 140 trainees have now participated in the programme. Over 42 quality improvement projects have been completed with the support of the programme. Evaluation of STEP has demonstrated an improvement across all domains explored throughout the duration of the programme, with benefits for the individual trainee and the wider organisation. We describe the programme in detail. The STEP curriculum can easily be adapted to meet the needs of NHS trainees, allowing them to understand the objectives and strategy of their employers and improve their ability to plan and deliver safe, effective, patient-centred care.

  16. Untangling approaches to management and leadership across systems of medical education.

    Hartley, Kathy

    2016-05-24

    How future doctors might be educated and trained in order to meet the population and system needs of countries is currently being debated. Incorporation of a broad range of capabilities, encompassed within categories of management and, increasingly, leadership, form part of this discussion. The purpose of this paper is to outline a framework by which countries' progress in this area might be assessed and compared. Key databases and journals related to this area were reviewed. From relevant articles potential factors impacting on the incorporation of aspects of management and leadership within medical education and training were identified. These factors were tested via an online survey during 2013 with six members of a European Association of doctors who promote medical involvement in hospital management, including members from countries less represented in the health management literature. A framework for analysing how management and leadership education is being approached within different systems of healthcare is developed and presented. More systematic work across a wider range of countries is needed if we are to have a better understanding of how countries within and beyond Europe are approaching and progressing the education of doctors in management and leadership.

  17. Medical Education and Leadership in Breastfeeding Medicine.

    Taylor, Julie Scott; Bell, Esther

    2017-10-01

    Physicians' experience with high quality training in breastfeeding during their medical education is historically varied. The process of becoming a board-certified physician entails more than 20 years of education, and although medical school and residency training timelines and courses are relatively standardized across the United States and even internationally, breastfeeding education varies greatly across schools and programs. The Academy of Breastfeeding Medicine (ABM) exists, in part, because historically, physicians have received too little clinical training in breastfeeding and infant nutrition. An overarching goal of ABM, which is a multispecialty organization of doctors around the world, is to educate all maternal-child healthcare professionals, not just physicians, about breastfeeding. Within the field of medicine, family doctors, pediatricians, and obstetrician/gynecologists are considered the most logical source of breastfeeding expertise. However, the need for breastfeeding education goes beyond those providers who have obvious interactions with mothers and babies. We must educate anesthesiologists, surgeons, internists, and psychiatrists, among others. Building pipelines of physicians who are well educated in breastfeeding medicine allows more effective collaboration and care of mothers and infants among providers in various medical and surgical specialties as well as between doctors and other healthcare providers. This evidence-based education needs to be multifaceted, with didactic curricula for a strong knowledge base complemented by clinical experiences for skill development and application. Clinical knowledge and skills can also be reinforced during nonclinical opportunities in teaching, research, advocacy, and professional development. In this article, we describe a foundational framework for physician education in breastfeeding medicine as well as several creative noncurricular opportunities to develop breastfeeding expertise in future

  18. Medical emergencies facing general practitioners: Drugs for the doctor's bag

    Janković Slobodan

    2014-01-01

    General practitioners are frequently facing medical emergencies. In order to react properly and administer therapy on time, a general practitioner needs to prepare and keep with himself the appropriate set of drugs which could be effectively used for treatment of the emergencies. The following drugs should find their place in the doctor's bag: acetaminophen (for mild and moderate pain, and for fever), morphine (for severe pain), naloxone (for heroin poisoning), ceftriaxone (for meningococcal ...

  19. Knowledge of medical imaging radiation dose and risk among doctors.

    Brown, Nicholas; Jones, Lee

    2013-02-01

    The growth of computed tomography (CT) and nuclear medicine (NM) scans has revolutionised healthcare but also greatly increased population radiation doses. Overuse of diagnostic radiation is becoming a feature of medical practice, leading to possible unnecessary radiation exposures and lifetime-risks of developing cancer. Doctors across all medical specialties and experience levels were surveyed to determine their knowledge of radiation doses and potential risks associated with some diagnostic imaging. A survey relating to knowledge and understanding of medical imaging radiation was distributed to doctors at 14 major Queensland public hospitals, as well as fellows and trainees in radiology, emergency medicine and general practice. From 608 valid responses, only 17.3% correctly estimated the radiation dose from CT scans and almost 1 in 10 incorrectly believed that CT radiation is not associated with any increased lifetime risk of developing cancer. There is a strong inverse relationship between a clinician's experience and their knowledge of CT radiation dose and risks, even among radiologists. More than a third (35.7%) of doctors incorrectly believed that typical NM imaging either does not use ionising radiation or emits doses equal to or less than a standard chest radiograph. Knowledge of CT and NM radiation doses is poor across all specialties, and there is a significant inverse relationship between experience and awareness of CT dose and risk. Despite having a poor understanding of these concepts, most doctors claim to consider them prior to requesting scans and when discussing potential risks with patients. © 2012 The Authors. Journal of Medical Imaging and Radiation Oncology © 2012 The Royal Australian and New Zealand College of Radiologists.

  20. Initial Results of the Master's Degree Programme in "Leadership in Medicine" – Impact on hospital-based follow-on training of doctors

    Wulfert, Chris-Henrik

    2017-11-01

    Full Text Available Objective: This pilot project, which was jointly conducted by a hospital and a university, describes the development of the Master's Degree Programme in Leadership in Medicine, a course designed to supplement medical specialty training. The aim of the pilot project is to demonstrate how hospital-based projects on personnel and organisational development undertaken under academic supervision can be used to increase leadership responsibility among doctors whose duties include providing initial and follow-on training and to professionalise medical specialty training as a leadership task. This need arose from the nationwide requirements and an internal audit regarding follow-on training. The version of the degree programme described below aims to further the personnel development of the participants in the field of didactics. Method: Each of the nine modules is made up of two classroom-based phases and one distance learning phase. The distance learning phase involves undertaking hospital-based projects on personnel and organisational development under academic supervision. The pilot phase participants were hospital doctors who, as part of their duties, hold leadership responsibility or are involved in the follow-on training of doctors.Results: The 17 participants successfully implemented more than 30 hospital-based projects during the distance learning phases of the nine modules. These projects included the development of medical specialty curricula, relevant didactic methods and evaluation design and were subsequently presented and subjected to reflection in interdisciplinary groups. The project presentation together with the project report were regarded as proof of competency. Conclusion: In addition to enhancing participant competency, the degree model described, which interlinks theory and practice, promotes organisational development through the implementation of projects undertaken under academic supervision. This has a double impact on the

  1. Expanding management and leadership education in medical schools

    Chaudry A

    2018-04-01

    Full Text Available Aqib Chaudry, Amar Sodha, Ahmed Nur Faculty of Medicine, Imperial College London, London, UK We read with great interest the article by Rouhani et al1 exploring the perceptions, attitudes, and interest of UK medical students toward medical leadership. As medical students who recently completed an intercalated degree in health care management at Imperial College London, we can offer a unique perspective on this important issue.Authors' responseMaral J Rouhani,1 Eleanor J Burleigh,2 Chloe Hobbis,2 Charlotte Dunford,1 Nadir I Osman,3 Christine Gan,1 Norma B Gibbons,1 Hashim U Ahmed,1,4 Saiful Miah1,51Department of Urology, Imperial College Healthcare NHS Trust, Charing Cross Hospital, London, UK; 2Medical School, University of Sheffield, Sheffield, UK; 3Department of Urology, Royal Hallamshire Hospital, Sheffield, UK; 4Division of Surgery, Department of Surgery and Cancer, Imperial College London, London, UK; 5Division of Surgery and Interventional Science, University College London, London, UK We read with great interest the response to our article1 by Chaudry et al. Their group have contemporary insight and valuable experience in this subject which can be attributed to the intercalated degrees they have undertaken in health care management. We are acutely aware that very few UK medical schools actually offer such an intercalated degree. However, we believe the proposal of Singh et al2 of a compulsory health care management BSc is a counterproductive one. Basic science and clinically orientated intercalated degrees expose the medical student to research techniques and methodology. At their very core, they inspire the medical mind and are not designed to instruct all doctors to be academic research scientists, but rather ensure that every clinician’s mind is tuned to continually evaluate standard practice, and ask can we do better? View the original paper by Rouhani and colleagues.

  2. Doctors of tomorrow: An innovative curriculum connecting underrepresented minority high school students to medical school.

    Derck, Jordan; Zahn, Kate; Finks, Jonathan F; Mand, Simanjit; Sandhu, Gurjit

    2016-01-01

    Racial minorities continue to be underrepresented in medicine (URiM). Increasing provider diversity is an essential component of addressing disparity in health delivery and outcomes. The pool of students URiM that are competitive applicants to medical school is often limited early on by educational inequalities in primary and secondary schooling. A growing body of evidence recognizing the importance of diversifying health professions advances the need for medical schools to develop outreach collaborations with primary and secondary schools to attract URiMs. The goal of this paper is to describe and evaluate a program that seeks to create a pipeline for URiMs early in secondary schooling by connecting these students with support and resources in the medical community that may be transformative in empowering these students to be stronger university and medical school applicants. The authors described a medical student-led, action-oriented pipeline program, Doctors of Tomorrow, which connects faculty and medical students at the University of Michigan Medical School with 9th grade students at Cass Technical High School (Cass Tech) in Detroit, Michigan. The program includes a core curriculum of hands-on experiential learning, development, and presentation of a capstone project, and mentoring of 9th grade students by medical students. Cass Tech student feedback was collected using focus groups, critical incident written narratives, and individual interviews. Medical student feedback was collected reviewing monthly meeting minutes from the Doctors of Tomorrow medical student leadership. Data were analyzed using thematic analysis. Two strong themes emerged from the Cass Tech student feedback: (i) Personal identity and its perceived effect on goal achievement and (ii) positive affect of direct mentorship and engagement with current healthcare providers through Doctors of Tomorrow. A challenge noted by the medical students was the lack of structured curriculum beyond the 1st

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

    Bekas, Stavros

    2015-01-01

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

  4. The medical leadership challenge in healthcare is an identity challenge.

    Andersson, Thomas

    2015-01-01

    The purpose of this article is to describe and analyse the identity challenges that physicians with medical leadership positions face. Four qualitative case studies were performed to address the fact that identity is processual, relational and situational. Physicians with managerial roles were interviewed, as well as their peers, supervisors and subordinates. Furthermore, observations were made to understand how different identities are displayed in action. This study illustrates that medical leadership implies identity struggles when physicians have manager positions, because of the different characteristics of the social identities of managers and physicians. Major differences are related between physicians as autonomous individuals in a system and managers as subordinates to the organizational system. There are psychological mechanisms that evoke the physician identity more often than the managerial identity among physicians who are managers, which explains why physicians who are managers tend to remain foremost physicians. The implications of the findings, that there are major identity challenges by being both a physician and manager, suggest that managerial physicians might not be the best prerequisite for medical leadership, but instead, cooperative relationships between physicians and non-physician managers might be a less difficult way to support medical leadership. Acknowledging and addressing identity challenges can be important both in creating structures in organizations and designing the training for managers in healthcare (both physicians and non-physicians) to support medical leadership. Medical leadership is most often related to organizational structure and/or leadership skills, but this paper discusses identity requirements and challenges related to medical leadership.

  5. Combining a leadership course and multi-source feedback has no effect on leadership skills of leaders in postgraduate medical education. An intervention study with a control group

    Scherpbier Albert

    2009-12-01

    Full Text Available Abstract Background Leadership courses and multi-source feedback are widely used developmental tools for leaders in health care. On this background we aimed to study the additional effect of a leadership course following a multi-source feedback procedure compared to multi-source feedback alone especially regarding development of leadership skills over time. Methods Study participants were consultants responsible for postgraduate medical education at clinical departments. Study design: pre-post measures with an intervention and control group. The intervention was participation in a seven-day leadership course. Scores of multi-source feedback from the consultants responsible for education and respondents (heads of department, consultants and doctors in specialist training were collected before and one year after the intervention and analysed using Mann-Whitney's U-test and Multivariate analysis of variances. Results There were no differences in multi-source feedback scores at one year follow up compared to baseline measurements, either in the intervention or in the control group (p = 0.149. Conclusion The study indicates that a leadership course following a MSF procedure compared to MSF alone does not improve leadership skills of consultants responsible for education in clinical departments. Developing leadership skills takes time and the time frame of one year might have been too short to show improvement in leadership skills of consultants responsible for education. Further studies are needed to investigate if other combination of initiatives to develop leadership might have more impact in the clinical setting.

  6. Combining a leadership course and multi-source feedback has no effect on leadership skills of leaders in postgraduate medical education. An intervention study with a control group.

    Malling, Bente; Mortensen, Lene; Bonderup, Thomas; Scherpbier, Albert; Ringsted, Charlotte

    2009-12-10

    Leadership courses and multi-source feedback are widely used developmental tools for leaders in health care. On this background we aimed to study the additional effect of a leadership course following a multi-source feedback procedure compared to multi-source feedback alone especially regarding development of leadership skills over time. Study participants were consultants responsible for postgraduate medical education at clinical departments. pre-post measures with an intervention and control group. The intervention was participation in a seven-day leadership course. Scores of multi-source feedback from the consultants responsible for education and respondents (heads of department, consultants and doctors in specialist training) were collected before and one year after the intervention and analysed using Mann-Whitney's U-test and Multivariate analysis of variances. There were no differences in multi-source feedback scores at one year follow up compared to baseline measurements, either in the intervention or in the control group (p = 0.149). The study indicates that a leadership course following a MSF procedure compared to MSF alone does not improve leadership skills of consultants responsible for education in clinical departments. Developing leadership skills takes time and the time frame of one year might have been too short to show improvement in leadership skills of consultants responsible for education. Further studies are needed to investigate if other combination of initiatives to develop leadership might have more impact in the clinical setting.

  7. Identifying challenges for academic leadership in medical universities in Iran.

    Bikmoradi, Ali; Brommels, Mats; Shoghli, Alireza; Khorasani-Zavareh, Davoud; Masiello, Italo

    2010-05-01

    CONTEXT The crucial role of academic leadership in the success of higher education institutions is well documented. Medical education in Iran has been integrated into the health care system through a complex organisational change. This has called into question the current academic leadership, making Iranian medical universities and schools a good case for exploring the challenges of academic leadership. OBJECTIVES This study explores the leadership challenges perceived by academic managers in medical schools and universities in Iran. METHODS A qualitative study using 18 face-to-face, in-depth interviews with academic managers in medical universities and at the Ministry of Health and Medical Education in Iran was performed. All interviews were recorded digitally, transcribed verbatim and analysed by qualitative content analysis. RESULTS The main challenges to academic leadership could be categorised under three themes, each of which included three sub-themes: organisational issues (inefficacy of academic governance; an overly extensive set of missions and responsibilities; concerns about the selection of managers); managerial issues (management styles; mismatch between authority and responsibilities; leadership capabilities), and organisational culture (tendency towards governmental management; a boss-centred culture; low motivation). CONCLUSIONS This study emphasises the need for academic leadership development in Iranian medical schools and universities. The ability of Iranian universities to grow and thrive will depend ultimately upon the application of leadership skills. Thus, it is necessary to better designate authorities, roles of academic staff and leaders at governance.

  8. Leadership in Undergraduate Medical Education: Training Future Physician Leaders.

    Clyne, Brian; Rapoza, Brenda; George, Paul

    2015-09-01

    To confront the challenges facing modern health care, experts and organizations are calling for an increase in physician leadership capabilities. In response to this need, physician leadership programs are proliferating, targeting all levels of experience at all levels of training. Many academic medical centers, major universities, and specialty societies now sponsor physician leadership training programs. To meet this need, The Warren Alpert Medical School of Brown University, as part of its Primary Care-Population Medicine (PC-PM) Program, designed a four-year integrated curriculum, Leadership in Health Care, to engage with leadership topics starting early in the preclinical stages of training. This paper describes the design and implementation of this leadership curriculum for PC-PM students.

  9. Twelve tips for integrating leadership development into undergraduate medical education.

    Till, Alex; McKimm, Judy; Swanwick, Tim

    2017-10-26

    Healthcare systems need effective leadership. All healthcare professionals can and should "learn to lead" and this requires a clear focus on leadership development from the earliest stages of a career. Within medicine, undergraduate students should be provided with opportunities to thrive and develop their skills in terms of leadership, management and followership. Drawing from the existing evidence base, the authors' expertise and the latest "thought leadership", these 12 tips provide practical guidance to universities and associated provider organizations, and to academic and clinical faculty, on how to integrate leadership development into their undergraduate medical programs. These 12 tips will help educators provide medical education that incorporates leadership as a core part of a professional's identity, and help students gain a deeper understanding of themselves and the teams, organizations and system they work within.

  10. Self-determining medical leadership needs of occupational health physicians

    Giri, Prosenjit; Aylott, Jill; Kilner, Karen

    2017-01-01

    Purpose: Medical leadership is seen as crucial to the transformation of healthcare services, yet leadership programmes are often designed with a top-down and centrally-commissioned 'one-size-fits-all' approach. In the UK the Smith Review (2015) concluded that more decentralised and locally-designed leadership development programmes were needed to meet the healthcare challenges of the future. However, there is an absence of an evidence-base to inform the design of effective strategies to motiv...

  11. Knowledge and awareness of medical doctors, medical students and nurses about dentistry in Nigeria.

    Oyetola, Elijah Olufemi; Oyewole, Taiwo; Adedigba, Micheal; Aregbesola, Stephen Tunde; Umezudike, Kehinde; Adewale, Adedotun

    2016-01-01

    Various studies have reported poor awareness and knowledge of dentistry in the Nigerian population. There is, however, paucity of information assessing the knowledge and awareness of medical doctors/students and nurses about dentistry. The present study is aimed at determining the knowledge and awareness of medical doctors/students and nurses about dentistry. Self-administered questionnaires were randomly distributed among medical doctors/students, and nurses of Obafemi Awolowo Teaching Hospitals' Complex, Ile-Ife, Nigeria. Information collected using the questionnaire included participants' biodata, questions evaluating dental awareness, knowledge of systemic and oral health connections as well as referral practices. The data analysis was done with STATA version 11 software. A total of 300 questionnaires were randomly distributed among doctors/students and nurses, 206 were returned (response rate of 69%). Of the returned questionnaires, 129(63%) were males and 77(37%) were females. There were 42 medical doctors, 49 nurses and 115 medical students. The mean age of the participants was 26.7 years (SD 5.2). Majority (99.5%) was aware of dental profession, but 92% had never referred patients for dental consultation. One third (31%) of medical doctors believed that Ludwig angina was a cardiac disease. A large proportion of the respondents (61%) see no need for routine dental visit while 27% would want to visit the dentist only when they had a dental complaint. Although a large percentage of the participants claimed to be aware of dentistry, our findings revealed low level of knowledge and attitude to Dentistry. Efforts should be made towards closing this knowledge gap to achieve efficient oral health.

  12. Becoming an Educational Leader--Exploring Leadership in Medical Education

    Bolander Laksov, Klara; Tomson, Tanja

    2017-01-01

    Research on educational leadership emphasizes the importance of having institutional leaders heavily involved with advanced instructional programming. Best practices for developing educational leadership in higher education health care and medical faculties have to be better understood. Within the framework of a seminar series, researchers and…

  13. The University of Illinois at Chicago School of Public Health Doctor of Public Health program: an innovative approach to doctoral-level practice leadership development.

    Lenihan, Patrick; Welter, Christina; Brandt-Rauf, Paul; Neuberger, Babette; Pinsker, Eve; Petros, Michael; Risley, Kristine

    2015-03-01

    The University of Illinois at Chicago, School of Public Health, Doctor of Public Health degree is designed to build leadership skills and an ability to contribute to the evidence base of practice. The competency-based, distance-format, doctoral-level program for midcareer professionals features an action learning approach in which students apply leadership principles from the virtual classroom to real-world problems at their work sites. Students demonstrate mastery of the competencies and readiness to advance to the dissertation stage through completing a portfolio by using a process of systematic reflection. The practice-oriented dissertation demonstrates the ability to contribute to the evidence base of public health practice in an area of emphasis. Preliminary evaluation data indicate that the program is meeting its intended purposes.

  14. Predictors of leadership styles of medical students: implications for medical education.

    Sriratanaban, J; Chiravisit, M; Viputsiri, O

    1999-09-01

    Providing effective health care services for a population involves a great deal of team-work among health care workers and leadership of physicians. The primary purpose of this study was to assess the leadership styles of medical students, and to explore factors that may be associated with them. Leadership questionnaires were used to assess leadership styles of 97 sixth-year medical students of the 1995 class at Chulalongkorn University attending the community medicine III program which was designed to introduce basic knowledge and skills in health care management. The baseline leadership styles of the students were more people-oriented than task-oriented. Multivariate analyses revealed that administrative experiences from extracurricular activities and perceived importance of a health administration course were significantly associated with leadership styles. Medical students should be encouraged to participate in extracurricular activities during their medical studies, taking leader positions, in order to develop an optimal leadership style to be effective health team leaders.

  15. [New model of doctor-nurse communication based on electronic medical advice platform].

    Cao, Yang; Ding, Aimin; Wang, Yan

    2012-01-01

    This article introduces a new model of the communication between doctors and nurses, with the aid of the electronic medical advice platform. This model has achieved good results in improving doctor and nurse's co-working efficiency, treating patients safely, preventing medical accidents, reducing medical errors and so on.

  16. The voices of neurosurgeons: doctors' non-medical writing.

    Bernstein, Mark

    2007-05-01

    Biomedical publishing is an integral part of medicine--both to those who produce it and those who consume it to improve the care of their patients. Non-medical writing by surgeons usually takes the form of creative non-fiction, generally reflective essays on moving and emotionally charged situations such as working in the trenches in war-time or in natural disasters, or dealing with individual patients. Such writing is both creative and cathartic for neurosurgeons, and can help educate patients thus improving the doctor-patient relationship. The purpose of this article is to encourage fellow neurosurgeons to pursue this enjoyable and valuable endeavour, to utter a call to arms so to speak.

  17. Teaching the art of doctoring: an innovative medical student elective.

    Shapiro, Johanna; Rucker, Lloyd; Robitshek, Daniel

    2006-02-01

    The authors describe a longitudinal third- and fourth-year elective, 'The Art of Doctoring', introduced in an attempt to counteract perceived frustration and cynicism in medical students at their home institution during the clinical years. The course goals aimed at helping students to develop self-reflective skills; improve awareness of and ability to modify personal attitudes and behaviors that compromise patient care; increase altruism, empathy and compassion toward patients; and sustain commitment to patient care, service and personal well-being. These goals were accomplished through introduction and development of five skill sets: learning from role models and peers; on-site readings of works by medical student- and physician-authors; self- and other-observation; self-reflective techniques; and case-based problem-solving. The course involved regular in-class exercises and homework assignments, as well as a personal project related to improving personal compassion, caring and empathy toward patients. Students also learned to use a coping algorithm to approach problematic clinical and interpersonal situations. Class discussions revealed three issues of recurring importance to students: loss of idealism, non-compliant patients, and indifferent, harsh or otherwise unpleasant attendings and residents. Quantitative and qualitative student evaluations overall indicated a generally favorable response to the course. Problems and barriers included attendance difficulties and variable levels of student engagement. Future directions for this type of educational intervention are considered, as well as its implications for medical education.

  18. Perceptions of migrant doctors joining the New Zealand medical workforce.

    Lillis, Steven; St George, Ian; Upsdell, Ruth

    2006-02-17

    New Zealand, like many first World countries, has become increasingly dependent on overseas-trained doctors (OTDs). This qualitative study identifies and explores issues of concern to OTDs when first integrating into the New Zealand medical system through the New Zealand Registration Examination (NZREX) pathway. The data were collected using semistructured interviews and focus groups involving 10 OTDs who were working in a New Zealand hospital. The study identified four key issues: work issues which included difficulty finding employment and difficulty integrating into their work role; a bridging programme which improved the ability of OTDs to gain knowledge and experience of the New Zealand medical working environment; financial difficulties which were a major impediment to attaining registration and a career pathway in New Zealand; and bureaucratic barriers (including examinations and information availability), which were seen as necessary but unsympathetic processes in gaining registration. Sociocultural educational theory provides a useful framework for understanding the difficulties faced by OTDs integrating into a New Zealand medical workforce.

  19. Arab doctors, evolving society and corruption: a medical student's perspective.

    Alamri, Yassar

    2015-01-01

    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.

  20. ["The Talpiot medical leadership program"--advancing the brightest young physicians and researchers to fill future leadership roles].

    Adler, Yehuda; Kinori, Michael; Zimlichman, Eyal; Rosinger, Avivit; Shalev, Guzu; Talmi, Rachel; Noy, Shlomo; Rotstein, Zeev

    2015-02-01

    The modern medical world is dynamic and boundless. There is a need for the medical training system currently existing in Israel to undergo a thorough conceptual change in order to strive for excellence and innovation on the one hand and to prevent the "brain drain" from Israel on the other. To report on the "Talpiot" program at the "Sheba Medical Center", which identifies, promotes and prepares the most talented young doctors to fill key positions in the fields of medicine and health in Israel. This study is based on a project with the same name in the Israeli Defense Forces (IDF). It promotes an elite group of physicians and researchers at the medical center and includes the provision of scholarships, personal guidance and customized educational opportunities for its members. Conversely, every member in the program is committed to complete five years of training followed by another five years as a senior physician or a researcher at the medical center. Since 2002, there have been six cycles of "Talpionaires". The current 46 members of the program fill key leadership roles in the medical center and are considered leaders in their field. Among the program's alumni are managers of institutes, units and research institutes. This group is responsible for the publication of hundreds of scientific papers studies and dozens of patents in medical technology. Some of them have progressed academically far beyond their peers. Excellence programs are an integral part of any institution which considers itself a leader, both in medicine and beyond. The exciting and visionary "Talpiot" program is Sheba's contribution to the quality of the medical system in the country of Israel in the long run. Promoting young doctors and researchers to become leaders in the Israeli medical system is an integral part of national interests.

  1. Gender variations in specialties among medical doctors working in ...

    Background: Gender variations exist in the choice of specialties among ... as it affects the distribution of doctors in public health institutions and patient care. ... For female doctors,pediatrics was the topmost specialty (25%) followed by ... Keywords: Gender variation,Specialties,Doctors,Public healthcare,Health workforce ...

  2. Empowering the Physiotherapy Profession in Ethiopia through Leadership Development within the Doctoring Process.

    Footer, Cheryl Burditt; Tsegaye, Hailu Seifu; Yitnagashaw, Tesfaye Asnake; Mekonnen, Wintana; Shiferaw, Tizita Destaw; Abera, Endashaw; Davis, Alice

    2017-01-01

    Ethiopia recently introduced the Doctor of Physiotherapy (DPT) degree at Addis Ababa University as a mechanism to increase the work force capacity of primary care providers in the health sector. The DPT program was supported by an international academic partnership and was designed to empower physiotherapists as leaders to move the profession forward. The curriculum was framed by core pedagogical principles and strategies and was phased into two programs. First, the 4-year Advanced Standing DPT program focused on developing registered Ethiopian physiotherapists with Bachelor of Science degrees as academic faculty. Second, these new faculty would then sustain a 6-year Generic DPT program that would matriculate students upon graduation from high school. The curriculum represented depth and breadth of foundation and clinical sciences, evidence-based practice, clinical reasoning skills, and interprofessional education opportunities. A leadership thread provided opportunities to develop skills necessary to effectively navigate and manage the challenges faced by the profession. The main outcomes included (1) an 8-year international partnership, (2) the academic performance of students, and (3) and leadership capabilities as demonstrated through activities and assignments. While the program has been criticized as an unnecessary extravagance for Ethiopia, the advantages of the DPT degree were revealed in a direct comparison to other academic physiotherapy programs in Ethiopia. In the end, because the DPT is new to the country, it will take time to fully understand the true impact within the Ethiopian health system.

  3. A DOCTORAL PROGRAM FOR THE WORLD: GLOBAL TERTIARY EDUCATION AND LEADERSHIP

    Jace Hargis

    2012-01-01

    Full Text Available The purpose of this paper is to share the findings of a highly generalizable investigative feasibility project, whose goal is to enhance the teaching ability of current higher education faculty members. The mission of the project was to introduce a new doctoral degree on Global Education and Leadership (GEL geared toward a ubiquitous, broad approach to assist faculty members in their pursuit of improved teaching and learning. The methods used were to perform an online search identifying 18 different institutions, whose mission focused on both student-centered learning, as well as pursued an active scholarship of teaching and learning agenda; contact 52 key personnel for a visit to share our program; travel to each of eight countries to share the vision of the program in five weeks; and finally to collate results and examine trends and identify host institutions, accreditation steps and start dates. The major result of this experience was the unanimous agreement on the universal unsystematic process of providing tertiary faculty members with the essential andragogical methods to efficiently and effectively become exemplar teachers. Due to the overwhelming uniformity in affirmative response to the program, the key conclusion is to move forward with the doctoral program aggressively.

  4. Medication communication between nurses and doctors for paediatric acute care: An ethnographic study.

    Borrott, Narelle; Kinney, Sharon; Newall, Fiona; Williams, Allison; Cranswick, Noel; Wong, Ian; Manias, Elizabeth

    2017-07-01

    To examine how communication between nurses and doctors occurred for managing medications in inpatient paediatric settings. Communication between health professionals influences medication incidents' occurrence and safe care. An ethnographic study was undertaken. Semi-structured interviews, observations and focus groups were conducted in three clinical areas of an Australian tertiary paediatric hospital. Data were transcribed verbatim and thematically analysed using the Medication Communication Model. The actual communication act revealed health professionals' commitment to effective medication management and the influence of professional identities on medication communication. Nurses and doctors were dedicated to providing safe, effective medication therapy for children, within their scope of practice and perceived role responsibilities. Most nurses and junior doctors used tentative language in their communication while senior doctors tended to use direct language. Irrespective of language style, nurses actively engaged with doctors to promote patients' needs. Yet, the medical hierarchical structure, staffing and attendant expectations influenced communication for medication management, causing frustration among nurses and doctors. Doctors' lack of verbal communication of documented changes to medication orders particularly troubled nurses. Nurses persisted in their efforts to acquire appropriate orders for safe medication administration to paediatric patients. Collaborative practice between nurses and doctors involved complex, symbiotic relationships. Their dedication to providing safe medication therapy to paediatric patients facilitated effective medication management. At times, shortcomings in interdisciplinary communication impacted on potential and actual medication incidents. Understanding of the complexities affecting medication communication between nurses and doctors helps to ensure interprofessional respect for each other's roles and inherent demands

  5. Medical emergencies facing general practitioners: Drugs for the doctor's bag

    Janković Slobodan

    2014-01-01

    Full Text Available General practitioners are frequently facing medical emergencies. In order to react properly and administer therapy on time, a general practitioner needs to prepare and keep with himself the appropriate set of drugs which could be effectively used for treatment of the emergencies. The following drugs should find their place in the doctor's bag: acetaminophen (for mild and moderate pain, and for fever, morphine (for severe pain, naloxone (for heroin poisoning, ceftriaxone (for meningococcal meningitis, albuterol (for bronchial asthma attack, hydrocortisone (for bronchial asthma attack, glucagon (for severe hypoglycemia, dextrose (for mild to moderate hypoglycemia, diazepam (for febrile convulsions or epileptic status, epinephrine (for anaphylaxis and cardiac arrest, atropine (for symptomatic bradicardia, chloropyramine (for acute allergy, aspirin (for acute myocardial infarction, nitroglycerine (for acute coronary syndrome, metoclopramide (for nausea and vomiting, haloperidol (for delirium, methylergometrine (for control of bleeding after delivery or abortion, furosemide (for acute pulmonary edema and flumazenil (for benzodiazepine poisoning. For each of the listed drugs a physician should well know the recommended doses, indications, contraindications and warnings. All of the listed drugs are either registered in Serbia or available through special import, so general practitioners may fill their bags with all necessary drugs and effectively and safely treat medical emergencies.

  6. [Doctoral thesis projects for medical students? Retrospective estimation of the fraction of successfully completed medical doctoral thesis projects at Witten/Herdecke University].

    Scharfenberg, Janna; Schaper, Katharina; Krummenauer, Frank

    2014-01-01

    The German "Dr med" plays a specific role in doctoral thesis settings since students may start the underlying doctoral project during their studies at medical school. If a Medical Faculty principally encourages this approach, then it should support the students in performing the respective projects as efficiently as possible. Consequently, it must be ensured that students are able to implement and complete a doctoral project in parallel to their studies. As a characteristic efficiency feature of these "Dr med" initiatives, the proportion of doctoral projects successfully completed shortly after graduating from medical school is proposed and illustrated. The proposed characteristic can be estimated by the time period between the state examination (date of completion of the qualifying medical examination) and the doctoral examination. Completion of the doctoral project "during their medical studies" was then characterised by a doctoral examination no later than 12 months after the qualifying medical state examination. To illustrate the estimation and interpretation of this characteristic, it was retrospectively estimated on the basis of the full sample of all doctorates successfully completed between July 2009 and June 2012 at the Department of Human Medicine at the Faculty of Health of the University of Witten/Herdecke. During the period of investigation defined, a total number of 56 doctoral examinations were documented, 30 % of which were completed within 12 months after the qualifying medical state examination (95% confidence interval 19 to 44 %). The median duration between state and doctoral examination was 27 months. The proportion of doctoral projects completed parallel to the medical studies increased during the investigation period from 14 % in the first year (July 2009 till June 2010) to 40 % in the third year (July 2011 till June 2012). Only about a third of all "Dr med" projects at the Witten/Herdecke Faculty of Health were completed during or close to

  7. Knowledge of medical doctors in Turkey about the relationship between periodontal disease and systemic health.

    Taşdemir, Zekeriya; Alkan, Banu Arzu

    2015-01-01

    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.

  8. Several factors increased job dissatisfaction among medical doctors in Indonesia

    Bastaman Basuki

    2013-07-01

    Full Text Available AbstrakLatar belakang: Beberapa faktor stresor kerja dapat meningkatkkan ketidakpusasan kerja. Tujuan penelitian ini untuk mengidentifikasi beberapa faktor dominan terkait dengan ketidakpusasan kerja.Metode: Studi potong lintgang dengan sampling purposif yang dilakukan pada bulan April-Juli 2011. Subyek terdiri dari mahasiswa pascasarjana dan dosen Fakultas Kedokteran Universitas Indonesia. Regresi linier digunakan untuk menganalisis data. Hasil: Peserta terdiri dari 306 subyek, berusia 23-47 tahun, mayoritas perempuan (61,4%, menikah, dan tidak pernah mengikuti pelatihan manajemen stres. Sedangkan pekerjaan saat ini/sebelumnya adalah dalam pelayanan kesehatan, atau pejabat pemerintah. Tingkat ketidakpuasan kerja berkaitan dengan tujuh faktor: yang tertinggi ialah kurangnya dukungan dari atasan, dan yang terendah ialah melakukan layanan di luar jam kerja. Satu poin kurang dukungan atasan akan meningkatkan ketidakpuasan kerja sebesar 1,26 [koefisien regresi (β = 1,26, P = 0,000; satu poin untuk menyediakan layanan di luar jam kerja akan meningkatkan 0,61 poin ketidakpuasan kerja (β= 0,6, P = 0,001. Kesimpulan: Kurangnya dukungan atasan dan interaksi dengan rekan kerja, peran organisasi ambiguitas, prosedur birokrasi, memberikan pelayanan di luar jam kerja, dan umpan balik yang tidak memadai dari pasien akan meningkatkan ketidakpuasan kerja. (Health Science Indones 2013;1:11-6Kata kunci:ketidakpuasan kerja, stresor kerja, dokterAbstractBackground:Several factors of work stressors may increase a person’s job dissatisfaction level. This study aimed to identify several dominant factors related to job dissatisfaction among medical doctors. Methods: A cross-sectional study with purposive sampling was conducted in April-July 2011. Subjects consisted of postgraduate students and faculty members of the Faculty of Medicine, Universitas Indonesia. Linear regression was used to analyze the data. Results: The participants consisted of 306 subjects, aged

  9. Competencies for Student Leadership Development in Doctor of Pharmacy Curricula to Assist Curriculum Committees and Leadership Instructors

    Traynor, Andrew P.; Boyle, Cynthia J.

    2013-01-01

    Objective. To assist curriculum committees and leadership instructors by gathering expert opinion to define student leadership development competencies for pharmacy curricula. Methods. Twenty-six leadership instructors participated in a 3-round, online, modified Delphi process to define competencies for student leadership development in pharmacy curricula. Round 1 asked open-ended questions about leadership knowledge, skills, and attitudes. Round 2 grouped responses for agreement rating and comment. Round 3 allowed rating and comment on competencies not yet meeting consensus, which was prospectively set at 80%. Results. Eleven competencies attained 80% consensus or higher and were grouped into 3 areas: leadership knowledge, personal leadership commitment, and leadership skill development. Connections to contemporary leadership development literature were outlined for each competency as a means of verifying the panel’s work. Conclusions. The leadership competencies will aid students in addressing: What is leadership? Who am I as a leader? What skills and abilities do I need to be effective? The competencies will help curriculum committees and leadership instructors to focus leadership development opportunities, identify learning assessments, and define program evaluation. PMID:24371346

  10. Competencies for student leadership development in doctor of pharmacy curricula to assist curriculum committees and leadership instructors.

    Janke, Kristin K; Traynor, Andrew P; Boyle, Cynthia J

    2013-12-16

    To assist curriculum committees and leadership instructors by gathering expert opinion to define student leadership development competencies for pharmacy curricula. Twenty-six leadership instructors participated in a 3-round, online, modified Delphi process to define competencies for student leadership development in pharmacy curricula. Round 1 asked open-ended questions about leadership knowledge, skills, and attitudes. Round 2 grouped responses for agreement rating and comment. Round 3 allowed rating and comment on competencies not yet meeting consensus, which was prospectively set at 80%. Eleven competencies attained 80% consensus or higher and were grouped into 3 areas: leadership knowledge, personal leadership commitment, and leadership skill development. Connections to contemporary leadership development literature were outlined for each competency as a means of verifying the panel's work. The leadership competencies will aid students in addressing: What is leadership? Who am I as a leader? What skills and abilities do I need to be effective? The competencies will help curriculum committees and leadership instructors to focus leadership development opportunities, identify learning assessments, and define program evaluation.

  11. Leadership Training in Graduate Medical Education: A Systematic Review.

    Sadowski, Brett; Cantrell, Sarah; Barelski, Adam; O'Malley, Patrick G; Hartzell, Joshua D

    2018-04-01

    Leadership is a critical component of physician competence, yet the best approaches for developing leadership skills for physicians in training remain undefined. We systematically reviewed the literature on existing leadership curricula in graduate medical education (GME) to inform leadership program development. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, we searched MEDLINE, ERIC, EMBASE, and MedEdPORTAL through October 2015 using search terms to capture GME leadership curricula. Abstracts were reviewed for relevance, and included studies were retrieved for full-text analysis. Article quality was assessed using the Best Evidence in Medical Education (BEME) index. A total of 3413 articles met the search criteria, and 52 were included in the analysis. Article quality was low, with 21% (11 of 52) having a BEME score of 4 or 5. Primary care specialties were the most represented (58%, 30 of 52). The majority of programs were open to all residents (81%, 42 of 52). Projects and use of mentors or coaches were components of 46% and 48% of curricula, respectively. Only 40% (21 of 52) were longitudinal throughout training. The most frequent pedagogic methods were lectures, small group activities, and cases. Common topics included teamwork, leadership models, and change management. Evaluation focused on learner satisfaction and self-assessed knowledge. Longitudinal programs were more likely to be successful. GME leadership curricula are heterogeneous and limited in effectiveness. Small group teaching, project-based learning, mentoring, and coaching were more frequently used in higher-quality studies.

  12. Leadership lessons from military education for postgraduate medical curricular improvement.

    Edler, Alice; Adamshick, Mark; Fanning, Ruth; Piro, Nancy

    2010-03-01

    quality medical education includes both teaching and learning of data-driven knowledge, and appropriate technical skills and tacit behaviours, such as effective communication and professional leadership. But these implicit behaviours are not readily adaptable to traditional medical curriculum models. This manuscript explores a medical leadership curriculum informed by military education. our paediatric anaesthesia residents expressed a strong desire for more leadership opportunity within the training programme. Upon exploration, current health care models for leadership training were limited to short didactic presentations or lengthy certificate programmes. We could not find an appropriate model for our 1-year fellowship. in collaboration with the US Naval Academy, we modified the 'Leadership Education and Development Program' curriculum to introduce daily and graduated leadership opportunities: starting with low-risk decision-making tasks and progressing to independent professional decision making and leadership. Each resident who opted into the programme had a 3-month role as team leader and spent 9 months as a team member. At the end of the first year of this curriculum both quantitative assessment and qualitative reflection from residents and faculty members noted significantly improved clinical and administrative decision making. The second-year residents' performance showed further improvement. medical education has long emphasised subject-matter knowledge as a prime focus. However, in competency-based medical education, new curriculum models are needed. Many helpful models can be found in other professional fields. Collaborations between professional educators benefit the students, who are learning these new skills, the medical educators, who work jointly with other professionals, and the original curriculum designer, who has an opportunity to reflect on the strengths and weaknesses of his or her model. Blackwell Publishing Ltd 2010.

  13. UK medical students' perceptions, attitudes, and interest toward medical leadership and clinician managers.

    Rouhani, Maral J; Burleigh, Eleanor J; Hobbis, Chloe; Dunford, Charlotte; Osman, Nadir I; Gan, Christine; Gibbons, Norma B; Ahmed, Hashim U; Miah, Saiful

    2018-01-01

    We aimed to determine UK medical students' perceptions and attitudes and interest toward medical leadership and clinician managers. A cross-sectional study was conducted during the academic year 2015-2016. An online questionnaire was distributed to 2,349 final-year students from 10 UK medical schools. Participants were asked to complete a 5-point Likert scale on their current perceptions, attitudes, and interest toward medical leadership and clinician managers. They were also asked to self-rate their leadership competences set by the Medical Leadership Competency Framework and to rate the quality of management and leadership training they received from their medical school. In total, we received 114 complete responses. Only 7.9% of respondents were in agreement (strongly agree or agree) when asked whether they felt they were well informed about what a managerial position in medicine entails. When asked whether clinicians should influence managerial decisions within a clinical setting, 94.7% of respondents were in agreement with the statement. About 85% of respondents were in agreement that it is important for clinicians to have managerial or leadership responsibilities, with 63.2% of students in agreement that they would have liked more management or leadership training during medical school. Over half the respondents rated their management and leadership training they received during medical school as "very poor" or "poor" (54.4%). Our study suggests that UK medical students have an appetite for management and leadership training and appreciate its importance but feel that the training they are receiving is poor. This suggests that there is a gap between the demand for management and leadership training and the quality of training supplied by UK medical schools.

  14. Should doctors provide futile medical treatment if patients or their ...

    Ethically and legally doctors are not obliged to provide futile treatment to patients, even if the patient or their proxies are prepared to pay for it. However, it may be justified where such treatment is harmless and has a placebo effect. In deciding about a request for futile treatment, doctors should be guided by the ethical ...

  15. [Medical Rehabilitation as an Attractive Field of Work for Medical Doctors? - A Qualitative Survey].

    Lederle, Mareike; Kotzjan, Priscilla Simone; Niehues, Christiane; Brüggemann, Silke; Bitzer, Eva-Maria

    2017-10-01

    In the German Health system there is an increasing competition in the recruitment of specialised staff, especially for rehabilitation centres, which are deemed less attractive. Therefore, this study examines the attractiveness of the field of medical rehabilitation from the point of view of medical professionals. We conducted 16 semi-structured interviews with doctors from 7 rehabilitation centres with different medical specialisations. The interviews were digitized and transcribed. A structured content analysis was carried out using the software MAXQDA 11. 745 codes were identified and assigned to the categories "attractiveness", "unfavourable aspects" and "special features" of rehabilitation. Regarding medical rehabilitation, the interviewees appreciated especially the predictable, flexible working environment with little time pressure. Other than working with rehabilitative patients working as part of an interdisciplinary team was of high importance for the interviewees. Among the special features of rehabilitation in comparison with acute care were the higher relevance of the bio-psycho-social model of health and illness as well as the higher proportion of communication and organisation. Medical rehabilitation in Germany is an attractive field of work for medical doctors. This fact should be considered more with regards to rehabilitation's public image. © Georg Thieme Verlag KG Stuttgart · New York.

  16. Moving Beyond Accidental Leadership: A Graduate Medical Education Leadership Curriculum Needs Assessment.

    Hartzell, Joshua D; Yu, Clifton E; Cohee, Brian M; Nelson, Michael R; Wilson, Ramey L

    2017-07-01

    Despite calls for greater physician leadership, few medical schools, and graduate medical education programs provide explicit training on the knowledge, skills, and attitudes necessary to be an effective physician leader. Rather, most leaders develop through what has been labeled "accidental leadership." A survey was conducted at Walter Reed to define the current status of leadership development and determine what learners and faculty perceived as key components of a leadership curriculum. A branching survey was developed for residents and faculty to assess the perceived need for a graduate medical education leadership curriculum. The questionnaire was designed using survey best practices and established validity through subject matter expert reviews and cognitive interviewing. The survey instrument assessed the presence of a current leadership curriculum being conducted by each department, the perceived need for a leadership curriculum for physician leaders, the topics that needed to be included, and the format and timing of the curriculum. Administered using an online/web-based survey format, all 2,041 house staff and educators at Walter Reed were invited to participate in the survey. Descriptive statistics were conducted using SPSS (version 22). The survey response rate was 20.6% (421/2,041). Only 17% (63/266) of respondents stated that their program had a formal leadership curriculum. Trainees ranked their current leadership abilities as slightly better than moderately effective (3.22 on a 5-point effectiveness scale). Trainee and faculty availability were ranked as the most likely barrier to implementation. Topics considered significantly important (on a 5-point effectiveness scale) were conflict resolution (4.1), how to motivate a subordinate (4.0), and how to implement change (4.0). Respondents ranked the following strategies highest in perceived effectiveness on a 5-point scale (with 3 representing moderate effectiveness): leadership case studies (3.3) and

  17. [Becoming medical doctors in colonial Korea: focusing on the faculty of medical colleges in early north Korea].

    Kim, Geun Bae

    2014-12-01

    This paper traces how Koreans of north area became medical doctors in colonial Korea. Most of the past research have focused only on the well-known medical doctors, or even when they discussed a great number of doctors, many research tended to only pay attention to the explicit final results of those doctors. This research, on the other hand, includes ordinary medical doctors as well as the renowed ones, and adjusts the focus to the lifetime period of their growth and activities. As a result, the misunderstanding and obscurity about the Korean medical doctors of north area during this period have been cleared. The new characteristics of the Korean medical doctors of this period have been found, along with their embodiment of historical significance. At the time, Koreans had to get through a number of qualifications in order to become doctors. First is the unique background of origin in which the family held interest in the modern education and was capable of supporting it financially. Second is the long-term status of education that the education from elementary to high school was completed without interruption. Third is the academic qualification that among various institutions of higher education, medical science was chosen as a major. Fourth is the condition of career in which as the career as a doctor had consistently continued. Thus, in oder to become a modern medical doctor, Koreans had to properly complete these multiple steps of process. The group of Korean medical doctors in north area, which was formed after getting through these series of process, possessed a number of characteristics. Firstly, as the upper-middle classes constituted the majority of medical doctors in Korea, the societal status of doctors rose and the foundation for the career as a doctor to be persisted as the family occupation settled. Secondly, the research career and academic degree became the principal method to escape from the discrimination and hierarchy existed between doctors. A

  18. No Third Parties. The Medical Profession Reclaims Authority in Doctor-Patient Relationships

    Lars Thorup Larsen

    2016-09-01

    Full Text Available A key aspect of the classic doctor-patient relationship is the idea that doctors exert a professional authority through medical expertise while also taking care of the patient. Some professional organizations have held that “no third parties” should come between doctor and patient, be it governments or corporations. The sanctity of medical authority has also met resistance, and doctors are often said to face more demanding patients today with their own information about diagnoses. This article concerns how the medical profession reacts faced with challenged authority. Do they seek to reestablish a classic authority position or develop an alternative relationship with citizens? The analysis compares approximately 1.000 editorials in American, British and Danish medical journals from 1950 to the present. The analysis shows that all medical professions see their authority challenged by third parties, but some react defensively while others try to rethink the authority relation between professionals and citizens.

  19. Information Needs and Information Gathering Behavior of Medical Doctors in Maiduguri, Nigeria

    Jonathan A. Ocheibi

    2003-06-01

    Full Text Available Survey data describes the results of an investigation on the information needs and information gathering behaviour of Medical doctors in Maiduguri, Nigeria. A total of 158 Medical doctors (128 males and 30 (females were used for the study. The overall response rate was around 70.2 percent. Medical doctors need specific medical information to enhance their knowledge on a day-to-day basis, particularly with the information explosion such as e-mail and internet facilities. Medical doctors prefer the use of publishers catalogues as the most important source for new developments in their relevant fields. Many do not have access to local data bases that are supposed to have remarkable impact on their information gathering behaviour.

  20. The Dialogue Between Medical Doctors and Bioethicists: Rethinking Experience to Improve Medical Education.

    Valera, Luca; Russo, María Teresa; Curcio, Giuseppe

    2016-01-01

    More and more seems to be necessary to find new ways of communication between medical doctors and bioethicists in order to build a shared vocabulary and to prevent conflicts: many bioethical problems seem to be caused by the lack of dialogue between them, which both seem to speak two different languages. Improving this dialogue means searching new languages and innovative forms of communication: the narration could be a really effective tool to enhance the physicians' and bioethicist's moral conscience, since it facilitates reasoning on someone's particular experience, and, ultimately, on our experience. Starting from the results of a questionnaire administered to a group of students of the Faculty of Medicine and Surgery of the University Campus Bio-Medico we present a theoretical discussion about the need for more dialogue and for a shared vocabulary in medical experiences. In this regard, we suggest as a possible solution to the conflicts among medical doctors and bioethicists, an educational strategy, i.e., humanities courses for medical students, which may help them to deeply describe their practical present (and future) experience.

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

    Prichard, David

    2012-02-01

    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.

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

    Prichard, David; Collins, Niamh; Boohan, Mairead; Wall, Catherine

    2011-04-01

    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. 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. 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. 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. 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.

  3. Applying the International Medical Graduate Program Model to Alleviate the Supply Shortage of Accounting Doctoral Faculty

    HassabElnaby, Hassan R.; Dobrzykowski, David D.; Tran, Oanh Thikie

    2012-01-01

    Accounting has been faced with a severe shortage in the supply of qualified doctoral faculty. Drawing upon the international mobility of foreign scholars and the spirit of the international medical graduate program, this article suggests a model to fill the demand in accounting doctoral faculty. The underlying assumption of the suggested model is…

  4. How medical residents perceive the quality of supervision provided by attending doctors in the clinical setting

    Busari, Jamiu O.; Weggelaar, Nielske M.; Knottnerus, Andrieke C.; Greidanus, Petra-Marie; Scherpbier, Albert J. J. A.

    2005-01-01

    The supervision of medical residents is a key responsibility of attending doctors in the clinical setting. Most attending doctors, however, are unfamiliar with the principles of effective supervision. Although inconsistent, supervision has been shown to be both important and effective for the

  5. UK medical students’ perceptions, attitudes, and interest toward medical leadership and clinician managers

    Rouhani MJ

    2018-02-01

    Full Text Available Maral J Rouhani,1 Eleanor J Burleigh,2 Chloe Hobbis,2 Charlotte Dunford,1 Nadir I Osman,3 Christine Gan,1 Norma B Gibbons,1 Hashim U Ahmed,1,4 Saiful Miah1,5 1Department of Urology, Imperial College Healthcare NHS Trust, Charing Cross Hospital, London, UK; 2Medical School, University of Sheffield, Sheffield, UK; 3Department of Urology, Royal Hallamshire Hospital, Sheffield, UK; 4Division of Surgery, Department of Surgery and Cancer, Imperial College London, London, UK; 5Division of Surgery and Interventional Science, University College London, London, UK Background: We aimed to determine UK medical students’ perceptions and attitudes and interest toward medical leadership and clinician managers. Methods: A cross-sectional study was conducted during the academic year 2015–2016. An online questionnaire was distributed to 2,349 final-year students from 10 UK medical schools. Participants were asked to complete a 5-point Likert scale on their current perceptions, attitudes, and interest toward medical leadership and clinician managers. They were also asked to self-rate their leadership competences set by the Medical Leadership Competency Framework and to rate the quality of management and leadership training they received from their medical school. Results: In total, we received 114 complete responses. Only 7.9% of respondents were in agreement (strongly agree or agree when asked whether they felt they were well informed about what a managerial position in medicine entails. When asked whether clinicians should influence managerial decisions within a clinical setting, 94.7% of respondents were in agreement with the statement. About 85% of respondents were in agreement that it is important for clinicians to have managerial or leadership responsibilities, with 63.2% of students in agreement that they would have liked more management or leadership training during medical school. Over half the respondents rated their management and leadership

  6. Leadership, Medication Administration, and Knowledge Retention: A Quality Improvement Project

    Treister, Pamela

    2017-01-01

    A leadership and quality improvement project was undertaken in order to assist undergraduate baccalaureate nursing students in knowledge retention for medication administration during their senior semester in nursing school. Specific changes in curriculum were implemented to assist these undergraduate baccalaureate nursing students at a suburban…

  7. Phases to face in national medical leadership development

    Keijser, Wouter Alexander; Wilderom, Celeste P.M.; Poorthuis, Max Bastiaan; Tweedie, Judith; Lees, Peter; Dickson, Graham

    2017-01-01

    Increasing economic and organizational challenges call physicians in action to engage in medical leadership (ML) roles. Yet, in only six of the 195 countries the content of ML development has recently been articulated in the form of comprehensive national schemes or programs. Despite increasing

  8. Building Effective Medical Missions with Servant Leadership Skills.

    Johanson, Linda

    Nurses are naturally drawn to service opportunities, such as short-term medical missions (STMM), which hold great potential to benefit health. But STMMs have been criticized as potentially being culturally insensitive, leading to dependency, inadvertently causing harm, or being unsustainable. Utilizing servant leadership skills, nurses can effectively build community, vision, and sustainability into STMM projects.

  9. Doctors applying for Danish postgraduate medical specialist training are getting younger

    Kjaer, N. K.; Clausen, L. W.; Qvesel, D.

    2012-01-01

    was 58 months. 6% of the recruited doctors had a PhD. 61% of the doctors were graduates from the University of Southern Denmark. 14% graduated from the University of Copenhagen and 12% from Aarhus University. Finally, 13% graduated from a foreign university. CONCLUSION: Applicants accepted for specialist......INTRODUCTION: It was previously shown that applicants for postgraduate medical specialist training in Denmark were old. In order to prevent potential shortage of specialists, the Danish health authorities have passed legislation to speed up the output of new specialists. The aim of this study...... was to highlight the present characteristics of young doctors who entered specialist training. MATERIAL AND METHODS: Data include 443 doctors who were enrolled in a formalized postgraduate medical training programme in the Region of Southern Denmark from 2009 to 2011. RESULTS: 41% of the recruited young doctors...

  10. Goleman's Leadership styles at different hierarchical levels in medical education.

    Saxena, Anurag; Desanghere, Loni; Stobart, Kent; Walker, Keith

    2017-09-19

    With current emphasis on leadership in medicine, this study explores Goleman's leadership styles of medical education leaders at different hierarchical levels and gain insight into factors that contribute to the appropriateness of practices. Forty two leaders (28 first-level with limited formal authority, eight middle-level with wider program responsibility and six senior- level with higher organizational authority) rank ordered their preferred Goleman's styles and provided comments. Eight additional senior leaders were interviewed in-depth. Differences in ranked styles within groups were determined by Friedman tests and Wilcoxon tests. Based upon style descriptions, confirmatory template analysis was used to identify Goleman's styles for each interviewed participant. Content analysis was used to identify themes that affected leadership styles. There were differences in the repertoire and preferred styles at different leadership levels. As a group, first-level leaders preferred democratic, middle-level used coaching while the senior leaders did not have one preferred style and used multiple styles. Women and men preferred democratic and coaching styles respectively. The varied use of styles reflected leadership conceptualizations, leader accountabilities, contextual adaptations, the situation and its evolution, leaders' awareness of how they themselves were situated, and personal preferences and discomfort with styles. The not uncommon use of pace-setting and commanding styles by senior leaders, who were interviewed, was linked to working with physicians and delivering quickly on outcomes. Leaders at different levels in medical education draw from a repertoire of styles. Leadership development should incorporate learning of different leadership styles, especially at first- and mid-level positions.

  11. Knowledge of medical doctors in Turkey about the relationship between periodontal disease and systemic health

    TAŞDEMIR,Zekeriya; ALKAN,Banu Arzu

    2015-01-01

    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 co...

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

    Payne Karl Frederick

    2012-10-01

    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.

  13. CPR and the RCP (2). Training of students and doctors in UK medical schools.

    Gillard, J H; Dent, T H; Jolly, B C; Wallis, D A; Hicks, B H

    1993-10-01

    We asked British medical schools and teaching hospitals about the training they offer to medical students and hospital doctors in cardiopulmonary resuscitation. The response rate was 96%. Training that is practical and consistent with guidelines is offered to nearly all students and house officers, often by consultants. Training for other junior doctors and consultants is much less common. The organisation of training is haphazard, and many hospitals have no resuscitation training officers. As a result, few doctors receive the frequent retraining needed to maintain competence in managing cardiopulmonary arrest.

  14. Emotional reactions of medical doctors and students following the ...

    2009-09-03

    Sep 3, 2009 ... throughout the interviews and that all information would be treated with confidentiality. ... change.7 Saunders and Valente found that when doctors had not been able, ... earlier loss, and perhaps adopting a coping strategy of avoiding all grief ..... Perceptions of clients by professional helpers. Psychological ...

  15. Microorganisms from hands of traditional Chinese medical doctors ...

    Background: In a central hospital, the heavy clinical workload makes one to overlook its hazard to health and can to a large extent promote the transmission of pathogenic microorganisms. It is not uncommon however, to observe practices that deviate from normal standards of hygiene. Hand contact between doctors of TCM ...

  16. Special Education Doctoral Programs: A 10-Year Comparison of the Suppliers of Leadership Personnel

    Smith, Deborah Deutsch; Montrosse, Bianca Elizabeth

    2012-01-01

    The first article in this special issue is about the doctoral programs, the suppliers of new doctoral graduates in special education. It focuses on one component of a larger effort, the Special Education Faculty Needs Assessment (SEFNA) project, which investigated many aspects of the supply of new doctoral graduates as well as the demand for new…

  17. Medical leaders or masters?-A systematic review of medical leadership in hospital settings.

    Berghout, Mathilde A; Fabbricotti, Isabelle N; Buljac-Samardžić, Martina; Hilders, Carina G J M

    2017-01-01

    Medical leadership is increasingly considered as crucial for improving the quality of care and the sustainability of healthcare. However, conceptual clarity is lacking in the literature and in practice. Therefore, a systematic review of the scientific literature was conducted to reveal the different conceptualizations of medical leadership in terms of definitions, roles and activities, and personal-and context-specific features. Eight databases were systematically searched for eligible studies, including empirical studies published in peer-reviewed journals that included physicians carrying out a manager or leadership role in a hospital setting. Finally, 34 articles were included and their findings were synthesized and analyzed narratively. Medical leadership is conceptualized in literature either as physicians with formal managerial roles or physicians who act as informal 'leaders' in daily practices. In both forms, medical leaders must carry out general management and leadership activities and acts to balance between management and medicine, because these physicians must accomplish both organizational and medical staff objectives. To perform effectively, credibility among medical peers appeared to be the most important factor, followed by a scattered list of fields of knowledge, skills and attitudes. Competing logics, role ambiguity and a lack of time and support were perceived as barriers. However, the extent to which physicians must master all elicited features, remains ambiguous. Furthermore, the extent to which medical leadership entails a shift or a reallocation of tasks that are at the core of medical professional work remains unclear. Future studies should implement stronger research designs in which more theory is used to study the effect of medical leadership on professional work, medical staff governance, and subsequently, the quality and efficiency of care.

  18. Medical leaders or masters?—A systematic review of medical leadership in hospital settings

    Fabbricotti, Isabelle N.; Buljac-Samardžić, Martina; Hilders, Carina G. J. M.

    2017-01-01

    Medical leadership is increasingly considered as crucial for improving the quality of care and the sustainability of healthcare. However, conceptual clarity is lacking in the literature and in practice. Therefore, a systematic review of the scientific literature was conducted to reveal the different conceptualizations of medical leadership in terms of definitions, roles and activities, and personal–and context-specific features. Eight databases were systematically searched for eligible studies, including empirical studies published in peer-reviewed journals that included physicians carrying out a manager or leadership role in a hospital setting. Finally, 34 articles were included and their findings were synthesized and analyzed narratively. Medical leadership is conceptualized in literature either as physicians with formal managerial roles or physicians who act as informal ‘leaders’ in daily practices. In both forms, medical leaders must carry out general management and leadership activities and acts to balance between management and medicine, because these physicians must accomplish both organizational and medical staff objectives. To perform effectively, credibility among medical peers appeared to be the most important factor, followed by a scattered list of fields of knowledge, skills and attitudes. Competing logics, role ambiguity and a lack of time and support were perceived as barriers. However, the extent to which physicians must master all elicited features, remains ambiguous. Furthermore, the extent to which medical leadership entails a shift or a reallocation of tasks that are at the core of medical professional work remains unclear. Future studies should implement stronger research designs in which more theory is used to study the effect of medical leadership on professional work, medical staff governance, and subsequently, the quality and efficiency of care. PMID:28910335

  19. Guiding Principles for Student Leadership Development in the Doctor of Pharmacy Program to Assist Administrators and Faculty Members in Implementing or Refining Curricula

    Boyle, Cynthia J.; Janke, Kristin K.

    2013-01-01

    Objective. To assist administrators and faculty members in colleges and schools of pharmacy by gathering expert opinion to frame, direct, and support investments in student leadership development. Methods. Twenty-six leadership instructors participated in a 3-round, online, modified Delphi process to define doctor of pharmacy (PharmD) student leadership instruction. Round 1 asked open-ended questions about leadership knowledge, skills, and attitudes to begin the generation of student leadership development guiding principles and competencies. Statements were identified as guiding principles when they were perceived as foundational to the instructional approach. Round 2 grouped responses for agreement rating and comment. Group consensus with a statement as a guiding principle was set prospectively at 80%. Round 3 allowed rating and comment on guidelines, modified from feedback in round 2, that did not meet consensus. The principles were verified by identifying common contemporary leadership development approaches in the literature. Results. Twelve guiding principles, related to concepts of leadership and educational philosophy, were defined and could be linked to contemporary leadership development thought. These guiding principles describe the motivation for teaching leadership, the fundamental precepts of student leadership development, and the core tenets for leadership instruction. Conclusions. Expert opinion gathered using a Delphi process resulted in guiding principles that help to address many of the fundamental questions that arise when implementing or refining leadership curricula. The principles identified are supported by common contemporary leadership development thought. PMID:24371345

  20. Guiding principles for student leadership development in the doctor of pharmacy program to assist administrators and faculty members in implementing or refining curricula.

    Traynor, Andrew P; Boyle, Cynthia J; Janke, Kristin K

    2013-12-16

    To assist administrators and faculty members in colleges and schools of pharmacy by gathering expert opinion to frame, direct, and support investments in student leadership development. Twenty-six leadership instructors participated in a 3-round, online, modified Delphi process to define doctor of pharmacy (PharmD) student leadership instruction. Round 1 asked open-ended questions about leadership knowledge, skills, and attitudes to begin the generation of student leadership development guiding principles and competencies. Statements were identified as guiding principles when they were perceived as foundational to the instructional approach. Round 2 grouped responses for agreement rating and comment. Group consensus with a statement as a guiding principle was set prospectively at 80%. Round 3 allowed rating and comment on guidelines, modified from feedback in round 2, that did not meet consensus. The principles were verified by identifying common contemporary leadership development approaches in the literature. Twelve guiding principles, related to concepts of leadership and educational philosophy, were defined and could be linked to contemporary leadership development thought. These guiding principles describe the motivation for teaching leadership, the fundamental precepts of student leadership development, and the core tenets for leadership instruction. Expert opinion gathered using a Delphi process resulted in guiding principles that help to address many of the fundamental questions that arise when implementing or refining leadership curricula. The principles identified are supported by common contemporary leadership development thought.

  1. Awareness of cardiopulmonary resuscitation in medical-students and doctors in Rawalpindi-Islamabad, Pakistan

    Zamir, Q.; Nadeem, A.; Rizvi, A.H.

    2012-01-01

    Objective: To assess the level of awareness regarding basic and practical knowledge of cardiopulmonary resuscitation and its importance in the eyes of medical/dental students and doctors. Methods: The cross-sectional study was conducted in medical and dental colleges as well as hospitals of Rawalpindi and Islamabad, Pakistan, from June to September 2011. Non-probability convenience sampling was used and structured questionnaires on basic and practical knowledge of the procedure were distributed. The questionnaire had 26 items related to basic and advanced knowledge of the required skills. Doctors were divided into two groups based on their years of service and practice. Those with less than 5 years' experience were grouped as junior doctors, while rest as senior doctors. Descriptive statistics were employed to analyse the data using SPPS version 17 and Microsoft Excel. Percentages were worked out and the results were interpreted. Result: Of the 1000 questionnaires distributed, 646 (64.6%) were received duly filled and represented the study sample. Of the 646 participants, 34 (5.26%) were dentists, 424 (65.63%) were medical students, 92 (14.24%) were doctors and 96 (14.86%) were dental students. Basic knowledge of doctors was found to be better than that of dentists (n=96; 50% vs. n=8; 23%). Similarly, the advance knowledge of doctors was better than the dentists (n=53; 58% vs. n=11; 31%). The basic knowledge of junior doctors was found to be almost equal to the senior doctors (n=26; 44.75% vs. n=15; 45.5%). The advance knowledge of junior doctors was found to be better than the senior doctors (n=27; 45.37% vs. n=10; 29.48%). Among the students, 157 (37%) of the medical students had basic knowledge of CPR, while 36 (38%) dental students had basic knowledge of the topic. Medical students had more advanced knowledge (n=157; 37%) than dental students (n=34; 35%). Conclusion: The awareness of basic and advance knowledge of cardiopulmonary resuscitation skills in medical

  2. Doctors' attitudes about prescribing and knowledge of the costs of common medications.

    McGuire, C

    2012-02-01

    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.

  3. Aspects of communication in medical life. Doctor-patient communication: differentiation and customization.

    Borţun, D; Matei, C S

    2017-01-01

    One of the weaknesses of the Romanian medical system is the absence of the communicational culture. This absence is felt at all levels of the healthcare system: doctor-patient relationship, doctor-patient's relatives relationship, labor relations within the medical teams and units, the management of the large hospitals and of the medical institutions from the public administration system and last, but not least, the relationships of these units and institutions with the public opinion and, particularly, with the stakeholders. This paper tackled with some of the principles and values that underlie an efficient communication, the default of which was felt in various domains of the Romanian medical life. They were analyzed from the perspective of the Romanian and international literature and the conclusions drawn might inspire proposals for the improvement of the medical education as well as for the professional development of the Romanian doctors.

  4. Doctoral profile of the medical radiation sciences: a baseline for Australia and New Zealand.

    Ekpo, Ernest U; Snaith, Beverly; Harris, Martine A; McEntee, Mark F

    2017-09-01

    Research is critical to evidence-based practice, and the rapid developments in technology provide opportunities to innovate and improve practice. Little is known about the research profile of the medical radiation science (MRS) profession in Australia and New Zealand (NZ). This study provides a baseline of their doctoral activity. A cross-sectional survey of MRS professionals in Australia and NZ holding a doctorate or undertaking doctoral studies, was performed using an online tool (Bristol Online Survey ® , Bristol, UK). A chain-referral sampling technique was adopted for data collection. An email invitation with a link to the survey was generated and distributed through email and social media. The survey contained questions related to participant demographics, doctoral status, qualification route, funding and employment. There were 63 responses to the survey comprising 50.8% diagnostic radiographers (DRs; n = 32), 23.8% radiation therapists (RTs; n = 15), with the remaining 25.4% (n = 16) equally split between sonographers and nuclear medicine technologists (NMTs). A total of 40 (63.5%) of respondents had completed their doctoral qualification. In NZ, only DRs held a doctoral award constituting 0.3% of DRs and 0.2% of the total registered MRS population. In Australia, there was a greater proportion of doctoral NMTs (n = 8/1098; 0.7%) than RTs (n = 15/2394; 0.6%) and DRs (n = 27/12,001; 0.2%). Similar to other countries, findings show a very small percentage of doctoral MRS professionals in Australia and NZ. Strategies to engage and support individuals in research, up to and beyond doctoral study, need to be embedded in practice. © 2017 The Authors. Journal of Medical Radiation Sciences published by John Wiley & Sons Australia, Ltd on behalf of Australian Society of Medical Imaging and Radiation Therapy and New Zealand Institute of Medical Radiation Technology.

  5. Educational climate seems unrelated to leadership skills of clinical consultants responsible of postgraduate medical education in clinical departments.

    Malling, Bente; Mortensen, Lene S; Scherpbier, Albert J J; Ringsted, Charlotte

    2010-09-21

    The educational climate is crucial in postgraduate medical education. Although leaders are in the position to influence the educational climate, the relationship between leadership skills and educational climate is unknown. This study investigates the relationship between the educational climate in clinical departments and the leadership skills of clinical consultants responsible for education. The study was a trans-sectional correlation study. The educational climate was investigated by a survey among all doctors (specialists and trainees) in the departments. Leadership skills of the consultants responsible for education were measured by multi-source feedback scores from heads of departments, peer consultants, and trainees. Doctors from 42 clinical departments representing 21 specialties participated. The response rate of the educational climate investigation was moderate 52% (420/811), Response rate was high in the multisource-feedback process 84.3% (420/498). The educational climate was scored quite high mean 3.9 (SD 0.3) on a five-point Likert scale. Likewise the leadership skills of the clinical consultants responsible for education were considered good, mean 5.4 (SD 0.6) on a seven-point Likert scale. There was no significant correlation between the scores concerning the educational climate and the scores on leadership skills, r = 0.17 (p = 0.29). This study found no relation between the educational climate and the leadership skills of the clinical consultants responsible for postgraduate medical education in clinical departments with the instruments used. Our results indicate that consultants responsible for education are in a weak position to influence the educational climate in the clinical department. Further studies are needed to explore, how heads of departments and other factors related to the clinical organisation could influence the educational climate.

  6. Relationships between academic performance of medical students and their workplace performance as junior doctors.

    Carr, Sandra E; Celenza, Antonio; Puddey, Ian B; Lake, Fiona

    2014-07-30

    Little recent published evidence explores the relationship between academic performance in medical school and performance as a junior doctor. Although many forms of assessment are used to demonstrate a medical student's knowledge or competence, these measures may not reliably predict performance in clinical practice following graduation. This descriptive cohort study explores the relationship between academic performance of medical students and workplace performance as junior doctors, including the influence of age, gender, ethnicity, clinical attachment, assessment type and summary score measures (grade point average) on performance in the workplace as measured by the Junior Doctor Assessment Tool. There were two hundred participants. There were significant correlations between performance as a Junior Doctor (combined overall score) and the grade point average (r = 0.229, P = 0.002), the score from the Year 6 Emergency Medicine attachment (r = 0.361, P gender or ethnicity on the overall combined score of performance of the junior doctor. Performance on integrated assessments from medical school is correlated to performance as a practicing physician as measured by the Junior Doctor Assessment Tool. These findings support the value of combining undergraduate assessment scores to assess competence and predict future performance.

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

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

    2016-01-01

    Introduction: It has been suggested that an indicator of a doctor's ability to assess patients' sexual function relates to the level of earlier training. The amount and quality of training the doctor receives at the undergraduate level and beyond could contribute to the doctor's confidence and competence. Aims: To evaluate whether doctors found that the teaching in human sexuality received at medical school was sufficient for their future practice and whether their chosen medical specialty...

  8. Medical Specialty Choice and Related Factors of Brazilian Medical Students and Recent Doctors.

    Ligia Correia Lima de Souza

    Full Text Available Choosing a medical specialty is an important, complex, and not fully understood process. The present study investigated the factors that are related to choosing and rejecting medical specialties in a group of students and recent medical doctors.A cross-sectional survey of 1,223 medical students and doctors was performed in Brazil in 2012. A standardized literature-based questionnaire was applied that gathered preferable or rejected specialties, and asked questions about extracurricular experiences and the influence of 14 factors on a Likert-type scale from 0 to 4. Specialties were grouped according to lifestyle categories: controllable and uncontrollable, which were subdivided into primary care, internal medicine, and surgical specialties. Notably, the time period of rejection was usually earlier than the time period of intended choice (p < 0.0001, χ(2 = 107.2. The choice mainly occurred during the internship period in medical school (n = 466; 38.7%. An overall large frequency of participation in extracurricular activities was observed (n = 1,184; 95.8%, which were highly associated with the respective medical area. Orthopedic surgery had the highest correlation with participation in specialty-specific organized groups (OR = 59.9, 95% CI = 21.6-166.3 and psychiatry was correlated with participation in research groups (OR = 18.0, 95% CI = 9.0-36.2. With regard to influential factors in controllable lifestyle specialties, "financial reason" (mean score ± standard deviation: 2.8 ± 1.0; median = 3 and "personal time" (3.1 ± 1.3; median = 4 were important factors. In primary care, these factors were less important (1.7 ± 1.3 and 1.7 ± 1.5, respectively; median = 2 for both, and higher scores were observed for "curricular internship" (3.2 ± 1.1, median = 4 and "social commitment" (2.6 ± 1.3, median = 3.The present findings provide important insights into developing strategies to stimulate interest in specialties based on the needs of the

  9. Importance of doctor-patient relationship for patient adherence with medication regimes

    Sokolowski, Ineta; Vedsted, Peter

    Aim: It has been supposed that the relation between the doctor and the patient has implications for the adherence to medication. This study explores the effect of patient reported doctor-patient relationship on patient adherence with medication regiments. Methods: Design: Prospective cohort study...... practices. Doctor-patient relationship was measured from The Danish version of the 23-item EUROPEP questionnaire measuring patient evaluation of general practice. From the register data on prescriptions we drew all subsidised drugs redeemed at pharmacies for each patient in 2002-2005. Patients, who did...... was measured as secondary non-compliance and as persistence. The incidence rate ratio of non-adherence was calculated for different levels of the patient evaluated doctor-patient-relationship. Results: A total of 482 patients started new treatment of which 98 were non-compliant and 7 were censored. This study...

  10. Master of science in medical leadership and management and its role in the current NHS.

    Barratt, Shaney; Bateman, Kathryn; Harvey, John

    2010-10-01

    Traditionally there has been little formal leadership and management education in the core medical curriculum. The Department of Health has recently emphasised the development of clinical leadership within the NHS. In this article, trainees share their experience of the Master of Science in medical leadership and management postgraduate qualification.

  11. Are tomorrow's doctors aware of the code of medical ethics?

    Arun Babu, T; Venkatesh, C; Sharmila, V

    2013-01-01

    The purpose of this study was to evaluate the awareness of the 'ethical code of conduct for medical practitioners' among medical undergraduate students. Tertiary care medical college and hospital. This study covered 172 medical students in a private medical school in Pondicherry, located in southern India. They were administered a questionnaire, containing ten scenarios, which was based on the 'medical code of ethics' as set out in the chapters on 'unethical acts' and 'misconduct' of the Indian Medical Council (Professional conduct, Etiquette and Ethics) Regulations, 2002. The students were given the option of responding with a 'yes,' 'no' or 'don't know.' Only 128 (74.4%) of the 172 medical undergraduates enrolled in the study returned the completed questionnaire. None of them answered all the questions correctly. The overall mean score was 6.13 out of 10, with an SD of 1.36. There were no significant differences between second-, third- or final-year students. There was no significant difference in the performance of boys and girls. Most of the students erred in scenarios related to decision-making and communication. There are major deficiencies in the understanding of medical ethics among medical undergraduates. Including medical ethics as a mandatory and separate subject in the first few years of under graduation can help students understand and follow ethical principles.

  12. Is the doctor on? In search of users for medical software in rural Himalayas

    P.A. Arora (Payal)

    2012-01-01

    textabstractThe Indian healthcare sector provides ripe ground for development as access to high-quality and timely medical diagnosis remains unrequited among its vast rural populace. With an acute shortage of doctors in rural areas, medical diagnostic software has been created as a surrogate,

  13. Practicing doctors' perceptions on new learning objectives for Vietnamese medical schools

    Hoat, L; Dung, DV; Wright, E.P.

    2008-01-01

    Background. As part of the process to develop more community-oriented medical teaching in Vietnam, eight medical schools prepared a set of standard learning objectives with attention to the needs of a doctor working with the community. Because they were prepared based on government documents and the

  14. Survey on Aesthetic Vulvovaginal Procedures: What do PortugueseDoctors andMedical Students Think?

    Vieira-Baptista, Pedro; Lima-Silva, Joana; Fonseca-Moutinho, José; Monteiro, Virgínia; Águas, Fernanda

    2017-01-01

    Abstract Objective To assess themedical doctors andmedical students’ opinion regarding the evidence and ethical background of the performance of vulvovaginal aesthetic procedures (VVAPs). Methods Cross-sectional online survey among 664 Portuguese medical doctors and students. Results Most participants considered that there is never or there rarely is amedical reason to perform: vulvar whitening (85.9% [502/584]); hymenoplasty (72.0% [437/607]); mons pubis liposuction (71.6% [426/595]); ...

  15. Significance of gender in the attitude towards doctor-patient communication in medical students and physicians.

    Löffler-Stastka, Henriette; Seitz, Tamara; Billeth, Sabrina; Pastner, Barbara; Preusche, Ingrid; Seidman, Charles

    2016-09-01

    Gender-specific differences in the attitudes towards doctor-patient communication among medical students and physicians were assessed. A total of 150 medical students and 51 physicians from different departments took part in the study. The association, attitude and experiences regarding doctor-patient communication were assessed with a series of tools and questionnaires. Female doctors and students tended to describe the doctor-patient communication with positive attributes, such as "helpful", "sentimental", "voluble", "sociable", "gentle", "yielding" and "peaceful". Male students and physicians, on the other hand, described doctor-patient communication as "overbearing", "robust" and "inhibited". The most frequent associations females had with the term doctor-patient communication were "empathy", "confidence", "openess", while the most frequent association of the male colleagues was "medical history". Female doctors reported speaking about the psychosocial situation of the patient significantly more often and believed in higher patient satisfaction by sharing more information. Furthermore, they reported having longer conversations with a more equal partnership than their male colleagues. Compared to male students, female students were willing to take part in training their communication skills more often and had more interest in research about doctor-patient communication. Male medical students reported self-doubt during conversations with female patients, while one third of the male physicians talked about "the power over the patient". This study indicates a gender-dependent communication style influenced by stereotypes. At the establishment of communication training these differences should be taken into account, especially to strengthen male communication skills and improve their attitudes.

  16. Awareness of basic life support among medical, dental, nursing students and doctors

    Shanta Chandrasekaran

    2010-01-01

    Full Text Available To study the awareness of Basic Life Support (BLS among students, doctors and nurses of medical, dental, homeopathy and nursing colleges. A cross-sectional study was conducted by assessing responses to 20 selected basic questions regarding BLS among students, doctors and nurses of medical, dental, homeopathy and nursing colleges. After excluding the incomplete response forms the data was analysed on 1,054 responders. The results were analysed using an answer key prepared with the use of the Advanced Cardiac Life Support manual. Out of 1,054 responders 345 were medical students, 75 were medical interns, 19 were dental students, 59 were dental interns, 105 were homeopathy interns, 319 were nursing students, 72 were doctors, 29 were dentists, 25 were nursing faculty and six were homeopathy doctors. No one among them had complete knowledge of BLS. Only two out of 1054 (0.19% had secured 80 - 89% marks, 10 out of 1054 (0.95% had secured 70 - 79% marks, 40 of 1054 (4.08% had secured 60 - 69% marks and 105 of 1054 (9.96% had secured 50 - 59% marks. A majority of them, that is, 894 (84.82% had secured less than 50% marks. Awareness of BLS among students, doctors and nurses of medical, dental, homeopathy and nursing colleges is very poor.

  17. Using medical knowledge sources on handheld computers--a qualitative study among junior doctors.

    Axelson, Christian; Wårdh, Inger; Strender, Lars-Erik; Nilsson, Gunnar

    2007-09-01

    The emergence of mobile computing could have an impact on how junior doctors learn. To exploit this opportunity it is essential to understand their information seeking process. To explore junior doctors' experiences of using medical knowledge sources on handheld computers. Interviews with five Swedish junior doctors. A qualitative manifest content analysis of a focus group interview followed by a qualitative latent content analysis of two individual interviews. A focus group interview showed that users were satisfied with access to handheld medical knowledge sources, but there was concern about contents, reliability and device dependency. Four categories emerged from individual interviews: (1) A feeling of uncertainty about using handheld technology in medical care; (2) A sense of security that handhelds can provide; (3) A need for contents to be personalized; (4) A degree of adaptability to make the handheld a versatile information tool. A theme was established to link the four categories together, as expressed in the Conclusion section. Junior doctors' experiences of using medical knowledge sources on handheld computers shed light on the need to decrease uncertainty about clinical decisions during medical internship, and to find ways to influence the level of self-confidence in the junior doctor's process of decision-making.

  18. Factors Associated with Medical Doctors' Intentions to Discriminate Against Transgender Patients in Kuala Lumpur, Malaysia

    Vijay, Aishwarya; Earnshaw, Valerie A.; Tee, Ying Chew; Pillai, Veena; White Hughto, Jaclyn M.; Clark, Kirsty; Kamarulzaman, Adeeba; Altice, Frederick L.

    2018-01-01

    Abstract Purpose: Transgender people are frequent targets of discrimination. Discrimination against transgender people in the context of healthcare can lead to poor health outcomes and facilitate the growth of health disparities. This study explores factors associated with medical doctors' intentions to discriminate against transgender people in Malaysia. Methods: A total of 436 physicians at two major university medical centers in Kuala Lumpur, Malaysia, completed an online survey. Sociodemographic characteristics, stigma-related constructs, and intentions to discriminate against transgender people were measured. Bivariate and multivariate linear regression were used to evaluate independent covariates of discrimination intent. Results: Medical doctors who felt more fearful of transgender people and more personal shame associated with transgender people expressed greater intention to discriminate against transgender people, whereas doctors who endorsed the belief that transgender people deserve good care reported lower discrimination intent. Stigma-related constructs accounted for 42% of the variance and 8% was accounted for by sociodemographic characteristics. Conclusions: Constructs associated with transgender stigma play an important role in medical doctors' intentions to discriminate against transgender patients. Development of interventions to improve medical doctors' knowledge about and attitudes toward transgender people are necessary to reduce discriminatory intent in healthcare settings. PMID:29227183

  19. Factors Associated with Medical Doctors' Intentions to Discriminate Against Transgender Patients in Kuala Lumpur, Malaysia.

    Vijay, Aishwarya; Earnshaw, Valerie A; Tee, Ying Chew; Pillai, Veena; White Hughto, Jaclyn M; Clark, Kirsty; Kamarulzaman, Adeeba; Altice, Frederick L; Wickersham, Jeffrey A

    2018-01-01

    Transgender people are frequent targets of discrimination. Discrimination against transgender people in the context of healthcare can lead to poor health outcomes and facilitate the growth of health disparities. This study explores factors associated with medical doctors' intentions to discriminate against transgender people in Malaysia. A total of 436 physicians at two major university medical centers in Kuala Lumpur, Malaysia, completed an online survey. Sociodemographic characteristics, stigma-related constructs, and intentions to discriminate against transgender people were measured. Bivariate and multivariate linear regression were used to evaluate independent covariates of discrimination intent. Medical doctors who felt more fearful of transgender people and more personal shame associated with transgender people expressed greater intention to discriminate against transgender people, whereas doctors who endorsed the belief that transgender people deserve good care reported lower discrimination intent. Stigma-related constructs accounted for 42% of the variance and 8% was accounted for by sociodemographic characteristics. Constructs associated with transgender stigma play an important role in medical doctors' intentions to discriminate against transgender patients. Development of interventions to improve medical doctors' knowledge about and attitudes toward transgender people are necessary to reduce discriminatory intent in healthcare settings.

  20. Preparing Community College Leaders: The AACC Core Competencies for Effective Leadership & Doctoral Education

    McNair, Delores E.

    2010-01-01

    Community colleges in the United States face shortages of leaders prepared to assume administrative positions in the 21st century. To respond to this shortage, graduate programs are emerging with a specific emphasis on community college leadership; other graduate programs offer broader curricula focused on educational leadership, policy, or higher…

  1. Duty of care or a matter of conduct -- can a doctor refuse a person in need of urgent medical attention?

    Dean, Jessica; Mahar, Patrick; Loh, Erwin; Ludlow, Karinne

    2013-10-01

    Medical practitioners may have their particular skills called upon outside a direct professional context. The responsibilities of medical practitioners outside their defined scope of clinical practice may not be clear to all clinicians. To consider the possible legal consequences of a doctor refusing to assist a person in need of urgent medical attention both in terms of medical negligence and professional misconduct. Where an established clinical relationship does not exist, and a doctor does not wish to render aid, three particular scenarios may arise. A doctor may actively deny being a doctor, passively avoid identifying themselves as a doctor or acknowledge being a doctor, but refuse to render assistance. Aside from any ethical issues, how a doctor chooses to act and represent themselves may lead to different legal ramifications. There exists significant variation in state provisions relating to legal obligations to render aid, which may benefit from review and revision at a national level.

  2. Medical students' unique experience of army leadership training: a qualitative study.

    Earis, John; Garner, J; Haddock, D; Jenkins, J; Jha, V

    2017-10-01

    To assess the interactive experience of first year medical students attending the leadership and management course hosted by a British Army Reserve Field Hospital developed in partnership with Liverpool University. 244 students submitted a 1000-word structured reflective learning assignment about their reaction to, learning from and any behaviour and attitude changes as a result of, the training. The assignments were thematically analysed to identify how aspects of the training had impacted upon the students' understanding of leadership and teamwork. Their comments relating to the army were analysed to gain insight into their views and experience of the training. Students were surprised at how enjoyable and useful they found the course. Initially they expressed scepticism about what they could learn in an army-based environment. However, the training, particularly command and planning tasks, helped them appreciate and understand the different skills individuals can bring to a team environment, and the importance of everyone contributing. While some students were challenged by aspects of the course, with support and encouragement from team-mates and the army personnel, they learned they could achieve more together. Teaching leadership and management skills to medical students is a challenge which can be effectively addressed by adapting and developing army training resources. Students overcame initial scepticism about participating, and learned a lot about themselves and each other. In addition, the army developed a better understanding of the doctors of the future. The expertise of the army in delivering this training was crucial to its success as the medical school could not have provided this experience unsupported. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  3. Teaching and Assessing Doctor-Patient Communication Using Remote Standardized Patients and SKYPE: Feedback from Medical Residents

    Horber, Dot; Langenau, Erik E.; Kachur, Elizabeth

    2014-01-01

    Teaching and assessing doctor-patient communication has become a priority in medical education. This pilot study evaluated resident physicians' perceptions of teaching and assessing doctor-patient communication skills related to pain management using a web-based format. Fifty-nine resident physicians completed four doctor-patient clinical…

  4. evaluative study of medical doctors' mode of referral for physiother

    Olwafemi Odebiyi

    physicians' mode of referral of patients for physiotherapy in Nigeria. A total of 1192 physicians .... The Influence of Medical School of Graduation. Table 1 shows the .... This must have also been responsible for the high rate of referral observed.

  5. The image ofan ideal psychiatrist inthe eyes of medical students, patients and doctors involved inpsychiatric care

    Aleksandra Margulska

    2013-03-01

    Full Text Available Aim: The aim of the study was to determine differences in the image of ideal psychiatrist (IIP among patients, doctors involved in psychiatric care and medical students and also between individuals with different work experience (doctors vs. students. The psychiatrist’s personality seems an important factor in supporting therapeutic process; therefore it is worth searching for the patient’s needs. Materials and methods: Three groups participated in the study: patients of the psychiatric units, medical students of 6th year and psychiatrists. The Gough and Heilbrun ACL (Adjective Check List – based on Mur‑ ray’s theory of needs – was used to assess IIP. Results: Data analysis revealed statistically significant differences among patients, doctors and students involving five scales: Nurturance, Aggression, Change, Succorance and Deference. Patients had lower scores on Change scale than doctors and higher scores on the Nurturance, Succurance and Deference than stu‑ dents. Psychiatrists had higher scores on Nurturance and Deference scale and lower score on Aggression scale than students. Conclusions: The findings showed differences in the expectations of patients compared to those of students and doctors. The most significant difference that was observed involved the Change. It may indicate that patients prefer order, conventional approach and stability in psychiatrist’s personality traits more commonly than doctors. Study findings suggest that work experience has impact on IIP: with increasing work experience, opinion about IIP comes closer to patients’ expectations.

  6. [Awareness survey of Healthcare Number System pros and cons according to medical doctors in Japan].

    Takahashi, Yoshimitsu; Uryuhara, Yoko; Inoue, Machiko; Okamoto, Shigeru; Kashihara, Hidenori; Kito, Kumiko; Shinohara, Keiko; Mandai, Marie; Morioka, Miho; Tanaka, Shiro; Kawakami, Koji; Nakayama, Takeo

    2015-01-01

    After bills to launch the Social Security and Tax Number System were enacted in 2013, health and political officials have considered the Healthcare Number System (the System). However, little is known about doctors' awareness and concerns about the System. This study aimed to measure how many doctors disagree with the System, examine the doctors' characteristics, and analyze the benefits and harms of the System that they identified. A cross-sectional survey was conducted of doctors via the Internet. The participants were selected from a convenience sample of a panel of doctors based on stratified sampling including four groups: working at a hospital and content analysis. There were 562 respondents (68%). By group, 16/143 (11%), 25/138 (18%), 31/132 (23%), and 43/149 (29%) doctors, respectively, thought that the System was unnecessary. The variables that correlated with the main outcome were age (per 5 years; odds ratio [95% confidence interval], 1.14 [1.01-1.29]) and type of medical facility (working at a clinic; 1.99 [1.30-3.08]). The doctors identified that unifying information could decrease administrative duties, facilitate inter-facility collaboration, and prevent inappropriate medical consultations. This could result in decreased healthcare costs and personalized healthcare. However, the doctors also identified that integrating information and dealing with big data could increase information leakage and information management, cause over-monitoring of doctors, and enable the inappropriate use of integrated information. This could result in deteriorating healthcare. Since some information should not be integrated, the System raises ethical considerations about privacy. Among the doctors surveyed here, 10-30% thought the System was unnecessary. These respondents tended to be older and work at a clinic. The System could decrease the cost of healthcare and enable personalized healthcare but could also increase information leakage and information management, cause

  7. [Medical intern or locum doctor--does job position affect learning?].

    Mars, Nina; Kalske, Jaakko; Halttunen-Nieminen, Mervi; Pitkäranta, Anne

    2015-01-01

    At the University of Helsinki, the licentiate degree in medicine involves internships that can be conducted as a medical intern or locum doctor. The students and their supervisors fill out a feedback form, which helps in assessing the students' improvement in various areas. Based on the feedback form between 2008 and 2013, students having worked as locum doctor rated better improvement in their diagnostic skills, writing medical records, interacting with the patient, and operating in the work community. Supervisor evaluations did not show a similar clear difference between the job positions.

  8. Deliberate Integration of Student Leadership Development in Doctor of Pharmacy Programs

    Nelson, Michael H.; Bzowyckyj, Andrew S.; Fuentes, David G.; Rosenberg, Ettie; DiCenzo, Robert

    2016-01-01

    The CAPE 2013 Outcomes answered the call for increased student leadership development (SLD) by identifying leadership as a desired curricular goal. To meet this outcome, colleges and schools of pharmacy are advised to first identify a set of SLD competencies aligned with their institution’s mission and goals and then organize these competencies into a SLD framework/model. Student leadership development should be integrated vertically and horizontally within the curriculum in a deliberate and longitudinal manner. It should include all student pharmacists, begin at the point of admission, and extend beyond extracurricular activities. The school’s assessment plan should be aligned with the identified SLD competencies so student learning related to leadership is assessed. To accomplish these recommendations, a positive environment for SLD should be cultivated within the school, including administrative backing and resources, as well as support among the broader faculty for integrating SLD into the curriculum. PMID:26941428

  9. Deliberate Integration of Student Leadership Development in Doctor of Pharmacy Programs.

    Janke, Kristin K; Nelson, Michael H; Bzowyckyj, Andrew S; Fuentes, David G; Rosenberg, Ettie; DiCenzo, Robert

    2016-02-25

    The CAPE 2013 Outcomes answered the call for increased student leadership development (SLD) by identifying leadership as a desired curricular goal. To meet this outcome, colleges and schools of pharmacy are advised to first identify a set of SLD competencies aligned with their institution's mission and goals and then organize these competencies into a SLD framework/model. Student leadership development should be integrated vertically and horizontally within the curriculum in a deliberate and longitudinal manner. It should include all student pharmacists, begin at the point of admission, and extend beyond extracurricular activities. The school's assessment plan should be aligned with the identified SLD competencies so student learning related to leadership is assessed. To accomplish these recommendations, a positive environment for SLD should be cultivated within the school, including administrative backing and resources, as well as support among the broader faculty for integrating SLD into the curriculum.

  10. Shared leadership in a medical practice: keys to success.

    Daiker, Barbara L

    2009-01-01

    Medical practices are in a complex industry and require the expertise of both physician and business leaders to be successful. Sharing the leadership between these two professionals brings with it challenges that are best met if the environment is supportive. This support comes in the form of external aspects such as selection, role definition, organizational hierarchy, time, and process. Critical to shared leadership is communication, both frequency and quality. Conflicts are likely to occur, and how they are resolved is what determines the strength of a shared governance relationship. Reality is that finding the balance in shared governance is diffcult, but with effort and commitment, it can provide the organization with the performance it hopes to achieve.

  11. Playing doctor, seriously: graduation follies at an American medical school.

    Segal, D

    1984-01-01

    In American medical schools, the period of time between the announcement of internships and graduation is known as FYBIGMI, for "Fuck You Brother I Got My Internship." At University Medical School (pseudonym), as at most American medical schools, this period culminates in an elaborate musical comedy (attended by faculty and relatives) in which faculty are abused, patients are represented in terms of stigmatized stereotypes, and the students demonstrate a profane familiarity with cultural taboos. Using the analytic methods of cultural anthropology, this examination of the FYBIGMI performance at U.M.S. focuses primarily on the seniors' presentation of their newly acquired professional identity, which is constituted in the skits by recurring oppositions to socially stigmatized, medically self-destructive patients. In this oppositional logic, racial stereotypes play a particularly large role. In addition, the seniors establish their new social status by inverting their relationship to their (former) supervisors on a personal basis, and by confronting the audience with their professional ability to treat cultural taboos with profane familiarity. The FYBIGMI theatrical, and its representation of professional identity, is analyzed in relation to a proposed model of the underlying structure of the process of medical education, that is, an escalating dialectic of intimidation and self-congratulation.

  12. Practicing doctors' perceptions on new learning objectives for Vietnamese medical schools

    Dung Do Van

    2007-06-01

    Full Text Available Abstract Background As part of the process to develop more community-oriented medical teaching in Vietnam, eight medical schools prepared a set of standard learning objectives with attention to the needs of a doctor working with the community. Because they were prepared based on government documents and the opinions of the teachers, it was necessary to check them with doctors who had already graduated and were working at different sites in the community. Methods Each of the eight medical faculties asked 100 practising recent graduates to complete a questionnaire to check the relevance of the skills that the teachers considered most important. We used mean and standard deviation to summarize the scores rated by the respondents for each skill and percentile at four points: p50, p25, p10 and p5 to describe the variation of scores among the respondents. Correlation coefficient was used to measure the relationship between skill levels set by the teachers and the perception of practicing doctors regarding frequency of using skills and priority for each skill. Additional information was taken from the records of focus group discussions to clarify, explain or expand on the results from the quantitative data. Results In many cases the skills considered important by teachers were also rated as highly necessary and/or frequently used by the respondents. There were, however, discrepancies: some skills important to teachers were seldom used and not considered important by the doctors. In focus group discussions the doctors also identified skills that are not taught at all in the medical schools but would be needed by practising doctors. Conclusion Although most of the skills and skill levels included in the learning objectives by the teachers were consistent with the opinions of their graduates, the match was not perfect. The experience of the graduates and their additional comments should be included as inputs to the definition of learning objectives for

  13. Accounting for psychotropic medication changes in prisons: patient and doctor perspectives.

    Hassan, Lamiece; Edge, Dawn; Senior, Jane; Shaw, Jenny

    2015-07-01

    Psychotropic medicines are widely used to treat mental illness; however, people entering prison commonly report that prescribed psychotropic medicines are changed or withdrawn, adding to their distress in difficult times. Drawing on three extracts from a larger qualitative dataset in which patients and doctors were interviewed about psychotropic medication use in English prisons, we combined discursive psychological and Foucauldian discourse analysis techniques to examine how individuals accounted for medication changes. Patients used four discursive strategies to organize descriptions of medication changes: they established entitlement to psychotropic medication, questioned the clinical judgment of prison doctors; highlighted communication problems; and attributed negative health outcomes to medication regime changes. In contrast, we examined an effective defense by a general practitioner, which showed how clinical needs were prioritized over previously held prescriptions when making prescribing decisions. Wider implications for continuity and equivalence of care between prisons and the wider community are discussed. © The Author(s) 2014.

  14. Attitudes toward depression among Japanese non-psychiatric medical doctors: a cross-sectional study.

    Ohtsuki, Tsuyuka; Kodaka, Manami; Sakai, Rumi; Ishikura, Fuminobu; Watanabe, Yoichiro; Mann, Anthony; Haddad, Mark; Yamada, Mitsuhiko; Inagaki, Masatoshi

    2012-08-16

    Under-recognition of depression is common in many countries. Education of medical staff, focusing on their attitudes towards depression, may be necessary to change their behavior and enhance recognition of depression. Several studies have previously reported on attitudes toward depression among general physicians. However, little is known about attitudes of non-psychiatric doctors in Japan. In the present study, we surveyed non-psychiatric doctors' attitude toward depression. The inclusion criteria of participants in the present study were as follows: 1) Japanese non-psychiatric doctors and 2) attendees in educational opportunities regarding depression care. We conveniently approached two populations: 1) a workshop to depression care for non-psychiatric doctors and 2) a general physician-psychiatrist (G-P) network group. We contacted 367 subjects. Attitudes toward depression were measured using the Depression Attitude Questionnaire (DAQ), a 20-item self-report questionnaire developed for general physicians. We report scores of each DAQ item and factors derived from exploratory factor analysis. We received responses from 230 subjects, and we used DAQ data from 187 non-psychiatric doctors who met the inclusion criteria. All non-psychiatric doctors (n = 187) disagreed with "I feel comfortable in dealing with depressed patients' needs," while 60 % (n = 112) agreed with "Working with depressed patients is heavy going." Factor analysis indicated these items comprised a factor termed "Depression should be treated by psychiatrists" - to which 54 % of doctors (n = 101) agreed. Meanwhile, 67 % of doctors (n = 126) thought that nurses could be useful in depressed patient support. The three factors derived from the Japanese DAQ differed from models previously derived from British GP samples. The attitude of Japanese non-psychiatric doctors concerning whether depression should be treated by psychiatrists was markedly different to that of British GPs. Japanese non

  15. [Big differences in leadership and management training within health care services. Leadership and issues concerning cooperation should be more emphasized in basic medical education].

    Hauptig, S; Collste, L; Hammar, M; Calltorp, J; Frischer, J; Haase, H; Lindquist, I; Andersson, C

    1999-12-08

    A recent survey of medical management programmes at universities across the country showed manifest national differences to exist, both quantitative and qualitative. Using a questionnaire, the Swedish Society of Medical Management examined the programmes for physiotherapists, occupational therapists, social workers, nurses and physicians, with respect to such issues as leadership, self-awareness and communication, health economics, and administration. It was concluded that knowledge acquired differs between fields; that physiotherapy programmes tend to have a very didactic approach; that nurses are taught the importance of participation in developmental processes; that doctors are exposed to somewhat the same approach but to a large extent on a voluntary basis; and that social workers obtain good insight into the administrative skills necessary to their work. In the article it is concluded that students would benefit from orientation in the diverse approaches used in the other fields than their own, and that pooling of resources among different programmes might be a more economic alternative to current practice.

  16. The Value of an Elective in Business and Leadership for Medical Students.

    Agarwal, Ankit; Anderson, Jade; Sarfaty, Suzanne; Rimer, Edward; Hirsch, Ariel E

    2015-01-01

    This report describes the impact of the implementation of an elective in business and leadership targeted to preclinical medical students. Of the 42 students who completed the elective, 30 (71%) completed the survey. Students reported that they had a better understanding of the U.S. healthcare system (p business and leadership in medicine is a valuable addition to the standard undergraduate medical curriculum to enhance medical student exposure to the principles of the business of medicine and physician leadership.

  17. Doctors or technicians: assessing quality of medical education

    Tayyab Hasan

    2010-09-01

    Full Text Available Tayyab HasanPAPRSB Institute of Health Sciences, University Brunei Darussalam, Bandar Seri Begawan, BruneiAbstract: Medical education institutions usually adapt industrial quality management models that measure the quality of the process of a program but not the quality of the product. The purpose of this paper is to analyze the impact of industrial quality management models on medical education and students, and to highlight the importance of introducing a proper educational quality management model. Industrial quality management models can measure the training component in terms of competencies, but they lack the educational component measurement. These models use performance indicators to assess their process improvement efforts. Researchers suggest that the performance indicators used in educational institutions may only measure their fiscal efficiency without measuring the quality of the educational experience of the students. In most of the institutions, where industrial models are used for quality assurance, students are considered as customers and are provided with the maximum services and facilities possible. Institutions are required to fulfill a list of recommendations from the quality control agencies in order to enhance student satisfaction and to guarantee standard services. Quality of medical education should be assessed by measuring the impact of the educational program and quality improvement procedures in terms of knowledge base development, behavioral change, and patient care. Industrial quality models may focus on academic support services and processes, but educational quality models should be introduced in parallel to focus on educational standards and products.Keywords: educational quality, medical education, quality control, quality assessment, quality management models

  18. Doctors or technicians: assessing quality of medical education.

    Hasan, Tayyab

    2010-01-01

    Medical education institutions usually adapt industrial quality management models that measure the quality of the process of a program but not the quality of the product. The purpose of this paper is to analyze the impact of industrial quality management models on medical education and students, and to highlight the importance of introducing a proper educational quality management model. Industrial quality management models can measure the training component in terms of competencies, but they lack the educational component measurement. These models use performance indicators to assess their process improvement efforts. Researchers suggest that the performance indicators used in educational institutions may only measure their fiscal efficiency without measuring the quality of the educational experience of the students. In most of the institutions, where industrial models are used for quality assurance, students are considered as customers and are provided with the maximum services and facilities possible. Institutions are required to fulfill a list of recommendations from the quality control agencies in order to enhance student satisfaction and to guarantee standard services. Quality of medical education should be assessed by measuring the impact of the educational program and quality improvement procedures in terms of knowledge base development, behavioral change, and patient care. Industrial quality models may focus on academic support services and processes, but educational quality models should be introduced in parallel to focus on educational standards and products.

  19. Key Elements of Clinical Physician Leadership at an Academic Medical Center

    Dine, C. Jessica; Kahn, Jeremy M; Abella, Benjamin S; Asch, David A; Shea, Judy A

    2011-01-01

    Background A considerable body of literature in the management sciences has defined leadership and how leadership skills can be attained. There is considerably less literature about leadership within medical settings. Physicians-in-training are frequently placed in leadership positions ranging from running a clinical team or overseeing a resuscitation effort. However, physicians-in-training rarely receive such training. The objective of this study was to discover characteristics associated with effective physician leadership at an academic medical center for future development of such training. Methods We conducted focus groups with medical professionals (attending physicians, residents, and nurses) at an academic medical center. The focus group discussion script was designed to elicit participants' perceptions of qualities necessary for physician leadership. The lead question asked participants to imagine a scenario in which they either acted as or observed a physician leader. Two independent reviewers reviewed transcripts to identify key domains of physician leadership. Results Although the context was not specified, the focus group participants discussed leadership in the context of a clinical team. They identified 4 important themes: management of the team, establishing a vision, communication, and personal attributes. Conclusions Physician leadership exists in clinical settings. This study highlights the elements essential to that leadership. Understanding the physician attributes and behaviors that result in effective leadership and teamwork can lay the groundwork for more formal leadership education for physicians-in-training. PMID:22379520

  20. Medication adherence in patients with hypertension: Does satisfaction with doctor-patient relationship work?

    Mahmoudian, Ahmad; Zamani, Ahmadreza; Tavakoli, Neda; Farajzadegan, Ziba; Fathollahi-Dehkordi, Fariba

    2017-01-01

    It is assumed that doctor-patient relationship plays an effective role in patients' satisfaction, medication adherence, and health outcomes since exploring different aspects of this relationship, such as addressing medication adherence, has rarely been investigated. Therefore, the main aim of the present study was to assess the impact of patients' satisfaction derived from communicating with doctors on medication adherence in hypertensive patients. This cross-sectional survey was conducted on three hundred patients with hypertension, using multistage sampling technique in health care centers in Isfahan, Iran. Data were collected by two questionnaires comprised (1) patients' satisfaction derived from the relationship with doctors and (2) medication adherence named "Morisky Medication Adherence Scale" with 8 items. Multivariate logistic regression model was applied to test the odds ratio (OR) of patients' satisfaction resulting from the relationship with physicians in numerous aspects in two groups: appropriate and inappropriate medication adherence. A lower level of satisfaction derived from building the relationship (confidence interval [CI] =0.95, 0.06-0.71 and OR = 0.20) and empathy subscales (CI = 0.95, 13-0.80 and OR = 0.33) was associated with nonadherence to treatment after controlling the physicians' gender and patients' age, gender, education, and duration of disease. Patients' satisfaction resulting from building the relationship and empathy with physicians appeared to be associated with medication adherence among hypertensive patients.

  1. Medication adherence in patients with hypertension: Does satisfaction with doctor-patient relationship work?

    Ahmad Mahmoudian

    2017-01-01

    Full Text Available Background: It is assumed that doctor-patient relationship plays an effective role in patients' satisfaction, medication adherence, and health outcomes since exploring different aspects of this relationship, such as addressing medication adherence, has rarely been investigated. Therefore, the main aim of the present study was to assess the impact of patients' satisfaction derived from communicating with doctors on medication adherence in hypertensive patients. Materials and Methods: This cross-sectional survey was conducted on three hundred patients with hypertension, using multistage sampling technique in health care centers in Isfahan, Iran. Data were collected by two questionnaires comprised (1 patients' satisfaction derived from the relationship with doctors and (2 medication adherence named “Morisky Medication Adherence Scale” with 8 items. Multivariate logistic regression model was applied to test the odds ratio (OR of patients' satisfaction resulting from the relationship with physicians in numerous aspects in two groups: appropriate and inappropriate medication adherence. Results: A lower level of satisfaction derived from building the relationship (confidence interval [CI] =0.95, 0.06–0.71 and OR = 0.20 and empathy subscales (CI = 0.95, 13–0.80 and OR = 0.33 was associated with nonadherence to treatment after controlling the physicians' gender and patients' age, gender, education, and duration of disease. Conclusion: Patients' satisfaction resulting from building the relationship and empathy with physicians appeared to be associated with medication adherence among hypertensive patients.

  2. Calling Orientations of Junior Doctors and Medical Interns in India: Cultural, Occupational and Relational Perspectives

    Nath, Vandana

    2017-01-01

    This study examines the factors that shape calling orientations within the Indian context. Based on the narratives of 72 junior doctors and medical interns, it is found that participants identify with harbouring a calling both prior and subsequent to occupational entry. Although factors such as self-recognition of talent and sensemaking of work as…

  3. Factors Associated with Medical Doctors' Intentions to Discriminate Against Transgender Patients in Kuala Lumpur, Malaysia

    Vijay, Aishwarya; Earnshaw, Valerie A.; Tee, Ying Chew; Pillai, Veena; White Hughto, Jaclyn M.; Clark, Kirsty; Kamarulzaman, Adeeba; Altice, Frederick L.; Wickersham, Jeffrey A.

    2018-01-01

    Purpose: Transgender people are frequent targets of discrimination. Discrimination against transgender people in the context of healthcare can lead to poor health outcomes and facilitate the growth of health disparities. This study explores factors associated with medical doctors' intentions to discriminate against transgender people in Malaysia.

  4. JOB SATISFACTION AND PSYCHOLOGICAL HEALTH OF MEDICAL DOCTORS IN CALABAR, SOUTHERN NIGERIA.

    Bello, S; Asuzu, M C; Ofili, A N

    2013-06-01

    Employees should be happy at their work, considering the amount of time they devote to it throughout their working life. There is paucity of data on the job satisfaction and psychological health of medical doctors in Nigeria. To assess the level of job satisfaction and its relationship to psychological health among medical doctors in a southern city of Nigeria. A cross-sectional descriptive survey. Three major public hospitals in Calabar, Nigeria. Medical doctors who had worked for at least six months in the hospitals. Response rate was 73.0%. More than half (56.7%) of the respondents expressed overall satisfaction with their job. Inadequate pay and work overload were the most commonly mentioned reasons for job dissatisfaction. About a fifth of the respondents were at increased likelihood of psychological disorder. There was a statistically significant negative correlation between job satisfaction scores and GHQ scores. Satisfied respondents were least likely to have psychological disorder. Causes of job dissatisfaction among medical doctors should be addressed to improve their psychological health.

  5. Continuing Medical Education for European General Practitioners in Doctor-Patient Relationship Skills and Psychosocial Issues.

    Barker, L. Randol

    1998-01-01

    Most of the 23 European providers of continuing medical education (CME) surveyed reported programming on the doctor-patient relationship and psychosocial issues. Visits to programs in France, the Netherlands, and Spain identified the formats used most often in small group instruction, intensive individual learning, and national-level CME. (SK)

  6. Presenile dementia in a 41-year old male Nigerian medical doctor ...

    Presenile dementia reflects an underlying pathology that affects the cerebral cortex, its sub-cortical connections or both occurring in persons below 65 years of age. In this study, a case report of a 41-yr old medical doctor whose mental illness spanned 8 yrs is presented. Initially he came with paranoid psychosis of the acute ...

  7. Medical doctors as the captain of a ship: an analysis of medical students' book reports on Joseph Conrad's "Lord Jim".

    Hwang, Kun; Lee, Seung Jae; Kim, Seong Yeon; Hwang, Se Won; Kim, Ae Yang

    2014-01-01

    In South Korean ferry disaster in 2014, the captain abandoned the ship with passengers including high school students still aboard. We noticed the resemblance of abandoning the ship with passengers still aboard the ferry (named the Sewol) and the ship Patna, which was full of pilgrims, in Joseph Conrad's novel "Lord Jim." The aim of this study is to see how medical students think about the role of a medical doctor as a captain of a ship by analyzing book reports on Conrad's "Lord Jim." Participants included 49 third-year medical students. Their book reports were analyzed. If placed in the same situation as the character of Jim, 24 students of the 49 respondents answered that they would stay with the passengers, while 18 students indicated they would escape from the ship with the crew. Most of the students thought the role of a doctor in the medical field was like that of a 'captain.' The medical students reported that they wanted to be a doctor who is responsible for his or her patients, highly moral, warm-hearted, honest, and with high self-esteem. In conclusion, we found that "Lord Jim" induced the virtue of 'responsibility' from the medical students. Consequently, "Lord Jim" could be good teaching material for medical humanities.

  8. Using Contemporary Leadership Skills in Medication Safety Programs.

    Hertig, John B; Hultgren, Kyle E; Weber, Robert J

    2016-04-01

    The discipline of studying medication errors and implementing medication safety programs in hospitals dates to the 1970s. These initial programs to prevent errors focused only on pharmacy operation changes - and not the broad medication use system. In the late 1990s, research showed that faulty systems, and not faulty people, are responsible for errors and require a multidisciplinary approach. The 2013 ASHP Statement on the Role of the Medication Safety Leader recommended that medication safety leaders be integrated team members rather than a single point of contact. Successful medication safety programs must employ a new approach - one that embraces the skills of all health care team members and positions many leaders to improve safety. This approach requires a new set of leadership skills based on contemporary management principles, including followership, team-building, tracking and assessing progress, storytelling and communication, and cultivating innovation, all of which promote transformational change. The application of these skills in developing or changing a medication safety program is reviewed in this article.

  9. Depression and stress related phenomena in medical doctors in the Czech Republic with regard to medical speciality

    Ptáček, R.; Čeledová, L.; Kuželová, H.; Čevela, R.; Kebza, V.; Šolcová, Iva

    2012-01-01

    Roč. 108, Suppl. 1 (2012), s. 282-282 ISSN 1212-0383. [WPA International Congress. 17.10.2012-21.10.2012, Praha] R&D Projects: GA ČR(CZ) GAP407/11/2226 Institutional support: RVO:68081740 Keywords : mental health * medical doctors * depression * burnout Subject RIV: AN - Psychology

  10. Doctors in space (ships): biomedical uncertainties and medical authority in imagined futures.

    Henderson, Lesley; Carter, Simon

    2016-12-01

    There has been considerable interest in images of medicine in popular science fiction and in representations of doctors in television fiction. Surprisingly little attention has been paid to doctors administering space medicine in science fiction. This article redresses this gap. We analyse the evolving figure of 'the doctor' in different popular science fiction television series. Building upon debates within Medical Sociology, Cultural Studies and Media Studies we argue that the figure of 'the doctor' is discursively deployed to act as the moral compass at the centre of the programme narrative. Our analysis highlights that the qualities, norms and ethics represented by doctors in space (ships) are intertwined with issues of gender equality, speciesism and posthuman ethics. We explore the signifying practices and political articulations that are played out through these cultural imaginaries. For example, the ways in which 'the simple country doctor' is deployed to help establish hegemonic formations concerning potentially destabilising technoscientific futures involving alternative sexualities, or military dystopia. Doctors mostly function to provide the ethical point of narrative stability within a world in flux, referencing a nostalgia for the traditional, attentive, humanistic family physician. The science fiction doctor facilitates the personalisation of technological change and thus becomes a useful conduit through which societal fears and anxieties concerning medicine, bioethics and morality in a 'post 9/11' world can be expressed and explored. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  11. Development of informational-communicative system, created to improve medical help for family medicine doctors.

    Smiianov, Vladyslav A; Dryha, Natalia O; Smiianova, Olha I; Obodyak, Victor K; Zudina, Tatyana O

    2018-01-01

    Introduction: Today mobile health`s protection service has no concrete meaning. As an research object it was called mHealth and named by Global observatory of electronic health`s protection as "Doctor and social health practice that can be supported by any mobile units (mobile phones or smartphones), units for patient`s health control, personal computers and other units of non-wired communication". An active usage of SMS in programs for patients` cure regimen keeping was quiet predictable. Mobile and electronic units only begin their development in medical sphere. Thus, to solve all health`s protection system reformation problems a special memorandum about cooperation in creating E-Health system in Ukraine was signed. The aim: Development of ICS for monitoring and non-infection ill patients` informing system optimization as a first level of medical help. Materials and methods: During research, we used systematical approach, meta-analysis, informational-analytical systems` schemes projection, expositive modeling. Developing the backend (server part of the site), we used next technologies: 1) the Apache web server; 2) programming language PHP; 3) Yii 2 PHP Framework. In the frontend developing were used the following technologies (client part of the site): 1) Bootstrap 3; 2) Vue JS Framework. Results and conclusions: Created duo-channel system "doctor-patient" and "patient-doctor" will allow usual doctors of family medicine (DFM) take the interactive dispensary cure and avoid uncontrolled illness progress. Doctor will monitor basic physical data of patient`s health and curing process. The main goal is to create automatic system to allow doctor regularly write periodical or non-periodical notifications, get patients` questioning answers and spread information between doctor and patient; that will optimize work of DFMs.

  12. Medical leaders or masters? - A systematic review of medical leadership in hospital settings

    M. Berghout (Mathilde); I.N. Fabbricotti (Isabelle); M. Buljac-Samardzic (Martina); C.G.J.M. Hilders (Carina)

    2017-01-01

    textabstractMedical leadership is increasingly considered as crucial for improving the quality of care and the sustainability of healthcare. However, conceptual clarity is lacking in the literature and in practice. Therefore, a systematic review of the scientific literature was conducted to reveal

  13. Does leadership effectiveness correlates with leadership styles in healthcare executives of Iran University of Medical Sciences

    Ebadifard Azar, Farbod; Sarabi Asiabar, Ali

    2015-01-01

    Background: Effective leadership is essential to passing through obstacles facing the health field.The current health care system in Iran has major problems and gaps in the field of effective leadership. The aim of this study was to evaluate hospital managers? leadership style through selfassessment and to determine the correlation between leadership styles with healthcare executives? leadership readiness and leadership effectiveness. Methods: In this cross-sectional study a self-administered...

  14. THE UNQUALIFIED MEDICAL PRACTITIONERS - Methods of Practice and Nexus with the Qualified Doctors

    K.V. Narayana

    2006-01-01

    The private sector accounts for about 75 percent of outpatient as well as inpatient medical care in Andhra Pradesh. The presence of a large number of unqualified medical practitioners in the rural areas and urban slums indicate that they provide most of the outpatient services in the private sector. Given the huge quantum of services provided by the RMPs, the present study aims at identifying their number, characteristics and the nexus with the qualified doctors through a case study of one di...

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

    Pilhammar Ewa

    2009-05-01

    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

  16. Peculiarities of family doctors' medical assistance for persons with 'Chernobyl syndrome'

    Margine, Le.; Tintiuc, D.; Grejdeanu, T.; Margine, Lu.; Badan, V.

    2012-01-01

    Medical and social protection and rehabilitation of patients with 'Chernobyl syndrome' is provided by legislation of the Republic of Moldova, which is reflected in a comprehensive action plan for rehabilitation and protection of this category of citizens. This plan includes such medical activities as detailed medical ambulatory and stationary examination, purchase prescription drugs, annual sanatorium treatment, annual compensation recovery in the value of 2 average monthly salaries for health improvement. The role of family doctors' medical assistance for persons suffered due to the accident at the Chernobyl Nuclear Power Plant is very important in this plan implementation.

  17. Attitudes toward depression among Japanese non-psychiatric medical doctors: a cross-sectional study

    Ohtsuki Tsuyuka

    2012-08-01

    Full Text Available Abstract Background Under-recognition of depression is common in many countries. Education of medical staff, focusing on their attitudes towards depression, may be necessary to change their behavior and enhance recognition of depression. Several studies have previously reported on attitudes toward depression among general physicians. However, little is known about attitudes of non-psychiatric doctors in Japan. In the present study, we surveyed non-psychiatric doctors’ attitude toward depression. Methods The inclusion criteria of participants in the present study were as follows: 1 Japanese non-psychiatric doctors and 2 attendees in educational opportunities regarding depression care. We conveniently approached two populations: 1 a workshop to depression care for non-psychiatric doctors and 2 a general physician-psychiatrist (G-P network group. We contacted 367 subjects. Attitudes toward depression were measured using the Depression Attitude Questionnaire (DAQ, a 20-item self-report questionnaire developed for general physicians. We report scores of each DAQ item and factors derived from exploratory factor analysis. Results We received responses from 230 subjects, and we used DAQ data from 187 non-psychiatric doctors who met the inclusion criteria. All non-psychiatric doctors (n = 187 disagreed with "I feel comfortable in dealing with depressed patients' needs," while 60 % (n = 112 agreed with "Working with depressed patients is heavy going." Factor analysis indicated these items comprised a factor termed "Depression should be treated by psychiatrists" - to which 54 % of doctors (n = 101 agreed. Meanwhile, 67 % of doctors (n = 126 thought that nurses could be useful in depressed patient support. The three factors derived from the Japanese DAQ differed from models previously derived from British GP samples. The attitude of Japanese non-psychiatric doctors concerning whether depression should be treated by psychiatrists was markedly

  18. Early Mentoring of Medical Students and Junior Doctors on a Path to Academic Cardiothoracic Surgery.

    Fricke, Tyson A; Lee, Melissa G Y; Brink, Johann; d'Udekem, Yves; Brizard, Christian P; Konstantinov, Igor E

    2018-01-01

    In 2005 the Department of Cardiothoracic Surgery at The Royal Children's Hospital started an early academic mentoring program for medical students and junior doctors with the aim of fostering an interest in academic surgery. Between 2005 and 2015, 37 medical students and junior doctors participated in research in the Department of Cardiothoracic Surgery at The Royal Children's Hospital. Each was given an initial project on which to obtain ethics approval, perform a literature review, data collection, statistical analysis, and prepare a manuscript for publication. A search of the names of these former students and doctors was conducted on PubMed to identify publications. A total of 113 journal articles were published in peer-reviewed journals with an average impact factor of 4.1 (range, 1.1 to 19.9). Thirty (30 of 37, 81%) published at least one article. A mean of 4.3 journal articles was published per student or junior doctor (range, 0 to 29). Eleven (11 of 37, 30%) received scholarships for their research. Nine (9 of 37, 24%) have completed or are enrolled in higher research degrees with a cardiothoracic surgery focus. Of these 9, 2 have completed doctoral degrees while in cardiothoracic surgery training. Five will complete their cardiothoracic surgery training with a doctoral degree and the other 2 are pursuing training in cardiology. A successful early academic mentoring program in a busy cardiothoracic surgery unit is feasible. Mentoring of motivated individuals in academic surgery benefits not only their medical career, but also helps maintain high academic output of the unit. Copyright © 2018 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  19. [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"].

    Itoh, Tsunetoshi

    2009-01-01

    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.

  20. Geographical distribution and profile of medical doctors in public sector hospitals of the Limpopo Province, South Africa.

    Ntuli, Samuel T; Maboya, Edwin

    2017-09-27

    The shortage and unequal distribution of medical doctors in low- and middle-income countries continues to be a public health concern. To establish the geographical distribution and demographic profile of medical doctors in public sector hospitals of the Limpopo Province, South Africa. The PERSAL system was used to obtain information on the number of medical doctors employed in public sector hospitals of the Limpopo Province. Data were exported from PERSAL's database and then analysed using STATA version 9.0. The mean age of the 887 medical doctors was 40.1 ± 11.2 years (range 24-79 years). Sixty per cent of the doctors were male, 66% were aged ≤ 45 years and 84% were African. Most of the doctors (86%) were medical officers, of which 55% had < 5 years working experience. Overall, the doctor-to-population ratio for the five districts in the province was 16.4/100 000, with Capricorn (33.7/100 000) and Waterberg (20.2/100 000) recording the highest ratios. A large proportion (43%) of medical officers are employed in the Capricorn District, of which 71% were practising at the tertiary hospital. This study demonstrated a shortage and maldistribution of medical doctors in the public sector hospitals of the Limpopo Province. This has a potentially negative effect on the delivery of an appropriate and efficient healthcare service to the population and requires urgent attention.

  1. Between professional values, social regulations and patient preferences: medical doctors' perceptions of ethical dilemmas.

    Bringedal, Berit; Isaksson Rø, Karin; Magelssen, Morten; Førde, Reidun; Aasland, Olaf Gjerløv

    2018-04-01

    We present and discuss the results of a Norwegian survey of medical doctors' views on potential ethical dilemmas in professional practice. The study was conducted in 2015 as a postal questionnaire to a representative sample of 1612 doctors, among which 1261 responded (78%). We provided a list of 41 potential ethical dilemmas and asked whether each was considered a dilemma, and whether the doctor would perform the task, if in a position to do so. Conceptually, dilemmas arise because of tensions between two or more of four doctor roles: the patient's advocate, a steward of societal interests, a member of a profession and a private individual. 27 of the potential dilemmas were considered dilemmas by at least 50% of the respondents. For more than half of the dilemmas, the anticipated course of action varied substantially within the professional group, with at least 20% choosing a different course than their colleagues, indicating low consensus in the profession. Doctors experience a large range of ethical dilemmas, of which many have been given little attention by academic medical ethics. The less-discussed dilemmas are characterised by a low degree of consensus in the profession about how to handle them. There is a need for medical ethicists, medical education, postgraduate courses and clinical ethics support to address common dilemmas in clinical practice. Viewing dilemmas as role conflicts can be a fruitful approach to these discussions. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  2. Authoring the identity of learner before doctor in the figured world of medical school.

    Stubbing, Evangeline; Helmich, Esther; Cleland, Jennifer

    2018-02-01

    Students enter the 'figured world' of medical school with preconceptions of what it means to be a doctor. The meeting of these early preconceptions and their newly developing identities can create emotional tensions. The aim of this study was to advance our understanding of how such tensions were experienced and managed. Using figured worlds as a theoretical framework we explored students' interactions of preconceptions with their newly developing professional identities in their first year at medical school. Advancing our understanding of this phenomena provided new insights into the complex process of identity formation. This was a qualitative study underpinned by a constructivist epistemology. We ran biannual focus groups with 23 first year students in one UK medical school. Data were recorded, transcribed and then template analysis used to undertake an inductive, iterative process of analysis until it was considered the template provided a detailed representation of the data. Significant preconceptions associated with the identity of a doctor were 'to help' and 'to be a leader'. These early preconceptions were in conflict with realities of the figured world of medical school creating the emotional tensions of 'being unable to help' and 'lacking power', with implications for interactions with patients. By the end of year one students' negotiated tensions and 'self-authored' their identity as a learner as opposed to an imagined 'as if' identity of a doctor. We revealed how preconceptions associated with becoming a doctor can conflict with a newly developing professional identity highlighting the importance of supporting students to embrace the formation of a 'learner' identity, a necessary part of the process of becoming a doctor.

  3. Exploring talent development environments –inspirations to medical education at doctoral level

    Christensen, Mette Krogh; Lund, Ole; Mørcke, Anne Mette

    Introduction: Doctoral students may be considered some of our most talented students. In order to maintain high quality in doctoral education we should be aware of optimizing the talent development environment in which the students develop their competencies. In this paper we explore the features...... has been on cognitive skills of individual talents and to a minor degree on institutional conditions and constraints within talent development environments. However, recent studies on talent development in sport recognize ‘talent’ as a social construction (1) and institutional and environmental...... features playing a decisive role in talent development (2). Our research question is: do concepts and models for talent development environments in sport apply to medical education at doctoral level? Considering the uniqueness of the two domains (they refer to different overall social fields: education...

  4. Teaching Advanced Leadership Skills in Community Service (ALSCS) to medical students.

    Goldstein, Adam O; Calleson, Diane; Bearman, Rachel; Steiner, Beat D; Frasier, Pamela Y; Slatt, Lisa

    2009-06-01

    Inadequate access to health care, lack of health insurance, and significant health disparities reflect crises in health care affecting all of society. Training U.S. physicians to possess not only clinical expertise but also sufficient leadership skills is essential to solve these problems and to effectively improve health care systems. Few models in the undergraduate medical curriculum exist for teaching students how to combine needed leadership competencies with actual service opportunities.The Advanced Leadership Skills in Community Service (ALSCS) selective developed in response to the shortage of leadership models and leadership training for medical students. The ALSCS selective is designed specifically to increase students' leadership skills, with an emphasis on community service. The selective integrates classroom-based learning, hands-on application of learned skills, and service learning. More than 60 medical students have participated in the selective since inception. Short-term outcomes demonstrate an increase in students' self-efficacy around multiple dimensions of leadership skills (e.g., fundraising, networking, motivating others). Students have also successfully completed more than a dozen leadership and community service projects. The selective offers an innovative model of a leadership-skills-based course that can have a positive impact on leadership skill development among medical school students and that can be incorporated into the medical school curriculum.

  5. Developing the professional competence of future doctors in the instructional setting of higher medical educational institutions.

    Morokhovets, Halyna Yu; Lysanets, Yuliia V

    The main objectives of higher medical education is the continuous professional improvement of physicians to meet the needs dictated by the modern world both at undergraduate and postgraduate levels. In this respect, the system of higher medical education has undergone certain changes - from determining the range of professional competences to the adoption of new standards of education in medicine. The article aims to analyze the parameters of doctor's professionalism in the context of competence-based approach and to develop practical recommendations for the improvement of instruction techniques. The authors reviewed the psycho-pedagogical materials and summarized the acquired experience of teachers at higher medical institutions as to the development of instruction techniques in the modern educational process. The study is based on the results of testing via the technique developed by T.I. Ilyina. Analytical and biblio-semantic methods were used in the paper. It has been found that the training process at medical educational institution should be focused on the learning outcomes. The authors defined the quality parameters of doctors' training and suggested the model for developing the professional competence of medical students. This model explains the cause-and-effect relationships between the forms of instruction, teaching techniques and specific components of professional competence in future doctors. The paper provides practical recommendations on developing the core competencies which a qualified doctor should master. The analysis of existing interactive media in Ukraine and abroad has been performed. It has been found that teaching the core disciplines with the use of latest technologies and interactive means keeps abreast of the times, while teaching social studies and humanities to medical students still involves certain difficulties.

  6. What do they do? Interactions between village doctors and medical representatives in Chakaria, Bangladesh.

    Rahman, M Hafizur; Agarwal, Smisha; Tuddenham, Susan; Peto, Heather; Iqbal, Mohammad; Bhuiya, Abbas; Peters, David H

    2015-07-01

    Informally trained village doctors supply the majority of healthcare services to the rural poor in many developing countries. This study describes the demographic and socio-economic differences between medical representatives (MRs) and village doctors in rural Bangladesh, and explores the nature of their interactions. This study was conducted in Chakaria, a rural sub-district of Bangladesh. Focus group discussions and in-depth interviews were conducted, along with a quantitative survey to understand practice perceptions. Data analysis was performed using grounded theory and bivariate statistical tests. We surveyed 43 MRs and 83 village doctors through 22 focus group discussions and 33 in-depth interviews. MRs have a higher average per capita monthly expenditure compared to village doctors. MRs are better educated with 98% having bachelor's degrees whereas 84% of village doctors have twelfth grade education or less (pmarkets require stricter regulations and educational initiatives for providers and MRs. © The Author 2014. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  7. Leadership and management in UK medical school curricula.

    Jefferies, Richard; Sheriff, Ibrahim H N; Matthews, Jacob H; Jagger, Olivia; Curtis, Sarah; Lees, Peter; Spurgeon, Peter C; Fountain, Daniel Mark; Oldman, Alex; Habib, Ali; Saied, Azam; Court, Jessica; Giannoudi, Marilena; Sayma, Meelad; Ward, Nicholas; Cork, Nick; Olatokun, Olamide; Devine, Oliver; O'Connell, Paul; Carr, Phoebe; Kotronias, Rafail Angelos; Gardiner, Rebecca; Buckle, Rory T; Thomson, Ross J; Williams, Sarah; Nicholson, Simon J; Goga, Usman

    2016-10-10

    Purpose Although medical leadership and management (MLM) is increasingly being recognised as important to improving healthcare outcomes, little is understood about current training of medical students in MLM skills and behaviours in the UK. The paper aims to discuss these issues. Design/methodology/approach This qualitative study used validated structured interviews with expert faculty members from medical schools across the UK to ascertain MLM framework integration, teaching methods employed, evaluation methods and barriers to improvement. Findings Data were collected from 25 of the 33 UK medical schools (76 per cent response rate), with 23/25 reporting that MLM content is included in their curriculum. More medical schools assessed MLM competencies on admission than at any other time of the curriculum. Only 12 schools had evaluated MLM teaching at the time of data collection. The majority of medical schools reported barriers, including overfilled curricula and reluctance of staff to teach. Whilst 88 per cent of schools planned to increase MLM content over the next two years, there was a lack of consensus on proposed teaching content and methods. Research limitations/implications There is widespread inclusion of MLM in UK medical schools' curricula, despite the existence of barriers. This study identified substantial heterogeneity in MLM teaching and assessment methods which does not meet students' desired modes of delivery. Examples of national undergraduate MLM teaching exist worldwide, and lessons can be taken from these. Originality/value This is the first national evaluation of MLM in undergraduate medical school curricula in the UK, highlighting continuing challenges with executing MLM content despite numerous frameworks and international examples of successful execution.

  8. Mandating doctors to attend counter-terrorism workshops is medically unethical

    Summerfield, Derek

    2016-01-01

    This is a brief exploration of the ethical issues raised for psychiatrists, and for universities, schools and wider society, by the demand that they attend mandatory training as part of the UK government's Prevent counter-terrorism strategy. The silence on this matter to date on the part of the General Medical Council, medical Royal Colleges, and the British Medical Association is a failure of ethical leadership. There is also a civil liberties issue, reminiscent of the McCarthyism of 1950s U...

  9. Hospital doctors' Opinions regarding educational Utility, public Sentiment and career Effects of Medical television Dramas: the HOUSE MD study.

    Haboubi, Hasan N; Morgan, Holly; Aldalati, Omar

    2015-12-14

    To evaluate the opinions of practicing clinicians on medical television dramas and the effects these series have on society as well as their own practice. Observational study using a structured questionnaire disseminated among doctors of all grades and specialties at one tertiary centre and two large secondary care district general hospitals in Wales, United Kingdom. Three hundred and seventy-two questionnaires were distributed over a 3-month period, with 200 completed questionnaires received (response rate, 54%). Frequency and reasons for watching these programs, and opinions regarding realism, educational value and public perception, evaluated by doctors' grades and specialties. Identification of work practice with any observed traits in fictional doctors was also analysed. 65% of doctors surveyed admitted to watching these programs on more than one occasion. Junior doctors (interns and resident medical officers) were more regular viewers. Most doctors who admitted to watching medical dramas did so for entertainment purposes (69%); 8% watched for educational purposes and, of these, 100% watched House MD, 82% felt that these dramas were unrepresentative of daily practice, and 10% thought that they accurately portrayed reality. Most of the positive responses were from junior doctors. 61% of doctors identified some aspect of their clinical practice with another doctor (fictional or non-fictional; most junior doctors identified with a fictional doctor, compared with non-fictional role models for more senior practicing clinicians. This survey shows that a large body of the medical workforce watches medical television dramas and that such programs exercise a growing influence on the practice of junior doctors, particularly those in physicianly specialties. The reasons for certain role model selections remain unknown and may require further evaluation.

  10. Comparative attitude and plans of the medical students and young Nepalese doctors.

    Lakhey, M; Lakhey, S; Niraula, S R; Jha, D; Pant, R

    2009-01-01

    Many doctors are leaving Nepal to work abroad. To understand this problem better, we decided to study the attitude and plans of young doctors and medical students. This cross-sectional study was conducted at Kathmandu Medical College involving 65 first year medical students, 100 interns and 100 house officers. The data collected was entered in Microsoft excel and analysed by SPSS (Statistical Package for Social Sciences) programme. Chi-square test was used to compare two proportions. Significance level was set at 5%. Only 2% house officers said that their job prospects were excellent as compared to 22.4% of students, whereas 20% house officers as compared to 9% students thought job prospects in Nepal were poor (p= 0.003). Eighty two percent of students thought that a doctor's service to his country was very important as compared to 51% of interns (p= 0.001) and 58% of house officers. Forty percent of students, 58% of interns and 48% of house officers (no statistical significance between the three groups) planned to migrate to a developed country after graduation. Eighty eight percent of students, 89% interns and 74% of house officers (no statistical significant differences between the three groups) were of the opinion that improving career opportunities or working environment of the doctor could make the profession more attractive. Although majority of students, interns and house officers were of the opinion that a doctor's service to his community/country was very important, almost half of them still planned to migrate to a developed country after graduation. Improving the chances of professional advancement and professional working environment can make the profession more attractive, and therefore, may decrease this tendency for brain drain from our country.

  11. AME survey-003 A1-part 2: the motivation factors of medical doctors in China.

    Wáng, Yì-Xiáng J; Káplár, Zoltán; L, Yáo T

    2015-12-01

    The professional moral and job satisfaction of medical profession remain highly disputed in media in China. On the other hand, there is wide disaffection of patients toward doctors in China. This survey aims to obtain a better understanding of the motivation of Chinese medical professionals. An anonymous online cross-sectional survey, AME survey III, was conducted using the platform provided by DXY (www.dxy.cn) during the period of September 10-23, 2015. In total 2,356 DXY users completed the survey, including 1,740 males and 617 females, with a mean age of 31.96±7.03 yrs. The reasons (multiple choices) for career disaffection included poor patient/doctor relationship (88.6%), imbalance between workload and pay (79.5%), could not enter the preferred specialty (14.14%), and working in small clinics with no career progress (11.17%). If given the choice to enter the specialty as well as the hospital grade of their choice, 73.8% dissatisfied respondents replied they would like to be a doctor. For the dis-satisfied respondents, university teacher appeared to be the most popular career choice. The cited high workload was considered to be due to (I) imbalance in geographical allocation of doctors and insufficient training of doctors; (II) many red-tapism formalities; (III) Chinese patients often have unreasonable requests; (IV) over-examination and over-treatment; (V) high pressure to publish papers. One hundred and twelve respondents have their child/children attending university or graduated from university, 25.0% of them are pursuing a career in medicine. Nine hundred and ninety respondents have child/children while did not reach university age yet, among them 23.62% would like their child/children to study medicine. 64.87% of the 2,356 participants favor China to open up medical market to qualified foreign medical organizations to take part in fair competition, and 57.91% favor the government supporting regulated private hospitals. The moral and motivation of medical

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

    Martin Talbot

    2006-04-01

    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.

  13. Differences in simulated doctor and patient medical decision making: a construal level perspective.

    Jiaxi Peng

    Full Text Available BACKGROUND: Patients are often confronted with diverse medical decisions. Often lacking relevant medical knowledge, patients fail to independently make medical decisions and instead generally rely on the advice of doctors. OBJECTIVE: This study investigated the characteristics of and differences in doctor-patient medical decision making on the basis of construal level theory. METHODS: A total of 420 undergraduates majoring in clinical medicine were randomly assigned to six groups. Their decisions to opt for radiotherapy and surgery were investigated, with the choices described in a positive/neutral/negative frame × decision making for self/others. RESULTS: Compared with participants giving medical advice to patients, participants deciding for themselves were more likely to select radiotherapy (F1, 404 = 13.92, p = 011. Participants from positive or neutral frames exhibited a higher tendency to choose surgery than did those from negative frames (F2, 404 = 22.53, p<.001. The effect of framing on independent decision making was nonsignificant (F2, 404 = 1.07, p = 35; however the effect of framing on the provision of advice to patients was significant (F2, 404 = 12.95, p<.001. The effect of construal level was significant in the positive frame (F1, 404 = 8.06, p = 005 and marginally significant in the neutral frame (F2, 404 = 3.31, p = 07 but nonsignificant in the negative frame (F2, 404 = .29, p = 59. CONCLUSION: Both social distance and framing depiction significantly affected medical decision making and exhibited a significant interaction. Differences in medical decision making between doctors and patients need further investigation.

  14. Differences in simulated doctor and patient medical decision making: a construal level perspective.

    Peng, Jiaxi; He, Fei; Zhang, Yan; Liu, Quanhui; Miao, Danmin; Xiao, Wei

    2013-01-01

    Patients are often confronted with diverse medical decisions. Often lacking relevant medical knowledge, patients fail to independently make medical decisions and instead generally rely on the advice of doctors. This study investigated the characteristics of and differences in doctor-patient medical decision making on the basis of construal level theory. A total of 420 undergraduates majoring in clinical medicine were randomly assigned to six groups. Their decisions to opt for radiotherapy and surgery were investigated, with the choices described in a positive/neutral/negative frame × decision making for self/others. Compared with participants giving medical advice to patients, participants deciding for themselves were more likely to select radiotherapy (F1, 404 = 13.92, p = 011). Participants from positive or neutral frames exhibited a higher tendency to choose surgery than did those from negative frames (F2, 404 = 22.53, pframing on independent decision making was nonsignificant (F2, 404 = 1.07, p = 35); however the effect of framing on the provision of advice to patients was significant (F2, 404 = 12.95, pframe (F1, 404 = 8.06, p = 005) and marginally significant in the neutral frame (F2, 404 = 3.31, p = 07) but nonsignificant in the negative frame (F2, 404 = .29, p = 59). Both social distance and framing depiction significantly affected medical decision making and exhibited a significant interaction. Differences in medical decision making between doctors and patients need further investigation.

  15. Nature of the last contact with a medical doctor before suicide

    Mars, Urša; Pirc, Lara; Mesec Rodi, Petra; Poštuvan, Vita; De Leo, Diego

    2018-01-01

    A relevant number of suicide decedents visit medical doctors (MDs) in a short period before death. This study aimed to learn about MDs’ attitudes towards suicide prevention, their previous education on suicide, the experience with suicide, and eventually the nature of the last visit with a patient that died by suicide. 159 Slovenian MDs participated in an online survey covering previously mentioned topics. More than a third of MDs have never been trained on suicide prevention and reported lac...

  16. Diversity leadership: the Rush University Medical Center experience.

    Clapp, J R

    2010-01-01

    Meeting the challenges of diversity is crucial, and within healthcare organizations a particularly strong case exists for a diversity strategy. Rush University Medical Center in 2006 was at an important juncture. Since its founding, the organization had made notable progress toward advancing diversity and inclusiveness. On the other hand, many diversity-related problems continued. Rush convened a committee to review the work of the institution in this area. The committee's report called for changes, and a Diversity Leadership Group (DLG) model was established. This article documents the progress made since 2006 through implementation of the DLG model. The changes prescribed for Rush are presented as recommendations and challenges that other healthcare organizations may find applicable to their own institutions.

  17. Psychosocial interventions for managing occupational stress and burnout among medical doctors: a systematic review.

    Clough, Bonnie A; March, Sonja; Chan, Raymond J; Casey, Leanne M; Phillips, Rachel; Ireland, Michael J

    2017-07-17

    Occupational stress and burnout are highly prevalent among medical doctors and can have adverse effects on patient, doctor, and organisational outcomes. The purpose of the current study was to review and evaluate evidence on psychosocial interventions aimed at reducing occupational stress and burnout among medical doctors. A systematic review was conducted for original research articles reporting on psychosocial interventions targeting occupational stress or burnout among medical doctors, published in the English language, and with data collected at a minimum of two time points. Searches were conducted across five electronic databases, as well as by manual search of Google Scholar. Data was extracted relating to study characteristics and outcomes, quality and rigour, as well as modes of delivery and engagement. Studies were appraised using the Strength of Recommendation Taxonomy (SORT) and Critical Appraisal Skills Programme (CASP). Twenty-three articles were reviewed, which reported on interventions utilising cognitive-behavioural, relaxation, and supportive discussion strategies. Only 12 studies allowed estimation of pre- to post-intervention effects. Cognitive behavioural interventions demonstrated the strongest evidence, particularly for reducing stress. Some evidence was identified to support the efficacy of relaxation-based approaches, but no such evidence was found for the efficacy of discussion-based interventions, such as Balint groups. There was a lack of quality among reviewed studies, with no studies receiving a quality rating of 1, and the overall body of evidence being rated as level B, according to the SORT. Effect sizes were not pooled due to a lack of quality among the study sample. This review found that despite increased scientific attention, the quality of research examining the benefits of psychosocial/behavioural interventions for occupational stress and burnout in medical doctors remains low. Despite this, interventions focused on cognitive

  18. What language is your doctor speaking? Facing the problems of translating medical documents into English

    Mićović Dragoslava

    2013-01-01

    Full Text Available What is translation - a craft, an art, a profession or a job? Although one of the oldest human activities, translation has not still been fully defined, and it is still young in terms of an academic discipline. The paper defines the difference between translation and interpreting and then attempts to find the answer to the question what characteristics, knowledge and skills a translator must have, particularly the one involved in court translation, and where his/her place in the communication process (both written and oral communication is. When translating medical documentation, a translator is set within a medical language environment as an intermediary between two doctors (in other words, two professionals in the process of communication which would be impossible without him, since it is conducted in two different languages. The paper also gives an insight into types of medical documentation and who they are intended for. It gives practical examples of the problems faced in the course of translation of certain types of medical documentation (hospital discharge papers, diagnoses, case reports,.... Is it possible to make this kind of communication between professionals (doctors standardized, which would subsequently make their translation easier? Although great efforts are made in Serbia regarding medical language and medical terminology, the conclusion is that specific problems encountered by translators can hardly be overcome using only dictionaries and translation manuals.

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

    Taylor Kathryn

    2010-11-01

    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

  20. Doctor-patient interaction in Finnish primary health care as perceived by first year medical students

    Mäntyselkä Pekka

    2005-09-01

    Full Text Available Abstract Background In Finland, public health care is the responsibility of primary health care centres, which render a wide range of community level preventive, curative and rehabilitative medical care. Since 1990's, medical studies have involved early familiarization of medical students with general practice from the beginning of the studies, as this pre-clinical familiarisation helps medical students understand patients as human beings, recognise the importance of the doctor-patient relationship and identify practicing general practitioners (GPs as role models for their professional development. Focused on doctor-patient relationship, we analysed the reports of 2002 first year medical students in the University of Kuopio. The students observed GPs' work during their 2-day visit to primary health care centres. Methods We analysed systematically the texts of 127 written reports of 2002, which represents 95.5% of the 133 first year pre-clinical medical students reports. The reports of 2003 (N = 118 and 2004 (N = 130 were used as reference material. Results Majority of the students reported GPs as positive role models. Some students reported GPs' poor attitudes, which they, however, regarded as a learning opportunity. Students generally observed a great variety of responsibilities in general practice, and expressed admiration for the skills and abilities required. They appreciated the GPs' interest in patients concerns. GPs' communication styles were found to vary considerably. Students reported some factors disturbing the consultation session, such as the GP staring at the computer screen and other team members entering the room. Working with marginalized groups, the chronically and terminally ill, and dying patients was seen as an area for development in the busy Finnish primary health care centres. Conclusion During the analysis, we discovered that medical students' perceptions in this study are in line with the previous findings about the

  1. Survey on Aesthetic Vulvovaginal Procedures: What do Portuguese Doctors and Medical Students Think?

    Vieira-Baptista, Pedro; Lima-Silva, Joana; Fonseca-Moutinho, José; Monteiro, Virgínia; Águas, Fernanda

    2017-08-01

    Objective  To assess the medical doctors and medical students' opinion regarding the evidence and ethical background of the performance of vulvovaginal aesthetic procedures (VVAPs). Methods  Cross-sectional online survey among 664 Portuguese medical doctors and students. Results  Most participants considered that there is never or there rarely is a medical reason to perform: vulvar whitening (85.9% [502/584]); hymenoplasty (72.0% [437/607]); mons pubis liposuction (71.6% [426/595]); "G-spot" augmentation (71.0% [409/576]); labia majora augmentation (66.3% [390/588]); labia minora augmentation (58.3% [326/559]); or laser vaginal tightening (52.3% [313/599]). Gynecologists and specialists were more likely to consider that there are no medical reasons to perform VVAPs; the opposite was true for plastic surgeons and students/residents.Hymenoplasty raised ethical doubts in 51.1% (283/554) of the participants. Plastic surgeons and students/residents were less likely to raise ethical objections, while the opposite was true for gynecologists and specialists.Most considered that VVAPs could contribute to an improvement in self-esteem (92.3% [613/664]); sexual function (78.5% [521/664]); vaginal atrophy (69.9% [464/664]); quality of life (66.3% [440/664]); and sexual pain (61.4% [408/664]). Conclusions  While medical doctors and students acknowledge the lack of evidence and scientific support for the performance of VVAPs, most do not raise ethical objections about them, especially if they are students or plastic surgeons, or if they have had or have considered having plastic surgery. Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil.

  2. Shared leadership in a newly merged medical center.

    Coluccio, M; Havlick, K

    1998-01-01

    Mergers of new health care entities require visionary leadership in forming effective partnerships. Shared leadership was one key ingredient in blending two major health care competitors in the Northwest. Building a successful foundation for shared leadership required formation of a common vision, definition of core values, and establishment of guiding principles. Honoring respective cultures, recognizing achievements, and inviting participation led to the design of the shared leadership model focused on the primary objective for the merger: Enhancing health care services to the community.

  3. The State of Leadership Education in Emergency Medical Services: A Multi-national Qualitative Study.

    Leggio, William Joseph

    2014-10-01

    This study investigated how leadership is learned in Emergency Medical Services (EMS) from a multi-national perspective by interviewing EMS providers from multiple nations working in Riyadh, Kingdom of Saudi Arabia. A phenomenological, qualitative methodology was developed and 19 EMS providers from multiple nations were interviewed in June 2013. Interview questions focused on how participants learned EMS leadership as an EMS student and throughout their careers as providers. Data were analyzed to identify themes, patterns, and codes to be used for final analysis to describe findings. Emergency Medical Services leadership is primarily learned from informal mentoring and on-the-job training in less than supportive environments. Participants described learning EMS leadership during their EMS education. A triangulation of EMS educational resources yielded limited results beyond being a leader of patient care. The only course that yielded results from triangulation was EMS Management. The need to develop EMS leadership courses was supported by the findings. Findings also supported the need to include leadership education as part of continuing medical education and training. Emergency Medical Services leadership education that prepares students for the complexities of the profession is needed. Likewise, the need for EMS leadership education and training to be part of continuing education is supported. Both are viewed as a way to advance the EMS profession. A need for further research on the topic of EMS leadership is recognized, and supported, with a call for action on suggested topics identified within the study.

  4. [Medical doctors as the state presidents and prime ministers--a biographical analysis].

    Lass, Piotr; Szarszewski, Adam; Gaworska-Krzemińska, Aleksandra; Sławek, Jarosław

    2012-01-01

    The authors overviewed the biographies of 29 medical doctors who became the heads of the state or the prime ministers of their countries. Most of them ruled in a countries of fresh or unstable democracies, most often in Asia, Africa and Latin America, three of them were bloody dictators. With the exemptions of Georges Clemenceau and Sun-Yat-Sen they were not famous as historical figures, although some were good administrators like the prime minister of Norway, Gro Harlem Brundtland, Malayan prime minister Mahatir bin Mohamad, Brasilian and Chilean presidents, Juscelino Kubitschek and Veronica Bachelet. Regarding specialisation was mostly general medics or they specialised in public health.

  5. Faculty development initiatives designed to promote leadership in medical education. A BEME systematic review: BEME Guide No. 19.

    Steinert, Yvonne; Naismith, Laura; Mann, Karen

    2012-01-01

    Due to the increasing complexity of medical education and practice, the preparation of healthcare professionals for leadership roles and responsibilities has become increasingly important. To date, the literature on faculty development designed to promote leadership in medical education has not been reviewed in a systematic fashion. The objective of this review is to synthesize the existing evidence that addresses the following question: 'What are the effects of faculty development interventions designed to improve leadership abilities on the knowledge, attitudes, and skills of faculty members in medicine and on the institutions in which they work?' The search, which covered the period 1980-2009, included six databases (Medline, EMBASE, CINAHL, Web of Science, ERIC, and ABI/Inform) and used the following keywords: faculty development; in-service training; doctor; medic; physician; faculty; leadership; management; administration; executive; and change agent. Hand searches were also conducted, and expert recommendations were solicited. Articles with a focus on faculty development to improve leadership, targeting basic science and clinical faculty members, were reviewed. All study designs that included outcome data beyond participant satisfaction were examined. From an initial 687 unique records, 48 articles met the review criteria in three broad categories: (1) reports in which leadership was the primary focus of the intervention; (2) reports in which leadership was a component of a broader focus on educational development; and (3) reports in which leadership was a component of a broader focus on academic career development. Data were extracted by three coders using the standardized Best Evidence Medical Education coding sheet adapted for our use. One reviewer coded all of the articles, and two reviewers each coded half of the dataset. Coding differences were resolved through discussion. Data were synthesized using Kirkpatrick's four levels of educational outcomes

  6. Erosion of Trust in the Medical Profession in India: Time for Doctors to Act

    Kane, Sumit; Calnan, Michael

    2017-01-01

    In India, over the last decade, a series of stewardship failures in the health system, particularly in the medical profession, have led to a massive erosion of trust in these institutions. In many low- and middle-income countries (LMICs), the situation is similar and has reached crisis proportions; this crisis requires urgent attention. This paper draws on the insights from the recent developments in India, to argue that a purely control-based regulatory response to this crisis in the medical profession, as is being currently envisaged by the Parliament and the Supreme Court of India, runs the risk of undermining the trusting interpersonal relations between doctors and their patients. A more balanced approach which takes into account the differences between system and interpersonal forms of trust and distrust is warranted. Such an approach should on one hand strongly regulate the institutions mandated with the stewardship and qualities of care functions, and simultaneously on the other hand, initiate measures to nurture the trusting interpersonal relations between doctors and patients. The paper concludes by calling for doctors, and those mandated with the stewardship of the profession, to individually and collectively, critically self-reflect upon the state of their profession, its priorities and its future direction. PMID:28005537

  7. Erosion of Trust in the Medical Profession in India: Time for Doctors to Act

    Sumit Kane

    2017-01-01

    Full Text Available In India, over the last decade, a series of stewardship failures in the health system, particularly in the medical profession, have led to a massive erosion of trust in these institutions. In many low- and middle-income countries (LMICs, the situation is similar and has reached crisis proportions; this crisis requires urgent attention. This paper draws on the insights from the recent developments in India, to argue that a purely control-based regulatory response to this crisis in the medical profession, as is being currently envisaged by the Parliament and the Supreme Court of India, runs the risk of undermining the trusting interpersonal relations between doctors and their patients. A more balanced approach which takes into account the differences between system and interpersonal forms of trust and distrust is warranted. Such an approach should on one hand strongly regulate the institutions mandated with the stewardship and qualities of care functions, and simultaneously on the other hand, initiate measures to nurture the trusting interpersonal relations between doctors and patients. The paper concludes by calling for doctors, and those mandated with the stewardship of the profession, to individually and collectively, critically self-reflect upon the state of their profession, its priorities and its future direction.

  8. The uses of the smartphone for doctors: an empirical study from samsung medical center.

    Choi, Jong Soo; Yi, Byoungkee; Park, Jong Hwan; Choi, Kyesook; Jung, Jaegon; Park, Seung Woo; Rhee, Poong-Lyul

    2011-06-01

    In healthcare, mobile computing made possible by smartphones is becoming an important tool among healthcare professionals. However, currently there is very little research into the effectiveness of such applications of technology. This study aims to present a framework for a smartphone application to give doctors mobile access to patient information, then review the consequences of its use and discuss its future direction. Since 2003 when Samsung Medical Center introduced its first mobile application, a need to develop a new application targeting the latest smartphone technology was identified. To that end, an application named Dr. SMART S was officially launched on December 22nd, 2010. We analyzed the usage data of the application for a month until April 25th, 2011. On average, 170 doctors (13% of the entire body of doctors) logged on 2.4 times per day and that number keeps growing. The number was uniformly distributed across all working hours, with exceptions of heavy accesses around 6-8 AM and 4-6 PM when doctors do their regular rounds to see the patients. The most commonly accessed content was inpatient information, this constituted 78.6% of all accesses, within this 50% was to accesses lab results. Looking at the usage data, we can see the use of Dr. SMART S by doctors is growing in sync with the popularity of smartphones. Since u-Health seem an inevitable future trend, a more rigorous study needs to be conducted on how such mobile applications as Dr. SMART S affect the quality of care and patient safety to derive directions for further improvements.

  9. The continuing medical education activities and attitudes of Australian doctors working in different clinical specialties and practice locations.

    Stewart, Grant D; Khadra, Mohamed H

    2009-02-01

    Currently, it is not clear which continuing medical education (CME) methods are being used by senior doctors and what their attitudes towards them are. The aims of this study were to investigate which modes of CME delivery senior Australian doctors utilise, to assess doctors' attitudes towards CME and to determine any differences in modes used and attitudes between clinical specialties and practice locations. A 52-statement questionnaire enquiring about doctors' current CME activities and their attitudes towards CME was distributed to 1336 senior Australian doctors. 494 doctors responded to the questionnaire. Traditional forms of CME (eg, meetings, conferences, journals and lectures) were most commonly used. Doctors thought CME involving face-to-face interaction was superior to electronic forms of CME. All doctors, especially those in hospital practice, had a positive attitude towards CME but found lack of time a barrier to learning. Rural doctors found CME sessions more difficult to attend than did their metropolitan colleagues. Traditional forms of CME were more popular than modern CME approaches, such as e-learning. Australian doctors had a positive attitude towards undertaking CME despite struggling to find time to perform CME. The differences in attitudes towards CME demonstrated between specialties and different practice location will aid future CME planning.

  10. [The essence of doctor-patient relationship in creating image of a medical institution].

    Dworzański, Wojciech; Dworzańska, Anna; Burdan, Franciszek

    2012-01-01

    Irrespective of changing standards and continuous reforms in health service, the patient should always remain the principal focus. The patient is a person who should be treated not only as a customer or a recipient of medical services but also as a person being in a situation which is difficult and often unacceptable. Among the factors affecting patients' satisfaction and contentment in the course of the disease it is profoundly important that he cooperates with his doctor. For years it has been attempted to create an ideal model of doctor-patient relationship which would be mutually beneficial and not violating privacy or welfare of any of them. These attempts focused on various theoretical models, among others paternalistic, informative and interpretive. However, special attention should be paid to adherence to principles which is based on respect for patient autonomy, harmlessness, charity and fairness.

  11. Why and when do Danish medical doctors choose to become a general practitioner?

    Lewandowska, Karolina; Kjær, Niels Kristian; Lillevang, Gunver

    of study is to examine why and when Danish junior doctors choose family medicine as their future specialty. Method: We carried out two focus group interviews with medical doctors from two regions. An academic employee from the Danish College of Family Medicine mediated the interviews assisted by a family......Background and Aim: Continued supply of qualified general practitioners is essential for the vitality of the primary health care sector. In Denmark however we have observed a decline in the number of applicants for our family medicine specialist training program, leaving some posts vacant. The aim......-graduate training the structure of the postgraduate educational program, working conditions, respect for general practice, uncertainty about the future for general practice as a profession, when did I decide to choose family medicine. Out of these themes we identified factors, which influenced the choice...

  12. [Medical doctors driving technological innovation: questions about and innovation management approaches to incentive structures for lead users].

    Bohnet-Joschko, Sabine; Kientzler, Fionn

    2010-01-01

    Management science defines user-generated innovations as open innovation and lead user innovation. The medical technology industry finds user-generated innovations profitable and even indispensable. Innovative medical doctors as lead users need medical technology innovations in order to improve patient care. Their motivation to innovate is mostly intrinsic. But innovations may also involve extrinsic motivators such as gain in reputation or monetary incentives. Medical doctors' innovative activities often take place in hospitals and are thus embedded into the hospital's organisational setting. Hospitals find it difficult to gain short-term profits from in-house generated innovations and sometimes hesitate to support them. Strategic investment in medical doctors' innovative activities may be profitable for hospitals in the long run if innovations provide first-mover competitive advantages. Industry co-operations with innovative medical doctors offer chances but also bear potential risks. Innovative ideas generated by expert users may result in even higher complexity of medical devices; this could cause mistakes when applied by less specialised users and thus affect patient safety. Innovations that yield benefits for patients, medical doctors, hospitals and the medical technology industry can be advanced by offering adequate support for knowledge transfer and co-operation models.

  13. Promoting medical competencies through international exchange programs: benefits on communication and effective doctor-patient relationships.

    Jacobs, Fabian; Stegmann, Karsten; Siebeck, Matthias

    2014-03-04

    Universities are increasingly organizing international exchange programs to meet the requirements of growing globalisation in the field of health care. Analyses based on the programs' fundamental theoretical background are needed to confirm the learning value for participants. This study investigated the extent of sociocultural learning in an exchange program and how sociocultural learning affects the acquisition of domain-specific competencies. Sociocultural learning theories were applied to study the learning effect for German medical students from the LMU Munich, Munich, Germany, of participation in the medical exchange program with Jimma University, Jimma, Ethiopia. First, we performed a qualitative study consisting of interviews with five of the first program participants. The results were used to develop a questionnaire for the subsequent, quantitative study, in which 29 program participants and 23 matched controls performed self-assessments of competencies as defined in the Tuning Project for Health Professionals. The two interrelated studies were combined to answer three different research questions. The participants rated their competence significantly higher than the control group in the fields of doctor-patient relationships and communication in a medical context. Participant responses in the two interrelated studies supported the link between the findings and the suggested theoretical background. Overall, we found that the exchange program affected the areas of doctor-patient relationships and effective communication in a medical context. Vygotsky's sociocultural learning theory contributed to explaining the learning mechanisms of the exchange program.

  14. A levels and intelligence as predictors of medical careers in UK doctors: 20 year prospective study

    McManus, I C; Smithers, Eleni; Partridge, Philippa; Keeling, A; Fleming, Peter R

    2003-01-01

    Objective To assess whether A level grades (achievement) and intelligence (ability) predict doctors' careers. Design Prospective cohort study with follow up after 20 years by postal questionnaire. Setting A UK medical school in London. Participants 511 doctors who had entered Westminster Medical School as clinical students between 1975 and 1982 were followed up in January 2002. Main outcome measures Time taken to reach different career grades in hospital or general practice, postgraduate qualifications obtained (membership/fellowships, diplomas, higher academic degrees), number of research publications, and measures of stress and burnout related to A level grades and intelligence (result of AH5 intelligence test) at entry to clinical school. General health questionnaire, Maslach burnout inventory, and questionnaire on satisfaction with career at follow up. Results 47 (9%) doctors were no longer on the Medical Register. They had lower A level grades than those who were still on the register (P < 0.001). A levels also predicted performance in undergraduate training, performance in postregistration house officer posts, and time to achieve membership qualifications (Cox regression, P < 0.001; b=0.376, SE=0.098, exp(b)=1.457). Intelligence did not independently predict dropping off the register, career outcome, or other measures. A levels did not predict diploma or higher academic qualifications, research publications, or stress or burnout. Diplomas, higher academic degrees, and research publications did, however, significantly correlate with personality measures. Conclusions Results of achievement tests, in this case A level grades, which are particularly used for selection of students in the United Kingdom, have long term predictive validity for undergraduate and postgraduate careers. In contrast, a test of ability or aptitude (AH5) was of little predictive validity for subsequent medical careers. PMID:12869457

  15. Managing medical groups: 21st century challenges and the impact of physician leadership styles.

    Martin, William E; Keogh, Timothy J

    2004-01-01

    Physician group managers and administrators charged with leading medical groups in the 21st century face a set of old and new challenges and opportunities. Leadership is assumed to make the difference between a successful and not-so-successful medical group. Yet, there is little research about how physician manager leadership styles contribute to the success of medical group practices. This article is a study of physician leadership styles using the DiSC, based upon a sample of 232 physician managers. Dominance (D) and conscientiousness (C) were the two dominant styles found in this study. Moreover, the two dominant combination leadership styles fall under the categories of the "creative" and the 'perfectionist." The article formulates practical recommendations for both physician managers and administrators for leading medical groups to respond more effectively to the challenges and opportunities facing medical groups in the 21st century.

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

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

    2017-01-01

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

  17. [Physician's role in "medical drama" pitfall? Reflection of stereotypical images of doctors in context of contemporary doctor's series].

    Köhler, M; Grabsch, C; Zellner, M; Noll-Hussong, M

    2014-04-17

    In contemporary U.S. doctor's series, the characters are usually represented by good-looking or typical character actors. The aim of our pilot study was to investigate whether the long-term impact of this format on German television viewers could have an influence on the choice of doctor in Germany. Two different groups of people anticipating TV consumption patterns were questioned: a first group of younger adults who knew theTV series was asked to judge their doctor choice using a web-based survey tool with respect to three criteria (sympathy, expertise and own treatment preference). The second group of adults beyond the 40th year of life who need not know theTV series were shown photos of the serial figures. Study participants should select the "doctor" of which they would most likely want to be treated and this based on two predetermined reasons (sympathy or expertise). Our results indicate that stereotypical images of doctors found high approval only in the first group of people, while the participants in the second group decided in majorityfora more realistic representation of average appearance.

  18. Doctor-patient communication without family is most frequently practiced in patients with malignant tumors in home medical care settings.

    Kimura, Takuma; Imanaga, Teruhiko; Matsuzaki, Makoto

    2014-01-01

    Promotion of home medical care is absolutely necessary in Japan where is a rapidly aging society. In home medical care settings, triadic communications among the doctor, patient and the family are common. And "communications just between the doctor and the patient without the family" (doctor-patient communication without family, "DPC without family") is considered important for the patient to frankly communicate with the doctor without consideration for the family. However, the circumstances associated with DPC without family are unclear. Therefore, to identify the factors of the occurrence of DPC without family, we conducted a cross-sectional mail-in survey targeting 271 families of Japanese patients who had previously received home medical care. Among 227 respondents (83.8%), we eventually analyzed data from 143, excluding families of patients with severe hearing or cognitive impairment and severe verbal communication dysfunction. DPC without family occurred in 26.6% (n = 38) of the families analyzed. A multivariable logistic regression analysis was performed using a model including Primary disease, Daily activity, Duration of home medical care, Interval between doctor visits, Duration of doctor's stay, Existence of another room, and Spouse as primary caregiver. As a result, DPC without family was significantly associated with malignant tumor as primary disease (OR, 3.165; 95% CI, 1.180-8.486; P = 0.022). In conclusion, the visiting doctors should bear in mind that the background factor of the occurrence of DPC without family is patient's malignant tumors.

  19. Differences in Simulated Doctor and Patient Medical Decision Making: A Construal Level Perspective

    Zhang, Yan; Liu, Quanhui; Miao, Danmin; Xiao, Wei

    2013-01-01

    Background Patients are often confronted with diverse medical decisions. Often lacking relevant medical knowledge, patients fail to independently make medical decisions and instead generally rely on the advice of doctors. Objective This study investigated the characteristics of and differences in doctor–patient medical decision making on the basis of construal level theory. Methods A total of 420 undergraduates majoring in clinical medicine were randomly assigned to six groups. Their decisions to opt for radiotherapy and surgery were investigated, with the choices described in a positive/neutral/negative frame × decision making for self/others. Results Compared with participants giving medical advice to patients, participants deciding for themselves were more likely to select radiotherapy (F1, 404 = 13.92, p = 011). Participants from positive or neutral frames exhibited a higher tendency to choose surgery than did those from negative frames (F2, 404 = 22.53, peffect of framing on independent decision making was nonsignificant (F2, 404 = 1.07, p = 35); however the effect of framing on the provision of advice to patients was significant (F2, 404 = 12.95, peffect of construal level was significant in the positive frame (F1, 404 = 8.06, p = 005) and marginally significant in the neutral frame (F2, 404 = 3.31, p = 07) but nonsignificant in the negative frame (F2, 404 = .29, p = 59). Conclusion Both social distance and framing depiction significantly affected medical decision making and exhibited a significant interaction. Differences in medical decision making between doctors and patients need further investigation. PMID:24244445

  20. A role for doctors in assisted dying? An analysis of legal regulations and medical professional positions in six European countries.

    Bosshard, G; Broeckaert, B; Clark, D; Materstvedt, L J; Gordijn, B; Müller-Busch, H C

    2008-01-01

    To analyse legislation and medical professional positions concerning the doctor's role in assisted dying in western Europe, and to discuss their implications for doctors. This paper is based on country-specific reports by experts from European countries where assisted dying is legalised (Belgium, The Netherlands), or openly practiced (Switzerland), or where it is illegal (Germany, Norway, UK). Laws on assisted dying in The Netherlands and Belgium are restricted to doctors. In principle, assisted suicide (but not euthanasia) is not illegal in either Germany or Switzerland, but a doctor's participation in Germany would violate the code of professional medical conduct and might contravene of a doctor's legal duty to save life. The Assisted Dying for the Terminally Ill Bill proposed in the UK in 2005 focused on doctors, whereas the Proposal on Assisted Dying of the Norwegian Penal Code Commission minority in 2002 did not. Professional medical organisations in all these countries except The Netherlands maintain the position that medical assistance in dying conflicts with the basic role of doctors. However, in Belgium and Switzerland, and for a time in the UK, these organisations dropped their opposition to new legislation. Today, they regard the issue as primarily a matter for society and politics. This "neutral" stance differs from the official position of the Royal Dutch Medical Association which has played a key role in developing the Dutch practice of euthanasia as a "medical end-of-life decision" since the 1970s. A society moving towards an open approach to assisted dying should carefully identify tasks to assign exclusively to medical doctors, and distinguish those possibly better performed by other professions.

  1. Transformational leadership in medical practice: capturing and influencing principles-driven work.

    Gabel, Stewart

    2012-01-01

    The importance of leadership in medicine is well recognized. Transformational leadership is a well-defined model that provides an empirically supported approach to foster organizational and personal change. It has been applied in health care settings with favorable outcomes. Transformational leadership is intended to help subordinates and followers transcend usual expectations of their own capabilities to reach higher levels of performance and personal meaning. The application of transformational leadership is appropriate to physicians in many roles, including to those who are supervisors in medical education or practice as team members in outpatient settings. Illustrations exemplify these points.

  2. Are the General Medical Council's Tests of Competence fair to long standing doctors? A retrospective cohort study.

    Mehdizadeh, Leila; Sturrock, Alison; Dacre, Jane

    2015-04-21

    The General Medical Council's Fitness to Practise investigations may involve a test of competence for doctors with performance concerns. Concern has been raised about the suitability of the test format for doctors who qualified before the introduction of Single Best Answer and Objective Structured Clinical Examination assessments, both of which form the test of competence. This study explored whether the examination formats used in the tests of competence are fair to long standing doctors who have undergone fitness to practise investigation. A retrospective cohort design was used to determine an association between year of primary medical qualification and doctors' test of competence performance. Performance of 95 general practitioners under investigation was compared with a group of 376 volunteer doctors. We analysed performance on knowledge test, OSCE overall, and three individual OSCE stations using Spearman's correlation and regression models. Doctors under investigation performed worse on all test outcomes compared to the comparison group. Qualification year correlated positively with performance on all outcomes except for physical examination (e.g. knowledge test r = 0.48, p fitness to practise investigation performed less well on the test of competence than their more recently qualified peers under investigation. The performance of the comparator group tended to stay consistent irrespective of year qualified. Our results suggest that the test format does not disadvantage early qualified doctors. We discuss findings in relation to the GMC's fitness to practise procedures and suggest alternative explanations for the poorer performance of long standing doctors under investigation.

  3. The relationship betweenmanagers’ leadership styles and emergency medical technicians’ job satisfaction

    Azimeh Ghorbanian

    2012-01-01

    Full Text Available Background/AimsLeadership plays a crucial role in many professions, especially in challenging positions such as emergency medical service jobs. The purpose of this study was to explore the relationship between managers’ leadership styles and emergency medical technicians’ job satisfaction.MethodThis is a descriptive and cross-sectional study that was carried out in 2010. The research population included 21 managers and 87 emergency medical technicians working in 23 stations in Isfahan city, Iran. The main tools used for data accumulation were the Multiple Leadership Questionnaire for evaluating leadership styles and the Job Descriptive Index for measuring job satisfaction levels. Also, the Pearson correlation analysis test was used to evaluate the relationship between leadership style and job satisfaction.ResultsAmong both managers and technicians, the highest mean score related to the transformational management style, whereas the lowest mean score related to the laissez-faire management style. Moreover, a significant relationship (P<0.01 was found between the transformational and transactional leadership styles and job satisfaction. However, no significant relationship was observed between the laissez-faire management style and job satisfaction.ConclusionConsidering the importance of job satisfaction in medical emergencies, it is recommended that health sector policy makers should provide the groundwork for implementing the transformational leadership style to enhance job satisfaction of the medical emergency staff.

  4. Thai and American doctors on medical ethics: religion, regulation, and moral reasoning across borders.

    Grol-Prokopczyk, Hanna

    2013-01-01

    Recent scholarship argues that successful international medical collaboration depends crucially on improving cross-cultural understanding. To this end, this study analyzes recent writings on medical ethics by physicians in two countries actively participating in global medicine, Thailand and the United States. Articles (133; published 2004-2008) from JAMA, the New England Journal of Medicine, and the Journal of the Medical Association of Thailand are analyzed to inductively build a portrait of two discursive ethical cultures. Frameworks of moral reasoning are identified across and within the two groups, with a focus on what authority (religion, law, etc.) is invoked to define and evaluate ethical problems. How might similarities and differences in ethical paradigms reflect the countries' historical "semicolonial" relationship, shed light on debates about Eastern vs. Western bioethics, and facilitate or hinder contemporary cross-national communication? Findings demonstrate substantial overlap in Thai and American doctors' vocabulary, points of reference, and topics covered, though only Thai doctors emphasize national interests and identity. American authors display a striking homogeneity in styles of moral reasoning, embracing a secular, legalistic, deontological ethics that generally eschews discussion of religion, personal character, or national culture. Among Thai authors, there is a schism in ethical styles: while some hew closely to the secular, deontological model, others embrace a virtue ethics that liberally cites Buddhist principles and emphasizes the role of doctors' good character. These two approaches may represent opposing reactions-assimilation and resistance, respectively-to Western influence. The current findings undermine the stereotype of Western individualism versus Eastern collectivism. Implications for cross-national dialog are discussed. Copyright © 2012 Elsevier Ltd. All rights reserved.

  5. [Doctor-Patient Relationship from the Perspective of Medical Students' Portfolio].

    Girela Pérez, Beatriz; Rodríguez Cano, María Araceli; Girela López, Eloy

    2018-01-01

    Doctor-patient relationship is of paramount importance for a good medical practice, however as long as medicine has been increasingly influenced by technology and science, it may be at risk of losing contact with basic human values of respect for the beliefs and preferences of the other person. In this study, we have analyzed the deontological vision of the physician-patient relationship perceived through clinical situations reflected in the portfolios carried out by 225 students of the 5th year of the Degree of Medicine at the University of Córdoba, during the courses 2014/15 and 2015/16. 201 out of 833 deontological considerations on articles of the Code of Medical Ethics constitute non-compliances. It is noteworthy that these breaches to the Code of Medical Ethics considered refer mainly (73%) to Chapter III (doctor-patient relationship). It is particularly interesting that the problems most frequently detected are those related to attitude, forms or language and lack of understanding/confidence of the physician with the patient (article 8 with 46 noncompliances), as well as problems in providing information (articles 12.1 and 15, with 18 and 42 noncompliances respectively).

  6. Junior doctors' experiences of managing patients with medically unexplained symptoms: a qualitative study.

    Yon, Katherine; Nettleton, Sarah; Walters, Kate; Lamahewa, Kethakie; Buszewicz, Marta

    2015-12-01

    To explore junior doctors' knowledge about and experiences of managing patients with medically unexplained symptoms (MUS) and to seek their recommendations for improved future training on this important topic about which they currently receive little education. Qualitative study using in-depth interviews analysed using the framework method. Participants were recruited from three North Thames London hospitals within the UK. Twenty-two junior doctors undertaking the UK foundation two-year training programme (FY1/FY2). The junior doctors interviewed identified a significant gap in their training on the topic of MUS, particularly in relation to their awareness of the topic, the appropriate level of investigations, possible psychological comorbidities, the formulation of suitable explanations for patients' symptoms and longer term management strategies. Many junior doctors expressed feelings of anxiety, frustration and a self-perceived lack of competency in this area, and spoke of over-investigating patients or avoiding patient contact altogether due to the challenging nature of MUS and a difficulty in managing the accompanying uncertainty. They also identified the negative attitudes of some senior clinicians and potential role models towards patients with MUS as a factor contributing to their own attitudes and management choices. Most reported a need for more training during the foundation years, and recommended interactive case-based group discussions with a focus on providing meaningful explanations to patients for their symptoms. There is an urgent need to improve postgraduate training about the topics of MUS and avoiding over-investigation, as current training does not equip junior doctors with the necessary knowledge and skills to effectively and confidently manage patients in these areas. Training needs to focus on practical skill development to increase clinical knowledge in areas such as delivering suitable explanations, and to incorporate individual management

  7. Leadership Training Program for Medical Staff in Belgium

    Claes, Neree; Brabanders, Valérie

    2016-01-01

    Today healthcare is facing many challenges in a volatile, uncertain, complex and ambiguous environment. There is a need to develop strong leaders who can cope with these challenges. This article describes the process of a leadership training program for healthcare professionals in Belgium (named "Clinical Leadership Program" or…

  8. Evaluiertes Training von Führungskompetenzen in der medizinischen Aus- und Weiterbildung [Training of Leadership Skills in Medical Education

    Fischer, Martin R.

    2013-11-01

    Full Text Available [english] Background: Effective team performance is essential in the delivery of high-quality health-care. Leadership skills therefore are an important part of physicians’ everyday clinical life. To date, the development of leadership skills are underrepresented in medical curricula. Appropriate training methods for equipping doctors with these leadership skills are highly desirable. Objective: The review aims to summarize the findings in the current literature regarding training in leadership skills in medicine and tries to integrate the findings to guide future research and training development. Method: The PubMED, ERIC, and PsycArticles, PsycINFO, PSYNDEX and Academic search complete of EBSCOhost were searched for in German and English. Relevant articles were identified and findings were integrated and consolidated regarding the leadership principles, target group of training and number of participants, temporal resources of the training, training content and methods, the evaluation design and trainings effects. Results: Eight studies met all inclusion criteria and no exclusion criteria. The range of training programs is very broad and leadership skill components are diverse. Training designs implied theoretical reflections of leadership phenomena as well as discussions of case studies from practice. The duration of training ranged from several hours to years. Reactions of participants to trainings were positive, yet no behavioral changes through training were examined. Conclusions: More research is needed to understand the factors critical to success in the development of leadership skills in medical education and to adapt goal-oriented training methods. Requirements analysis might help to gain knowledge about the nature of leadership skills in medicine. The authors propose a stronger focus on behavioral training methods like simulation-based training for leadership skills in medical education.[german] Hintergrund: Eine effektive

  9. Exploration of a leadership competency model for medical school faculties in Korea.

    Lee, Yong Seok; Oh, Dong Keun; Kim, Myungun; Lee, Yoon Seong; Shin, Jwa Seop

    2010-12-01

    To adapt to rapid and turbulent changes in the field of medicine, education, and society, medical school faculties need appropriate leadership. To develop leadership competencies through education, coaching, and mentoring, we need a leadership competency model. The purpose of this study was to develop a new leadership competency model that is suitable for medical school faculties in Korea. To collect behavioral episodes with regard to leadership, we interviewed 54 subjects (faculties, residents, nurses) and surveyed 41 faculties with open-ended questionnaires. We classified the behavioral episodes based on Quinn and Cameron's leadership competency model and developed a Likert scale questionnaire to perform a confirmatory factor analysis. Two hundred seven medical school faculties responded to the questionnaire. The competency clusters that were identified by factor analysis were professionalism, citizenship, leadership, and membership to an organization. Accordingly, each cluster was linked with a dimension: self, society, team (that he/she is leading), and organization (to which he/she belongs). The clusters of competencies were: professional ability, ethics/morality, self-management, self-development, and passion; public interest, networking, social participation, and active service; motivating, caring, promoting teamwork, nurturing, conflict management, directing, performance management, and systems thinking; organizational orientation, collaboration, voluntary participation, and cost-benefit orientation. This competency model that fits medical school faculties in Korea can be used to design and develop selection plans, education programs, feedback tools, diagnostic evaluation tools, and career plan support programs.

  10. Leadership and followership in the healthcare workplace: exploring medical trainees’ experiences through narrative inquiry

    Gordon, Lisi J; Rees, Charlotte E; Ker, Jean S; Cleland, Jennifer

    2015-01-01

    Objectives To explore medical trainees’ experiences of leadership and followership in the interprofessional healthcare workplace. Design A qualitative approach using narrative interviewing techniques in 11 group and 19 individual interviews with UK medical trainees. Setting Multisite study across four UK health boards. Participants Through maximum variation sampling, 65 medical trainees were recruited from a range of specialties and at various stages of training. Participants shared stories about their experiences of leadership and followership in the healthcare workplace. Methods Data were analysed using thematic and narrative analysis. Results We identified 171 personal incident narratives about leadership and followership. Participants most often narrated experiences from the position of follower. Their narratives illustrated many factors that facilitate or inhibit developing leadership identities; that traditional medical and interprofessional hierarchies persist within the healthcare workplace; and that wider healthcare systems can act as barriers to distributed leadership practices. Conclusions This paper provides new understandings of the multiple ways in which leadership and followership is experienced in the healthcare workplace and sets out recommendations for future leadership educational practices and research. PMID:26628525

  11. Role of accrediting bodies in providing education leadership in medical education

    Sam Leinster

    2014-01-01

    Role of accreditation authorities: If accreditation authorities are to provide leadership in medical education they must undertake regular review of their standards. This should be informed by all stakeholders and include experts in medical education. The format of the standards must provide clear direction to medical schools. Accreditation should take place regularly and should result in the production of a publicly accessible report.

  12. [Analysis of qualifications of medical and health institutions and certified doctors for providing occupational disease diagnosis in China].

    Wang, Huan-qiang; Li, Tao; Qi, Fang; Wu, Rui; Nie, Wu; Yu, Chen

    2013-10-01

    To investigate the qualifications and current situations of the medical and health institutions and certified doctors for providing occupational disease diagnosis in China and to provide a reference for developing relevant policies. Work reports and questionnaires survey were used to investigate the qualifications of all medical and health institutions and certified doctors for providing occupational disease diagnosis in China and their acceptance and diagnosis of occupational disease cases from 2006 to 2010. The rate for the work reports was 100%, and the response rate for the questionnaires was 71.0%. By the end of 2010, in the 31 provincial-level regions (excluding Hong Kong, Macao, and Taiwan) in China, there had been 503 medical and health institutions which were qualified for providing occupational disease diagnosis, including 207 centers for disease control and prevention, accounting for 41.2%, 145 general hospitals, accounting for 28.8%, 69 enterprise-owned hospitals, accounting for 13.7%, and 64 institutes or centers for occupational disease prevention and control, accounting for 12.7%; 4986 certified doctors got the qualification for providing occupational disease diagnosis, with 9.4 certified doctors on average in each institution, and there was 0.65 certified doctor per 100 000 employees. In addition, 16.5% of the institutions got all the qualifications for diagnosing 9 occupational diseases, and 17.1% of the institutions got the qualification for diagnosing one occupational disease. Each certified doctor accepted diagnosis of 16.8 cases of occupational diseases on average every year. A national occupational disease diagnosis network has been established in China, but the imbalance in regional distribution and specialty programs still exists among the qualified medical and health institutions and certified doctors. It is essential to further strengthen the development of regional qualified medical and health institutions and training of qualified

  13. Cross-sectional study on awareness and knowledge of torture investigation and documentation among Greek doctors and senior medical students.

    Orfanou, Christina; Tsiamis, Costas; Karamagioli, Evika; Pikouli, Anastasia; Terzidis, Agis; Pikoulis, Emmanuel

    2018-06-05

    Doctors in Greece face the possibility of encountering a person that has suffered torture, especially since the high rates of refugees' and migrants' inflows that took place over the last years. In order to assess the awareness and the knowledge of doctors and senior medical students in Greece regarding a manual on effective investigation and documentation of torture such as Istanbul Protocol (official United Nation document since 1999), a cross-sectional study was conducted using a structured anonymous questionnaire. The sample was doctors practicing in public hospitals in Greece, doctors volunteering at a non-governmental organization (NGO) and undergraduate medical students in their final year of studies in the Medical School of National and Kapodistrian University of Athens. The data were analyzed using IBM SPSS version 23, using descriptive statistics and statistical significance tests.In a total of 289 participants, the mean total score of Istanbul Protocol knowledge was 4.43 ± 1.104 (the maximum possible score was 10) and the mean total score of Istanbul Protocol awareness was 2.04 ± 1.521 (the maximum possible score was 10). The most important conclusion was that among doctors and senior medical students, there seem to be knowledge, awareness, and information deficit about Istanbul Protocol and several issues relating to torture. The overall research outcome highlights the need for the development of a relevant informative/educational program, in order to cover the corresponding existing needs of the population of doctors in Greece.

  14. Reasons and remedies for under-representation of women in medical leadership roles: a qualitative study from Australia

    Bismark, Marie; Morris, Jennifer; Thomas, Laura; Loh, Erwin; Phelps, Grant; Dickinson, Helen

    2015-01-01

    Objective To elicit medical leaders? views on reasons and remedies for the under-representation of women in medical leadership roles. Design Qualitative study using semistructured interviews with medical practitioners who work in medical leadership roles. Interviews were transcribed verbatim and transcripts were analysed using thematic analysis. Setting Public hospitals, private healthcare providers, professional colleges and associations and government organisations in Australia. Participant...

  15. Development of a patient-doctor communication skills model for medical students.

    Lee, Young Hee; Lee, Young-Mee

    2010-09-01

    Communication is a core clinical skill that can be taught and learned. The authors intended to develop a patient-doctor communication model for teaching and assessing undergraduate medical students in Korea. To develop a model, literature reviews and an iterative process of discussion between faculty members of a communication skills course for second year medical students were conducted. The authors extracted common communication skill competencies by comparing the Kalamazoo Consensus Statement, SEGUE framework communication skills, the Calgary Cambridge Observation Guides, and previous communication skills lists that have been used by the authors. The content validity, with regard to clinical importance and feasibility, was surveyed by both faculty physicians and students. The first version of the model consisted of 36 items under 7 categories: initiating the session (8 items), building a relationship (6), gathering information (8), understanding a patient's perspectives (4), sharing information (4), reaching an agreement (3), and closing the session (3). It was used as a guide for both students and teachers in an actual communication skills course. At the end of the course, student performance was assessed using two 7-minute standardized patient interviews with a 34-item checklist. This assessment tool was modified from the first version of the model to reflect the case specificity of the scenarios. A patient-doctor communication model, which can be taught to those with limited patient care experience, was finally developed. We recommended a patient-doctor communication skills model that can be used for teaching and evaluating preclinical and clinical students. Further studies are needed to verify its validity and reliability.

  16. Educating doctors in the clinical workplace: unraveling the process of teaching and learning in the medical resident as teacher.

    Busari, J O; Arnold, Aer

    2009-01-01

    In recent years, higher medical education has witnessed major changes in the structure and content of postgraduate medical training. Seven professional competencies have been described that address the medical doctors' ability to effectively communicate and transfer medical information, interact effectively and professionally, and demonstrate a good grasp of clinical knowledge and skills. Proficiency in didactic skills, however, is an important competency that has not received prominent attention. In the clinical setting, attending-physicians and medical residents are responsible for teaching. Consequently, several medical institutions have proposed the need for teacher training programs to improve the teaching skills of attending doctors and medical residents. The supporters of these programs believe that through teaching, medical doctors improve their individual professional and clinical problem-solving abilities. Hence, it is logical to assume that didactic skills' training would contribute to the professional development of doctors. In this paper, we re-examine the underlying theory of the didactic proficiency, how it relates to the clinical setting, and why it may be beneficial for the professional training of medical residents.

  17. The role of controllable lifestyle in the choice of specialisation among Hungarian medical doctors.

    Girasek, Edmond; Szócska, Miklós; Kovács, Eszter; Gaál, Péter

    2017-11-13

    Hungary has been serious facing human resources crisis in health care, as a result of a massive emigration of health workers. The resulting shortage is unevenly distributed among medical specialisations. The findings of research studies are consistent in that the most important motivating factor of the choice of the medical career and of medical specialisations is professional interest. Beyond this, it is important to examine other reasons of why students do or do not choose certain specialisations. The lifestyle determined by the chosen speciality is one such factor described in the literature. Using convenient sampling, first year resident medical doctors from each of the four Hungarian universities with a medical faculty were asked to participate in the study in 2008. In total 391 first year resident medical doctors completed the self-administered questionnaire indicating a 57.3% response rate. On the basis of the work of Schwartz et al. (Acad Med 65(3):207-210, 1990), the specialisation fields were divided into the two main categories of non-controllable (NCL) or controllable lifestyles (CL). We carried out a factor analysis on motivating factors and set up an explanatory model regarding the choice of CL and NCL specialisations. Two maximum likelihood factors were extracted from the motivational questions: "lifestyle and income" and "professional interest and consciousness". The explanatory model on specialisation choice shows that the "professional interest and consciousness" factor increases the likelihood of choosing NCL specialisations. In contrast the "lifestyle and income" factor has no significant impact on the choice of CL/NCL specialisations in the model. Our results confirm the important role of professional interest in the choice of medical specializations in Hungary. On the other hand, it seems surprising that we found no significant difference in the "lifestyle and income" related motivation among those medical residents, who opted for CL as

  18. The role of controllable lifestyle in the choice of specialisation among Hungarian medical doctors

    Edmond Girasek

    2017-11-01

    Full Text Available Abstract Background Hungary has been serious facing human resources crisis in health care, as a result of a massive emigration of health workers. The resulting shortage is unevenly distributed among medical specialisations. The findings of research studies are consistent in that the most important motivating factor of the choice of the medical career and of medical specialisations is professional interest. Beyond this, it is important to examine other reasons of why students do or do not choose certain specialisations. The lifestyle determined by the chosen speciality is one such factor described in the literature. Methods Using convenient sampling, first year resident medical doctors from each of the four Hungarian universities with a medical faculty were asked to participate in the study in 2008. In total 391 first year resident medical doctors completed the self-administered questionnaire indicating a 57.3% response rate. On the basis of the work of Schwartz et al. (Acad Med 65(3:207–210, 1990, the specialisation fields were divided into the two main categories of non-controllable (NCL or controllable lifestyles (CL. We carried out a factor analysis on motivating factors and set up an explanatory model regarding the choice of CL and NCL specialisations. Results Two maximum likelihood factors were extracted from the motivational questions: “lifestyle and income” and “professional interest and consciousness”. The explanatory model on specialisation choice shows that the “professional interest and consciousness” factor increases the likelihood of choosing NCL specialisations. In contrast the “lifestyle and income” factor has no significant impact on the choice of CL/NCL specialisations in the model. Conclusions Our results confirm the important role of professional interest in the choice of medical specializations in Hungary. On the other hand, it seems surprising that we found no significant difference in the “lifestyle and

  19. UK doctors' views on the implementation of the European Working Time Directive as applied to medical practice: a quantitative analysis.

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

    2014-02-06

    To report on doctors' views, from all specialty backgrounds, about the European Working Time Directive (EWTD) and its impact on the National Health Service (NHS), senior doctors and junior doctors. All medical school graduates from 1999 to 2000 were surveyed by post and email in 2012. The UK. Among other questions, in a multipurpose survey on medical careers and career intentions, doctors were asked to respond to three statements about the EWTD on a five-point scale (from strongly agree to strongly disagree): 'The implementation of the EWTD has benefited the NHS', 'The implementation of the EWTD has benefited senior doctors' and 'The implementation of the EWTD has benefited junior doctors'. The response rate was 54.4% overall (4486/8252), 55.8% (2256/4042) of the 1999 cohort and 53% (2230/4210) of the 2000 cohort. 54.1% (2427) of all respondents were women. Only 12% (498/4136 doctors) agreed that the EWTD has benefited the NHS, 9% (377) that it has benefited senior doctors and 31% (1289) that it has benefited junior doctors. Doctors' views on EWTD differed significantly by specialty groups: 'craft' specialties such as surgery, requiring extensive experience in performing operations, were particularly critical. These cohorts have experience of working in the NHS before and after the implementation of EWTD. Their lack of support for the EWTD 4 years after its implementation should be a concern. However, it is unclear whether problems rest with the current ceiling on hours worked or with the ways in which EWTD has been implemented.

  20. From here and now to infinity and eternity: a message to new medical doctors(*).

    Lapeña, José Florencio F

    2014-01-01

    Commencement means both an end and a beginning; the end of the academic year and the beginning of the rest of your life as new physicians. For such a beginning, it is useful to view it in retrospect, from the point of view of the end, by conducting a pre-mortem on your life. Taking the existentialist (ex sistere, to stand forth) stance, each of us can be classified into one of four basic types of person, based on our characteristic space and time (or spatio-temporal) context or horizon. Our space can be limited to the "here" and our time to the "now;" or our space may extend to "infinity" and our time embark on "eternity." In-between these poles, most have space contexts rooted in their home and work "turf" and time involving their "lifetime," while some expand their space to include the "world" and their time to encompass "history." From the "here and now" and "turf and lifetime" contexts, the horizons of "world and history," and "infinity and eternity" are examined, challenging new medical doctors to realize their full potential. The new physician is exhorted not to wait for a post-mortem to define (des finitus, to set limits) his or her life. He or she should stand forth, to live, and give life. The new medical doctor is encouraged to look to the sunrise, draw strength from the sunshine, to be brave, and strong and true.

  1. The state of leadership education in US medical schools: results of a national survey.

    Neeley, Sabrina M; Clyne, Brian; Resnick-Ault, Daniel

    2017-01-01

    Over the past two decades, there have been increasing calls for physicians to develop the capabilities to lead health care transformation. Many experts and authors have suggested that leadership education should begin during medical school; however, little information exists regarding the presence or nature of undergraduate medical education leadership curricula in the USA. This study sought to determine the prevalence of formal leadership education in US undergraduate medical schools, as well as the delivery methods and degree of student participation. A web-based survey of medical education deans from US allopathic medical schools (N = 144) was administered from November 2014 to February 2015. The survey included questions on the presence of leadership curricula, delivery format, student participation rates, and forms of recognition. Eighty-eight surveys were completed; the majority (85%) of respondents were associate or assistant deans for medical education. Approximately half (54.5%) of respondents reported leadership curricula within their medical schools. Of those, 34.8% (16/46) were required; 32.6% (15/46) were elective; and 32.6% (15/46) indicated both required and elective components. Of schools with formal leadership curricula ​(n = 48), the common forms of content delivery were: mentoring programs (65.1%); dual degree programs (54.5%); workshops (48.8%); seminar/lecture series (41.9%); courses (41.9%); or single seminars (18.6%). Nineteen percent of institutions offer longitudinal leadership education throughout medical school. Common forms of recognition for leadership education were: course credit (48.8%); dual degrees (37.2%); certificates of completion (18.6%); and transcript notations (7.0%). This study indicates that formal leadership education exists in more than half of US allopathic medical schools, suggesting it is an educational priority. Program format, student participation, delivery methods, and recognition varied considerably

  2. Development of physician leadership competencies: perceptions of physician leaders, physician educators and medical students.

    McKenna, Mindi K; Gartland, Myles P; Pugno, Perry A

    2004-01-01

    Research regarding the development of healthcare leadership competencies is widely available. However, minimal research has been published regarding the development of physician leadership competencies, despite growing recognition in recent years of the important need for effective physician leadership. Usingdata from an electronically distributed, self-administered survey, the authors examined the perceptions held by 110 physician leaders, physician educators, and medical students regarding the extent to which nine competencies are important for effective physician leadership, ten activities are indicative of physician leadership, and seven methods are effective for the development of physician leadership competencies. Results indicated that "interpersonal and communication skills" and "professional ethics and social responsibility" are perceived as the most important competencies for effective physician leadership. Furthermore, respondents believe "influencing peers to adopt new approaches in medicine" and "administrative responsibility in a healthcare organization" are the activities most indicative of effective physician leadership. Finally, respondents perceive"coaching or mentoring from an experienced leader" and "on-job experience (e.g., a management position)" as the most effective methods for developing physician leadership competencies. The implications of these findings for the education and development of physician leaders are discussed.

  3. A medical student leadership course led to teamwork, advocacy, and mindfulness.

    Warde, Carole M; Vermillion, Michelle; Uijtdehaage, Sebastian

    2014-06-01

    Many medical trainees seek work among underserved communities but may be unprepared to cope with the challenges. Relationship-centered qualities have been shown to promote physician resilience and prevent burnout. The UCLA-PRIME program aims to prepare medical students to work among vulnerable groups and begins with a 3-week leadership course. We describe this course and share lessons with those seeking to foster leadership, advocacy, and resiliency in our future physician workforce. Twenty students participated in our curriculum that emphasized five competencies: leadership, advocacy, teamwork, mindfulness, and self-care. Course activities complemented the students' work as they developed a community outreach project. They assessed and reflected on their leadership, relationship, and team behaviors, were coached to improve these, learned mindfulness meditation, and participated in community forums. Our evaluation assessed course quality, project completion, leadership, mindfulness, and team relational coordination. Students were very satisfied with all aspects of the course. They designed a medical student elective addressing the health challenges of an incarcerated and formerly incarcerated population. While we found no change in leadership practices scores, students had high team relational coordination scores and improved mindfulness scores upon course completion. Our course to develop medical students as resilient leaders, team members, and advocates for medically underserved groups consisted of a community-based service project, coupled with a facilitated relationship-centered curriculum. It promoted qualities in students that characterize effective and resilient physician leaders; they were more mindful, related to each other effectively, and coordinated their activities well with one another.

  4. The relationship between managers' leadership styles and emergency medical technicians' job satisfaction.

    Ghorbanian, Azimeh; Bahadori, Mohammadkarim; Nejati, Mostafa

    2012-01-01

    Leadership plays a crucial role in many professions, especially in challenging positions such as emergency medical service jobs. The purpose of this study was to explore the relationship between managers' leadership styles and emergency medical technicians' job satisfaction. This is a descriptive and cross-sectional study that was carried out in 2010. The research population included 21 managers and 87 emergency medical technicians working in 23 stations in Isfahan city, Iran. The main tools used for data accumulation were the Multiple Leadership Questionnaire for evaluating leadership styles and the Job Descriptive Index for measuring job satisfaction levels. Also, the Pearson correlation analysis test was used to evaluate the relationship between leadership style and job satisfaction. Among both managers and technicians, the highest mean score related to the transformational management style, whereas the lowest mean score related to the laissez-faire management style. Moreover, a significant relationship (Pleadership styles and job satisfaction. However, no significant relationship was observed between the laissez-faire management style and job satisfaction. Considering the importance of job satisfaction in medical emergencies, it is recommended that health sector policy makers should provide the groundwork for implementing the transformational leadership style to enhance job satisfaction of the medical emergency staff.

  5. Unhappiness and dissatisfaction in doctors cannot be predicted by selectors from medical school application forms: A prospective, longitudinal study

    Ferguson E

    2005-12-01

    Full Text Available Abstract Background Personal statements and referees' reports are widely used on medical school application forms, particularly in the UK, to assess the suitability of candidates for a career in medicine. However there are few studies which assess the validity of such information for predicting unhappiness or dissatisfaction with a career in medicine. Here we combine data from a long-term prospective study of medical student selection and training, with an experimental approach in which a large number of assessors used a paired comparison technique to predict outcome. Methods Data from a large-scale prospective study of students applying to UK medical schools in 1990 were used to identify 40 pairs of doctors, matched by sex, for whom personal statements and referees' reports were available, and who in a 2002/3 follow-up study, one pair member was very satisfied and the other very dissatisfied with medicine as a career. In 2005, 96 assessors, who were experienced medical school selectors, doctors, medical students or psychology students, used information from the doctors' original applications to judge which member of each pair of doctors was the happier, more satisfied doctor. Results None of the groups of assessors were significantly different from chance expectations in using applicants' personal statements and the referees' reports to predict actual future satisfaction or dissatisfaction, the distribution being similar to binomial expectations. However judgements of pairs of application forms from pairs of doctors showed a non-binomial distribution, indicating consensus among assessors as to which doctor would be the happy doctor (although the consensus was wrong in half the cases. Assessors taking longer to do the task concurred more. Consensus judgements seem mainly to be based on referees' predictions of academic achievement (even though academic achievement is not actually a valid predictor of happiness or satisfaction. Conclusion

  6. Will the Traditional Health Practitioners Act (Act No 22, 2007 challenge the holy grails of South African medical doctors?

    Gabriel Louw

    2017-02-01

    Full Text Available Background The South African healthcare establishment is primarily managed and overseen by medical doctors. This powerbase was established over many years, especially after the early 1930s. World War II gave doctors the final approval to take this supervisory and sole decision-making role regarding healthcare training, practice models and other health workers in South Africa. This phenomenon led initially to doctors having a certain jurisdiction to set the pace and to make the rules. This jurisdiction became more comprehensive and extent with time in South Africa to include a collection of unique medical traditions, customs, privileges, habits, healthcare rights and empowerment as well as exclusive medical training and practice models to become known as the holy grails of the South African medical doctors. The power of these holy grails has become untouchable to anyone outside the medical domain. Since the 1980s, some powers vested in these holy grails have been lost to the allied health professions and to other insiders of the HPCSA brotherhood itself. The recognition of traditional healers by means of the Traditional Health Practitioners Act (Act No 22, 2007 seems to challenge these holy grails of medical doctors. This may also create internal conflict in the South African medical brotherhood that can cost medical doctors more ground. Aims The study aimed to determine if the Traditional Health Practitioners Act No 22 (2007 challenges the holy grails of South African medical doctors, subsequently affecting the long-established management and guardian system of the medical field within South Africa or the practice rights of medical doctors. Methods This is an exploratory and descriptive study that makes use of an historical approach by means of investigation and a literature review. The emphasis is on using current documentation like articles, books and newspapers as primary sources to reflect on the possible effect of the Traditional Health

  7. The study on the perceptions of radiological technologist in medical imaging equipment used by the oriental doctor

    Choi, Jae Ho; Kang, Gi Bong; Kim, Sang Hyun

    2017-01-01

    In order to examine how Radiological Technologists perceive the oriental doctor's use of Medical Imaging Equipment, surveys were conducted for the members of the Korean Radiological Technologists Association. The total number of respondents were 515 and 481, with 34 insincere responses removed caused of nonvalidated answer. The results of the analysis are as follows. Although there were no statistical significance in the difference in perception by location of residence, work place, and educational background, respondents with higher education showed a tendency to agree on the use of comprehensive medical imaging equipment, but tended to oppose the use of special medical imaging equipment. Differences in perception by gender showed a greater negative perception toward the oriental doctor's use of medical imaging equipment by women than men. In particular, women showed more negative tendency for oriental doctor's use of special medical imaging equipment such as MRI, CT, and ultrasound equipment compared to men, and this was statistically significant. The difference in perception by age showed that the oriental doctor's use of medical imaging equipment was negative in the 20∼30s, neutral in the 40∼50s, and positive in the 60s, which were statistically significant. The difference in perception by work experience showed that the longer the work experience was, the more positive it was toward oriental doctor's use of medical imaging equipment. Specifically, the most favorable tendency was found with work experience of more than 30 years, which was statistically significant. The results of this study revealed the Radiological Technologists' perceptions on the oriental doctor's use of Medical Imaging Equipment and this can contribute to the direction of public health promotion in the future

  8. The study on the perceptions of radiological technologist in medical imaging equipment used by the oriental doctor

    Choi, Jae Ho [Dept. of Radiological Technology, Ansan University, Ansan (Korea, Republic of); Kang, Gi Bong [Dept. of Radiology, Yonsei University College of Medicine, Seoul (Korea, Republic of); Kim, Sang Hyun [Dept. of Radiology, Shinhan University, Seongnam (Korea, Republic of); and others

    2017-03-15

    In order to examine how Radiological Technologists perceive the oriental doctor's use of Medical Imaging Equipment, surveys were conducted for the members of the Korean Radiological Technologists Association. The total number of respondents were 515 and 481, with 34 insincere responses removed caused of nonvalidated answer. The results of the analysis are as follows. Although there were no statistical significance in the difference in perception by location of residence, work place, and educational background, respondents with higher education showed a tendency to agree on the use of comprehensive medical imaging equipment, but tended to oppose the use of special medical imaging equipment. Differences in perception by gender showed a greater negative perception toward the oriental doctor's use of medical imaging equipment by women than men. In particular, women showed more negative tendency for oriental doctor's use of special medical imaging equipment such as MRI, CT, and ultrasound equipment compared to men, and this was statistically significant. The difference in perception by age showed that the oriental doctor's use of medical imaging equipment was negative in the 20∼30s, neutral in the 40∼50s, and positive in the 60s, which were statistically significant. The difference in perception by work experience showed that the longer the work experience was, the more positive it was toward oriental doctor's use of medical imaging equipment. Specifically, the most favorable tendency was found with work experience of more than 30 years, which was statistically significant. The results of this study revealed the Radiological Technologists' perceptions on the oriental doctor's use of Medical Imaging Equipment and this can contribute to the direction of public health promotion in the future.

  9. Training tomorrow's doctors to explain 'medically unexplained' physical symptoms: An examination of UK medical educators' views of barriers and solutions.

    Joyce, Emmeline; Cowing, Jennifer; Lazarus, Candice; Smith, Charlotte; Zenzuck, Victoria; Peters, Sarah

    2018-05-01

    Co-occuring physical symptoms, unexplained by organic pathology (known as Functional Syndromes, FS), are common and disabling presentations. However, FS is absent or inconsistently taught within undergraduate medical training. This study investigates the reasons for this and identifies potential solutions to improved implementation. Twenty-eight medical educators from thirteen different UK medical schools participated in semi-structured interviews. Thematic analysis proceeded iteratively, and in parallel with data production. Barriers to implementing FS training are beliefs about the complexity of FS, tutors' negative attitudes towards FS, and FS being perceived as a low priority for the curriculum. In parallel participants recognised FS as ubiquitous within medical practice and erroneously assumed it must be taught by someone. They recommended that students should learn about FS through managed exposure, but only if tutors' negative attitudes and behaviour are also addressed. Negative attitudes towards FS by educators prevents designing and delivering effective education on this common medical presentation. Whilst there is recognition of the need to implement FS training, recommendations are multifaceted. Increased liaison between students, patients and educators is necessary to develop more informed and effective teaching methods for trainee doctors about FS and in order to minimise the impact of the hidden curriculum. Crown Copyright © 2017. Published by Elsevier B.V. All rights reserved.

  10. Commentary: Interim leadership of academic departments at U.S. medical schools.

    Grigsby, R Kevin; Aber, Robert C; Quillen, David A

    2009-10-01

    Medical schools and teaching hospitals are experiencing more frequent turnover of department chairs. Loss of a department chair creates instability in the department and may have a negative effect on the organization at large. Interim leadership of academic departments is common, and interim chairs are expected to immediately demonstrate skills and leadership abilities. However, little is known about how persons are prepared to assume the interim chair role. Newer competencies for effective leadership include an understanding of the business of medicine, interpersonal and communication skills, the ability to deal with conflict and solve adaptive challenges, and the ability to build and work on teams. Medical schools and teaching hospitals need assistance to meet the unique training and support needs of persons serving as interim leaders. For example, the Association of American Medical Colleges and individual chair societies can develop programs to allow current chairs to reflect on their present positions and plan for the future. Formal leadership training, mentorship opportunities, and conscientious succession planning are good first steps in preparing to meet the needs of academic departments during transitions in leadership. Also, interim leadership experience may be useful as a means for "opening the door" to underrepresented persons, including women, and increasing the diversity of the leadership team.

  11. Doctor in the lead: balancing between two worlds

    Witman, Yolande; Smid, Gerhard A. C.; Meurs, Pauline L.; Willems, Dick L.

    2011-01-01

    The article examines the leadership of department heads in a university hospital in day-to-day practice. These 'doctors in the lead' bridge the medical and the management world in the hospital organization. They are better able to influence their colleagues' clinical activities than a non-medical

  12. Transformational leadership in nursing and medication safety education: a discussion paper.

    Vaismoradi, Mojtaba; Griffiths, Pauline; Turunen, Hannele; Jordan, Sue

    2016-10-01

    This paper discusses the application of transformational leadership to the teaching and learning of safe medication management. The prevalence of adverse drug events (ADEs) and medication-related hospitalisations (one hundred thousand each year in the USA) are of concern. This discussion is based on a narrative literature review and scrutiny of international nursing research to synthesise pedagogical strategies for the application of transformational leadership to teaching medication safety. The four elements relating transformational leadership to medication safety education are: 'Idealised influence' or role modelling, both actual and exemplary, 'Inspirational motivation' providing students with commitment to medication safety, 'Intellectual stimulation' encouraging students to value improvement and change, and 'Individualised consideration' of individual students' educational goals, practice development and patient outcomes. The model lends itself to experiential learning and a case-study approach to teaching, offering an opportunity to reduce nursing's theory-practice gap. Transformational leadership for medication safety education is characterised by a focus on the role of nurse educators and mentors in the development of students' abilities, creation of a supportive culture, and enhancement of students' creativity, motivation and ethical behaviour. This will prepare nursing graduates with the competencies necessary to be diligent about medication safety and the prevention of errors. Teaching medication safety through transformational leadership requires the close collaboration of educators, managers and policy makers. Investigation of strategies to reduced medication errors and consequent patient harm should include exploration of the application of transformational leadership to education and its impact on the number and severity of medication errors. © 2016 John Wiley & Sons Ltd.

  13. What Clinical Information Is Valuable to Doctors Using Mobile Electronic Medical Records and When?

    Kim, Junetae; Lee, Yura; Lim, Sanghee; Kim, Jeong Hoon; Lee, Byungtae; Lee, Jae-Ho

    2017-10-18

    There has been a lack of understanding on what types of specific clinical information are most valuable for doctors to access through mobile-based electronic medical records (m-EMRs) and when they access such information. Furthermore, it has not been clearly discussed why the value of such information is high. The goal of this study was to investigate the types of clinical information that are most valuable to doctors to access through an m-EMR and when such information is accessed. Since 2010, an m-EMR has been used in a tertiary hospital in Seoul, South Korea. The usage logs of the m-EMR by doctors were gathered from March to December 2015. Descriptive analyses were conducted to explore the overall usage patterns of the m-EMR. To assess the value of the clinical information provided, the usage patterns of both the m-EMR and a hospital information system (HIS) were compared on an hourly basis. The peak usage times of the m-EMR were defined as continuous intervals having normalized usage values that are greater than 0.5. The usage logs were processed as an indicator representing specific clinical information using factor analysis. Random intercept logistic regression was used to explore the type of clinical information that is frequently accessed during the peak usage times. A total of 524,929 usage logs from 653 doctors (229 professors, 161 fellows, and 263 residents; mean age: 37.55 years; males: 415 [63.6%]) were analyzed. The highest average number of m-EMR usage logs (897) was by medical residents, whereas the lowest (292) was by surgical residents. The usage amount for three menus, namely inpatient list (47,096), lab results (38,508), and investigation list (25,336), accounted for 60.1% of the peak time usage. The HIS was used most frequently during regular hours (9:00 AM to 5:00 PM). The peak usage time of the m-EMR was early in the morning (6:00 AM to 10:00 AM), and the use of the m-EMR from early evening (5:00 PM) to midnight was higher than during regular

  14. Inhaled medication for asthma management: evaluation of how asthma patients, medical students, and doctors use the different devices

    Muniz Janaína Barbosa

    2003-01-01

    Full Text Available Asthma results from a combination of three essential features: airflow obstruction, hyperresponsiveness of airways to endogenous or exogenous stimuli and inflammation. Inadequacy of the techniques to use different inhalation devices is one of the causes of therapeutic failure. The main purpose of this study was to evaluate how 20 medical students, 36 resident physicians of Internal Medicine/Pediatrics, and 40 asthma patients used three devices for inhalation therapy containing placebo. All patients were followed at the Pulmonary Outpatient Service of Botucatu Medical School and had been using inhaled medication for at least six months. The following devices were evaluated: metered dose inhalers (MDI, dry powder inhalers (DPI, and MDI attached to a spacer device. A single observer applied a protocol containing the main steps necessary to obtain a good inhaler technique to follow and grade the use of different devices. Health care professionals tested all three devices and patients tested only the device being used on their management. MDI was the device best known by doctors and patients. MDI use was associated with errors related to the coordination between inspiration and device activation. Failure to exhale completely before inhalation of the powder was the most frequent error observed with DPI use. In summary, patients did not receive precise instruction on how to use inhaled medication and health care professionals were not well prepared to adequately teach their patients.

  15. The law of doctoring: a study of the codification of medical professionalism.

    Fichter, Andrew

    2009-01-01

    This essay argues that the concept of professionalism as it appears in health law is undergoing transformation as the applicable common law doctrines are increasingly being superseded by statutes and regulations. The doctor-patient relationship is being subjected to new rules of conduct intended to affirm the rights not only of patients but also of society at large. The bilateral relationship between doctor and patient has in many respects been transformed into a triadic one in which the concerns of public, as consumer and payor, are increasingly taken into account. In many respects this change has been necessary and inevitable as medicine has become a more commercial enterprise; but the change has also put traditional notions of professionalism at risk. Where professionalism is adversely affected by the process of its codification, it is incumbent upon law and policy makers to be aware of the fact. To this end, this essay first undertakes to define medical professionalism as a legal construct, and then formulates an analytic method with which to determine when professionalism is implicated and whether it is adequately accommodated by the law. The definition of professionalism the author advances is informed by concepts established in the literature of sociology, which identifies four core attributes-functional specificity, trust, disinterestedness and self-regulation. Each of these attributes is examined in turn with reference to case law selected to identify the value in question and to illustrate the nature of the change resulting from its codification.

  16. Leadership

    Eagly, A. H.; Antonakis, J.

    2015-01-01

    In this chapter, we review leadership research, with special attention to the questions that psychologists have addressed. Our presentation emphasizes that the phenomena of leadership can be predicted by a wide range of situational, social, and individual differences factors. Although not organized into a single, coherent theory, these bodies of knowledge are sufficiently related that we are able to piece together a moderately cohesive picture of leadership. This emergent understanding derive...

  17. Leadership

    2003-04-07

    USAWC STRATEGY RESEARCH PROJECT LEADERSHIP by LIEUTENANT COLONEL RONALD D. JOHNSON United States Army Colonel David R. Brooks Project Advisor The...TITLE AND SUBTITLE Leadership Unclassified 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Johnson, Ronald D. ; Author... Leadership FORMAT: Strategy Research Project DATE: 07 April 2003 PAGES: 28 CLASSIFICATION: Unclassified This SRP shows that values and ethics are essential

  18. The sexual division of leadership in volunteer emergency medical service squads.

    Thompson, A M

    1995-01-01

    This article reports on theoretical and empirical research that explored the hypothesis that there is a sexual division of leadership in volunteer emergency medical service (EMS) squads. This hypothesis was tested against survey data obtained from 216 current members of nine upstate New York volunteer EMS squads. Despite several mitigating characteristics of these organizations, and despite the lack of supporting statistical evidence at the aggregate level of officership, the research found statistically significant confirmation of sex bias in officer selection when leadership was disaggregated into line and staff officer positions. Medical qualifications and length of EMS squad membership were also included in the model as determinants of leadership experience. These results are discussed relative to the question of the sexual division of leadership in the overarching nonprofit and voluntary sector of the U.S. economy.

  19. The hospital doctor in legislation and medical deontology: tension between profession and institution.

    Schutyser, K

    1998-01-01

    1. Every health policy should make clear the organization of its offer of care; also, more particularly, the role of the individual professionals and their groups, as well as the role of the services and institutions, all within the chosen private, public or mixed framework. 2. Both in public law and in private law as well as in deontology, clear rules will have to be formulated concerning the relationship of doctor-patient and institution-patient; therefore also concerning the relationship of hospital-doctor. 3. It is evident that the lack of clarity frequently encountered in the Belgian and many other national legal systems with respect to these matters is unfortunately also reflected in international health law. 4. The issue of the legal relationships in the patient-doctor-hospital triangle should no longer be delayed until the catastrophic moment when medical liability should be considered. 5. Can we indeed speak of integral quality of a hospital, when it is anything but clear whether it concerns a single integrated enterprise or a roof under which two or more enterprises or entrepreneurs organize their own separate services to the clients? 6. Although the decision is a societal matter, the organisations of institutions and professionals should (continue to) play an important role in the preparation of this debate, which must bring the necessary clarity to the present relations and preferably also about the future options with respect to these relations. 7. A fundamental question, which remains to be solved for the future health policy, appears to be whether hospitals can be integrated institutions and, in the affirmative, whether they should be so. 8. The law, with priority to deontology, should formulate basic rules to clarify all possibilities in the patient-hospital-doctor triangle relationship--which is evolving into a polygon through fusion and group practices--and especially to trace out the consequences of health policy options with regard to the

  20. Complementary and Alternative Medicine: Comparison of Current Knowledge, Attitudes and Interest among German Medical Students and Doctors

    Karsten Münstedt

    2011-01-01

    Full Text Available Although it has been agreed that complementary and alternative medicine (CAM should be included in the German medical curriculum, there is no consensus on which methods and how it should be taught. This study aimed to assess needs for CAM education by evaluating current knowledge, attitudes and interests of medical students, general physicians and gynecologists. Two instruments based on established and validated questionnaires were developed. One was given to seventh semester medical students and the other to office-based doctors. Data were analyzed by bivariate correlation and cross-tabulation. Altogether 550 questionnaires were distributed—280 to doctors and 270 to medical students. Completed questionnaires were returned by 80.4% of students and 78.2% of doctors. Although 73.8% (160/219 of doctors and 40% (87/217 of students had already informed themselves about CAM, neither group felt that they knew much about CAM. Doctors believed that CAM was most useful in general medicine, supportive oncology, pediatrics, dermatology and gynecology, while students believed that dermatology, general medicine, psychiatry and rheumatology offered opportunities; both recommended that CAM should be taught in these areas. Both groups believed that CAM should be included in medical education; however, they believed that CAM needed more investigation and should be taught “critically". German doctors and students would like to be better informed about CAM. An approach which teaches fundamental competences to students, chooses specific content based on evidence, demographics and medical conditions and provides students with the skills they need for future learning should be adopted.

  1. Nuclear risk: information of medical practitioners in Isere Department. Impact of the booklet: 'doctors and nuclear risk'

    Jonquet, M.E.

    1990-02-01

    In this thesis, the author first presents 'Isere, pilot department' operation, then the importance of nuclear risks in Isere, considers the role and place of medical practitioners in the management of this risk and in information request of medical personnel. The author also presents the booklet 'Doctors and nuclear risk' and analyzes the results of study on its impact close to medical population. 9 tabs., 25 figs

  2. Why do doctors emigrate from Sri Lanka? A survey of medical undergraduates and new graduates.

    de Silva, Nipun Lakshitha; Samarasekara, Keshinie; Rodrigo, Chaturaka; Samarakoon, Lasitha; Fernando, Sumadhya Deepika; Rajapakse, Senaka

    2014-12-16

    Migration of medical professionals is a long recognized problem in Sri Lanka, but it has not been studied in depth. Undergraduate and postgraduate medical education in Sri Lanka is state sponsored, and loss of trained personnel is a loss of investment. This study assessed the intention to migrate among medical students and newly passed out graduates from the largest medical school in Sri Lanka. A cross sectional descriptive study was conducted in the Faculty of Medicine, University of Colombo in September 2013 with the participation of first and fourth year medical students and pre-intern medical graduates. Data was collected using a self administered, pre-tested questionnaire that collected data on socio-demographic details, intention to migrate and factors influencing a decision for or against migration. There were 374 respondents, 162 from first year (females; 104, 64.2%), 159 from fourth year (females; 85, 53.5%) and 53 pre interns (females; 22, 41.5%). Of the entire sample, 89 (23.8%) had already decided to migrate while another 121 (32.3%) were not sure of their decision. The most cited reasons for migration were a perceived better quality of life, better earnings and more training opportunities in the host country. There were no socio-demographic characteristics that had a significant association with the intention to migrate, indicating that it is a highly individualized decision. The rate of intention to migrate in this sample is low when compared to international studies from Africa and South Asia, but is still significant. The core reasons which prompt doctors to migrate should be addressed by a multipronged approach to prevent brain drain.

  3. The study of knowledge, attitude and practice of medical law and ethics among doctors in a tertiary care hospital

    Tahira, Q.U.A.; Lodhi, S.; Haider, S.T.; Abaidullah, S.

    2013-01-01

    Objective: To assess the knowledge, attitude and practice regarding medical law and ethics among doctors of a medical unit in a tertiary care teaching hospital in Lahore. Study Design: Descriptive cross sectional study. Methodology: A three part self - administered structured questionnaire designed to test the knowledge and practices regarding medical law and ethics was distributed among doctors in a medical unit in Mayo Hospital, Lahore during September - October, 2012. Results: The 52 respondent doctors included in the study comprised of 20 (38.5%) house officers, 22 (42.3%) postgraduate residents and 10 (19.2%) consultants. In keeping with the Pakistan Medical and Den-tal Council code of ethics, the correct responses of house officers, postgraduate residents and consultants regarding knowledge of medical law and ethics were respectively 50%, 27.3% and 10% for patient's autonomy, 40%, 36.4% and 10% for adhering to patient's wishes, 10%, 63.6% and 50% for breaching confidentiality, 35%, 36.4% and 0% for informed consent, 10%, 22.7% and 10% for doing best regardless of patient's opinion, 5%, 31.8% and 10% for informing patient's relatives, 15%, 4.5% and 0% for treating violent patients. The practical application part of the questionnaire was a general reflection of the knowledge and attitudes. Conclusion: Most of the doctors were poorly acquainted with PMDC code of ethics. (author)

  4. Medical doctors and complementary and alternative medicine: the context of holistic practice.

    Winnick, Terri A

    2006-04-01

    Consumers, health care financing, external and internal competition are factors identified in the medical literature as prompting change within medicine. I test these factors to determine if they also prompt regular doctors to define themselves as 'holistic MDs' and align themselves with complementary and alternative medicine (CAM). State-level regression analyses on the number of MDs advertising in referral directories for CAM therapies find holistic practice a function of practice locale. The proportion of holistic MDs increases in states with an older population, where more patients survive despite serious disabilities, and where non-physician providers pose a competitive threat. Consumer demand, specialization and licensing do not significantly influence adoption of CAM treatments in these analyses. Health care financing has disparate effects. Indemnity insurance constrains holistic practice while HMO penetration enhances it. These results suggest that holistic practice may be an integral part of the regular profession's ongoing professionalization project.

  5. [Concept and applications of the Web 3.0: an introduction for medical doctors].

    Mayer, Miguel Angel; Leis, Angela

    2010-05-01

    The development of the Internet is continuous and appears to be never-ending, although with the arrival of Web 3.0 it could be said that the Internet is what its creators intended it to be from the first moment, an extraordinary and immense organised, understandable, and easy to access data base, characteristics still not achieved. The innovations and services included in Web 3.0 will result, in the first place, in better, faster and safer access to quality information. In the second place it should provide better personalisation of the health services that Internet users access, avoiding irrelevant information that may contain wrong, false and dangerous recommendations. However, these changes will have to be accompanied by the legal requirements common to the information society, by the ethical aspects associated with medical care, guaranteeing and contributing, in all cases, to improving the doctor-patient relationship. Copyright 2009 Elsevier España, S.L. All rights reserved.

  6. Goleman?s Leadership styles at different hierarchical levels in medical education

    Saxena, Anurag; Desanghere, Loni; Stobart, Kent; Walker, Keith

    2017-01-01

    Background With current emphasis on leadership in medicine, this study explores Goleman?s leadership styles of medical education leaders at different hierarchical levels and gain insight into factors that contribute to the appropriateness of practices. Methods Forty two leaders (28 first-level with limited formal authority, eight middle-level with wider program responsibility and six senior- level with higher organizational authority) rank ordered their preferred Goleman?s styles and provided...

  7. Educating doctors in the clinical workplace: Unraveling the process of teaching and learning in the medical resident as teacher

    Busari J

    2009-01-01

    Full Text Available In recent years, higher medical education has witnessed major changes in the structure and content of postgraduate medical training. Seven professional competencies have been described that address the medical doctors′ ability to effectively communicate and transfer medical information, interact effectively and professionally, and demonstrate a good grasp of clinical knowledge and skills. Proficiency in didactic skills, however, is an important competency that has not received prominent attention. In the clinical setting, attending-physicians and medical residents are responsible for teaching. Consequently, several medical institutions have proposed the need for teacher training programs to improve the teaching skills of attending doctors and medical residents. The supporters of these programs believe that through teaching, medical doctors improve their individual professional and clinical problem-solving abilities. Hence, it is logical to assume that didactic skills′ training would contribute to the professional development of doctors. In this paper, we re-examine the underlying theory of the didactic proficiency, how it relates to the clinical setting, and why it may be beneficial for the professional training of medical residents.

  8. Gestational diabetes mellitus: Confusion among medical doctors caused by multiple international criteria.

    Agarwal, Mukesh M; Shah, Syed M; Al Kaabi, Juma; Saquib, Shabnam; Othman, Yusra

    2015-06-01

    The aim of this study was to appraise the current regional practices of screening, diagnosis and follow-up of gestational diabetes mellitus (GDM) because the approach to GDM is frequently inconsistent. A 21-item questionnaire was distributed to physicians taking care of pregnant women in seven hospitals in the United Arab Emirates and one hospital in Oman. Besides assessing their attitudes towards testing for GDM, the questionnaire assessed familiarity with the Hyperglycemia and Pregnancy Outcome study and the International Association of Diabetes in Pregnancy Study Groups GDM guidelines. One hundred and forty-eight (93%) of the 159 questionnaires distributed to the medical doctors (106 [72%] obstetricians and 42 [28%] internists) were returned. For GDM screening, six hospitals used five different tests; two hospitals utilized one single test. For GDM diagnosis, six hospitals employed the 2-h, 75-g oral glucose tolerance test (OGTT) (four different criteria) while two hospitals used the 3-h, 100-g OGTT (single criteria). For post-delivery follow-up, the 2-h, 75-g OGTT and fasting plasma glucose were accepted by 103 (70%) and 38 (26%) of the 148 medical doctors, respectively. Ninety-eight (69%) of 143 responding physicians were aware of the Hyperglycemia and Pregnancy Outcome study, while 85 (61%) of 140 responders were familiar with the guidelines of the International Association of Diabetes in Pregnancy Study Groups; this knowledge was independent of specialty, seniority, academia, years in practice or country trained. Although this study is parochial, its implications are global; that is, further education of caregivers would make the discordant approach to GDM (within and between hospitals) more harmonious and improve the obstetric care of pregnant women. © 2014 The Authors. Journal of Obstetrics and Gynaecology Research © 2014 Japan Society of Obstetrics and Gynecology.

  9. Prevalence of orthorexia nervosa in resident medical doctors in the faculty of medicine (Ankara, Turkey).

    Bağci Bosi, A Tülay; Camur, Derya; Güler, Cağatay

    2007-11-01

    This study has been carried out to "identify highly sensitive behavior on healthy nutrition (orthorexia nervosa-ON)" in residence medical doctors (MD) in the Faculty of Medicine. Diagnoses of ON was based on the presence of a disorder with obsessive-compulsive personality. The study is a cross-sectional research, which reached out to the entire 318 MD. The ORTO-15 test was used to propose a diagnostic proceeding and to try verify the prevalence of ON. Those subjects who were classified below 40 from the ORTO-15 test are accepted to have ON. Chi-square test, ANOVA (univariate) analysis and logistic regression were used for analyses of the data. Mean score of the participants from the ORTO-15 test is 39.8+/-0.22, and there is no statistical difference between women and men. A total of 45.5% of the residence MD involved in the research scored below 40 in the ORTO-15 test. Those who do their food shopping themselves, skip a meal with a salad/fruit, care about the quality of the things they eat, think that eating outside is healthy, look at the content of what they eat and the content of food is important in selection of a product score lower in their average marks in ORTO-15 and the difference among the groups is statistically significant. Food selection of 20.1% of the male participants and 38.9% of the female participants among the residence MD is influenced by the programs on nutrition/health in mass-media. The difference between the groups is statistically significant (p<0.05). Female medical doctors are more careful than men of their physical appearance and weight control and consume less caloric food, which is statistically significant. Since those who exhibit "healthy fanatic" eating habits may have a risk of ON in the future, it would be useful to conduct studies that identify the prevalence of ON in the public.

  10. From Here and Now to Infinity and Eternity: A Message to New Medical Doctors*

    Lapeña, José Florencio F.

    2014-01-01

    Commencement means both an end and a beginning; the end of the academic year and the beginning of the rest of your life as new physicians. For such a beginning, it is useful to view it in retrospect, from the point of view of the end, by conducting a pre-mortem on your life. Taking the existentialist (ex sistere, to stand forth) stance, each of us can be classified into one of four basic types of person, based on our characteristic space and time (or spatio-temporal) context or horizon. Our space can be limited to the “here” and our time to the “now;” or our space may extend to “infinity” and our time embark on “eternity.” In-between these poles, most have space contexts rooted in their home and work “turf” and time involving their “lifetime,” while some expand their space to include the “world” and their time to encompass “history.” From the “here and now” and “turf and lifetime” contexts, the horizons of “world and history,” and “infinity and eternity” are examined, challenging new medical doctors to realize their full potential. The new physician is exhorted not to wait for a post-mortem to define (des finitus, to set limits) his or her life. He or she should stand forth, to live, and give life. The new medical doctor is encouraged to look to the sunrise, draw strength from the sunshine, to be brave, and strong and true. PMID:24891804

  11. Clinical leadership development in postgraduate medical education and training: policy, strategy, and delivery in the UK National Health Service

    Aggarwal R

    2015-11-01

    Full Text Available Reena Aggarwal,1,2 Tim Swanwick2 1Women's Health, Whittington Health, London, UK; 2Health Education England, North Central and East London, London, UK Abstract: Achieving high quality health care against a background of continual change, increasing demand, and shrinking financial resource is a major challenge. However, there is significant international evidence that when clinicians use their voices and values to engage with system delivery, operational efficiency and care outcomes are improved. In the UK National Health Service, the traditional divide between doctors and managers is being bridged, as clinical leadership is now foregrounded as an important organizational priority. There are 60,000 doctors in postgraduate training (junior doctors in the UK who provide the majority of front-line patient care and form an "operating core" of most health care organizations. This group of doctors is therefore seen as an important resource in initiating, championing, and delivering improvement in the quality of patient care. This paper provides a brief overview of leadership theories and constructs that have been used to develop a raft of interventions to develop leadership capability among junior doctors. We explore some of the approaches used, including competency frameworks, talent management, shared learning, clinical fellowships, and quality improvement. A new paradigm is identified as necessary to make a difference at a local level, which moves learning and leadership away from developing "leaders", to a more inclusive model of developing relationships between individuals within organizations. This shifts the emphasis from the development of a "heroic" individual leader to a more distributed model, where organizations are "leader-ful" and not just "well led" and leadership is centered on a shared vision owned by whole teams working on the frontline. Keywords: National Health Service, junior doctors, quality improvement, management, health care

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

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

    2016-09-01

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

  13. Leadership

    anonymous

    2001-01-01

    Leadership in a community of 30,000 offers lessons to all of us on vision, responsibility and character. See how the leaders of Garden City, Kansas deal with challenges that many communities face. This issue also provides information about leadership and Community Affairs resources.

  14. Level, pattern, and determinants of polypharmacy and inappropriate use of medications by village doctors in a rural area of Bangladesh

    Rasu RS

    2014-12-01

    Full Text Available Rafia S Rasu,1 Mohammad Iqbal,2 SMA Hanifi,2 Ariful Moula2 Shahidul Hoque,2 Sabrina Rasheed,2 Abbas Bhuiya2 1School of Pharmacy, University of Missouri-Kansas City, Kansas City, MO, USA; 2Centre for Equity and Health System, International Centre for Diarrhoeal Disease Research (ICDDR,B, Dhaka, Bangladesh Objective: Village doctors, informal health care providers practicing modern medicine, are dominant health care providers in rural Bangladesh. Given their role, it is important to examine their prescription pattern and inappropriate use of medication. Methods: These cross-sectional study data were collected through surveys of patients seen by village doctors during 2008 and 2010 at Chakaria, a typical rural area of Bangladesh. Categorization of appropriate, inappropriate, and harmful prescriptions by disease conditions was based on guidelines defined by the World Health Organization (WHO, the United Nations Children’s Fund (UNICEF, and the Government of Bangladesh. Analytical categorization of polypharmacy was defined when five or more medications were prescribed for a patient at a single visit. Findings: A total of 2,587 prescriptions were written by village doctors during the survey periods. Among the prescriptions were appropriate (10%, inappropriate (8%, combination of appropriate and inappropriate (63%, and harmful medications (19%. Village doctors with more than high school education were 53% less likely (odds ratio [OR]: 0.47, 95% confidence interval [CI]: 0.26–0.86 to give polypharmacy prescriptions than those with less than high school education. While exploring determinants of prescribing inappropriate and harmful medications, this study found that polypharmacy prescriptions were six times more likely [OR: 6.00, 95% CI: 3.88–9.29] to have harmful medications than prescriptions with <5 medications. Conclusion: Village doctors’ training and supervision may improve the quality of services and establish accountability for the

  15. Intellectual disability health content within medical curriculum: an audit of what our future doctors are taught.

    Trollor, Julian N; Ruffell, Beth; Tracy, Jane; Torr, Jennifer J; Durvasula, Seeta; Iacono, Teresa; Eagleson, Claire; Lennox, Nicolas

    2016-04-11

    of content. There is a mismatch between the considerable unmet health needs of people with intellectual disability and the inconsistent teaching within medical schools. Future doctors will be better equipped to support the health and wellbeing of people with intellectual disability if curricula are enhanced in this area.

  16. Reasons and remedies for under-representation of women in medical leadership roles: a qualitative study from Australia.

    Bismark, Marie; Morris, Jennifer; Thomas, Laura; Loh, Erwin; Phelps, Grant; Dickinson, Helen

    2015-11-16

    To elicit medical leaders' views on reasons and remedies for the under-representation of women in medical leadership roles. Qualitative study using semistructured interviews with medical practitioners who work in medical leadership roles. Interviews were transcribed verbatim and transcripts were analysed using thematic analysis. Public hospitals, private healthcare providers, professional colleges and associations and government organisations in Australia. 30 medical practitioners who hold formal medical leadership roles. Despite dramatic increases in the entry of women into medicine in Australia, there remains a gross under-representation of women in formal, high-level medical leadership positions. The male-dominated nature of medical leadership in Australia was widely recognised by interviewees. A small number of interviewees viewed gender disparities in leadership roles as a 'natural' result of women's childrearing responsibilities. However, most interviewees believed that preventable gender-related barriers were impeding women's ability to achieve and thrive in medical leadership roles. Interviewees identified a range of potential barriers across three broad domains-perceptions of capability, capacity and credibility. As a counter to these, interviewees pointed to a range of benefits of women adopting these roles, and proposed a range of interventions that would support more women entering formal medical leadership roles. While women make up more than half of medical graduates in Australia today, significant barriers restrict their entry into formal medical leadership roles. These constraints have internalised, interpersonal and structural elements that can be addressed through a range of strategies for advancing the role of women in medical leadership. These findings have implications for individual medical practitioners and health services, as well as professional colleges and associations. Published by the BMJ Publishing Group Limited. For permission to use

  17. 'Multiple-test' approach to the laboratory diagnosis of tuberculosis -perception of medical doctors from Ujjain, India.

    Purohit, Manju Raj; Sharma, Megha; Rosales-Klintz, Senia; Lundborg, Cecilia Stålsby

    2015-08-11

    Delay in diagnosis is one of the most important factors for the control of tuberculosis (TB) in endemic countries like India. As laboratory diagnosis is the mainstay for identification of active disease, we aim to explore and understand the opinions of medical doctors about the laboratory diagnosis of TB in Ujjain, India. Sixteen qualified specialist medical doctors from Ujjain were purposefully selected for the study. Individual interviews with the doctors (13 men and 3 women), were conducted. As one interview could not be completed, data from 15 interviews were analyzed using manifest and latent content analysis. Based on perception of the doctors, the theme; 'challenges and need for the laboratory diagnosis of TB' emerged from the following subthemes: (i) Relationship between basic element of the TB diseases process such as 'Symptoms prior to diagnoses' and 'Clinical characteristics of TB', which were not specific enough to diagnose TB (ii) The prevailing conditions such as lack of explicit diagnostic tools, lead to the doctors using the 'multiple tests' or 'empiric treatment' approach (iii) The doctors proposed that there is a need for access to a rapid, single and simple diagnostic test, and a need for awareness and knowledge of the practitioners regarding specific TB investigations, and early referral to improve the situation at resource-limited settings. The medical specialists use a 'multiple test' or 'empiric treatment' approach to diagnose TB. According to the participants, there is a low dependence and uptake of the available laboratory TB investigations by medical practitioners. There is an urgent need to have a specific, simple and reliable test, and a protocol, to improve diagnosis of TB and to prevent development of resistant TB.

  18. Medical emergencies on large passenger ships without doctors: the Oslo-Kiel-Oslo ferry experience.

    Holt, Thor-Erik; Tveten, Agnar; Dahl, Eilif

    2017-01-01

    The Oslo-Kiel-Oslo route is currently the only direct ferry crossing between Norway and Germany, covered by 2 cruise-and-cars ferries carrying about 2,600 passengers each and sailing every day (20 h at sea, 4 h in port). Unlike most ocean going cruise vessels, they are not required to carry a physician but an on-board paramedic handles medical emergencies. The aim of the study was to provide data on medical emergencies leading to helicopter evacuations (helivacs) or other urgent transfers to facilities ashore from the two ferries during a 3-year period. Data about the ferries, passengers, crew, helivacs and other medical transfers were collected from official company statistics and the paramedics' transfer reports. A total of 169 persons, including 14 (8.3%) crewmembers, were transferred from the ferries to land-based facilities by ambulance while alongside (n = 80; 47.3%) or evacuated by helicopter (n = 85; 50.3%) and rescue boat (n = 4; 2.4%) during the 3-year period. Transfer destinations were Denmark (n = 53), Germany (n = 49), Norway (n = 48) and Sweden (n = 19). The passenger helivac rate was 2.4 per 100,000 passenger-days. One person was airlifted from a ferry every 2 weeks. Among helivacs, 40% were heart-related, and more cardiac cases were airlifted than transferred by ambulance in port. All helivac requests were made after discussion between the ferry's paramedic and telemedical doctors ashore and agreement that the medical challenge exceeded the ferry's capability. This close cooperation kept the threshold for arranging helivacs from the ferries low, enabling short transport times to land-based facilities for critically ill patients. Further studies, including feedback from the receiving hospitals, are needed to determine measures that can reduce possible helicopter overutilisation without compromising patient safety and outcome.

  19. Leadership development in a professional medical society using 360-degree survey feedback to assess emotional intelligence.

    Gregory, Paul J; Robbins, Benjamin; Schwaitzberg, Steven D; Harmon, Larry

    2017-09-01

    The current research evaluated the potential utility of a 360-degree survey feedback program for measuring leadership quality in potential committee leaders of a professional medical association (PMA). Emotional intelligence as measured by the extent to which self-other agreement existed in the 360-degree survey ratings was explored as a key predictor of leadership quality in the potential leaders. A non-experimental correlational survey design was implemented to assess the variation in leadership quality scores across the sample of potential leaders. A total of 63 of 86 (76%) of those invited to participate did so. All potential leaders received feedback from PMA Leadership, PMA Colleagues, and PMA Staff and were asked to complete self-ratings regarding their behavior. Analyses of variance revealed a consistent pattern of results as Under-Estimators and Accurate Estimators-Favorable were rated significantly higher than Over-Estimators in several leadership behaviors. Emotional intelligence as conceptualized in this study was positively related to overall performance ratings of potential leaders. The ever-increasing roles and potential responsibilities for PMAs suggest that these organizations should consider multisource performance reviews as these potential future PMA executives rise through their organizations to assume leadership positions with profound potential impact on healthcare. The current findings support the notion that potential leaders who demonstrated a humble pattern or an accurate pattern of self-rating scored significantly higher in their leadership, teamwork, and interpersonal/communication skills than those with an aggrandizing self-rating.

  20. Medical Device Plug-and-Play Interoperability Standards and Technology Leadership

    2017-10-01

    Award Number: W81XWH-09-1-0705 TITLE: “Medical Device Plug-and-Play Interoperability Standards and Technology Leadership” PRINCIPAL INVESTIGATOR...Sept 2016 – 20 Sept 2017 4. TITLE AND SUBTITLE “Medical Device Plug-and-Play Interoperability 5a. CONTRACT NUMBER Standards and Technology ...efficiency through interoperable medical technologies . We played a leadership role on interoperability safety standards (AAMI, AAMI/UL Joint

  1. Combining a leadership course and multi-source feedback has no effect on leadership skills of leaders in postgraduate medical education. An intervention study with a control group

    Malling, Bente; Mortensen, Lene; Bonderup, Thomas

    2009-01-01

    regarding development of leadership skills over time. METHODS: Study participants were consultants responsible for postgraduate medical education at clinical departments. STUDY DESIGN: pre-post measures with an intervention and control group. The intervention was participation in a seven-day leadership...... of variances. RESULTS: There were no differences in multi-source feedback scores at one year follow up compared to baseline measurements, either in the intervention or in the control group (p = 0.149). CONCLUSION: The study indicates that a leadership course following a MSF procedure compared to MSF alone does...... not improve leadership skills of consultants responsible for education in clinical departments. Developing leadership skills takes time and the time frame of one year might have been too short to show improvement in leadership skills of consultants responsible for education. Further studies are needed...

  2. [Continuous medical education of general practitioners/family doctors in chronic wound care].

    Sinozić, Tamara; Kovacević, Jadranka

    2014-10-01

    A number of healthcare professionals, specialists in different fields and with different levels of education, as well as non-healthcare professionals, are involved in the care of chronic wound patients, thus forming a multidisciplinary team that is not only responsible for the course and outcome of treatment, but also for the patient quality of life. Family doctor is also member of the team the task of which is to prevent, diagnose, monitor and anticipate complications and relapses, as well as complete recovery of chronic wound patients, with the overall care continuing even after the wound has healed, or is involved in palliative care. A family medicine practitioner with specialized education and their team of associates in the primary health care, along with material conditions and equipment improvement, can provide quality care for patients with peripheral cardiovascular diseases and chronic wounds, organized according to the holistic approach. It is essential that all professional associations of family medicine as well as professional associations of other specialties - fields that are involved in wound prevention and treatment - be included in developing the continuous medical education program. The benefits of modern information technology should be used to good advantage. The education should be adapted to the needs of family practitioners in terms of the form, place, time, volume, financial affordability and choice of topic. The interest shown in team education should be transformed into specialized programs in the creation of which it is essential to include both physicians and nurses and their respective professional associations. Special attention should be paid to education and training of young doctors/nurses, those with less work experience, those that have not yet been part of such education, those that lack experience in working with wound patients, those whose teams deal mostly with elderly patients, and also residents in family medicine and

  3. The current shortage and future surplus of doctors: a projection of the future growth of the Japanese medical workforce.

    Takata, Hideaki; Nagata, Hiroshi; Nogawa, Hiroki; Tanaka, Hiroshi

    2011-05-27

    Starting in the late 1980s, the Japanese government decreased the number of students accepted into medical school each year in order to reduce healthcare spending. The result of this policy is a serious shortage of doctors in Japan today, which has become a social problem in recent years. In an attempt to solve this problem, the Japanese government decided in 2007 to increase the medical student quota from 7625 to 8848. Furthermore, the Democratic Party of Japan (DPJ), Japan's ruling party after the 2009 election, promised in their manifesto to increase the medical student quota to 1.5 times what it was in 2007, in order to raise the number of medical doctors to more than 3.0 per 1000 persons. It should be noted, however, that this rapid increase in the medical student quota may bring about a serious doctor surplus in the future, especially because the population of Japan is decreasing.The purpose of this research is to project the future growth of the Japanese medical doctor workforce from 2008 to 2050 and to forecast whether the proposed additional increase in the student quota will cause a doctor surplus. Simulation modeling of the Japanese medical workforce. Even if the additional increase in the medical student quota promised by the DPJ fails, the number of practitioners is projected to increase from 286 699 (2.25 per 1000 persons) in 2008 to 365 533 (over the national numerical goal of 3.0 per 1000) in 2024. The number of practitioners per 1000 persons is projected to further increase to 3.10 in 2025, to 3.71 in 2035, and to 4.69 in 2050. If the additional increase in the medical student quota promised by the DPJ is realized, the total workforce is projected to rise to 392 331 (3.29 per 1000 persons) in 2025, 464 296 (4.20 per 1,000 persons) in 2035, and 545 230 (5.73 per 1000 persons) in 2050. The plan to increase the medical student quota will bring about a serious doctor surplus in the long run.

  4. Newly qualified doctors' views on the significance and accessibility of career advice during medical training in Saudi Arabia

    Mehmood, Syed Imran; Norcini, John J.; Borleffs, Jan C. C.

    2013-01-01

    Background: Career advice is an important instrument to help students with the proper specialty selection. The study aims (1) to explore the views of newly graduated doctors in Saudi Arabia about their experience with the current status of career support system during medical training and (2) to

  5. [The Ethics and Deontology division of the French National Council of Medical Doctors, eight years of activity, 1993-2001].

    Hoerni, Bernard

    2011-01-01

    The activity of the division of Ethics and deontology of the French National council of medical doctors is analysed by its former president (1993-2001). Among a lot of topics, a new version of the professionnal Code of deontology and patients' information were the main subjects of reflection and action.

  6. Finger Pricks and Blood Vials: How doctors medicalize 'cultural' solutions to demedicalize the 'broken' hymen in the Netherlands.

    Ayuandini, Sherria

    2017-03-01

    This paper provides new perspectives on the scholarship on medicalization and demedicalization, building on an ethnography of hymenoplasty consultations in the Netherlands. By examining how doctors can play an active role in demedicalization, this paper presents novel insights into Dutch physicians' attempt to demedicalize the "broken" hymen. In their consultations, Dutch doctors persuade hymenoplasty patients to abandon the assumed medical definition of the "broken" hymen and offer nonmedical solutions to patients' problems. Drawing from unique ethnographical access from 2012 to 2015 to 70 hymenoplasty consultations in the Netherlands, this paper's original contribution comes from closely examining how demedicalization can be achieved through the process of medicalization. It investigates how Dutch physicians go even further in their efforts to demedicalize by medicalizing "cultural" solutions as an alternative course of action to surgery. Copyright © 2017 Elsevier Ltd. All rights reserved.

  7. Impact of Electronic Medical Record Use on the Patient-Doctor Relationship and Communication: A Systematic Review.

    Alkureishi, Maria Alcocer; Lee, Wei Wei; Lyons, Maureen; Press, Valerie G; Imam, Sara; Nkansah-Amankra, Akua; Werner, Deb; Arora, Vineet M

    2016-05-01

    While Electronic Medical Record (EMR) use has increased dramatically, the EMR's impact on the patient-doctor relationship remains unclear. This systematic literature review sought to understand the impact of EMR use on patient-doctor relationships and communication. Parallel searches in Ovid MEDLINE, PubMed, Scopus, PsycINFO, Cochrane Library, reference review of prior systematic reviews, meeting abstract reviews, and expert reviews from August 2013 to March 2015 were conducted. Medical Subject Heading terms related to EMR use were combined with keyword terms identifying face-to-face patient-doctor communication. English language observational or interventional studies (1995-2015) were included. Studies examining physician attitudes only were excluded. Structured data extraction compared study population, design, data collection method, and outcomes. Fifty-three of 7445 studies reviewed met inclusion criteria. Included studies used behavioral analysis (28) to objectively measure communication behaviors using video or direct observation and pre-post or cross-sectional surveys to examine patient perceptions (25). Objective studies reported EMR communication behaviors that were both potentially negative (i.e., interrupted speech, low rates of screen sharing) and positive (i.e., facilitating questions). Studies examining overall patient perceptions of satisfaction, communication or the patient-doctor relationship (n = 22) reported no change with EMR use (16); a positive impact (5) or showed mixed results (1). Study quality was not assessable. Small sample sizes limited generalizability. Publication bias may limit findings. Despite objective evidence that EMR use may negatively impact patient-doctor communication, studies examining patient perceptions found no change in patient satisfaction or patient-doctor communication. Therefore, our findings should encourage providers to adopt the EMR as a communication tool. Future research is needed to better understand how

  8. Leadership theory and motivation of medical imaging employees.

    Kalar, Traci; Wright, Donna Lee

    2007-01-01

    *This literature review explores how transactional, transformational, and charismatic leadership theories might be applied in a typical stressful hypothetical department situation. *Transactional department leaders motivate employees using extrinsic rewards, encouraging them to do what is needed to get the minimal results with no encouragement for higher levels of thinking. *Transformational department leaders motivate employees by transforming their beliefs and values to be more in alignment with the organization's values and goals. This alignment helps create higher levels of intrinsic motivation. *Charismatic leaders exhibit the same behaviors as transformational leaders to motivate employees; however; because of their specific characteristics, their effectiveness can be limited to only times of distress or crisis. The situation in the particular department determines which leadership theory is likely to be most successful.

  9. Seeing the doctor without fear: www.doctortea.org for the desensitization for medical visits in Autism Spectrum Disorders.

    Boada, Leticia; Parellada, Mara

    Doctor Tea is an online website designed to facilitate medical visits for those with autism spectrum disorder and other disabilities. People diagnosed with autism not only have greater medical needs than the general population, but also have particular characteristics that are often not accommodated by medical services. This lack of medical accommodation often creates a very complicated, and sometimes traumatic experience, when visiting medical facilities. Individuals with autism have great difficulty understanding social situations and contexts, such as medical tests or consultations, as well as difficulty in tolerating new situations and atypical sensory thresholds. Doctor Tea aims to reduce anxiety before medical consultations and procedures from a safe and well-known environment (school, home, etc.). The website, www.doctortea.org, provides information and materials (videos, cartoon, 3D animations, pictogram sequences, etc.) about the most frequent medical procedures and practices for patients with autism. The website also offers information to the doctors and families of patients with autism about the most common medical problems associated with autism. A total of 17,199 different users visited the website during 2015, with a total of 23,348 online visitors from more than 70 different countries since the website's release in November 2014. The familiarisation with the medical procedures and its environment appears to decrease the anxiety in patients with disabilities during medical visits, as well as optimising the effectiveness of their medical visits and tests. Copyright © 2016 SEP y SEPB. Publicado por Elsevier España, S.L.U. All rights reserved.

  10. Exploring the implications of the influence of organisational culture on work-life balance practices: evidence from Nigerian medical doctors

    Adisa, Toyin Ajibade; Modi, Chima; Osabutey, Ellis L. C.

    2017-01-01

    Purpose - Whilst significant evidence of western work-life balance (WLB) challenges exists, studies that explore Sub-Saharan Africa (SSA) are scarce. This article explores how organisational culture in Nigerian medical organisations influences doctors’ WLB and examines the implications of supportive and unsupportive cultures on doctors’ WLB. \\ud \\ud Methodology - The paper uses qualitative data gleaned from semi-structured interviews of 60 medical doctors across the six geo-political zones of...

  11. Evaluating the quality of informed consent and contemporary clinical practices by medical doctors in South Africa: an empirical study.

    Chima, Sylvester C

    2013-01-01

    Informed consent is a legal and ethical doctrine derived from the principle of respect for autonomy. Generally two rights derived from autonomy are accorded legal protection. The constitutional right to bodily integrity followed by the right to bodily well-being, protected by professional negligence rules. Therefore healthcare professionals treating patients' without valid consent may be guilty of infringing patients' rights. Many challenges are experienced by doctors obtaining informed consent in complex multicultural societies like South Africa. These include different cultural ethos, multilingualism, poverty, education, unfamiliarity with libertarian rights based autonomy, and power asymmetry between doctors and patients. All of which could impact on the ability of doctors to obtain legally valid informed consent. The objective of this study was to evaluate whether the quality of informed consent obtained by doctors practicing in South Africa is consistent with international ethical standards and local regulations. Responses from 946 participants including doctors, nurses and patients was analyzed, using a semi-structured self-administered questionnaire and person triangulation in selected public hospitals in Durban, KwaZulu-Natal, South Africa. The median age of 168 doctors participating was 30 years with 51% females, 28% interns, 16% medical officers, 26% registrars, 30% consultant/specialists. A broad range of clinical specialties were represented. Challenges to informed consent practice include language difficulties, lack of interpreters, workload, and time constraints. Doctors spent 5-10 minutes on consent, disclosed most information required to patients, however knowledge of essential local laws was inadequate. Informed consent aggregate scores (ICAS) showed that interns/registrars scored lower than consultants/specialists. ICAS scores were statistically significant by specialty (p = 0.005), with radiologists and anaesthetists scoring lowest, while

  12. Perception and attitude of medical doctors in Dhaka, Bangladesh, with regard to Ayurvedic medicine.

    Yoshida, Yoshitoku; Alim, Md Abdul; Alam, Zakia; Asaduzzaman, Mohammad; Yoshida, Yasuko; Manikdrs, Shahabuddin

    2017-02-01

    The World Health Organization (WHO) Traditional Medicine Strategy (2014-2023) aimed to help member states promote the safe and effective use of traditional medicine. While economic conditions have markedly improved in Bangladesh, the country is experiencing significant public health problems. Because of limited medical resources, there is a strong incentive to enhance complementary and alternative medicine usage in Bangladesh. Therefore, this study aimed to confirm the perceptions and attitudes of medical doctors (MDs) in Dhaka, Bangladesh, with regard to Ayurvedic medicine (AM). A total number of 159 MDs in Dhaka were interviewed by face-to-face between February and June 2015. The study revealed that 62.0% of MDs had treated patients with AM and 55.3% believed that AM should be regarded as its own specialty, whereas 39.7% of MDs believed that AM should be part of the conventional medical curriculum and 32.7% thought that AM did not seem scientific. In terms of gender, 45.3% of male MDs agreed or strongly agreed that AM only had a placebo effect. On the other hand, 65.8% of female MDs disagreed or strongly disagreed it. In terms of age, 77.0% of MDs aged 36 or elder (elder MDs) believed they were more likely to recommend AM use and 80.3% of elder MDs believed that the government should encourage more initiatives to promote AM. To enhance AM use, scientifically robust information on the efficacy, safety and scientific basis of AM should be more effectively conveyed to male MDs.

  13. Finding the right doctoral thesis - an innovative research fair for medical students.

    Steffen, Julius; Grabbert, Markus; Pander, Tanja; Gradel, Maximilian; Köhler, Lisa-Maria; Fischer, Martin R; von der Borch, Philip; Dimitriadis, Konstantinos

    2015-01-01

    The importance of research, as promoted by the CanMEDS framework, is widely acknowledged. Many medical students in Germany work on a research project as part of their doctoral thesis whilst still going to medical school. However, a significant amount of projects are abandoned unfinished, which leads to substantial wastage of resources. One reason for this is an information deficit concerning undergraduate research projects. To counteract this, we introduced an annual event at LMU Munich called DoktaMed with more than 600 visitors each year. It combines medical convention and research fair including keynote lectures, workshops and poster sessions as well as an exhibition of research groups and institutes. DoktaMed is a peer-to-peer event organized by a team of 40 students. A needs analysis before its implementation underlined the information deficit as a possible cause for the high rate of abandoned projects. In the annual evaluation, visitors of DoktaMed rate the event with an average grade of 2.1 on a six-level Likert scale (n=558, SD=1.06, with "1=very good", "6=poor"). They stated to now feel better informed about the topic and regarded visiting DoktaMed as a worthwhile investment of time. Students are generally satisfied with the event and feel better informed after visiting DoktaMed. However, many students never visit DoktaMed for various reasons. A possible improvement would be to present a greater number of clinical studies in addition to the laboratory work that DoktaMed focuses on now. Evaluation after six years of DoktaMed is very promising. Visitors seem to be better informed. Nevertheless there is space for improvement in order to get more students and more faculty members involved. More studies are needed to assess long-term effects.

  14. Finding the right doctoral thesis – an innovative research fair for medical students

    Steffen, Julius

    2015-08-01

    Full Text Available Introduction: The importance of research, as promoted by the framework, is widely acknowledged. Many medical students in Germany work on a research project as part of their doctoral thesis whilst still going to medical school. However, a significant amount of projects are abandoned unfinished, which leads to substantial wastage of resources. One reason for this is an information deficit concerning undergraduate research projects.Project description: To counteract this, we introduced an annual event at LMU Munich called with more than 600 visitors each year. It combines medical convention and research fair including keynote lectures, workshops and poster sessions as well as an exhibition of research groups and institutes. is a peer-to-peer event organized by a team of 40 students. Results: A needs analysis before its implementation underlined the information deficit as a possible cause for the high rate of abandoned projects. In the annual evaluation, visitors of rate the event with an average grade of 2.1 on a six-level Likert scale (n=558, SD=1.06, with "1=very good", "6=poor". They stated to now feel better informed about the topic and regarded visiting as a worthwhile investment of time.Discussion: Students are generally satisfied with the event and feel better informed after visiting . However, many students never visit DoktaMed for various reasons. A possible improvement would be to present a greater number of clinical studies in addition to the laboratory work that focuses on now.Conclusion: Evaluation after six years of is very promising. Visitors seem to be better informed. Nevertheless there is space for improvement in order to get more students and more faculty members involved. More studies are needed to assess long-term effects.

  15. Self-assessment of managerial knowledge and skills of medical doctors in primary health care

    Aida Pilav

    2016-03-01

    Full Text Available Introduction: The aim of this paper was to evaluate the managerial knowledge and skills of mid-level managers – medical doctors in Medical center of the Canton Sarajevo.Methods: A cross-sectional study of the mid-level managers in the Medical center of the Canton Sarajevo was conducted using an originally developed questionnaire for self-assessment of managerial knowledge and skills. The respondents answered each of the questions using a 5-point Likert scale. Apart from the quantitative section, the respondents could present their observations concerning the educational needs in the health care system.Results: Almost 40% of the respondents said that the process of assessing health care needs is not conducted. No statistical significance was observed in the responses according to the length of service in a managerial position. In total, 41% of the respondents were not sure whether a plan exists, even though the development of these plans should be a principal managerial responsibility in the quality management. Managers who were longer in the position reported no plans for corrective actions. This result was in contrast with the answers obtained from the managers who were in the position for a shorter period. In addition, 91% of the respondents said that they regularly discuss problems with their employees.Conclusions: Self- assessment and assessment of managerial competencies should be regular activities in a health care organization, in order to monitor the knowledge and skills, as well as to make the development plans. The results of this study could serve as the basis for planning and developing the health management education in the Canton Sarajevo.

  16. Leadership challenges in multinational medical peacekeeping operations: Lessons from UNIFIL Hospital.

    Datta, Rakesh; Khanna, Sangeeta

    2017-10-01

    Commanding a military multinational and multilingual healthcare facility can be a formidable task with very little margin for error. The authors were in leadership positions of UNIFIL Hospital, unique in its diversity of both staff and clientele. Experience about the challenges faced and methods adopted to overcome them will be shared. Troops from diverse backgrounds differ in their competency, and also in their attitudinal approach to situations. It is imperative for the medical commanders to identify these differences, and work towards harnessing individual strengths to form a cohesive unit. Frequent rotation of team members and thereby difficulty in adapting to new environment makes the tasks more challenging. Challenges can be broadly categorized in those dealing with functional roles (providing medical support) and command and control issues. Linguistic challenges especially in situations where professionals have to work as a coordinated unit remains a major challenge. The threat of medical errors arising out of misunderstandings is very real. Gender sensitization is essential to avoid potential unpleasant situations. Interpersonal conflict can easily go out of hand. The leadership has to be more direct and deliberate relying less on hierarchy and more on direct communication. A strict enforcement of UN standards for equipment and competence, frequent joint medical drills help to overcome interoperability issues and develop mutual confidence. Leadership in multinational UN hospitals is a demanding task with its peculiar set of challenges. A systematic and deliberate approach focused on mutual respect, flexibility and direct leadership can help medical commanders in such situations.

  17. Adverse effects on health and wellbeing of working as a doctor: views of the UK medical graduates of 1974 and 1977 surveyed in 2014.

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

    2017-05-01

    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.

  18. Newly qualified doctors' views on the significance and accessibility of career advice during medical training in Saudi Arabia.

    Mehmood, Syed Imran; Norcini, John J; Borleffs, Jan C C

    2013-01-01

    Career advice is an important instrument to help students with the proper specialty selection. The study aims (1) to explore the views of newly graduated doctors in Saudi Arabia about their experience with the current status of career support system during medical training and (2) to identify cross-cultural similarities and differences. A cross-sectional design study was conducted using a questionnaire to elicit the responses of participants from newly qualified doctors concerning the availability and significance of career advice. SPSS (version 11.0; Chicago, IL) was used to analyze the data and statistical tests, such as chi-square and unpaired t tests, were used to analyze the observations. A response rate of 94.7% was obtained. Among this group, 102 were males and 78 were females. Only 53% did receive career advice. The majority of men felt that career advice during medical studies was inadequate, while women were less negative (69% versus 32%; p = 0.0001). Furthermore, men were more disappointed about the possibilities for career advice after graduating than women (34% versus 13%, p = 0.0001). The results show that only half of newly graduated doctors had received any career advice during medical training. As the health care system cannot afford the potential waste of time and resources for doctors, career guidance should begin in undergraduate training so that the process of thinking about their future career starts longtime before they make their career choice.

  19. Doctor's Orders

    VALERIE SARTOR

    2010-01-01

    @@ "To become a doctor is like becoming a bomb expert:It takes a long time to learn this skill; you must use care and intuition; and you must understand that your work has grave consequences for those around you,"said Amgalan Gamazhapov,an advanced medical student who studies traditional Chinese and Mongolian medicine at the Inner Mongolia Medical University.

  20. Which way ahead?: I want my doctor to.... The mechanics of market research for medics in the millenium: special communication.

    Hicks, A

    2004-12-01

    A brief description is given of the changing politico-social structure today involving medicine and especially the cosy personal doctor-patient relationship of the past which has now become triangular involving Managed Health Care Organisations in many cases. The Medical Practitioners' and Dentists' Board (the Board) appointed the Ethics Conference Committee largely composed of non-Board members to collect and collate information of what doctors, paramedics and the lay public expected from their doctors today. It is planned that the Committee's Report summarising this information would form the basis of the new guidelines to modern ethics to be published by the Board later. In this paper the mechanics, funding and production of the report are described but not the contents of the report which is still being considered by the new Board.

  1. NATURE OF THE LAST CONTACT WITH A MEDICAL DOCTOR BEFORE SUICIDE

    Urša Mars Bitenc

    2018-01-01

    Full Text Available A relevant number of suicide decedents visit medical doctors (MDs in a short period before death. This study aimed to learn about MDs’ attitudes towards suicide prevention, their previous education on suicide, the experience with suicide, and eventually the nature of the last visit with a patient that died by suicide. 159 Slovenian MDs participated in an online survey covering previously mentioned topics. More than a third of MDs have never been trained on suicide prevention and reported lack of knowledge in this area. More than half experienced suicide of a patient or close one. During the last contact before suicide, MDs frequently noticed symptoms of mental health problems, hopelessness, sleep problems, somatic pain and suicidal ideation. More seldom they observed stocking pills, giving away values, gaining access to firearms, and changing a will. At the time of the last visit, main diagnoses were depression (54.5%, schizophrenia (22.7%, bipolar disorder (12.5%, alcohol use disorder (9.6%, and dementia (4.5%. To improve risk assessment and suicide prevention in health-care settings, a specific training would be a highly desirable option for educating MD's.

  2. Knowledge of Childhood Autism and Challenges of Management among Medical Doctors in Kaduna State, Northwest Nigeria

    E. E. Eseigbe

    2015-01-01

    Full Text Available Autism is a neurodevelopmental disorder with serious implications in childhood. There is a significant gap in the identification and provision of health and social services for autism in Africa. The knowledge of autism among health care providers and identifying challenges associated with its management could facilitate bridging the gap and ensuring better outcomes. A self-administered tool, the Knowledge about Childhood Autism among Health Workers (KCAHW questionnaire, was used in assessing knowledge of autism among 175 medical doctors (participants attending an annual scientific meeting in northwest Nigeria. Other parameters assessed were sociodemographic and professional characteristics of the participants and challenges encountered in the management of autism. Out of 175 questionnaires distributed, 167 (95.4% were returned. Good knowledge (KCAHW score ≥15 was significantly associated with being a paediatrician or psychiatrist and practicing in a tertiary health facility (P<0.05, while poor knowledge (KCAHW score <15 was significant among general practitioners (P<0.05. The highest knowledge gap was associated with onset of autism and its comorbidities (KCAHW Domain 4 while the least was concerning communication impairments (KCAHW Domain 2. Major challenges encountered in autism management were dearth of specialist services, cost of evaluation, and poor caregiver perspectives of autism.

  3. Medical doctors as the captain of a ship: an analysis of medical students’ book reports on Joseph Conrad’s “Lord Jim”

    2014-01-01

    Purpose: In South Korean ferry disaster in 2014, the captain abandoned the ship with passengers including high school students still aboard. We noticed the resemblance of abandoning the ship with passengers still aboard the ferry (named the Sewol) and the ship Patna, which was full of pilgrims, in Joseph Conrad’s novel “Lord Jim.” The aim of this study is to see how medical students think about the role of a medical doctor as a captain of a ship by analyzing book reports on Conrad’s “Lord Jim.” Methods: Participants included 49 third-year medical students. Their book reports were analyzed. Results: If placed in the same situation as the character of Jim, 24 students of the 49 respondents answered that they would stay with the passengers, while 18 students indicated they would escape from the ship with the crew. Most of the students thought the role of a doctor in the medical field was like that of a ‘captain.’ The medical students reported that they wanted to be a doctor who is responsible for his or her patients, highly moral, warm-hearted, honest, and with high self-esteem. Conclusion: In conclusion, we found that “Lord Jim” induced the virtue of ‘responsibility’ from the medical students. Consequently, “Lord Jim” could be good teaching material for medical humanities. PMID:25417908

  4. Medical doctors as the captain of a ship: an analysis of medical students’ book reports on Joseph Conrad’s “Lord Jim”

    Kun Hwang

    2014-11-01

    Full Text Available Purpose: In South Korean ferry disaster in 2014, the captain abandoned the ship with passengers including high school students still aboard. We noticed the resemblance of abandoning the ship with passengers still aboard the ferry (named the Sewol and the ship Patna, which was full of pilgrims, in Joseph Conrad’s novel “Lord Jim.” The aim of this study is to see how medical students think about the role of a medical doctor as a captain of a ship by analyzing book reports on Conrad’s “Lord Jim.” Methods: Participants included 49 third-year medical students. Their book reports were analyzed. Results: If placed in the same situation as the character of Jim, 24 students of the 49 respondents answered that they would stay with the passengers, while 18 students indicated they would escape from the ship with the crew. Most of the students thought the role of a doctor in the medical field was like that of a ‘captain.’ The medical students reported that they wanted to be a doctor who is responsible for his or her patients, highly moral, warm-hearted, honest, and with high self-esteem. Conclusion: In conclusion, we found that “Lord Jim” induced the virtue of ‘responsibility’ from the medical students. Consequently, “Lord Jim” could be good teaching material for medical humanities.

  5. Leadership, management and teamwork learning through an extra-curricular project for medical students: descriptive study.

    Jorge, Maria Lucia da Silva Germano; Coelho, Izabel Cristina Meister; Paraizo, Mariana Martins; Paciornik, Ester Fogel

    2014-01-01

    Professionalism in medicine requires preparation for the globalized world. Our objective was to describe a project that introduces medical students to the community, hospital and laboratory activities, thereby allowing them to gain experience in people management, leadership and teamwork. Descriptive study of the process applied at a philanthropic medical school in Curitiba, Paraná. Inclusion of management and leadership practices as part of the medical degree program. The study groups consisted of fifteen students. After six months, any of the participants could be elected as a subcoordinator, with responsibility for managing tasks and representing the team in hospital departments and the community. The activities required increasing levels of responsibility. In medical schools, students' involvement in practical activities is often limited to observation. They are not required to take responsibilities or to interact with other students and stakeholders. However, they will become accountable, which thus has an adverse effect on all involved. The learning space described here aims to fill this gap by bringing students closer to the daily lives and experiences of healthcare professionals. Being a physician requires not only management and leadership, but also transferrable competencies, communication and critical thinking. These attributes can be acquired through experience of teamwork, under qualified supervision from teaching staff. Students are thus expected to develop skills to deal with and resolve conflicts, learn to share leadership, prepare others to help and replace them, adopt an approach based on mutual responsibility and discuss their performance.

  6. Developing leadership as a trainee- opportunities, barriers and potential improvements.

    Doherty, Rachel; Lawson, Sara; Mc Laughlin, Laura; Donaghy, Grainne; Courtney, Julia; Gardiner, Keith

    2018-05-01

    The General Medical Council explicitly state that doctors completing training should demonstrate capabilities in leadership and teamwork. 1 However, most trainees receive little formal training in leadership. In March 2017, at the Faculty of Medical Leadership and Management (FMLM) Northern Ireland Regional Conference, a workshop on developing leadership skills as a trainee was hosted and the views of doctors in training regarding current opportunities, potential barriers and improvements were sought. In Northern Ireland presently there are a number of opportunities available for trainees to gain experience in leadership - both by learning through observation and learning through experience. These range from informal activities which do not require significant time commitment to focused, immersive leadership experiences such as ADEPT (Achieve Develop Explore Programme for Trainees) 2 , and the Royal College of Physicians' Chief Registrar scheme. 3 Several barriers to developing leadership have been identified, including limited understanding of what constitutes leadership, a lack of senior support and little formal recognition for trainees leading teams. Time pressures, frequently rotating jobs, limited resources and difficulty upscaling can also undermine the sustainability of improvement and other leadership projects. Incorporating awareness of and training in leadership skills, as well as greater engagement with senior leaders and managers, at an early stage in training could promote understanding and encourage trainees. Formalising leadership roles within training posts may improve experience. Deaneries and Trusts can also enable leadership opportunities by facilitating study leave, raising awareness amongst supervisors, and providing career enhancing incentives for interested trainees.

  7. Knowledge and perception regarding clinical trials among doctors of government medical colleges: A questionnaire-based study

    Supriyo Choudhury

    2016-01-01

    Full Text Available Aims: By virtue of being a specialized field by itself, the science of clinical trials (CTs may not be well understood by doctors who are not specifically trained in it. A lack of knowledge may translate to a negative perception toward CT. With the idea of getting a situational snapshot, we estimated the knowledge and perception of CTs among doctors from government medical colleges of West Bengal who are not trained on CT in their postgraduate curriculum. Several determinants of knowledge and perception regarding CT were also evaluated. Methods: We have quantified the knowledge and perception of CTs by a structured validated questionnaire. Development and validation of the questionnaire was performed prior to the study. Results: Among 133 participants, 7.5% received focused training on CT and 16.5% participated in CTs as investigators. Majority of the doctors were unfamiliar with the basic terminologies such as, “adverse event” and “good clinical practice.” Encouragingly, 93.3% doctors advised that a detailed discussion of CT methodology should be incorporated in the under graduate medical science curriculum. They had an overall positive attitude toward CTs conducted in India, with a mean score that is 72.6% of the maximum positive score. However, a large number of the doctors were skeptical about the primary motivation and operations of pharmaceutical industry sponsored CTs, with 45% of them believing that patients are exploited in these sponsored CTs. Conclusion: Participant doctors had a basic knowledge of CT methodology. The study has revealed specific areas of deficient knowledge, which might be emphasized while designing focused training on CT methodology.

  8. The McDonaldization of appraisal? Doctors' views of the early impacts of medical revalidation in the United Kingdom.

    Archer, Julian; Nunn, Suzanne; Regan de Bere, Sam

    2017-09-01

    Medical regulation is rapidly changing with claims that systems such as revalidation/relicensing will reassure the public. Yet the impact of such initiatives is unknown. Using the principles of efficiency, calculability, predictability and control through technology, identified by Ritzer, and exampled by the McDonalds business model, we analyzed interviews with doctors between May 2012-Dec 2013 which focused on doctor experiences of appraisal and revalidation in SW England. The research found significant changes in appraisals since the launch of revalidation in December 2012. Appraisal has been standardized with a list of supporting information that must be collected by doctors. The success of implementation is measured in the numbers of appraisals completed but less is known about the quality of the appraisal itself. Such efficiencies have been supported by IT systems that themselves might be at risk of driving the process. There are potential advantages to McDonaldization including appraisals available to all, not just for doctors working in the NHS, and a potentially more appetizing recipe for their completion. As yet a state of McAppraisal has not been reached; with a complete transfer of trust in the doctor to trust in the appraisal process within revalidation. However policymakers will need to continue to ensure that regulatory initiatives, such as revalidation, are not just a process for their own sake. Copyright © 2017 Elsevier B.V. All rights reserved.

  9. Undergraduate medical education for the 21st century: leadership and teamwork.

    O'Connell, Mark T; Pascoe, John M

    2004-01-01

    The health care delivery system is experiencing enormous flux. The knowledge and skills sets required of today's physicians include expertise in competency areas that have not been included in the traditional medical curricula. The Undergraduate Medical Education for the 21st Century (UME-21) project was designed to develop innovative curricula that addressed the training necessary for medical students to gain skills required to provide high-quality, accessible, and affordable care in the modern health care environment. One of the nine UME-21 content areas, leadership and teamwork, has historically received relatively little attention in medical education. Each school participating in the UME-21 project submitted a final report that provided information for this descriptive summary of curricular innovations for teaching the concepts of leadership and teamwork to medical students. A classification lexicon for the curricular content and experiences in this content area was derived from these UME-21 project reports. Each school evaluated its curricular innovations independently using a variety of methods, largely descriptive and qualitative in nature. Eight UME-21 schools developed curricula addressing the content area of leadership and teamwork. The majority of these curricula used the clinical care teams in the clinical rotations to demonstrate the principles and importance of leadership and teamwork. Three of the schools implemented didactic sessions and workshops to explicitly address leadership and teamwork. One school used the gross anatomy dissection teams as the "laboratory" for demonstrating this content material. The evaluations of these curricular efforts showed them to be positively regarded by the medical students. Outcomes of measurable changes in competency in this area of expertise were not evaluated. There is little past experience in teaching leadership and teamwork in medical school. The UME-21 project supported the design and implementation of

  10. Individual medication management system (IMMS) as a proposition of obeying the doctor's recommendation with pharmacist cooperation.

    Waszyk-Nowaczyk, Magdalena; Simon, Marek; Matwij, Karolina

    2012-01-01

    The pharmacist is an expert with the knowledge of drugs, who has a possibility to follow the patient's individual pharmacotherapy, which is the basis of the pharmaceutical care programme. The implementation of the Individual Medication Management System (IMMS) may be one of the proposals which will enable an analysis of the course of pharmacotherapy and elimination of drug problems, which are the chief goals of pharmaceutical care. In order to determine community pharmacy patients' degree of interest in the IMMS and to evaluate the degree of patients' discipline concerning the application of doctors' recommendations they were given an anonymous questionnaire. The research was done from August 2009 to May 2010 on a sample of 179 people selected at random. They were patients of community pharmacies in Poznań, where 70% were women and 30% were men, all of them aged between 20 and 85 years. The individual age groups were: 20-40 years--27.0%, 41-50 years--10.8%, 51-64 years--43.6%, 65 years or more--18.6%. The patients' education was as follows: primary--4.7%, vocational--8.0%, secondary--31.0%, incomplete university--12.0% and university--44.3%. The chi2 and Fisher-Freeman-Halton tests were used for statistical analysis of the results. Each time the level of statistical significance was assumed at p system. However, it was mostly women and respondents with university education that were the most interested in it. More than 50% of the patients aged 20-40 years and those aged over 65 years indicate the purposefulness of the systems. It is mainly the group aged 20-40 years that confirms facilitation in following the doctor's recommendations (p = 0.02). The respondents indicated their interest and confirmed the purposefulness of the IMMS mainly due to the fact that it helps to avoid drug-related problems resulting from omitting doses and helps to keep the dosage time and frequency in a long-term therapy. The research confirms the fact that individualized therapy will

  11. Leadership Identity Development Through Reflection and Feedback in Team-Based Learning Medical Student Teams.

    Alizadeh, Maryam; Mirzazadeh, Azim; Parmelee, Dean X; Peyton, Elizabeth; Mehrdad, Neda; Janani, Leila; Shahsavari, Hooman

    2018-01-01

    Studies on leadership identity development through reflection with Team-Based Learning (TBL) in medical student education are rare. We assumed that reflection and feedback on the team leadership process would advance the progression through leadership identity development stages in medical students within the context of classes using TBL. This study is a quasi-experimental design with pretest-posttest control group. The pretest and posttest were reflection papers of medical students about their experience of leadership during their TBL sessions. In the intervention group, TBL and a team-based, guided reflection and feedback on the team leadership process were performed at the end of all TBL sessions. In the other group, only TBL was used. The Stata 12 software was used. Leadership Identity was treated both as a categorical and quantitative variable to control for differences in baseline and gender variables. Chi-square, t tests, and linear regression analysis were performed. The population was a cohort of 2015-2016 medical students in a TBL setting at Tehran University of Medical Sciences, School of Medicine. Teams of four to seven students were formed by random sorting at the beginning of the academic year (intervention group n = 20 teams, control group n = 19 teams). At baseline, most students in both groups were categorized in the Awareness and Exploration stage of leadership identity: 51 (52%) in the intervention group and 59 (55%) in the control group: uncorrected χ 2 (3) = 15.6, design-based F(2.83, 108) = 4.87, p = .003. In the posttest intervention group, 36 (36%) were in exploration, 33 (33%) were in L-identified, 20 (20%) were in Leadership Differentiated, and 10 (10%) were in the Generativity. None were in the Awareness or Integration stages. In the control group, 3 (20%) were in Awareness, 56 (53%) were in Exploration, 35 (33%) were in Leader Identified, 13 (12%) were in Leadership Differentiated. None were in the Generativity and Integration stages

  12. Leadership and followership in the healthcare workplace: exploring medical trainees' experiences through narrative inquiry

    Gordon, Lisi J.; Rees, Charlotte E.; Ker, Jean S.; Cleland, Jennifer

    2015-01-01

    This research was part of LJG’s PhD research which was generously funded by NHS Education for Scotland through SMERC. OBJECTIVES: To explore medical trainees' experiences of leadership and followership in the interprofessional healthcare workplace. DESIGN: A qualitative approach using narrative interviewing techniques in 11 group and 19 individual interviews with UK medical trainees. SETTING: Multisite study across four UK health boards. PARTICIPANTS: Through maximum variation sampling, 65...

  13. Clinical leadership development in postgraduate medical education and training: policy, strategy, and delivery in the UK National Health Service.

    Aggarwal, Reena; Swanwick, Tim

    2015-01-01

    Achieving high quality health care against a background of continual change, increasing demand, and shrinking financial resource is a major challenge. However, there is significant international evidence that when clinicians use their voices and values to engage with system delivery, operational efficiency and care outcomes are improved. In the UK National Health Service, the traditional divide between doctors and managers is being bridged, as clinical leadership is now foregrounded as an important organizational priority. There are 60,000 doctors in postgraduate training (junior doctors) in the UK who provide the majority of front-line patient care and form an "operating core" of most health care organizations. This group of doctors is therefore seen as an important resource in initiating, championing, and delivering improvement in the quality of patient care. This paper provides a brief overview of leadership theories and constructs that have been used to develop a raft of interventions to develop leadership capability among junior doctors. We explore some of the approaches used, including competency frameworks, talent management, shared learning, clinical fellowships, and quality improvement. A new paradigm is identified as necessary to make a difference at a local level, which moves learning and leadership away from developing "leaders", to a more inclusive model of developing relationships between individuals within organizations. This shifts the emphasis from the development of a "heroic" individual leader to a more distributed model, where organizations are "leader-ful" and not just "well led" and leadership is centered on a shared vision owned by whole teams working on the frontline.

  14. Clinical leadership development in postgraduate medical education and training: policy, strategy, and delivery in the UK National Health Service

    Aggarwal, Reena; Swanwick, Tim

    2015-01-01

    Achieving high quality health care against a background of continual change, increasing demand, and shrinking financial resource is a major challenge. However, there is significant international evidence that when clinicians use their voices and values to engage with system delivery, operational efficiency and care outcomes are improved. In the UK National Health Service, the traditional divide between doctors and managers is being bridged, as clinical leadership is now foregrounded as an important organizational priority. There are 60,000 doctors in postgraduate training (junior doctors) in the UK who provide the majority of front-line patient care and form an “operating core” of most health care organizations. This group of doctors is therefore seen as an important resource in initiating, championing, and delivering improvement in the quality of patient care. This paper provides a brief overview of leadership theories and constructs that have been used to develop a raft of interventions to develop leadership capability among junior doctors. We explore some of the approaches used, including competency frameworks, talent management, shared learning, clinical fellowships, and quality improvement. A new paradigm is identified as necessary to make a difference at a local level, which moves learning and leadership away from developing “leaders”, to a more inclusive model of developing relationships between individuals within organizations. This shifts the emphasis from the development of a “heroic” individual leader to a more distributed model, where organizations are “leader-ful” and not just “well led” and leadership is centered on a shared vision owned by whole teams working on the frontline. PMID:29355184

  15. Improving perception, attitude and interest in medical leadership and management – a novel model proposed by medical students

    Shah OA

    2018-05-01

    Full Text Available Owais Ali Shah, Mohammed Khalid Aslami, Amir-Humza Tahir SulemanFaculty of Medicine, St. George’s Hospital Medical School, London, UKAfter reading the article by Rouhani et al1 with great interest, we agree that the level of medical leadership and management (MLM training in the UK medical schools could be improved massively. As fellow medical students, we would like to offer our perspective on how universities can better implement MLM teaching into curricula to effectively mould future clinician leaders within an ever-expanding National Health Service. As reported, the General Medical Council provides curriculum guidance for medical schools based on the skills identified in the Medical Leadership Competency Framework (MLCF.1 In line with the findings of the authors, a study showed that only 56% of the responding universities incorporate MLCF into their curriculum, and remarkably, 81.9% of students were unaware of the MLCF.2 This can lead to a lack of insight and awareness into MLM among medical students possibly leading to reluctance in pursuing MLM roles in the future.View the original paper by Rouhani and colleagues.

  16. Integration of leadership training into a problem/case-based learning program for first- and second-year medical students.

    Ginzburg, Samara B; Deutsch, Susan; Bellissimo, Jaclyn; Elkowitz, David E; Stern, Joel Nh; Lucito, Robert

    2018-01-01

    The evolution of health care systems in response to societal and financial pressures has changed care delivery models, which presents new challenges for physicians. Leadership training is increasingly being recognized as an essential component of medical education training to prepare physicians to meet these needs. Unfortunately, most medical schools do not include leadership training. It has been suggested that a longitudinal and integrated approach to leadership training should be sought. We hypothesized that integration of leadership training into our hybrid problem-based learning (PBL)/case-based learning (CBL) program, Patient-Centered Explorations in Active Reasoning, Learning and Synthesis (PEARLS), would be an effective way for medical students to develop leadership skills without the addition of curricular time. We designed a unique leadership program in PEARLS in which 98 medical students participated during each of their six courses throughout the first 2 years of school. A program director and trained faculty facilitators educated students and coached them on leadership development throughout this time. Students were assessed by their facilitator at the end of every course on development of leadership skills related to teamwork, meaningful self-assessment, process improvement, and thinking outside the box. Students consistently improved their performance from the first to the final course in all four leadership parameters evaluated. The skills that demonstrated the greatest change were those pertaining to thinking outside the box and process improvement. Incorporation of a longitudinal and integrated approach to leadership training into an existing PBL/CBL program is an effective way for medical students to improve their leadership skills without the addition of curricular time. These results offer a new, time-efficient option for leadership development in schools with existing PBL/CBL programs.

  17. From "uncertifiable" medical practice to Berlin Clinic of Women Doctors: the medical career of Franziska Tiburtius (M.D. Zurich, 1876).

    Meyer, P

    1999-01-01

    Problems in gender expectations and relationships complicated increasing professionalization of medical arts at an important point of transformation toward the modern industrial European state. Subordination of women's work in these processes altered possible outcomes for German society in general and for female medical careers in particular. Franziska Tiburtius was one of twenty German women who graduated from the coeducational medical school in Zurich, Switzerland, in the nineteenth century. She was a founder of the Clinic of Women Doctors despite prohibitions against certifying women as physicians. Imperial Germany was the last Western nation to admit women to full medical practice in 1899.

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

    Dattatray B Pawar

    2012-01-01

    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

  19. Flipping the classroom to teach Millennial residents medical leadership: a proof of concept.

    Lucardie, Alicia T; Berkenbosch, Lizanne; van den Berg, Jochem; Busari, Jamiu O

    2017-01-01

    The ongoing changes in health care delivery have resulted in the reform of educational content and methods of training in postgraduate medical leadership education. Health care law and medical errors are domains in medical leadership where medical residents desire training. However, the potential value of the flipped classroom as a pedagogical tool for leadership training within postgraduate medical education has not been fully explored. Therefore, we designed a learning module for this purpose and made use of the flipped classroom model to deliver the training. The flipped classroom model reverses the order of learning: basic concepts are learned individually outside of class so that more time is spent applying knowledge to discussions and practical scenarios during class. Advantages include high levels of interaction, optimal utilization of student and expert time and direct application to the practice setting. Disadvantages include the need for high levels of self-motivation and time constraints within the clinical setting. Educational needs and expectations vary within various generations and call for novel teaching modalities. Hence, the choice of instructional methods should be driven not only by their intrinsic values but also by their alignment with the learners' preference. The flipped classroom model is an educational modality that resonates with Millennial students. It helps them to progress quickly beyond the mere understanding of theory to higher order cognitive skills such as evaluation and application of knowledge in practice. Hence, the successful application of this model would allow the translation of highly theoretical topics to the practice setting within postgraduate medical education.

  20. Perceptions of junior doctors and undergraduate medical students as anatomy teachers: Investigating distance along the near-peer teaching spectrum.

    Hall, Samuel; Stephens, Jonathan; Andrade, Teu; Davids, Joseph; Powell, Matthew; Border, Scott

    2014-01-01

    Near-peer teaching involves more experienced students acting as tutors and has been widely used in anatomy education. This approach has many advantages for the learner due to the social and cognitive congruence they share with the teacher, however, the influence of distance between the teacher and learner on these congruences has yet to be explored. The aim of this study was to compare the attitudes and perceptions of the student learner towards neuroanatomy review sessions taught by either a senior medical student or a junior doctor. The students were randomly assigned to an allocated tutor. All tutors used standardized material and had access to identical resources. The type of allocated tutor was swapped between the two teaching sessions and 99 student feedback forms were collected in total. The rating for the overall quality of the teaching session was not significantly different between the junior doctors and senior medical students (P = 0.11). However, criteria closely relating to social and cognitive congruence such as "enjoyment of the session," "delivery of the teaching," and "was it a good use of time" were all rated significantly higher for the senior medical students (P peer teaching spectrum have an impact upon the student's perception of their learning experience. While all teachers were suitable role models it appears that junior doctors are too far removed from their own undergraduate experiences to share congruences with pre-clinical medical students. © 2013 American Association of Anatomists.

  1. Review of determinants of national medical leadership development

    Keijser, Wouter Alexander; Poorthuis, Max Bastiaan; Tweedie, Judith; Wilderom, Celeste P.M.

    2017-01-01

    Increasingly, physician engagement in management, quality and innovation is being recognised as vital, requiring ’medical leadership’ (ML) competencies. Besides numerous local institutional efforts and despite the high level of autonomy of the medical profession and the education of its members, in

  2. Role of Leading Programs in Doctoral Education: A New Type of Leadership Education in the Sciences at University of Hyogo, Japan

    Maya Okamoto

    2015-01-01

    Full Text Available Fostering global leaders for the next generation is an important mission of universities. In Japan, Leading Programs in Doctoral Education (LP has been implemented in many graduate schools. The main goal of this program is to foster PhDs with deep specialization and peer leadership who will be able to compete well internationally. The Graduate School of Life Science, University of Hyogo is implementing a LP to foster global leaders using cutting-edge technology. They are also trying to create new evaluation criteria of human resource development with their corporate sponsors. The success of LP depends not only on how many graduates can play leading roles globally, but also how university staff can create a superior new evaluation criteria of human resource development and how much it can be shared with universities and industry. Development of students and graduates with a high level of ability takes time, thus it is important to consider the continuous development of LP.

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

    Sandeep Kumar Gupta

    2016-01-01

    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.

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

    Gupta, Sandeep Kumar; Nayak, Roopa P; Sivaranjani, R

    2016-01-01

    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. 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. 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. 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). 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.

  5. Doctors Today

    Murphy, JFA

    2012-03-01

    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.

  6. A survey of how and why medical students and junior doctors choose a career in ENT surgery.

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

    2016-11-01

    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.

  7. The social negotiation of fitness for work: tensions in doctor-patient relationships over medical certification of chronic pain.

    Wainwright, Elaine; Wainwright, David; Keogh, Edmund; Eccleston, Christopher

    2015-01-01

    The UK government is promoting the health benefits of work, in order to change doctors' and patients' behaviour and reduce sickness absence. The rationale is that many people 'off sick' would have better outcomes by staying at work; but reducing the costs of health care and benefits is also an imperative. Replacement of the 'sick note' with the 'fit note' and a national educational programme are intended to reduce sickness-certification rates, but how will these initiatives impact on doctor-patient relationships and the existing tension between the doctor as patient advocate and gate-keeper to services and benefits? This tension is particularly acute for problems like chronic pain where diagnosis, prognosis and work capacity can be unclear. We interviewed 13 doctors and 30 chronic pain patients about their experiences of negotiating medical certification for work absence and their views of the new policies. Our findings highlight the limitations of naïve rationalist approaches to judgements of work absence and fitness for work for people with chronic pain. Moral, socio-cultural and practical factors are invoked by doctors and patients to contest decisions, and although both groups support the fit note's focus on capacity, they doubt it will overcome tensions in the consultation. Doctors value tacit skills of persuasion and negotiation that can change how patients conceptualise their illness and respond to it. Policy-makers increasingly recognise the role of this tacit knowledge and we conclude that sick-listing can be improved by further developing these skills and acknowledging the structural context within which protagonists negotiate sick-listing. © The Author(s) 2014.

  8. Attitudes of Korean and Chinese traditional medical doctors on education of East Asian traditional medicine

    Hyun-Ji Lee

    2016-03-01

    Conclusion: This study revealed the attitude of Korean and Chinese TRM doctors on their educational system, and discussed the implication of similarities and differences between them. It would provide foundations for the improvement of the TRM educational curriculums.

  9. Autotelic vs instrumental motivation of doctors and their medical specialty choice in relation to sense of coherence.

    Jabłoński, Marcin J; Szot-Parda, Magdalena; Grzegorek, Tomasz; Prusak, Jacek; Jach, Robert; Posadzka, Ewa

    2016-01-01

    Analysis and comparison of two types of motivation (autotelic and non-autotelic) which are behind the choice of medical specialisation by doctors in relation to their sense of coherence. Questionnaire method was used in the study. The study included a group of 86 graduates of the Faculty of Medicine of the Jagiellonian University, who have completed postgraduate internships at the Department of Haematology and Oncology, Department of Gynaecology of the Jagiellonian University and the L. Rydygier hospital in Krakow in 2010-2012. Statistical analyses were performed using the IBM SPSS Statistics 21. The level of significance was alpha = 0.05. It has been shown that doctors are more frequently characterised by the autotelic type of motivation. It has also been proven that there is a relationship between the male sex of the surveyed doctors and their autotelic type of motivation. Moreover, it has been demonstrated that there is a correlation between the comprehensibility component of the sense of coherence and the male sex. It has been also demonstrated that there is a correlation between meaningfulness component of the sense of coherence and the choice of surgical specialisation. Autotelic motivation prevails when choosing a medical specialty and this tendency is more noticeable in men than in women. The meaningfulness component of SoC plays a regulatory role in making career decisions related to the greater physical and mental pressure put on doctors. The observed differences in the types of motivation and the size of the components of the sense of coherence in groups of surveyed doctors - men and women - encourage further observations of these relationships on a larger population.

  10. UK doctors' views on the implementation of the European Working Time Directive as applied to medical practice: a qualitative analysis.

    Clarke, Rachel T; Pitcher, Alex; Lambert, Trevor W; Goldacre, Michael J

    2014-02-06

    To report on what doctors at very different levels of seniority wrote, in their own words, about their concerns about the European Working Time Directive (EWTD) and its implementation in the National Health Service (NHS). All medical school graduates from 1993, 2005 and 2009 were surveyed by post and email in 2010. The UK. Using qualitative methods, we analysed free-text responses made in 2010, towards the end of the first year of full EWTD implementation, of three cohorts of the UK medical graduates (graduates of 1993, 2005 and 2009), surveyed as part of the UK Medical Careers Research Group's schedule of multipurpose longitudinal surveys of doctors. Of 2459 respondents who gave free-text comments, 279 (11%) made unprompted reference to the EWTD; 270 of the 279 comments were broadly critical. Key themes to emerge included frequent dissociation between rotas and actual hours worked, adverse effects on training opportunities and quality, concerns about patient safety, lowering of morale and job satisfaction, and attempts reportedly made in some hospitals to persuade junior doctors to collude in the inaccurate reporting of compliance. Further work is needed to determine whether problems perceived with the EWTD, when they occur, are attributable to the EWTD itself, and shortened working hours, or to the way that it has been implemented in some hospitals.

  11. Building bridges : engaging medical residents in quality improvement and medical leadership

    Voogt, Judith J; van Rensen, Elizabeth L J; van der Schaaf, Marieke F; Noordegraaf, Mirko; Schneider, Margriet Me

    2017-01-01

    OBJECTIVE: To develop an educational intervention that targets residents' beliefs and attitudes to quality Improvement (QI) and leadership in order to demonstrate proactive behaviour. DESIGN: Theory-driven, mixed methods study including document analysis, interviews, observations and open-ended

  12. Military Medical Leadership in Uniformed Medical Students: Creating a New Assessment Instrument Using the Delphi Method

    2015-12-17

    gratitude to Erin Barry, who is the lynchpin, foundation, and soul of the Grunberg lab. There is little doubt in my mind that you are an integral part of...focus on charisma in TLT inspires Khoo (101) and others to warn against the “ dark -side” of charisma using examples of charismatic, yet nefarious...Khoo H, Burch G. 2008. The ‘ dark side’of leadership personality and transformational leadership: An exploratory study. Personality and Individual

  13. How stressful is doctor-patient communication? Physiological and psychological stress of medical students in simulated history taking and bad-news consultations

    Hulsman, Robert L.; Pranger, Susan; Koot, Stephanie; Fabriek, Marcel; Karemaker, John M.; Smets, Ellen M. A.

    2010-01-01

    Introduction: Medical communication can be a stressful experience for both doctors and patients. In particular, inexperienced doctors facing the demanding task of a bad news consultation may experience high levels of distress. The aim of this exploratory study is to test students' differential

  14. Educational climate seems unrelated to leadership skills of clinical consultants responsible of postgraduate medical education in clinical departments

    Malling, Bente Vigh; Mortensen, Lene S.; Scherpbier, Albert J J

    2010-01-01

    The educational climate is crucial in postgraduate medical education. Although leaders are in the position to influence the educational climate, the relationship between leadership skills and educational climate is unknown. This study investigates the relationship between the educational climate...... in clinical departments and the leadership skills of clinical consultants responsible for education....

  15. Games, civil war and mutiny: metaphors of conflict for the nurse-doctor relationship in medical television programmes.

    Weaver, Roslyn

    2013-12-01

    Metaphors of medicine are common, such as war, which is evident in much of our language about health-care where patients and healthcare professionals fight disease, or the game, which is one way to frame the nurse-doctor professional relationship. This study analyses six pilot episodes of American (Grey's Anatomy, Hawthorne, Mercy, Nurse Jackie) and Australian (All Saints, RAN) medical television programmes premiering between 1998 and 2009 to assess one way that our contemporary culture understands and constructs professional relationships between nurses and doctors. Analysis shows that these popular television programmes frequently depict conflict, with games, civil war and mutiny between nurses and doctors over patient safety rather than professionals working collaboratively in teams to deliver health-care. Although the benefit of this televised conflict is the implication that nurses are knowledgeable, skilled professionals, the negative connotations include a dysfunctional and dangerous healthcare system, and also ongoing power struggles. Given that popular culture can sometimes influence the public's understanding of real-life nursing practice, it is important to explore what these metaphors of conflict are communicating about the nurse-doctor relationship. © 2013 John Wiley & Sons Ltd.

  16. "On the doctor's orders": A pilot study of the effects of website marketing for medical specialist providers under gatekeeping arrangements.

    Zwier, Sandra

    2017-01-01

    Websites from medical specialist providers are becoming increasingly marketing oriented, but there exists a paucity of empirical research on the effects. This experimental study explored effects of exposure to real websites from medical specialist providers among Dutch adults under physician gatekeeper arrangements. Exposure led to a stronger intention to seek treatment from the specialist provider and motivation to rely on the providers' claims. Weaker to absent effects were found for intention to question the physician gatekeeper's referral and this was chiefly motivated by the belief that "the doctor knows best." Implications for specialist provider marketing under gatekeeping arrangements are discussed.

  17. Completion of Limitation of Medical Treatment forms by junior doctors for patients with dementia: clinical, medicolegal and education perspectives.

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

    2017-10-01

    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

  18. Occupational factors for mood and anxiety disorders among junior medical doctors.

    Pougnet, R; Di Costanzo, Laurence Pougnet; Kerrien, Margaux; Jousset, D; Loddé, B; Dewitte, J D; Garlantézec, R

    2015-09-09

    Junior doctors are exposed to multiple occupational risks. The aim of this study was to assess the risk factors and protective factors for mood and anxiety disorders among junior doctors. We conducted a cross-sectional study via an anonymous online questionnaire between October 2011 and June 2012. All the junior doctors in our faculty were included. The questionnaire inquired about demographic and health data. It contained four validated scales: the Center for Epidemiologic Studies Depression Scale (CES-D), the Spielberger anxiety questionnaire, the WHO quality of life (WHO - QOL) questionnaire and the Job Content Questionnaire. Finally, it sought to clarify the conditions of professional practice and the interactions between university programmes and junior doctorate students (change of specialty, pregnancy, leave of absence, etc.). 192 juniors doctors participated in the study, 68.2% of whom were women. Out of the group, 13.0% presented a depressive syndrome, while 28.7% presented an anxiety disorder, 32.8% were experiencing Job Strain and 29.7% Iso Strain. The risk factor for anxiety was competition between junior doctors: OR=4.23 (1.06 ‒ 16.82). The protective factors for mood disorders were the help provided by senior physicians and the respect shown by patients: OR=0.21 (0.06-0.74) and 0.20 (0.06-0.75), respectively. This study demonstrated the impact of the relationships with senior physicians and patients on junior doctors' health at work. Consequently, prevention should not be focused uniquely on work organization, but should increase physicians' awareness of the importance of this relationship.

  19. Stress, burnout and doctors' attitudes to work are determined by personality and learning style: a twelve year longitudinal study of UK medical graduates.

    McManus, I C; Keeling, A; Paice, E

    2004-08-18

    The study investigated the extent to which approaches to work, workplace climate, stress, burnout and satisfaction with medicine as a career in doctors aged about thirty are predicted by measures of learning style and personality measured five to twelve years earlier when the doctors were applicants to medical school or were medical students. Prospective study of a large cohort of doctors. The participants were first studied when they applied to any of five UK medical schools in 1990. Postal questionnaires were sent to all doctors with a traceable address on the current or a previous Medical Register. The current questionnaire included measures of Approaches to Work, Workplace Climate, stress (General Health Questionnaire), burnout (Maslach Burnout Inventory), and satisfaction with medicine as a career and personality (Big Five). Previous questionnaires had included measures of learning style (Study Process Questionnaire) and personality. Doctors' approaches to work were predicted by study habits and learning styles, both at application to medical school and in the final year. How doctors perceive their workplace climate and workload is predicted both by approaches to work and by measures of stress, burnout and satisfaction with medicine. These characteristics are partially predicted by trait measures of personality taken five years earlier. Stress, burnout and satisfaction also correlate with trait measures of personality taken five years earlier. Differences in approach to work and perceived workplace climate seem mainly to reflect stable, long-term individual differences in doctors themselves, reflected in measures of personality and learning style.

  20. Stress, burnout and doctors' attitudes to work are determined by personality and learning style: A twelve year longitudinal study of UK medical graduates

    Paice E

    2004-08-01

    Full Text Available Abstract Background The study investigated the extent to which approaches to work, workplace climate, stress, burnout and satisfaction with medicine as a career in doctors aged about thirty are predicted by measures of learning style and personality measured five to twelve years earlier when the doctors were applicants to medical school or were medical students. Methods Prospective study of a large cohort of doctors. The participants were first studied when they applied to any of five UK medical schools in 1990. Postal questionnaires were sent to all doctors with a traceable address on the current or a previous Medical Register. The current questionnaire included measures of Approaches to Work, Workplace Climate, stress (General Health Questionnaire, burnout (Maslach Burnout Inventory, and satisfaction with medicine as a career and personality (Big Five. Previous questionnaires had included measures of learning style (Study Process Questionnaire and personality. Results Doctors' approaches to work were predicted by study habits and learning styles, both at application to medical school and in the final year. How doctors perceive their workplace climate and workload is predicted both by approaches to work and by measures of stress, burnout and satisfaction with medicine. These characteristics are partially predicted by trait measures of personality taken five years earlier. Stress, burnout and satisfaction also correlate with trait measures of personality taken five years earlier. Conclusions Differences in approach to work and perceived workplace climate seem mainly to reflect stable, long-term individual differences in doctors themselves, reflected in measures of personality and learning style.

  1. Stress, burnout and doctors' attitudes to work are determined by personality and learning style: A twelve year longitudinal study of UK medical graduates

    McManus, IC; Keeling, A; Paice, E

    2004-01-01

    Background The study investigated the extent to which approaches to work, workplace climate, stress, burnout and satisfaction with medicine as a career in doctors aged about thirty are predicted by measures of learning style and personality measured five to twelve years earlier when the doctors were applicants to medical school or were medical students. Methods Prospective study of a large cohort of doctors. The participants were first studied when they applied to any of five UK medical schools in 1990. Postal questionnaires were sent to all doctors with a traceable address on the current or a previous Medical Register. The current questionnaire included measures of Approaches to Work, Workplace Climate, stress (General Health Questionnaire), burnout (Maslach Burnout Inventory), and satisfaction with medicine as a career and personality (Big Five). Previous questionnaires had included measures of learning style (Study Process Questionnaire) and personality. Results Doctors' approaches to work were predicted by study habits and learning styles, both at application to medical school and in the final year. How doctors perceive their workplace climate and workload is predicted both by approaches to work and by measures of stress, burnout and satisfaction with medicine. These characteristics are partially predicted by trait measures of personality taken five years earlier. Stress, burnout and satisfaction also correlate with trait measures of personality taken five years earlier. Conclusions Differences in approach to work and perceived workplace climate seem mainly to reflect stable, long-term individual differences in doctors themselves, reflected in measures of personality and learning style. PMID:15317650

  2. Tetrahedron of medical academics: reasons for training in management, leadership and informatics.

    Martins, Henrique

    2009-06-01

    Medical school professors and lecturers are often called to be practicing clinicians, researchers in their own field, in addition to executing their education and curricular responsibilities. Some further accumulate healthcare management responsibilities. These areas pose conflicting demands on time and intellectual activity, but despite their apparent differences, knowledge and skills from management, leadership and informatics may prove useful in helping to smooth these conflicts and hence increase personal effectiveness in these areas. This article tries to clarify some concepts and advance why training in management, leadership and health informatics would seem particularly useful for the medical academic. As opposed to the idea of educational dispersion/specialization, the concept of an integrative tetrahedronal education framework is advanced as a way to plan workshops and other faculty development activities which could be implemented transnationally as well as locally.

  3. 'And you'll suddenly realise 'I've not washed my hands': medical students', junior doctors' and medical educators' narratives of hygiene behaviours.

    Cresswell, Penelope; Monrouxe, Lynn V

    2018-03-22

    Compliance to hygiene behaviours has long been recognised as important in the prevention and control of healthcare associated infections, but medical doctors still display some of the lowest rates of compliance of all healthcare workers. We aim to understand compliance to hygiene behaviours by analysing medical students', junior doctors' and medical educators' narratives of these behaviours to identify their respective attitudes and beliefs around compliance and how these are learnt during training. Such an understanding can inform future interventions to improve compliance targeted to areas of greatest need. A qualitative study, using narrative interviews (nine focus groups and one individual interview). Data were analysed thematically using inductive framework analysis. Teaching hospitals in the UK. Convenience sample of 25 participants: third-year medical students in their first clinical year (n=13), junior doctors (n=6) and medical educators (n=6). We identified four main themes: (1) knowledge, (2) constraints, (3) role models/culture and (4) hygiene as an added extra. Knowledge varied across participant groups and appeared to influence behaviours; medical students relied on what they have been told by seniors, while medical educators relied on their own knowledge and experience. There was a strong belief that evidence for the effectiveness of good hygiene behaviours is lacking. Furthermore, medical educators' behaviour appears to strongly influence others. Finally, hygiene was predominately viewed as an added extra rather than an integral part of the process. Awareness of the evidence around good hygiene needs to be improved at all levels. Medical students and junior doctors should be encouraged to consider why they are asked to perform certain hygiene behaviours in order to improve ownership of those behaviours. Medical educators need to recognise their responsibilities as role models for their junior counterparts, thereby understanding their role in

  4. Job Satisfaction among Doctors of a Government Medical College and Hospital of Eastern India.

    Bhattacherjee, Sharmistha; Ray, Kuntala; Kumar Roy, Jayanta; Mukherjee, Abhijit; Roy, Hironmoy; Datta, Saikat

    2016-10-01

    Job satisfaction expresses the extent of congruence between an individual’s expectation of the job and the reward that the job provides.Job satisfaction among doctors is an issue that is of utmost importance because offactors like patient relationships and time pressures associated with managed care. The current study was done to determine the level of job satisfaction in doctors posted in a tertiary care hospital of eastern India and to find out the factors associated with it. A descriptive cross sectional study was conducted among 255 doctors posted in a tertiary care hospital of eastern India. Data werecollected using a self-reported questionnaire consisting of 49 items addressing the seven domains of job satisfaction, where higher values indicated higher level of satisfaction. The average scores of items were computed to construct factor scores for each individual. Two stage cluster analysis was performed to get the proportion of satisfied doctors and binary logistic regression was used for comparison of predictors of job satisfaction. The proportion of job satisfaction was found to be 59.6% and the most important factor was found to be working space. On adjustment, the odds of being satisfied were found to be higher in the older age groups, among males, doctors posted in preclinical or paraclinical departments and those staying in present setting for 5 years or more. More than half of the doctors were found to be satisfied with their job which can help the policy makers to make necessary strategies to increase the level of satisfaction of the employees. .

  5. Leadership, management and teamwork learning through an extra-curricular project for medical students: descriptive study

    Maria Lucia da Silva Germano Jorge

    Full Text Available CONTEXT AND OBJECTIVE: Professionalism in medicine requires preparation for the globalized world. Our objective was to describe a project that introduces medical students to the community, hospital and laboratory activities, thereby allowing them to gain experience in people management, leadership and teamwork.DESIGN AND SETTING: Descriptive study of the process applied at a philanthropic medical school in Curitiba, Paraná.METHOD: Inclusion of management and leadership practices as part of the medical degree program.RESULTS: The study groups consisted of fifteen students. After six months, any of the participants could be elected as a subcoordinator, with responsibility for managing tasks and representing the team in hospital departments and the community. The activities required increasing levels of responsibility. In medical schools, students' involvement in practical activities is often limited to observation. They are not required to take responsibilities or to interact with other students and stakeholders. However, they will become accountable, which thus has an adverse effect on all involved. The learning space described here aims to fill this gap by bringing students closer to the daily lives and experiences of healthcare professionals.CONCLUSION: Being a physician requires not only management and leadership, but also transferrable competencies, communication and critical thinking. These attributes can be acquired through experience of teamwork, under qualified supervision from teaching staff. Students are thus expected to develop skills to deal with and resolve conflicts, learn to share leadership, prepare others to help and replace them, adopt an approach based on mutual responsibility and discuss their performance.

  6. Balancing Work and Life Promotes Job Satisfaction – Generational Gap among Medical Doctors

    Perumal, Kala Premarani

    2013-01-01

    The profession of a doctor is considered to be one of the noblest professions. Doctors in general work around the clock in their deed of saving human lives and relieving them of physical ailments. However, on their personal front, most of them do not find them to fulfil their personal obligations. A work-life balance, which is nothing but the art of balancing personal and professional lives, is important for any individual to have fulfilment and satisfaction in life. This research intended to...

  7. The agency of patients and carers in medical care and self-care technologies for interacting with doctors.

    Nunes, Francisco; Andersen, Tariq; Fitzpatrick, Geraldine

    2017-06-01

    People living with Parkinson's disease engage in self-care for most of the time but, two or three times a year, they meet with doctors to re-evaluate the condition and adjust treatment. Patients and (informal) carers participate actively in these encounters, but their engagement might change as new patient-centred technologies are integrated into healthcare infrastructures. Drawing on a qualitative study that used observations and interviews to investigate consultations, and digital ethnography to understand interactions in an online community, we describe how patients and carers living with Parkinson's participate in the diagnosis and treatment decisions, engage in discussions to learn about certain topics, and address inappropriate medication. We contrast their engagement with a review of self-care technologies that support interactions with doctors, to investigate how these artefacts may influence the agency of patients and carers. Finally, we discuss design ideas for improving the participation of patients and carers in technology-mediated scenarios.

  8. Flipping the classroom to teach Millennial residents medical leadership: a proof of concept

    Lucardie AT

    2017-01-01

    Full Text Available Alicia T Lucardie,1 Lizanne Berkenbosch,2 Jochem van den Berg,3 Jamiu O Busari3,4 1Faculty of Health, Medicine and Life Sciences, Maastricht University, 2Department of Pediatrics, Maastricht University Medical Centre, Maastricht, 3Department of Pediatrics, Zuyderland Medical Center, Heerlen, 4Department of Educational Development and Research, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands Introduction: The ongoing changes in health care delivery have resulted in the reform of educational content and methods of training in postgraduate medical leadership education. Health care law and medical errors are domains in medical leadership where medical residents desire training. However, the potential value of the flipped classroom as a pedagogical tool for leadership training within postgraduate medical education has not been fully explored. Therefore, we designed a learning module for this purpose and made use of the flipped classroom model to deliver the training. Evidence: The flipped classroom model reverses the order of learning: basic concepts are learned individually outside of class so that more time is spent applying knowledge to discussions and practical scenarios during class. Advantages include high levels of interaction, optimal utilization of student and expert time and direct application to the practice setting. Disadvantages include the need for high levels of self-motivation and time constraints within the clinical setting. Discussion: Educational needs and expectations vary within various generations and call for novel teaching modalities. Hence, the choice of instructional methods should be driven not only by their intrinsic values but also by their alignment with the learners’ preference. The flipped classroom model is an educational modality that resonates with Millennial students. It helps them to progress quickly beyond the mere understanding of theory to higher order

  9. [Publication rates of Turkish medical specialty and doctorate theses on Medical Microbiology, Clinical Microbiology and Infectious Diseases disciplines in international journals].

    Sipahi, Oğuz Reşat; Caglayan Serin, Derya; Pullukcu, Hüsnü; Tasbakan, Meltem; Köseli Ulu, Demet; Yamazhan, Tansu; Arda, Bilgin; Sipahi, Hilal; Ulusoy, Sercan

    2014-04-01

    Writing a thesis is mandatory for getting a postgraduate medical degree in Turkey. Publication of the results of the thesis in an indexed journal makes the results available to researchers, however publication rate is usually low. The aim of this retrospective observational study was to investigate the publication rate of Turkish Infectious Diseases and Clinical Microbiology, Medical Microbiology specialty theses and Microbiology doctorate theses in international peer-review journals. On August 17th 2007, the thesis database of the Council of Higher Education of the Republic of Turkey (YOK) where all specialization and doctorate theses are recorded obligatorily, was searched for Infectious Diseases and Clinical Microbiology and Medical Microbiology specialty and Microbiology doctorate theses. Assuming that publication of a thesis would last at least six months, theses dated to February 2007 and after were excluded. The publication rate of those theses was found out by searching Science Citation Index-Expanded database for thesis author and supervisor between August 17-September 12, 2007. Chi-square test was used for statistical analysis. Our search yielded a total of 834 theses dated from 1997 to 2007, however 10 of them were excluded, since they were dated to February 2007 or after. It was found that the overall publication rate was 11.4% (94/824). The publication rates for Microbiology doctorate, Medical Microbiology and Infectious Diseases and Clinical Microbiology specialty theses were 13.7% (34/249), 10.7% (33/309) and 10.2% (27/266), respectively, with no statistical significance (p> 0.05). It was determined that nine (9.6%) of the 94 published theses belonged to 1997-2001 period, whereas 85 (80.4%) were in 2002-2007 period (p< 0.05). The probable reason for this increase was thought to be related with the updated criteria of YOK carried out in 2000 for academic promotions, nevertheless the publication rate of the investigated theses in international peer

  10. Physical activity education in the undergraduate curricula of all UK medical schools: are tomorrow's doctors equipped to follow clinical guidelines?

    Weiler, Richard; Chew, Stephen; Coombs, Ngaire; Hamer, Mark; Stamatakis, Emmanuel

    2012-11-01

    Physical activity (PA) is a cornerstone of disease prevention and treatment. There is, however, a considerable disparity between public health policy, clinical guidelines and the delivery of physical activity promotion within the National Health Service in the UK. If this is to be addressed in the battle against non-communicable diseases, it is vital that tomorrow's doctors understand the basic science and health benefits of physical activity. The aim of this study was to assess the provision of physical activity teaching content in the curricula of all medical schools in the UK. Our results, with responses from all UK medical schools, uncovered some alarming findings, showing that there is widespread omission of basic teaching elements, such as the Chief Medical Officer recommendations and guidance on physical activity. There is an urgent need for physical activity teaching to have dedicated time at medical schools, to equip tomorrow's doctors with the basic knowledge, confidence and skills to promote physical activity and follow numerous clinical guidelines that support physical activity promotion.

  11. Medical Student and Junior Doctors' Tolerance of Ambiguity: Development of a New Scale

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

    2015-01-01

    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…

  12. Doctor-Patient Relationship and the Medical Student: The Use of Trigger Films.

    Alroy, Gideon; Ber, Rosalie

    1982-01-01

    Trigger films (short situational films followed by discussion) are seen as a suitable medium for teaching the intricacies of the interpersonal relationship, legitimate behavior patterns following doctor-patient interaction, and the sensitivity and ability to detect nonverbal and accessory communication. Guidelines for the production and use of…

  13. First and second year medical students identify and self-stereotype more as doctors than as students: a questionnaire study.

    Burford, Bryan; Rosenthal-Stott, Harriet E S

    2017-11-13

    The emergence of medical students' professional identity is important. This paper considers this in a snapshot of the early years of undergraduate medical education. From the perspective of social identity theory, it also considers self-stereotyping, the extent to which individuals associate with attributes identified as typical of groups. Paper questionnaires were completed by first and second year medical students following teaching sessions at the beginning (October) and end (April) of the academic year. Questionnaires consisted of scales measuring the strength and importance of identity and self-stereotyping, referent to 'doctors' and 'students'. Linear mixed effects regression considered longitudinal and cross-sectional effects of progress through the course, and differences in responses to 'doctor' and 'student' measures. In October, responses were received from 99% (n = 102) and 75% (n = 58) of first and second year cohorts respectively, and in April from 81% (n = 83) and 73% (n = 56). Response rates were over 95% of those present. Linear mixed effects regression found that all 'doctor'-referent measures were higher than 'student' measures. Strength of identity and self-stereotyping decreased between beginning and end of the year (across both groups). Men indicated lower importance of identity than women, also across both groups. There were no differences between year groups. Self-stereotyping was predicted more by importance of identification with a group than by strength of identification. Findings reinforce observations that medical students identify strongly as doctors from early in their studies, and that this identification is greater than as students. Decreases over time are surprising, but may be explained by changing group salience towards the end of the academic year. The lack of a gender effect on strength of identification contrasts with the literature, but may reflect students' lack of 'performance' of professional identity, while the

  14. Medical doctors as the captain of a ship: an analysis of medical students? book reports on Joseph Conrad?s ?Lord Jim?

    Hwang, Kun; Lee, Seung Jae; Kim, Seong Yeon; Hwang, Se Won; Kim, Ae Yang

    2014-01-01

    Purpose: In South Korean ferry disaster in 2014, the captain abandoned the ship with passengers including high school students still aboard. We noticed the resemblance of abandoning the ship with passengers still aboard the ferry (named the Sewol) and the ship Patna, which was full of pilgrims, in Joseph Conrad’s novel “Lord Jim.” The aim of this study is to see how medical students think about the role of a medical doctor as a captain of a ship by analyzing book reports on Conrad’s “Lord Jim...

  15. Gender differences in leadership amongst first-year medical students in the small-group setting.

    Wayne, Nancy L; Vermillion, Michelle; Uijtdehaage, Sebastian

    2010-08-01

    To investigate the extent of gender bias in the volunteerism of small-group leaders amongst first-year medical students, and whether bias could be eliminated with special instructions to the students. The gender of leaders in small-group sessions in a real academic setting was monitored under two conditions: control conditions, in which basic instructions were provided to participants, and intervention conditions, in which the same basic instructions were provided plus a brief "pep talk" on the importance of experiencing a leadership role in a safe environment. During the small-group sessions, an observer noted the gender and names of group leaders for later analysis. After a class debriefing, a subset of leaders and nonleaders from both the control and intervention groups were invited to be interviewed about their perceptions of the small-group experience. Interviews were tape recorded and transcribed for analysis. In 2007-2008 and 2008-2009, disproportionately fewer women than men volunteered to become small-group leaders under control conditions. This gender bias was eliminated under intervention conditions. The interviews illustrated how a subtle change in instructions helped some female students take on a leadership role. Gender bias in leadership in the small-group setting amongst medical students-even when women make up half of the class-may persist without targeted intervention. The authors suggest that frequent and consistent intervention during medical school could be an important factor in encouraging women to identify themselves as leaders, promoting confidence to consider leadership roles in medicine.

  16. Analysis of medical student's book reports on Cronin's The Citadel: would young doctors give up ideals for prestige and wealth?

    Hwang, Se Won; Kim, Hun; Kim, Ae Yang; Hwang, Kun

    2016-06-01

    The purpose of this study is to find what medical students think the reward for their future work should be and whether they would keep their ideals or abandon them for prestige and wealth by analyzing the book reports of Cronin's The Citadel. Participants were 50 medical students of junior class. A month before the classroom lecture, the book and digital video disk were provided. Students had discussions in groups of seven and wrote book reports which include answers of three questions. Regarding what should be the reward for the medical doctor, two-thirds of students (66.7%) answered with spiritual compensation, while one-third (33.3%) chose material reward. In the situation presented to Manson, three-fifths (60.0%) answered they would keep their ideals (idealist), while the remaining two-fifths (40.0%) decided they would abandon them. Less than one-third of students (30.0%) answered they would reveal the corruptions of the doctor's society, while two-thirds (64.0%) would not. The larger number of idealists who prefer spiritual reward rather than a material reward represents the innocence of youth as in portrayed in The Citadel.

  17. What do patients choose to tell their doctors? Qualitative analysis of potential barriers to reattributing medically unexplained symptoms.

    Peters, Sarah; Rogers, Anne; Salmon, Peter; Gask, Linda; Dowrick, Chris; Towey, Maria; Clifford, Rebecca; Morriss, Richard

    2009-04-01

    Despite both parties often expressing dissatisfaction with consultations, patients with medically unexplained symptoms (MUS) prefer to consult their general practitioners (GPs) rather than any other health professional. Training GPs to explain how symptoms can relate to psychosocial problems (reattribution) improves the quality of doctor-patient communication, though not necessarily patient health. To examine patient experiences of GPs' attempts to reattribute MUS in order to identify potential barriers to primary care management of MUS and improvement in outcome. Qualitative study. Patients consulting with MUS whose GPs had been trained in reattribution. A secondary sample of patients of control GPs was also interviewed to ascertain if barriers identified were specific to reattribution or common to consultations about MUS in general. Thematic analysis of in-depth interviews. Potential barriers include the complexity of patients' problems and patients' judgements about how to manage their presentation of this complexity. Many did not trust doctors with discussion of emotional aspects of their problems and chose not to present them. The same barriers were seen amongst patients whose GPs were not trained, suggesting the barriers are not particular to reattribution. Improving GP explanation of unexplained symptoms is insufficient to reduce patients' concerns. GPs need to (1) help patients to make sense of the complex nature of their presenting problems, (2) communicate that attention to psychosocial factors will not preclude vigilance to physical disease and (3) ensure a quality of doctor-patient relationship in which patients can perceive psychosocial enquiry as appropriate.

  18. Perspectives of female medical faculty in Ethiopia on a leadership fellowship program.

    Kvach, Elizabeth; Yesehak, Bethlehem; Abebaw, Hiwot; Conniff, James; Busse, Heidi; Haq, Cynthia

    2017-09-01

    This study aims to evaluate a leadership fellowship program through perspectives of Ethiopian women medical faculty participants. An intensive two-week leadership development fellowship was designed for women faculty from Ethiopian medical schools and conducted from 2011-2015 at the University of Wisconsin-School of Medicine and Public Health in Madison, Wisconsin. Nine Ethiopian women working in early- or mid-level academic positions were selected. Semi-structured interviews were conducted with the fellows. Transcripts were reviewed through qualitative analysis to assess the perceived impact of the training on their careers. Three male academic leaders were interviewed to solicit feedback on the program. Eight of 9 fellows were interviewed. Themes describing the benefits of the fellowship included: increased awareness of gender inequities; enhanced motivation for career advancement; increased personal confidence; and improved leadership skills. Fellows provided suggestions for future training and scaling up efforts to promote gender equity. Male leaders described the benefits of men promoting gender equity within academic health centers. This paper provides evidence that targeted brief training programs can enhance women's motivation and skills to become effective leaders in academic medicine in Ethiopia. Promoting gender equity in academic medicine is an important strategy to address health workforce shortages and to provide professional role models for female students in the health professions.

  19. Human rights from the Nuremberg Doctors Trial to the Geneva Declaration. Persons and institutions in medical ethics and history.

    Frewer, Andreas

    2010-08-01

    The "Universal Declaration of Human Rights" and the "Geneva Declaration" by the World Medical Association, both in 1948, were preceded by the foundation of the United Nations in New York (1945), the World Medical Association in London (1946) and the World Health Organization in Geneva (1948). After the end of World War II the community of nations strove to achieve and sustain their primary goals of peace and security, as well as their basic premise, namely the health of human beings. All these associations were well aware of the crimes by medicine, in particular by the accused Nazi physicians at the Nuremberg Doctors Trial (1946/47, sentence: August 1947). During the first conference of the World Medical Association (September 1947) issues of medical ethics played a major role: and a new document was drafted concerning the values of the medical profession. After the catastrophe of the War and the criminal activities of scientists, the late 1940s saw increased scrutiny paid to fundamental questions of human rights and medical ethics, which are still highly relevant for today's medicine and morality. The article focuses on the development of medical ethics and human rights reflected in the statement of important persons, codes and institutions in the field.

  20. Cost incentives for doctors

    Schottmüller, Christoph

    2013-01-01

    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....

  1. The value of vaccination: results of an Italian survey among Medical Doctors, Policy Makers and General Population

    Chiara Cadeddu

    2012-03-01

    Full Text Available

    Abstract:

    Background: In the Italian context, evolving toward the abandonment of compulsory vaccination, the
    maintenance of adequate levels of coverage appears as essential. The promotion of a good vaccination
    knowledge, supported by strong scientific evidence, and the collaboration of all the involved stakeholders,
    appears hence fundamental. The aim of this survey was to understand why vaccination is not appreciated
    for its real value by different stakeholders.
    Methods: In collaboration with other Italian Universities and Health Districts, in Summer 2011 we submitted
    a survey of 17 questions to a convenience sample of Italian Medical Doctors, Policy Makers and General
    Population. The main questions analyzed the importance of vaccination for health, actions to attain vaccination
    value and consequences of a free choice policy.
    Results: Of the 173 stakeholders interviewed, 78% of Medical Doctors, 82% Policy Makers and 46%
    General Population believe that vaccination is important for health. The most important actions suggested
    for strengthening vaccination were information about its efficacy and safety and studies on its impact on
    Public Health, according to most of General Population and of Medical Doctors and Policy Makers, respectively.
    According to 60.4% Medical Doctors, 72.8% Policy Makers and 56.3% General Population the abolition
    of compulsory vaccination would lead to a reduction of vaccinees in all the Italian regions.
    Conclusions: Our study confirms the need for a thorough “education in vaccination”. Among stakeholders
    there are still doubts that hinder the decision process about vaccination policies and programmes. On
    the other hand, a call for an “Alliance” for promoting and implementing vaccination to its full potential
    would be favoured, as

  2. What influences national and foreign physicians' geographic distribution? An analysis of medical doctors' residence location in Portugal.

    Russo, Giuliano; Ferrinho, Paulo; de Sousa, Bruno; Conceição, Cláudia

    2012-07-02

    The debate over physicians' geographical distribution has attracted the attention of the economic and public health literature over the last forty years. Nonetheless, it is still to date unclear what influences physicians' location, and whether foreign physicians contribute to fill the geographical gaps left by national doctors in any given country. The present research sets out to investigate the current distribution of national and international physicians in Portugal, with the objective to understand its determinants and provide an evidence base for policy-makers to identify policies to influence it. A cross-sectional study of physicians currently registered in Portugal was conducted to describe the population and explore the association of physician residence patterns with relevant personal and municipality characteristics. Data from the Portuguese Medical Council on physicians' residence and characteristics were analysed, as well as data from the National Institute of Statistics on municipalities' population, living standards and health care network. Descriptive statistics, chi-square tests, negative binomial and logistic regression modelling were applied to determine: (a) municipality characteristics predicting Portuguese and International physicians' geographical distribution, and; (b) doctors' characteristics that could increase the odds of residing outside the country's metropolitan areas. There were 39,473 physicians in Portugal in 2008, 51.1% of whom male, and 40.2% between 41 and 55 years of age. They were predominantly Portuguese (90.5%), with Spanish, Brazilian and African nationalities also represented. Population, Population's Purchasing Power, Nurses per capita and Municipality Development Index (MDI) were the municipality characteristics displaying the strongest association with national physicians' location. For foreign physicians, the MDI was not statistically significant, while municipalities' foreign population applying for residence

  3. The communicative dimension in medical training: A proposal to strengthen the doctor-patient relationship

    Jacinto Sánchez-Angarita

    2017-10-01

    Based on these approaches, a proposal is made to promote education considering the PBL teaching strategy that favors training in the communicative dimension, in order to promote the integration of disciplines, the construction of meaningful learning, interdisciplinary work, and problem solving with a holistic vision. Additionally, obtaining information to solve learning situations, making decisions and finding ways of communicating with patients is intended with the purpose of strengthening the doctor-patient relationship.

  4. Medical consultation and communication with a family doctor from the patients’ perspective – a review of the literature

    Ludmiła Marcinowicz

    2016-09-01

    Full Text Available The modern understanding of the quality of healthcare takes into account new roles that were granted to patients, including the possibility to assess healthcare based on their experience. A review of the literature shows that among the basic dimensions which serve to measure patients’ satisfaction, issues related to communication are essential. The aim of the study is to determine the aspects of communication with a family doctor which are particularly important from the perspective of the patient. A review of the literature from the years 2000–2016 on communication with family doctors was performed, including articles based on both quantitative and qualitative studies. The main source of the data was the English-language online database PubMed, in which articles were searched for based on such key words as: “medical consultation”, “family doctor”, “general practitioner”, “communication”, “patient’s perspective”. Furthermore, information was searched for in Polish-language journals, books and textbooks for physicians, using a method of manual screening. Analysis of the literature allowed for the identification of the following aspects of communicating with a family doctor perceived by patients: the experience of patients, establishing rapport with a patient, listening, informing a patient, non-verbal behavior, use of a computer during a visit, communication issues from older patients’ perspective, and the relationship between communication and dissatisfaction with care. In summary, the problems of communication between the patient and a family doctor are complex and diverse. The patients’ perspective, with regard to expectations and satisfaction with various aspects of care, including communication, is an important indicator of the quality of care delivered by a family physician.

  5. Career Choices and Career Progression of Junior Doctors in Dermatology: Surveys of UK Medical Graduates.

    Barat, Atena; Goldacre, Michael J; Lambert, Trevor W

    2018-01-01

    To report UK-trained doctors' career choices for dermatology, career destinations, and factors influencing career pathways. Multicohort multipurpose longitudinal surveys of UK-trained doctors who graduated between 1974 and 2015. In all, 40,412 doctors (58% of graduates) responded in year 1, 31,466 (64%) in year 3, and 24,970 (67%) in year 5. One year after graduation, 1.7% of women and 0.6% of men made dermatology their first choice but by five years after graduation the respective figures were 1.0% and 0.7%. Compared to their predecessors, its popularity fell more substantially from years 1 to 5 among recent graduates (2005-15), particularly for women (from 2.1% in year 1 to 0.8% in year 5) compared with a fall from 0.8% to 0.5% among men. The most important factor influencing dermatology choice was "hours/working conditions": in year one, 69% regarded this as important compared with 31% of those choosing other hospital physician specialties. Only 18% of respondents who chose dermatology at year 1 eventually worked in it; however, almost all practising dermatologists (94%), 10 years after qualifying, had made their future career decision by year 5. Dermatology is popular among female UK graduates. Most dermatologists made their career decision late but decisively.

  6. Dealing With Deans and Academic Medical Center Leadership: Advice From Leaders.

    Sanfilippo, Fred; Powell, Deborah; Folberg, Robert; Tykocinski, Mark

    2018-01-01

    The 2017 Association of Pathology Chairs Annual Meeting included a session for department chairs and other department leaders on "how to deal with deans and academic medical center leadership." The session was focused on discussing ways to foster positive relationships with university, medical school, and health system leaders, and productively address issues and opportunities with them. Presentations and a panel discussion were provided by 4 former pathology chairs who subsequently have served as medical deans and in other leadership positions including university provost, medical center CEO, and health system board chair. There was a strong consensus among the participants on how best to deal with superiors about problems, conflicts, and requests for additional resources and authority. The importance of teamwork and accountability in developing a constructive and collaborative relationship with leaders and peers was discussed in detail. Effectiveness in communication, negotiation, and departmental advocacy were highlighted as important skills. As limited resources and increased regulations have become growing problems for universities and health systems, internal stress and competition have increased. In this rapidly changing environment, advice on how chairs can interact most productively with institutional leaders is becoming increasingly important.

  7. 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.

    Liu, Wei; Gerdtz, Marie; Manias, Elizabeth

    2016-10-01

    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

  8. Postgraduates' perceptions of preparedness for work as a doctor and making future career decisions: support for rural, non-traditional medical schools.

    Eley, D S

    2010-08-01

    The intern year is a critical time for making career decisions and gaining confidence in clinical skills, communication and teamwork practices; this justifies an interest in junior doctors' perceptions of their level of preparedness for hospital work. This study explored Australian junior doctors' perspectives regarding the transition from student to doctor roles, their preparation as medical undergraduates within either traditional metropolitan schools or smaller, outer metropolitan-based (rural) programs such as Rural Clinical Schools (RCS), and the educational environment they experienced in their internship. A qualitative cross-sectional design used semi-structured interviews with postgraduate year one and two junior doctors (9 females and 11 males) within teaching hospitals in Queensland Australia. Interview questions focussed on four major content areas: preparedness for hospital work, undergraduate training, building confidence and career advice. Data were analyzed using a framework method to identify and explore major themes. Junior doctors who spent undergraduate years training at smaller, non-traditional medical schools felt more confident and better prepared at internship. More hands-on experience as students, more patient contact and a better grounding in basic sciences were felt by interns to be ideal for building confidence. Junior doctors perceived a general lack of career guidance in both undergraduate and postgraduate teaching environments to help them with the transition from the student to junior doctor roles. Findings are congruent with studies that have confirmed student opinion on the higher quality of undergraduate medical training outside a traditional metropolitan-based program, such as a RCS. The serious shortage of doctors in rural and remote Australia makes these findings particularly relevant. It will be important to gain a better understanding of how smaller non-traditional medical programs build confidence and feelings of work

  9. The Current Status and a New Approach for Chinese Doctors to Obtain Medical Knowledge Using Social Media: A Study of WeChat

    Li Liu

    2018-01-01

    Full Text Available Background. WeChat is the most widely and frequently used mobile social media in China and has profoundly integrated into the daily life of many Chinese people. A variety of medicine-related information may be found on WeChat. As users of WeChat, doctors often access health-related information and even provide a variety of medical services or participate in various types of mobile communication with patients. Objective. This study is the first attempt to quantitatively explore the approaches by doctors of acquiring medical knowledge using Internet resources especially social media such as WeChat to access knowledge. Methods. A self-administered questionnaire was designed, distributed, collected, and analyzed utilizing the online survey tool Sojump. WeChat was adopted to randomly release the questionnaires using snowball sampling and collect the results after a certain amount of time. Results. 292 valid questionnaires out of 314 questionnaires by clinical doctors were analyzed. Regarding the current status of accessing medical knowledge among doctors, more than 60% of the doctors regularly used the Internet to search for medical knowledge, 19.86% used WeChat as a channel to acquire medical knowledge, and only 23.97% were satisfied with acquiring medical knowledge through the Internet. Regarding the frequency of WeChat usage, nearly 40% of the doctors accessed WeChat more than 20 times per day and over 70% used WeChat for over half an hour every day. Regarding the status of accessing medical knowledge through WeChat, nearly half (47.26% of the doctors stated that they often read professional medical articles on WeChat and the most common channel is friends’ moment sharing and public account subscriptions, with selection rates of 59.93% and 60.27%, respectively. The most desirable mode of acquiring medical knowledge through WeChat was the following: “professional medical knowledge from peers, with a reminder.” Conclusion. WeChat has become a

  10. Future doctors : Mental distress during medical education: cross-sectional and longitudinal studies

    Dahlin, Marie

    2007-01-01

    Medical education is long and stressful and medical students may suffer from mental distress. The aims of this dissertation are threefold; to investigate levels of distress in medical students at one Swedish medical school, to examine gender differences in such distress and to study individual and environmental determinants of distress. Major outcome measures were self-rated depression, burnout and interviewer-rated psychiatric morbidity. The thesis consists of two cross-sec...

  11. Professional identity formation in the transition from medical school to working life: a qualitative study of group-coaching courses for junior doctors.

    de Lasson, Lydia; Just, Eva; Stegeager, Nikolaj; Malling, Bente

    2016-06-24

    The transition from student to medical doctor is challenging and stressful to many junior doctors. To practice with confidence and professionalism the junior doctors have to develop a strong professional identity. Various suggestions on how to facilitate formation of professional identity have been offered including the possible positive effect of group-coaching courses. The purpose of this study was to explore how group-coaching might facilitate professional identity formation among junior doctors in the transition period. Group-coaching courses comprising three whole-day sessions and five 2 h sessions during a period of 4 months were offered to junior doctors in the first years after graduation. The purpose was to support the participants' professional development, ability to relate to patients, relatives and staff and career development. The coaches in this study had a background as health professionals combined with coaching educations. Data was obtained through observations, open-ended questionnaires and interviews. A generic thematic analysis was applied. Forty-five doctors participated in six coaching groups. The three main themes emerging in the sessions were: Adoption to medical culture, career planning, and work/life-balance. The junior doctors found the coaching intervention highly useful in order to cope with these challenges. Furthermore, the group was a forum where the junior doctors could share thoughts and feelings with colleagues without being afraid that this would endanger their professional career. Many found new ways to respond to everyday challenges mainly through a new awareness of patterns of thinking and feeling. The participants found that the group-coaching course supported their professional identity formation (thinking, feeling and acting as a doctor), adoption to medical culture, career planning and managing a healthy work/life-balance. Further studies in different contexts are recommended as well as studies using other methods to

  12. Socialization, Indifference, and Convenience: Exploring the Uptake of Influenza Vaccine Among Medical Students and Early Career Doctors.

    Edge, Rhiannon; Goodwin, Dawn; Isba, Rachel; Keegan, Thomas

    2017-11-01

    The Chief Medical Officer recommends that all health care workers receive an influenza vaccination annually. High vaccination coverage is believed to be the best protection against the spread of influenza within a hospital, although uptake by health care workers remains low. We conducted semistructured interviews with seven medical students and nine early career doctors, to explore the factors informing their influenza vaccination decision making. Data collection and analysis took place iteratively, until theoretical saturation was achieved, and a thematic analysis was performed. Socialization was important although its effects were attenuated by participants' previous experiences and a lack of clarity around the risks and benefits of vaccination. Many participants did not have strong intentions regarding vaccination. There was considerable disparity between an individual's opinion of the vaccine, their intentions, and their vaccination status. The indifference demonstrated here suggests few are strongly opposed to the vaccination-there is potential to increase vaccination coverage.

  13. Developing leadership competencies among medical trainees: five-year experience at the Cleveland Clinic with a chief residents' training course.

    Farver, Carol F; Smalling, Susan; Stoller, James K

    2016-10-01

    Challenges in healthcare demand great leadership. In response, leadership training programs have been developed within academic medical centers, business schools, and healthcare organizations; however, we are unaware of any well-developed programs for physicians-in-training. To address this gap, we developed a two-day leadership development course for chief residents (CRs) at the Cleveland Clinic, framed around the concept of emotional intelligence. This paper describes our five-year experience with the CRs leadership program. Since inception, 105 CRs took the course; 81 (77%) completed before-and-after evaluations. Participants indicated that they had relatively little prior knowledge of the concepts that were presented and that the workshop greatly enhanced their familiarity with leadership competencies. Qualitative analysis of open-ended responses indicated that attendees valued the training, especially in conflict resolution and teamwork, and indicated specific action plans for applying these skills. Furthermore, the workshop spurred some participants to express plans to learn more about leadership competencies. This study extends prior experience in offering an emotional intelligence-based leadership workshop for CRs. Though the program is novel, further research is needed to more fully understand the impact of leadership training for CRs and for the institutions and patients they serve. © The Royal Australian and New Zealand College of Psychiatrists 2016.

  14. South African Dental Students' Perceptions of Most Important Nonclinical Skills According to Medical Leadership Competency Framework.

    Van der Berg-Cloete, Sophy E; Snyman, Lorraine; Postma, Thomas C; White, John G

    2016-11-01

    Recent developmental frameworks suggest that dental curricula should focus on developing nonclinical skills in dental students. The aim of this study was to qualitatively map students' perceptions of the most important nonclinical skills against the Medical Leadership Competency Framework (MLCF). A representative sample of second- to fifth-year students (n=594; overall response rate 69%) from all four dental schools in South Africa participated in a cross-sectional survey in 2014-15 enquiring about nonclinical skills and dental practice management. One of the questions required students to list the four most important nonclinical skills required for a dentist. Students (n=541) most frequently noted competencies related to working with others (97.9%), personal qualities (72.3%), and managing services (42.9%) as the most important nonclinical skills. Very few students mentioned competencies related to the improvement of services (14.1%) and the provision of strategic direction (10.9%). The students' attention appeared to be on nonclinical skills generally required for clinical care with some realization of the importance of managing services, indicating a need for a stronger focus on leadership and management training in dental schools in South Africa. The results also helped to unravel some of the conceptual ambiguity of the MLCF and highlight opportunities for leadership research using the MLCF as a conceptual framework.

  15. Mais Médicos program: provision of medical doctors in rural, remote and socially vulnerable areas of Brazil, 2013-2014.

    Pereira, Lucélia L; Santos, Leonor M P; Santos, Wallace; Oliveira, Aimê; Rattner, Daphne

    2016-01-01

    maroon communities in the richest regions had more than 1.0 doctors per thousand inhabitants, whereas in the poorest regions fewer than 7% of municipalities reached that level. The Mais Médicos program has granted medical assistance to these historically overlooked populations. However, it is important to evaluate the mid- and long-term sustainability of this initiative.

  16. Career Choices and Career Progression of Junior Doctors in Dermatology: Surveys of UK Medical Graduates

    Atena Barat

    2018-01-01

    Full Text Available Objective. To report UK-trained doctors’ career choices for dermatology, career destinations, and factors influencing career pathways. Methods. Multicohort multipurpose longitudinal surveys of UK-trained doctors who graduated between 1974 and 2015. Results. In all, 40,412 doctors (58% of graduates responded in year 1, 31,466 (64% in year 3, and 24,970 (67% in year 5. One year after graduation, 1.7% of women and 0.6% of men made dermatology their first choice but by five years after graduation the respective figures were 1.0% and 0.7%. Compared to their predecessors, its popularity fell more substantially from years 1 to 5 among recent graduates (2005–15, particularly for women (from 2.1% in year 1 to 0.8% in year 5 compared with a fall from 0.8% to 0.5% among men. The most important factor influencing dermatology choice was “hours/working conditions”: in year one, 69% regarded this as important compared with 31% of those choosing other hospital physician specialties. Only 18% of respondents who chose dermatology at year 1 eventually worked in it; however, almost all practising dermatologists (94%, 10 years after qualifying, had made their future career decision by year 5. Conclusion. Dermatology is popular among female UK graduates. Most dermatologists made their career decision late but decisively.

  17. 'Bourdieu', medical elites and 'social class': a qualitative study of 'desert island' doctors.

    McDonald, Ruth

    2014-07-01

    Sociologists of professions draw on Weberian theories of closure. However they have tended to ignore Bourdieu's work, which rejects Weberian notions of class and status groups as distinct ideal types and sees these concepts as inextricably linked. Bourdieu emphasises the importance of a class-based habitus which generates orientations, inclinations and dispositions that organise practices and the perception of practice. For Bourdieu, because individuals perceive one another primarily through the status that attaches to their practices (through a symbolic veil of honour) they fail to perceive the real basis of these practices: the forms of capital that underlie the different habitus and enable their realisation. This article draws on interviews with 17 elite doctors appearing on a national (UK) radio show during which they choose eight discs to take to a desert island. According to Bourdieu, 'nothing more clearly affirms one's "class", nothing more infallibly classifies, than one's taste in music'. An analysis of the doctors' musical tastes and their mode of acquisition (largely, for these elites, via their family and education at independent schools), as well as other insights into their cultural capital reveals the importance of linking class and status when exploring professional status and prestige. © 2014 The Author. Sociology of Health & Illness © 2014 Foundation for the Sociology of Health & Illness/John Wiley & Sons Ltd.

  18. Defining Components of Team Leadership and Membership in Prehospital Emergency Medical Services.

    Crowe, Remle P; Wagoner, Robert L; Rodriguez, Severo A; Bentley, Melissa A; Page, David

    2017-01-01

    Teamwork is critical for patient and provider safety in high-stakes environments, including the setting of prehospital emergency medical services (EMS). We sought to describe the components of team leadership and team membership on a single patient call where multiple EMS providers are present. We conducted a two-day focus group with nine subject matter experts in crew resource management (CRM) and EMS using a structured nominal group technique (NGT). The specific question posed to the group was, "What are the specific components of team leadership and team membership on a single patient call where multiple EMS providers are present?" After round-robin submission of ideas and in-depth discussion of the meaning of each component, participants voted on the most important components of team leadership and team membership. Through the NGT process, we identified eight components of team leadership: a) creates an action plan; b) communicates; c) receives, processes, verifies, and prioritizes information; d) reconciles incongruent information; e) demonstrates confidence, compassion, maturity, command presence, and trustworthiness; f) takes charge; g) is accountable for team actions and outcomes; and h) assesses the situation and resources and modifies the plan. The eight essential components of team membership identified included: a) demonstrates followership, b) maintains situational awareness, c) demonstrates appreciative inquiry, d) does not freelance, e) is an active listener, f) accurately performs tasks in a timely manner, g) is safety conscious and advocates for safety at all times, and h) leaves ego and rank at the door. This study used a highly structured qualitative technique and subject matter experts to identify components of teamwork essential for prehospital EMS providers. These findings and may be used to help inform the development of future EMS training and assessment initiatives.

  19. “But my Doctor Recommended Pot”: Medical Marijuana and the Patient–Physician Relationship

    Nussbaum, Abraham M.; Boyer, Jonathan A.; Kondrad, Elin C.

    2011-01-01

    As the use of medical marijuana expands, it is important to consider its implications for the patient–physician relationship. In Colorado, a small cohort of physicians is recommending marijuana, with 15 physicians registering 49% of all medical marijuana patients and a single physician registering 10% of all patients. Together, they have registered more than 2% of the state to use medical marijuana in the last three years. We are concerned that this dramatic expansion is occurring in a settin...

  20. How do medical doctors in the European Union demonstrate that they continue to meet criteria for registration and licencing?

    Solé, Meritxell; Panteli, Dimitra; Risso-Gill, Isabelle; Döring, Nora; Busse, Reinhard; McKee, Martin; Legido-Quigley, Helena

    2014-12-01

    This paper reviews procedures for ensuring that physicians in the European Union (EU) continue to meet criteria for registration and the implications of these procedures for cross-border movement of health professionals following implementation of the 2005/36/EC Directive on professional qualifications. A questionnaire was completed by key informants in 10 EU member states, supplemented by a review of peer-reviewed and grey literature and a review conducted by key experts in each country. The questionnaire covered three aspects: actors involved in processes for ensuring continued adherence to standards for registration and/or licencing (such as revalidation), including their roles and functions; the processes involved, including continuing professional development (CPD) and/or continuing medical education (CME); and contextual factors, particularly those impacting professional mobility. All countries included in the study view CPD/CME as one mechanism to demonstrate that doctors continue to meet key standards. Although regulatory bodies in a few countries have established explicit systems of ensuring continued competence, at least for some doctors (in Belgium, Germany, Hungary, the Netherlands, Slovenia and the UK), self-regulation is considered sufficient to ensure that physicians are up to date and fit to practice in others (Austria, Finland, Estonia and Spain). Formal systems vary greatly in their rationale, structure, and coverage. Whereas in Germany, Hungary and Slovenia, systems are exclusively focused on CPD/CME, the Netherlands also includes peer review and minimum activity thresholds. Belgium and the UK have developed more complex mechanisms, comprising a review of complaints or compliments on performance and (in the UK) colleague and patient questionnaires. Systems for ensuring that doctors continue to meet criteria for registration and licencing across the EU are complex and inconsistent. Participation in CPD/CME is only one aspect of maintaining

  1. The Being of Leadership

    Souba Wiley W

    2011-02-01

    Full Text Available Abstract The ethical foundation of the medical profession, which values service above reward and holds the doctor-patient relationship as inviolable, continues to be challenged by the commercialization of health care. This article contends that a realigned leadership framework - one that distinguishes being a leader as the ontological basis for what leaders know, have, and do - is central to safeguarding medicine's ethical foundation. Four ontological pillars of leadership - awareness, commitment, integrity, and authenticity - are proposed as fundamental elements that anchor this foundation and the basic tenets of professionalism. Ontological leadership is shaped by and accessible through language; what health care leaders create in language "uses" them by providing a point of view (a context within and from which they orient their conversations, decisions, and conduct such that they are ethically aligned and grounded. This contextual leadership framework exposes for us the limitations imposed by our mental maps, creating new opportunity sets for being and action (previously unavailable that embody medicine's charter on professionalism. While this leadership methodology contrasts with the conventional results-oriented model where leading is generally equated with a successful clinical practice, a distinguished research program, or a promotion, it is not a replacement for it; indeed, results are essential for performance. Rather, being and action are interrelated and their correlated nature equips leaders with a framework for tackling health care's most complex problems in a manner that preserves medicine's venerable ethical heritage.

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

    Hills, Laura

    2016-01-01

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

  3. Medical-surgical nurses' perceived self-confidence and leadership abilities as first responders in acute patient deterioration events.

    Hart, Patricia L; Spiva, LeeAnna; Baio, Pamela; Huff, Barbara; Whitfield, Denice; Law, Tammy; Wells, Tiffany; Mendoza, Inocenica G

    2014-10-01

    To explore and understand medical-surgical nurses' perceived self-confidence and leadership abilities as first responders in recognising and responding to clinical deterioration prior to the arrival of an emergency response team. Patients are admitted to hospitals with multiple, complex health issues who are more likely to experience clinical deterioration. The majority of clinical deterioration events occur on medical-surgical units, and medical-surgical nurses are frequently the first healthcare professionals to identify signs and symptoms of clinical deterioration and initiate life-saving interventions. A prospective, cross-sectional, descriptive quantitative design using a survey method was used. Nurses were recruited from an integrated healthcare system located in the south-east United States. Nurses completed a demographic, a self-confidence and a leadership ability questionnaire. One hundred and forty-eight nurses participated in the study. Nurses felt moderately self-confident in recognising, assessing and intervening during clinical deterioration events. In addition, nurses felt moderately comfortable performing leadership skills prior to the arrival of an emergency response team. A significant, positive relationship was found between perceived self-confidence and leadership abilities. Age and certification status were significant predictors of nurses' leadership ability. Although nurses felt moderately self-confident and comfortable with executing leadership abilities, improvement is needed to ensure nurses are competent in recognising patients' deterioration cues and making sound decisions in taking appropriate, timely actions to rescue patients. Further strategies need to be developed to increase nurses' self-confidence and execution of leadership abilities in handling deterioration events for positive patient outcomes. Educational provisions should focus on various clinical deterioration events to build nurses' self-confidence and leadership abilities

  4. When you can't have the cake and eat it too: a study of medical doctors' priorities in complex choice situations.

    Carlsen, Benedicte; Hole, Arne Risa; Kolstad, Julie Riise; Norheim, Ole Frithjof

    2012-12-01

    Available literature provides little insight into medical doctors' prescription choices when they are required to make complex trade-offs between different concerns such as treatment effect, costs, and patient preferences simultaneously. This study investigates this issue. It is based on a Discrete Choice Experiment (DCE) conducted with 571 Norwegian doctors, where the DCE captures preferences for medications described along five dimensions important for both clinical decision-making and prioritisation in the health sector. Although effectiveness is the most important determinant of choice in our study, doctors also put considerable weight on patients' preferences and on avoiding high total costs. The probability of choosing a particular medication increases when doctors have a positive experience with the medication. GPs value high clinical effectiveness less than hospital consultants do. They are also less concerned with patient preferences. For both groups of doctors it turns out that they are willing to make difficult trade-offs between attributes they are often assumed not to be willing to compromise on, like effectiveness or patient preferences, and cost measures - given that they have proper information about these attributes. Copyright © 2012 Elsevier Ltd. All rights reserved.

  5. Planning a pharmacy-led medical mission trip, part 2: servant leadership and team dynamics.

    Brown, Dana A; Brown, Daniel L; Yocum, Christine K

    2012-06-01

    While pharmacy curricula can prepare students for the cognitive domains of pharmacy practice, mastery of the affective aspects can prove to be more challenging. At the Gregory School of Pharmacy, medical mission trips have been highly effective means of impacting student attitudes and beliefs. Specifically, these trips have led to transformational changes in student leadership capacity, turning an act of service into an act of influence. Additionally, building team unity is invaluable to the overall effectiveness of the trip. Pre-trip preparation for teams includes activities such as routine team meetings, team-building activities, and implementation of committees, as a means of promoting positive team dynamics. While in the field, team dynamics can be fostered through activities such as daily debriefing sessions, team disclosure times, and provision of medical services.

  6. The relationship between transformational leadership and social capital in hospitals--a survey of medical directors of all German hospitals.

    Hammer, Antje; Ommen, Oliver; Röttger, Julia; Pfaff, Holger

    2012-01-01

    The German hospital market has been undergoing major changes in recent years. Success in this new market is determined by a multitude of factors. One is the quality of the social relationships between staff and the presence of shared values and rules. This factor can be considered an organization's "social capital." This study investigates the relationship between social capital and leadership style in German hospitals using a written survey of medical directors. In 2008, a cross-sectional representative study was conducted with 1224 medical directors from every hospital in Germany with at least 1 internal medicine unit and 1 surgery unit. Among the scales included in the standardized questionnaire were scales used to assess the medical directors' evaluation of social capital and transformational leadership in the hospital. We used a multiple linear regression model to examine the relationship between social capital and internal coordination. We controlled for hospital ownership, teaching status, and number of beds. In total, we received questionnaires from 551 medical directors, resulting in a response rate of 45.2%. The participating hospitals had an average of 345 beds. The sample included public (41.3%), not-for-profit (46.9%), and for-profit (11.7%) hospitals. The data, which exclusively represent the perceptions of the medical directors, indicate a significant correlation between a transformational leadership style of the executive management and the social capital as perceived by medical directors. A transformational leadership style of the executive management accounted for 36% of variance of the perceived social capital. The perceived social capital in German hospitals is closely related to the leadership style of the executive management. A transformational leadership style of the executive management appears to successfully strengthen the hospital's social capital.

  7. The role of encapsulated knowledge in clinical case representations of medical students and family doctors

    Rikers, Remy MJP; Loyens, Sofie MM; Schmidt, Henk G

    2004-01-01

    BACKGROUND: Previous studies on the development of medical expertise, predominantly using measures of free recall and pathophysiological explanations, have shown ambiguous results concerning the relationship between expertise level and encapsulated knowledge. PURPOSE: To investigate differences in

  8. Acute effects of urban ambient air pollution on respiratory symptoms, asthma medication use, and doctor visits for asthma in a cohort of Australian children

    Jalaludin, Bin B.; O'Toole, Brian I.; Leeder, Stephen R.

    2004-01-01

    We enrolled a cohort of primary school children with a history of wheeze (n=148) in an 11-month longitudinal study to examine the relationship between ambient air pollution and respiratory morbidity. We obtained daily air pollution (ozone, particulate matter less than 10 μm, and nitrogen dioxide), meteorological, and pollen data. One hundred twenty-five children remained in the final analysis. We used logistic regression models to determine associations between air pollution and respiratory symptoms, asthma medication use, and doctor visits for asthma. There were no associations between ambient ozone concentrations and respiratory symptoms, asthma medication use, and doctor visits for asthma. There was, however, an association between PM 10 concentrations and doctor visits for asthma (RR=1.11, 95% CI=1.04-1.19) and between NO 2 concentration and wet cough (RR=1.05, 95% CI=1.003-1.10) in single-pollutant models. The associations remained significant in multipollutant models. There was no consistent evidence that children with wheeze, positive histamine challenge, and doctor diagnosis of asthma reacted differently to air pollution from children with wheeze and doctor diagnosis of asthma and children with wheeze only. There were significant associations between PM 10 levels and doctor visits for asthma and an association between NO 2 levels and the prevalence of wet cough. We were, however, unable to demonstrate that current levels of ambient air pollution in western Sydney have a coherent range of adverse health effects on children with a history of wheezing

  9. Working time of doctors in medical entities taking into account practical application of working time systems

    Jagoda Jaskulska

    2015-12-01

    all their formal working hours. In such cases it seems right to aim to reduce the number of not-working hours and complete the doctor’s weekly workload with medical duty hours only when necessary. The authors present how theoretical deliberations on designing working time schedules are manifested in practice. They take into account the basic assumptions concerning working time, specific provisions of the Medical Services Act and the recent decisions of the Supreme Court (further referred to as: SC.

  10. Strong leadership and teamwork drive culture and performance change: Ohio State University Medical Center 2000-2006.

    Sanfilippo, Fred; Bendapudi, Neeli; Rucci, Anthony; Schlesinger, Leonard

    2008-09-01

    Several characteristics of academic health centers have the potential to create high levels of internal conflict and misalignment that can pose significant leadership challenges. In September 2000, the positions of Ohio State University (OSU) senior vice president for health sciences, dean of the medical school, and the newly created position of chief executive officer of the OSU Medical Center (OSUMC) were combined under a single leader to oversee the OSUMC. This mandate from the president and trustees was modeled after top institutions with similar structures. The leader who assumed the role was tasked with improving OSUMC's academic, clinical, and financial performance. To achieve this goal, the senior vice president and his team employed the service value chain model of improving performance, based on the premise that leadership behavior/culture drives employee engagement/satisfaction, leading to customer satisfaction and improved organizational performance. Implementing this approach was a seven-step process: (1) selecting the right leadership team, (2) assessing the challenges and opportunities, (3) setting expectations for performance and leadership behavior, (4) aligning structures and functions, (5) engaging constituents, (6) developing leadership skills, and (7) defining strategies and tracking goals. The OSUMC setting during this period provides an observational case study to examine how these stepwise changes, instituted by strong leadership and teamwork, were able to make and implement sound decisions that drove substantial and measurable improvements in the engagement and satisfaction of faculty and staff; the satisfaction of students and patients; and academic, clinical, and financial performance.

  11. International medical migration: a critical conceptual review of the global movements of doctors and nurses.

    Bradby, Hannah

    2014-11-01

    This paper critically appraises the discourse around international medical migration at the turn of the 21st century. A critical narrative review of a range of English-language sources, including grey literature, books and research reports, traces the development and spread of specific causative models. The attribution of causative relations between the movement of skilled medical workers, the provision of health care and population health outcomes illustrates how the global reach of biomedicine has to be understood in the context of local conditions. The need to understand migration as an aspect of uneven global development, rather than a delimited issue of manpower services management, is illustrated with reference to debates about 'brain drain' of Africa's health-care professionals, task-shifting and the crisis in health-care human resources. The widespread presumed cause of shortages of skilled health-care staff in sub-Saharan Africa was overdetermined by a compelling narrative of rich countries stealing poor countries' trained health-care professionals. This narrative promotes medical professional interests and ignores historical patterns of underinvestment in health-care systems and structures. Sociological theories of medicalization suggest that the international marketization of medical recruitment is a key site where the uneven global development of capital is at work. A radical reconfiguration of medical staffing along the lines of 'task-shifting' in rich and poor countries' health-care systems alike offers one means of thinking about global equity in access to quality care. © The Author(s) 2014.

  12. Do doctors benefit from their profession?--A survey of medical practitioners' health promotion and health safety practices.

    O'Connor, M

    1998-12-01

    Three hundred Irish Medical Organisation members were surveyed on health promotion and health and safety issues. 64.7% responded (65.3 males; 33.7% < thirty-five years). Over half (54.9%) were aware of the safety legislation and very few reported available occupational health services. A majority wanted more such services. Nearly all believed health promotion was important yet only 35.2% always availed of opportunities to give such advice. 36.3% were often stressed, particularly at work. Alcohol was sometimes or frequently used to cope by around half of respondents. Although less than half (47.7%) used whole milk, one third usually or always added salt to their food. 15.5% took no weekly aerobic exercise but 42.0% claimed to do so three times weekly. 11.4 were current smokers. A third of women had never had a cervical smear. We conclude doctors require adequate occupational health services.

  13. Heritage of Stanisław Ostrowski - the only one medical doctor who became state Polish President - Patriae Semper Fidelis.

    Woltanowska, Martyna; Woltanowski, Piotr; Wincewicz, Andrzej; Woltanowska, Magdalena

    2018-01-01

    Our purpose was to write a biography of Stanisław Ostrowski that would address in the first place the medical aspect of his professional life, with a comprehensive approach of others fields of his activity. We essentially grounded the paper on primary resources that were papers authored by Ostrowski including his scientific publications, memories, speeches as well as contemporaneous official documents that referred to Ostrowski. Second resources were also used to double check some data from primary resources and to place the biography of Stanisław Ostrowski in a proper background with special care to social, professional and political context. In this study, second resources comprised papers, that were prepared after the death of Stanisław Ostrowski. Stanisław Ostrowski, MD was a meticulous military medical doctor with an academic engagement at the King John Casimir University of Lvov. In addition, he was an excellent organizer, who soon got involved in politics to serve the local community with essential projects in public health particularly anti-tuberculosis campaigns in Lvov district. His quiet and proficient nature made him an ideal statesman with incredible skills to reconcile social, national and political enemies. Ostrowski was elected a member of parliament three times. He also held the position of President of the city of Lvov until World War Two. During the war, he was imprisoned and deported to Siberia, Soviet Union, in years 1939-1941. Subsequently he fought against Nazi Germans in the Polish II Corps. Ostrowski survived the war providing medical service in the various military units. Afterwards, he ran his medical practice in the UK. Stanisław Ostrowski was the only dermatologist who became a state president. He held an office of state president of the Polish Republic on exile in London. His life is not a simple story, but a great lesson that provides clear guidelines how to find a stable ground for lifetime being a medical doctor in the

  14. Educational leadership during a decade of medical curricular innovation and renewal.

    Pinder, Karen E; Shabbits, Jennifer A

    2018-03-05

    The past decade has witnessed successful expansion, distribution and curricular renewal at the University of British Columbia (UBC) medical school. The expansion and distribution of the medical program doubled enrollment and established the first North American medical school training students across multiple geographical locations. The more recent competency-based curriculum renewal demonstrates sustained innovation within UBC medicine. This paper describes that a significant contributor to these successes has been a team of teaching faculty whose exclusive roles have been providing curricular support. Over the past decade, this group has evolved into a vital component of the day-to-day operations and performance of the distributed medical curriculum; they now provide continuity in leadership and innovation across multiple educational facets of the program. This paper reports on the evolution and significance of these faculty members. The descriptions establish the success of an investment in teaching faculty and underscore the importance of engaging faculty whose primary commitments are to teaching, educational pedagogy, and student support. This efficacious model of supporting and advancing a complex distributed medical program over more than a decade of pivotal change will be of interest to faculties and programs that are contemplating or navigating similar pursuits.

  15. Evaluation of doctors? performance as facilitators in basic medical science lecture classes in a new Malaysian medical school

    Ismail, Salwani; Salam, Abdus; Alattraqchi, Ahmed G; Annamalai, Lakshmi; Chockalingam, Annamalai; Elena, Wan Putri; Rahman, Nor Iza A; Abubakar, Abdullahi Rabiu; Haque, Mainul

    2015-01-01

    Salwani Ismail,1 Abdus Salam,2 Ahmed G Alattraqchi,1 Lakshmi Annamalai,1 Annamalai Chockalingam,1 Wan Putri Elena,3 Nor Iza A Rahman,1 Abdullahi Rabiu Abubakar,1 Mainul Haque1 1Faculty of Medicine, Universiti Sultan Zainal Abidin, Kuala Terengganu, Terengganu, Malaysia; 2Department of Medical Education, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia; 3School of Health Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia Background: Dida...

  16. Medical doctors profile in Ethiopia: production, attrition and retention. In memory of 100-years Ethiopian modern medicine & the new Ethiopian millennium.

    Berhan, Yifru

    2008-01-01

    Although the practice of western medicine in Ethiopia dates back to the time of King Libne Dengel (1520-1535), organized and sustainable modern medical practice started after the battle of Adwa (1896). To review hospitals construction, medical doctors production and attrition, and to suggest alternative medical doctors retention mechanisms in the public sector and production scale up options. In this article, 100 years Ethiopian modern medical history is revised from old and recent medical chronicles. Until December 2006 primary data was collected from 87 public hospitals. Much emphasis is given to medical doctors profile (1906-2006), hospitals profile (1906-2005), medical doctors to population and hospitals ratio (1965-2006), Ethiopian public medical schools 42 years attainment (1964-2006), annual attrition rate (1984-2006), organizational structure of medical faculties & university hospitals, medical doctors remuneration by the Ministry of Health (MOH), Ministry of Education (MOE), NGOs and private health institutions. This article also addresses the way forward from physician training and retention perspectives, multiple alternate mechanisms to increase physicians' motivation to work in government institutions and reveres the loss. Medical doctors production scale up option is also given much emphasis. Most data are presented using line and bar graphs. Literature review showed that the first three hospitals were constructed in 1896 (Russian hospital), 1903 (Harar Ras Mekonnen hospital) and 1906 (Menelik II hospital). In 2005, 139 hospitals (87 public and 52 others) were reported. Remarkable hospital construction was done between 1935 and 1948, and recently between 1995 and 2005; however, in the latter case, private hospitals construction took the lions share. By the time MOH was established (1948), 110 Ethiopian and expatriate medical doctors were working, mainly in the capital, and 46 hospitals constructed. Physician number increment was very slow till 1980 at

  17. To rub shoulders with the traditional health practitioner or not, that is the question for the medical doctor in the New South Africa

    Gabriel Louw

    2017-03-01

    Full Text Available Background The South African medical doctor has been well established over the years as the keeper of the holy medical grails. Entrance for newcomers to the medical domain has not been and is still not easy. The hostility towards the allied professions in the 1950s and later in the 1980s provides evidence of this. Certain prerequisites for entrance were set and jealously guarded by the medical fraternity. The Traditional Health Practitioners Act, (Act No 22, 2007 is another such a challenge. This time it is not an outsider fraternity that is fighting alone for its own recognition. They are backed by a government and political force to get the traditional health practitioner (previously known as the traditional healer statutorily recognized. Aims The study aimed to reflect on the future professional relationship between the medical doctor and the traditional health practitioner in South Africa. Methods This is an exploratory and descriptive study that makes use of an historical approach by means of investigation and a literature review. The emphasis is on using current documentation like articles, books and newspapers as primary sources to reflect on the future professional relationship between the medical doctor and the traditional health practitioner in South Africa. The findings are offered in narrative form. Results It is clear that the Traditional Health Practitioners Act No 22 (2007 will put enormous pressure on the medical doctor, not only to relinquish some of his healthcare empowerment, but also to see and to accept the traditional health practitioner as a new, respectable health copractitioner and colleague. Facts hereto reveal that there are in terms of training, health ethics, practice approaches, attitudes and views, basically not a single point of similarity or agreement between the medical doctor and the traditional health practitioner whatsoever. Notwithstanding these enormous differences, the existence of the Traditional Health

  18. The effect of Health smart cards for Quality Health care services ( doctor martyr Beheshti medical research center in Qom

    Saeed zarandi

    2016-03-01

    Full Text Available The main objective of this study was to investigate the effect of the use health smart card on the aspects quality of healthcare services in doctor martyr beheshti medical research center in qom . With regard to the measures taken in the context of the establishment of this card in Qom and the lack of previous experience in this province, one of the concerns of the authorities to investigate the performance and capabilities of the card and its effects on the quality of health services is affecting the present study is to respond to this concerns. This research method is descriptive and applied to the target population of physicians, nurses and medical record experts employed at the Medical Center have formed a martyr Beheshti Qom due to more awareness cognitive advantages associated with its use of smart cards have given. The population is equal to the number of 444 and 124 questionnaire for data analysis is used. The sampling method used in this research was stratified random sampling conducted in the respective classes. Spss software for data analysis & exploratory factor analysis & confirmed, Kolmogorov-Smirnov Test, Wilcoxon Test & matrix of factors were used. The analysis results showed that Health Smart Cards for quality of health care services positive and significant effects on Dimension quality of the reliability & Tangibles . Analysis of demographic variables that influence opinions about the quality of health care Health Smart Cards significantly related to gender and education level, and also no experience discussed the variables significantly associated with age.

  19. Impact of reduction in working hours for doctors in training on postgraduate medical education and patients' outcomes: systematic review.

    Moonesinghe, S R; Lowery, J; Shahi, N; Millen, A; Beard, J D

    2011-03-22

    To determine whether a reduction in working hours of doctors in postgraduate medical training has had an effect on objective measures of medical education and clinical outcome. Systematic review. Medline, Embase, ISI Web of Science, Google Scholar, ERIC, and SIGLE were searched without language restriction for articles published between 1990 and December 2010. Reference lists and citations of selected articles. Studies that assessed the impact of a change in duty hours using any objective measure of outcome related to postgraduate medical training, patient safety, or clinical outcome. Any study design was eligible for inclusion. 72 studies were eligible for inclusion: 38 reporting training outcomes, 31 reporting outcomes in patients, and three reporting both. A reduction in working hours from greater than 80 hours a week (in accordance with US recommendations) does not seem to have adversely affected patient safety and has had limited effect on postgraduate training. Reports on the impact of European legislation limiting working hours to less than 56 or 48 a week are of poor quality and have conflicting results, meaning that firm conclusions cannot be made. Reducing working hours to less than 80 a week has not adversely affected outcomes in patient or postgraduate training in the US. The impact of reducing hours to less than 56 or 48 a week in the UK has not yet been sufficiently evaluated in high quality studies. Further work is required, particularly in the European Union, using large multicentre evaluations of the impact of duty hours' legislation on objective educational and clinical outcomes.

  20. Licensing procedures and registration of medical doctors in the European Union.

    Kovacs, Eszter; Schmidt, Andrea E; Szocska, Gabor; Busse, Reinhard; McKee, Martin; Legido-Quigley, Helena

    2014-06-01

    The current proposals to update the European Union (EU) directive on professional qualifications will have potentially important implications for health professions. Yet those discussing it will struggle to find basic information on key issues such as licensing and registration of physicians in different countries. A survey was conducted among national experts in 14 EU member states, supplemented by literature and independent expert review. The questionnaire covered five components of licensing and registration: (1) definitions, (2) regulatory basis, (3) governance, (4) the process of registration and (5) flow and quantity of applications. We identify seven areas of concern: (1) the meaning of terminology, which is inconsistent; (2) the role of language assessments and the responsibility for them; (3) whether approval to practise should be lifelong or time limited, subject to periodic assessment; (4) the need for improved systems to identify those deemed no longer fit to practise in one member state; (5) the complexity of processes for graduates from non-EU/European Economic Area (EAA) countries; (6) public access to registers; and (7) transparency of systems of governance. The systems of licensing and registration of doctors in Europe have developed within specific national contexts and vary widely. This creates inevitable problems in the context of free movement of professionals and increasing mobility. © 2014 Royal College of Physicians.

  1. The difficulty of professional continuation among female doctors in Japan: a qualitative study of alumnae of 13 medical schools in Japan

    Nomura, Kyoko; Yamazaki, Yuka; Gruppen, Larry D; Horie, Saki; Takeuchi, Masumi; Illing, Jan

    2015-01-01

    Objectives To investigate the difficulties Japanese female doctors face in continuing professional practice. Design A qualitative study using the Kawakita Jiro method. Setting A survey conducted in 2011 of 13 private Japanese medical school alumni associations. Participants 359 female doctors. Primary outcome measures Barriers of balancing work and gender role. Results The female doctors reported that professional practice was a struggle with long working hours due to a current shortage of doctors in Japan. There was also a severe shortage of childcare facilities in the workplace. Some women appeared to have low confidence in balancing the physician's job and personal life, resulting in low levels of professional pursuit. There appeared to be two types of stereotypical gender roles, including one expected from society, stating that “child rearing is a woman's job”, and the other perceived by the women themselves, that some women had a very strong desire to raise their own children. Male doctors and some female doctors who were single or older were perceived to be less enthusiastic about supporting women who worked while raising children because these coworkers feared that they would have to perform additional work as a result of the women taking long periods of leave. Conclusions Important factors identified for promoting the continuation of professional practice among female doctors in Japan were the need to improve working conditions, including cutting back on long working hours, a solution to the shortage of nurseries, a need for the introduction of educational interventions to clarify professional responsibilities, and redefinition of the gender division of labour for male and female doctors. In addition, we identified a need to modernise current employment practices by introducing temporary posts to cover maternity leave and introducing flexible working hours during specialist training, thus supporting and encouraging more women to continue their medical

  2. The difficulty of professional continuation among female doctors in Japan: a qualitative study of alumnae of 13 medical schools in Japan.

    Nomura, Kyoko; Yamazaki, Yuka; Gruppen, Larry D; Horie, Saki; Takeuchi, Masumi; Illing, Jan

    2015-03-27

    To investigate the difficulties Japanese female doctors face in continuing professional practice. A qualitative study using the Kawakita Jiro method. A survey conducted in 2011 of 13 private Japanese medical school alumni associations. 359 female doctors. Barriers of balancing work and gender role. The female doctors reported that professional practice was a struggle with long working hours due to a current shortage of doctors in Japan. There was also a severe shortage of childcare facilities in the workplace. Some women appeared to have low confidence in balancing the physician's job and personal life, resulting in low levels of professional pursuit. There appeared to be two types of stereotypical gender roles, including one expected from society, stating that "child rearing is a woman's job", and the other perceived by the women themselves, that some women had a very strong desire to raise their own children. Male doctors and some female doctors who were single or older were perceived to be less enthusiastic about supporting women who worked while raising children because these coworkers feared that they would have to perform additional work as a result of the women taking long periods of leave. Important factors identified for promoting the continuation of professional practice among female doctors in Japan were the need to improve working conditions, including cutting back on long working hours, a solution to the shortage of nurseries, a need for the introduction of educational interventions to clarify professional responsibilities, and redefinition of the gender division of labour for male and female doctors. In addition, we identified a need to modernise current employment practices by introducing temporary posts to cover maternity leave and introducing flexible working hours during specialist training, thus supporting and encouraging more women to continue their medical careers. Published by the BMJ Publishing Group Limited. For permission to use (where not

  3. [Publications in the Croatian medical journals by doctoral candidates at University of Zagreb School of Medicine].

    Sember, Marijan; Petrak, Jelka

    2014-01-01

    By searching Medline/PubMed bibliographic database we collected data on publications of two groups of PhD candidates who earned their PhD degrees at University of Zagreb Medical School in 2000 and 2010. We identifed their publications in the Croatian medical journals and separately in the Croatian language. First group of PhD candidates (y 2000) published in the Croatian journals 34% of all published papers, with a share of 29% in the Croatian language. Another group (y 2010) published in the Croatian journals 44% of all published papers in which the number of papers published in the Croatian journals in English language grow significantly (5% vs. 31%). The number of papers published in the Croatian language decreased to 13%. Our results agreed with the global decreasing trend of the number of medical papers in non-English languages. The importance of mother-tongue in the medical education and health care may have influence on preserving scientific communication in non-English medical journals.

  4. Doctors qualifying from United Kingdom medical schools during the calendar years 1977 and 1983.

    Parkhouse, J; Parkhouse, H F

    1989-01-01

    At the conclusion of undergraduate medical education in the United Kingdom most students pass a university qualifying examination and obtain a degree in medicine and surgery. Some students pass an external non-university qualifying examination in medicine as an alternative to obtaining a degree, and some do both. The degree may be obtained in the same year as the non-university qualifying examination, or in a different year. Some students from a medical school intake qualify in a later year than expected, for various reasons. Data from university, Health Department and other sources may relate to the academic year, the calendar year, or a fixed date such as 30 September. It is not a simple exercise, therefore, to define the exact number of people who qualify to practise medicine, for the first time, in any given 'year'. In counting qualifiers from individual medical schools, the problems are further compounded by the movement of students between the preclinical and clinical stages of the course, particularly from Oxford and Cambridge to London teaching hospitals. This paper analyses the situation for the calendar years 1977 and 1983, showing a decline in the number of students obtaining double (i.e. both university and non-university) qualifications. The number of UK graduates not registering with the General Medical Council to practise, at least for a time, in the UK was small, and the population base compiled for Medical Career Research Group studies was reasonably accurate in each of the 2 years examined.

  5. Healers, deities, saints and doctors: elements for the analysis of medical systems.

    Pedersen, D; Baruffati, V

    1989-01-01

    This article provides the basic elements for the discussion and analysis of medical systems and their inter-dependency, with special reference to Latin America and, in particular, to the Andean countries. In a culturally diverse and socially stratified population, such as in contemporary Latin America, medical systems constitute a social representation resulting from the historical relationship between autochtonous medical cultures and those from other latitudes. The impregnation of scientific and popular knowledge results not only in the incorporation (and often expropriation) of folk in professional or scientific medicine, but also in the increasing 'medicalisation' of popular and traditional therapeutic practices. The emergent 'popular' medical system draws from both the professional and folk models, and in its actual practice, integrates both popular beliefs and materia medica with elements drawn from popular religions and pre-Hispanic deities. The degree of competitiveness, co-operation or 'integration' among medical systems depends mainly on the asymmetrical distribution of power and resources, and is conditioned by the population's behaviour in the management of disease. Existing pluralist systems of health care reveal a valuable array of survival strategies, which far outreach the proposals for integration called for by official sectors. On the other hand, knowledge derived from traditional medicine can contribute to the development of new models of clinical practice and to the expansion of the conventional epidemiological model.

  6. Evaluation of doctors' performance as facilitators in basic medical science lecture classes in a new Malaysian medical school

    Ismail S

    2015-03-01

    Full Text Available Salwani Ismail,1 Abdus Salam,2 Ahmed G Alattraqchi,1 Lakshmi Annamalai,1 Annamalai Chockalingam,1 Wan Putri Elena,3 Nor Iza A Rahman,1 Abdullahi Rabiu Abubakar,1 Mainul Haque1 1Faculty of Medicine, Universiti Sultan Zainal Abidin, Kuala Terengganu, Terengganu, Malaysia; 2Department of Medical Education, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia; 3School of Health Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia Background: Didactic lecture is the oldest and most commonly used method of teaching. In addition, it is considered one of the most efficient ways to disseminate theories, ideas, and facts. Many critics feel that lectures are an obsolete method to use when students need to perform hands-on activities, which is an everyday need in the study of medicine. This study evaluates students' perceptions regarding lecture quality in a new medical school. Methods: This was a cross-sectional study conducted of the medical students of Universiti Sultan Zainal Abidin. The study population was 468 preclinical medical students from years 1 and 2 of academic year 2012–2013. Data were collected using a validated instrument. There were six different sections of questions using a 5-point Likert scale. The data were then compiled and analyzed, using SPSS version 20. Results: The response rate was 73%. Among 341 respondents, 30% were male and 70% were female. Eighty-five percent of respondents agree or strongly agree that the lectures had met the criteria with regard to organization of lecture materials. Similarly, 97% of students agree or strongly agree that lecturers maintained adequate voices and gestures. Conclusion: Medical students are quite satisfied with the lecture classes and the lectures. However, further research is required to identify student-centered teaching and learning methods to promote active learning. Keywords: lecture, effectiveness, evaluation, undergraduate medical

  7. "But my doctor recommended pot": medical marijuana and the patient-physician relationship.

    Nussbaum, Abraham M; Boyer, Jonathan A; Kondrad, Elin C

    2011-11-01

    As the use of medical marijuana expands, it is important to consider its implications for the patient-physician relationship. In Colorado, a small cohort of physicians is recommending marijuana, with 15 physicians registering 49% of all medical marijuana patients and a single physician registering 10% of all patients. Together, they have registered more than 2% of the state to use medical marijuana in the last three years. We are concerned that this dramatic expansion is occurring in a setting rife with conflicts of interest despite insufficient scientific knowledge about marijuana. This system diminishes the patient-physician relationship to the recommendation of a single substance while unburdening physicians of their usual responsibilities to the welfare of their patients.

  8. Self-reported medical care seeking behaviour of doctors in Nigeria

    A.E. Fawibe

    2016-05-14

    May 14, 2016 ... b Department of Family Medicine, University of Ilorin Teaching ... Purpose: This work was therefore designed to study the medical care ... for their health problems and find it difficult to adopt the role ..... Conflict of interest. None ...

  9. Between forwarding and mentoring: a qualitative study of recommending medical doctors for international postdoctoral research positions.

    Sambunjak, Dario; Marušić, Matko

    2011-06-09

    Young scientists rarely have extensive international connections that could facilitate their mobility. They often rely on their doctoral supervisors and other senior academics, who use their networks to generate opportunities for young scientists to gain international experience and provide the initial trigger for an outward move. To explore the process of informal recommending of young physicians from a small country for postdoctoral research positions in foreign countries, we conducted in-depth interviews with eight senior academics who acted as recommenders and eight physicians who, based on the recommendations of senior academics, spent at least a year working in a laboratory abroad. Interviews were transcribed and analyzed by using the framework approach. The findings showed that recommending can take four distinct forms: 1) forwarding information, 2) passive recommending, 3) active recommending, and 4) mentor recommending. These forms differ in their level of commitment and mutual trust among actors, and possible control over the success of the process. Two groups of recommendees--'naive' and 'experienced'--can be distinguished based on their previous scientific experience and research collaboration with the recommender. Crucial for the success of the process is an adequate preparation of recommendees' stay abroad, as well as their return and reintegration. The benefits of recommending extend beyond the individual participants to the scientific community and broader society of the sending country. With a sufficient level of commitment by the actors, informal recommending can be a part of or grow into an all-encompassing developmental relationship equal to mentoring. The importance of senior academics' informal contacts and recommendations in promoting junior scientists' mobility should be acknowledged and encouraged by the research institutions and universities, particularly in developing countries.

  10. Between forwarding and mentoring: a qualitative study of recommending medical doctors for international postdoctoral research positions

    Marušić Matko

    2011-06-01

    Full Text Available Abstract Background Young scientists rarely have extensive international connections that could facilitate their mobility. They often rely on their doctoral supervisors and other senior academics, who use their networks to generate opportunities for young scientists to gain international experience and provide the initial trigger for an outward move. Methods To explore the process of informal recommending of young physicians from a small country for postdoctoral research positions in foreign countries, we conducted in-depth interviews with eight senior academics who acted as recommenders and eight physicians who, based on the recommendations of senior academics, spent at least a year working in a laboratory abroad. Interviews were transcribed and analyzed by using the framework approach. Results The findings showed that recommending can take four distinct forms: 1 forwarding information, 2 passive recommending, 3 active recommending, and 4 mentor recommending. These forms differ in their level of commitment and mutual trust among actors, and possible control over the success of the process. Two groups of recommendees - 'naive' and 'experienced' - can be distinguished based on their previous scientific experience and research collaboration with the recommender. Crucial for the success of the process is an adequate preparation of recommendees' stay abroad, as well as their return and reintegration. The benefits of recommending extend beyond the individual participants to the scientific community and broader society of the sending country. Conclusions With a sufficient level of commitment by the actors, informal recommending can be a part of or grow into an all-encompassing developmental relationship equal to mentoring. The importance of senior academics' informal contacts and recommendations in promoting junior scientists' mobility should be acknowledged and encouraged by the research institutions and universities, particularly in developing

  11. 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.

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

    2016-05-24

    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

  12. Evaluation of doctors' performance as facilitators in basic medical science lecture classes in a new Malaysian medical school.

    Ismail, Salwani; Salam, Abdus; Alattraqchi, Ahmed G; Annamalai, Lakshmi; Chockalingam, Annamalai; Elena, Wan Putri; Rahman, Nor Iza A; Abubakar, Abdullahi Rabiu; Haque, Mainul

    2015-01-01

    Didactic lecture is the oldest and most commonly used method of teaching. In addition, it is considered one of the most efficient ways to disseminate theories, ideas, and facts. Many critics feel that lectures are an obsolete method to use when students need to perform hands-on activities, which is an everyday need in the study of medicine. This study evaluates students' perceptions regarding lecture quality in a new medical school. This was a cross-sectional study conducted of the medical students of Universiti Sultan Zainal Abidin. The study population was 468 preclinical medical students from years 1 and 2 of academic year 2012-2013. Data were collected using a validated instrument. There were six different sections of questions using a 5-point Likert scale. The data were then compiled and analyzed, using SPSS version 20. The response rate was 73%. Among 341 respondents, 30% were male and 70% were female. Eighty-five percent of respondents agree or strongly agree that the lectures had met the criteria with regard to organization of lecture materials. Similarly, 97% of students agree or strongly agree that lecturers maintained adequate voices and gestures. Medical students are quite satisfied with the lecture classes and the lectures. However, further research is required to identify student-centered teaching and learning methods to promote active learning.

  13. Building bridges: engaging medical residents in quality improvement and medical leadership.

    Voogt, Judith J; van Rensen, Elizabeth L J; van der Schaaf, Marieke F; Noordegraaf, Mirko; Schneider, Margriet Me

    2016-12-01

    To develop an educational intervention that targets residents' beliefs and attitudes to quality Improvement (QI) and leadership in order to demonstrate proactive behaviour. Theory-driven, mixed methods study including document analysis, interviews, observations and open-ended questionnaires. Six Dutch teaching hospitals. Using expertise from medicine, psychology, organizational and educational sciences we developed a situated learning programme named Ponder and IMProve (PIMP). The acronym PIMP reflects the original upbeat name in Dutch, Verwonder & Verbeter. It has a modern, positive meaning that relates to improving your current circumstances. In quarterly 1-h sessions residents are challenged to identify daily workplace frustrations and translate them into small-scale QI activities. Organizational awareness, beliefs and attitudes to QI and organizational responsibilities, resident behaviour, barriers and facilitators to successful learning and the programme's potential impact on the organization. Overall, 19 PIMP meetings were held over a period of 3 years. Residents defined 119 PIMP goals, resolved 37 projects and are currently working on another 39 projects. Interviews show that PIMP sessions make residents more aware of the organizational aspects of their daily work. Moreover, residents feel empowered to take up the role of change agent. Facilitators for success include a positive cost-benefit trade-off, a valuable group process and a safe learning environment. This article demonstrates the added value of multidisciplinary theory-driven research for the design, development and evaluation of educational programmes. Residents can be encouraged to develop organizational awareness and reshape their daily frustrations in QI work. © The Author 2016. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

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

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

    de Andrade, Elizabeth da Trindade; Hennington, Élida Azevedo; de Siqueira, Hélio Ribeiro; Rolla, Valeria Cavalcanti; Mannarino, Celina

    2015-01-01

    Introduction 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. Goal To evaluate existing intersections in the conceptions relative to the knowledge of TB, the experience of the illness and the treatment. Methods 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. Results 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. Conclusion 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

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

    de Andrade, Elizabeth da Trindade; Hennington, Élida Azevedo; Siqueira, Hélio Ribeiro de; Rolla, Valeria Cavalcanti; Mannarino, Celina

    2015-01-01

    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 strategies.

  17. From confident medical students to confident doctors through exposure to simulated and clinical resuscitation

    Abdoolraheem MY

    2018-04-01

    Full Text Available Mohammad Yusuf Abdoolraheem,1 Mohammad Farwana2 1GKT School of Medical Education, King’s College London, UK; 2Frimley Health Foundation Trust, Camberley, UKWe read with great interest the research article published by Aggarwal and Khan1 concerning the experiences of final-year medical students in terms of both cardiopulmonary resuscitation (CPR and discussions of advanced directives during clinical placements. While we would agree with the concluding opinion that there should be standardized formal education concerning CPR and “Do Not Attempt CPR” (DNACPR; the knowledge and skills developed during theoretical and simulation based teaching should also be complemented by clinical exposure to various scenarios such that the students are more prepared prior to starting their Foundation year training. View the original paper by Aggarwal and Khan. 

  18. A first step toward understanding best practices in leadership training in undergraduate medical education: a systematic review.

    Webb, Allison M B; Tsipis, Nicholas E; McClellan, Taylor R; McNeil, Michael J; Xu, MengMeng; Doty, Joseph P; Taylor, Dean C

    2014-11-01

    To characterize leadership curricula in undergraduate medical education as a first step toward understanding best practices in leadership education. The authors systematically searched the PubMed, Education Resources Information Center, Academic Search Complete, and Education Full Text databases for peer-reviewed English-language articles published 1980-2014 describing curricula with interventions to teach medical students leadership skills. They characterized educational settings, curricular format, and learner and instructor types. They assessed effectiveness and quality of evidence using five-point scales adapted from Kirkpatrick's four-level training evaluation model (scale: 0-4) and a Best Evidence Medical Education guide (scale: 1-5), respectively. They classified leadership skills taught into the five Medical Leadership Competency Framework (MLCF) domains. Twenty articles describing 24 curricula met inclusion criteria. The majority of curricula (17; 71%) were longitudinal, delivered over periods of one semester to four years. The most common setting was the classroom (12; 50%). Curricula were frequently provided to both preclinical and clinical students (11; 46%); many (9; 28%) employed clinical faculty as instructors. The majority (19; 79%) addressed at least three MLCF domains; most common were working with others (21; 88%) and managing services (18; 75%). The median effectiveness score was 1.5, and the median quality of evidence score was 2. Most studies did not demonstrate changes in student behavior or quantifiable results. Aligning leadership curricula with competency models, such as the MLCF, would create opportunities to standardize evaluation of outcomes, leading to better measurement of student competency and a better understanding of best practices.

  19. Hybrid Doctoral Program: Innovative Practices and Partnerships

    Alvich, Dori; Manning, JoAnn; McCormick, Kathy; Campbell, Robert

    2012-01-01

    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…

  20. Leadership and management in the undergraduate medical curriculum: a qualitative study of students' attitudes and opinions at one UK medical school.

    Quince, Thelma; Abbas, Mark; Murugesu, Sughashini; Crawley, Francesca; Hyde, Sarah; Wood, Diana; Benson, John

    2014-06-25

    To explore undergraduate medical students' attitudes towards and opinions about leadership and management education. Between 2009 and 2012 we conducted a qualitative study comprising five focus group discussions, each devoted to one of the five domains in the Medical Leadership Competency Framework, (Personal Qualities, Working with Others, Managing Services, Improving Services and Setting Direction). Each discussion examined what should be learnt, when should learning occur, what methods should be used, how should learning be assessed, what are the barriers to such education. 28 students from all three clinical years (4-6) of whom 10 were women. 2 inter-related themes emerged: understanding the broad perspective of patients and other stakeholders involved in healthcare provision and the need to make leadership and management education relevant in the clinical context. Topics suggested by students included structure of the National Health Service (NHS), team working skills, decision-making and negotiating skills. Patient safety was seen as particularly important. Students preferred experiential learning, with placements seen as providing teaching opportunities. Structured observation, reflection, critical appraisal and analysis of mistakes at all levels were mentioned as existing opportunities for integrating leadership and management education. Students' views about assessment and timing of such education were mixed. Student feedback figured prominently as a method of delivery and a means of assessment, while attitudes of medical professionals, students and of society in general were seen as barriers. Medical students may be more open to leadership and management education than thought hitherto. These findings offer insights into how students view possible developments in leadership and management education and stress the importance of developing broad perspectives and clinical relevance in this context. Published by the BMJ Publishing Group Limited. For

  1. Leadership and management in the undergraduate medical curriculum: a qualitative study of students’ attitudes and opinions at one UK medical school

    Quince, Thelma; Abbas, Mark; Murugesu, Sughashini; Crawley, Francesca; Hyde, Sarah; Wood, Diana; Benson, John

    2014-01-01

    Objective To explore undergraduate medical students’ attitudes towards and opinions about leadership and management education. Design Between 2009 and 2012 we conducted a qualitative study comprising five focus group discussions, each devoted to one of the five domains in the Medical Leadership Competency Framework, (Personal Qualities, Working with Others, Managing Services, Improving Services and Setting Direction). Each discussion examined what should be learnt, when should learning occur, what methods should be used, how should learning be assessed, what are the barriers to such education. Participants 28 students from all three clinical years (4–6) of whom 10 were women. Results 2 inter-related themes emerged: understanding the broad perspective of patients and other stakeholders involved in healthcare provision and the need to make leadership and management education relevant in the clinical context. Topics suggested by students included structure of the National Health Service (NHS), team working skills, decision-making and negotiating skills. Patient safety was seen as particularly important. Students preferred experiential learning, with placements seen as providing teaching opportunities. Structured observation, reflection, critical appraisal and analysis of mistakes at all levels were mentioned as existing opportunities for integrating leadership and management education. Students’ views about assessment and timing of such education were mixed. Student feedback figured prominently as a method of delivery and a means of assessment, while attitudes of medical professionals, students and of society in general were seen as barriers. Conclusions Medical students may be more open to leadership and management education than thought hitherto. These findings offer insights into how students view possible developments in leadership and management education and stress the importance of developing broad perspectives and clinical relevance in this context. PMID

  2. The medical consultation viewed as a value chain: a neurobehavioral approach to emotion regulation in doctor-patient interaction.

    Finset, Arnstein; Mjaaland, Trond A

    2009-03-01

    To present a model of the medical consultation as a value chain, and to apply a neurobehavioral perspective to analyze each element in the chain with relevance for emotion regulation. Current knowledge on four elements in medical consultations and neuroscientific evidence on corresponding basic processes are selectively reviewed. The four elements of communication behaviours presented as steps in a value chain model are: (1) establishing rapport, (2) patient disclosure of emotional cues and concerns, (3) the doctor's expression of empathy, and (4) positive reappraisal of concerns. The metaphor of the value chain, with emphasis on goal orientation, helps to understand the impact of each communicative element on the outcome of the consultation. Added value at each step is proposed in terms of effects on outcome indicators; in this case patients affect regulation. Neurobehavioral mechanisms are suggested to explain the association between communication behaviour and affect regulation outcome. The value chain metaphor and the emphasis on behaviour-outcome-mechanisms associations may be of interest as conceptualizations for communications skills training.

  3. Aspects of spirituality in medical doctors and their relation to specific views of illness and dealing with their patients' individual situation

    Büssing, Arndt; Hirdes, Almut Tabea; Baumann, Klaus

    2013-01-01

    . Data from an anonymous survey enrolling 237 medical doctors from Germany (mean age 45.7 +/- 9.6, 58% male, 42% female) indicated that secular forms of spirituality scored highest, while specific religious orientation had the lowest scores. Physicians with a specific specialization in complementary...

  4. Use of electronic medical records and quality of patient data: different reaction patterns of doctors and nurses to the hospital organization.

    Lambooij, Mattijs S; Drewes, Hanneke W; Koster, Ferry

    2017-02-10

    As the implementation of Electronic Medical Records (EMRs) in hospitals may be challenged by different responses of different user groups, this paper examines the differences between doctors and nurses in their response to the implementation and use of EMRs in their hospital and how this affects the perceived quality of the data in EMRs. Questionnaire data of 402 doctors and 512 nurses who had experience with the implementation and the use of EMRs in hospitals was analysed with Multi group Structural equation modelling (SEM). The models included measures of organisational factors, results of the implementation (ease of use and alignment of EMR with daily routine), perceived added value, timeliness of use and perceived quality of patient data. Doctors and nurses differ in their response to the organisational factors (support of IT, HR and administrative departments) considering the success of the implementation. Nurses respond to culture while doctors do not. Doctors and nurses agree that an EMR that is easier to work with and better aligned with their work has more added value, but for the doctors this is more pronounced. The doctors and nurses perceive that the quality of the patient data is better when EMRs are easier to use and better aligned with their daily routine. The result of the implementation, in terms of ease of use and alignment with work, seems to affect the perceived quality of patient data more strongly than timeliness of entering patient data. Doctors and nurses value bottom-up communication and support of the IT department for the result of the implementation, and nurses respond to an open and innovative organisational culture.

  5. Human resource management practices in a medical complex in the Eastern Cape, South Africa: assessing their impact on the retention of doctors.

    Longmore, Bruce; Ronnie, Linda

    2014-03-26

    Human resource management (HRM) practices have the potential to influence the retention of doctors in the public health sector. To explore the key human resource (HR) practices affecting doctors in a medical complex in the Eastern Cape, South Africa. We used an open-ended questionnaire to gather data from 75 doctors in this setting. The most important HR practices were paying salaries on time and accurately, the management of documentation, communication, HR staff showing that they respected and valued the doctors, and reimbursement for conferences and special leave requests. All these practices were judged to be poorly administered. Essential HR characteristics were ranked in the following order: task competence of HR staff, accountability, general HR efficiency, occupation-specific dispensation adjustments and performance management and development system efficiency, and availability of HR staff. All these characteristics were judged to be poor. HRM practices in this Eastern Cape medical complex were inadequate and a source of frustration. This lack of efficiency could lead to further problems with regard to retaining doctors in public sector service.

  6. A comparative study on the clinical decision-making processes of nurse practitioners vs. medical doctors using scenarios in a secondary care environment.

    Thompson, Stephen; Moorley, Calvin; Barratt, Julian

    2017-05-01

    To investigate the decision-making skills of secondary care nurse practitioners compared with those of medical doctors. A literature review was conducted, searching for articles published from 1990 - 2012. The review found that nurse practitioners are key to the modernization of the National Health Service. Studies have shown that compared with doctors, nurse practitioners can be efficient and cost-effective in consultations. Qualitative research design. The information processing theory and think aloud approach were used to understand the cognitive processes of 10 participants (5 doctors and 5 nurse practitioners). One nurse practitioner was paired with one doctor from the same speciality and they were compared using a structured scenario-based interview. To ensure that all critical and relevant cues were covered by the individual participating in the scenario, a reference model was used to measure the degree of successful diagnosis, management and treatment. This study was conducted from May 2012 - January 2013. The data were processed for 5 months, from July to November 2012. The two groups of practitioners differed in the number of cue acquisitions obtained in the scenarios. In our study, nurse practitioners took 3 minutes longer to complete the scenarios. This study suggests that nurse practitioner consultations are comparable to those of medical doctors in a secondary care environment in terms of correct diagnoses and therapeutic treatments. The information processing theory highlighted that both groups of professionals had similar models for decision-making processes. © 2016 John Wiley & Sons Ltd.

  7. [Medical errors from positions of mutual relations of patient-lawyer-doctor].

    Radysh, Ia F; Tsema, Ie V; Mehed', V P

    2013-01-01

    The basic theoretical and practical aspects of problem of malpractice in the system of health protection Ukraine are presented in the article. On specific examples the essence of the term "malpractice" is expounded. It was considered types of malpractice, conditions of beginning and kinds of responsibility to assumption of malpractice. The special attention to the legal and mental and ethical questions of problem from positions of protection of rights for a patient and medical worker is spared. The necessity of qualification malpractices on intentional and unintentional, possible and impermissible is grounded.

  8. Doctors in Balzac's work.

    Moulin, Thierry

    2013-01-01

    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. Copyright © 2013 S. Karger AG, Basel.

  9. Analysis of radiology education in undergraduate medical doctors training in Europe

    Kourdioukova, Elena V.; Valcke, Martin; Derese, Anselme; Verstraete, Koenraad L.

    2011-01-01

    Objectives: The purpose of the present study is to describe how undergraduate radiology teaching is organized in Europe and to identify important characteristics of undergraduate radiology curriculum. Methods: An electronic survey on undergraduate teaching was distributed by the European Society of Radiology (ESR) to 38 national delegates of the ESR Education Committee. Results: The 'classic type' of radiology teaching method is more frequent than the 'modular type'. In 38% of medical training centres the first experience with radiology is in pre-clinical years. The students enrolled in the fourth medical year experience the largest involvement in radiology education. The total number of teaching hours (mean 89 h, median 76 h) varies across the countries and differs depending on the radiological topic (mean across all topics 14.8 h, median 13). Written tests and oral exams were the most frequently used examination modes. Clerkships are reported as a key part of training. Conclusion: This first international comparative study of undergraduate radiological curriculum in Europe identifies a large number of differences in curriculum content and teaching methods throughout Europe. More research is needed to establish the radiological educational competences resulting from these differing curricula's to improve and to standardize the teaching according to (inter)national and institutional needs.

  10. First and second year medical students identify and self-stereotype more as doctors than as students: a questionnaire study

    Bryan Burford

    2017-11-01

    Full Text Available Abstract Background The emergence of medical students’ professional identity is important. This paper considers this in a snapshot of the early years of undergraduate medical education. From the perspective of social identity theory, it also considers self-stereotyping, the extent to which individuals associate with attributes identified as typical of groups. Method Paper questionnaires were completed by first and second year medical students following teaching sessions at the beginning (October and end (April of the academic year. Questionnaires consisted of scales measuring the strength and importance of identity and self-stereotyping, referent to ‘doctors’ and ‘students’. Linear mixed effects regression considered longitudinal and cross-sectional effects of progress through the course, and differences in responses to ‘doctor’ and ‘student’ measures. Results In October, responses were received from 99% (n = 102 and 75% (n = 58 of first and second year cohorts respectively, and in April from 81% (n = 83 and 73% (n = 56. Response rates were over 95% of those present. Linear mixed effects regression found that all ‘doctor’-referent measures were higher than ‘student’ measures. Strength of identity and self-stereotyping decreased between beginning and end of the year (across both groups. Men indicated lower importance of identity than women, also across both groups. There were no differences between year groups. Self-stereotyping was predicted more by importance of identification with a group than by strength of identification. Conclusions Findings reinforce observations that medical students identify strongly as doctors from early in their studies, and that this identification is greater than as students. Decreases over time are surprising, but may be explained by changing group salience towards the end of the academic year. The lack of a gender effect on strength of identification contrasts with the literature

  11. But I Don't Want to Be a Professor! The Innovations of an Online Practitioner Doctorate Focused on Educational Technology Leadership

    Miller, Christopher T.; Curry, John H.

    2014-01-01

    There is growing potential for the development of practitioner-based doctor of education (EdD) programs as potential students in the field recognize that they do not need to leave their current work positions to obtain a doctorate particularly if it enhances their work. This article chronicles 1 university's process in developing an innovative…

  12. The Process in Completing a Nontraditional Group Dissertation in Practice for the Carnegie Project on the Education Doctorate, the Ed.D. Educational Leadership Program at Lynn University

    Vickers, Jerome

    2016-01-01

    This study focused on how a cohort of scholarly practitioners extended the traditional Doctorate in Education (Ed.D.) model at Lynn University by undertaking a nontraditional group Dissertation in Practice (DiP). The participants were a cohort of 11 scholarly practitioners known as Cohort 5 who became the first Lynn University doctoral students to…

  13. How doctors learn: the role of clinical problems across the medical school-to-practice continuum.

    Slotnick, H B

    1996-01-01

    The author proposes a theory of how physicians learn that uses clinical problem solving as its central feature. His theory, which integrates insights from Maslow, Schön, Norman, and others, claims that physicians-in-training and practicing physicians learn largely by deriving insights from clinical experience. These insights allow the learner to solve future problems and thereby address the learner's basic human needs for security, affiliation, and self-esteem. Ensuring that students gain such insights means that the proper roles of the teacher are (1) to select problems for students to solve and offer guidance on how to solve them, and (2) to serve as a role model of how to reflect on the problem, its solution, and the solution's effectiveness. Three principles guide instruction within its framework for learning: (1) learners, whether physicians-in-training or practicing physicians, seek to solve problems they recognize they have; (2) learners want to be involved in their own learning; and (3) instruction must both be time-efficient and also demonstrate the range of ways in which students can apply what they learn. The author concludes by applying the theory to an aspect of undergraduate education and to the general process of continuing medical education.

  14. Integrated approach in the development of competencies valeological students - medical doctor

    Y.F. Ostafijchuk

    2013-11-01

    Full Text Available The analysis of the scientific - methodical sources. We prove the feasibility of using an integrative approach in the training of future health professionals. Scientists are perspectives on the essence of the concept of integration, their position relative to integrative learning in higher education. Integrative learning is seen as a new educational technology. The basic components of the integration of modern science: Interscience synthesis, synthesis of methodological, social synthesis. It is found that an integrative technology is based on the principles of integrative and personal - oriented education. Reveals the main ways of implementing these principles: the design of interdisciplinary integration, the identification of the same type of interdisciplinary topics; orientation training content on the personality of the student, the formation integrity valeological knowledge and practical skills (in the context valeological behavior. Lit their own opinions of the authors on the formation valeological competence of students of medical colleges in the integration environment. Predicted the final result of this process - a methodological willingness of future health professionals to use valeological component in professional activities.

  15. Attitudes and self-reported behavior of patients, doctors, and pharmacists in New Zealand and Belgium toward direct-to-consumer advertising of medication.

    Dens, Nathalie; Eagle, Lynne C; De Pelsmacker, Patrick

    2008-01-01

    Patients', doctors', and pharmacists' attitudes toward direct-to-consumer advertising (DTCA) for medication and their perceptions of its impact on patient self-reported behavior in terms of request for, and consumption of, advertised medication were investigated. Data were obtained in New Zealand, 1 of only 2 countries that allow mass-media DTCA for prescription medication, and in Belgium, which does not. Attitudes were relatively negative in both countries, but significantly more positive in New Zealand than in Belgium. The impact of DTCA (both in a positive and a negative sense) on self-reported patient behavior and patient interaction with doctors and pharmacists was limited in both countries. Although -- as already established in previous work -- the informativeness and reliability of DTCA can be much improved, and the attitude of medical professionals toward DTCA is negative in both countries, from the point of view of medical professionals and patients, DTCA does not harm the self-reported relationship between doctors, pharmacists, and patients.

  16. Negotiating explanations: doctor-patient communication with patients with medically unexplained symptoms-a qualitative analysis.

    den Boeft, Madelon; Huisman, Daniëlle; Morton, LaKrista; Lucassen, Peter; van der Wouden, Johannes C; Westerman, Marjan J; van der Horst, Henriëtte E; Burton, Christopher D

    2017-02-01

    Patients with medically unexplained physical symptoms (MUPS) seek explanations for their symptoms, but often find general practitioners (GPs) unable to deliver these. Different methods of explaining MUPS have been proposed. Little is known about how communication evolves around these explanations. To examine the dialogue between GPs and patients related to explanations in a community-based clinic for MUPS. We categorized dialogue types and dialogue outcomes. Patients were ≥18 years with inclusion criteria for moderate MUPS: ≥2 referrals to specialists, ≥1 functional syndrome/symptoms, ≥10 on the Patient Health Questionnaire-15 and GP's judgement that symptoms were unexplained. We analysed transcripts of 112 audio-recorded consultations (39 patients and 5 GPs) from two studies on the Symptoms Clinic Intervention, a consultation intervention for MUPS in primary care. We used constant comparative analysis to code and classify dialogue types and outcomes. We extracted 115 explanation sequences. We identified four dialogue types, differing in the extent to which the GP or patient controlled the dialogue. We categorized eight outcomes of the sequences, ranging from acceptance to rejection by the patient. The most common outcome was holding (conversation suspended in an unresolved state), followed by acceptance. Few explanations were rejected by the patient. Co-created explanations by patient and GP were most likely to be accepted. We developed a classification of dialogue types and outcomes in relation to explanations offered by GPs for MUPS patients. While it requires further validation, it provides a framework, which can be used for teaching, evaluation of practice and research. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  17. How do we talk about doctors and drugs? Sentiment analysis in forums expressing opinions for medical domain.

    Jiménez-Zafra, Salud María; Martín-Valdivia, M Teresa; Molina-González, M Dolores; Ureña-López, L Alfonso

    2018-04-20

    The main goal of this study is to examine how people express their opinion in medical forums. We analyze the language used in order to determine the best way to tackle sentiment analysis in this domain. We have applied supervised learning and lexicon-based sentiment analysis approaches over two different corpora extracted from social web. Specifically, we have focused on two aspects: drugs and doctors. We have selected two forums and we have collected corpora for each one: (i) DOS, a Spanish corpus of drug reviews and (ii) COPOS, a Spanish corpus of patients' opinions about physicians. The classification results show that drug reviews are more difficult to classify than those about physicians. In order to understand the difference in the results, we have studied the linguistic features of both corpora. Although opinions about physicians and drugs are written in most cases by non-professional users, reviews about physicians are characterized by the use of an informal language while reviews about drugs are characterized by a combination of informal language with specific terminology (e.g. adverse effects, drug names) with greater lexical diversity, making the task of sentiment analysis difficult. Copyright © 2018 Elsevier B.V. All rights reserved.

  18. Talking to Your Doctor

    Full Text Available ... Lines Health Services Locator HealthCare.gov NIH Clinical Research Trials and You Talking to Your Doctor Science ... More » Quick Links NIH News in Health NIH Research Matters NIH Record Research & Training Medical Research Initiatives ...

  19. Talking to Your Doctor

    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 ...

  20. Talking to Your Doctor

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

  1. Talking to Your Doctor

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

  2. Dimensions, discourses and differences: trainees conceptualising health care leadership and followership.

    Gordon, Lisi J; Rees, Charlotte E; Ker, Jean S; Cleland, Jennifer

    2015-12-01

    As doctors in all specialties are expected to undertake leadership within health care organisations, leadership development has become an inherent part of medical education. Whereas the leadership literature within medical education remains mostly focused on individual, hierarchical leadership, contemporary theory posits leadership as a group process, which should be distributed across all levels of health care organisation. This gap between theory and practice indicates that there is a need to understand what leadership and followership mean to medical trainees working in today's interprofessional health care workplace. Epistemologically grounded in social constructionism, this research involved 19 individual and 11 group interviews with 65 UK medical trainees across all stages of training and a range of specialties. Semi-structured interviewing techniques were employed to capture medical trainees' conceptualisations of leadership and followership. Interviews were audiotaped, transcribed verbatim and analysed using thematic framework analysis to identify leadership and followership dimensions which were subsequently mapped onto leadership discourses found in the literature. Although diversity existed in terms of medical trainees' understandings of leadership and followership, unsophisticated conceptualisations focusing on individual behaviours, hierarchy and personality were commonplace in trainees' understandings. This indicated the dominance of an individualist discourse. Patterns in understandings across all stages of training and specialties, and whether definitions were solicited or unsolicited, illustrated that context heavily influenced trainees' conceptualisations of leadership and followership. Our findings suggest that UK trainees typically hold traditional understandings of leadership and followership, which are clearly influenced by the organisational structures in which they work. Although education may change these understandings to some extent

  3. Changes in prevalence of workplace violence against doctors in all medical specialties in Norway between 1993 and 2014: a repeated cross-sectional survey.

    Johansen, Ingrid Hjulstad; Baste, Valborg; Rosta, Judith; Aasland, Olaf G; Morken, Tone

    2017-08-11

    The aim of this study was to investigate whether reported prevalence of experienced threats, real acts of violence and debilitating fear of violence among Norwegian doctors have increased over the last two decades. Repeated cross-sectional survey. All healthcare levels and medical specialties in Norway. Representative samples of Norwegian doctors in 1993 (n=2628) and 2014 (n=1158). Relative risk (RR) of self-reported prevalence of work-time experiences of threats and real acts of violence, and of being physically or psychologically unfit during the last 12 months due to fear of violence, in 2014 compared with 1993, adjusted by age, gender and medical specialty. There were no differences in self-reported threats (adjusted RR=1.01, 95% CI 0.95 to 1.08) or real acts (adjusted RR=0.90, 95% CI 0.80 to 1.03) of violence when comparing 2014 with 1993. The proportion of doctors who had felt unfit due to fear of violence decreased from 1993 to 2014 (adjusted RR=0.53, 95% CI 0.39 to 0.73). Although still above average, the proportion of doctors in psychiatry who reported real acts of violence decreased substantially from 1993 to 2014 (adjusted RR=0.75, 95% CI 0.60 to 0.95). A substantial proportion of doctors experience threats and real acts of violence during their work-time career, but there was no evidence that workplace violence has increased over the last two decades. Still, the issue needs to be addressed as part of the doctors' education and within work settings. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  4. Doktor Kot, Doktor Sla - book doctors, plant doctors and the segmentation of the medical market place in Meghalaya, northeast India.

    Albert, Sandra; Porter, John; Green, Judith

    2017-10-16

    Despite decades of research on India's plural health care market, the practices of many local health traditions outside the allopathic and codified traditions are under-studied. Drawing on interview and observational data, this paper explores the space in which indigenous traditional Khasi healers in Meghalaya state, northeast India, practice. Khasi indigenous healers describe themselves as doktor sla, plant doctors, to distinguish themselves from doktor kot, or book doctors. This distinction operates as a rhetorical resource, utilised to carve a distinct sphere of expertise in relation to the allopathic sector, and to mark claims for the specifically local appropriateness of traditional practices within a shifting market of state-sponsored provision. Khasi healers are a heterogeneous group who treat a wide variety of conditions, including physical ailments which have no obvious correlates in biomedical systems, and musculoskeletal disorders, with which they have recognised expertise. In addition to claiming these discrete strengths, healers also present themselves as accommodating deficiencies in biomedicine, including inherent generic weaknesses of allopathic care as well as specific local gaps in rural health care provision. Thus, the expertise niches of traditional healers have evolved through their interactions with, and the needs of, the community, but also through managing a shifting boundary with biomedical practitioners, who are explicitly sceptical of their efficacy, but tacitly accepting of the ways in which they manage the gaps in biomedical provision. While codified non-biomedical traditions in India have engaged in universalising professionalising projects, in this setting at least, non-codified practitioners have instead utilised discourses of localism.

  5. Graduates from a reformed undergraduate medical curriculum based on Tomorrow's Doctors evaluate the effectiveness of their curriculum 6 years after graduation through interviews

    Taylor David CM

    2010-09-01

    Full Text Available Abstract Background In 1996 Liverpool reformed its medical curriculum from a traditional lecture based course to a curriculum based on the recommendations in Tomorrow's Doctors. A project has been underway since 2000 to evaluate this change. This paper focuses on the views of graduates from that reformed curriculum 6 years after they had graduated. Methods Between 2007 and 2009 45 interviews took place with doctors from the first two cohorts to graduate from the reformed curriculum. Results The interviewees felt like they had been clinically well prepared to work as doctors and in particular had graduated with good clinical and communication skills and had a good knowledge of what the role of doctor entailed. They also felt they had good self directed learning and research skills. They did feel their basic science knowledge level was weaker than traditional graduates and perceived they had to work harder to pass postgraduate exams. Whilst many had enjoyed the curriculum and in particular the clinical skills resource centre and the clinical exposure of the final year including the "shadowing" and A & E attachment they would have liked more "structure" alongside the PBL when learning the basic sciences. Conclusion According to the graduates themselves many of the aims of curriculum reform have been met by the reformed curriculum and they were well prepared clinically to work as doctors. However, further reforms may be needed to give confidence to science knowledge acquisition.

  6. Graduates from a reformed undergraduate medical curriculum based on Tomorrow's Doctors evaluate the effectiveness of their curriculum 6 years after graduation through interviews.

    Watmough, Simon D; O'Sullivan, Helen; Taylor, David C M

    2010-09-29

    In 1996 Liverpool reformed its medical curriculum from a traditional lecture based course to a curriculum based on the recommendations in Tomorrow's Doctors. A project has been underway since 2000 to evaluate this change. This paper focuses on the views of graduates from that reformed curriculum 6 years after they had graduated. Between 2007 and 2009 45 interviews took place with doctors from the first two cohorts to graduate from the reformed curriculum. The interviewees felt like they had been clinically well prepared to work as doctors and in particular had graduated with good clinical and communication skills and had a good knowledge of what the role of doctor entailed. They also felt they had good self directed learning and research skills. They did feel their basic science knowledge level was weaker than traditional graduates and perceived they had to work harder to pass postgraduate exams. Whilst many had enjoyed the curriculum and in particular the clinical skills resource centre and the clinical exposure of the final year including the "shadowing" and A & E attachment they would have liked more "structure" alongside the PBL when learning the basic sciences. According to the graduates themselves many of the aims of curriculum reform have been met by the reformed curriculum and they were well prepared clinically to work as doctors. However, further reforms may be needed to give confidence to science knowledge acquisition.

  7. Study of the relationship between the leadership style of managers and Job Burnout among the staff of Lorestan university of medical sciences in 2010

    anahita Almasian

    2012-06-01

    Conclusion: There is also a significant relationship between the leadership style of managers and job burnout among the employees of the Lorestan university of medical sciences. The presence of a relationship between the leadership style of managers and job burnout among the employees demonstrates that there is an urgent need that managers use scientific methods of management in dealing with the personnel.

  8. Gender role stereotype and poor working condition pose obstacles for female doctors to stay in full-time employment: alumnae survey from two private medical schools in Japan.

    Izumi, Miki; Nomura, Kyoko; Higaki, Yuko; Akaishi, Yu; Seki, Masayasu; Kobayashi, Shizuko; Komoda, Takayuki; Otaki, Junji

    2013-03-01

    The shortage of physicians has become a serious problem in Japan. It has been pointed out that an increase in the number of female doctors may contribute to the aggravation of this shortage because it is known that women work fewer hours than male doctors. Here, we investigated how many female doctors had ever resigned from a full-time position, and elucidated the reasons why female doctors find it difficult to stay in full-time employment. An alumnae survey of 2 private medical schools was conducted in 2007. A self-administered questionnaire was sent to 1423 graduates and 711 responded with informed consent (response rate, 50%; mean age, 39 years). Overall, 55% of the respondents had previously resigned from full-time employment, of which 90% resigned within 10 years of graduating from medical school. The difficulty in balancing work, childbirth and child rearing (45%) were the top 2 reasons for resignation, followed by physical problems (12%) and long working hours (8%). Among those who resigned, only 33% returned to full-time employment. Women who had at least 1 child were only 30% of those who had never resigned and 84% of those who had previously resigned. The majority of study subjects, regardless of experience of resignation (88%), agreed that women should continue to work even after childbirth. In conclusion, the results of this study suggested that many female doctors resigned from a full-time position within 10 years of graduating from medical school, largely because of the gender role stereotype and poor working conditions.

  9. Disclosure of Traditional and Complementary Medicine Use and Its Associated Factors to Medical Doctor in Primary Care Clinics in Kuching Division, Sarawak, Malaysia.

    Johny, Anak Kelak; Cheah, Whye Lian; Razitasham, Safii

    2017-01-01

    The decision by the patients to disclose traditional and complementary medicine (TCM) use to their doctor is an important area to be explored. This study aimed to determine the disclosure of TCM use and its associated factors to medical doctor among primary care clinic attendees in Kuching Division, Sarawak. It was a cross-sectional study using questionnaire, interviewer administered questionnaire. A total of 1130 patients were screened with 80.2% reporting using TCM. Logistic regression analysis revealed that being female (AOR = 3.219, 95% CI: 1.385, 7.481), perceived benefits that TCM can prevent complication of illness (AOR = 3.999, 95% CI: 1.850, 8.644) and that TCM is more gentle and safer (AOR = 4.537, 95% CI: 2.332, 8.828), perceived barriers of not having enough knowledge about TCM (AOR = 0.530, 95% CI: 0.309, 0.910), patient dissatisfaction towards healthcare providers being too business-like and impersonal (AOR = 0.365, 95% CI: 0.199, 0.669) and paying more for healthcare than one can afford (AOR = 0.413, 95% CI: 0.250, 0.680), and accessibility of doctors (AOR = 3.971, 95% CI: 2.245, 7.023) are the predictors of disclosure of TCM use. An open communication between patients and doctor is important to ensure safe implementation and integration of both TCM and medical treatment.

  10. Bench-to-bedside review: leadership and conflict management in the intensive care unit.

    Strack van Schijndel, Rob J M; Burchardi, Hilmar

    2007-01-01

    In the management of critical care units, leadership and conflict management are vital areas for the successful performance of the unit. In this article a practical approach to define competencies for leadership and principles and practices of conflict management are offered. This article is, by lack of relevant intensive care unit (ICU) literature, not evidence based, but it is the result of personal experience and a study of literature on leadership as well on conflicts and negotiations in non-medical areas. From this, information was selected that was recognisable to the authors and, thus, also seems to be useful knowledge for medical doctors in the ICU environment.

  11. Patient's Decision to Disclose the Use of Traditional and Complementary Medicine to Medical Doctor: A Descriptive Phenomenology Study

    Kelak, Johny Anak; Safii, Razitasham

    2018-01-01

    Nondisclosure of traditional and complementary medicine (T&CM) use may cause individual to be at risk of undue harm. This study aimed to explore patient's experience and views on their decision to disclose the use of T&CM to the doctor. An exploratory qualitative study using in-depth interview involving 10 primary care clinics attendees in Kuching was conducted. The results indicated that disclosure of T&CM use will motivate them to get information, increase doctor's awareness, and get support from family and friends for disclosure. Fear of negative relationship and negative response from doctors was a barrier for disclosure. Doctor's interpersonal and communication skills of being involved, treating patients respectfully, listening attentively, respecting privacy, and taking time for the patient were a critical component for disclosure. Intrapersonal trust regarding doctor influences their satisfaction on healthcare. Women are more open and receptive to a health concern and expressing negative emotions and tend to share problems, whereas men always described themselves as healthy, tended to keep their own personal feeling to themselves, and tended to not share. The doctor should consider gender differences in disclosure, their attitude towards T&CM use, and gained patient's trust in the delivery of healthcare services. Good interpersonal and communication skills must be maintained between doctor and patients. PMID:29636778

  12. Leadership in anesthesiology: not just a one man show

    Tjokorda GA Senapathi

    2017-05-01

    Full Text Available Anesthesiology had been one of highly skilled professional specialty with diversity of training but with a structured model of leadership culture. The culture which could be drawn back since medical training to become a medical doctor. School of medicine had already established a standard model of teaching and training. The tutoring method is implemented mostly based on classroom meetings in traditional basic lesson, bedside teaching for clerkship and internship and lately adopted method of case-based discussion

  13. Review of monograph of Doctor of Medicine, Professor Prokopov V.O. «Drinking water of Ukraine: medical-ecologic and sanitary-hygiene aspects» edited by Doctor of Medicine, Academician of NAMS of Ukraine A.M. Serdiuk. – K.: Academic Press «Medicine», 2016.

    Shevchenko, O. A.

    2017-01-01

    Review of monograph of Doctor ofMedicine, Professor Prokopov V.O. «Drinking water ofUkraine: medical-ecologic and sanitary-hygiene aspects»edited by Doctor of Medicine, Academician of NAMS ofUkraine A.M. Serdiuk. – K.: Academic Press «Medicine»,2016. – 400 p.

  14. The transition from medical student to doctor: perceptions of final year students and preregistration house officers related to expected learning outcomes.

    Lempp, H; Seabrook, M; Cochrane, M; Rees, J

    2005-03-01

    In this prospective qualitative study over 12 months, we evaluated the educational and clinical effectiveness of a new final year undergraduate programme in a London medical school (Guy's, King's and St Thomas'). A stratified sample of 17/360 final year students were interviewed four times, and the content was assessed against 32 amalgamated learning outcomes identified in 1997 in The New Doctor. At the beginning of the preregistration year, eight of the learning outcomes were already met, 10 partly, eight remained to be attained and for six, insufficient evidence existed. Preregistration house officers who have been through the final year student house officer programme expressed competence in many of the outcomes of the General Medical Council's New Doctor. The study identified areas such as prescribing where further developments are needed and will help in planning the new foundation programme.

  15. Work related stress and its anticipated solutions among post-graduate medical resident doctors: a cross-sectional survey conducted at a tertiary municipal hospital in Mumbai, India.

    Rajan, Pavithra; Bellare, Bharati

    2011-03-01

    It is now known that resident doctors registered for postgraduate studies are prone to work related stress and eventual burnout. Though stress can happen in any profession, reduced performance of resident doctors due to vocational stress could cause an increase in medical errors and thus affect the quality of life of the patients. Resident doctors at a Municipal hospital in India form a unique population as number of stresses they undergo are many and varied. To study the prevalence of work-related stress and its anticipated solutions among the resident doctors registered for postgraduate studies in clinical subjects at a tertiary Municipal hospital. A stratified sampling cross-sectional survey was conducted at the Inpatient, Outpatient, and Intensive Care Units at a tertiary Municipal hospital in Mumbai, India. Data collection was done using a validated 20-point questionnaire to assess the factors causing stress and their anticipated