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Sample records for medical licensure examination

  1. Three controversies over item disclosure in medical licensure examinations

    Directory of Open Access Journals (Sweden)

    Yoon Soo Park

    2015-09-01

    Full Text Available In response to views on public's right to know, there is growing attention to item disclosure – release of items, answer keys, and performance data to the public – in medical licensure examinations and their potential impact on the test's ability to measure competence and select qualified candidates. Recent debates on this issue have sparked legislative action internationally, including South Korea, with prior discussions among North American countries dating over three decades. The purpose of this study is to identify and analyze three issues associated with item disclosure in medical licensure examinations – 1 fairness and validity, 2 impact on passing levels, and 3 utility of item disclosure – by synthesizing existing literature in relation to standards in testing. Historically, the controversy over item disclosure has centered on fairness and validity. Proponents of item disclosure stress test takers’ right to know, while opponents argue from a validity perspective. Item disclosure may bias item characteristics, such as difficulty and discrimination, and has consequences on setting passing levels. To date, there has been limited research on the utility of item disclosure for large scale testing. These issues requires ongoing and careful consideration.

  2. Predicting United States Medical Licensure Examination Step 2 clinical knowledge scores from previous academic indicators

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    Monteiro KA

    2017-06-01

    Full Text Available Kristina A Monteiro, Paul George, Richard Dollase, Luba Dumenco Office of Medical Education, The Warren Alpert Medical School of Brown University, Providence, RI, USA Abstract: The use of multiple academic indicators to identify students at risk of experiencing difficulty completing licensure requirements provides an opportunity to increase support services prior to high-stakes licensure examinations, including the United States Medical Licensure Examination (USMLE Step 2 clinical knowledge (CK. Step 2 CK is becoming increasingly important in decision-making by residency directors because of increasing undergraduate medical enrollment and limited available residency vacancies. We created and validated a regression equation to predict students’ Step 2 CK scores from previous academic indicators to identify students at risk, with sufficient time to intervene with additional support services as necessary. Data from three cohorts of students (N=218 with preclinical mean course exam score, National Board of Medical Examination subject examinations, and USMLE Step 1 and Step 2 CK between 2011 and 2013 were used in analyses. The authors created models capable of predicting Step 2 CK scores from academic indicators to identify at-risk students. In model 1, preclinical mean course exam score and Step 1 score accounted for 56% of the variance in Step 2 CK score. The second series of models included mean preclinical course exam score, Step 1 score, and scores on three NBME subject exams, and accounted for 67%–69% of the variance in Step 2 CK score. The authors validated the findings on the most recent cohort of graduating students (N=89 and predicted Step 2 CK score within a mean of four points (SD=8. The authors suggest using the first model as a needs assessment to gauge the level of future support required after completion of preclinical course requirements, and rescreening after three of six clerkships to identify students who might benefit from

  3. 45 CFR 60.8 - Reporting licensure actions taken by Boards of Medical Examiners.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Reporting licensure actions taken by Boards of Medical Examiners. 60.8 Section 60.8 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION NATIONAL PRACTITIONER DATA BANK FOR ADVERSE INFORMATION ON PHYSICIANS AND OTHER HEALTH CARE...

  4. Discriminant analysis of Social Work’s performance in licensure examination

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    Jonel R. Alonzo

    2017-12-01

    Full Text Available Many research studies have examined academic factors as predictors of success in licensure examination. The purpose of this descriptive discriminant analysis was to explore possible factors in passing social work licensure examination. Data were examined from academic records of 69 (37 passed and 32 failed Social Work graduates of the University of Mindanao who took Social Work Licensure Examination 2014. This can be used as a basis of Social Work program in planning and administering strategies to improve its national passing rates. Discriminant analysis was employed along five academic factors which are Human Behavior and Social Environment (HBSE, Social Work Programs and Policies (SWPP, Social Work Methods (SWM, Field Practice (FP and Grade Point Average (GPA. The analysis generated three significant predictors accounting for 76.22% of between group variability. The function had a hit ratio of 100%. Structure matrix revealed that three cluster subjects were identified as good factors of passing the social work licensure examination: HBSE, SWPP and SWM had a correlation value of 0.713, 0.768 and 0.840, respectively.

  5. Nursing Students' Intrinsic Motivation and Performance on the Licensure Examination.

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    Hackney, Michele G

    Unsuccessful attempts at licensure adversely affect graduates, prelicensure nursing education programs, health care agencies, and ultimately, patient safety. The purpose of this quantitative, correlational study was to investigate the relationship between nursing students' intrinsic motivation and performance on the licensure examination. Nursing students responded to 12 questions related to reasons for learning as indicators of motivation type. Results indicated no statistically significant correlations between variables.

  6. Previous Education, Sociodemographic Characteristics, and Nursing Cumulative Grade Point Average as Predictors of Success in Nursing Licensure Examinations

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    Isaac Amankwaa

    2015-01-01

    Full Text Available Introduction. Success in the licensure examination is the only legal prerequisite to practice as a nurse in Ghana. However, a large percentage of nursing students who sit fail this examination for the first time. This study sought to unravel whether prior education, sociodemographic characteristics, and nursing Cumulative Grade Point Average (CGPA could predict performance in the licensure examinations. Methods. The study was a descriptive cross-sectional survey conducted from November 2014 to April 2015 in the Kumasi metropolis, Ghana on 176 past nursing students. Data was collected using questionnaires and analyzed using SPSS version 22. A logistic regression model was fitted to look at the influence of the explanatory variables on the odds of passing the licensure examinations. All statistical significances were tested at p value of <0.05. Results. Majority, 56.3%, were females and 86.4% were between the ages of 25 and 31 years. Most of the students (88.6% entered the nursing training colleges with a WASSCE qualification and 38% read general science. 73.9% passed the licensure examinations and the mean CGPA of the students was 2.89 SD=0.37. Sociodemographic characteristics and previous education had no influence on performance in the licensure examinations. CGPA had strong positive relationship with performance in licensure examinations (AOR = 15.27; 95% CI = 6.28, 27.11. Conclusion. Students CGPA could be a good predictor of their performance in the licensure examinations. On the other hand, students’ sociodemographic and previous educational characteristics might not be important factors to consider in admitting students into the nursing training programme.

  7. Previous Education, Sociodemographic Characteristics, and Nursing Cumulative Grade Point Average as Predictors of Success in Nursing Licensure Examinations.

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    Amankwaa, Isaac; Agyemang-Dankwah, Anabella; Boateng, Daniel

    2015-01-01

    Introduction. Success in the licensure examination is the only legal prerequisite to practice as a nurse in Ghana. However, a large percentage of nursing students who sit fail this examination for the first time. This study sought to unravel whether prior education, sociodemographic characteristics, and nursing Cumulative Grade Point Average (CGPA) could predict performance in the licensure examinations. Methods. The study was a descriptive cross-sectional survey conducted from November 2014 to April 2015 in the Kumasi metropolis, Ghana on 176 past nursing students. Data was collected using questionnaires and analyzed using SPSS version 22. A logistic regression model was fitted to look at the influence of the explanatory variables on the odds of passing the licensure examinations. All statistical significances were tested at p value of <0.05. Results. Majority, 56.3%, were females and 86.4% were between the ages of 25 and 31 years. Most of the students (88.6%) entered the nursing training colleges with a WASSCE qualification and 38% read general science. 73.9% passed the licensure examinations and the mean CGPA of the students was 2.89 (SD = 0.37). Sociodemographic characteristics and previous education had no influence on performance in the licensure examinations. CGPA had strong positive relationship with performance in licensure examinations (AOR = 15.27; 95% CI = 6.28, 27.11). Conclusion. Students CGPA could be a good predictor of their performance in the licensure examinations. On the other hand, students' sociodemographic and previous educational characteristics might not be important factors to consider in admitting students into the nursing training programme.

  8. CASPer, an online pre-interview screen for personal/professional characteristics: prediction of national licensure scores.

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    Dore, Kelly L; Reiter, Harold I; Kreuger, Sharyn; Norman, Geoffrey R

    2017-05-01

    Typically, only a minority of applicants to health professional training are invited to interview. However, pre-interview measures of cognitive skills predict for national licensure scores (Gauer et al. in Med Educ Online 21 2016) and subsequently licensure scores predict for performance in practice (Tamblyn et al. in JAMA 288(23): 3019-3026, 2002; Tamblyn et al. in JAMA 298(9):993-1001, 2007). Assessment of personal and professional characteristics, with the same psychometric rigour of measures of cognitive abilities, are needed upstream in the selection to health profession training programs. To fill that need, Computer-based Assessment for Sampling Personal characteristics (CASPer)-an on-line, video-based screening test-was created. In this paper, we examine the correlation between CASPer and Canadian national licensure examination outcomes in 109 doctors who took CASPer at the time of selection to medical school. Specifically, CASPer scores were correlated against performance on cognitive and 'non-cognitive' subsections of both the Medical Council of Canada Qualifying Examination (MCCQE) Parts I (end of medical school) and Part II (18 months into specialty training). Unlike most national licensure exams, MCCQE has specific subcomponents examining personal/professional qualities, providing a unique opportunity for comparison. The results demonstrated moderate predictive validity of CASPer to national licensure outcomes of personal/professional characteristics three to six years after admission to medical school. These types of disattenuated correlations (r = 0.3-0.5) are not otherwise predicted by traditional screening measures. These data support the ability of a computer-based strategy to screen applicants in a feasible, reliable test, which has now demonstrated predictive validity, lending evidence of its validation for medical school applicant selection.

  9. Prediction Models for Licensure Examination Performance using Data Mining Classifiers for Online Test and Decision Support System

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    Ivy M. Tarun

    2017-05-01

    Full Text Available This study focuse d on two main points: the generation of licensure examination performan ce prediction models; and the development of a Decision Support System. In this study, data mining classifiers were used to generate the models using WEKA (Waikato Environment for Knowledge Analysis. These models were integrated into the Decision Support System as default models to support decision making as far as appropriate interventions during review sessions are concerned. The system developed mainly involves the repeated generation of MR models for performance prediction and also provides a Mock Boar d Exam for the reviewees to take. From the models generated, it is established that the General Weighted Average of the reviewees in their General Education subjects, the result of the Mock Board Exam and the instance when the reviewee is conducting a sel f - review are good predictors of the licensure examination performance. Further , it is concluded that the General Weighted Average of the reviewees in their Major or Content courses is the best predictor of licensure examination performance. Based from the evaluation results of the system , the system satisfied its implied functions and is efficient, usable, reliable and portable. Hence, it can already be used not as a substitute to the face - to - face review sessions but to enhance the reviewees’ licensure exa mination review and allow initial identification of those who are likely to have difficulty in passing the licensure examination, therefore providing sufficient time and opportunities for appropriate interventions.

  10. The influence of globalization on medical regulation: a descriptive analysis of international medical graduates registered through alternative licensure routes in Ontario

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    Yen, Wendy; Hodwitz, Kathryn; Thakkar, Niels; Martimianakis, Maria Athina (Tina); Faulkner, Dan

    2016-01-01

    The increasing globalization of the medical profession has influenced health policy, health human resource planning, and medical regulation in Canada. Since the early 2000s, numerous policy initiatives have been created to facilitate the entry of international medical graduates (IMGs) into the Canadian workforce. In Ontario, the College of Physicians and Surgeons of Ontario (CPSO) developed alternative licensure routes to increase the ability of qualified IMGs to obtain licenses to practice. The current study provides demographic and descriptive information about the IMGs registered through the CPSO’s alternative licensure routes between 2000 and 2012. An analysis of the characteristics and career trajectories of all IMGs practicing in the province sheds light on broader globalization trends and raises questions about the future of health human resource planning in Canada. As the medical profession becomes increasingly globalized, health policy and regulation will continue to be influenced by trends in international migration, concerns about global health equity, and the shifting demographics of the Canadian physician workforce. Implications for future policy development in the complex landscape of medical education and practice are discussed. PMID:28344705

  11. The influence of globalization on medical regulation: a descriptive analysis of international medical graduates registered through alternative licensure routes in Ontario.

    Science.gov (United States)

    Yen, Wendy; Hodwitz, Kathryn; Thakkar, Niels; Martimianakis, Maria Athina Tina; Faulkner, Dan

    2016-12-01

    The increasing globalization of the medical profession has influenced health policy, health human resource planning, and medical regulation in Canada. Since the early 2000s, numerous policy initiatives have been created to facilitate the entry of international medical graduates (IMGs) into the Canadian workforce. In Ontario, the College of Physicians and Surgeons of Ontario (CPSO) developed alternative licensure routes to increase the ability of qualified IMGs to obtain licenses to practice. The current study provides demographic and descriptive information about the IMGs registered through the CPSO's alternative licensure routes between 2000 and 2012. An analysis of the characteristics and career trajectories of all IMGs practicing in the province sheds light on broader globalization trends and raises questions about the future of health human resource planning in Canada. As the medical profession becomes increasingly globalized, health policy and regulation will continue to be influenced by trends in international migration, concerns about global health equity, and the shifting demographics of the Canadian physician workforce. Implications for future policy development in the complex landscape of medical education and practice are discussed.

  12. The influence of globalization on medical regulation: a descriptive analysis of international medical graduates registered through alternative licensure routes in Ontario

    Directory of Open Access Journals (Sweden)

    Wendy Yen

    2016-12-01

    Full Text Available The increasing globalization of the medical profession has influenced health policy, health human resource planning, and medical regulation in Canada. Since the early 2000s, numerous policy initiatives have been created to facilitate the entry of international medical graduates (IMGs into the Canadian workforce. In Ontario, the College of Physicians and Surgeons of Ontario (CPSO developed alternative licensure routes to increase the ability of qualified IMGs to obtain licenses to practice. The current study provides demographic and descriptive information about the IMGs registered through the CPSO’s alternative licensure routes between 2000 and 2012. An analysis of the characteristics and career trajectories of all IMGs practicing in the province sheds light on broader globalization trends and raises questions about the future of health human resource planning in Canada. As the medical profession becomes increasingly globalized, health policy and regulation will continue to be influenced by trends in international migration, concerns about global health equity, and the shifting demographics of the Canadian physician workforce. Implications for future policy development in the complex landscape of medical education and practice are discussed.

  13. National Systematic Legal Review of State Policies on Emergency Medical Services Licensure Levels' Authority to Administer Opioid Antagonists.

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    Kinsman, Jeremiah M; Robinson, Kathy

    2018-02-27

    Previous research conducted in November 2013 found there were a limited number of states and territories in the United States (US) that authorize emergency medical technicians (EMTs) and emergency medical responders (EMRs) to administer opioid antagonists. Given the continued increase in the number of opioid-related overdoses and deaths, many states have changed their policies to authorize EMTs and EMRs to administer opioid antagonists. The goal of this study is to provide an updated description of policy on EMS licensure levels' authority to administer opioid antagonists for all 50 US states, the District of Columbia (DC), and the Commonwealth of Puerto Rico (PR). State law and scopes of practice were systematically reviewed using a multi-tiered approach to determine each state's legally-defined EMS licensure levels and their authority to administer an opioid antagonist. State law, state EMS websites, and state EMS scope of practice documents were identified and searched using Google Advanced Search with Boolean Search Strings. Initial results of the review were sent to each state office of EMS for review and comment. As of September 1, 2017, 49 states and DC authorize EMTs to administer an opioid antagonist. Among the 40 US jurisdictions (39 states and DC) that define the EMR or a comparable first responder licensure level in state law, 37 states and DC authorize their EMRs to administer an opioid antagonist. Paramedics are authorized to administer opioid antagonists in all 50 states, DC, and PR. All 49 of the US jurisdictions (48 states and DC) that define the advanced emergency medical technician (AEMT) or a comparable intermediate EMS licensure level in state law authorize their AEMTs to administer an opioid antagonist. 49 out of 52 US jurisdictions (50 states, DC, and PR) authorize all existing levels of EMS licensure levels to administer an opioid antagonist. Expanding access to this medication can save lives, especially in communities that have limited

  14. History of the medical licensing examination (uieop in Korea’s Goryeo Dynasty (918-1392

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    Kyung-Lock Lee

    2015-05-01

    Full Text Available This article aims to describe the training and medical licensing system (uieop for becoming a physician officer (uigwan during Korea’s Goryeo Dynasty (918-1392. In the Goryeo Dynasty, although no license was necessary to provide medical services to the common people, there was a licensing examination to become a physician officer. No other national licensing system for healthcare professionals existed in Korea at that time. The medical licensing examination was administered beginning in 958. Physician officers who passed the medical licensing examination worked in two main healthcare institutions: the Government Hospital (Taeuigam and Pharmacy for the King (Sangyakguk. The promotion and expansion of medical education differed depending on the historical period. Until the reign of King Munjong (1046-1083, medical education as a path to licensure was encouraged in order to increase the number of physician officers qualifying for licensure by examination; thus, the number of applicants sitting for the examination increased. However, in the late Goryeo Dynasty, after the officer class of the local authorities (hyangri showed a tendency to monopolize the examination, the Goryeo government limited the examination applications by this group. The medical licensing examination was divided into two parts: medicine and ‘feeling the pulse and acupuncture’ (jugeumeop. The Goryeo Dynasty followed the Chinese Dang Dynasty’s medical system while also taking a strong interest in the Chinese Song Dynasty’s ideas about medicine.

  15. Examining the Factors of Licensure Examination for Teachers Performance for Program Strategy Enhancement

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    Januard D. Dagdag

    2017-11-01

    Full Text Available Passing the Licensure Examination for Teachers (LET has been the ultimate focus of tertiary education institutions in the Philippines to meet the present demand of local and global parties and communities. Hence, various strategies are conducted to increase the likelihood that the prospect will happen. With this, the current study determines the predictors of LET performance of the 146 Bachelor of Secondary Education graduates that could serve as basis for enhancing program strategies for a better LET rating. A descriptive correlational method through the analysis of registration data on LET, grade weighted average, college admission test (CAT scores, and course audit scores was conducted. Descriptive statistics and correlational tests were employed in the analysis of these data. Results showed that low LET performance is influenced by low performances in academics and admission test, and limited course audit units taken. Admission test performance, however, does not predict LET performance in Major. On the other hand, course audit performance can only forecast licensure exam scores in Major. Hence, to increase LET performance, the program should consider benchmarking from LET performing institutions, choose the right faculty to teach a course, secure the validity and/or reliability of instructional materials and assessment tools with LET competencies, strictly implement the admission and retention policy, and assess regularly the efficacy of the course audit in all areas

  16. Impact of Online Learning Modules on Medical Student Microbiology Examination Scores

    OpenAIRE

    Johnson, Mary T.

    2008-01-01

    Medical students have a limited amount of time in which to acquire working knowledge of an enormous amount of information, and this is especially relevant for microbiology. One large midwestern medical school is unique in having medical microbiology taught at nine regional campuses using a single core curriculum. A committee of statewide course directors writes a licensure board-style final examination that is referenced to the core and used at all campuses. To prepare for the final examinati...

  17. Portfolios for determining initial licensure competency.

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    Chambers, David W

    2004-02-01

    Because attempts to improve initial licensure examinations have not been grounded in measurement theory, partial and inadequate remedies have led to a cycle of refutations, defenses and political polarization. The author reviewed the psychometric literature, focusing on high-stakes professional decisions. Editorials in the dental literature and position papers of involved organizations often use words from this literature without incorporating its fundamental concepts. The reliability of one-shot initial licensure examinations is estimated to be approximately r = .40, which is a value well under the standard for such tests in other professions. Validity has not been investigated rigorously, but the one-shot format and proposals to remove live patients certainly would reduce validity. The use of portfolios--a small number of evaluations in several realistic task domains--is a viable means of achieving psychometric standards for initial licensure decisions. Boards are charged with making valid and reliable licensure decisions, not with conducting examinations. At a minimum, they must define the competencies of beginning practitioners and establish the psychometric criteria for their decisions (neither of which are done currently). Gathering data then can be delegated to whoever is best qualified to meet these standards.

  18. Impact of Time Lapse on ASCP Board of Certification Medical Laboratory Scientist (MLS) and Medical Laboratory Technician (MLT) Examination Scores.

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    Brown, Karen A; Fenn, JoAnn P; Freeman, Vicki S; Fisher, Patrick B; Genzen, Jonathan R; Goodyear, Nancy; Houston, Mary Lunz; O'Brien, Mary Elizabeth; Tanabe, Patricia A

    2015-01-01

    Research in several professional fields has demonstrated that delays (time lapse) in taking certification examinations may result in poorer performance by examinees. Thirteen states and/or territories require licensure for laboratory personnel. A core component of licensure is passing a certification exam. Also, many facilities in states that do not require licensure require certification for employment or preferentially hire certified individuals. To analyze examinee performance on the American Society for Clinical Pathology (ASCP) Board of Certification (BOC) Medical Laboratory Scientist (MLS) and Medical Laboratory Technician (MLT) certification examinations to determine whether delays in taking the examination from the time of program completion are associated with poorer performance. We obtained examination data from April 2013 through December 2014 to look for changes in mean (SD) exam scaled scores and overall pass/fail rates. First-time examinees (MLS: n = 6037; MLT, n = 3920) were divided into 3-month categories based on the interval of time between date of program completion and taking the certification exam. We observed significant decreases in mean (SD) scaled scores and pass rates after the first quarter in MLS and MLT examinations for applicants who delayed taking their examination until the second, third, and fourth quarter after completing their training programs. Those who take the ASCP BOC MLS and MLT examinations are encouraged to do so shortly after completion of their educational training programs. Delays in taking an exam are generally not beneficial to the examinee and result in poorer performance on the exam. Copyright© by the American Society for Clinical Pathology (ASCP).

  19. Predictors of Success on the National Council Licensure Examination for Registered Nurses among Transfer BSN Students

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    Fortier, Mary E.

    2010-01-01

    This quantitative research study (N=175) examined predictors of first time success on the National Council Licensure Examination for Registered Nurses (NCLEX-RN) among transfer students in a baccalaureate degree program (BSN). The predictors were chosen after an extensive literature review yielded few studies related to this population. Benner's…

  20. Examining changes in certification/licensure requirements and the international medical graduate examinee pool.

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    McKinley, Danette W; Hess, Brian J; Boulet, John R; Lipner, Rebecca S

    2014-03-01

    Changes in certification requirements and examinee characteristics are likely to influence the validity of the evidence associated with interpretations made based on test data. We examined whether changes in Educational Commission for Foreign Medical Graduates (ECFMG) certification requirements over time were associated with changes in internal medicine (IM) residency program director ratings and certification examination scores. Comparisons were made between physicians who were ECFMG-certified before and after the Clinical Skills Assessment (CSA) requirement. A multivariate analysis of covariance was conducted to examine the differences in program director ratings based on CSA cohort and whether the examinees emigrated for undergraduate medical education (national vs. international students). A univariate analysis of covariance was conducted to examine differences in scores from the American Board of Internal Medicine (ABIM) Internal Medicine Certification Examination. For both analyses, United States Medical Licensing Examination (USMLE) Step 1 and Step 2 scores were used as covariates. Results indicate that, of those certified by ECFMG between 1993 and 1997, 17 % (n = 1,775) left their country of citizenship for undergraduate medical education. In contrast, 38 % (n = 1,874) of those certified between 1999 and 2003 were international students. After adjustment by covariates, the main effect of cohort membership on the program director ratings was statistically significant (Wilks' λ = 0.99, F 5, 15391 = 19.9, P migration status was statistically significant and weak (Wilks' λ = 0.98, F 5,15391 = 45.3, P Internal Medicine Certification Examination scores based on whether or not CSA were required was statistically significant, although the magnitude of the association between these variables was very small. The findings suggest that the implementation of an additional evaluation of skills (e.g., history-taking, physical examination) as a

  1. NVESTIGATION OF INTERNATIONAL ENGINEERING LICENSURE SYSTEMS

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    Selim BARADAN

    2009-01-01

    Full Text Available In many countries, engineers are legally required to register to a "licensure" system, which is founded on education and experience criteria and administered by a government body, to use the "engineer" title and offer professional services to the public. In today's globalized world, international alliances such as FEANI, APEC and EMF award engineers with European, APEC and International Professional engineer titles within a framework of mutual recognition of qualifications enabling them to practice outside their own country. This article examines such international licensure systems, particularly their administration processes and registration criteria, and discusses how current licensure procedures in Turkey should be revamped in case of joining an international alliance such as European Union.

  2. Parent and teen agreement on driving expectations prior to teen licensure.

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    Hamann, Cara J; Ramirez, Marizen; Yang, Jingzhen; Chande, Vidya; Peek-Asa, Corinne

    2014-01-01

    To examine pre-licensure agreement on driving expectations and predictors of teen driving expectations among parent-teen dyads. Cross-sectional survey of 163 parent-teen dyads. Descriptive statistics, weighted Kappa coefficients, and linear regression were used to examine expectations about post-licensure teen driving. Teens reported high pre-licensure unsupervised driving (N = 79, 48.5%) and regular access to a car (N = 130, 81.8%). Parents and teens had low agreement on teen driving expectations (eg, after dark, κw = 0.23). Each time teens currently drove to/from school, their expectation of driving in risky conditions post-licensure increased (β = 0.21, p = .02). Pre-licensure improvement of parent-teen agreement on driving expectations are needed to have the greatest impact on preventing teens from driving in high risk conditions.

  3. Principal Licensure Exams and Future Job Performance: Evidence from the School Leaders Licensure Assessment

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    Grissom, Jason A.; Mitani, Hajime; Blissett, Richard S. L.

    2017-01-01

    Many states require prospective principals to pass a licensure exam to obtain an administrative license, but we know little about the potential effects of principal licensure exams on the pool of available principals or whether scores predict later job performance. We investigate the most commonly used exam, the School Leaders Licensure Assessment…

  4. Evaluation of Romblon State University’s Adopt-a-Reviewee Project for Certified Public Accountant Licensure Examination

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    Sherryll M. Fetalvero

    2018-02-01

    Full Text Available This study is part of a bigger evaluation research about the Adopt-a-Reviewee Project for Certified Public Accountant Licensure Examination (ADOPT of the College of Business and Accountancy of Romblon State University. The project was assessed using Stufflebeam’s Context, Input, Process and Product (CIPP evaluation model. This paper however, focuses only on CIPP’s product evaluation component which is essential in making decisions as to the continuation or abortion of the project. A mixed method research was employed in gathering information from 16 beneficiaries and their respective families using two parallel forms of validated evaluation questionnaire complemented with interviews. These data were triangulated in a focus group composed of beneficiaries, benefactors, administrative officials, college dean and accounting teachers. To determine the effect of ADOPT on RSU’s passing performance in the CPA Licensure Examination (CPALE, a series of comparative tests was done. Results reveal that ADOPT is an effective intervention in improving RSU’s performance in CPALE as well as the socio- economic condition and well-being of the beneficiaries and their families. Workable measures are advanced in order to sustain the project despite challenges in fund sourcing and generation.

  5. Making the Case for Uniformity in Professional State Licensure Requirements

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    Janice A. Brannon

    2012-06-01

    Full Text Available Telehealth, the use of communication and information technologies to deliver health services, was initially envisioned as a way for persons in rural or remote settings to receive otherwise unavailable healthcare services. Now, in addition to overcoming personnel shortages for underserved populations, telehealth shows promise in meeting the needs of a constantly mobile U.S. society and workforce.  Fortunately, telerehabilitation can meet the needs of a mobile society and workforce by enabling continuity of care for individuals who are out-of-town, on vacation, in temporary residence as a university student, or on business travel. Unfortunately, outdated legislative and regulatory policies and inhospitable infrastructures currently stand in the way of a seamless continuum of care.In 2010, the American Telemedicine Association’s Telerehabilitation Special Interest Group (TR SIG convened a License Portability Sub-Committee to explore ways to diminish barriers for state licensure portability with a particular focus on physical therapy, occupational therapy, speech therapy, and audiology.  In 2011, the Subcommittee published a factsheet that detailed the challenges and potential solutions that surround the difficult issue of licensure portability.  Concurrently, the American Telemedicine Association is advocating for national reform of professional licensure.At the heart of all licensure requirements is the ability to determine who should be granted the authority to practice in a particular profession.  This is done by focusing on educational, examination and behavioral requirements that are deemed the minimum necessary to protect the public from harm.  States, however, with whom authority for licensure of health professionals rests, have independently determined those minimum requirements.  This approach has led to a myriad of requirements that vary from state to state. Licensure portability will best succeed when variability between

  6. An Analysis of Programmatic Variables Relating to the Pass Rates on the Licensure Examination by Practical Nurses in Tennessee Technology Centers

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    Simpson, Janis Lee

    2013-01-01

    The purpose of this quantitative research study was to determine the degree to which Licensed Practical Nursing programmatic variables positively correlate with select Tennessee Technology Center institution pass rates on the licensure examination--NCLEX-PNRTM. This study investigated the relationship between the dependent variable of NCLEX-PNRTM…

  7. Novel licensure pathways for expeditious introduction of new tuberculosis vaccines: a discussion of the adaptive licensure concept.

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    Rustomjee, Roxana; Lockhart, Stephen; Shea, Jacqueline; Fourie, P Bernard; Hindle, Zoë; Steel, Gavin; Hussey, Gregory; Ginsberg, Ann; Brennan, Michael J

    2014-03-01

    The ultimate goal of vaccine development is licensure of a safe and efficacious product that has a well-defined manufacturing process resulting in a high quality product. In general, clinical development and regulatory approval occurs in a linear, sequential manner: Phase 1 - safety, immunogenicity; Phase 2 - immunogenicity, safety, dose ranging and preliminary efficacy; Phase 3 - definitive efficacy, safety, lot consistency; and, following regulatory approval, Phase 4 - post-marketing safety and effectiveness. For candidate TB vaccines, where correlates of protection are not yet identified, phase 2 and 3 efficacy of disease prevention trials are, by necessity, very large. Each trial would span 2-5 years, with full licensure expected only after 1 or even 2 decades of development. Given the urgent unmet need for a new TB vaccine, a satellite discussion was held at the International African Vaccinology Conference in Cape Town, South Africa in November 2012, to explore the possibility of expediting licensure by use of an "adaptive licensure" process, based on a risk/benefit assessment that is specific to regional needs informed by epidemiology. This may be appropriate for diseases such as TB, where high rates of morbidity, mortality, particularly in high disease burden countries, impose an urgent need for disease prevention. The discussion focused on two contexts: licensure within the South African regulatory environment - a high burden country where TB vaccine efficacy trials are on-going, and licensure by the United States FDA --a well-resourced regulatory agency where approval could facilitate global licensure of a novel TB vaccine. Copyright © 2013. Published by Elsevier Ltd.

  8. The Affordances and Constraints of Special Education Initial Teacher Licensure Policy for Teacher Preparation

    Science.gov (United States)

    Blanton, Linda P.; Boveda, Mildred; Munoz, Lorena R.; Pugach, Marleen C.

    2017-01-01

    Initial licensure polices in special education were examined to determine how these policies support or hinder reform efforts to develop teacher education programs that prepare graduates for the increasingly complex needs of diverse students. Initial special education licensure policies are described with an emphasis on the differences across…

  9. Simulation Performance and National Council Licensure Examination for Registered Nurses Outcomes: Field Research Perspectives.

    Science.gov (United States)

    Brackney, Dana E; Lane, Susan Hayes; Dawson, Tyia; Koontz, Angie

    2017-11-01

    This descriptive field study examines processes used to evaluate simulation for senior-level Bachelor of Science in Nursing (BSN) students in a capstone course, discusses challenges related to simulation evaluation, and reports the relationship between faculty evaluation of student performance and National Council Licensure Examination for Registered Nurses (NCLEX-RN) first-time passing rates. Researchers applied seven terms used to rank BSN student performance (n = 41, female, ages 22-24 years) in a senior-level capstone simulation. Faculty evaluation was correlated with students' NCLEX-RN outcomes. Students evaluated as "lacking confidence" and "flawed" were less likely to pass the NCLEX-RN on the first attempt. Faculty evaluation of capstone simulation performance provided additional evidence of student preparedness for practice in the RN role, as evidenced by the relationship between the faculty assessment and NCLEX-RN success. Simulation has been broadly accepted as a powerful educational tool that may also contribute to verification of student achievement of program outcomes and readiness for the RN role.

  10. Variations by state in physician disciplinary actions by US medical licensure boards.

    Science.gov (United States)

    Harris, John Alexander; Byhoff, Elena

    2017-03-01

    To investigate the variation in the rate of state medical board physician disciplinary actions between US states. Longitudinal study of state medical board physician disciplinary action rates using the US National Practitioner Data Bank and American Medical Association estimates of physician demographics across all 50 states and the District of Columbia from 2010 to 2014. Results were reliability adjusted using a multilevel logistic model controlling for year of disciplinary action, physicians per capita in each state and the rate of malpractice claims per physician in each state. From 2010 to 2014, there were a total of 5046 506 physician licensure years present. Medical boards reported a total of 21 647 disciplinary actions, of which 5137 (23.7%) were major disciplinary actions involving revocation, suspension or surrender of licence. The mean, reliability-adjusted rate of all disciplinary actions was 3.76 (95% CI 3.21 to 4.42) with a significant variation between states. State rates ranged from 2.13 (95% CI 1.86 to 2.45) to 7.93 (95% CI 6.33 to 9.93) actions per 1000 physicians. The mean rate of major disciplinary actions was 2.71 (95% CI 1.93 to 3.82), ranging from 0.64 (95% CI 0.53 to 0.76) to 2.71 (95% CI 1.93 to 3.82) actions per 1000 physicians. The correlation between the rate of major disciplinary action and minor disciplinary actions was 0.34. There is a significant, fourfold variation in the annual rate of medical board physician disciplinary action by state in the USA. When indicated, state medical boards should consider policies aimed at improving standardisation and coordination to provide consistent supervision to physicians and ensure public safety. 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. Expected Changes in Regulation and Licensure: Influence on Future Education of Dentists.

    Science.gov (United States)

    Catalanotto, Frank A

    2017-09-01

    This article is based on the following assumptions about dental care in the United States: there is an access to oral health care problem; the number of individuals with dental insurance is increasing; the demographics of the dental profession does not mirror the overall demographics of the U.S. population; and emerging oral health workforce models may help improve access to care. Based on these assumptions, this article explores related licensure and regulatory factors that will influence the education and practice of dentists in the future. The issues discussed are licensure of emerging oral health practitioners, mobility of the dental health care workforce, corporate ownership of dental practices, ethical issues related to use of human subjects in dental licensure examinations, interprofessional education and practice, and health care reform. The licensure and regulatory bodies discussed are the Commission on Dental Accreditation (CODA), state legislatures and boards of dentistry, federal legislative activities, judicial activities, and the Federal Trade Commission. Recommendations based on this discussion are presented. This article was written as part of the project "Advancing Dental Education in the 21 st Century."

  12. Licensed physicians – competent physicians?: The new German licensure law as a basis for competency-based curricula

    Directory of Open Access Journals (Sweden)

    Öchsner, Wolfgang

    2005-01-01

    Full Text Available Background: Competency-based curricula define their educational goals according to profession-specific roles and competencies. Thus, this type of curricula is outcome-oriented, in contrast to the traditional German curricula, which are mainly procedure-oriented. This study investigates the new licensure legislation in Germany, mandatory for all medical faculties, to see if it allows the development of competency-based curricula.Methods: For the first step we clustered all demands to roles. In step two we transformed the procedure-oriented demands into outcome-oriented competencies, according to the 6 roles found, pursuing strictly the wording of the law.Results: Although the principal goals in the new German licensure law are outcome-oriented, namely three abilities of a certified physician, still the majority of requirements and demands remain procedure-oriented. Clustering resulted in the following six roles: medical expert, health advocate, teamworker, manager, representative of the medical profession and, life-long learner. The relevant competencies for the six roles, we could derive from the standards set by the law.Conclusion: We were able to show that the new German licensure order comprises a useful framework for the development of outcome-oriented, competency-based curricula.

  13. Evaluating the Validity of Portfolio Assessments for Licensure Decisions

    Science.gov (United States)

    Wilson, Mark; Hallam, P. J.; Pecheone, Raymond; Moss, Pamela A.

    2014-01-01

    This study examines one part of a validity argument for portfolio assessments of teaching practice used as an indicator of teaching quality to inform a licensure decision. We investigate the relationship among portfolio assessment scores, a test of teacher knowledge (ETS's Praxis I and II), and changes in student achievement (on…

  14. Paths to Licensure: Things Physicists Should Know

    Science.gov (United States)

    Stewart, Gay; Stewart, John

    2016-03-01

    The path to licensure can be quite complicated, and can thwart a physics department's efforts to produce more and better prepared high school physics teachers. Each state has different pathways to licensure. Acronyms like CAEP and SPA are not within the normal physicist's vocabulary. Some understanding of this topic can allow physics faculty advisers to help our students so that fewer are derailed on their path to the classroom, or take a path that will leave them less well prepared if they do find themselves there. Examples of different approaches that work within state licensure systems from two different states will be presented. Physics teacher preparation efforts in both Arkansas and West Virginia have been supported in part by the Physics Teacher Education Coalition (PhysTEC).

  15. Tiered Licensure: Connecting Educator Effectiveness Policies. Ask the Team

    Science.gov (United States)

    Paliokas, Kathleen

    2013-01-01

    Multitiered licensure structures can provide educators incentives to develop and improve their performance as they work toward advanced status. When working in tandem with compensation, career ladders, and ongoing professional learning policies, licensure can be a lever to promote educator development, advancement, and retention. Licensure…

  16. Counseling Psychology Licensure in Taiwan: Development, Challenges, and Opportunities

    Science.gov (United States)

    Wang, Li-fei; Kwan, Kwong-Liem K.; Huang, Su-Fei

    2011-01-01

    The development and consequences of licensure for counseling psychologists in Taiwan are presented to promote cross-cultural awareness surrounding issues in the counseling psychology profession. The national licensure statute for counseling psychologists in Taiwan was established by the Taiwanese Legislature in 2001. While the licensing system…

  17. The costs and effectiveness of large Phase III pre-licensure vaccine clinical trials.

    Science.gov (United States)

    Black, Steven

    2015-01-01

    demonstrated in efficacy trials. Notably, pre-licensure trials of pneumococcal conjugate severely underestimated their true effect and cost-effectiveness. In fact, in discussions prior to vaccine introduction in the USA for PCV7, the vaccine was said to be not cost-effective and some counseled against its introduction. In reality, following introduction, PCV7 has been shown to be highly cost-effective. In the last decade, new methods have been identified using large linked databases such as the Vaccine Safety Datalink in the USA that allow identification of an increased risk of an event within a few months of vaccine introduction and that can screen for unanticipated very rare events as well. In addition, the availability of electronic medical records and hospital discharge data in many settings allows for accurate assessment of vaccine effectiveness. Given the high financial and opportunity cost of requiring large pre-licensure safety studies, consideration could be given to 'conditional licensure' of vaccines whose delivery system is well characterized in a setting where sophisticated pharmacovigilance systems exist on the condition that such licensure would incorporate a requirement for rapid cycle and other real-time evaluations of safety and effectiveness following introduction. This would actually allow for a more complete and timely evaluation of vaccines, lower the financial barrier to development of new vaccines and thus allow a broader portfolio of vaccines to be developed and successfully introduced.

  18. Attitudes to proposed assessment of pharmacy skills in Korean pharmacist licensure examination.

    Science.gov (United States)

    Kim, Joo Hee; Lee, Ju-Yeun; Lee, Young Sook; Yong, Chul-Soon; Han, Nayoung; Gwak, Hye Sun; Oh, Jungmi; Lee, Byung Koo; Lee, Sukhyang

    2017-01-01

    The survey aimed to obtain opinions about a proposed implementation of pharmacy skills assessment in Korean pharmacist licensure examination (KPLE). A 16-question survey was distributed electronically to 2,738 people including 570 pharmacy professors of 35 pharmacy schools, 550 preceptors from 865 practice sites and 1,618 students who graduated in 2015. The survey solicited responses concerning the adequacy of the current KPLE in assessing pharmacy knowledge/skills/attitudes, deficiencies of pharmacy skills testing in assessing the professional competencies necessary for pharmacists, plans for pharmacy skills tests in the current KPLE, and subject areas of pharmacy practice. A total of 466 surveys were returned. The current exam is not adequate for assessing skills and attitudes according to 42%-48% of respondents. Sixty percent felt that skills test is necessary to assess qualifications and professional competencies. Almost two-thirds of participants stated that testing should be implemented within 5 years. More than 60% agreed that candidates should be graduates and that written and skills test scores can be combined for pass-fail decisions. About 70% of respondents felt that the test should be less than 2 hours in duration. Over half of the respondents thought that the assessor should be a pharmacy faculty member with at least 5 years of clinical experience. Up to 70% stated that activities related to patient care were appropriate and practical for the scope of skills test. Pharmacy skills assessment was supported by the majority of respondents.

  19. CDC STATE System Tobacco Legislation - Licensure

    Data.gov (United States)

    U.S. Department of Health & Human Services — 1995-2018. Centers for Disease Control and Prevention (CDC). State Tobacco Activities Tracking and Evaluation (STATE) System. Legislation—Licensure. The STATE System...

  20. Driver licensing and reasons for delaying licensure among young adults ages 18-20, United States, 2012.

    Science.gov (United States)

    Tefft, Brian C; Williams, Allan F; Grabowski, Jurek G

    2014-12-01

    Motor vehicle crashes are the leading cause of death for teens and young adults in the United States. Graduated driver licensing (GDL) systems were designed to protect young novice drivers by limiting their exposure to specific risks while they gain experience driving. In the United States, most states' GDL systems only apply to new drivers younger than 18. Some experts suggest that GDL might encourage young people to wait until age 18 to obtain a license, to avoid GDL requirements, resulting in older teenagers having less driving experience and higher crash risk than they might have had without GDL. This study examined the prevalence and timing of licensure among young adults, and explored factors associated with delaying licensure among those not licensed before age 18. An online questionnaire was completed by 1,039 persons aged 18-20 years, recruited from a representative panel of United States households. Main outcome measures were acquisition of driver's license (a) within 12 months of the state minimum age for licensure, (b) before age 18. Associations of timing of licensure with demographic characteristics were assessed using multivariable logistic regression. Respondents not licensed before age 18 were asked to rate the importance of various possible reasons for delaying licensure. 54% of respondents were licensed before age 18. Blacks (37%; adjusted Prevalence Ratio 0.67, 95% Confidence Interval 0.48-0.93) and Hispanics (29%; adjusted Prevalence Ratio 0.60, 95% Confidence Interval 0.45-0.81) were less likely than non-Hispanic whites (67%) to be licensed before age 18. Lower household income was independently associated with delayed licensure (P self-reported reasons for not becoming licensed sooner were not having a car, being able to get around without driving, and costs associated with driving. There was little evidence that GDL is a major contributor to delayed licensure; however, a substantial minority of young people do not obtain a driver

  1. Perceived risk and other predictors and correlates of teenagers' safety belt use during the first year of licensure.

    Science.gov (United States)

    Ouimet, Marie Claude; Morton, Bruce G Simons; Noelcke, Elizabeth A; Williams, Allan F; Leaf, William A; Preusser, David F; Hartos, Jessica L

    2008-03-01

    Teenagers have the lowest rate of safety belt use and the highest crash rate compared to other age groups. Past studies on teenagers' belt use have mostly been cross-sectional. The first goals of this study were to examine, at licensure, teenagers' and parents' perceptions of risk of crash/injury for newly licensed teenagers when driving unbelted and teenagers' perceived and parents' intended consequences for safety belt rule violations. In addition, the comparability of these variables to other risky driving behaviors was explored. The second goal was to evaluate the importance of these variables in the prediction of teenagers' belt use during the first year of licensure, relative to other factors related to belt use, including demographics and substance use. More than 2,000 parent-teenager dyads were interviewed by telephone, parents at permit and licensure and teenagers at permit, licensure, and 3, 6, and 12 months after licensure. Approximately a third of the teenagers reported at least once at 3, 6, or 12 months post-licensure not always using their safety belt in the past week. At licensure, participants' perceived risk of safety belt non-use was high and ranked among the behaviors most related to crash/injury for newly licensed teenagers, behind driving under the influence of alcohol or drugs. Parent-imposed consequences for safety belt rule violations were not as highly rated as parent-imposed consequences for driving under the influence of alcohol or drugs. Sequential logistic regression modeled the relationship between safety belt use and perceived risk and consequences of non-use, as well as other prospective predictors assessed at permit and licensure, and driving correlates measured after licensure. Teenagers' extreme perceived risk and parents' intended sure consequences for non-use were significant prospective predictors of regular use during the first year of licensure. Other significant predictors and correlates were race (White), high school grade

  2. CDC STATE System E-Cigarette Legislation - Licensure

    Data.gov (United States)

    U.S. Department of Health & Human Services — 1995-2018. Centers for Disease Control and Prevention (CDC). State Tobacco Activities Tracking and Evaluation (STATE) System. E-Cigarette Legislation—Licensure. The...

  3. Correction to: CASPer, an online pre-interview screen for personal/professional characteristics: prediction of national licensure scores.

    Science.gov (United States)

    Dore, Kelly L; Reiter, Harold I; Kreuger, Sharyn; Norman, Geoffrey R

    2017-12-01

    In re-examining the paper "CASPer, an online pre-interview screen for personal/professional characteristics: prediction of national licensure scores" published in AHSE (22(2), 327-336), we recognized two errors of interpretation.

  4. CDC STATE System E-Cigarette Legislation - Licensure

    Data.gov (United States)

    U.S. Department of Health & Human Services — 1995-2017. Centers for Disease Control and Prevention (CDC). State Tobacco Activities Tracking and Evaluation (STATE) System. E-Cigarette Legislation—Licensure....

  5. A Short Profile of Hypnotherapy Licensure in Israel.

    Science.gov (United States)

    Binyaminy, Binyamin; Haas, Eric J

    2016-01-01

    In Israel, only physicians, dentists, and psychologists who complete an accredited licensing process may practice hypnosis. This study examines the characteristics of hypnotherapists compared to nonhypnotherapists in the same discipline. All hypnotherapists in Israel were compared to nonhypnotherapist health professionals. There are more subspecialists among hypnotists, and the most common specialties were psychiatry, pediatric dentistry, and clinical psychology. These findings imply self-sorting of hypnotists as a result of the regulation in Israel. Licensure of hypnotherapists could be useful in other countries by comprehensive follow-up of all licensed hypnotists and by improving public and health professional perceptions of the field and its relevance to clinical practice.

  6. Challenges to Licensure of Enterovirus 71 Vaccines

    Science.gov (United States)

    Wang, Jen-Ren; Chi, Chia-Yu; Chong, Pele; Su, Ih-Jen

    2012-01-01

    Human enteroviruses usually cause self-limited infections except polioviruses and enterovirus 71 (EV71), which frequently involve neurological complications. EV71 vaccines are being evaluated in humans. However, several challenges to licensure of EV71 vaccines need to be addressed. Firstly, EV71 and coxsackievirus A (CA) are frequently found to co-circulate and cause hand-foot-mouth disease (HFMD). A polyvalent vaccine that can provide protection against EV71 and prevalent CA are desirable. Secondly, infants are the target population of HFMD vaccines and it would need multi-national efficacy trials to prove clinical protection and speed up the licensure and usage of HFMD vaccines in children. An international network for enterovirus surveillance and clinical trials is urgently needed. Thirdly, EV71 is found to evolve quickly in the past 15 years. Prospective cohort studies are warranted to clarify clinical and epidemiological significances of the antigenic and genetic variations between different EV71 genogroups, which is critical for vaccine design. PMID:22953003

  7. Challenges to licensure of enterovirus 71 vaccines.

    Directory of Open Access Journals (Sweden)

    Min-Shi Lee

    Full Text Available Human enteroviruses usually cause self-limited infections except polioviruses and enterovirus 71 (EV71, which frequently involve neurological complications. EV71 vaccines are being evaluated in humans. However, several challenges to licensure of EV71 vaccines need to be addressed. Firstly, EV71 and coxsackievirus A (CA are frequently found to co-circulate and cause hand-foot-mouth disease (HFMD. A polyvalent vaccine that can provide protection against EV71 and prevalent CA are desirable. Secondly, infants are the target population of HFMD vaccines and it would need multi-national efficacy trials to prove clinical protection and speed up the licensure and usage of HFMD vaccines in children. An international network for enterovirus surveillance and clinical trials is urgently needed. Thirdly, EV71 is found to evolve quickly in the past 15 years. Prospective cohort studies are warranted to clarify clinical and epidemiological significances of the antigenic and genetic variations between different EV71 genogroups, which is critical for vaccine design.

  8. Evaluation of the current status of Rehabilitation, Physical Medicine and Naturopathy education 10 years after the reform of the Medical Licensure Act – a nationwide survey of German Medical Universities

    Directory of Open Access Journals (Sweden)

    Stock-Schröer, Beate

    2017-02-01

    Full Text Available Introduction: After the reform of the German Medical Licensure Act of 2003, Rehabilitation, Naturopathy and Physical Medicine were integrated into one discipline to be taught in Medical University. The aim of this survey is to determine the outcome of this change by evaluating the current status of education of these three disciplines based on the experience and satisfaction reported by lecturers responsible for teaching these subjects to medical students. Methods: A questionnaire-based survey. A paper version of the questionnaire for each discipline was posted to each Medical University in Germany. The first part asked about the current status of teaching; the second part asked about facilities and requirements; the third part asked respondents to give information on their career and teaching experience in this subjectResults: The response rate was 51.5% for Rehabilitation, 48.5% for Physical Medicine and 60.6% for Naturopathy. A vast range of people and faculties were involved in the curricula. The percentage of each discipline taught was unevenly distributed: the major proportion being rehabilitation (38%, then naturopathy 34% lastly physical medicine with less than a third (28%. The main delivery of these disciplines was through lectures in plenary sessions. Modern teaching methods were not in evidence. Lecturers were generally pleased to be working with the combination of the three disciplines. Conclusion: Future medical education should improve upon teaching coordination and aim towards a common curriculum for these three disciplines. Expected future changes to medical curricula will provide opportunities to improve the implementation of Rehabilitation, Physical Medicine and Naturopathy in teaching and research.

  9. An Analysis of State Music Education Certification and Licensure Practices in the United States

    Science.gov (United States)

    May, Brittany Nixon; Willie, Karen; Worthen, Cherilyn; Pehrson, Allyssa

    2017-01-01

    Teacher certification and licensure practices for music educators vary by state. Enhancing music teacher educator knowledge of state music education certification and licensure practices can inform music teacher preparation and improve future music teacher quality. The purpose of this study was to compile relevant information for music educators…

  10. 42 CFR 422.400 - State licensure requirement.

    Science.gov (United States)

    2010-10-01

    ... authorized to operate under State law, as a risk-bearing entity (as defined in § 422.2) eligible to offer... (CONTINUED) MEDICARE PROGRAM MEDICARE ADVANTAGE PROGRAM Organization Compliance With State Law and Preemption by Federal Law § 422.400 State licensure requirement. Except in the case of a PSO granted a waiver...

  11. Trends in teen driver licensure, driving patterns and crash involvement in the United States, 2006-2015.

    Science.gov (United States)

    Shults, Ruth A; Williams, Allan F

    2017-09-01

    The Monitoring the Future (MTF) survey provides nationally-representative annual estimates of licensure and driving patterns among U.S. teens. A previous study using MTF data reported substantial declines in the proportion of high school seniors that were licensed to drive and increases in the proportion of nondrivers following the recent U.S. economic recession. To explore whether licensure and driving patterns among U.S. high school seniors have rebounded in the post-recession years, we analyzed MTF licensure and driving data for the decade of 2006-2015. We also examined trends in teen driver involvement in fatal and nonfatal injury crashes for that decade using data from the Fatality Analysis Reporting System and National Automotive Sampling System General Estimates System, respectively. During 2006-2015, the proportion of high school seniors that reported having a driver's license declined by 9 percentage points (11%) from 81% to 72% and the proportion that did not drive during an average week increased by 8 percentage points (44%) from 18% to 26%. The annual proportion of black seniors that did not drive was consistently greater than twice the proportion of nondriving white seniors. Overall during the decade, 17- and 18-year-old drivers experienced large declines in fatal and nonfatal injury crashes, although crashes increased in both 2014 and 2015. The MTF data indicate that licensure and driving patterns among U.S. high school seniors have not rebounded since the economic recession. The recession had marked negative effects on teen employment opportunities, which likely influenced teen driving patterns. Possible explanations for the apparent discrepancies between the MTF data and the 2014 and 2015 increases in crashes are explored. MTF will continue to be an important resource for clarifying teen driving trends in relation to crash trends and informing strategies to improve teen driver safety. Published by Elsevier Ltd.

  12. 10 CFR 55.21 - Medical examination.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 2 2010-01-01 2010-01-01 false Medical examination. 55.21 Section 55.21 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) OPERATORS' LICENSES Medical Requirements § 55.21 Medical examination. An applicant for a license shall have a medical examination by a physician. A licensee shall have a medical...

  13. 22 CFR 41.108 - Medical examination.

    Science.gov (United States)

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Medical examination. 41.108 Section 41.108... AND NATIONALITY ACT, AS AMENDED Application for Nonimmigrant Visa § 41.108 Medical examination. (a) Requirements for medical examination. An applicant for a nonimmigrant visa shall be required to take a medical...

  14. 25 CFR 11.1014 - Medical examination.

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false Medical examination. 11.1014 Section 11.1014 Indians... ORDER CODE Juvenile Offender Procedure § 11.1014 Medical examination. The children's court may order a medical examination for a minor who is alleged to be a juvenile offender. ...

  15. 22 CFR 42.66 - Medical examination.

    Science.gov (United States)

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Medical examination. 42.66 Section 42.66... NATIONALITY ACT, AS AMENDED Application for Immigrant Visas § 42.66 Medical examination. (a) Medical examination required of all applicants. Before the issuance of an immigrant visa, the consular officer shall...

  16. Health Manpower Credentialing: Legal Implications of Institutional Licensure. Health Manpower Policy Discussion Paper Series No.: C3.

    Science.gov (United States)

    Crane, Stephen

    The objective of this analysis is to outline in broad fashion the current trends and issues in the licensure of health manpower and to contrast two proposed alternative systems of credentialing that focus on licensure of health care institutions instead of individual health care providers. The argument of the analysis is that the current system of…

  17. Advocating for School Psychologists in Response to the APA's Proposed "Model Act for State Licensure of Psychologists"

    Science.gov (United States)

    Skalski, Anastasia Kalamaros

    2009-01-01

    On March 6, 2009, the APA Model Licensure Act Task Force released its second draft of the policy document known as the proposed "Model Act for State Licensure of Psychologists". This policy document serves as guidance to state legislatures for how they should set up their psychology licensing laws. The general expectations promoted in the model…

  18. 8 CFR 245.5 - Medical examination.

    Science.gov (United States)

    2010-01-01

    ... 8 Aliens and Nationality 1 2010-01-01 2010-01-01 false Medical examination. 245.5 Section 245.5... THAT OF PERSON ADMITTED FOR PERMANENT RESIDENCE § 245.5 Medical examination. Pursuant to section 232(b) of the Act, an applicant for adjustment of status shall be required to have a medical examination by...

  19. 78 FR 27343 - Medical Examiner's Certification Integration

    Science.gov (United States)

    2013-05-10

    ... efficiency; (2) reflect current medical terminology and examination components; and (3) be a self-contained... 391 [Docket No. FMCSA-2012-0178] RIN 2126-AB40 Medical Examiner's Certification Integration AGENCY...: FMCSA proposes to require certified medical examiners (MEs) performing physical examinations on drivers...

  20. 45 CFR 60.9 - Reporting licensure actions taken by States.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Reporting licensure actions taken by States. 60.9 Section 60.9 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION NATIONAL PRACTITIONER DATA BANK FOR ADVERSE INFORMATION ON PHYSICIANS AND OTHER HEALTH CARE PRACTITIONERS Reporting of...

  1. Career and Technical Education Administration: Requirements, Certification/Licensure, and Preparation

    Science.gov (United States)

    Zirkle, Christopher J.; Jeffery, Jeremy O.

    2017-01-01

    The current climate of career and technical administration requirements in all 50 states was detailed and explored. An increasing number of states are not requiring specific career-technical administration certification/licensure in order to oversee secondary career and technical education (CTE) programs, with more states moving towards a general…

  2. Nuclear medical examinations

    International Nuclear Information System (INIS)

    Chiba, Kazuo; Yamada, Hideo

    1983-01-01

    Nuclear medical examinations for cerebral vascular diseases were outlined. These procedures developed associated with development of scanners, production of radionuclides and development of labelled compounds. Examination of cerebral circulation with 133 Xe and sup(87m)Kr was replaced by CT. Furthermore, emission CT developed. Each of brain scintiscan, measurement of regional cerebral blood flow, positron emission CT and single photon emission CT was reviewed. (Namekawa, K.)

  3. Crossing boundaries: a comprehensive survey of medical licensing laws and guidelines regulating the interstate practice of pathology.

    Science.gov (United States)

    Hiemenz, Matthew C; Leung, Stanley T; Park, Jason Y

    2014-03-01

    In the United States, recent judicial interpretation of interstate licensure laws has found pathologists guilty of malpractice and, more importantly, the criminal practice of medicine without a license. These judgments against pathologists highlight the need for a timely and comprehensive survey of licensure requirements and laws regulating the interstate practice of pathology. For all 50 states, each state medical practice act and state medical board website was reviewed. In addition, each medical board was directly contacted by electronic mail, telephone, or US registered mail for information regarding specific legislation or guidelines related to the interstate practice of pathology. On the basis of this information, states were grouped according to similarities in legislation and medical board regulations. This comprehensive survey has determined that states define the practice of pathology on the basis of the geographic location of the patient at the time of surgery or phlebotomy. The majority of states (n=32) and the District of Columbia allow for a physician with an out-of-state license to perform limited consultation to a physician with the specific state license. Several states (n=5) prohibit physicians from consultation without a license for the specific state. Overall, these results reveal the heterogeneity of licensure requirements between states. Pathologists who either practice in multiple states, send cases to out-of-state consultants, or serve as consultants themselves should familiarize themselves with the medical licensure laws of the states from which they receive or send cases.

  4. Age of licensure and monitoring teenagers' driving: survey of parents of novice teenage drivers.

    Science.gov (United States)

    McCartt, Anne T; Hellinga, Laurie A; Haire, Emily R

    2007-01-01

    To assess parental decision making regarding the timing of teenagers initiating driving and monitoring teenagers' driving after licensure. About 300 parents were interviewed during spring 2006 in Minnesota, North Carolina, and Rhode Island, states with varying licensing provisions, while teenagers took their first on-road driving tests. States' differences in ages of obtaining learner's permits and licenses reflected different licensing laws, but most teenagers obtained permits and took road tests within the first few months after they became eligible. Common reasons for delaying obtaining permits were fulfilling driver education requirements and lack of readiness/immaturity. Insufficient practice driving most often delayed licensure. Among the parents interviewed, 33-49% believed the minimum licensure age should be 17 or older. Almost all parents planned to supervise teenagers' driving after licensure, and most wanted to know about speeding or distractions. When asked about in-vehicle devices to monitor teenagers' driving, 37-59% of parents had heard of them. Parents were least interested in using video cameras and about equally interested in computer chips and cell-phone-based GPS systems. Disinterest in monitoring devices most often was attributed to trusting teenagers or respecting their privacy. Licensing laws influence ages of initiating driving. Although many parents support licensing at 17 or older - higher than in all but one state - most teenagers initiate driving soon after reaching the minimum age. Parents plan to supervise teenagers' driving, and many say they are open to using in-vehicle monitoring devices. Many parents support a minimum licensing age of 17 or older and would consider in-vehicle devices to extend their supervision of teenager's driving.

  5. 8 CFR 1245.5 - Medical examination.

    Science.gov (United States)

    2010-01-01

    ... 8 Aliens and Nationality 1 2010-01-01 2010-01-01 false Medical examination. 1245.5 Section 1245.5... examination. Pursuant to section 232(b) of the Act, an applicant for adjustment of status shall be required to have a medical examination by a designated civil surgeon, whose report setting forth the findings of...

  6. Leadership and Licensure for Drug Treatment and the Implementation of Co-Occurring Disorder Treatment in Community Mental Health Centers.

    Science.gov (United States)

    Guerrero, Erick G; Padwa, Howard; Lengnick-Hall, Rebecca; Kong, Yinfei; Perrigo, Judith L

    2015-07-01

    Using a random sample of 48 outpatient mental health programs in low-income and racial and ethnic minority communities, this study examined directorial leadership, drug treatment licensure, and implementation of evidence-based protocols and practices to address co-occurring mental health and substance abuse disorders (COD). Understanding of findings was enhanced with focus groups at six clinics. Most programs (81 %) offered COD treatment. Directorial leadership was positively associated with COD treatment (β = 0.253, p = 0.047, 95 % CI 0.003, 0.502) and COD supervision and training (β = 0.358, p = 0.002, 95 % CI 0.142, 0.575). Licensure was negatively associated with COD treatment (β = -0.235, p = 0.041, 95 % CI -0.460, -0.010) and COD supervision and training (β = -0.195, p = 0.049, 95 % CI -0.389, -0.001). Although lack of financial integration may limit the effect of licensing on COD treatment implementation, the response of leaders to regulation, funding, and human resources issues may encourage COD treatment practices. Implications for leadership interventions and policy are discussed in the context of health care reform.

  7. Magnetic resonance image examinations in emergency medical care

    International Nuclear Information System (INIS)

    Yamashiro, Takanobu; Yoshizumi, Tohru; Ogura, Akio; Hongou, Takaharu; Kikumoto, Rikiya

    2006-01-01

    There is a growing consensus in terms of the need for effective use of magnetic resonance imaging (MRI) diagnostic devices in emergency medical care. However, a thorough assessment of risk management in emergency medical care is required because of the high magnetic field in the MRI room. To understand the conditions required for the execution of emergency MRI examinations in individual medical facilities, and to prepare guidelines for emergency MRI examinations, we carried out a questionnaire survey concerning emergency MRI examinations. We obtained responses from 71% of 230 medical facilities and used this information in considering a system of emergency MRI examinations. Moreover, some difficulties were experienced in half of the facilities where emergency MRI examinations had been enacted, the main cause of which was the medics. Based on the results of the questionnaire, guidelines are necessary to maintain an urgent system for MRI examinations. Moreover, we were able to comprehend the current state of emergency MRI examinations in other medical facilities through this investigation, and we are preparing a system for the implementation of emergency MRI examinations. (author)

  8. Examination results of medical students with dyslexia.

    Science.gov (United States)

    McKendree, Jean; Snowling, Margaret J

    2011-02-01

    dyslexia is a learning disorder, the primary sign of which is significant difficulty in learning to read and spell. However, accumulating evidence suggests that many people with dyslexia can overcome their reading difficulties and enjoy high levels of educational success. There is debate about the appropriateness of different forms of summative assessment for people with dyslexia, but there is little research investigating different examination formats, particularly in higher education, including medical education. Currently, medical school examinations comprise a range of different assessments, both written and performance-based, offering an opportunity to compare performance on different formats. This study compared results between students with and without dyslexia on all summative assessment types used at one UK medical school. examination scores were collated for all summative Year 1 and 2 examinations at Hull York Medical School (HYMS) over four cohorts entering from 2004 to 2007. These included scores on two types of forced-choice question (multiple-choice and extended matching question) examinations, on short written answer examinations and on performance in a 16-station objective structured clinical examination (OSCE). Results for written answers were gathered separately for basic science questions and for questions involving critical analysis and evidence-based medicine. an overall multivariate analysis of covariance (mancova) on examinations across both years controlling for gender, ethnicity and age on entry indicated that there was no significant overall effect of dyslexia on examination results. Regression analysis further showed that dyslexia was not a significant predictor on any of the examination forms in Year 1 or Year 2. there is no indication that any of the assessment methods used in HYMS, in common with many other medical schools, disadvantage students with dyslexia in comparison with their peers. In the light of these findings, we support

  9. 21 CFR 880.6320 - AC-powered medical examination light.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false AC-powered medical examination light. 880.6320... Miscellaneous Devices § 880.6320 AC-powered medical examination light. (a) Identification. An AC-powered medical examination light is an AC-powered device intended for medical purposes that is used to illuminate body...

  10. Literacy Course Priorities and Signature Aspects of Nine Elementary Initial Licensure Programs

    Science.gov (United States)

    Lenski, Susan; Ganske, Kathy; Chambers, Sandy; Wold, Linda; Dobler, Elizabeth; Grisham, Dana L.; Scales, Roya; Smetana, Linda; Wolsey, Thomas Devere; Yoder, Karen K.; Young, Janet

    2013-01-01

    The purpose of this article is to describe the first part of a three-phase study to learn what makes an effective elementary literacy initial licensure program. The first step was to identify how nine programs prioritized research-based literacy practices and to identify each program's unique features, which we called "signature aspects." Findings…

  11. Practice of Periodic Medical Examination among Hospital Workers ...

    African Journals Online (AJOL)

    Two-thirds of those who did the medical examination did so just to satisfy the hospital management requirement. Only 20.6% of the respondents had ever had periodic medical examination (PME) while on employment of the hospital. Among those that ever had PME the mean number of times that they had periodic medical ...

  12. Medical radiography examinations and carcinogenic effects

    International Nuclear Information System (INIS)

    Demina, Eh.A.

    2014-01-01

    The purpose of the review was the synthesis of the literature data and the results of our radiobiological (biodosimetric) research on the development of radiation-associated tumors as a result of medical radiography (X-ray) diagnostic. Medical X-ray examinations contribute the most to the excess of radiation exposure of the population, much of which is subject to examination to diagnose the underlying disease, the dynamic observation of the patient during treatment, the research of related diseases, and preventative examinations. The review provides arguments for the necessity of developing a more balanced indication for preventative radiological examination of the population in the aftermath of radio-ecological crisis caused by the Chornobyl accident, taking into account the likelihood of radiation carcinogenesis. The problems and tasks of biological (cytogenetic) dosimetry in radiology are formulated

  13. 28 CFR 90.14 - Forensic medical examination payment requirement.

    Science.gov (United States)

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Forensic medical examination payment... Program § 90.14 Forensic medical examination payment requirement. (a) For the purpose of this subpart B, a... entity incurs the full out-of-pocket costs of forensic medical examinations for victims of sexual assault...

  14. DO GENERAL MEDICAL PRACTITIONERS EXAMINE INJURED RUNNERS?

    DEFF Research Database (Denmark)

    Videbæk, Solvej; Jensen, A V; Rasmussen, S

    2017-01-01

    BACKGROUND: General Medical Practitioners (GMP) in Denmark perform clinical examinations of patients with musculoskeletal pain. However, the prevalence proportion of examinations caused by running-related injuries remains unknown. PURPOSE: The primary purpose of the present study was to estimate...... the prevalence proportion of consultations in general medical practice caused by running-related injuries. The secondary purpose was to estimate the prevalence proportion of injured runners, who consult their GMP, that are referred to additional examinations or treatments. STUDY DESIGN: A survey-based study...

  15. Nuclear medical examinations in Marfan's syndrome

    International Nuclear Information System (INIS)

    D'haene, E.G.M.

    1985-01-01

    Four patients of one family with the Marfan's syndrome have been examined with nuclear medical techniques. A combination of isotopes, angiography and ECG triggered bloodpoolscintigraphy with echocardiography are very suitable to examine the course of the disease. (Auth.)

  16. A Framework for Evidence-Based Licensure of Adaptive Autonomous Systems: Technical Areas

    Science.gov (United States)

    2016-03-01

    autonomous tractor-trailer, the natural next evolution of the self - driving cars under development today. The tractor-trailer must be able to drive safely...letting other teens drive the vehicle , etc.) In this example, gradual permission for additional licensure and extended autonomous driving privileges under...to achieve a quasi-structured goal such as landing an airplane or driving a vehicle . This kind of autonomous system begins with core

  17. The value of nuclear medical examinations in paediatrics

    International Nuclear Information System (INIS)

    Sixthofer, A.

    1991-02-01

    In 1988 155 children were nuclear medically examined at the university clinic in Innsbruck. The first separations to be made were sex and age. A more precise organization concerning the clinically allocated diagnosis of the patients showed, that nephrological and urological questions were asked in 2/3 of the cases. The second point was the cure of inflammation and tumourous cases of the skeletal system (osteomyelitis, osteosarcoma) followed by the assessment of the practical and morphological disturbances to the thyroid glands. Nuclear medical examinations also, occasionally, used questions from the fields of neurology, gastroenterology, cardiology and pulmonology. Analysis regarding the concordance of nuclear medicine with the clinic expresses the diagnostical precision of nuclear medicine well. Nuclear medical diagnosis corresponded to conclusive clinical diagnosis in 73.75 % of the cases. The classification concerning with clinical relevance of the nuclear medical findings for treatment showed that, in only 7.5 % of all cases there was no influence of the nuclear medical diagnosis on the treatment. The investigation of radiation was done in three age groups (0 to 5 years, 5 to 10 years, 10 to 15 years). The calculations, especially with the kidney examinations, produced definite results, it could be illustrated that the nuclear medical examinations show a smaller amount of radiation as a radiological alternative, on intravenous urogram, for example. (author)

  18. A Survey of Optometry Graduates to Determine Practice Patterns: Part II: Licensure and Practice Establishment Experiences.

    Science.gov (United States)

    Bleimann, Robert L.; Smith, Lee W.

    1985-01-01

    A summary of Part II of a two-volume study of optometry graduates conducted by the Association of Schools and Colleges of Optometry is presented. Part II includes the analysis of the graduates' licensure and practice establishment experiences. (MLW)

  19. Implementing Assessment Engineering in the Uniform Certified Public Accountant (CPA) Examination

    Science.gov (United States)

    Burke, Matthew; Devore, Richard; Stopek, Josh

    2013-01-01

    This paper describes efforts to bring principled assessment design to a large-scale, high-stakes licensure examination by employing the frameworks of Assessment Engineering (AE), the Revised Bloom's Taxonomy (RBT), and Cognitive Task Analysis (CTA). The Uniform CPA Examination is practice-oriented and focuses on the skills of accounting. In…

  20. 75 FR 60763 - Privacy Act of 1974; Report of an Altered System of Records

    Science.gov (United States)

    2010-10-01

    ... clinical privilege actions, disciplinary actions taken by Boards of Medical Examiners, and professional... licensure and clinical privilege actions, disciplinary actions taken by Boards of Medical Examiners, and...), Health Resources and Services Administration (HRSA). ACTION: Notice of an Altered System of Records (SOR...

  1. An Examination of Professional Goal Plans and Leadership Ethics

    Science.gov (United States)

    Flumerfelt, Shannon; Ingram, Ilene L.; Smith, Julia; Brockberg, Kevin H.

    2009-01-01

    This article presents a mixed-methods study that examined leadership program graduates' self-assessments as they specifically related to the knowledge, performance, and disposition indicators of the Interstate School Leader Licensure Consortium (ISLLC) Standard 5 (1996). This ISLLC standard is generally referred to as the "ethics standard" by…

  2. 77 FR 56717 - Specifications for Medical Examinations of Underground Coal Miners

    Science.gov (United States)

    2012-09-13

    ... CFR Part 37 Specifications for Medical Examinations of Underground Coal Miners; Final Rule #0;#0... 0920-AA21 Specifications for Medical Examinations of Underground Coal Miners AGENCY: Centers for... medical examinations of underground coal miners. Existing regulations established specifications for...

  3. 45 CFR 61.7 - Reporting licensure actions taken by Federal or State licensing and certification agencies.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Reporting licensure actions taken by Federal or State licensing and certification agencies. 61.7 Section 61.7 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION HEALTHCARE INTEGRITY AND PROTECTION DATA BANK FOR FINAL ADVERSE...

  4. Do general medical practitioners examine injured runners?

    DEFF Research Database (Denmark)

    Andersen, Solvej Videbæk; Jensen, A V; Rasmussen, Sten

    2017-01-01

    BACKGROUND: General Medical Practitioners (GMP) in Denmark perform clinical examinations of patients with musculoskeletal pain. However, the prevalence proportion of examinations caused by running-related injuries remains unknown. PURPOSE: The primary purpose of the present study was to estimate...... the prevalence proportion of consultations in general medical practice caused by running-related injuries. The secondary purpose was to estimate the prevalence proportion of injured runners, who consult their GMP, that are referred to additional examinations or treatments. STUDY DESIGN: A survey-based study....... METHODS: An online survey was distributed in October and November 2015 to more than 370 GMPs in Denmark and completed by 27. RESULTS: The median prevalence proportion of consultations caused by running-related injuries in the prior two weeks was 0.80% [25th percentile = 0.00%; 75th percentile = 1...

  5. Investigating Reports of Complex Regional Pain Syndrome: An Analysis of HPV-16/18-Adjuvanted Vaccine Post-Licensure Data

    Directory of Open Access Journals (Sweden)

    Frank Huygen

    2015-09-01

    There is not sufficient evidence to suggest an increased risk of developing CRPS following vaccination with HPV-16/18-adjuvanted vaccine. Post-licensure safety surveillance confirms the acceptable benefit-risk of HPV-16/18 vaccination.

  6. Overview and current management of computerized adaptive testing in licensing/certification examinations

    Directory of Open Access Journals (Sweden)

    Dong Gi Seo

    2017-07-01

    Full Text Available Computerized adaptive testing (CAT has been implemented in high-stakes examinations such as the National Council Licensure Examination-Registered Nurses in the United States since 1994. Subsequently, the National Registry of Emergency Medical Technicians in the United States adopted CAT for certifying emergency medical technicians in 2007. This was done with the goal of introducing the implementation of CAT for medical health licensing examinations. Most implementations of CAT are based on item response theory, which hypothesizes that both the examinee and items have their own characteristics that do not change. There are 5 steps for implementing CAT: first, determining whether the CAT approach is feasible for a given testing program; second, establishing an item bank; third, pretesting, calibrating, and linking item parameters via statistical analysis; fourth, determining the specification for the final CAT related to the 5 components of the CAT algorithm; and finally, deploying the final CAT after specifying all the necessary components. The 5 components of the CAT algorithm are as follows: item bank, starting item, item selection rule, scoring procedure, and termination criterion. CAT management includes content balancing, item analysis, item scoring, standard setting, practice analysis, and item bank updates. Remaining issues include the cost of constructing CAT platforms and deploying the computer technology required to build an item bank. In conclusion, in order to ensure more accurate estimations of examinees’ ability, CAT may be a good option for national licensing examinations. Measurement theory can support its implementation for high-stakes examinations.

  7. Post-licensure safety surveillance for human papillomavirus-16/18-AS04-adjuvanted vaccine: more than 4 years of experience.

    Science.gov (United States)

    Angelo, Maria-Genalin; Zima, Julia; Tavares Da Silva, Fernanda; Baril, Laurence; Arellano, Felix

    2014-05-01

    To summarise post-licensure safety surveillance over more than 4 years of routine use of the human papillomavirus-16/18-AS04-adjuvanted vaccine (HPV-16/18 vaccine: Cervarix®, GlaxoSmithKline, Belgium). We describe global post-licensure passive surveillance data based on routine pharmacovigilance from 18 May 2007 until 17 November 2011 and enhanced surveillance implemented during the 2-year national immunisation programme in the UK (school years 2008-2010). Spontaneous reports from countries worldwide showed a similar pattern for the most frequently reported adverse events after HPV-16/18 vaccination. No patterns or trends were observed for potential immune-mediated diseases after vaccination. Observed incidences of Bell's palsy and confirmed Guillain-Barré syndrome were within the expected range in the general population. Outcomes of pregnancy in women who were inadvertently exposed to HPV-16/18 vaccine during pregnancy, were in line with published reports for similar populations. Enhanced surveillance of adverse events in the UK triggered a review of cases of anaphylaxis, angioedema and syncope reports, leading to an update to the prescribing information. Collaborative partnerships between industry and national regulatory agencies facilitated rapid notification and transfer of safety information, allowing for rapid responses in the event of a safety signal of adverse event of concern. More than 4 years of post-licensure experience may provide confidence to providers and the public about the safety profile of HPV-16/18 vaccine in routine use. The safety profile appears to be consistent with pre-licensure data reporting that HPV-16/18 vaccine has an acceptable benefit-risk profile in adolescent girls and women. © 2014 The Authors. Pharmacoepidemiology and Drug Safety published by John Wiley & Sons, Ltd.

  8. Health Medical Examination and the Prevalence of Metabolic Syndrome

    Directory of Open Access Journals (Sweden)

    Yong Hwan Kim

    2018-06-01

    Full Text Available Metabolic syndrome (MetS is a highly prevalent condition that cannot be cured but can be controlled by health management. Health management not only includes regulation of drinking, smoking, and physical activity but also health medical examinations. However, health medical examinations at private medical facilities involve high cost, limiting continuous and regular examination. The aim of this study was to analyze the prevalence of MetS and health management behavior according to the number of health medical examinations conducted in 14 years. According to the number of health medical examinations undertaken each year from 1999 to 2012, in 2012, 21,803 visitors (14,511 men and 7,292 women from a health medical examination center at a private medical facility were assigned to low- (3–5 health examinations in 14 years, middle- (6–10 health examinations in 14 years, and high-frequency groups (11–14 health examinations during 14 years. MetS was evaluated according to the criteria of the National Cholesterol Education Program and Adult Treatment Panel III and waist circumference was measured according to the standard for Asians by the World Health Organization. Odds ratio (OR was calculated by logistic regression analysis. Blood pressure tended to decrease to 124.5 vs. 123.9 vs. 123.5 in the low-, middle-, and high-frequency groups in men, respectively. In addition, middle- and high-frequency groups demonstrated better total cholesterol, high-density lipoprotein, low-density lipoprotein, and systolic blood pressure compared with the low-frequency group. The prevalence of MetS demonstrated no significance before adjusting for variables in men, and high-frequency examinees demonstrated 18% low OR values (0.823, p<0.001 after adjusting for age. OR was 0.868 (p=0.015 when adjusted for age, other socioeconomic factors, and health behavior. In women, the prevalence of MetS demonstrated significantly high OR of 1.205 (p=0.007 and 1.300 (p=0.008 in

  9. Evaluation of Clark County School District's Alternative Route to Licensure Program from the Program Participants' Perspectives

    Science.gov (United States)

    Kenyon, James J., Jr.

    2013-01-01

    This evaluation assesses the Alternative Route to Licensure (ARL) program of the Clark County School District (CCSD), in Clark County, Nevada from the program participants' perspectives. The program was implemented to reduce teacher shortages in the school district and allow persons with non-education-related Bachelor's Degrees to obtain teaching…

  10. Exploring the potential uses of value-added metrics in the context of postgraduate medical education.

    Science.gov (United States)

    Gregory, Simon; Patterson, Fiona; Baron, Helen; Knight, Alec; Walsh, Kieran; Irish, Bill; Thomas, Sally

    2016-10-01

    Increasing pressure is being placed on external accountability and cost efficiency in medical education and training internationally. We present an illustrative data analysis of the value-added of postgraduate medical education. We analysed historical selection (entry) and licensure (exit) examination results for trainees sitting the UK Membership of the Royal College of General Practitioners (MRCGP) licensing examination (N = 2291). Selection data comprised: a clinical problem solving test (CPST); a situational judgement test (SJT); and a selection centre (SC). Exit data was an applied knowledge test (AKT) from MRCGP. Ordinary least squares (OLS) regression analyses were used to model differences in attainment in the AKT based on performance at selection (the value-added score). Results were aggregated to the regional level for comparisons. We discovered significant differences in the value-added score between regional training providers. Whilst three training providers confer significant value-added, one training provider was significantly lower than would be predicted based on the attainment of trainees at selection. Value-added analysis in postgraduate medical education potentially offers useful information, although the methodology is complex, controversial, and has significant limitations. Developing models further could offer important insights to support continuous improvement in medical education in future.

  11. Predictive value of grade point average (GPA), Medical College Admission Test (MCAT), internal examinations (Block) and National Board of Medical Examiners (NBME) scores on Medical Council of Canada qualifying examination part I (MCCQE-1) scores.

    Science.gov (United States)

    Roy, Banibrata; Ripstein, Ira; Perry, Kyle; Cohen, Barry

    2016-01-01

    To determine whether the pre-medical Grade Point Average (GPA), Medical College Admission Test (MCAT), Internal examinations (Block) and National Board of Medical Examiners (NBME) scores are correlated with and predict the Medical Council of Canada Qualifying Examination Part I (MCCQE-1) scores. Data from 392 admitted students in the graduating classes of 2010-2013 at University of Manitoba (UofM), College of Medicine was considered. Pearson's correlation to assess the strength of the relationship, multiple linear regression to estimate MCCQE-1 score and stepwise linear regression to investigate the amount of variance were employed. Complete data from 367 (94%) students were studied. The MCCQE-1 had a moderate-to-large positive correlation with NBME scores and Block scores but a low correlation with GPA and MCAT scores. The multiple linear regression model gives a good estimate of the MCCQE-1 (R2 =0.604). Stepwise regression analysis demonstrated that 59.2% of the variation in the MCCQE-1 was accounted for by the NBME, but only 1.9% by the Block exams, and negligible variation came from the GPA and the MCAT. Amongst all the examinations used at UofM, the NBME is most closely correlated with MCCQE-1.

  12. Proposed Regulations for Medical Examination of the Radiation Worker

    International Nuclear Information System (INIS)

    Shabon, M.H.

    2015-01-01

    Owing to the widespread use of ionising radiation and radioactive isotopes and their well recognized adverse effects on human health. General requirements for workers to grant license to use ionizing radiation in Egypt was reported in the executive of Egyptian ionizing radiation regulation in 1962 following ionizing radiation law no. 59 for the year 1960. Egyptian Nuclear and Radiological Regulatory Authority (ENRRA) has enforced law no. 7 in 2010 and its executive regulation in 2011 through requesting certificates of medical examination as a requirement to grant Egyptian license to ionizing radiation worker. A deficiency in medical examination and special investigations for pre-placement and follow up of the radiation worker has been noticed. This paper provides practical guidance to the employers and the appointed doctors about health surveillance and medical examinations of the radiation worker. Past history, present history, clinical examination and investigations are presented. Illnesses and conditions that prevent the person to be classified are also mentioned.

  13. The value of simulation-based learning in pre-licensure nurse education: A state-of-the-art review and meta-analysis.

    Science.gov (United States)

    Cant, Robyn P; Cooper, Simon J

    2017-11-01

    Simulation modalities are numerous in nursing education, with a need to reveal their range and impact. We reviewed current evidence for effectiveness of medium to high fidelity simulation as an education mode in pre-licensure/pre-registration nurse education. A state-of-the-art review and meta-analyses was conducted based on a systematic search of publications in English between 2010 and 2015. Of 72 included studies, 43 were quantitative primary studies (mainly quasi-experimental designs), 13 were qualitative studies and 16 were reviews of literature. Forty of 43 primary studies reported benefits to student learning, and student satisfaction was high. Simulation programs provided multi-modal ways of learning. A meta-analysis (8 studies, n = 652 participants) identified that simulation programs significantly improved clinical knowledge from baseline. The weighted mean increase was 5.0 points (CI: 3.25-6.82) on a knowledge measure. Other objectively rated measures (eg, trained observers with checklists) were few. Reported subjective measures such as confidence and satisfaction when used alone have a strong potential for results bias. Studies presented valid empirical evidence, but larger studies are required. Simulation programs in pre-licensure nursing curricula demonstrate innovation and excellence. The programs should be shared across the discipline to facilitate development of multimodal learning for both pre-licensure and postgraduate nurses. Copyright © 2017 Elsevier Ltd. All rights reserved.

  14. Medical Student Psychiatry Examination Performance at VA and Non-VA Clerkship Sites

    Science.gov (United States)

    Tucker, Phebe; von Schlageter, Margo Shultes; Park, EunMi; Rosenberg, Emily; Benjamin, Ashley B.; Nawar, Ola

    2009-01-01

    Objective: The authors examined the effects of medical student assignment to U.S. Department of Veterans Affairs (VA) Medical Center inpatient and outpatient psychiatry clerkship sites versus other university and community sites on the performance outcome measure of National Board of Medical Examiners (NBME) subject examination scores. Methods:…

  15. The Prevalence of Multiple-Choice Testing in Registered Nurse Licensure-Qualifying Nursing Education Programs in New York State.

    Science.gov (United States)

    Birkhead, Susan; Kelman, Glenda; Zittel, Barbara; Jatulis, Linnea

    The aim of this study was to describe nurse educators' use of multiple-choice questions (MCQs) in testing in registered nurse licensure-qualifying nursing education programs in New York State. This study was a descriptive correlational analysis of data obtained from surveying 1,559 nurse educators; 297 educators from 61 institutions responded (response rate [RR] = 19 percent), yielding a final cohort of 200. MCQs were reported to comprise a mean of 81 percent of questions on a typical test. Baccalaureate program respondents were equally likely to use MCQs as associate degree program respondents (p > .05) but were more likely to report using other methods of assessing student achievement to construct course grades (p < .01). Both groups reported little use of alternate format-type questions. Respondent educators reported substantial reliance upon the use of MCQs, corroborating the limited data quantifying the prevalence of use of MCQ tests in licensure-qualifying nursing education programs.

  16. PRESENT STATUS OF MEDICAL EDUCATION IN POLAND.

    Science.gov (United States)

    SELZER, A

    1965-04-01

    In the past few years medical education in Poland has undergone considerable change, particularly at the graduate and postgraduate levels, and has shown increasing Western influences. On the negative side, a physician who was trained in pre-war Poland and is now in the United States, noted mass production of physicians with modest clinical facilities and the preponderance of didactic lecturing over semi-individual instruction-conditions rather characteristic of most European medical schools. On the positive side were well-informed, up-to-date faculties and the thoughtful planning and organization of graduate and postgraduate medical education. The overall impression was a favorable one, but the system of schooling and of evaluation of students' work made it possible for indifferent students to progress to licensure.

  17. Factors and Processes That Influence E-Professionalism among Pre-Licensure Baccalaureate Nursing Students When Utilizing Social Media

    Science.gov (United States)

    Skrabal, Julie

    2017-01-01

    There is limited research related to nursing students' social media use. Because of this, there was a need to further explore how they were using social media and their ability to maintain e-professionalism. This study discovered that pre-licensure baccalaureate nursing students are actively using multiple social media accounts on a daily basis.…

  18. The Therapy Beneath the Fun: Medical Clowning During Invasive Examinations on Children.

    Science.gov (United States)

    Ofir, Shoshi; Tener, Dafna; Lev-Wiesel, Rachel; On, Avi; Lang-Franco, Nessia

    2016-01-01

    The qualitative research presented here is part of a larger project on the significance of medical clowning during invasive examinations in children in the Department of Gastroenterology and the Center for the Sexually Abused in a hospital in Israel. It investigated what makes up the essence of medical clowning, what skills and techniques are used by medical clowns, and whether their work contains therapeutic elements. A total of 9 children undergoing invasive examinations and 9 of their accompanying parents participated in semistructured interviews, which were analyzed using a thematic analysis methodology assisted by an Atlas-ti software program. The interviews revealed that the medical clowning intervention during invasive examinations was essentially therapeutic, with the clown using theatrical and clowning tools to incorporate therapeutic elements such as empowerment, reversal of role, reframing, and building a therapeutic alliance. In addition, during the invasive examinations, the medical clowning followed the model of brief crisis intervention therapy. The study advances the need to incorporate medical clowns as an integral part of medical teams performing invasive procedures and to include clowns in all stages of the hospital visit when children undergo invasive examinations. © The Author(s) 2015.

  19. Process-outcome interrelationship and standard setting in medical education: the need for a comprehensive approach.

    Science.gov (United States)

    Christensen, Leif; Karle, Hans; Nystrup, Jørgen

    2007-09-01

    An outcome-based approach to medical education compared to a process/content orientation is currently being discussed intensively. In this article, the process and outcome interrelationship in medical education is discussed, with specific emphasis on the relation to the definition of standards in basic medical education. Perceptions of outcome have always been an integrated element of curricular planning. The present debate underlines the need for stronger focus on learning objectives and outcome assessment in many medical schools around the world. The need to maintain an integrated approach of process/content and outcome is underlined in this paper. A worry is expressed about the taxonomy of learning in pure outcome-based medical education, in which student assessment can be a major determinant for the learning process, leaving the control of the medical curriculum to medical examiners. Moreover, curricula which favour reductionism by stating everything in terms of instrumental outcomes or competences, do face a risk of lowering quality and do become a prey for political interference. Standards based on outcome alone rise unclarified problems in relationship to licensure requirements of medical doctors. It is argued that the alleged dichotomy between process/content and outcome seems artificial, and that formulation of standards in medical education must follow a comprehensive line in curricular planning.

  20. Laughing through this pain: medical clowning during examination of sexually abused children: an innovative approach.

    Science.gov (United States)

    Tener, Dafna; Lev-Wiesel, Rachel; Franco, Nessia Lang; Ofir, Shoshi

    2010-03-01

    This study examined the role of medical clowns during medical examinations of children who were sexually abused. Three case studies are described, illustrating diverse interactions among the victimized child, the medical clown, and the medical forensical examiner during medical forensic examinations held at the Tene Center for Sexually Abused Children, Poria-Pade Medical Center, Israel. The results indicated that medical clowns play a unique role both in lowering anxiety and fear among children before and during the unpleasant forensic examination as well as in mitigating potential retraumatization of the sexual abuse event resulting from the medical examination. The medical clown was found to assist in creating a pleasant and calm atmosphere, thus improving the child's cooperation during the examination.

  1. [Study on the reform and improvement of the medical device registration system in China].

    Science.gov (United States)

    Wang, Lanming

    2012-11-01

    Based on the theories of the Government Regulation and Administrative Licensure, aiming at the current situations of medical device registration system in China, some policy suggestions for future reform and improvement were provided as follows. (1) change the concepts of medical device registration administration. (2) perfect the regulations of medical device registration administration. (3) reform the medical device review organizational system. (4) Optimize the procedure of review and approval. (5) set up and maintain a professional team of review and approval staff. (6) reinforce the post-marketing supervision of medical devices. (7) foster and bring into play of the role of non-government organizations.

  2. Development of the competency-based medical curriculum for the new Augsburg University Medical School

    Directory of Open Access Journals (Sweden)

    Härtl, Anja

    2017-05-01

    Full Text Available Aim: With the resolution from April 28, 2014, the Bavarian state government in Germany decided to found a new medical school at Augsburg University, thereby requiring the development of a competency-based medical curriculum.Methods: Two interdisciplinary groups developed a spiral curriculum (following Harden employing the model of Thumser-Dauth & Öchsner. The curriculum focuses on specifically defined competencies: medical expertise, independent scientific reasoning, argumentation and scholarship, as well as communication skills.Results: The spiral curriculum was developed as a hybrid curriculum. Its modular structure incorporates the mandatory subjects required by the German regulations for medical licensure (Approbationsordnung into organ- and system-centered blocks which are integrated both horizontally and vertically. Basic preclinical sciences are covered in the blocks “Movement,” “Balance” and “Contact.” The clinical sciences are organized according to six pillars (conservative medicine, surgical medicine, men’s-women’s-children’s medicine, the senses, the nervous system and the mind, and general medicine which students revisit three times each over the course of the program. A longitudinal clinical course incorporates interdisciplinary education. A particular focus is on scientific education encompassing a longitudinal course in the sciences (including interdisciplinary classes with other university departments, block practicums, and two scientific projects.Conclusion: It is not only the degree of integration und intensity of the Augsburg University undergraduate medical degree program, but also its targeted advancement of academic, social and communication skills that have not yet been realized to such an extent elsewhere in Germany. On July 8, 2016, the German Council of Science and Humanities unanimously gave this concept a positive evaluation. Future research will examine and evaluate the Augsburg medical curriculum

  3. Combined Common Person and Common Item Equating of Medical Science Examinations.

    Science.gov (United States)

    Kelley, Paul R.

    This equating study of the National Board of Medical Examiners Examinations was a combined common persons and common items equating, using the Rasch model. The 1,000-item test was administered to about 3,000 second-year medical students in seven equal-length subtests: anatomy, physiology, biochemistry, pathology, microbiology, pharmacology, and…

  4. Assessment of obesity management in medical examination

    Directory of Open Access Journals (Sweden)

    Treyzon Leo

    2005-03-01

    Full Text Available Abstract Obesity is a growing international health problem that has already reached epidemic proportions, particularly within the United States where a majority of the population is overweight or obese. Effective methods of treatment are needed, and should be taught to physicians by efficient means. There exists a disconnect between the rising obesity prevalence with its high toll on medical resources, and the lack of obesity education provided to practitioners in the course of their training. One particular shortfall is the lack of representation of obesity on standardized medical examinations. Physician attitudes toward obesity are influenced by their lack of familiarity with the management of the disease. This may include dietary restriction, increasing physical activity, behavior modification, pharmacotherapy, and surgical interventions. Thus, curricular changes in the medical education of obesity could help reduce morbidity and mortality associated with this disease.

  5. Public opinion and medical cannabis policies: examining the role of underlying beliefs and national medical cannabis policies

    OpenAIRE

    Sznitman, Sharon R.; Bretteville-Jensen, Anne Line

    2015-01-01

    Background Debate about medical cannabis legalization are typically informed by three beliefs: (1) cannabis has medical effects, (2) medical cannabis is addictive and (3) medical cannabis legalization leads to increased used of cannabis for recreational purposes (spillover effects). We examined how strongly these beliefs are associated with public support for medical cannabis legalization and whether this association differs across divergent medical cannabis policy regimes. Methods Robust reg...

  6. Required Critical Conversations Between Medical Examiners/Coroners and Forensic Nurses.

    Science.gov (United States)

    Infanti Mraz, Megan A

    2016-01-01

    Forensic teams work with the deceased and their families on a daily basis. The forensic team fulfills an important role during the death process and serves as a medium between the medical community and investigative community. The medical examiner, or coroner, depending on jurisdiction, plays a critical role in the death investigation, whose assessments and findings are a key element in care for the deceased in relation to the investigation. Communication regarding care for the deceased is critical to the completion of the investigation. Nine key discussion points are addressed as a means to launch communications between the forensic team and the medical examiner/coroner's office.

  7. Preemployment medical examinations in a large occupational health service

    NARCIS (Netherlands)

    Kort, W.L.A.M. de; Fransman, L.G.; Dijk, F.J.H. van

    1991-01-01

    Several hundreds of thousands of preemployment medical examinations are performed in The Netherlands each year, with the objective of screening for obvious risks for the applicants or others. Neither the efficacy of these examinations nor determinants for rejection are known. Altogether 101,754

  8. Workplace-based assessment for vocational registration of international medical graduates.

    Science.gov (United States)

    Lillis, Steven; Van Dyk, Valencia

    2014-01-01

    Medical regulatory authorities need efficient and effective methods of ensuring the competence of immigrating international medical graduates (IMGs). Not all IMGs who apply for specialist vocational registration will have directly comparable qualifications to those usually accepted. As general licensure examinations are inappropriate for these doctors, workplace-based assessment (WBA) techniques would appear to provide a solution. However, there is little published data on such outcomes. All cases of WBA (n = 81) used for vocational registration of IMGs in New Zealand between 2008 and 2013 were collated and analyzed. The successful completion rate of IMGs through the pathway was 87%. The majority (64%) undertook the year of supervised practice and the final assessment in a provincial center. For those unsuccessful in the pathway, inadequate clinical knowledge was the most common deficit found, followed by poor clinical reasoning. A WBA approach for assessing readiness of IMGs for vocational registration is feasible. The constructivist theoretical perspective of WBA has particular advantages in assessing the standard of practice for experienced practitioners working in narrow scopes than traditional methods of assessment. The majority of IMGs undertook both the clinical year and the assessment in provincial hospitals, thus providing a workforce for underserved areas. © 2014 The Alliance for Continuing Education in the Health Professions, the Society for Academic Continuing Medical Education, and the Council on Continuing Medical Education, Association for Hospital Medical Education.

  9. Aviation medical examiner 2012 feedback survey : content analysis of recommendations.

    Science.gov (United States)

    2013-06-01

    The Civil Aerospace Medical Institute (CAMI), as a component of the Office of Aerospace Medicine (OAM), surveyed the population of aviation medical examiners (AMEs), as federal designees, in 2012 to assess their satisfaction with Federal Aviation Adm...

  10. Control of radioactive materials on the medical science campus

    International Nuclear Information System (INIS)

    Thompson, C.H.; Vandergrift, J.F.; Slayden, S.A.; Dalrymple, G.V.

    1977-01-01

    There are persistent and difficult control problems associated with the large scale use of radionuclides: nowhere are these more apparent than in a large university medical center. If a safe environment is to be maintained with respect to employees, students, patients, and the general public, a program must be devised for effective supervision and control of radioactive sources. An automated system has been developed for the inventory and control of radioactive materials that has proven a valuable asset in a large institution. The reports generated have assisted in making responsible judgements, as well as assuring the continuation of single licensure for the medical science campus. (author)

  11. The Medical Examiner/Coroner's Guide for Contaminated Deceased Body Management.

    Science.gov (United States)

    Hanzlick, Randy; Nolte, Kurt; deJong, Joyce

    2009-12-01

    In the past few years, a number of publications and other resources have appeared concerning the management of mass fatality incidents. Some are geared toward the general management of incidents while others cover more specific topics such as decontamination procedures. Still others cover selected agents, including chemical, biologic, or radiologic ones. Few publications have been written specifically for medical examiners and coroners. The Medical Examiner and Coroner's Guide for Contaminated Deceased Body Management is written specifically for the medical examiner or coroner who will be in charge of investigations of fatalities that result from terrorism or other events that result in contaminated remains. In some such cases, agents may be used that will require mitigation of environmental hazards and decontamination of human bodies. To that end, this Guide provides information and suggestions that may be useful in understanding the principles involved in decontamination procedures, recognizing that it may not be the medical examiner or coroner staff who actually conducts decontamination procedures. The suggestions in this guide may differ slightly from those in other publications. However, those who have contributed to this guide believe that the recommendations are practical, workable, have a scientific basis, and do not differ much in substance when compared with other relevant publications. The contents of this Guide may be reproduced for practical use but the Guide may not be sold and it may not be cited for advertisement purposes. Reference to specific commercial products is for informational purposes only and does not constitute endorsement of the product or company which produces the product. The recommendations contained in this Guide are not mandated nor are they required by federal, state, or local law. Rather, the recommendations are intended to assist medical examiners and coroners for the purposes of planning and providing a set of reasonable

  12. Using web-based video to enhance physical examination skills in medical students.

    Science.gov (United States)

    Orientale, Eugene; Kosowicz, Lynn; Alerte, Anton; Pfeiffer, Carol; Harrington, Karen; Palley, Jane; Brown, Stacey; Sapieha-Yanchak, Teresa

    2008-01-01

    Physical examination (PE) skills among U.S. medical students have been shown to be deficient. This study examines the effect of a Web-based physical examination curriculum on first-year medical student PE skills. Web-based video clips, consisting of instruction in 77 elements of the physical examination, were created using Microsoft Windows Moviemaker software. Medical students' PE skills were evaluated by standardized patients before and after implementation of the Internet-based video. Following implementation of this curriculum, there was a higher level of competency (from 87% in 2002-2003 to 91% in 2004-2005), and poor performances on standardized patient PE exams substantially diminished (from a 14%-22%failure rate in 2002-2003, to 4% in 2004-2005. A significant improvement in first-year medical student performance on the adult PE occurred after implementing Web-based instructional video.

  13. Development of new core competencies for Taiwanese Emergency Medical Technicians.

    Science.gov (United States)

    Chang, Yu-Tung; Tsai, Kuang-Chau; Williams, Brett

    2018-01-01

    Core competencies are considered the foundation for establishing Emergency Medical Technician (EMT) and paramedic curricula, and for ensuring performance standards in the delivery of prehospital care. This study surveyed EMT instructors and medical directors to identify the most desirable core competencies for all levels of EMTs in Taiwan. A principal components analysis with Varimax rotation was conducted. An online questionnaire was distributed to obtain perspectives of EMT instructors and medical directors on the most desirable core competencies for EMTs. The target population was EMT training-course instructors and medical directors of fire departments in Taiwan. The questionnaire comprised 61 competency items, and multiple-choice and open-ended questions were used to obtain respondents' perspectives of the Taiwanese EMT training and education system. The results identified three factors at EMT-1 and EMT-2 levels and five factors at the EMT-Paramedic level. The factors for EMT-1 and EMT-2 were similar, and those for EMT-Paramedics identified further comprehensive competence perspectives. The key factors that appear to influence the development of the Taiwanese Emergency Medical Services (EMS) education system are the attitude of authorities, the licensure system, and legislation. The findings present new core competencies for the Taiwanese EMT system and provide capacity to redesign curricula and reconsider roles for EMT-1 and EMT-2 technicians. At the EMT-Paramedic level, the findings demonstrate the importance of incorporating competency standards in the current skills-based curriculum. Moreover, the core-competencies gap that exists between Taiwanese EMT-1s, EMT-2s, and EMT-Paramedics and internationally recognized core competencies needs to be addressed. By identifying the key factors that potentially impact the development of the EMS education system, such as the attitude of authorities, the licensure system, and legislation, these findings will inform

  14. Evaluation of the Learning and Teaching Environment of the Faculty ...

    African Journals Online (AJOL)

    2017-09-14

    Sep 14, 2017 ... perceptions of atmosphere, and social self-perceptions. Results: The ... to Bloom, the learning environment is a network of physical, social, as well as ..... Medical Licensure Examination in Japan. BMC Med Educ. 2010;10:35.

  15. Students' Demographic, Academic Characteristics and Performance in Registered General Nursing Licensing Examination in Ghana

    Science.gov (United States)

    Doe, Patience Fakornam; Oppong, Elizabeth Agyeiwaa; Sarfo, Jacob Owusu

    2018-01-01

    The decreasing performance of student nurses in the professional licensure examinations (LE) in Ghana is a major concern to stakeholders, especially at a time when the nurse-patient ratio stands at 1: 1500. The study sought to determine the effect of students' demographic and academic characteristics on performance in the Registered General…

  16. Exploring the Relationships Between USMLE Performance and Disciplinary Action in Practice: A Validity Study of Score Inferences From a Licensure Examination.

    Science.gov (United States)

    Cuddy, Monica M; Young, Aaron; Gelman, Andrew; Swanson, David B; Johnson, David A; Dillon, Gerard F; Clauser, Brian E

    2017-12-01

    Physicians must pass the United States Medical Licensing Examination (USMLE) to obtain an unrestricted license to practice allopathic medicine in the United States. Little is known, however, about how well USMLE performance relates to physician behavior in practice, particularly conduct inconsistent with safe, effective patient care. The authors examined the extent to which USMLE scores relate to the odds of receiving a disciplinary action from a U.S. state medical board. Controlling for multiple factors, the authors used non-nested multilevel logistic regression analyses to estimate the relationships between scores and receiving an action. The sample included 164,725 physicians who graduated from U.S. MD-granting medical schools between 1994 and 2006. Physicians had a mean Step 1 score of 214 (standard deviation [SD] = 21) and a mean Step 2 Clinical Knowledge (CK) score of 213 (SD = 23). Of the physicians, 2,205 (1.3%) received at least one action. Physicians with higher Step 2 CK scores had lower odds of receiving an action. A 1-SD increase in Step 2 CK scores corresponded to a decrease in the chance of disciplinary action by roughly 25% (odds ratio = 0.75; 95% CI = 0.70-0.80). After accounting for Step 2 CK scores, Step 1 scores were unrelated to the odds of receiving an action. USMLE Step 2 CK scores provide useful information about the odds a physician will receive an official sanction for problematic practice behavior. These results provide validity evidence supporting current interpretation and use of Step 2 CK scores.

  17. Quality criteria for the indication and interpretation of nuclear medical examinations

    International Nuclear Information System (INIS)

    Reiners, C.; Becker, W.; Boerner, W.

    1984-01-01

    The correct indication presupposes the consideration of the history, signs symptoms and preexisting finding. With repect to minimal radiation exposure the optimal radiopharmaceutical substance has to be selected. Physiological or pharmacokinetic effects should be used to reduce radiation exposure. This would also provided additional information to be obtained by stimulation or suppression tests. If several nuclear medical examination are needed, the correct sequence and timing should be considered. With regard to the correct interpretation of in vivo examination in nuclear medicine, the basic requirement is to strictly differentiate between the mere description of results in the sense of findings and the final summary in the sense of judgement. The specificity of diagnoses can be increased by considering the history, signs, symptoms and premedication. To correctly interprete nuclear medical findings the physician should know the numerous causes of potential misinterpretations. Last but not least a permanent exchange of information between the nuclear medical physician, the X-ray and ultrasounds diagnostician, the clinician and the pathologist will provide increased diagnostic accuracy of nuclear medical in vivo examinations. (orig./MG) [de

  18. [Problems of military medical examination of military servicemen suffering from chronic obstructive pulmonary disease].

    Science.gov (United States)

    Chapliuk, A L; Brovkin, S G; Kal'manov, A S; Bulavin, V V

    2015-02-01

    The authors showed that at the present time military much more servicemen, suffering from obstructive pulmonary disease, may receive medical examination in outpatient conditions. Series of researches allow us to perform a medical examination on an outpatient basis. The calculation of the cost-effectiveness of health services to such patients during a military medical examination in the hospital and clinics was made. Savings during the examination in the clinic for 1 patient was 2829 rubbles.

  19. Hybrid Simulation in Teaching Clinical Breast Examination to Medical Students.

    Science.gov (United States)

    Nassif, Joseph; Sleiman, Abdul-Karim; Nassar, Anwar H; Naamani, Sima; Sharara-Chami, Rana

    2017-10-10

    Clinical breast examination (CBE) is traditionally taught to third-year medical students using a lecture and a tabletop breast model. The opportunity to clinically practice CBE depends on patient availability and willingness to be examined by students, especially in culturally sensitive environments. We propose the use of a hybrid simulation model consisting of a standardized patient (SP) wearing a silicone breast simulator jacket and hypothesize that this, compared to traditional teaching methods, would result in improved learning. Consenting third-year medical students (N = 82) at a university-affiliated tertiary care center were cluster-randomized into two groups: hybrid simulation (breast jacket + SP) and control (tabletop breast model). Students received the standard lecture by instructors blinded to the randomization, followed by randomization group-based learning and practice sessions. Two weeks later, participants were assessed in an Objective Structured Clinical Examination (OSCE), which included three stations with SPs blinded to the intervention. The SPs graded the students on CBE completeness, and students completed a self-assessment of their performance and confidence during the examination. CBE completeness scores did not differ between the two groups (p = 0.889). Hybrid simulation improved lesion identification grades (p simulation relieved the fear of missing a lesion on CBE (p = 0.043) and increased satisfaction with the teaching method among students (p = 0.002). As a novel educational tool, hybrid simulation improves the sensitivity of CBE performed by medical students without affecting its specificity. Hybrid simulation may play a role in increasing the confidence of medical students during CBE.

  20. Community medicine in the medical curriculum: a statistical analysis of a professional examination.

    Science.gov (United States)

    Craddock, M J; Murdoch, R M; Stewart, G T

    1984-01-01

    This paper analyses the examination results of two cohorts of medical students at the University of Glasgow. It discusses the usefulness of Scottish higher grades as predictors of ability to pass examinations in medicine. Further correlations are made between the results from community medicine and other fourth- and fifth-year medical school examinations.

  1. 76 FR 44086 - Agency Information Collection (Report of Medical Examination for Disability Evaluation) Activity...

    Science.gov (United States)

    2011-07-22

    ... Medical Examination for Disability Evaluation, VA Form 21-2545. OMB Control Number: 2900-0052. Type of... of Medical Examination for Disability Evaluation) Activity Under OMB Review AGENCY: Veterans Benefits... prior to undergoing a VA examination for disability benefits. The examining physician also completes the...

  2. Examination of Market Segmentation among Medical Marijuana Dispensaries.

    Science.gov (United States)

    Cooke, Alexis; Freisthler, Bridget; Mulholland, Elycia

    2018-01-05

    As medical marijuana legislation becomes more common, concerns arise about the overconcentration of dispensaries, raising questions about the number of medicinal marijuana dispensaries (MMD) needed to serve medicinal users. This paper applies niche-marketing theory-which suggests dispensaries market to specific types of people-to examine if MMDs might be targeting recreational users. Observed differences between dispensary populations and between dispensary clients and local residents may indicate that dispensaries are drawing in patients based on factors other than medical need. Data were collected via exit surveys with patients at four dispensaries in Long Beach, CA. A total of 132 patients were surveyed regarding demographic data, purchase information, medical condition, and nearest cross street for their home address. Census tract information was collected for every dispensary. Chi-squared tests show significant associations between dispensary visited and race (χ 2 = 31.219, p market segmentation.

  3. Medical Examination of Aliens--Revisions to Medical Screening Process. Final rule.

    Science.gov (United States)

    2016-01-26

    The Centers for Disease Control and Prevention (CDC), within the Department of Health and Human Services (HHS), is issuing this final rule (FR) to amend its regulations governing medical examinations that aliens must undergo before they may be admitted to the United States. Based on public comment received, HHS/CDC did not make changes from the NPRM published on June 23, 2015. Accordingly, this FR will: Revise the definition of communicable disease of public health significance by removing chancroid, granuloma inguinale, and lymphogranuloma venereum as inadmissible health-related conditions for aliens seeking admission to the United States; update the notification of the health-related grounds of inadmissibility to include proof of vaccinations to align with existing requirements established by the Immigration and Nationality Act (INA); revise the definitions and evaluation criteria for mental disorders, drug abuse and drug addiction; clarify and revise the evaluation requirements for tuberculosis; clarify and revise the process for the HHS/CDC-appointed medical review board that convenes to reexamine the determination of a Class A medical condition based on an appeal; and update the titles and designations of federal agencies within the text of the regulation.

  4. The use of interpreters in medical settings and forensic medical examinations in Australia: the relationship between medicine and linguistics.

    Science.gov (United States)

    Schreiber, Jason R; Odell, Morris S

    2014-07-01

    Medical examinations are dependent on combining communication with professional competence. In the development of a global multicultural community with the use of multiple languages, doctors have become increasingly dependent on language facilitation such as interpreting and translation. Despite professional studies, the use of language facilitation with its associated problems has not been fully explored in graduate and post-graduate medical and forensic medical training. There may still be some lack of reciprocal understanding between the medical and linguistic fields, their ethics, obligations and limits although both fields and their ethical frameworks are closer related than might be expected. This article is a discussion that aims at providing a basic understanding of guidelines as to the origin and appropriate use of language interpretation in medical and forensic medical examinations. Copyright © 2014 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  5. Development and validation of a musculoskeletal physical examination decision-making test for medical students.

    Science.gov (United States)

    Bishop, Julie Y; Awan, Hisham M; Rowley, David M; Nagel, Rollin W

    2013-01-01

    Despite a renewed emphasis among educators, musculoskeletal education is still lacking in medical school and residency training programs. We created a musculoskeletal multiple-choice physical examination decision-making test to assess competency and physical examination knowledge of our trainees. We developed a 20-question test in musculoskeletal physical examination decision-making test with content that most medical students and orthopedic residents should know. All questions were reviewed by ratings of US orthopedic chairmen. It was administered to postgraduate year 2 to 5 orthopedic residents and 2 groups of medical students: 1 group immediately after their 3-week musculoskeletal course and the other 1 year after the musculoskeletal course completion. We hypothesized that residents would score highest, medical students 1 year post-musculoskeletal training lowest, and students immediately post-musculoskeletal training midrange. We administered an established cognitive knowledge test to compare student knowledge base as we expected the scores to correlate. Academic medical center in the Midwestern United States. Orthopedic residents, chairmen, and medical students. Fifty-four orthopedic chairmen (54 of 110 or 49%) responded to our survey, rating a mean overall question importance of 7.12 (0 = Not Important; 5 = Important; 10 = Very Important). Mean physical examination decision-making scores were 89% for residents, 77% for immediate post-musculoskeletal trained medical students, and 59% 1 year post-musculoskeletal trained medical students (F = 42.07, pphysical examination decision-making test was found to be internally consistent (Kuder-Richardson Formula 20 = 0.69). The musculoskeletal cognitive knowledge test was 78% for immediate post-musculoskeletal trained students and 71% for the 1 year post-musculoskeletal trained students. The student physical examination and cognitive knowledge scores were correlated (r = 0.54, pphysical examination decision-making test

  6. Don’t let up: implementing and sustaining change in a new post-licensure education model for developing extended role practitioners involved in arthritis care

    Directory of Open Access Journals (Sweden)

    Lundon K

    2015-08-01

    Full Text Available Katie Lundon,1,3 Rachel Shupak,1–3 Sonya Canzian,4 Ed Ziesmann,5 Rayfel Schneider,6,71Office of Continuing Professional Development, Faculty of Medicine, University of Toronto, 2Division of Rheumatology, St Michael's Hospital, 3Department of Medicine, University of Toronto, 4Trauma/Neurosurgery and Mobility Programs, St Michael's Hospital, 5Programs and Services, The Arthritis Society, 6Division of Rheumatology, The Hospital for Sick Children, 7Department of Paediatrics, University of Toronto, Toronto, ON, CanadaKey message: Across a 9-year period, the Advanced Clinician Practitioner in Arthritis Care program has achieved a set of short-term “wins” giving direction and momentum to the development of new roles for health care practitioners providing arthritis care.Implications: This is a viable model for post-licensure training offered to multiple allied health professionals to support the development of competent extended role practitioners (extended scope practice. Challenges at this critical juncture include: retain focus, drive, and commitment; develop academic and financial partnerships transferring short-term success to long-term sustainability; advanced, context-driven, system-level evaluation including fiscal outcome; health care policy adaptation to new human health resource development.Supporting evidence: Success includes: completed 2-year health services research evaluating 37 graduates; leadership, innovation, educational excellence, and human health resource benefit awards; influential publications/presentations addressing post-licensure education/outcome, interprofessional collaboration, and improved patient care. Keywords: human health resource development, post-licensure education, arthritis, extended role practitioners, allied health professionals

  7. The predictive validity of the BioMedical Admissions Test for pre-clinical examination performance.

    Science.gov (United States)

    Emery, Joanne L; Bell, John F

    2009-06-01

    Some medical courses in the UK have many more applicants than places and almost all applicants have the highest possible previous and predicted examination grades. The BioMedical Admissions Test (BMAT) was designed to assist in the student selection process specifically for a number of 'traditional' medical courses with clear pre-clinical and clinical phases and a strong focus on science teaching in the early years. It is intended to supplement the information provided by examination results, interviews and personal statements. This paper reports on the predictive validity of the BMAT and its predecessor, the Medical and Veterinary Admissions Test. Results from the earliest 4 years of the test (2000-2003) were matched to the pre-clinical examination results of those accepted onto the medical course at the University of Cambridge. Correlation and logistic regression analyses were performed for each cohort. Section 2 of the test ('Scientific Knowledge') correlated more strongly with examination marks than did Section 1 ('Aptitude and Skills'). It also had a stronger relationship with the probability of achieving the highest examination class. The BMAT and its predecessor demonstrate predictive validity for the pre-clinical years of the medical course at the University of Cambridge. The test identifies important differences in skills and knowledge between candidates, not shown by their previous attainment, which predict their examination performance. It is thus a valid source of additional admissions information for medical courses with a strong scientific emphasis when previous attainment is very high.

  8. Analysis of School Leaders Licensure Assessment Content Category I-V Scores and Principal Internship Self-Assessment Scores for ISLLC Standards I-V

    Science.gov (United States)

    Kelly, Michael D.

    2016-01-01

    This study compares School Leaders Licensure Assessment (SLLA) sub-scores with principal interns' self-assessment sub-scores (ISA) for a principal internship evaluation instrument in one educational leadership graduate program. The results of the study will be used to help establish the effectiveness of the current principal internship program,…

  9. Medical examination of A-bomb survivors on Nagasaki A-bomb Casualty

    International Nuclear Information System (INIS)

    Tagawa, Masuko

    1996-01-01

    Medical examination of A-bomb survivors was described and discussed on history, time change of examinee number, action for subjects not examined, change of prevalence, cancer examination, examination for the second generation, and education and enlightenment. Free examination of the survivors was begun in 1953 and the present casualty was made in 1958 on the law for medical care for the survivors. Systematic examination started from 1967 and the examination for the 2nd generation, from 1974. Cancer examination was from 1988. The number of the survivors was the maximum of 82,439 in 1974 and decreased to 61,388 in 1994, when the actual number of examinees, which being rather settled recently, was 32,294 and their average age was 64 y. The examination is done by tour or at the Center. Subjects receive the information of the examination twice by mail. Hematopoietic diseases like anemia, hepatic ones, metabolic and endocrinic ones like diabetes, renal impairment and others (mostly hyperlipidemia) are increasing recently. The number of examinees for cancer is increasing. Lung cancer is examined by the direct roentgenography, gastric cancer by transillumination, and other cancers like myeloma, those in large bowel, uterus and mammary gland, by the respective suitable methods. Health education and enlightenment have been conceivably effective. (H.O.)

  10. A survey of collection development for United States Medical Licensing Examination (USMLE) and National Board Dental Examination (NBDE) preparation material.

    Science.gov (United States)

    Hendrix, Dean; Hasman, Linda

    2008-07-01

    The research sought to ascertain medical and dental libraries' collection development policies, evaluation methods, purchase decisions, and issues that relate to print and electronic United States Medical Licensing Examination (USMLE) and National Board Dental Examination (NBDE) preparation materials. The investigators surveyed librarians supporting American Association of Medical Colleges (AAMC)-accredited medical schools (n = 58/125) on the USMLE and librarians supporting American Dental Association (ADA)-accredited dental schools (n = 23/56) on the NBDE. The investigators analyzed the data by cross-tabulating and filtering the results using EFM Continuum web survey software. Investigators also surveyed print and electronic USMLE and NBDE preparation materials from 2004-2007 to determine the number of publications and existence of reviews. A majority of responding AAMC libraries (62%, n = 58) provide at least 1 electronic or online USMLE preparation resource and buy an average of 11.6 print USMLE titles annually. Due to a paucity of NBDE print and electronic resources, ADA libraries bought significantly fewer print resources, and only 1 subscribed to an electronic resource. The most often reported evaluation methods for both populations were feedback from medical or dental students, feedback from medical or dental faculty, and online trials. Some AAMC (10%, n = 58) and ADA libraries (39%, n = 23) libraries reported that no evaluation of these materials occured at their libraries. From 2004-2007, publishers produced 45 USMLE preparation resources (total n = 546) to every 1 NBDE preparation resource (total n = 12). Users' needs, institutional missions and goals, financial status, and official collection policies most often underlie decisions to collect or not collect examination preparation materials. Evaluating the quality of examination preparation materials can be problematic due to lack of published reviews, lack of usability testing by libraries, and

  11. What is the impact of commercial test preparation courses on medical examination performance?

    Science.gov (United States)

    McGaghie, William C; Downing, Steven M; Kubilius, Ramune

    2004-01-01

    Commercial test preparation courses are part of the fabric of U.S. medical education. They are also big business with 2,000 sales for 1 firm listed at nearly $250 million. This article systematically reviews and evaluates research published in peer-reviewed journals and in the "grey literature" that addresses the impact of commercial test preparation courses on standardized, undergraduate medical examinations. Thirteen computerized English language databases were searched using 29 search terms and search concepts from their onset to October 1, 2002. Also manually searched was medical education conference proceedings and publications after the end date; and medical education journal editors were contacted about articles accepted for publication, but not yet in print, that were deemed pertinent to this review. Studies that met three criteria were selected: (a) a commercial test preparation course or service was an educational intervention, (b) the outcome variable was one of several standardized medical examinations, and (c) results are published in a peer-reviewed journal or another outlet that insures scholarly scrutiny. The criteria were applied and data extracted by consensus of 2 reviewers. The search identified 11 empirical studies, of which 10 (8 journal articles, 2 unpublished reports) are included in this review. Qualitative data synthesis and tabular presentation of research methods and outcomes are used. The articles and unpublished reports reveal that current research lacks control and rigor; the incremental validity of the commercial courses on medical examination performance, if any, is extremely small; and evidence in support of the courses is weak or nonexistent; almost no details are given about the form and conduct of the commercial test preparation courses; studies are confined to courses in preparation for the Medical College Admission Test, the former National Board of Medical Examiners Part 1, and the United States Medical Licensing Examination

  12. Step-2 Thai Medical Licensing Examination result: a follow-up study.

    Science.gov (United States)

    Wanvarie, Samkaew; Prakunhungsit, Supavadee

    2008-12-01

    The Thai medical students sat for the Medical Licensing Examination of Thailand (MLET) Step 2 for the first time in 2008. This paper analysed the first batch of Ramathibodi students taking the MLET Steps 1 and 2 in 2006 and 2008 respectively. The scores from the MLET Steps1 and 2, and fifth-year cumulative grade point averages (GPAX) of 108 students were analysed. Only 6 (5.6%) students failed the MLET Step 2 examination. Students who failed the MLET Step1 were more likely to fail their MLET Step 2 (relative risk, 5.8; 95% confidence interval, 1.3-26.0). Students with low GPAX or scoring in the lowest quintile or tertile on the MLET Step1 were also at increased risk of failing the LET Step 2. The data suggest that performance on the MLET Step 1 and GPAX are important predictors of a student's chances of passing the MLET Step 2. Students with poor academic achievement or failing the MLET Step1 should be given intensive tutorials to pass the medical licensing examination.

  13. Job-specific mandatory medical examinations for the police force

    NARCIS (Netherlands)

    Boschman, J. S.; Hulshof, C. T. J.; Frings-Dresen, M. H. W.; Sluiter, J. K.

    2017-01-01

    Background Mandatory medical examinations (MMEs) of workers should be based on the health and safety requirements that are needed for effectively performing the relevant work. For police personnel in the Netherlands, no job-specific MME exists that takes the specific tasks and duties into account.

  14. [Evolution of worker's health in the social security medical examination in Brazil].

    Science.gov (United States)

    Pinto Júnior, Afrânio Gomes; Braga, Ana Maria Cheble Bahia; Roselli-Cruz, Amadeu

    2012-10-01

    In order to analyze the practice of the social security medical examination starting from the introduction of the worker's health paradigms, data was gathered on the granting of social security disability benefits to assess worker illness based on notification of work-related accidents in the cement industries of Rio de Janeiro. From 2007 to 2009 there was only one notification, which involved a worker handling toxic waste instead of the energy matrix. However, the analysis revealed sources and mechanisms of illness overlooked in the social security medical examination, which is still focused on the one-cause-only logic of occupational medicine. To achieve the worker's health paradigms, changes are required to alter the way of conducting the social security medical examination, by re-establishing partnerships, training human resources, adopting epidemiological indicators, as well as setting and assessing social security goals that transcend the mere granting of disability benefits.

  15. Knowledge brokers, companions, and navigators: a qualitative examination of informal caregivers' roles in medical tourism.

    Science.gov (United States)

    Casey, Victoria; Crooks, Valorie A; Snyder, Jeremy; Turner, Leigh

    2013-12-01

    Many studies examining the phenomena of medical tourism have identified health equity issues associated with this global health services practice. However, there is a notable lack of attention in this existing research to the informal care provided by the friends and family members who typically accompany medical tourists abroad. To date, researchers have not examined the care roles filled by informal caregivers travelling with medical tourists. In this article, we fill this gap by examining these informal caregivers and the roles they take on towards supporting medical tourists' health and wellbeing. We conducted 21 interviews with International Patient Coordinators (IPCs) working at medical tourism hospitals across ten countries. IPCs work closely with informal caregivers as providers of non-medical personal assistance, and can therefore offer broad insight on caregiver roles. The interviews were coded and analyzed thematically. Three roles emerged: knowledge broker, companion, and navigator. As knowledge brokers, caregivers facilitate the transfer of information between the medical tourist and formal health care providers as well as other staff members at medical tourism facilities. The companion role involves providing medical tourists with physical and emotional care. Meanwhile, responsibilities associated with handling documents and coordinating often complex journeys are part of the navigation role. This is the first study to examine informal caregiving roles in medical tourism. Many of the roles identified are similar to those of conventional informal caregivers while others are specific to the transnational context. We conclude that these roles make informal caregivers an integral part of the larger phenomenon of medical tourism. We further contend that examining the roles taken on by a heretofore-unconsidered medical tourism stakeholder group sheds valuable insight into how this industry operates and that such knowledge is necessary in order to respond to

  16. Framing medical tourism: an examination of appeal, risk, convalescence, accreditation, and interactivity in medical tourism web sites.

    Science.gov (United States)

    Mason, Alicia; Wright, Kevin B

    2011-02-01

    This exploratory study analyzed the content of medical tourism Web sites in an attempt to examine how they convey information about benefits and risks of medical procedures, how they frame credibility, and the degree to which these Web sites include interactive features for consumers. Drawing upon framing theory, the researchers content analyzed a sample of 66 medical tourism Web sites throughout the world. The results indicated that medical tourism Web sites largely promote the benefits of medical procedures while downplaying the risks, and relatively little information regarding the credibility of these services appears. In addition, the presentation of benefits/risks, credibility, and Web site interactivity were found to differ by region and type of facility. The authors discuss the implications of these findings concerning the framing of medical tourism Web site content, future directions for research, and limitations.

  17. 77 FR 24537 - Draft Standards and Best Practices for Interaction Between Medical Examiner/Coroner and Organ and...

    Science.gov (United States)

    2012-04-24

    ... Best Practices for Interaction Between Medical Examiner/Coroner and Organ and Tissue Procurement... Committee Standards and Best Practices for Interaction Between Medical Examiner/Coroner Offices and Organ... coroner/medical examiner office representatives, law enforcement agencies, organizations, and all other...

  18. Introduction to an open source internet-based testing program for medical student examinations.

    Science.gov (United States)

    Lee, Yoon-Hwan

    2009-12-20

    The author developed a freely available open source internet-based testing program for medical examination. PHP and Java script were used as the programming language and postgreSQL as the database management system on an Apache web server and Linux operating system. The system approach was that a super user inputs the items, each school administrator inputs the examinees' information, and examinees access the system. The examinee's score is displayed immediately after examination with item analysis. The set-up of the system beginning with installation is described. This may help medical professors to easily adopt an internet-based testing system for medical education.

  19. [The state's physics examinations for medical students and the construction of a natural science basis for academic medical training between 1865-1880].

    Science.gov (United States)

    Van Lieburg, M J

    1995-01-01

    Betweem 1865, when the new Dutch Health Acts introduced the legal monopoly of the academic medical profession, and 1879, when a new law for higher education provided the basis for the integration of the non-academic teaching of medicine within the universities, non-academic students could pass state medical examinations in order to become a physician. In this article I studied in detail the first phase of this examination route, when students were questioned about their knowledge of mathematics, physics, chemistry and the life sciences. The state commissions responsible for taking these examinations have certainly played an important role in the process of the introduction of scientific medicine into the universities as well as the introduction of the sciences into secondary schools, preparing scholars for academic medical training. Moreover, because scientists, physicians and secondary school teachers participated together in these commissions, the science examination boards linked the several educational echelons and divisions in science and medicine concerned with this process of transformation of the medical professions and medical science in the 1860s and 1870s.

  20. 77 FR 4061 - Submission for Review: Certificate of Medical Examination, 3206-0250.

    Science.gov (United States)

    2012-01-26

    ... medical information about individuals who are incumbents of positions which require physical fitness/agility testing and/or medical examinations, or who have been selected for such a position contingent upon... under the Americans with Disabilities Act (ADA). As required by the Paperwork Reduction Act of 1995 (Pub...

  1. Licensing telemedicine: the need for a national system.

    Science.gov (United States)

    Jacobson, P D; Selvin, E

    2000-01-01

    The expansion of information technology has shattered geographic boundaries, allowing for extraordinarily increased access to health information and expanded opportunities for telemedicine practice across state boundaries. But despite its recent growth, telemedicine technology remains embedded in a state-based licensure system that places severe limits on its expansion. The current system of medical licensure is based primarily on statutes written at the turn of the 20th century. This system is inadequate to address the emerging medical practices and future uses of medical technology in the telecommunications age. To respond to the changes offered by the telecommunications revolution, we need to design a new regulatory structure for the 21st century. The purpose of this article is to propose a policy of national telemedicine licensure. The primary goal here is not to simply develop a policy proposal, but to discuss the rationale for national licensure and place it on the policy agenda. A national licensure system will expand the market for telemedicine, promote both the use and development of new technologies, and simultaneously eliminate many of the legal and regulatory ambiguities that plague and constrain the present system.

  2. Introduction to an Open Source Internet-Based Testing Program for Medical Student Examinations

    Directory of Open Access Journals (Sweden)

    Yoon-Hwan Lee

    2009-12-01

    Full Text Available The author developed a freely available open source internet-based testing program for medical examination. PHP and Java script were used as the programming language and postgreSQL as the database management system on an Apache web server and Linux operating system. The system approach was that a super user inputs the items, each school administrator inputs the examinees’ information, and examinees access the system. The examinee’s score is displayed immediately after examination with item analysis. The set-up of the system beginning with installation is described. This may help medical professors to easily adopt an internet-based testing system for medical education.

  3. The use of an essay examination in evaluating medical students during the surgical clerkship.

    Science.gov (United States)

    Smart, Blair J; Rinewalt, Daniel; Daly, Shaun C; Janssen, Imke; Luu, Minh B; Myers, Jonathan A

    2016-01-01

    Third-year medical students are graded according to subjective performance evaluations and standardized tests written by the National Board of Medical Examiners (NBME). Many "poor" standardized test takers believe the heavily weighted NBME does not evaluate their true fund of knowledge and would prefer a more open-ended forum to display their individualized learning experiences. Our study examined the use of an essay examination as part of the surgical clerkship evaluation. We retrospectively examined the final surgical clerkship grades of 781 consecutive medical students enrolled in a large urban academic medical center from 2005 to 2011. We examined final grades with and without the inclusion of the essay examination for all students using a paired t test and then sought any relationship between the essay and NBME using Pearson correlations. Final average with and without the essay examination was 72.2% vs 71.3% (P essay examination increasing average scores by .4, 1.8, and 2.5 for those receiving high pass, pass, and fail, respectively. The essay decreased the average score for those earning an honors by .4. Essay scores were found to overall positively correlate with the NBME (r = .32, P essay examination as part of the third-year surgical core clerkship final did increase the final grade a modest degree, especially for those with lower scores who may identify themselves as "poor" standardized test takers. A more open-ended forum may allow these students an opportunity to overcome this deficiency and reveal their true fund of surgical knowledge. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. Rape as a legal indication for abortion: implications and consequences of the medical examination requirement.

    Science.gov (United States)

    Teklehaimanot, K I; Smith, C Hord

    2004-01-01

    A number of countries adopt abortion laws recognizing rape as a legal ground for access to safe abortion service. As rape is a crime, these abortion laws carry with them criminal and health care elements that in turn result in the involvement of legal and medical expertise. The most common objective of the laws should be providing safe abortion services to women survivors of rape. Depending on purposes of a given abortion law, the laws usually require women to undergo a medical examination to qualify for a legal abortion. Some abortion laws are so vague as to result in uncertainties regarding the steps health personnel must follow in conducting medical examination. Another group of abortion laws do not leave room for regulation and remain too rigid to respond to changing socio-economic circumstances. Still others require medical examination as a prerequisite for abortion. As a result, a number of abortion laws remain on the books. The paper attempts to analyze legal and practical issues related to medical examination in rape cases.

  5. Resource-oriented coaching for reduction of examination-related stress in medical students: an exploratory randomized controlled trial.

    Science.gov (United States)

    Kötter, Thomas; Niebuhr, Frank

    2016-01-01

    The years spent in acquiring medical education is considered a stressful period in the life of many students. Students whose mental health deteriorates during this long period of study are less likely to become empathic and productive physicians. In addition to other specific stressors, academic examinations seem to further induce medical school-related stress and anxiety. Combined group and individual resource-oriented coaching early in medical education might reduce examination-related stress and anxiety and, consequently, enhance academic performance. Good quality evidence, however, remains scarce. In this study, therefore, we explored the question of whether coaching affects examination-related stress and health in medical students. We conducted a randomized controlled trial. Students who registered for the first medical academic examination in August 2014 at the University of Lübeck were recruited and randomized into three groups. The intervention groups 1 and 2 received a 1-hour psychoeducative seminar. Group 1 additionally received two 1-hour sessions of individual coaching during examination preparation. Group 3 served as a control group. We compared changes in self-rated general health (measured by a single item), anxiety and depression (measured by the hospital anxiety and depression scale), as well as medical school stress (measured by the perceived medical school stress instrument). In order to further investigate the influence of group allocation on perceived medical school stress, we conducted a linear regression analysis. We saw a significant deterioration of general health and an increase in anxiety and depression scores in medical students while preparing for an examination. We found a small, but statistically significant, effect of group allocation on the development of perceived medical school stress. However, we could not differentiate between the effects of group coaching only and group coaching in combination with two sessions of individual

  6. Analysis of factors correlating with medical radiological examination frequencies

    International Nuclear Information System (INIS)

    Jahnen, A.; Jaervinen, H.; Bly, R.; Olerud, H.; Vassilieva, J.; Vogiatzi, S.; Shannoun, F.

    2015-01-01

    The European Commission (EC) funded project Dose Datamed 2 (DDM2) had two objectives: to collect available data on patient doses from the radiodiagnostic procedures (X-ray and nuclear medicine) in Europe, and to facilitate the implementation of the Radiation Protection 154 Guidelines (RP154). Besides the collection of frequency and dose data, two questionnaires were issued to gather information about medical radiological imaging. This article analyses a possible correlation between the collected frequency data, selected variables from the results of the detailed questionnaire and national economic data. Based on a 35 countries dataset, there is no correlation between the gross domestic product (GDP) and the total number of X-ray examinations in a country. However, there is a significant correlation ( p < 0.01) between the GDP and the overall CT examination frequency. High income countries perform more CT examinations per inhabitant. That suggests that planar X-ray examinations are replaced by CT examinations. (authors)

  7. [Potential improvements in medical education as retrospectively evaluated by candidates for specialist examinations].

    Science.gov (United States)

    Hofer, M; Jansen, M; Soboll, S

    2006-02-24

    As part of the new regulations for licensing doctors there have been numerous attempts at reform by many medical faculties to consider interdisciplinary linkage of the curriculum with emphasis on teaching of small groups of students. This study was undertaken to help answer the question of how much weight should be given to the various subjects and what resources are needed for any reformed curriculum and what key areas of competence need to be given greater importance. 1029 candidates of specialist examinations of the Medical Council of North-Rhine in 2002 and 2003 filled in questionnaires to evaluate retrospectively the actual relevance of individual preclinical and clinical subjects, courses and areas of practical competence to their further medical education and related potentials for improvement in their studies. The participants were from 5 medical faculties in the North-Rhine area of Germany. They were also asked about methods of examination that were effective in aiding their learning behaviour. Those answering the questionnaire considered especially chemistry and physics as well as environmental, occupational and forensic medicine, bio-mathematics, radiotherapy and nuclear medicine among the less relevant subjects. On the other hand, anatomy, physiology, internal medicine, pharmacology and surgery were considered especially relevant. The greatest deficiencies in most of the medical curricula as taught in the North-Rhine medical courses are in the areas of competence in communication and practical clinical skills. Members of this group also pleaded for an increased use of standardized objective structured clinical examinations (OSCE).

  8. Resource-oriented coaching for reduction of examination-related stress in medical students: an exploratory randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Kötter T

    2016-08-01

    Full Text Available Thomas Kötter,1 Frank Niebuhr2 1Institute of Social Medicine and Epidemiology, 2Institute of Family Medicine, University of Lübeck, Lübeck, Germany Introduction: The years spent in acquiring medical education is considered a stressful period in the life of many students. Students whose mental health deteriorates during this long period of study are less likely to become empathic and productive physicians. In addition to other specific stressors, academic examinations seem to further induce medical school-related stress and anxiety. Combined group and individual resource-oriented coaching early in medical education might reduce examination-related stress and anxiety and, consequently, enhance academic performance. Good quality evidence, however, remains scarce. In this study, therefore, we explored the question of whether coaching affects examination-related stress and health in medical students.Methods: We conducted a randomized controlled trial. Students who registered for the first medical academic examination in August 2014 at the University of Lübeck were recruited and randomized into three groups. The intervention groups 1 and 2 received a 1-hour psychoeducative seminar. Group 1 additionally received two 1-hour sessions of individual coaching during examination preparation. Group 3 served as a control group. We compared changes in self-rated general health (measured by a single item, anxiety and depression (measured by the hospital anxiety and depression scale, as well as medical school stress (measured by the perceived medical school stress instrument. In order to further investigate the influence of group allocation on perceived medical school stress, we conducted a linear regression analysis.Results: We saw a significant deterioration of general health and an increase in anxiety and depression scores in medical students while preparing for an examination. We found a small, but statistically significant, effect of group allocation on

  9. Post-licensure safety monitoring of quadrivalent human papillomavirus vaccine in the Vaccine Adverse Event Reporting System (VAERS), 2009-2015.

    Science.gov (United States)

    Arana, Jorge E; Harrington, Theresa; Cano, Maria; Lewis, Paige; Mba-Jonas, Adamma; Rongxia, Li; Stewart, Brock; Markowitz, Lauri E; Shimabukuro, Tom T

    2018-03-20

    The Food and Drug Administration (FDA) approved quadrivalent human papillomavirus vaccine (4vHPV) for use in females and males aged 9-26 years, since 2006 and 2009 respectively. We characterized reports to the Vaccine Adverse Event Reporting System (VAERS), a US spontaneous reporting system, in females and males who received 4vHPV vaccination. We searched VAERS for US reports of adverse events (AEs) following 4vHPV from January 2009 through December 2015. Signs and symptoms were coded using Medical Dictionary for Regulatory Activities (MedDRA). We calculated reporting rates and conducted empirical Bayesian data mining to identify disproportional reports. Clinicians reviewed available information, including medical records, and reports of selected pre-specified conditions. VAERS received 19,760 reports following 4vHPV; 60.2% in females, 17.2% in males, and in 22.6% sex was missing. Overall, 94.2% of reports were non-serious; dizziness, syncope and injection site reactions were commonly reported in both males and females. Headache, fatigue and nausea were commonly reported serious AEs. More than 60 million 4vHPV doses were distributed during the study period. Crude AE reporting rates were 327 reports per million 4vHPV doses distributed for all reports, and 19 per million for serious reports. Among 29 verified reports of death, there was no pattern of clustering of deaths by diagnosis, co-morbidities, age, or interval from vaccination to death. No new or unexpected safety concerns or reporting patterns of 4vHPV with clinically important AEs were detected. Safety profile of 4vHPV is consistent with data from pre-licensure trials and postmarketing safety data. Published by Elsevier Ltd.

  10. Prevalence of examination related anxiety in a private medical college.

    Science.gov (United States)

    Khan, Abdul Najeeb; Rasool, Sohail Ataur; Sultan, Ambreen; Tahira, Irum

    2013-01-01

    To assess examination related anxiety among first professional medical students and to determine the factors contributing to this kind of anxiety among them. A cross-sectional study using structured self-administered questionnaire was carried out over 10 days in Frontier Medical and Dental College, Abbottabad, in December 2012, using sample size of 200 students,. Survey questionnaire consisted of twenty questions regarding life style, study style, psychological and social problems, and results were analyzed by Visual Analogue Scale (VAS). A total of 200 students out of 220 (90.90%) filled in the questionnaire. There were 61.50% male and 38.50% female students. The average maximum Examination related Anxiety marked on VAS was 47 +/- 21. Among different factors contributing to exam anxiety, inadequate rest (89%), irrational thoughts (67.50) and excessive course load (60%) were the most important factors reported by the students. Most of the students were aware of anxiety-reduction techniques but seldom implement them. On a VAS, examination, in its own right, has been established as a definite cause of anxiety, although the magnitude is not alarming. Students who regularly participate in class tests and perform well there, are least affected by this anxiety.

  11. An Action Research Project: Development of a Pre-Licensure Examination Review Course for Emergency Medical Technician Program Graduates at a Rural Community College

    Science.gov (United States)

    Boucher, Daryl

    2013-01-01

    This action research project examined how "Efficiency in Learning" ("EL") strategies, "Appreciative Inquiry" ("AI") and the "Interactive Model of Program Planning" ("IMPP") could be used to discern the content and preferred pedagogical approaches in the development of a pre-licensure…

  12. Medical, social, and law characteristics of intoxicant's users medically examined in police custody.

    Science.gov (United States)

    Clement, Renaud; Gerardin, Marie; Vigneau Victorri, Caroline; Guigand, Gabriel; Wainstein, Laura; Jolliet, Pascale

    2013-11-01

    There are no studies on medically examined persons in custody which specifically focus on identifying dependence profiles among users of intoxicants. Nonetheless, the characterisation of dependence profiles for intoxicants such as alcohol, cannabis, cocaine, heroin, amphetamines and their by-products is a medical necessity in this setting. A prospective, monocentric, open-ended study conducted by structured questionnaire was carried out on detainees who admitted to having taken an intoxicant/s (tobacco, alcohol, drugs or illegal substances). Social, legal and medical data were collected. The aim of the study was to explore characteristics of these persons in police custody. 817 questionnaires were examined. More than one-third have a dependence on at least one substance. 37.7% were dependant of tobacco, 86.5% of drinkers, 24.7% of cannabis users. Of these, 90.1% were from men with a mean age of 29.4 years, 40% from individuals living alone, 25.7% from persons with no financial means and 19.6% from homeless persons. 10% were believed to be suffering from mental illness, 7.2% were thought to be asthmatic, 3% to have a chronic infection, and 2.9% to have epilepsy. 36.2% reportedly received treatment, 37.5% of which included benzodiazepine and 20.3% opiate substitution therapy. Incidence of psychological and psychiatric disorders is close to 10% of intoxicant detainees. In this study, some of the stated pathologies occur in ratios similar to those in other published results. But, there is a high, and probably underestimated, prevalence of psychological and psychiatric disorders in this population of detainees reporting exposure to intoxicant or illegal substances. Copyright © 2013 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  13. Cooperation between National Defense Medical College and Fukushima Medical University in thyroid ultrasound examination after the Fukushima Daiichi nuclear power plant disaster

    International Nuclear Information System (INIS)

    Yamamoto, Yoritsuna; Fujita, Masanori; Tachibana, Shoich; Morita, Koji; Hamano, Kunihisa; Hamada, Koji; Uchida, Kosuke; Tanaka, Yuji

    2013-01-01

    Fukushima Daiichi Nuclear Power Plant was utterly destroyed by The Great East Japan Earthquake which happened on March 11, 2011, and followed by radioactive contamination to the surrounding areas. Based on the known radioactive iodine ("1"3"1I) which led to thyroid cancer in children after the Chernobyl nuclear power plant disaster in 1986, children living in Fukushima should be carefully observed for the development of thyroid cancer. Fukushima Prefecture and Fukushima Medical University started ''Fukushima Health Management Survey'' in May 2011, which includes screening for thyroid cancer by ultrasonography (Thyroid Ultrasound Examination). Thyroid Ultrasound Examination would cover roughly 360,000 residents aged 0 to 18 years of age at the time of the nuclear disaster. The initial screening is to be performed within the first three years after the accident, followed by complete thyroid examinations from 2014 onwards, and the residents will be monitored regularly thereafter. As Thyroid Ultrasound Examination is being mainly performed by medical staff at Fukushima Medical University, there is insufficient manpower to handle the large number of potential examinees. Thus, specialists of thyroid diseases from all over Japan have begun to support this examination. Six endocrinologists including the authors belonging to the National Defense Medical College are cooperating in part of this examination. This paper briefly reports the outline of Thyroid Ultrasound Examination and our cooperation. (author)

  14. Frequency of medical and dental x-ray examinations in the UK. 1997/98

    International Nuclear Information System (INIS)

    Tanner, R.; Wall, B.; Shrimpton, P.

    2000-12-01

    A survey has been performed to assess the numbers of all types of radiological x-ray examination conducted in the UK during the period from April 1997 to March 1998. The survey covers all diagnostic and interventional procedures using x-rays for medical and dental purposes, both within and outside the National Health Service (NHS), but excludes a detailed analysis of magnetic resonance imaging (MRI), ultrasound and nuclear medicine. This is the first such national survey conducted by NRPB since 1983. The results provide a current picture of the pattern of medical x-ray imaging practice in the UK and will allow revised estimates to be made of the collective dose to the population from these procedures. The survey has utilised detailed information available from radiology management systems at a selected sample of 38 English NHS trusts. The different classifications of x-ray procedure have been re-arranged into 62 standardised categories based on anatomical location and whether they were conventional, computed tomography (CT) or interventional procedures. Extrapolation of the sample data to the whole of England was carried out using broad NHS radiology statistics (KH12 returns) for the period of the survey from the Department of Health. Additional data have been obtained covering NHS radiology practice in Wales and Northern Ireland and also for x-ray imaging practice outside NHS hospitals such as that performed in independent hospitals and by dentists and chiropractors. Results are presented giving the annual numbers and relative frequencies of x-ray examinations in the 62 categories and the contributions from radiology practice outside NHS hospitals and from the whole of the UK. Altogether, about 41.5 million medical and dental x-ray examinations were conducted in the UK in 1997/98, corresponding to 704 examinations per 1000 inhabitants. The increase since 1983 for medical examinations conducted in NHS hospitals has just kept pace with the increase in population

  15. Do no more harm: the psychological stress of the medical examination for alleged child sexual abuse.

    Science.gov (United States)

    Marks, Susan; Lamb, Robyn; Tzioumi, Dimitra

    2009-03-01

    Currently, there is some controversy that the medical examination following allegations of child sexual abuse may further traumatise the child. Access for children to appropriate care may be hindered if decisions about referral are influenced by personal beliefs, rather than by recognition of the potential health and psychological benefits of the assessment. We aimed to study the expectations and emotional responses of children and their parents to the medical examination. We conducted a prospective quantitative and qualitative study at the Children's Hospital at Westmead. Participants completed questionnaires pre-examination and post-examination, including Children's Anxiety and Pain Scales. Clinicians recorded a Genital Examination Distress Scale and a questionnaire about potentially prognostic variables. Parents found the medical examination significantly less stressful than they had anticipated. They highlighted the importance of being involved in the process, the child's reaction, staff attitudes and the doctor's explanations. Although most parents expected that the medical would be stressful for their child, this did not correlate with the children's reports of feeling scared beforehand. Increased parental and child distress were significantly associated with the child being 12 years or older. The type of abuse was not significantly linked to any of the parent or child self-reports. Our findings indicate that the medical examination is not as stressful as expected and support the recommendation that timely medical assessment by appropriately trained professionals should be offered for all children following allegations of sexual abuse.

  16. [Identification of circulatory diseases and their risk during medical examination of an adult population: methodological aspects].

    Science.gov (United States)

    Kalinina, A M; Ipatov, P V; Kaminskaya, A K; Kushunina, D V

    2015-01-01

    To study the efficiency of a methodology for the active detection of coronary heart disease (CHD) and cerebrovascular diseases (CVD) during medical examination and to determine the need and possible ways of its improvement. The medical examinations of 19.4 million people (94.6% of all the citizens who had undergone medical examinations in all the regions of Russia in 2013) were analyzed and the methodological aspects of identification of the circulatory diseases (CDs) that were induced by coronary and cerebral vessel atherosclerosis and had common risk factors, primarily CHD and CVD, were assessed. The medical examinations revealed 2,915,445 cases of CDs and their suspicions, during which its clinical diagnosis was established in 57.2%. The suspected disease requiring that its diagnosis should be further specified; off-medical examinations revealed hypertension in more than 770,000 cases, CHD in 232,000, and CVD in 146,000. The proportion of stable angina pectoris of all angina cases was much higher at a young age (25.6%) than at middle (15.6%) and elderly (11.3%) ages. Brachiocephalic artery stenoses were detected in almost 13,000 cases. According to the official health statistics, within the years preceding the introduction of large-scale medical examinations, there was a slight rise in new CD cases among the adult population of Russia, which was more significant in 2013 (according to the preliminary data) than in 2012. The methodology for the active detection of CDs through a two-step medical examination, which is used during a follow-up, makes it possible to substantially increase detection rates for CDs. There has been shown to be a need for the better quality and completeness of diagnostic examination in real practice.

  17. Examining Career Success of Minority and Women Emergency Medical Technicians (EMTs): A LEADS Project

    Science.gov (United States)

    Russ-Eft, Darlene F.; Dickison, Philip D.; Levine, Roger

    2008-01-01

    Emergency medical technicians (EMTs) are a critical segment in prehospital medical care. This study examined EMT-paramedic career success focused on minorities and women, as part of the Longitudinal Emergency Medical Technician Attributes and Demographics Study (LEADS). The LEADS data come from a representative sampling of EMTs throughout the…

  18. Development of new core competencies for Taiwanese Emergency Medical Technicians

    Directory of Open Access Journals (Sweden)

    Chang YT

    2018-03-01

    Full Text Available Yu-Tung Chang,1,2 Kuang-Chau Tsai,2 Brett Williams1,3 1Department of Community Emergency Health and Paramedic Practice, Faculty of Medicine, Nursing and Health Sciences, Monash University, Frankston, VIC, Australia; 2Department of Emergency Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan; 3Division of Paramedicine, University of Tasmania, Hobart, TAS, Australia Objectives: Core competencies are considered the foundation for establishing Emergency Medical Technician (EMT and paramedic curricula, and for ensuring performance standards in the delivery of prehospital care. This study surveyed EMT instructors and medical directors to identify the most desirable core competencies for all levels of EMTs in Taiwan. Methods: A principal components analysis with Varimax rotation was conducted. An online questionnaire was distributed to obtain perspectives of EMT instructors and medical directors on the most desirable core competencies for EMTs. The target population was EMT training-course instructors and medical directors of fire departments in Taiwan. The questionnaire comprised 61 competency items, and multiple-choice and open-ended questions were used to obtain respondents’ perspectives of the Taiwanese EMT training and education system. Results: The results identified three factors at EMT-1 and EMT-2 levels and five factors at the EMT-Paramedic level. The factors for EMT-1 and EMT-2 were similar, and those for EMT-Paramedics identified further comprehensive competence perspectives. The key factors that appear to influence the development of the Taiwanese Emergency Medical Services (EMS education system are the attitude of authorities, the licensure system, and legislation. Conclusion: The findings present new core competencies for the Taiwanese EMT system and provide capacity to redesign curricula and reconsider roles for EMT-1 and EMT-2 technicians. At the EMT-Paramedic level, the findings demonstrate the importance of

  19. Senior medical students' awareness of radiation risks from common diagnostic imaging examinations.

    Science.gov (United States)

    Scali, Elena; Mayo, John; Nicolaou, Savvas; Kozoriz, Michael; Chang, Silvia

    2017-12-01

    Senior medical students represent future physicians who commonly refer patients for diagnostic imaging studies that may involve ionizing radiation. The radiology curriculum at the University of British Columbia provides students with broad-based knowledge about common imaging examinations. The purpose of this study was to investigate students' awareness of radiation exposures and risks. An anonymous multiple-choice cross-sectional questionnaire was distributed to final year medical students to assess knowledge of radiation from common diagnostic examinations and radiation-related risks following completion of the longitudinal radiology curriculum, carried out over the four years of medical training. Sixty-three of 192 eligible students participated (33% response rate). The majority felt that knowledge of radiation doses of common imaging examinations is somewhat or very important; however, only 12% (N = 8) routinely discuss radiation-related risks with patients. While all respondents recognized children as most sensitive to the effects of radiation, only 24% (N = 15) correctly identified gonads as the most radiation-sensitive tissue. Almost all respondents recognized ultrasound and MRI as radiation free modalities. Respondents who correctly identified the relative dose of common imaging examinations in chest x-ray equivalents varied from 3-77% (N = 2 - 49); the remaining responses were largely underestimates. Finally, 44% (N = 28) correctly identified the excess risk of a fatal cancer from an abdominal CT in an adult, while the remainder underestimated this risk. Medical students acknowledge the importance of radiation-related issues to patient care. While almost all students are familiar with radiation-free modalities, many are not familiar with, and commonly underestimate, the relative doses and risks of common imaging studies. This may expose patients to increasing imaging investigations and exposure to radiation hazards.

  20. Evaluation of medical examination of A-bomb survivors in cardiovascular disease

    International Nuclear Information System (INIS)

    Hayakawa, Norihiko; Matsuura, Masaaki; Kurihara, Minoru; Itoh, Chikako; Ishibashi, Shinzou; Sugimoto, Sumio.

    1989-01-01

    This is an analysis of 1311 death cases from cardiovascular disease (CVD) in A-bomb survivors aged 50-69 (665 men and 646 women), with the purpose of evaluating the significance of medical examination for A-bomb survivors. Control subjects consisted of 1311 A-bomb survivors dying of diseases other than CVD who were matched for sex and date of death. The commonest cause of death was cerebrovascular disease (56%), followed by ischemic heart disease (22%). An average number of participation in medical examination was 11.9 in the CVD group and 12.0 in the control group. The CVD group tended to have received detailed examinations, including serum total cholesterol, beta-lipoprotein, neutral fat, ECG, cardiothoracic radio, and glucose, as opposed to the control group receiving general examinations, such as urinary protein, urinary glucose and blood pressure. The following items showed significantly higher relative risks between the CVD and control groups: blood pressure (3.3), urinary protein (3.1), ECG (2.6), beta-lipoprotein (1.8), cardiothoracic ratio (1.9), serum total cholesterol (1.7), urinary glucose (1.6), and subjective symptoms (1.5). (N.K.)

  1. Associations between United States Medical Licensing Examination (USMLE) and Internal Medicine In-Training Examination (IM-ITE) scores.

    Science.gov (United States)

    McDonald, Furman S; Zeger, Scott L; Kolars, Joseph C

    2008-07-01

    Little is known about the associations of previous standardized examination scores with scores on subsequent standardized examinations used to assess medical knowledge in internal medicine residencies. To examine associations of previous standardized test scores on subsequent standardized test scores. Retrospective cohort study. One hundred ninety-five internal medicine residents. Bivariate associations of United States Medical Licensing Examination (USMLE) Steps and Internal Medicine In-Training Examination (IM-ITE) scores were determined. Random effects analysis adjusting for repeated administrations of the IM-ITE and other variables known or hypothesized to affect IM-ITE score allowed for discrimination of associations of individual USMLE Step scores on IM-ITE scores. In bivariate associations, USMLE scores explained 17% to 27% of the variance in IME-ITE scores, and previous IM-ITE scores explained 66% of the variance in subsequent IM-ITE scores. Regression coefficients (95% CI) for adjusted associations of each USMLE Step with IM-ITE scores were USMLE-1 0.19 (0.12, 0.27), USMLE-2 0.23 (0.17, 0.30), and USMLE-3 0.19 (0.09, 0.29). No single USMLE Step is more strongly associated with IM-ITE scores than the others. Because previous IM-ITE scores are strongly associated with subsequent IM-ITE scores, appropriate modeling, such as random effects methods, should be used to account for previous IM-ITE administrations in studies for which IM-ITE score is an outcome.

  2. Report on the results of the thirteenth medical examination of atomic bomb survivors resident in north america

    Energy Technology Data Exchange (ETDEWEB)

    Yamamoto, Yasuji; Ohta, Michiya [Hiroshima Prefectural Medical Association (Japan); Urabe, Takeshi [Hiroshima Prefectural Hospital (Japan)] [and others

    2002-05-01

    The thirteenth medical examination of A-bomb survivors resident in North America was carried out from June 13th through June 27th and from July 12th through July 26th, 2001, in the cities of Los Angeles, San Francisco, Seattle, and Honolulu. The total number of those who underwent the thirteenth medical examination was 399, 53 of whom were second-generation A-bomb survivors. As the survivors in North America are advancing in age, the average age of the examinee was 69.5 years. The examination items included an interview, clinical and physical examinations, electrocardiography (E.C.G.), and blood, urine, and stool tests. The review of the medical history showed that hypertension was the most frequent in the survivors examined, with the prevalence of 39.3%. Previous history of malignant tumors was observed in 13.6% of the survivors examined, with major sites being the mammary gland, uterine, and colon. As a result of the blood test, 9.5% of the survivors examined were diagnosed as diabetic, and hypercholesterolemia was found in 32.1% of the survivors examined. Latent hypothyroidism was found in 18.5% of the survivors examined. No disease or examination finding showed a clear relation with exposure status. A report providing the results of the medical examination and necessity of undergoing closer examination and receiving medical treatment, if any, was mailed to each examinee. (author)

  3. Report on the results of the thirteenth medical examination of atomic bomb survivors resident in north america

    International Nuclear Information System (INIS)

    Yamamoto, Yasuji; Ohta, Michiya; Urabe, Takeshi

    2002-01-01

    The thirteenth medical examination of A-bomb survivors resident in North America was carried out from June 13th through June 27th and from July 12th through July 26th, 2001, in the cities of Los Angeles, San Francisco, Seattle, and Honolulu. The total number of those who underwent the thirteenth medical examination was 399, 53 of whom were second-generation A-bomb survivors. As the survivors in North America are advancing in age, the average age of the examinee was 69.5 years. The examination items included an interview, clinical and physical examinations, electrocardiography (E.C.G.), and blood, urine, and stool tests. The review of the medical history showed that hypertension was the most frequent in the survivors examined, with the prevalence of 39.3%. Previous history of malignant tumors was observed in 13.6% of the survivors examined, with major sites being the mammary gland, uterine, and colon. As a result of the blood test, 9.5% of the survivors examined were diagnosed as diabetic, and hypercholesterolemia was found in 32.1% of the survivors examined. Latent hypothyroidism was found in 18.5% of the survivors examined. No disease or examination finding showed a clear relation with exposure status. A report providing the results of the medical examination and necessity of undergoing closer examination and receiving medical treatment, if any, was mailed to each examinee. (author)

  4. 76 FR 81999 - Submission for Review: Certificate of Medical Examination

    Science.gov (United States)

    2011-12-29

    ... information about individuals who are incumbents of positions which require physical fitness/agility testing and/or medical examinations, or who have been selected for such a position contingent upon meeting... Americans with Disabilities Act (ADA). As required by the Paperwork Reduction Act of 1995 (Pub. L. 104-13...

  5. Report on the results of the eighteenth medical examination of atomic bomb survivors resident in North America

    International Nuclear Information System (INIS)

    Usui, Shizuteru; Matsumura, Makoto; Yanagida, Jitsuro

    2012-01-01

    The eighteenth medical examination of A-bomb survivors resident in North America was carried out from June 15th through 29th and from July 13th through 27th, 2011, in the cities of Los Angeles, Honolulu, San Francisco, and Seattle. The total number of those who underwent the eighteenth medical examination was 378, 77 of whom were second-generation A-bomb survivors. As the survivors in North America are advancing in age, the average age of the examinees was 77.6 years. The examination items included an medical interview, clinical (including surgical and gynecological) examinations, physical measurement, electrocardiography (ECG), and hematology, blood biochemistry, urine, and fecal occult blood reaction tests, and cervical cancer screening. The review of the medical history showed that hypertension was the most frequent in the survivors examined, with the prevalence of about 60%. Previous history of malignant tumors was observed in about 18% of the survivors examined, with major cancer sites being the prostate, mammary gland, colon, and uterus. As a result of the blood biochemistry test, about 38% and 67% of the survivors examined were diagnosed with diabetes mellitus and/or impaired glucose tolerance (IGT) and dyslipidemia, respectively. Analyses of the A-bomb survivors who underwent this examination showed no statistically significant associations between exposure status and any disease or examination finding. A report providing the results of the medical examination and the necessity of undergoing closer examination, receiving medical treatment, and clinical follow-up, if any, was mailed to each examinee. (author)

  6. Report on the results of the eighteenth medical examination of atomic bomb survivors resident in North America

    Energy Technology Data Exchange (ETDEWEB)

    Usui, Shizuteru; Matsumura, Makoto; Yanagida, Jitsuro [Hiroshima Prefectural Medical Association, Hiroshima, Hiroshima (Japan); others, and

    2012-05-15

    The eighteenth medical examination of A-bomb survivors resident in North America was carried out from June 15th through 29th and from July 13th through 27th, 2011, in the cities of Los Angeles, Honolulu, San Francisco, and Seattle. The total number of those who underwent the eighteenth medical examination was 378, 77 of whom were second-generation A-bomb survivors. As the survivors in North America are advancing in age, the average age of the examinees was 77.6 years. The examination items included an medical interview, clinical (including surgical and gynecological) examinations, physical measurement, electrocardiography (ECG), and hematology, blood biochemistry, urine, and fecal occult blood reaction tests, and cervical cancer screening. The review of the medical history showed that hypertension was the most frequent in the survivors examined, with the prevalence of about 60%. Previous history of malignant tumors was observed in about 18% of the survivors examined, with major cancer sites being the prostate, mammary gland, colon, and uterus. As a result of the blood biochemistry test, about 38% and 67% of the survivors examined were diagnosed with diabetes mellitus and/or impaired glucose tolerance (IGT) and dyslipidemia, respectively. Analyses of the A-bomb survivors who underwent this examination showed no statistically significant associations between exposure status and any disease or examination finding. A report providing the results of the medical examination and the necessity of undergoing closer examination, receiving medical treatment, and clinical follow-up, if any, was mailed to each examinee. (author)

  7. Statistical evaluation of physical examinations conducted under atomic bomb survivors medical treatment law Nagasaki

    Energy Technology Data Exchange (ETDEWEB)

    Ohri, Shigehisa; Shimada, Daisaburo; Ishida, Morthiro; Onishi, Shigeyuki

    1961-09-19

    An evaluation was made of the reliability and validity of the information obtained by the first examination completed under the ABSMTL. Results of the analysis show clearly that the materials hardly can be utilized for studying the relationship between findings obtained from the medical examination and distance from the hypocenter. From the standpoint of clinical medicine, the lack of exactness in the examinations may be a major difficulty. However, as long as the degree of inexactness of the medical examinations is distributed equally to all sample members, comparison of the findings may be made within the limits of their accuracy. 4 references, 1 figure, 3 tables.

  8. Measurement of contamination by radioisotopes for medical examination and treatment in medical organizations

    International Nuclear Information System (INIS)

    Hamada, Masahiko

    1975-01-01

    For safety control of radioactive contamination by medical examination and treatment in medical organizations, establishment of a Health and Physics Department is desired. It is necessary to dispose of radiopharmaceuticals according to the classification of safety and to separate the use of non-sealed nuclides from the radiotherapy room. In relation to radioactive air pollution, attention should be paid to the sampling test of hood, management of 133 Xe using room, and air pollution in the disposal storage room and patient urine storage room. Concerning the disposal of liquid waste, it is most important to devise entirely different method of disposal according to the level differences in the amount of diagnostic use and the therapeutic dose. The method of use is most important also for the decision of the size of storage tank. For sampling and monitoring it is advisable to use up to the 10th rank nuclide for safety counting in consideration of physicochemical conditions. (Chiba, N.)

  9. Report on the results of the fourteenth medical examination of atomic bomb survivors resident in North America

    International Nuclear Information System (INIS)

    Yanagida, Jitsuro; Kambe, Masayuki; Hakoda, Masayuki

    2004-01-01

    The fourteenth medical examination of atomic-bomb (A-bomb) survivors resident in North America was carried out from June 18th through July 2nd and from July 24th through August 6th, 2003, in the cities of Los Angeles, San Francisco, Seattle, and Honolulu. The total number of those who underwent the fourteenth medical examination was 453, 65 of whom were second-generation A-bomb survivors. As the survivors in North America are advancing in age, the average age of the examinee was 71.6 years. The examination items included an interview, clinical and physical examinations, electrocardiography (E.C.G.), and blood, urine, and stool tests. The review of the medical history showed that hypertension was the most frequent in the survivors examined, with the prevalence of 45.4%. Previous history of malignant tumors was observed in 15.7% of the survivors examined, with major sites being the mammary gland, uterine, colon, and prostate. As a result of the blood test, 14.9% of the survivors examined were diagnosed as diabetic, and hypercholesterolemia was found in 28.4% of the survivors examined. Latent hypothyroidism was found in 21.2% of the survivors examined. No disease or examination finding showed a clear relation with exposure status. A report providing the results of the medical examination and necessity of undergoing closer examination and receiving medical treatment, if any, was mailed to each examinee. (author)

  10. Report on the results of the fifteenth medical examination of atomic bomb survivors resident in North America

    International Nuclear Information System (INIS)

    Kambe, Masayuki; Matsumura, Makoto; Suyama, Akihiko

    2006-01-01

    The fifteenth medical examination of A-bomb survivors resident in North America was carried out from May 11th through May 25th and from June 15th through June 29th, 2005, in the cities of Los Angeles, San Francisco, Seattle, and Honolulu. The total number of those who underwent the fifteenth medical examination was 435, 68 of whom were second-generation A-bomb survivors. As the survivors in North America are advancing in age, the average age of the examinees was 73.1 years. The examination items included an interview, clinical and physical examinations, electrocardiography (E.C.G.), and blood, urine, and stool tests. The review of the medical history showed that hypertension was the most frequent in the survivors examined, with the prevalence of 51.8%. Previous history of malignant tumors was observed in 19.6% of the survivors examined, with major sites being the mammary gland, uterus, colon, and prostate. As a result of the blood test, 12.8% of the survivors examined were diagnosed as diabetic, and hypercholesterolemia was found in 26.2% of the survivors examined. Latent hypothyroidism was found in 16.9% of the survivors examined. Among the examinees of A-bomb survivors, statistically significant associations with exposure status were not found in any disease or examination finding. A report providing the results of the medical examination and the necessity of undergoing closer examination and receiving medical treatment, if any, was mailed to each examinee. (author)

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

    Science.gov (United States)

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

    2016-10-21

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

  12. Roentgenodiagnostics in medical labor examination and in rehabilitation of patients with occupational diseases

    International Nuclear Information System (INIS)

    Sokolik, L.I.

    1981-01-01

    Objective medical labour examination and judgement of labour rehabilitation of patients are based on the results of comprehensive roentgenological examination. Roentgenological pictures of different occupational diseases taking into account working conditions and concrete labour sanitary-and-hygienic characteristics are discussed [ru

  13. Examining Sense of Community among Medical Professionals in an Online Graduate Program

    Directory of Open Access Journals (Sweden)

    Kadriye O. Lewis

    2015-01-01

    Full Text Available As the number of online degree programs continues to grow, one of the greatest challenges is developing a sense of community among learners who do not convene at the same time and place. This study examined the sense of community among medical professionals in an online graduate program for healthcare professionals. We took the sample from a fully online program delivered jointly by a state university and a local children's hospital in the Midwest. We administered Rovai's Classroom Community Survey with 11 additional demographic questions. We also utilized online interviews to further explore students’ understanding of sense of community. A bi-factor model was fitted to the online sense of community survey data. Using multivariate analysis of variance (MANOVA and univariate analysis of variance (ANOVA we identified potential group differences. The qualitative data were analyzed thematically in a recursive and iterative process. Study results suggested that a dominant factor existed: sense of community with two sub-domain factors including sense of learning and sense of connectedness. No significant differences in sense of community with regard to gender, native language, or area of medical practice were detected. However, results showed a difference in sense of community between the three courses examined. This study is the first to examine the sense of community among online medical professionals. Since our findings are in contrast to those of previous studies, this opens the door to additional studies around the possible differences between the community characteristics and needs of medical professionals as online students.

  14. Examining Sexual Orientation Disparities in Unmet Medical Needs among Men and Women

    OpenAIRE

    Everett, Bethany G.; Mollborn, Stefanie

    2013-01-01

    Using the National Longitudinal Study of Adolescent Health (N = 13,810), this study examines disparities in unmet medical needs by sexual orientation identity during young adulthood. We use binary logistic regression and expand Andersen’s health care utilization framework to identify factors that shape disparities in unmet medical needs by sexual orientation. We also investigate whether the well-established gender disparity in health-seeking behaviors among heterosexual persons holds for sexu...

  15. The fundamentals of integrating service in a post-licensure RN to BSN program.

    Science.gov (United States)

    Washington-Brown, Linda; Ritchie, Arlene

    2014-01-01

    Integrating service in a post-licensure registered nurse to bachelor of science in nursing (RN to BSN) program provides licensed registered nurse (RN) students the opportunity to learn, develop, and experience different cultures while serving the community and populations in need (McKinnon & Fitzpatrick, 2012). Service to the community, integrated with academic learning can be applied in a wide variety of settings, including schools, universities, and community faith-based organizations. Academic service-learning (ASL) can involve a group of students, a classroom, or an entire school. In the RN to BSN program, the authors use a student-directed service learning approach that integrates service-learning throughout the curriculum. RN students are introduced to service-learning at program orientation prior to the start of classes and receive reinforcement and active engagement throughout the curriculum. The students and volunteer agencies receive and give benefits from the services provided and the life lessons gained through mentorship, education, and hands-on experiences.

  16. Features of commercial computer software systems for medical examiners and coroners.

    Science.gov (United States)

    Hanzlick, R L; Parrish, R G; Ing, R

    1993-12-01

    There are many ways of automating medical examiner and coroner offices, one of which is to purchase commercial software products specifically designed for death investigation. We surveyed four companies that offer such products and requested information regarding each company and its hardware, software, operating systems, peripheral devices, applications, networking options, programming language, querying capability, coding systems, prices, customer support, and number and size of offices using the product. Although the four products (CME2, ForenCIS, InQuest, and Medical Examiner's Software System) are similar in many respects and each can be installed on personal computers, there are differences among the products with regard to cost, applications, and the other features. Death investigators interested in office automation should explore these products to determine the usefulness of each in comparison with the others and in comparison with general-purpose, off-the-shelf databases and software adaptable to death investigation needs.

  17. Time to Loosen the Apron Strings: Cohort-based Evaluation of a Learner-driven Remediation Model at One Medical School.

    Science.gov (United States)

    Bierer, S Beth; Dannefer, Elaine F; Tetzlaff, John E

    2015-09-01

    Remediation in the era of competency-based assessment demands a model that empowers students to improve performance. To examine a remediation model where students, rather than faculty, develop remedial plans to improve performance. Private medical school, 177 medical students. A promotion committee uses student-generated portfolios and faculty referrals to identify struggling students, and has them develop formal remediation plans with personal reflections, improvement strategies, and performance evidence. Students submit reports to document progress until formally released from remediation by the promotion committee. Participants included 177 students from six classes (2009-2014). Twenty-six were placed in remediation, with more referrals occurring during Years 1 or 2 (n = 20, 76 %). Unprofessional behavior represented the most common reason for referral in Years 3-5. Remedial students did not differ from classmates (n = 151) on baseline characteristics (Age, Gender, US citizenship, MCAT) or willingness to recommend their medical school to future students (p < 0.05). Two remedial students did not graduate and three did not pass USLME licensure exams on first attempt. Most remedial students (92 %) generated appropriate plans to address performance deficits. Students can successfully design remedial interventions. This learner-driven remediation model promotes greater autonomy and reinforces self-regulated learning.

  18. Investigation of organ dose difference of age phantoms for medical X-ray examinations

    International Nuclear Information System (INIS)

    Park, Sang Hyun; Kim, Woo Ran; Lee, Jai Ki; Lee, Choon Sik

    2003-01-01

    Methodology for calculating the organ equivalent doses and the effective doses of pediatric and adult patients undergoing medical X-ray examinations were established. The MIRD-type mathematical phantoms of 4 age groups were constructed with addition of the esophagus to the same phantoms. Two typical examination procedures, chest PA and abdomen AP, were simulated for the pediatric patients as well as the adult as illustrative examples. The results confirmed that patients pick up approximate 0.03 mSv of effective dose from a single chest PA examination, and 0.4 to 1.7 mSv from an abdomen AP examination depending on the ages. For dose calculations where irradiation is made with a limited field, the details of the position, size and shape of the organs and the organ depth from the entrance surface considerably affect the resulting doses. Therefore, it is important to optimize radiation protection by control of X-ray properties and beam examination field. The calculation result, provided in this study, can be used to implement optimization for medical radiation protection

  19. The social life of the dead: The role of post-mortem examinations in medical student socialisation.

    Science.gov (United States)

    Goodwin, Dawn; Machin, Laura; Taylor, Adam

    2016-07-01

    Dissection has held a privileged position in medical education although the professional values it inculcates have been subject to intense debate. Claims vary from it generating a dehumanising level of emotional detachment, to promotion of rational and dispassionate decision-making, even to being a positive vehicle for ethical education. Social scientists have positioned dissection as a critical experience in the emotional socialisation of medical students. However, curricular revision has provoked debate about the style and quantity of anatomy teaching thus threatening this 'rite of passage' of medical students. Consequently, some UK medical schools do not employ dissection at all. In its place, observation of post-mortem examinations - a long established, if underutilised, practice - has re-emerged in an attempt to recoup aspects of anatomical knowledge that are arguably lost when dissection is omitted. Bodies for post-mortem examinations and bodies for dissection, however, have striking differences, meaning that post-mortem examinations and dissection cannot be considered comparable opportunities to learn anatomy. In this article, we explore the distinctions between dissection and post-mortem examinations. In particular, we focus on the absence of a discourse of consent, concerns about bodily integrity, how the body's shifting ontology, between object and person, disrupts students' attempts to distance themselves, and how the observation of post-mortem examinations features in the emotional socialisation of medical students. Copyright © 2016 Elsevier Ltd. All rights reserved.

  20. Factors influencing medical students' self-assessment of examination performance accuracy: A United Arab Emirates study.

    Science.gov (United States)

    Shaban, Sami; Aburawi, Elhadi H; Elzubeir, Khalifa; Elango, Sambandam; El-Zubeir, Margaret

    2016-01-01

    Assessment of one's academic capabilities is essential to being an effective, self-directed, life-long learner. The primary objective of this study was to analyze self-assessment accuracy of medical students attending the College of Medicine and Health Sciences, United Arab Emirates University, by examining their ability to assess their own performance on an MCQ examination. 1 st and 2 nd year medical students (n = 235) self-assessed pre and post-examination performance were compared with objectively measured scores (actual examination performance). Associations between accuracy of score prediction (pre and post assessment), and students' gender, year of education, perceived preparation, confidence and anxiety were also determined. Expected mark correlated significantly with objectively assessed marks (r = 0.407; P self-assessment accuracy. Findings reinforce existing evidence indicating that medical students are poor self-assessors. There are potentially multiple explanations for misjudgment of this multidimensional construct that require further investigation and change in learning cultures. The study offers clear targets for change aimed at optimizing self-assessment capabilities.

  1. Examining Sexual Orientation Disparities in Unmet Medical Needs among Men and Women.

    Science.gov (United States)

    Everett, Bethany G; Mollborn, Stefanie

    2014-08-01

    Using the National Longitudinal Study of Adolescent Health (N = 13,810), this study examines disparities in unmet medical needs by sexual orientation identity during young adulthood. We use binary logistic regression and expand Andersen's health care utilization framework to identify factors that shape disparities in unmet medical needs by sexual orientation. We also investigate whether the well-established gender disparity in health-seeking behaviors among heterosexual persons holds for sexual minorities. The results show that sexual minority women are more likely to report unmet medical needs than heterosexual women, but no differences are found between sexual minority and heterosexual men. Moreover, we find a reversal in the gender disparity between heterosexual and sexual minority populations: heterosexual women are less likely to report unmet medical needs than heterosexual men, whereas sexual minority women are more likely to report unmet medical needs compared to sexual minority men. Finally, this work advances Andersen's model by articulating the importance of including social psychological factors for reducing disparities in unmet medical needs by sexual orientation for women.

  2. Examining Sexual Orientation Disparities in Unmet Medical Needs among Men and Women

    Science.gov (United States)

    Everett, Bethany G.; Mollborn, Stefanie

    2013-01-01

    Using the National Longitudinal Study of Adolescent Health (N = 13,810), this study examines disparities in unmet medical needs by sexual orientation identity during young adulthood. We use binary logistic regression and expand Andersen’s health care utilization framework to identify factors that shape disparities in unmet medical needs by sexual orientation. We also investigate whether the well-established gender disparity in health-seeking behaviors among heterosexual persons holds for sexual minorities. The results show that sexual minority women are more likely to report unmet medical needs than heterosexual women, but no differences are found between sexual minority and heterosexual men. Moreover, we find a reversal in the gender disparity between heterosexual and sexual minority populations: heterosexual women are less likely to report unmet medical needs than heterosexual men, whereas sexual minority women are more likely to report unmet medical needs compared to sexual minority men. Finally, this work advances Andersen’s model by articulating the importance of including social psychological factors for reducing disparities in unmet medical needs by sexual orientation for women. PMID:25382887

  3. A Qualitative Examination of the Administrative Process of Fleet Enlisted Personnel in Various Medical Categories

    National Research Council Canada - National Science Library

    Weatherford, Lenora

    2003-01-01

    The purpose of this research is to examine the medical management process of placing and monitoring active duty fleet enlisted personnel in a temporary medical duty status and its impact on fleet readiness...

  4. Self-Regulated Learning: Examining the Baccalaureate Millennial Nursing Student's Approach.

    Science.gov (United States)

    Robb, Meigan K

    2016-01-01

    Pre-licensure baccalaureate nursing programs are facing the demand to retain and graduate students with the skills needed for the complex health care environment. Nursing faculty are challenged to identify the best pedagogical methods for educating the current generation of students. The influence of student-centered approaches is documented in the literature. However, the effective use of these methods requires a collaborative partnership. The cognitive, self-regulated approaches used by millennial nursing students is not well understood. This article describes the findings of a study that examined the relationship between self-regulated approaches to learning, self-efficacy, independent study behaviors, and grade point average.

  5. 77 FR 31041 - Draft Standards and Best Practices for Interaction Between Medical Examiner/Coroner and Organ and...

    Science.gov (United States)

    2012-05-24

    ... Best Practices for Interaction Between Medical Examiner/Coroner and Organ and Tissue Procurement... titled ``Organ and Tissue Procurement Committee Standards and Best Practices for Interaction Between Medical Examiner/Coroner Offices and Organ Tissue Procurement Organizations'' from May 12, 2012, to June...

  6. Re-examining medical modernization

    DEFF Research Database (Denmark)

    Tupasela, Aaro Mikael

    2007-01-01

    Despite recent evidence that suggests that knowledge production within the medical community is increasingly based on knowledge-making coalitions or what some have called the co-production of knowledge, there remains a strong expert led policy agenda in many countries in relation to human genome...

  7. Ranking Spain's medical schools by their performance in the national residency examination.

    Science.gov (United States)

    Lopez-Valcarcel, B G; Ortún, V; Barber, P; Harris, J E; García, B

    2013-12-01

    Medical school graduates in Spain must take a uniform national exam (called "examen MIR") in order to enter postgraduate training in a specialty. Its results offer a unique opportunity to rank medical schools according to this exam. We measured differences in the MIR exam results among Spanish medical schools and assessed the stability of the MIR-based rankings for the period 2003-2011. In the year 2011 a total of 6873 residency positions nationwide were offered by the Spanish Ministry of Health, Social Services and Equality. These positions covered 47 specialties distributed over 231 training centers. A total of 11,550 medical graduates (including 1997 foreign graduates) took the MIR examination. Marked differences among medical schools were evident. The median graduate from medical school #1 and #29 occupied the positions 1477 and 5383, respectively. These figures correspond to a standardized ranking of 21 out of 100 for medical school #1 (that is, 1477/6873; half of medical school #1 obtained better [below position 21%] and half worse [over position 21%] results) and a standardized ranking of 70 out of 100 for medical school #29. While 81% of the medical school #1 graduates were amongst the best 3000 MIR exams and only 5% above the 5000 position the corresponding figures for medical school #29 graduates were 21% and 44%, respectively. The ranking position of the 29 medical schools was very stable between the years 2003 and 2011. There are marked differences in medical schools in Spain and these differences are very consistent over the years 2003-2011. Copyright © 2013 Elsevier España, S.L. All rights reserved.

  8. Effectiveness of a 40-minute Ophthalmologic Examination Teaching Session on Medical Student Learning

    Directory of Open Access Journals (Sweden)

    Wirachin Hoonpongsimanont

    2015-10-01

    Full Text Available Introduction: Emergency physicians are among the few specialists besides ophthalmologists who commonly perform ophthalmologic examinations using the slit lamp and other instruments. However, most medical schools in the United States do not require an ophthalmology rotation upon completion. Teaching procedural skills to medical students can be challenging due to limited resources and instructor availability. Our study assesses the effectiveness of a 40-minute hands-on teaching session on ophthalmologic examination for medical students using only two instructors and low-cost equipment. Methods: We performed an interventional study using a convenience sample of subjects. Pre- and post-workshop questionnaires on students’ confidence in performing ophthalmologic examination were administered. We used a paired t-test and Wilcoxon rank test to analyze the data. Results: Of the 30 participants in the study, the mean age was 25 and the majority were first-year medical students. The students’ confidence in performing every portion of the ophthalmologic exam increased significantly after the teaching session. We found that the average confidence level before the teaching session were below 2 on a 1-5 Likert scale (1 being the least confident. Confidence levels in using the slit lamp had the highest improvement among the skills taught (2.17 95% CI [1.84-2.49]. Students reported the least improvement in their confidence in assessing extraocular movements (0.73, 95% CI [0.30-1.71] and examining pupillary function (0.73, 95% CI [0.42-1.04]. We observed the biggest difference in median confidence level in the use of the tonometer (4 with a p-value of <0.05. Conclusion: A 40-minute structured hands-on training session can significantly improve students’ confidence levels in ophthalmologic skills.

  9. Dose variation in the practice of medical examination

    International Nuclear Information System (INIS)

    Huyskens, C.

    1989-01-01

    A discussion is presented on dose variation in the practice of the x-ray examination and on the desirability of checks in the framework of quality care. It is shown that, roughly speaking, for all examination types the dose distribution per action shows the same character. About 20% of the actions cause about half of the collective dose and the individual radiation burden in this is a factor 3 up to 10 larger than average, the remaining 80%. Insight in the distribution of the use of radiation per action is characterized as a necessary step in the control of patient doses. Radiation protection of patients is of avail mostly when the attention is aimed in first instance at examination categories with an average high dose and at the 2-% group of actions with the relatively highest radiation use. Regularly measuring of the 'actual practice' in relation to the 'good practice' is a logical test which makes part of the general quality assurance of medical action. It is recommended to take in hand the care for radiation protection of the patient in this way, within the own department or institute as well as by means of inter collegial checks on a national level. (author). 2 refs.; 3 figs

  10. Radiation exposure of the UK population from medical and dental x-ray examinations

    International Nuclear Information System (INIS)

    Hart, D.; Wall, B.F.

    2002-03-01

    Knowledge of recent trends in the radiation doses from x-ray examinations and their distribution for the UK population provides useful guidance on where best to concentrate efforts on patient dose reduction in order to optimise the protection of the population in a cost-effective manner. In this report, the results of a recent survey of the frequency of medical and dental x-ray examinations in the UK and contemporary data on the radiation doses typically received by patients, are used to assess trends in the extent and the pattern of the population exposure. Individual patient doses, expressed in terms of the effective dose, range from a few microsieverts for simple radiographic examinations of the teeth, limbs or chest to tens of millisieverts for prolonged fluoroscopic procedures or some computed tomography (CT) examinations. A total of about 41.5 million medical and dental x-ray examinations are now conducted each year in the UK (0.70 examination per head of population) resulting in an annual per caput effective dose of 330 μSv. This is not significantly different from the previous rough estimate of 350 μSv for 1991. However, over the last ten years CT has more than doubled its contribution and is now responsible for 40% of the total dose to the population from medical x-rays. In contrast, the contribution from conventional radiographic and fluoroscopic examinations has nearly halved to about 44%. Interventional and angiographic procedures together contribute the remaining 16%. The annual per caput dose of 330 μSv is low in comparison with other countries having similarly developed systems of health care. This is due to both a lower frequency of x-ray examinations per head of population and generally lower doses in the UK than in other developed countries. However, the much increased contributions of CT, angiography and interventional procedures to the UK population dose indicate an urgent need to develop radiation protection and optimisation activities for

  11. Physical examination in undergraduate medical education in the field of general practice - a scoping review.

    Science.gov (United States)

    Moßhammer, Dirk; Graf, Joachim; Joos, Stefanie; Hertkorn, Rebekka

    2017-11-25

    Physical examination (PE) is an essential clinical skill and a central part of a physician's daily activity. Teaching of PE has been integrated into medical school by many clinical disciplines with respective specific examination procedures. For instance, PE teaching in general practice may include a full-body examination approach. Studies show that PE-skills of medical students often need enhancement. The aim of this article was to scope the literature regarding the teaching and research of PE within general practice during undergraduate medical education. We evaluated a wide breadth of literature relating to the content, study design, country of research institution and year of publication. Literature search in Medline along the PRISMA-P protocol was performed by search syntax ("physical examination" AND "medical education" AND "undergraduate" AND general practice) considering Medline MeSH (Medical Subject Heading)-Terms and Medline search term tree structure. Independent title, abstract and full-text screening with defined inclusion and exclusion criteria was performed. Full texts were analyzed by publication year, country of origin, study design and content (by categorizing articles along their main topic according to qualitative content analysis of Mayring). One-hundred seven articles were included. The annual number of publications ranged from 4 to 14 and had a slightly rising trend since 2000. Nearly half of the publications originated from the United States (n = 54), 33 from Canada and the United Kingdom. Overall, intervention studies represented the largest group (n = 60, including uncontrolled and controlled studies, randomized and non-randomized), followed by cross-sectional studies (n = 29). The 117 studies could be assigned to five categories "teaching methods (n = 53)", "teaching quality (n = 33)", "performance evaluation and examination formats (n=19)", "students' views (n = 8)" and "patients' and standardized patients' views

  12. What does the neurosurgeon expect from nuclear medical brain examinations

    Energy Technology Data Exchange (ETDEWEB)

    Friedrich, H.

    1985-12-01

    The management of neurosurgical diseases includes a number of measures influencing cerebral pressure, blood flow and metabolism such as hypothermia, hyperventilation, haemodilution, cerebral dehydration, administration of ganglion blockers, steroids, barbiturates - to mention only a few factors - the effect of which has not been proven, though. Combined use of current examination procedures and nuclear medical techniques will enable a critical review of some of these substances or measures in the future. Nuclear medical techniques serve to complement current procedures such as computerized tomography and angiography, thus providing new applications for diagnosis of, and clinical research into cerebral haemodynamics and cerebral metabolism. There is a need for more information about the relationship between the function, blood flow and metabolism of the human brain, especially in neurosurgical patients with craniocerebral traumas, tumours and cerebral ischemia.

  13. [Current teaching, learning and examination methods in medical education and potential applications in rehabilitative issues].

    Science.gov (United States)

    Schwarzkopf, S R; Morfeld, M; Gülich, M; Lay, W; Horn, K; Mau, W

    2007-04-01

    With introduction of the new Federal Medical Licensing Regulations (Approbationsordnung) in Germany, integrated teaching in "Rehabilitation, Physical Medicine, Naturopathic Treatment" (Querschnittsbereich Q12) has become obligatory for the first time. Furthermore, the new Regulations require the medical faculties in Germany to realize an innovative didactic orientation in teaching. This paper provides an overview of recent applications of teaching techniques and examination methods in medical education with special consideration of the new integrated course Q12 and further teaching methods related to rehabilitative issues. Problem-oriented learning (POL), problem-based learning (PBL), bedside teaching, eLearning, and the examination methods Objective Structured Clinical Examination (OSCE) and Triple Jump are in the focus. This overview is intended as the basis for subsequent publications of the Commission for Undergraduate and Postgraduate Training of the German Society of Rehabilitation Science (DGRW), which will present examples of innovative teaching material.

  14. A history and overview of the certification exam for medical dosimetrists

    International Nuclear Information System (INIS)

    Pusey, Damien; Smith, Lisette; Zeman, Elaine M.; Adams, Robert

    2005-01-01

    During the last century, the creation and implementation of board certification has had a powerful impact on the medical community. Board certification has helped to shape the scope and practice of medical professionals and the care they provide, as well as to influence the way the health insurance industry sets standards for reimbursement. One profession that offers board certification to its members is medical dosimetry. The Medical Dosimetrist Certification Board exam has been administered since 1988 and its content covers a broad spectrum of information from the radiation therapy sciences. The exam has strict application requirements and is rather difficult to pass. Those who pass the exam can then call themselves Certified Medical Dosimetrists. For data purposes of this study, several members of the dosimetry community were solicited to participate in a survey regarding the exam's content and history, and to provide relevant statistical data. Currently 2,177 medical dosimetrists are board certified, with an additional 1,500 estimated to be working without certification. Although board certification is not currently required to practice medical dosimetry, new legislation known as the CARE Bill could change this. The CARE Bill, if passed, would mandate nationwide compulsory licensure and/or certification for medical dosimetrists and other medical professionals who want to work in radiation-related health care. Health maintenance organizations and other insurance carriers may likewise require certification for reimbursement purposes

  15. Factors influencing medical informatics examination grade--can biorhythm, astrological sign, seasonal aspect, or bad statistics predict outcome?

    Science.gov (United States)

    Petrovecki, Mladen; Rahelić, Dario; Bilić-Zulle, Lidija; Jelec, Vjekoslav

    2003-02-01

    To investigate whether and to what extent various parameters, such as individual characteristics, computer habits, situational factors, and pseudoscientific variables, influence Medical Informatics examination grade, and how inadequate statistical analysis can lead to wrong conclusions. The study included a total of 382 second-year undergraduate students at the Rijeka University School of Medicine in the period from 1996/97 to 2000/01 academic year. After passing the Medical Informatics exam, students filled out an anonymous questionnaire about their attitude toward learning medical informatics. They were asked to grade the course organization and curriculum content, and provide their date of birth; sex; study year; high school grades; Medical Informatics examination grade, type, and term; and describe their computer habits. From these data, we determined their zodiac signs and biorhythm. Data were compared by the use of t-test, one-way ANOVA with Tukey's honest significance difference test, and randomized complete block design ANOVA. Out of 21 variables analyzed, only 10 correlated with the average grade. Students taking Medical Informatics examination in the 1998/99 academic year earned lower average grade than any other generation. Significantly higher Medical Informatics exam grade was earned by students who finished a grammar high school; owned and regularly used a computer, Internet, and e-mail (pzodiac sign, zodiac sign quality, or biorhythm cycles, except when intentionally inadequate statistics was used for data analysis. Medical Informatics examination grades correlated with general learning capacity and computer habits of students, but showed no relation to other investigated parameters, such as examination term or pseudoscientific parameters. Inadequate statistical analysis can always confirm false conclusions.

  16. Syndrome surveillance of fentanyl-laced heroin outbreaks: Utilization of EMS, Medical Examiner and Poison Center databases.

    Science.gov (United States)

    Moore, P Quincy; Weber, Joseph; Cina, Steven; Aks, Steven

    2017-11-01

    Describe surveillance data from three existing surveillance systems during an unexpected fentanyl outbreak in a large metropolitan area. We performed a retrospective analysis of three data sets: Chicago Fire Department EMS, Cook County Medical Examiner, and Illinois Poison Center. Each included data from January 1, 2015 through December 31, 2015. EMS data included all EMS responses in Chicago, Illinois, for suspected opioid overdose in which naloxone was administered and EMS personnel documented other criteria indicative of opioid overdose. Medical Examiner data included all deaths in Cook County, Illinois, related to heroin, fentanyl or both. Illinois Poison Center data included all calls in Chicago, Illinois, related to fentanyl, heroin, and other prescription opioids. Descriptive statistics using Microsoft Excel® were used to analyze the data and create figures. We identified a spike in opioid-related EMS responses during an 11-day period from September 30-October 10, 2015. Medical Examiner data showed an increase in both fentanyl and mixed fentanyl/heroin related deaths during the months of September and October, 2015 (375% and 550% above the median, respectively.) Illinois Poison Center data showed no significant increase in heroin, fentanyl, or other opioid-related calls during September and October 2015. Our data suggests that EMS data is an effective real-time surveillance mechanism for changes in the rate of opioid overdoses. Medical Examiner's data was found to be valuable for confirmation of EMS surveillance data and identification of specific intoxicants. Poison Center data did not correlate with EMS or Medical Examiner data. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. Use of the National Board of Medical Examiners® Comprehensive Basic Science Exam: survey results of US medical schools.

    Science.gov (United States)

    Wright, William S; Baston, Kirk

    2017-01-01

    The National Board of Medical Examiners ® (NBME) Comprehensive Basic Science Exam (CBSE) is a subject exam offered to US medical schools, where it has been used for external validation of student preparedness for the United States Medical Licensing Examination ® (USMLE) Step 1 in new schools and schools undergoing curricular reform. Information regarding the actual use of the NBME CBSE is limited. Therefore, the aim of the survey was to determine the scope and utilization of the NBME CBSE by US medical schools. A survey was sent in May 2016 to curriculum leadership of the 139 US medical schools listed on the Liaison Committee on Medical Education (LCME ® ) website with provisional or full accreditation as of February 29, 2016. Responses were received from 53 schools (38% response rate). A series of different follow-up questions were asked if respondents stated "yes" or "no" to the initial question "Does your institution administer the NBME CBSE prior to the USMLE Step 1?". A total of 37 schools (70%) administered the NBME CBSE. In all, 36 of the 37 schools responded to follow-up questions. Of 36 schools, 13 schools (36%) used the NBME CBSE for curriculum modification. Six schools (17%) used the NBME CBSE for formative assessment for a course, and five schools (14%) used the NBME CBSE for summative assessment for a course. A total of 28 schools (78%) used the NBME CBSE for identifying students performing below expectations and providing targeted intervention strategies. In all, 24 schools (67%) of the 36 responding schools administering the NBME CBSE administered the test once prior to the administration of the USMLE Step 1, whereas 10 (28%) schools administered the NBME CBSE two or more times prior to the administration of the USMLE Step 1. Our data suggest that the NBME CBSE is administered by many US medical schools. However, the objective, timing, and number of exams administered vary greatly among schools.

  18. Increased knowledge of thalassemia promotes early carrier status examination among medical students

    Directory of Open Access Journals (Sweden)

    Julius Broto Dewanto

    2016-04-01

    A higher thalassemia knowledge score causes medical students to be willing to undergo thalassemia carrier status examination at an earlier point in timing. A well-organized educational program focusing on thalassemia and early screening in young adults may enhance the thalassemia prevention program.

  19. Family history and medical examination of occupationally exposed employees against ionizing radiation

    International Nuclear Information System (INIS)

    Heinemann, G.

    2000-01-01

    Searching for individual radiosensitivity could improve the quality of the medical examination of occupationally exposed employees and thus provide real protection of the individual against ionizing radiation. For this purpose genetic family history should be recorded by a skilled interviewer. (orig.) [de

  20. Examination of image diagnosis system at high level emergency medical service

    International Nuclear Information System (INIS)

    Hirose, Masaharu; Endo, Toshio; Aoki, Tomio

    1983-01-01

    This is a report of the basic idea on imaging system focussing on a necessary X-ray system for high-level emergencies which was worked out due to the establishment of the independent emergency medical institute specialized in the tertiary lifesaving and emergency, and of examinations on satisfactory results we gained for about three years of usage. (author)

  1. 75 FR 61998 - Programs for Specific Positions and Examinations (Miscellaneous)

    Science.gov (United States)

    2010-10-07

    ... professional responsibility. However, on July 18, 2008, OPM published an interim rule, at 73 FR 41235... require as to lawyers serving as ALJs.'' OPM is considering whether the licensure requirement for...

  2. The Relationship among Health Education Systems, Inc. Progression and Exit Examination Scores, Day or Evening Enrollment, Final Grade Point Average and NCLEX-RN® Success in Associate Degree Nursing Students

    Science.gov (United States)

    Barnwell-Sanders, Pamela

    2015-01-01

    Graduates of associate degree (AD) nursing programs form the largest segment of first-time National Council Licensure Examination for Registered Nurses (NCLEX-RN®) test takers, yet also experience the highest rate of NCLEX-RN® failures. NCLEX-RN® failure delays entry into the profession, adding an emotional and financial toll to the unsuccessful…

  3. Licensure tests for special education teachers: how well they assess knowledge of reading instruction and mathematics.

    Science.gov (United States)

    Stotsky, Sandra

    2009-01-01

    To determine the extent to which knowledge of evidence-based reading instruction and mathematics is assessed on licensure tests for prospective special education teachers, this study drew on information provided by Educational Testing Service (ETS), the American Board for Certification of Teacher Excellence, and National Evaluation Systems (now Evaluation Systems group of Pearson). It estimated the percentage of test items on phonemic awareness, phonics, and vocabulary knowledge and on mathematics content. It also analyzed descriptions of ETS's tests of "principles of teaching and learning." Findings imply that prospective special education teachers should be required to take both a dedicated test of evidence-based reading instructional knowledge, as in California, Massachusetts, and Virginia, and a test of mathematical knowledge, as in Massachusetts. States must design their own tests of teaching principles to assess knowledge of evidence-based educational theories.

  4. Correlations between the scores of computerized adaptive testing, paper and pencil tests, and the Korean Medical Licensing Examination

    Directory of Open Access Journals (Sweden)

    Mee Young Kim

    2005-06-01

    Full Text Available To evaluate the usefulness of computerized adaptive testing (CAT in medical school, the General Examination for senior medical students was administered as a paper and pencil test (P&P and using CAT. The General Examination is a graduate examination, which is also a preliminary examination for the Korean Medical Licensing Examination (KMLE. The correlations between the results of the CAT and P&P and KMLE were analyzed. The correlation between the CAT and P&P was 0.8013 (p=0.000; that between the CAT and P&P was 0.7861 (p=0.000; and that between the CAT and KMLE was 0.6436 (p=0.000. Six out of 12 students with an ability estimate below 0.52 failed the KMLE. The results showed that CAT could replace P&P in medical school. The ability of CAT to predict whether students would pass the KMLE was 0.5 when the criterion of the theta value was set at -0.52 that was chosen arbitrarily for the prediction of pass or failure.

  5. The "Near-Peer" Approach to Teaching Musculoskeletal Physical Examination Skills Benefits Residents and Medical Students.

    Science.gov (United States)

    Rosenberg, Casandra J; Nanos, Katherine N; Newcomer, Karen L

    2017-03-01

    The musculoskeletal physical examination (MSK PE) is an essential part of medical student training, and it is best taught in a hands-on, longitudinal fashion. A barrier to this approach is faculty instructor availability. "Near-peer" teaching refers to physicians-in-training teaching their junior colleagues. It is unknown whether near-peer teaching is effective in teaching this important physical examination skill. To investigate attitudes of medical students and physical medicine and rehabilitation (PM&R) residents regarding near-peer teaching in an MSK PE curriculum. Qualitative, anonymous paper and online surveys. Tertiary academic center with a medical school and PM&R training program. Ninety-nine second- and third-year medical students and 13 PM&R residents in their third or fourth postgraduate year. Attitudes of second- and third-year medical students were measured immediately after their MSK PE course. Resident attitudes were measured in a single cross-sectional sample. Student attitudes were assessed via a questionnaire with 5-point Likert scales and a free-text comment section. The resident questionnaire included a combination of multiple-choice questions, rankings, free-text responses, and Likert scales. All 99 students completed the questionnaire. The majority of students (n = 79 [80%]) reported that resident involvement as hands-on instructors of examination skills was "very useful," and 87 (88%) indicated that resident-led small discussion groups were "very helpful" or "somewhat helpful." Fifty-seven of 99 students (58%) reported that the resident-facilitated course was "much better" than courses without resident involvement. Twelve of 13 eligible residents completed the survey, and of those, 8 found teaching "very helpful" to their MSK knowledge, and 11 became "somewhat" or "much more confident" in clinical examination skills. Our study supports educational benefits to medical students and resident instructors in our MSK PE program. We recommend

  6. The need to incorporate health information technology into physicians' education and professional development.

    Science.gov (United States)

    Graham-Jones, Pierce; Jain, Sachin H; Friedman, Charles P; Marcotte, Leah; Blumenthal, David

    2012-03-01

    Nationwide, as physicians and health care systems adopt electronic health records, health information technology is becoming integral to the practice of medicine. But current medical education and professional development curricula do not systematically prepare physicians to use electronic health records and the data these systems collect. We detail how training in meaningful use of electronic health records could be incorporated into physician training, from medical school, through licensure and board certification, to continuing medical education and the maintenance of licensure and board certification. We identify six near-term opportunities for professional organizations to accelerate the integration of health information technology into their requirements.

  7. Auto-exame das mamas entre estudantes de medicina Breast self-examination among medical students

    Directory of Open Access Journals (Sweden)

    Ruffo de Freitas Júnior

    1999-06-01

    Full Text Available Objetivo: avaliar o nível de conhecimento e prática do auto-exame da mama entre os estudantes do curso médico e determinar possíveis fatores associados a esta prática. Métodos: foi utilizado um questionário que continha informações sobre os alunos e o seu conhecimento a respeito do auto-exame, permitindo ainda, verificar entre as alunas a prática do mesmo. Utilizaram-se os testes do qui quadrado e "t" de Student, quando aplicáveis, para verificar a associação de alguns fatores com o auto-exame. Resultados: dos 348 questionários respondidos, 55 (16% pertenciam aos alunos do 5º ano (estudantes que haviam cursado a Disciplina de Ginecologia da Universidade Federal de Goiás, 43% eram mulheres, 62% tinham familiares médicos e 17% apresentavam história familiar de câncer de mama. Em relação ao conhecimento do auto-exame, 95% conheciam o método. Das 149 estudantes, apenas 64% o praticavam. Os motivos para não fazê-lo eram: por ser muito jovem (24%, por não acreditar que pudesse acontecer com ela (4%, por medo (9% e por preguiça (19%, sendo que 44% das alunas não souberam explicar o motivo. Tanto o conhecimento quanto a prática do auto-exame não estiveram associados ao ano do curso médico, história familiar de câncer de mama ou à presença de familiar médico. Conclusão: o auto-exame é conhecido por praticamente todos os estudantes de medicina mesmo assim, um terço das estudantes não o praticam. Com isso ressalta-se a importância do auto-exame no curso médico, a fim de que os alunos possam levar mais informações à população, não limitando esta tarefa aos meios de comunicação.Purpose: to evaluate the knowledge and practice of breast self-examination among medical students and to determine possible factors associated with this practice. Method: the authors used a questionnaire to gather information about the students and their knowledge of this self-examination. This questionnaire also allowed the authors to

  8. Emergency Department Crowding and Loss of Medical Licensure: A New Risk of Patient Care in Hallways

    Directory of Open Access Journals (Sweden)

    Robert W. Derlet

    2014-03-01

    Full Text Available We report the case of a 32-year-old male recently diagnosed with type 2 diabetes treated at an urban university emergency department (ED crowded to 250% over capacity. His initial symptoms of shortness of breath and feeling ill for several days were evaluated with chest radiograph, electrocardiogram (EKG, and laboratory studies, which suggested mild diabetic ketoacidosis. His medical care in the ED was conducted in a crowded hallway. After correction of his metabolic abnormalities he felt improved and was discharged with arrangements made for outpatient follow-up. Two days later he returned in cardiac arrest, and resuscitation efforts failed. The autopsy was significant for multiple acute and chronic pulmonary emboli but no coronary artery disease. The hospital settled the case for $1 million and allocated major responsibility to the treating emergency physician (EP. As a result the state medical board named the EP in a disciplinary action, claiming negligence because the EKG had not been personally interpreted by that physician. A formal hearing was conducted with the EP’s medical license placed in jeopardy. This case illustrates the risk to EPs who treat patients in crowded hallways, where it is difficult to provide the highest level of care. This case also demonstrates the failure of hospital administration to accept responsibility and provide resources to the ED to ensure patient safety. [West J Emerg Med. 2014;15(2:137–141.

  9. United States Medical Licensing Examination and American Board of Pediatrics Certification Examination Results: Does the Residency Program Contribute to Trainee Achievement.

    Science.gov (United States)

    Welch, Thomas R; Olson, Brad G; Nelsen, Elizabeth; Beck Dallaghan, Gary L; Kennedy, Gloria A; Botash, Ann

    2017-09-01

    To determine whether training site or prior examinee performance on the US Medical Licensing Examination (USMLE) step 1 and step 2 might predict pass rates on the American Board of Pediatrics (ABP) certifying examination. Data from graduates of pediatric residency programs completing the ABP certifying examination between 2009 and 2013 were obtained. For each, results of the initial ABP certifying examination were obtained, as well as results on National Board of Medical Examiners (NBME) step 1 and step 2 examinations. Hierarchical linear modeling was used to nest first-time ABP results within training programs to isolate program contribution to ABP results while controlling for USMLE step 1 and step 2 scores. Stepwise linear regression was then used to determine which of these examinations was a better predictor of ABP results. A total of 1110 graduates of 15 programs had complete testing results and were subject to analysis. Mean ABP scores for these programs ranged from 186.13 to 214.32. The hierarchical linear model suggested that the interaction of step 1 and 2 scores predicted ABP performance (F[1,1007.70] = 6.44, P = .011). By conducting a multilevel model by training program, both USMLE step examinations predicted first-time ABP results (b = .002, t = 2.54, P = .011). Linear regression analyses indicated that step 2 results were a better predictor of ABP performance than step 1 or a combination of the two USMLE scores. Performance on the USMLE examinations, especially step 2, predicts performance on the ABP certifying examination. The contribution of training site to ABP performance was statistically significant, though contributed modestly to the effect compared with prior USMLE scores. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. Risk assessment of medical exposure in X-ray examinations of children

    Directory of Open Access Journals (Sweden)

    I. G. Shatsky

    2017-01-01

    Full Text Available The use of the effective dose (the concept of which was developed for radiation protection of workers and public and the nominal risk coefficients, averaged by sex and age, to assess the radiation risks of medical exposure has some significant limitations. Age and sex distribution of the staff and the entire population may be quite different from the sex and age distribution of patients undergoing medical exposure. Moreover, the structure of the age and sex of patients may be different for various medical examinations. There are simplified methods for evaluating individual risk for patients undergoing medical exposure. The methods are based on the effective dose evaluation and those take in to account age and gender. A more accurate assessment of lifetime risk of delayed stochastic effects for health of the patient is achieved by using the organ doses and the age and gender risk factors. The aim of this work was evaluation of the lifetime risk of long-term stochastic health effects for different gender and age groups of children undergoing various radiographic investigations by using organ doses and the age and gender risk factors, and subsequent classification in accordance with generally accepted international risk scale. Data from surveys of33 X-ray units in 29 specialized pediatric health care organizations in Russia were used in the work. Organ doses and patient’s effective doses were calculated on the basis of the defined for each x-ray machine typical modes for the 12 radiographic procedures (X-ray exam of the skull, chest, cervical spine, thoracic spine, lumbar spine–all in two projections – of the abdomen and pelvis – both in one projectionusing a computer program PCXMC., Radiation risks for selected studies were estimated using the obtained organ doses and the age and gender risk factors calculated for the Russian population. The radiation risks were classified according to the international scale of the risks. It was found

  11. A Survey of Digital Rectal Examination Training in Canadian Medical Schools

    Directory of Open Access Journals (Sweden)

    Alysha Nensi

    2012-01-01

    Full Text Available BACKGROUND: The digital rectal examination (DRE is important for the diagnosis of a variety of gastrointestinal, urological and gynecological disorders. However, it appears that Canadian medical students may not be adequately taught nor provided the opportunity to practice their skills often enough. The present study was an analysis of the current practices in DRE teaching and evaluation in undergraduate medicine programs across Canada.

  12. Use of the National Board of Medical Examiners® Comprehensive Basic Science Exam: survey results of US medical schools

    Directory of Open Access Journals (Sweden)

    Wright WS

    2017-06-01

    Full Text Available William S Wright,1 Kirk Baston2 1Department of Biomedical Sciences, 2Department of Pathology, University of South Carolina School of Medicine Greenville, Greenville, SC, USA Purpose: The National Board of Medical Examiners® (NBME Comprehensive Basic Science Exam (CBSE is a subject exam offered to US medical schools, where it has been used for external validation of student preparedness for the United States Medical Licensing Examination® (USMLE Step 1 in new schools and schools undergoing curricular reform. Information regarding the actual use of the NBME CBSE is limited. Therefore, the aim of the survey was to determine the scope and utilization of the NBME CBSE by US medical schools.Methods: A survey was sent in May 2016 to curriculum leadership of the 139 US medical schools listed on the Liaison Committee on Medical Education (LCME® website with provisional or full accreditation as of February 29, 2016. Responses were received from 53 schools (38% response rate. A series of different follow-up questions were asked if respondents stated “yes” or “no” to the initial question “Does your institution administer the NBME CBSE prior to the USMLE Step 1?”.Results: A total of 37 schools (70% administered the NBME CBSE. In all, 36 of the 37 schools responded to follow-up questions. Of 36 schools, 13 schools (36% used the NBME CBSE for curriculum modification. Six schools (17% used the NBME CBSE for formative assessment for a course, and five schools (14% used the NBME CBSE for summative assessment for a course. A total of 28 schools (78% used the NBME CBSE for identifying students performing below expectations and providing targeted intervention strategies. In all, 24 schools (67% of the 36 responding schools administering the NBME CBSE administered the test once prior to the administration of the USMLE Step 1, whereas 10 (28% schools administered the NBME CBSE two or more times prior to the administration of the USMLE Step 1.Conclusion

  13. Logistic regression analysis to predict Medical Licensing Examination of Thailand (MLET) Step1 success or failure.

    Science.gov (United States)

    Wanvarie, Samkaew; Sathapatayavongs, Boonmee

    2007-09-01

    The aim of this paper was to assess factors that predict students' performance in the Medical Licensing Examination of Thailand (MLET) Step1 examination. The hypothesis was that demographic factors and academic records would predict the students' performance in the Step1 Licensing Examination. A logistic regression analysis of demographic factors (age, sex and residence) and academic records [high school grade point average (GPA), National University Entrance Examination Score and GPAs of the pre-clinical years] with the MLET Step1 outcome was accomplished using the data of 117 third-year Ramathibodi medical students. Twenty-three (19.7%) students failed the MLET Step1 examination. Stepwise logistic regression analysis showed that the significant predictors of MLET Step1 success/failure were residence background and GPAs of the second and third preclinical years. For students whose sophomore and third-year GPAs increased by an average of 1 point, the odds of passing the MLET Step1 examination increased by a factor of 16.3 and 12.8 respectively. The minimum GPAs for students from urban and rural backgrounds to pass the examination were estimated from the equation (2.35 vs 2.65 from 4.00 scale). Students from rural backgrounds and/or low-grade point averages in their second and third preclinical years of medical school are at risk of failing the MLET Step1 examination. They should be given intensive tutorials during the second and third pre-clinical years.

  14. Clinical Examination Component of Telemedicine, Telehealth, mHealth, and Connected Health Medical Practices.

    Science.gov (United States)

    Weinstein, Ronald S; Krupinski, Elizabeth A; Doarn, Charles R

    2018-05-01

    Telemedicine and telehealth are the practices of medicine at a distance. Performing the equivalent of a complete clinical examination by telemedicine would be unusual. However, components of a more traditional clinical examination are part of the telemedicine workup for specific conditions. Telemedicine clinical examinations are facilitated, and enhanced, through the integration of a class of medical devices referred to as telemedicine peripherals (eg, electronic stethoscopes, tele-ophthalmoscopes, video-otoscopes, and so forth). Direct-to-consumer telehealth is a rapidly expanding segment of the health care service industry. Copyright © 2018 Elsevier Inc. All rights reserved.

  15. Scoring and setting pass/fail standards for an essay certification examination in nurse-midwifery.

    Science.gov (United States)

    Fullerton, J T; Greener, D L; Gross, L J

    1992-03-01

    Examination for certification or licensure of health professionals (credentialing) in the United States is almost exclusively of the multiple choice format. The certification examination for entry into the practice of the profession of nurse-midwifery has, however, used a modified essay format throughout its twenty-year history. The examination has recently undergone a revision in the method for score interpretation and for pass/fail decision-making. The revised method, described in this paper, has important implications for all health professional credentialing agencies which use modified essay, oral or practical methods of competency assessment. This paper describes criterion-referenced scoring, the process of constructing the essay items, the methods for assuring validity and reliability for the examination, and the manner of standard setting. In addition, two alternative methods for increasing the validity of the pass/fail decision are evaluated, and the rationale for decision-making about marginal candidates is described.

  16. Examining the medical blogosphere: an online survey of medical bloggers.

    Science.gov (United States)

    Kovic, Ivor; Lulic, Ileana; Brumini, Gordana

    2008-09-23

    Blogs are the major contributors to the large increase of new websites created each year. Most blogs allow readers to leave comments and, in this way, generate both conversation and encourage collaboration. Despite their popularity, however, little is known about blogs or their creators. To contribute to a better understanding of the medical blogosphere by investigating the characteristics of medical bloggers and their blogs, including bloggers' Internet and blogging habits, their motivations for blogging, and whether or not they follow practices associated with journalism. We approached 197 medical bloggers of English-language medical blogs which provided direct contact information, with posts published within the past month. The survey included 37 items designed to evaluate data about Internet and blogging habits, blog characteristics, blogging motivations, and, finally, the demographic data of bloggers. Pearson's Chi-Square test was used to assess the significance of an association between 2 categorical variables. Spearman's rank correlation coefficient was utilized to reveal the relationship between participants' ages, as well as the number of maintained blogs, and their motivation for blogging. The Mann-Whitney U test was employed to reveal relationships between practices associated with journalism and participants' characteristics like gender and pseudonym use. A total of 80 (42%) of 197 eligible participants responded. The majority of responding bloggers were white (75%), highly educated (71% with a Masters degree or doctorate), male (59%), residents of the United States (72%), between the ages of 30 and 49 (58%), and working in the healthcare industry (67%). Most of them were experienced bloggers, with 23% (18/80) blogging for 4 or more years, 38% (30/80) for 2 or 3 years, 32% (26/80) for about a year, and only 7% (6/80) for 6 months or less. Those who received attention from the news media numbered 66% (53/80). When it comes to best practices associated

  17. Correlation of United States Medical Licensing Examination and Internal Medicine In-Training Examination performance.

    Science.gov (United States)

    Perez, Jose A; Greer, Sharon

    2009-12-01

    The Internal Medicine In-Training Examination (ITE) is administered during residency training in the United States as a self-assessment and program assessment tool. Performance on this exam correlates with outcome on the American Board of Internal Medicine Certifying examination. Internal Medicine Program Directors use the United States Medical Licensing Examination (USMLE) to make decisions in recruitment of potential applicants. This study was done to determine a correlation of USMLE Steps 1, 2 and 3 results with ITE scores in each level of Internal Medicine training. A retrospective review of all residents graduating from an Internal Medicine program from 1999 to 2006 was done. Subjects included had data for all USMLE Steps and ITE during all years of training. Thirty-one subjects were included in the study. Correlations of USMLE Steps 1, 2 and 3 were done with ITE scores (percent correct) in each year of training. Pearson's correlation coefficient (r) was determined for each pairing and a t test to determine statistical significance of the correlation was done. Statistical significance was defined as P value ITE percent correct in PGY I, II and III were 0.46, 0.55 and 0.51 respectively. Corresponding r values for USMLE Step 2 and ITE percent correct were 0.79, 0.70 and 0.72; for USMLE Step 3 these values were 0.51, 0.37 and 0.51 respectively for each training year. USMLE scores are correlated with ITE scores. This correlation was strongest for USMLE Step 2.

  18. Family-centered rounds and medical student performance on the NBME pediatrics subject (shelf) examination: a retrospective cohort study.

    Science.gov (United States)

    Kimbrough, Tiffany N; Heh, Victor; Wijesooriya, N Romesh; Ryan, Michael S

    2016-01-01

    To determine the association between family-centered rounds (FCR) and medical student knowledge acquisition as assessed by the National Board of Medical Examiners (NBME) pediatric subject (shelf) exam. A retrospective cohort study was conducted of third-year medical students who graduated from Virginia Commonwealth University School of Medicine between 2009 and 2014. This timeframe represented the transition from 'traditional' rounds to FCR on the pediatric inpatient unit. Data collected included demographics, United States Medical Licensing Examination (USMLE) Step 1 and 2 scores, and NBME subject examinations in pediatrics (PSE), medicine (MSE), and surgery (SSE). Eight hundred and sixteen participants were included in the analysis. Student performance on the PSE could not be statistically differentiated from performance on the MSE for any year except 2011 (z-score=-0.17, p=0.02). Average scores on PSE for years 2009, 2010, 2013, and 2014 were significantly higher than for SSE, but not significantly different for all other years. The PSE was highly correlated with USMLE Step 1 and Step 2 examinations (correlation range 0.56-0.77) for all years. Our results showed no difference in PSE performance during a time in which our institution transitioned to FCR. These findings should be reassuring for students, attending physicians, and medical educators.

  19. Context, evidence and attitude: the case for photography in medical examinations of asylum seekers in the Netherlands.

    Science.gov (United States)

    Park, Rebekah; Oomen, Janus

    2010-07-01

    Can photographs of scars serve as evidence of torture? Amnesty International's Medical Examination Group in the Netherlands (AI-MEG) has, for more than a decade, been photographing torture scars to supplement the testimonies of asylum seekers who have been denied refuge. AI-MEG only intervenes at this point, when asylum seekers face extradition. Proving allegations of torture is of vital importance, as asylum seekers face rising anti-immigrant sentiment in European countries. All victims examined by AI-MEG present a combination of mental, physical and emotional scars. We summarize five cases where AI-MEG used photography in their medical examinations, and consider the ethical role physicians play in helping asylum seekers obtain refuge. Though photographs cannot capture all forms of trauma, as visual documents, they are a compelling form of concrete evidence of torture. In this way, photographs complement verbal testimonies and help doctors and immigration authorities to see and understand physical scars left by various forms of torture. AI-MEG explains in medical terms the connections between the visible late sequelae of torture and victims' testimonies. They then assess whether or not the physical scars are consistent with the forms of torture recounted by victims, using the terminology of the Istanbul Protocol (1999), the United Nations-adopted manual of guidelines that explains how to document torture. This paper outlines the medical examination process and argues for the use of photography as medical evidence on behalf of asylum seekers. Copyright 2010 Elsevier Ltd. All rights reserved.

  20. Do medical French students know how to properly score a mini mental state examination?

    Science.gov (United States)

    Hernandorena, Intza; Chauvelier, Sophie; Vidal, Jean-Sébastien; Piccoli, Matthieu; Coulon, Joséphine; Hugonot-Diener, Laurence; Rigaud, Anne-Sophie; Hanon, Olivier; Duron, Emmanuelle

    2017-06-01

    The mini mental state examination (MMSE) is a validated tool to assess global cognitive function. Training is required before scoring. Inaccurate scoring can lead to inappropriate medical decisions. In France, MMSE is usually scored by medical students. To assess if medical French students know how to properly score a mini mental state examination. Two « physician-patient » role playings performed by 2 specialized physicians, were performed in front of University Paris V medical students. Role playing A: Scoring of a MMSE according to a script containing five tricks; Role playing B: Find the 5 errors committed in a pre-filled MMSE form, according to the second script. One hundred and five students (64.4% of women, 49.5% in fifth medical school year) anonymously participated. Eighty percent of students had already scored a MMSE and 40% had been previously trained to MMSE scoring. Forty five percent of students previously scored an MMSE, without previously being trained. In test A, 16% of students did not commit any errors, 45.7% one error and 38.1% two errors. In test B, the proportion of students who provided 0, 1, 2, 3, 4 and 5 good answers was 3.3%, 29.7%, 29.7%, 25.3%, 7.7% and 4.4% respectively. No association between medical school year, previous training to MMSE scoring and performances at both tests were found. French students do not properly score MMSE. MMSE scoring is not enough or accurately taught (by specialists). The university will provide on line the tests and a short filmed teaching course performed by neuropsychological specialists.

  1. Effects of changes in the pre-licensure education of health workers on health-worker supply.

    Science.gov (United States)

    Pariyo, George W; Kiwanuka, Suzanne N; Rutebemberwa, Elizeus; Okui, Olico; Ssengooba, Freddie

    2009-04-15

    The current and projected crisis because of a shortage of health workers in low and middle-income countries (LMICs) requires that effective strategies for expanding the numbers of health workers are quickly identified in order to inform action by policymakers, educators, and health managers. To assess the effect of changes in the pre-licensure education of health professionals on health-worker supply. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2007, Issue 3), EMBASE, Ovid (1980 to week 3, October 2007), MEDLINE, Ovid (1950 to week 3, October 2007), CINAHL (October 2007), LILACS (week 4, November 2007), ERIC (1966 to week 3, February 2008), and Sociological Abstracts (October 2007). We searched WHO (WHOLIS) (February 2008), World Bank, Google Scholar, and human resources on health-related websites to obtain grey literature. Key experts in human resources for health were contacted to identify unpublished studies. The reference lists of included studies were searched for additional articles. Randomised controlled trials, non-randomised controlled trials, controlled before and after studies, and interrupted time-series studies that measured increased numbers of health workers ultimately available for recruitment into the health workforce or improved patient to health professional ratios as their primary outcomes were considered. Although the focus of the review was on LMIC, we included studies regardless of where they were done. Heterogeneity between the two included studies precluded meta-analysis; therefore, data were presented separately for each study. Two studies of the 7880 identified from searching the electronic databases met the inclusion criteria. Both studies were controlled before and after studies, of moderate to high risk of bias, that explored the effects of interventions to improve retention of minority groups in health professional training institutions. These studies reported that an intervention

  2. Examining Health Information Technology Implementations: Case of the Patient-Centered Medical Home

    Science.gov (United States)

    Behkami, Nima A.

    2012-01-01

    It has been shown that the use of Health Information Technology (HIT) is associated with reduced cost and increased quality of care. This dissertation examined the use of registries in Patient Centered Medical Home (PCMH) practices. A survey questionnaire was sent to a nationwide group of clinics certified for being a PCMH. They were asked to…

  3. Live-attenuated tetravalent dengue vaccines: The needs and challenges of post-licensure evaluation of vaccine safety and effectiveness.

    Science.gov (United States)

    Wichmann, Ole; Vannice, Kirsten; Asturias, Edwin J; de Albuquerque Luna, Expedito José; Longini, Ira; Lopez, Anna Lena; Smith, Peter G; Tissera, Hasitha; Yoon, In-Kyu; Hombach, Joachim

    2017-10-09

    Since December 2015, the first dengue vaccine has been licensed in several Asian and Latin American countries for protection against disease from all four dengue virus serotypes. While the vaccine demonstrated an overall good safety and efficacy profile in clinical trials, some key research questions remain which make risk-benefit-assessment for some populations difficult. As for any new vaccine, several questions, such as very rare adverse events following immunization, duration of vaccine-induced protection and effectiveness when used in public health programs, will be addressed by post-licensure studies and by data from national surveillance systems after the vaccine has been introduced. However, the complexity of dengue epidemiology, pathogenesis and population immunity, as well as some characteristics of the currently licensed vaccine, and potentially also future, live-attenuated dengue vaccines, poses a challenge for evaluation through existing monitoring systems, especially in low and middle-income countries. Most notable are the different efficacies of the currently licensed vaccine by dengue serostatus at time of first vaccination and by dengue virus serotype, as well as the increased risk of dengue hospitalization among young vaccinated children observed three years after the start of vaccination in one of the trials. Currently, it is unknown if the last phenomenon is restricted to younger ages or could affect also seronegative individuals aged 9years and older, who are included in the group for whom the vaccine has been licensed. In this paper, we summarize scientific and methodological considerations for public health surveillance and targeted post-licensure studies to address some key research questions related to live-attenuated dengue vaccines. Countries intending to introduce a dengue vaccine should assess their capacities to monitor and evaluate the vaccine's effectiveness and safety and, where appropriate and possible, enhance their surveillance

  4. 78 FR 50136 - Notice of Information Collection Under Emergency Review: Medical History and Examination for...

    Science.gov (United States)

    2013-08-16

    ...: Medical History and Examination for Foreign Service DS-1843 and DS-1622 ACTION: Notice of request for... methods: Web: Persons with access to the Internet may use the Federal Docket Management System (FDMS) to... History and Examination for Foreign Service. OMB Control Number: 1405-0068. Type of Request: Emergency...

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

    Science.gov (United States)

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

    2014-01-01

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

  6. Medical students' attitudes towards peer physical examination: findings from an international cross-sectional and longitudinal study.

    Science.gov (United States)

    Rees, Charlotte E; Wearn, Andy M; Vnuk, Anna K; Sato, Toshio J

    2009-03-01

    Although studies have begun to shed light on medical students' attitudes towards peer physical examination (PPE), they have been conducted at single sites, and have generally not examined changes in medical students' attitudes over time. Employing both cross-sectional and longitudinal designs, the current study examines medical students' attitudes towards PPE at schools from different geographical and cultural regions and assess changes in their attitudes over their first year of medical study. Students at six schools (Peninsula, UK; Durham, UK; Auckland, New Zealand; Flinders, Australia; Sapporo, Japan and Li Ka Shing, Hong Kong) completed the Examining Fellow Students (EFS) questionnaire near the start of their academic year (T1), and students at four schools (Peninsula, Durham, Auckland and Flinders) completed the EFS for a second time, around the end of their academic year (T2). Univariate and multivariate analyses revealed a high level of acceptance for PPE of non-intimate body regions amongst medical students from all schools (greater than 83%, hips, at T1 and 94.5%, hips and upper body, at T2). At T1 and T2, students' willingness to engage in PPE was associated with their gender, ethnicity, religiosity and school. Typically, students least comfortable with PPE at T1 and T2 were female, non-white, religious and studying at Auckland. Although students' attitudes towards PPE were reasonably stable over their first year of study, and after exposure to PPE, we did find some statistically significant differences in attitudes between T1 and T2. Interestingly, attitude changes were consistently predicted by gender, even when controlling for school. While male students' attitudes towards PPE were relatively stable over time, females' attitudes were changeable. In this paper, we discuss our findings in light of existing research and theory, and discuss their implications for educational practice and further research.

  7. The medically examined applicant for private insurance and his/her right to informed consent: a comparative analysis.

    Science.gov (United States)

    Defloor, Sarah

    2011-05-01

    Within the context of health and insurance law, an important question that arises is "to what extent is an applicant for private insurance truly capable of giving his/her 'free' and informed consent for a medical examination?". It should be borne in mind that it is the private insurer who requires a medical examination in order to gather medical information, and, moreover, that the insurer will not be inclined to conclude or carry out an insurance contract without this medical information. A distinction has to be made between not being free by legal coercion and not being (completely) free by factual circumstances. Exercising the right to informed consent involves exactly weighing up the consequences of the decision. Hence the applicant must be put in a position of being able to weigh up the consequences and take them into consideration.

  8. Report on the results of the fifth medical examination of atomic bomb survivors resident in the South America

    International Nuclear Information System (INIS)

    Hasegawa, Kenji; Hirata, Katsumi; Chiyoda, Shin; Moteki, Noriyuki; Ishino, Makoto; Hirai, Motohisa; Fukumoto, Masayuki.

    1993-01-01

    From October 20 to Novermber 6, 1992, medical examination was made in A-bomb survivors living in Brazil, Argentina, Bolivia, Peru and Paraguay. A total of 198 A-bomb survivors were identified in these 5 countries. Among them, 106 (53.5%) participated in the present medical examination, consisting of 49 men and 57 women. Seventy-two and 34 persons came from Hiroshima and Nagasaki, respectively. A mean age was 63.5±8.5 years for men and 63.8±7.3 years for women. The acquisition rate of A-bomb survivors' handbook was 51.9%. Medical questionnaires revealed surgical treatment for cancer in 4 persons. Subjective symptoms included fatigue, heat exhaustion, decreased body strength, and sensation of numbness. Laboratory findings revealed hypertension in 36 persons (38.3%), the necessity of ECG in 7 (6.5%), abnormal GOT in 5 (5.3%) and abnormal GPT in 2 (2.1%), hypercholesteremia in 20 (21.3%), hyperuricemia in 14 (14.9%), and high levels of fasting glucose in 10 (10.6%). The present medical examination revealed that 38 persons (35.8%) were required to take detailed examination and that common diseases were hypertension, hyperlipemia, hyperuricemia and cardiovascular diseases. (N.K.)

  9. [From the licensure of vaccines to the recommendation of the Standing Committee on Vaccination in Germany : criteria for the assessment of benefits and risks].

    Science.gov (United States)

    Pfleiderer, Michael; Wichmann, Ole

    2015-03-01

    Vaccines are among the most effective preventive measures in modern medicine and have led to a dramatic decline and-for a few diseases-even to the elimination of severely infectious diseases. There are some particularities of the risk-benefit assessment of vaccines compared with that of therapeutic drugs. These include the fact that vaccines are applied to healthy individuals with the aim of preventing an infectious disease, while therapeutic drugs are administered to sick people to cure them of an already acquired disease. The acceptable level of risk associated with the application of a vaccine is therefore much lower. In addition, high vaccination coverage can lead to population-level effects (e.g., the indirect protection of unvaccinated individuals) that can confer additional benefits to the population overall. When a marketing authorization application (MAA) for a novel vaccine is evaluated, conclusions are made regarding its quality, safety, and efficacy, and a benefit-risk assessment is carried out accordingly. In contrast, when deciding on the introduction of a new vaccine into a national immunization program or on a recommendation for a specific risk-group, the focus is shifted to considerations of how a licensed vaccine can be best used in a population (e.g., which immunization strategy is most effective in preventing deaths or hospitalizations, or in reducing treatment costs for the health care system). Stringent assessment criteria have been developed that require a robust safety analysis before a new vaccine is administered to humans for the first time in pre-licensure studies. Similarly, criteria are applied for calculating the benefit-risk ratio at the time of the licensure of a new vaccine in addition to during the entire post-licensure period. However, when deciding if and how a licensed vaccine can best be integrated into an existing immunization program, additional criteria are applied that are different, yet complementary to those applied for

  10. Using death certificates and medical examiner records for adolescent occupational fatality surveillance and research: a case study.

    Science.gov (United States)

    Rauscher, Kimberly J; Runyan, Carol W; Radisch, Deborah

    2012-01-01

    Death certificates and medical examiner records have been useful yet imperfect data sources for work-related fatality research and surveillance among adult workers. It is unclear whether this holds for work-related fatalities among adolescent workers who suffer unique detection challenges in part because they are not often thought of as workers. This study investigated the utility of using these data sources for surveillance and research pertaining to adolescent work-related fatalities. Using the state of North Carolina as a case study, we analyzed data from the death certificates and medical examiner records of all work-related fatalities data among 11- to 17-year-olds between 1990-2008 (N = 31). We compared data sources on case identification, of completeness, and consistency information. Variables examined included those on the injury (e.g., means), occurrence (e.g., place), demographics, and employment (e.g., occupation). Medical examiner records (90%) were more likely than death certificates (71%) to identify adolescent work-related fatalities. Data completeness was generally high yet varied between sources. The most marked difference being that in medical examiner records, type of business/industry and occupation were complete in 72 and 67% of cases, respectively, while on the death certificates these fields were complete in 90 and 97% of cases, respectively. Taking the two sources together, each field was complete in upward of 94% of cases. Although completeness was high, data were not always of good quality and sometimes conflicted across sources. In many cases, the decedent's occupation was misclassified as "student" and their employer as "school" on the death certificate. Even though each source has its weaknesses, medical examiner records and death certificates, especially when used together, can be useful for conducting surveillance and research on adolescent work-related fatalities. However, extra care is needed by data recorders to ensure that

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

    Science.gov (United States)

    Lutz, Tasha

    2015-01-01

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

  12. 20 CFR 416.919n - Informing the medical source of examination scheduling, report content, and signature requirements.

    Science.gov (United States)

    2010-04-01

    ... scheduling, report content, and signature requirements. 416.919n Section 416.919n Employees' Benefits SOCIAL... medical source of examination scheduling, report content, and signature requirements. The medical sources... report containing all of the elements in paragraph (c). (e) Signature requirements. All consultative...

  13. 20 CFR 404.1519n - Informing the medical source of examination scheduling, report content, and signature requirements.

    Science.gov (United States)

    2010-04-01

    ... scheduling, report content, and signature requirements. 404.1519n Section 404.1519n Employees' Benefits... medical source of examination scheduling, report content, and signature requirements. The medical sources... report containing all of the elements in paragraph (c). (e) Signature requirements. All consultative...

  14. Objective structured practical examination in biochemistry: An experience in Medical College, Kolkata.

    Science.gov (United States)

    Kundu, Dipankar; Das, H N; Sen, Gargi; Osta, Manish; Mandal, T; Gautam, Divyendu

    2013-01-01

    Undergraduate medical examination is undergoing extensive re evaluation with new core educational objectives being defined. Consequently, new exam systems have also been designed to test the objectives. Objective structured practical examination (OSPE) is one of them. To introduce OSPE as a method of assessment of practical skills and learning and to determine student satisfaction regarding the OSPE. Furthermore, to explore the faculty perception of OSPE as a learning and assessment tool. The first M.B.B.S students of 2011 12 batch of Medical College, Kolkata, were the subjects for the study. OSPE was organized and conducted on "Identification of Unknown Abnormal Constituents in Urine." Coefficient of reliability of questions administered was done by calculating Cronbach's alpha. A questionnaire on various components of the OSPE was administered to get the feedback. 16 students failed to achieve an average of 50% or above in the assessment. However, 49 students on an average achieved >75%, 52 students achieved between 65% and 75%, and 29 students scored between 50% and 65%. Cronbach's alpha of the questions administered showed to be having high internal consistency with a score of 0.80. Ninety nine percent of students believed that OSPE helps them to improve and 81% felt that this type of assessment fits in as both learning and evaluation tools. Faculty feedback reflected that such assessment tested objectivity, measured practical skills better, and eliminated examiner bias to a greater extent. OSPE tests different desired components of competence better and eliminated examiner bias. Student feedback reflects that such assessment helps them to improve as it is effective both as teaching and evaluation tools.

  15. A randomised controlled trial of blended learning to improve the newborn examination skills of medical students.

    Science.gov (United States)

    Stewart, Alice; Inglis, Garry; Jardine, Luke; Koorts, Pieter; Davies, Mark William

    2013-03-01

    To evaluate the hypotheses that a blended learning approach would improve the newborn examination skills of medical students and yield a higher level of satisfaction with learning newborn examination. Undergraduate medical students at a tertiary teaching hospital were individually randomised to receive either a standard neonatology teaching programme (control group), or additional online access to the PENSKE Baby Check Learning Module (blended learning group). The primary outcome was performance of newborn examination on standardised assessment by blinded investigators. The secondary outcomes were performance of all 'essential' items of the examination, and participant satisfaction. The recruitment rate was 88% (71/81). The blended learning group achieved a significantly higher mean score than the control group (p=0.02) for newborn examination. There was no difference for performance of essential items, or satisfaction with learning newborn examination. The blended learning group rated the module highly for effective use of learning time and ability to meet specific learning needs. A blended learning approach resulted in a higher level of performance of newborn examination on standardised assessment. This is consistent with published literature on blended learning and has implications for all neonatal clinicians including junior doctors, midwifes and nurse practitioners.

  16. The Final Oral/Practical State Examination at Freiburg Medical Faculty in 2012--Analysis of grading to test quality assurance.

    Science.gov (United States)

    Schickler, Angela; Brüstle, Peter; Biller, Silke

    2015-01-01

    The aim of this study is to analyze the grades given for the oral/practical part of the German State Examination at the Medical Faculty of Freiburg. We examined whether or not the grades given for the written and the oral/practical examinations correlated and if differences in grading between the Freiburg University Medical Center (UMC) and the other teaching hospitals could be found. In order to improve the quality of the state examination, the medical school has been offering standardized training for examiners for several years. We evaluated whether or not trained and untrained examiners differed in their grading of the exam and how these differences have changed over time. The results of the 2012 spring and fall exams were analyzed (N=315). The relevant data set was made available to us by the Baden-Württemberg Examination Office (Landesprüfungsamt). The data were analyzed by means of descriptive and inferential statistics. We observed a correlation of ρ=0.460** between the grades for the written and the oral/practical exams. The UMC and the teaching hospitals did not differ significantly in their grade distributions. Compared to untrained examiners, trained ones assigned the grade of "very good" less often. Furthermore, they displayed a significantly higher variance in the grades given (p=0.007, phi=0.165). This effect is stronger when concentrating specifically on those examiners who took part in the training less than a year before. The results of this study suggest that the standardized training for examiners at the Medical Faculty of Freiburg is effective for quality assurance. As a consequence, more examiners should be motivated to take part in the training.

  17. The Path to Advanced Practice Licensure for Clinical Nurse Specialists in Washington State.

    Science.gov (United States)

    Schoonover, Heather

    The aim of this study was to provide a review of the history and process to obtaining advanced practice licensure for clinical nurse specialists in Washington State. Before 2016, Washington State licensed certified nurse practitioners, certified nurse midwives, and certified nurse anesthetists under the designation of an advanced registered nurse practitioner; however, the state did not recognize clinical nurse specialists as advanced practice nurses. The work to drive the rule change began in 2007. The Washington Affiliate of the National Association of Clinical Nurse Specialists used the Power Elite Theory to guide advocacy activities, building coalitions and support for the desired rule changes. On January 8, 2016, the Washington State Nursing Care Quality Assurance Commission voted to amend the state's advanced practice rules, including clinical nurse specialists in the designation of an advanced practice nurse. Since the rule revision, clinical nurse specialists in Washington State have been granted advanced registered nurse practitioner licenses. Driving changes in state regulatory rules requires diligent advocacy, partnership, and a deep understanding of the state's rule-making processes. To be successful in changing rules, clinical nurse specialists must build strong partnerships with key influencers and understand the steps in practice required to make the desired changes.

  18. Trends in Radiation Doses to Patients from Medical X-ray Examinations in Romania

    Energy Technology Data Exchange (ETDEWEB)

    Olga Iacob; Irina Anca Popescu [Institute of Public Health, Iassy (Romania); Mihai Radu Iacob [University ' Al. I. Cuza' Iassy (Romania)

    2006-07-01

    Even if the doses received by patients during 2005 survey are lower than those estimated in the 2000 national survey on diagnostic medical radiation exposure by 27 percent, on average, their values still indicate an urgent need to develop radiation protection and optimization activities for X ray examinations, especially in pediatrics radiology. The increasing attention given in last years to radiation protection for conventional examinations, with development of national patient dosimetry protocols and reference doses, new radiation protection legislation and norms have played a significant part in this substantial reduction in effective doses. (N.C.)

  19. Developing a Best-Evidence Pre-employment Medical Examination: An Example from the Construction Industry

    NARCIS (Netherlands)

    Gouttebarge, Vincent; van der Molen, Henk F.; Frings-Dresen, Monique H. W.; Sluiter, Judith K.

    2014-01-01

    The Dutch construction industry has introduced a compulsory preemployment medical examination (PE-ME). Best-evidence contents related to specific job demands are, however, lacking and need to be gathered. After the identification of job demands and health problems in the construction industry

  20. Stochastic risk estimation from medical x-ray diagnostic examinations, 2

    International Nuclear Information System (INIS)

    Hashizume, Tadashi; Maruyama, Takashi; Noda, Yutaka; Iwai, Kazuo; Tateno, Y.; Nishizawa, Kanae.

    1981-01-01

    The risks of genetic, leukemia and malignant diseases from medical X-ray diagnostic examinations were estimated using the frequency of radiographic and fluoroscopic exposures per diagnostic examination, child expectancy, leukemia and malignancy significant factors, and using a weighting factor determined on the basis of data concerning the cancer mortality among atomic bomb survivors in Nagasaki and of a recommendation of International Commission of Radiological Protection. The organ or tissue doses with respect to the stochastic risks were determined with ionization chambers and thermoluminescent dosimeters placed at the positions of the organs or tissues in a RANDO woman phantom which was exposed to diagnostic X-rays according to technical factors of typical radiographic and fluoroscopic examinations obtained from a nationwide survey. The resultant risks by age-group and type of radiographic and fluoroscopic examination are tabulated in terms of risk level of 10 -6 . In general, the total risk defined as the sum of genetic, leukemia and malignant risks was a high value for the X-ray diagnosis of digestive organs involving barium meal and barium enema. For example, the total risk for young age-group was 100 to 200 x 10 -6 for the X-ray diagnosis of digestive organs. The total risk from the chest radiography was lower value as compared with the risk from the X-ray diagnosis of other organs or tissues. On the contrary, the risk from the chest tomography was comparable to the risk from the diagnosis of digestive organs. The total risk decreased with increasing of age for every X-ray diagnostic examination. (author)

  1. Using item response theory to explore the psychometric properties of extended matching questions examination in undergraduate medical education

    Directory of Open Access Journals (Sweden)

    Lawton Gemma

    2005-03-01

    Full Text Available Abstract Background As assessment has been shown to direct learning, it is critical that the examinations developed to test clinical competence in medical undergraduates are valid and reliable. The use of extended matching questions (EMQ has been advocated to overcome some of the criticisms of using multiple-choice questions to test factual and applied knowledge. Methods We analysed the results from the Extended Matching Questions Examination taken by 4th year undergraduate medical students in the academic year 2001 to 2002. Rasch analysis was used to examine whether the set of questions used in the examination mapped on to a unidimensional scale, the degree of difficulty of questions within and between the various medical and surgical specialties and the pattern of responses within individual questions to assess the impact of the distractor options. Results Analysis of a subset of items and of the full examination demonstrated internal construct validity and the absence of bias on the majority of questions. Three main patterns of response selection were identified. Conclusion Modern psychometric methods based upon the work of Rasch provide a useful approach to the calibration and analysis of EMQ undergraduate medical assessments. The approach allows for a formal test of the unidimensionality of the questions and thus the validity of the summed score. Given the metric calibration which follows fit to the model, it also allows for the establishment of items banks to facilitate continuity and equity in exam standards.

  2. The American Board of Internal Medicine Maintenance of Certification Examination and State Medical Board Disciplinary Actions: a Population Cohort Study.

    Science.gov (United States)

    McDonald, Furman S; Duhigg, Lauren M; Arnold, Gerald K; Hafer, Ruth M; Lipner, Rebecca S

    2018-03-07

    Some have questioned whether successful performance in the American Board of Internal Medicine (ABIM) Maintenance of Certification (MOC) program is meaningful. The association of the ABIM Internal Medicine (IM) MOC examination with state medical board disciplinary actions is unknown. To assess risk of disciplinary actions among general internists who did and did not pass the MOC examination within 10 years of initial certification. Historical population cohort study. The population of internists certified in internal medicine, but not a subspecialty, from 1990 through 2003 (n = 47,971). ABIM IM MOC examination. General internal medicine in the USA. The primary outcome measure was time to disciplinary action assessed in association with whether the physician passed the ABIM IM MOC examination within 10 years of initial certification, adjusted for training, certification, demographic, and regulatory variables including state medical board Continuing Medical Education (CME) requirements. The risk for discipline among physicians who did not pass the IM MOC examination within the 10 year requirement window was more than double than that of those who did pass the examination (adjusted HR 2.09; 95% CI, 1.83 to 2.39). Disciplinary actions did not vary by state CME requirements (adjusted HR 1.02; 95% CI, 0.94 to 1.16), but declined with increasing MOC examination scores (Kendall's tau-b coefficient = - 0.98 for trend, p actions were less severe among those passing the IM MOC examination within the 10-year requirement window than among those who did not pass the examination. Passing a periodic assessment of medical knowledge is associated with decreased state medical board disciplinary actions, an important quality outcome of relevance to patients and the profession.

  3. Multimedia system for creation, transmission and consultation of medical examination records

    International Nuclear Information System (INIS)

    Le Rest, C.; Fortineau, J.; Bernier, M.; Guillo, P.; Cavarec, M.

    1997-01-01

    Achieving an urgency examination requires a rapid transmission of the results to the examiner. An efficient method of their communication could be achieved by producing a multimedia record consisting of images, comments and voiced utterances. We have retained for illustration the case of pulmonary scintigraphy in the diagnosis of pulmonary emboli. Following the acquisition the images are transferred to a PC (under Interfile format). These are displayed on the screen in association with anatomic schemes. In order to present all the elements important for interpretation, a series of tools was developed. Thus, to single out the anomalies the editor is provided with arrows to which verbal comments can be associated. Subsequently, he enters up its record. The interpreted examination is transferred to the examiner's PC via an ATM network. The consultant may then investigate the multimedia record by displaying images and comments and listening to the comments and conclusion of the isotope investigator. A prototype is already operational and its evaluation phase is to start. This stage refers to the quality of transmitted information. A quest among examiners will then allow to evaluate whether the examination reading out and the comprehension of the isotope investigators' conclusions are easier. The speed of transmission will be compared with the current routine (based on manuscript records) and its practical impact in case of urgency circumstances will be assessed. The technical facilities utilized by us allow an easy generalization of the approach to other image-based medical examinations performed in case of urgency

  4. Accuracy of Medical Students in Detecting Pleural Effusion Using Lung Ultrasound as an Adjunct to the Physical Examination.

    Science.gov (United States)

    Steinmetz, Peter; Oleskevich, Sharon; Dyachenko, Alina; McCusker, Jane; Lewis, John

    2018-03-25

    This study compared the accuracy of medical students in identifying pleural effusion in hospitalized patients using the physical examination versus lung ultrasound (US). Fourth-year medical students (n = 14) received 20 hours of general practical US training (including 2 hours of specialized lung US training) plus theoretical and video documentation. The students used the physical examination alone versus the physical examination plus lung US to document the presence or absence of pleural effusion in the right and left hemithoraces of hospitalized patients (n = 11 patients; 22 hemithoraces examined 544 times in total). The reference standard for identification of pleural effusion was a lung US examination by 2 expert point-of-care sonographers. The odds of correctly identifying the presence versus absence of pleural effusion was 5 times greater with lung US as an adjunct to the physical examination compared to the physical examination alone (odds ratio [OR], 5.1 from multivariate logistic regression; 95% confidence interval, 3.3-8.0). The addition of lung US to the physical examination resulted in an increase in sensitivity from 48% to 90%, in specificity from 73% to 86%, and in accuracy from 60% to 88%. The benefits of using US were greater when pleural effusion was present versus absent (OR, 10.8 versus 2.4) and when examining older versus younger patients (OR, 10.2 versus 2.8). These results demonstrate that medical students' ability to detect the presence or absence of pleural effusion is superior when using lung US as an adjunct to the physical examination than when using the physical examination alone. © 2018 by the American Institute of Ultrasound in Medicine.

  5. Radiation doses to patients in medical diagnostic x-ray examinations in New Zealand: a 1983-84 survey

    International Nuclear Information System (INIS)

    Williamson, B.D.P.; Poletti, J.L.; Cartwright, P.H.; Le Heron, J.C.

    1993-06-01

    A survey of doses to patients undergoing diagnostic x-ray examinations was performed in 1983-84. Developments since 1983-84 were reviewed and estimates made of the frequency of x-ray examinations, and doses to patients, as at 1992. The collective effective dose from general medical diagnostic radiology in 1983-84 was estimated to have been about 443 μSv per capita per annum. The figure excluded computed tomography which was estimated to have contributed about 5.6 μSv per capita per annum and mammography gave 0.3 μSv per annum. The total per capital effective dose from all medical diag over the whole period from 1983-84 to 1992. The highest dose examinations in 1983-84 were the fluoroscopic procedures barium enema and meal. Over the whole period 1983-84 to 1992 the genetically significant dose (GSD) to the population of New Zealand from medical diagnostic radiology was estimated to have been in the range 200-250 μSv per capita per annum. The two opposing tendencies noted for effective dose, viz, the fall in frequency of some examination types and the rise of Computed tomography, acted also upon this dose index. 43 refs., tabs., figs., ills

  6. What to do, for the nuclear medical examination to be accepted without anxiety?

    International Nuclear Information System (INIS)

    Watanabe, Hiroshi

    2013-01-01

    After Fukushima Nuclear Power Plant Accident in 2011, various standard limits of food and water radioactivity level are consequently noticed again for preventing the public internal exposure, which are defined at Bq levels. Against the public anxiety to the exposure, MBq levels are necessary for the nuclear medical examination, and explanation and consultation of patients about their needed examination have become more important: the question in the title rises afresh. Standing on the situation, this paper documents author's possible answers to the question by instances of social precedents, experience in his hospital and means for risk communication. To patients, should be informed such precedents as a security event in the airport of the pilot who had 201 Tl examination (Lancet, 2005), frequent malfunction of fire detector to patient's radioactivity in the public toilet, popularized radio-detectors present in a crowd, and radiological workers who had the examination without its realization. Communication with patients in author's hospital is conducted by oral interview and use of document and leaflet written by manufacturer of the radiopharmaceutical and/or by Japan Radioisotope Association with the Japanese Society of Nuclear Medicine Technology (JSNMT). The hospital has a consulting window for the radiological department, where about 5 patients (0.1% of the whole) visit monthly. As well, the certificates are posted at the gate for the facility to make effort to reduce medical dose issued by the Japan Association of Radiological Technologists, which conceivably helps to relieve the anxiety. JSNMT also plays a role in this field by issuing the guidelines and organizing the committee. Broad knowledge, good-nature and patience of risk communicator are required for explaining and consulting patients about their radiological examination. (T.T.)

  7. US Medical Student Performance on the NBME Subject Examination in Internal Medicine: Do Clerkship Sequence and Clerkship Length Matter?

    Science.gov (United States)

    Ouyang, Wenli; Cuddy, Monica M; Swanson, David B

    2015-09-01

    Prior to graduation, US medical students are required to complete clinical clerkship rotations, most commonly in the specialty areas of family medicine, internal medicine, obstetrics and gynecology (ob/gyn), pediatrics, psychiatry, and surgery. Within a school, the sequence in which students complete these clerkships varies. In addition, the length of these rotations varies, both within a school for different clerkships and between schools for the same clerkship. The present study investigated the effects of clerkship sequence and length on performance on the National Board of Medical Examiner's subject examination in internal medicine. The study sample included 16,091 students from 67 US Liaison Committee on Medical Education (LCME)-accredited medical schools who graduated in 2012 or 2013. Student-level measures included first-attempt internal medicine subject examination scores, first-attempt USMLE Step 1 scores, and five dichotomous variables capturing whether or not students completed rotations in family medicine, ob/gyn, pediatrics, psychiatry, and surgery prior to taking the internal medicine rotation. School-level measures included clerkship length and average Step 1 score. Multilevel models with students nested in schools were estimated with internal medicine subject examination scores as the dependent measure. Step 1 scores and the five dichotomous variables were treated as student-level predictors. Internal medicine clerkship length and average Step 1 score were used to predict school-to-school variation in average internal medicine subject examination scores. Completion of rotations in surgery, pediatrics and family medicine prior to taking the internal medicine examination significantly improved scores, with the largest benefit observed for surgery (coefficient = 1.58 points; p value internal medicine subject examination performance. At the school level, longer internal medicine clerkships were associated with higher scores on the internal medicine

  8. Does Ultrasound-Enhanced Instruction of Musculoskeletal Anatomy Improve Physical Examination Skills of First-Year Medical Students?

    Science.gov (United States)

    Walrod, Bryant J; Schroeder, Allison; Conroy, Mark J; Boucher, Laura C; Bockbrader, Marcia; Way, David P; McCamey, Kendra L; Hartz, Clinton A; Jonesco, Michael A; Bahner, David P

    2018-01-01

    Ultrasound imaging is commonly used to teach basic anatomy to medical students. The purpose of this study was to determine whether learning musculoskeletal anatomy with ultrasound improved performance on medical students' musculoskeletal physical examination skills. Twenty-seven first-year medical students were randomly assigned to 1 of 2 instructional groups: either shoulder or knee. Both groups received a lecture followed by hands-on ultrasound scanning on live human models of the assigned joint. After instruction, students were assessed on their ability to accurately palpate 4 anatomic landmarks: the acromioclavicular joint, the proximal long-head biceps tendon, and the medial and lateral joint lines of the knee. Performance scores were based on both accuracy and time. A total physical examination performance score was derived for each joint. Scores for instructional groups were compared by a 2-way analysis of variance with 1 repeated measure. Significant findings were further analyzed with post hoc tests. All students performed significantly better on the knee examination, irrespective of instructional group (F = 14.9; df = 1.25; P = .001). Moreover, the shoulder instruction group performed significantly better than the knee group on the overall assessment (t = -3.0; df = 25; P soft tissue landmark. Both groups performed similarly on palpation of all other anatomic structures. The use of ultrasound appears to provide an educational advantage when learning musculoskeletal physical examination of soft tissue landmarks. © 2017 by the American Institute of Ultrasound in Medicine.

  9. Use of Video-Projected Structured Clinical Examination (ViPSCE) instead of the traditional oral (Viva) examination in the assessment of final year medical students.

    Science.gov (United States)

    El Shallaly, Gamal; Ali, Eltayeb

    2004-03-01

    Assessment of medical students using the traditional oral (viva) system has been marred by being highly subjective, non-structured, and biased. The use of the objective structured clinical examination (OSCE) would circumvent these disadvantages. The OSCE is, however, costly and time-consuming particularly if used for assessment of large numbers of students. The need for another form of examination that enjoys the advantages of the OSCE while avoiding its disadvantages in the face of limited resources has been the inspiration behind this innovative approach. (1) To identify the characteristics of the new Video-Projected Structured Clinical Examination (ViPSCE). (2) To compare the acceptability of ViPSCE and OSCE by students and tutors. (3) To compare the time-effectiveness of ViPSCE and OSCE. We used a slide video projection to assess the surgical knowledge, problem solving and management abilities of 112 final year medical students at Alazhari University, Khartoum, Sudan. Students completed evaluation forms at the end of the examination. The administration of the ViPSCE was smooth and straightforward. Feedback of the students showed that they preferred the ViPSCE to both traditional oral (viva) examination and OSCE. The examination time was 2 hours using video projection compared to the 6 hours that it used to take a class of 112 students to complete a classical OSCE. The ViPSCE is a better replacement for the traditional oral exam. It is much less time- consuming than traditional OSCE.

  10. Ectromelia Virus Infections of Mice as a Model to Support the Licensure of Anti-Orthopoxvirus Therapeutics

    Directory of Open Access Journals (Sweden)

    R. Mark Buller

    2010-09-01

    Full Text Available The absence of herd immunity to orthopoxviruses and the concern that variola or monkeypox viruses could be used for bioterroristic activities has stimulated the development of therapeutics and safer prophylactics. One major limitation in this process is the lack of accessible human orthopoxvirus infections for clinical efficacy trials; however, drug licensure can be based on orthopoxvirus animal challenge models as described in the “Animal Efficacy Rule”. One such challenge model uses ectromelia virus, an orthopoxvirus, whose natural host is the mouse and is the etiological agent of mousepox. The genetic similarity of ectromelia virus to variola and monkeypox viruses, the common features of the resulting disease, and the convenience of the mouse as a laboratory animal underscores its utility in the study of orthopoxvirus pathogenesis and in the development of therapeutics and prophylactics. In this review we outline how mousepox has been used as a model for smallpox. We also discuss mousepox in the context of mouse strain, route of infection, infectious dose, disease progression, and recovery from infection.

  11. Correlation of the National Board of Medical Examiners Emergency Medicine Advanced Clinical Examination Given in July to Intern American Board of Emergency Medicine in-training Examination Scores: A Predictor of Performance?

    Science.gov (United States)

    Hiller, Katherine; Franzen, Doug; Heitz, Corey; Emery, Matthew; Poznanski, Stacy

    2015-11-01

    There is great variation in the knowledge base of Emergency Medicine (EM) interns in July. The first objective knowledge assessment during residency does not occur until eight months later, in February, when the American Board of EM (ABEM) administers the in-training examination (ITE). In 2013, the National Board of Medical Examiners (NBME) released the EM Advanced Clinical Examination (EM-ACE), an assessment intended for fourth-year medical students. Administration of the EM-ACE to interns at the start of residency may provide an earlier opportunity to assess the new EM residents' knowledge base. The primary objective of this study was to determine the correlation of the NBME EM-ACE, given early in residency, with the EM ITE. Secondary objectives included determination of the correlation of the United States Medical Licensing Examination (USMLE) Step 1 or 2 scores with early intern EM-ACE and ITE scores and the effect, if any, of clinical EM experience on examination correlation. This was a multi-institutional, observational study. Entering EM interns at six residencies took the EM-ACE in July 2013 and the ABEM ITE in February 2014. We collected scores for the EM-ACE and ITE, age, gender, weeks of clinical EM experience in residency prior to the ITE, and USMLE Step 1 and 2 scores. Pearson's correlation and linear regression were performed. Sixty-two interns took the EM-ACE and the ITE. The Pearson's correlation coefficient between the ITE and the EM-ACE was 0.62. R-squared was 0.5 (adjusted 0.4). The coefficient of determination was 0.41 (95% CI [0.3-0.8]). For every increase of one in the scaled EM-ACE score, we observed a 0.4% increase in the EM in-training score. In a linear regression model using all available variables (EM-ACE, gender, age, clinical exposure to EM, and USMLE Step 1 and Step 2 scores), only the EM-ACE score was significantly associated with the ITE (pcorrelation with ITE. Clinical EM experience prior to the in-training exam did not affect the

  12. The Final Oral/Practical State Examination at Freiburg Medical Faculty in 2012 – Analysis of grading to test quality assurance

    Directory of Open Access Journals (Sweden)

    Schickler, Angela

    2015-10-01

    Full Text Available Aim: The aim of this study is to analyze the grades given for the oral/practical part of the German State Examination at the Medical Faculty of Freiburg. We examined whether or not the grades given for the written and the oral/practical examinations correlated and if differences in grading between the Freiburg University Medical Center (UMC and the other teaching hospitals could be found.In order to improve the quality of the state examination, the medical school has been offering standardized training for examiners for several years. We evaluated whether or not trained and untrained examiners differed in their grading of the exam and how these differences have changed over time.Methods: The results of the 2012 spring and fall exams were analyzed (N=315. The relevant data set was made available to us by the Baden-Württemberg Examination Office (. The data were analyzed by means of descriptive and inferential statistics.Results: We observed a correlation of ρ=0.460** between the grades for the written and the oral/practical exams. The UMC and the teaching hospitals did not differ significantly in their grade distributions. Compared to untrained examiners, trained ones assigned the grade of “very good” less often. Furthermore, they displayed a significantly higher variance in the grades given (p=0.007, phi=0.165. This effect is stronger when concentrating specifically on those examiners who took part in the training less than a year before.Conclusion: The results of this study suggest that the standardized training for examiners at the Medical Faculty of Freiburg is effective for quality assurance. As a consequence, more examiners should be motivated to take part in the training.

  13. The Final Oral/Practical State Examination at Freiburg Medical Faculty in 2012 – Analysis of grading to test quality assurance

    Science.gov (United States)

    Schickler, Angela; Brüstle, Peter; Biller, Silke

    2015-01-01

    Aim: The aim of this study is to analyze the grades given for the oral/practical part of the German State Examination at the Medical Faculty of Freiburg. We examined whether or not the grades given for the written and the oral/practical examinations correlated and if differences in grading between the Freiburg University Medical Center (UMC) and the other teaching hospitals could be found. In order to improve the quality of the state examination, the medical school has been offering standardized training for examiners for several years. We evaluated whether or not trained and untrained examiners differed in their grading of the exam and how these differences have changed over time. Methods: The results of the 2012 spring and fall exams were analyzed (N=315). The relevant data set was made available to us by the Baden-Württemberg Examination Office (Landesprüfungsamt). The data were analyzed by means of descriptive and inferential statistics. Results: We observed a correlation of ρ=0.460** between the grades for the written and the oral/practical exams. The UMC and the teaching hospitals did not differ significantly in their grade distributions. Compared to untrained examiners, trained ones assigned the grade of “very good” less often. Furthermore, they displayed a significantly higher variance in the grades given (p=0.007, phi=0.165). This effect is stronger when concentrating specifically on those examiners who took part in the training less than a year before. Conclusion: The results of this study suggest that the standardized training for examiners at the Medical Faculty of Freiburg is effective for quality assurance. As a consequence, more examiners should be motivated to take part in the training. PMID:26483852

  14. Will medical examination gloves protect rescuers from defibrillation voltages during hands-on defibrillation?

    Science.gov (United States)

    Sullivan, Joseph L; Chapman, Fred W

    2012-12-01

    Continuing compressions during a defibrillation shock has been proposed as a method of reducing pauses in cardiopulmonary resuscitation (CPR) but the safety of this procedure is unproven. The medical examination gloves worn by rescuers play an important role in protecting the rescuer yet the electrical characteristics of these gloves are unknown. This study examined the response of medical examination gloves to defibrillation voltages. Part 1 of this study measured voltage-current curves for a small sample (8) of gloves. Part 2 tested more gloves (460) to determine the voltage required to produce a specific amount of current flow. Gloves were tested at two current levels: 0.1 mA and 10 mA. Testing included four glove materials (chloroprene, latex, nitrile, and vinyl) in a single layer and double-gloved. All gloves tested in part 1 allowed little current to flow (gloves and 93 of 120 (77%) double gloves allowed at least 0.1 mA of current flow at voltages within the external defibrillation voltage range. Also, 6 of 80 (7.5%) single gloves and 5 of 80 (6.2%) double gloves allowed over 10 mA. Few of the gloves tested limited the current to levels proven to be safe. A lack of sensation during hands-on defibrillation does not guarantee that a safety margin exists. As such, we encourage rescuers to minimize rather than eliminate the pause in compressions for defibrillation. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  15. Organization of prophylactic medical examination of personnel dealing with the sources of ionizing radiation

    International Nuclear Information System (INIS)

    Gus'kova, A.K.

    1980-01-01

    The paper concerns principal instructions for introducing a differential approach to the scope and time of examination depending on the formation dynamics and the integral dose of occupational irradiation. Particular attention is paid to prophylaxis and creation of distinct organizational bases of hygienic investigation and rendering medical aid in all cases of over-irradiation from external and internal sources. The variants of the effect and the forms of the disease are characterized. The patterns of recording the results of the primary clinical examination of the victims are presented

  16. Medical educators' perspectives of teaching physical examinations using ultrasonography at the undergraduate level

    Directory of Open Access Journals (Sweden)

    Irene Ma

    2013-03-01

    Full Text Available Background: Ultrasonography is increasingly used for teaching physical examination in medical schools. This study seeks the opinions of educators as to which physical examinations would be most enhanced by the addition of ultrasonography. We also asked when ultrasound-aided physical examination teaching could have deleterious effects if used outside its intended scope. Methods: All of the educators from the University of Calgary Master Teacher Program were invited to complete a 22-item paper-based survey. Survey items were generated independently by two investigators, with input from an expert panel (N = 5. Results: Of the 36 educators, 27 (75% completed the survey. Examinations identified to be potentially most useful included: measuring the size of the abdominal aorta, identifying the presence/absence of ascites, identifying the presence/absence of pleural effusions, and measuring the size of the bladder. Examinations thought to be potentially most harmful included: identifying the presence/absence of intrauterine pregnancy, measuring the size of the abdominal aorta, and identifying the presence/absence of pericardial effusion. Conclusions: Examinations that are potentially the most useful may also be potentially the most harmful. When initiating an ultrasound curriculum for physical examinations, educators should weigh the risks and benefits of examinations chosen.

  17. Stakeholders' perceptions on competency and assessment program of entry-level pharmacists in developing countries.

    Science.gov (United States)

    Asante, Isaac; Andoh, Irene; Muijtjens, Arno M M; Donkers, Jeroen

    2017-05-01

    To assess the stakeholders' perceptions on the competency of entry-level pharmacists and the use of written licensure examination as the primary assessment for licensure decisions on entry-level pharmacists who have completed the Pharmacy Internship Program 1 (PIP) in developing countries. A cross-sectional survey was conducted among stakeholders in which they completed a web-based 21-item pre-tested questionnaire to determine their views regarding the competency outcomes and assessment program for entry-level pharmacist. The stakeholders rated the entry-level pharmacists to possess all competencies except research skills. Stakeholders suggested improvement of the program by defining the competency framework and training preceptors. However, stakeholders disagree on using written examination as the primary assessment for licensure decision and suggested the incorporation of other performance-based assessments like preceptor's assessment reports. Stakeholders are uncertain on entry-level pharmacists in developing countries possessing adequate research competencies and think their assessment program for licensure need more than written examination to assess all required competencies. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Testicular Cancer and Testicular Self-Examination; Knowledge, Attitudes and Practice in Final Year Medical Students in Nigeria

    Science.gov (United States)

    Ugwumba, Fred O; Ekwueme, Osa Eloka C; Okoh, Agharighom D

    2016-11-01

    The testicular cancer (TCa) incidence is increasing in many countries, with age-standardized incidence rates up to 7.8/100,000 men in the Western world, although reductions in mortality and increasingly high cure rates are being witnessed at the same time. In Africa, where rates are lower, presentation is often late and morbidity and mortality high. Given this scenario, awareness of testicular cancer and practice of testicular self-examination among future first response doctors is very important. This study was conducted to determine knowledge and attitude to testicular cancer, and practice of testicular self-examination (TSE) among final (6th) year medical students. In addition, the effect of an intervention in the form of a single PowerPoint® lecture, lasting 40 minutes with image content on testicular cancer and testicular self examination was assessed. Pre and post intervention administration of a self-administered structured pre tested questionnaire was performed on 151 medical students, 101 of whom returned answers (response rate of 66.8%). In the TC domain, there was a high level of awareness of testicular cancer, but poor knowledge of the age group most affected, with significant improvement post intervention (ptesticular self-examination pre-intervention was found considering the nature of the study group..Respondents had surprisingly weak/poor responses to the question “How important to men’s health is regular testicular self-examination?” Answers to the questions “Do you think it is worthwhile to examine your testis regularly?” and “Would you be interested in more information on testicular cancer and testicular self-examination?” were also suboptimal, but improved post intervention ptesticular cancer in the curricula of medical schools and other training institutions for health care personnel. Creative Commons Attribution License

  19. Report on results of fourth medical examination of atomic bomb survivors residing in the U.S

    International Nuclear Information System (INIS)

    Monzen, Tetsuo; Ito, Chikako; Tanaka, Yoshikiyo; Kodama, Kazunori; Inamizu, Tsutomu.

    1984-01-01

    Review was made of the fourth medical examination and the actual state of health of the U.S. atomic-bomb (A-bomb) survivors. The number of survivors registered with the Committee of A-bomb Survivors residing in the U.S. as of the end of June 1983 in 592 (males 154, females 438), of whom 58.8% possess U.S. citizenship. Survivor's health handbooks issued to survivors under the Japanese A-bomb Survivors Medical Treatment Law are possessed by 29.2%, with female holders being about twice as numerous as males. Responses to the health survey questionnaire were received from 306. Complaints of subjective symptoms tended to be higher in the early entrants, and by place of examination, those of Honolulu had the higher rate. Those who underwent health examination numbered 305 (73 males and 232 females). RBC and hemoglobin value were higher in the U.S. survivors than in Hiroshima survivors. No abnormality was observed in 47.5%. The main abnormalities noted were obesity, hypertension, hyperlipidemia, ischemic heart disease, diabetes mellitus, hypothyroidism, and liver disease. Comparison of those who had received examination on two consecutive occasions in 1981 and 1983 and those who were examined for the first time in 1983 showed a decrease in the frequency of obesity and hypertension. (J.P.N.)

  20. Report on results of fourth medical examination of atomic bomb survivors residing in the U. S

    Energy Technology Data Exchange (ETDEWEB)

    Monzen, Tetsuo (Hiroshima Prefectural Medical Association (Japan)); Ito, Chikako; Tanaka, Yoshikiyo; Kodama, Kazunori; Inamizu, Tsutomu

    1984-01-01

    Review was made of the fourth medical examination and the actual state of health of the U.S. atomic-bomb (A-bomb) survivors. The number of survivors registered with the Committee of A-bomb Survivors residing in the U.S. as of the end of June 1983 in 592 (males 154, females 438), of whom 58.8% possess U.S. citizenship. Survivor's health handbooks issued to survivors under the Japanese A-bomb Survivors Medical Treatment Law are possessed by 29.2%, with female holders being about twice as numerous as males. Responses to the health survey questionnaire were received from 306. Complaints of subjective symptoms tended to be higher in the early entrants, and by place of examination, those of Honolulu had the higher rate. Those who underwent health examination numbered 305 (73 males and 232 females). RBC and hemoglobin value were higher in the U.S. survivors than in Hiroshima survivors. No abnormality was observed in 47.5%. The main abnormalities noted were obesity, hypertension, hyperlipidemia, ischemic heart disease, diabetes mellitus, hypothyroidism, and liver disease. Comparison of those who had received examination on two consecutive occasions in 1981 and 1983 and those who were examined for the first time in 1983 showed a decrease in the frequency of obesity and hypertension.

  1. Report on results of fourth medical examination of atomic bomb survivors residing in the U. S

    Energy Technology Data Exchange (ETDEWEB)

    Monzen, Tetsuo [Hiroshima Prefectural Medical Association (Japan); Ito, Chikako; Tanaka, Yoshikiyo; Kodama, Kazunori; Inamizu, Tsutomu

    1984-01-01

    Review was made of the fourth medical examination and the actual state of health of the U.S. atomic-bomb (A-bomb) survivors. The number of survivors registered with the Committee of A-bomb Survivors residing in the U.S. as of the end of June 1983 in 592 (males 154, females 438), of whom 58.8% possess U.S. citizenship. Survivor's health handbooks issued to survivors under the Japanese A-bomb Survivors Medical Treatment Law are possessed by 29.2%, with female holders being about twice as numerous as males. Responses to the health survey questionnaire were received from 306. Complaints of subjective symptoms tended to be higher in the early entrants, and by place of examination, those of Honolulu had the higher rate. Those who underwent health examination numbered 305 (73 males and 232 females). RBC and hemoglobin value were higher in the U.S. survivors than in Hiroshima survivors. No abnormality was observed in 47.5%. The main abnormalities noted were obesity, hypertension, hyperlipidemia, ischemic heart disease, diabetes mellitus, hypothyroidism, and liver disease. Comparison of those who had received examination on two consecutive occasions in 1981 and 1983 and those who were examined for the first time in 1983 showed a decrease in the frequency of obesity and hypertension.

  2. The medical examination in United States immigration applications: the potential use of genetic testing leads to heightened privacy concerns.

    Science.gov (United States)

    Burroughs, A Maxwell

    2005-01-01

    The medical examination has been an integral part of the immigration application process since the passing of the Immigration Act of 1891. Failing the medical examination can result in denial of the application. Over the years the medical examination has been expanded to include questioning about diseases that are scientifically shown to be rooted in an individual's genetic makeup. Recent advances in the fields of genomics and bioinformatics are making accurate and precise screening for these conditions a reality. Government policymakers will soon be faced with decisions regarding whether or not to sanction the use of these newly-developed genetic tests in the immigration application procedure. The terror threat currently facing the United States may ultimately bolster the argument in favor of genetic testing and/or DNA collection of applicants. However, the possibility of a government mandate requiring genetic testing raises a host of ethical issues; including the threat of eugenics and privacy concerns. Genetic testing has the ability to uncover a wealth of sensitive medical information about an individual and currently there are no medical information privacy protections afforded to immigration applicants. This article examines the potential for genetic testing in the immigration application process and the ethical issues surrounding this testing. In particular, this article explores the existing framework of privacy protections afforded to individuals living in the United States and how this and newly-erected standards like those released by the Health and Human Services (HHS) might apply to individuals seeking to immigrate to the United States.

  3. Medical licensing examination (uigwa and the world of the physician officers (uigwan in Korea’s Joseon Dynasty

    Directory of Open Access Journals (Sweden)

    Nam Hee Lee

    2015-05-01

    Full Text Available Physicians for ordinary people in Korea’s Joseon Dynasty (1392-1910 did not need to pass the national medical licensing examination. They were able to work after a sufficient apprenticeship period. Only physician officers were licensed as technical civil servants. These physician officers were middle class, located socially between the nobility and the commoner. They had to pass a national licensing examination to be considered for high-ranking physician officer positions, that is, those at the rank equal to or above the 6th level out of a total of 9 ranks, where the first rank was highest. Royal physicians also had to pass this examination before accepting responsibility for the King’s healthcare. This article aims to describe the world of physician officers during the Joseon Dynasty. Physician officers enjoyed considerable social status because they dealt with matters of life and death. Owing to the professional nature of their fields and a strong sense of group identity, they came to compose a distinct social class. The physician officers’ world was marked by strong group allegiances based on shared professional knowledge; the use of marriage to gain and maintain social status; and the establishment of hereditary technical posts within the medical profession that were handed down from one generation to the next. The medical licensing examination persisted until 1894 when the civil service examination agency, of which it was part, was abolished. Until that time, the testing agency, the number of candidates who were accepted, two-step test procedures, and the method of test item selection were maintained and enforced.

  4. Medical and psychological examination of women seeking asylum: documentation of human rights abuses.

    Science.gov (United States)

    Laws, A; Patsalides, B

    1997-01-01

    Human rights abuses of women are ubiquitous throughout the world. Those perpetrated by governments entitle women to seek political asylum, and many women refugees do so in the United States. The asylum process often requires medical or psychological evaluations to corroborate women's reports of torture or other abuses. This article provides an overview of how to conduct such examinations and how to document findings for the asylum process.

  5. Optimal use of acute headache medication: a qualitative examination of behaviors and barriers to their performance.

    Science.gov (United States)

    Seng, Elizabeth K; Holroyd, Kenneth A

    2013-10-01

    This study aims to qualitatively examine the behaviors required to optimally use acute headache medication and the barriers to successful performance of these behaviors. The efficacy of drug treatment is partly determined by medication adherence. The adherence literature has focused almost exclusively on the behaviors required to optimally use medications that are taken on a fixed schedule, as opposed to medications taken on an as needed basis to treat acute episodes of symptoms, such as headaches. Twenty-one people with headache and 15 health care providers participated in qualitative phenomenological interviews that were transcribed and coded by a multidisciplinary research team using phenomenological analysis. Interviews revealed 8 behaviors required to optimally use acute headache medication, including cross-episode behaviors that people with headache regularly perform to ensure optimal acute headache medication use, and episode-specific behaviors used to treat an individual headache episode. Interviews further revealed 9 barriers that hinder successful performance of these behaviors. Behaviors required to optimally use acute headache medication were numerous, often embedded in a larger chain of behaviors, and were susceptible to disruption by numerous barriers. © 2013 American Headache Society.

  6. 20 CFR 416.919k - Purchase of medical examinations, laboratory tests, and other services.

    Science.gov (United States)

    2010-04-01

    ... for the Type of Referral and for Report Content § 416.919k Purchase of medical examinations... determinations of disability may not exceed the highest rate paid by Federal or public agencies in the State for the same or similar types of service. See §§ 416.1024 and 416.1026 of this part. (b) If a physician's...

  7. 20 CFR 404.1519k - Purchase of medical examinations, laboratory tests, and other services.

    Science.gov (United States)

    2010-04-01

    ... Standards for the Type of Referral and for Report Content § 404.1519k Purchase of medical examinations... determinations of disability may not exceed the highest rate paid by Federal or public agencies in the State for the same or similar types of service. See §§ 404.1624 and 404.1626 of this part. (b) If a physician's...

  8. Too much small talk? Medical students' pelvic examination skills falter with pleasant patients.

    Science.gov (United States)

    Posner, Glenn D; Hamstra, Stanley J

    2013-12-01

    The competent performance of a female pelvic examination requires both technical proficiency and superlative communication skills. However, the ideal medium with which to assess these skills remains to be elucidated. Part-task trainers (PTTs) offer an effective and affordable means of testing technical skills, but may not allow students to demonstrate their communication skills. Hybrids involving standardised patients (SPs) (SP-PTT) offer a more realistic assessment of communication, but students may feel awkward when examining the female genitalia. The objective of this study was to compare the use of PTTs with that of SP-PTT hybrids in the assessment of technical and communication skills in the female pelvic examination. A total of 145 medical students were randomised to one of three conditions during their summative objective structured clinical examination (OSCE) at the completion of clerkship. Students performed the female pelvic examination on: (i) a PTT alone ('plastic' condition); (ii) an SP-PTT hybrid with an SP who did not engage in any superfluous conversation ('perfunctory' condition), or (iii) an SP-PTT hybrid with an SP who was trained to offer small talk and banter, which was judged to better reflect the typical doctor-patient interaction ('pleasant' condition). Communication skills did not differ significantly among the three groups (p = 0.354). There was a significant difference among groups in technical skills scores (p = 0.0018). Students in the 'plastic' condition performed best, followed by those in the 'perfunctory' and 'pleasant' conditions, respectively. Medical students demonstrate equivalent communication skills whether they work with a PTT or an SP-PTT hybrid, but their technical skills suffer in the presence of an SP. Working with the PTT alone does not appear to disadvantage students in terms of communication skills, but may offer better conditions for performing technical aspects of the procedure. Whether the 'plastic patient' is

  9. Academic performance of male in comparison with female undergraduate medical students in Pharmacology examinations.

    Science.gov (United States)

    Faisal, Rizwan; Shinwari, Laiyla; Hussain, Shahzadi Saima

    2017-02-01

    To compare the academic performance of male and female medical students in Pharmacology examinations. The comparative study was conducted at Rehman Medical College, Peshawar, Pakistan, from March to August 2015. For evaluating the students' academic performance, male and female students of academic sessions 2013-14 and 2014-15 were divided into 4 groups. Group 1: 80% marks. SPSS 20 was used for data analysis. Of the 200 medical students enrolled, 102(51%) were male and 98(41%) were female. There was no significant difference in the academic performance in terms of gender in multiple choice questions (p=0.811) and short essay questions (p=0.515). The effect of attendance was also insignificant (p=0.130). Significant difference was found between the academic records of urban male and female students compared to rural students (p=0.038). Boarder students' results were insignificantly different from those of day scholars (p=0.887). There was no significant difference between the academic performance of male and female students.

  10. Graduates of different UK medical schools show substantial differences in performance on MRCP(UK Part 1, Part 2 and PACES examinations

    Directory of Open Access Journals (Sweden)

    Mollon Jennifer

    2008-02-01

    Full Text Available Abstract Background The UK General Medical Council has emphasized the lack of evidence on whether graduates from different UK medical schools perform differently in their clinical careers. Here we assess the performance of UK graduates who have taken MRCP(UK Part 1 and Part 2, which are multiple-choice assessments, and PACES, an assessment using real and simulated patients of clinical examination skills and communication skills, and we explore the reasons for the differences between medical schools. Method We perform a retrospective analysis of the performance of 5827 doctors graduating in UK medical schools taking the Part 1, Part 2 or PACES for the first time between 2003/2 and 2005/3, and 22453 candidates taking Part 1 from 1989/1 to 2005/3. Results Graduates of UK medical schools performed differently in the MRCP(UK examination between 2003/2 and 2005/3. Part 1 and 2 performance of Oxford, Cambridge and Newcastle-upon-Tyne graduates was significantly better than average, and the performance of Liverpool, Dundee, Belfast and Aberdeen graduates was significantly worse than average. In the PACES (clinical examination, Oxford graduates performed significantly above average, and Dundee, Liverpool and London graduates significantly below average. About 60% of medical school variance was explained by differences in pre-admission qualifications, although the remaining variance was still significant, with graduates from Leicester, Oxford, Birmingham, Newcastle-upon-Tyne and London overperforming at Part 1, and graduates from Southampton, Dundee, Aberdeen, Liverpool and Belfast underperforming relative to pre-admission qualifications. The ranking of schools at Part 1 in 2003/2 to 2005/3 correlated 0.723, 0.654, 0.618 and 0.493 with performance in 1999–2001, 1996–1998, 1993–1995 and 1989–1992, respectively. Conclusion Candidates from different UK medical schools perform differently in all three parts of the MRCP(UK examination, with the

  11. Work-Related Trauma, Alienation, and Posttraumatic and Depressive Symptoms in Medical Examiner Employees.

    Science.gov (United States)

    Brondolo, Elizabeth; Eftekharzadeh, Pegah; Clifton, Christine; Schwartz, Joseph E; Delahanty, Douglas

    2017-10-05

    First-responder employees, including firefighters, police, and medical examiners, are at risk for the development of depression and posttraumatic stress disorder (PTSD) as a result of exposure to workplace trauma. However, pathways linking workplace trauma exposure to mental health symptoms are not well understood. In the context of social-cognitive models of depression/PTSD, we examined the role of negative cognitions as mediators of the cross-sectional and longitudinal relationship of workplace trauma exposure to symptoms of depression/PTSD in medical examiner (ME) employees. 259 ME personnel were recruited from 8 sites nationwide and completed an online questionnaire assessing potential trauma exposure (i.e., exposure to disturbing cases and contact with distressed families of the deceased), negative cognitions, and symptoms of depression and PTSD, and 151 completed similar assessments 3 months later. Longitudinal analyses indicated that increases in negative cognitions, and, in particular, thoughts about alienation predicted increases in depressive symptoms from Time 1 to Time 2. In cross-sectional analyses, but not longitudinal analyses, negative cognitions mediated the relationship of case exposure to symptoms of both depression and PTSD. Negative cognition also mediated the relationship of contact with distressed families to depressive symptoms. The strongest effects were for negative cognitions about being alienated from others. The results of this study support social-cognitive models of the development of posttraumatic distress in the workplace and have implications for the development of interventions to prevent and treat mental health symptoms in first responders. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  12. Report on the results of the tenth medical examination of atomic bomb survivors resident in North America

    International Nuclear Information System (INIS)

    Shibata, Jun; Ohta, Nobuhiro; Sasaki, Hideo

    1996-01-01

    The 10th medical examination of A-bomb survivors resident in North America was conducted from 6 June to 6 July 1995 in L.A., S.F., Seattle, Wailuku, and Honolulu. Since this is the 10th medical examination, results of the previous examination are summarized. With the exclusion of 55 whose death has been confirmed, the total registered number of A-bomb survivors resident in North America is 1,043. The examinees in the present examination amounted to 463 (48 of them are the children of A-bomb survivors), 26 of whom are newly registered survivors. The mean age of the examinees in 64 years. The proportion of those having US nationality gradually increased and reached 62% at the time of the 10th examination, while that of those who have Japanese nationality and permanent US residency rights decreased to 30%. When the examination program was initiated, A-bomb survivors resident in 15 states of the US, but now, in Canada and 31 states of the US. About 90% of these survivors reside along the west coast of the US including Hawaii. The number of holders of A-bomb survivor's health handbook has increased year after year, reaching 612. When the holders in North-America visit Japan for medical treatment, they are treated similarly with their counterparts in Japan. The major subjective symptoms are complete exhaustion or fatigue, heat intolerance, loss of vigor, and numbness or tingling. The prevalence of obesity, hypertension, and diabetes mellitus and the proportion of abnormal ECG findings has been increasing with the age. The prevalence of hypercholesterolemia was high and that of low HDL cholesterolemia was low. A significant difference was observed between the A-bomb survivors in Hiroshima and North America. Hypertension, hyperlipidemia, obesity, ischemic heart disease, and diabetes mellitus were observed mainly. Diseased of specific places were not observed. (H.O.)

  13. Report on the results of the tenth medical examination of atomic bomb survivors resident in North America

    Energy Technology Data Exchange (ETDEWEB)

    Shibata, Jun [Hiroshima Prefectural Medical Association (Japan); Ohta, Nobuhiro; Sasaki, Hideo [and others

    1996-01-01

    The 10th medical examination of A-bomb survivors resident in North America was conducted from 6 June to 6 July 1995 in L.A., S.F., Seattle, Wailuku, and Honolulu. Since this is the 10th medical examination, results of the previous examination are summarized. With the exclusion of 55 whose death has been confirmed, the total registered number of A-bomb survivors resident in North America is 1,043. The examinees in the present examination amounted to 463 (48 of them are the children of A-bomb survivors), 26 of whom are newly registered survivors. The mean age of the examinees in 64 years. The proportion of those having US nationality gradually increased and reached 62% at the time of the 10th examination, while that of those who have Japanese nationality and permanent US residency rights decreased to 30%. When the examination program was initiated, A-bomb survivors resident in 15 states of the US, but now, in Canada and 31 states of the US. About 90% of these survivors reside along the west coast of the US including Hawaii. The number of holders of A-bomb survivor`s health handbook has increased year after year, reaching 612. When the holders in North-America visit Japan for medical treatment, they are treated similarly with their counterparts in Japan. The major subjective symptoms are complete exhaustion or fatigue, heat intolerance, loss of vigor, and numbness or tingling. The prevalence of obesity, hypertension, and diabetes mellitus and the proportion of abnormal ECG findings has been increasing with the age. The prevalence of hypercholesterolemia was high and that of low HDL cholesterolemia was low. A significant difference was observed between the A-bomb survivors in Hiroshima and North America. Hypertension, hyperlipidemia, obesity, ischemic heart disease, and diabetes mellitus were observed mainly. Diseased of specific places were not observed. (H.O.).

  14. Associations of Undergoing a Routine Medical Examination or Not with Prevalence Rates of Hypertension and Diabetes Mellitus: A Cross-Sectional Study.

    Science.gov (United States)

    Zhang, Lin; Zhang, Wei; Zhang, Lingling; Tian, Danping; Li, Li; Deng, Xin; Deng, Jing; Ning, Peishan; Hu, Guoqing

    2016-06-23

    Undergoing a routine medical examination may be associated with the prevalence rate of chronic diseases from a population-based household interview survey. However, this important issue has not been examined so far. Data came from the first health service household interview of Hunan province, China, in 2013. A Rao-Scott chi-square test was performed to examine the difference in prevalence rates between subgroups. Adjusted odds ratio (OR) was calculated using the PROC SURVEYLOGISTIC procedure of SAS9.1 statistical software. In total, 24,282 residents of 8400 households were surveyed. A higher proportion of elderly adults had undergone a medical examination within the prior 12 months compared with young adults (≥65 years, 60%; 45-64 years, 46%; 18-44 years, 37%). After controlling for location, sex, and household income per capita, undergoing a medical examination was significantly associated with high prevalence rates of hypertension (adjusted OR: 2.0, 95% CI: 1.1-3.5) and of diabetes mellitus (adjusted OR: 3.3, 95% CI: 1.7-6.5) for young adults aged 18-44 years. The associations were not statistically significant for age groups 45-64 years and 65 years or older. The prevalence rates of hypertension and diabetes mellitus may be seriously underestimated for young adults not undergoing a routine medical examination in a health household interview survey.

  15. A new method for the assessment of patient safety competencies during a medical school clerkship using an objective structured clinical examination

    Directory of Open Access Journals (Sweden)

    Renata Mahfuz Daud-Gallotti

    2011-01-01

    Full Text Available INTRODUCTION: Patient safety is seldom assessed using objective evaluations during undergraduate medical education. OBJECTIVE: To evaluate the performance of fifth-year medical students using an objective structured clinical examination focused on patient safety after implementation of an interactive program based on adverse events recognition and disclosure. METHODS: In 2007, a patient safety program was implemented in the internal medicine clerkship of our hospital. The program focused on human error theory, epidemiology of incidents, adverse events, and disclosure. Upon completion of the program, students completed an objective structured clinical examination with five stations and standardized patients. One station focused on patient safety issues, including medical error recognition/disclosure, the patient-physician relationship and humanism issues. A standardized checklist was completed by each standardized patient to assess the performance of each student. The student's global performance at each station and performance in the domains of medical error, the patient-physician relationship and humanism were determined. The correlations between the student performances in these three domains were calculated. RESULTS: A total of 95 students participated in the objective structured clinical examination. The mean global score at the patient safety station was 87.59 ± 1.24 points. Students' performance in the medical error domain was significantly lower than their performance on patient-physician relationship and humanistic issues. Less than 60% of students (n = 54 offered the simulated patient an apology after a medical error occurred. A significant correlation was found between scores obtained in the medical error domains and scores related to both the patient-physician relationship and humanistic domains. CONCLUSIONS: An objective structured clinical examination is a useful tool to evaluate patient safety competencies during the medical

  16. Development of a questionnaire to assess medical competencies: Reliability and validity of the Questionnaire

    Science.gov (United States)

    Giesler, Marianne; Forster, Johannes; Biller, Silke; Fabry, Götz

    2011-01-01

    Introduction: While preparing a graduate survey for medical education in 2008 we realized that no instrument existed that would be suitable to evaluate whether the learning outcomes outlined in the Medical Licensure Act (ÄAppO) would be met. Therefore we developed the Freiburg Questionnaire to Assess Competencies in Medicine (Freiburger Fragebogen zur Erfassung von Kompetenzen in der Medizin, FKM)1 which has been revised and extended several times since then. Currently the FKM includes 45 items which are assigned to nine domains that correspond to the CanMEDS roles: medical expertise, communication, team-work, health and prevention, management, professionalism, learning, scholarship, and personal competencies. Methods: In order to test the reliability and validity of the questionnaire we have repeatedly surveyed medical students and residents since May 2008. In this article we report on the results of a cross-sectional study with 698 medical students from the preclinical and clinical years. In addition, we report the results of a survey of 514 residents who were up to two years into their residency. Results and conclusions: In summary, results show that the scales of the FKM are reliable (Cronbach’s α between .68 and .97). Significant differences in means between selected groups of students support the measure’s construct validity. Furthermore, there is evidence that the FKM might be used as a screening tool e.g. in graduate surveys to identify weaknesses in the medical education curriculum. PMID:21818241

  17. Identifying Best Practices for and Utilities of the Pharmacy Curriculum Outcome Assessment Examination.

    Science.gov (United States)

    Mok, Timothy Y; Romanelli, Frank

    2016-12-25

    Objective. A review was conducted to determine implementation strategies, utilities, score interpretation, and limitations of the Pharmacy Curriculum Outcome Assessment (PCOA) examination. Methods. Articles were identified through the PubMed and American Journal of Pharmaceutical Education , and International Pharmaceutical Abstracts databases using the following terms: "Pharmacy Curriculum Outcomes Assessment," "pharmacy comprehensive examination," and "curricular assessment." Studies containing information regarding implementation, utility, and predictive values for US student pharmacists, curricula, and/or PGY1/PGY2 residents were included. Publications from the Academic Medicine Journal , the Accreditation Council for Pharmacy Education (ACPE), and the American Association of Colleges of Pharmacy (ACCP) were included for background information and comparison of predictive utilities of comprehensive examinations in medicine. Results. Ten PCOA and nine residency-related publications were identified. Based on published information, the PCOA may be best used as an additional tool to identify knowledge gaps for third-year student pharmacists. Conclusion. Administering the PCOA to students after they have completed their didactic coursework may yield scores that reflect student knowledge. Predictive utility regarding the North American Pharmacy Licensure Examination (NAPLEX) and potential applications is limited, and more research is required to determine ways to use the PCOA.

  18. Report on the results of the sixth medical examination of atomic bomb survivors resident in the South America

    International Nuclear Information System (INIS)

    Oda, Hiroaki; Hirata, Katsumi; Taguchi, Atsushi; Sakamoto, Fumio; Nawachi, Sadahiro; Terada, Kensaku.

    1995-01-01

    The medical examination of A-bomb survivors was carried out in Brazil, Argentina, Bolivia, Republic of Peru, and Paraguay from October 25th to November 11th 1994. The survivors were 191 persons, and 98 (51.3%) of them received health consultation. Sixty-two persons were exposured in Hiroshima and 36 in Nagasaki. Average age of the medical examinee was 65.0±8.5-year-old. The holding rate of A-bomb survivor's handbook was 55.1%. The lowered physical vitality and the involution of the mental vitality with increased age were observed from interview sheets. This first orthopedic examination revealed abnormal findings in 12 persons. Sixty-five persons required further examinations. Cardiovascular risk factors of such as hypertension, obesity, hyperlipidemia and diabetes mellitus were observed. (H.O.)

  19. Report on the results of the sixth medical examination of atomic bomb survivors resident in the South America

    Energy Technology Data Exchange (ETDEWEB)

    Oda, Hiroaki [Hiroshima Univ. (Japan). School of Medicine; Hirata, Katsumi; Taguchi, Atsushi; Sakamoto, Fumio; Nawachi, Sadahiro; Terada, Kensaku

    1995-11-01

    The medical examination of A-bomb survivors was carried out in Brazil, Argentina, Bolivia, Republic of Peru, and Paraguay from October 25th to November 11th 1994. The survivors were 191 persons, and 98 (51.3%) of them received health consultation. Sixty-two persons were exposured in Hiroshima and 36 in Nagasaki. Average age of the medical examinee was 65.0{+-}8.5-year-old. The holding rate of A-bomb survivor`s handbook was 55.1%. The lowered physical vitality and the involution of the mental vitality with increased age were observed from interview sheets. This first orthopedic examination revealed abnormal findings in 12 persons. Sixty-five persons required further examinations. Cardiovascular risk factors of such as hypertension, obesity, hyperlipidemia and diabetes mellitus were observed. (H.O.).

  20. Communication education for pre-licensure nursing students: literature review 2002-2013.

    Science.gov (United States)

    Grant, Marian S; Jenkins, Louise S

    2014-11-01

    Effective communication skills are fundamental to good nursing care and required by certification bodies for nursing education. The purpose of this literature review was to update one done in 2002 of communication education to pre-licensure registered nursing students. That review concluded that it was unclear which interventions were most effective due to methodological and other quality issues. The goal of this review was to identify recent educational methods, frameworks, and evaluation tools and to assess the quality of this recent evidence. Literature review. PubMed, CINAHL, and PsychINFO. Inclusion criteria were articles in English, 2002 to 2013, full text available, addressing nurse:patient communication, and educational interventions. Exclusion criteria were inter-professional interventions as they are not yet as widely available. Studies were evaluated using the Johns Hopkins Nursing Evidence-based Practice (JHNEBP) Rating Scale. This scale categorizes the levels of evidence and methodological quality. The search yielded 457 titles, 115 abstracts, and 38 articles. Twenty studies met inclusion and exclusion search criteria. They included a range of research designs, samples, and outcomes. In line with recent communication educational trends, the interventions all involved active learning. Using the JHNEBP scale, the quality of the 20 studies was low due to both research design and methodological issues. Despite the importance of communication in nursing education, the quality of evidence to support specific communication interventions continues to be low. Recommendations for future communication education research are to (1) explore the highest quality designs available and use randomization where possible; (2) more consistently use theoretical frameworks and their accompanying outcome measures; and (3) that tools be tested for evidence of reliability and validity. Copyright © 2014 Elsevier Ltd. All rights reserved.

  1. Medical tourism's impacts on health worker migration in the Caribbean: five examples and their implications for global justice.

    Science.gov (United States)

    Snyder, Jeremy; Crooks, Valorie A; Johnston, Rory; Adams, Krystyna; Whitmore, Rebecca

    2015-01-01

    Medical tourism is a practice where individuals cross international borders in order to access medical care. This practice can impact the global distribution of health workers by potentially reducing the emigration of health workers from destination countries for medical tourists and affecting the internal distribution of these workers. Little has been said, however, about the impacts of medical tourism on the immigration of health workers to medical tourism destinations. We discuss five patterns of medical tourism-driven health worker migration to medical tourism destinations: 1) long-term international migration; 2) long-term diasporic migration; 3) long-term migration and 'black sheep'; 4) short-term migration via time share; and 5) short-term migration via patient-provider dyad. These patterns of health worker migration have repercussions for global justice that include potential negative impacts on the following: 1) health worker training; 2) health worker distributions; 3) local provision of care; and 4) local economies. In order to address these potential negative impacts, policy makers in destination countries should work to ensure that changes in health worker training and licensure aimed at promoting the medical tourism sector are also supportive of the health needs of the domestic population. Policy makers in both source and destination countries should be aware of the effects of medical tourism on health worker flows both into and out of medical tourism destinations and work to ensure that the potential harms of these worker flows to both groups are mitigated.

  2. Medical tourism's impacts on health worker migration in the Caribbean: five examples and their implications for global justice

    Directory of Open Access Journals (Sweden)

    Jeremy Snyder

    2015-04-01

    Full Text Available Medical tourism is a practice where individuals cross international borders in order to access medical care. This practice can impact the global distribution of health workers by potentially reducing the emigration of health workers from destination countries for medical tourists and affecting the internal distribution of these workers. Little has been said, however, about the impacts of medical tourism on the immigration of health workers to medical tourism destinations. We discuss five patterns of medical tourism-driven health worker migration to medical tourism destinations: 1 long-term international migration; 2 long-term diasporic migration; 3 long-term migration and ‘black sheep’; 4 short-term migration via time share; and 5 short-term migration via patient-provider dyad. These patterns of health worker migration have repercussions for global justice that include potential negative impacts on the following: 1 health worker training; 2 health worker distributions; 3 local provision of care; and 4 local economies. In order to address these potential negative impacts, policy makers in destination countries should work to ensure that changes in health worker training and licensure aimed at promoting the medical tourism sector are also supportive of the health needs of the domestic population. Policy makers in both source and destination countries should be aware of the effects of medical tourism on health worker flows both into and out of medical tourism destinations and work to ensure that the potential harms of these worker flows to both groups are mitigated.

  3. Medical tourism's impacts on health worker migration in the Caribbean: five examples and their implications for global justice

    Science.gov (United States)

    Snyder, Jeremy; Crooks, Valorie A.; Johnston, Rory; Adams, Krystyna; Whitmore, Rebecca

    2015-01-01

    Medical tourism is a practice where individuals cross international borders in order to access medical care. This practice can impact the global distribution of health workers by potentially reducing the emigration of health workers from destination countries for medical tourists and affecting the internal distribution of these workers. Little has been said, however, about the impacts of medical tourism on the immigration of health workers to medical tourism destinations. We discuss five patterns of medical tourism-driven health worker migration to medical tourism destinations: 1) long-term international migration; 2) long-term diasporic migration; 3) long-term migration and ‘black sheep’; 4) short-term migration via time share; and 5) short-term migration via patient-provider dyad. These patterns of health worker migration have repercussions for global justice that include potential negative impacts on the following: 1) health worker training; 2) health worker distributions; 3) local provision of care; and 4) local economies. In order to address these potential negative impacts, policy makers in destination countries should work to ensure that changes in health worker training and licensure aimed at promoting the medical tourism sector are also supportive of the health needs of the domestic population. Policy makers in both source and destination countries should be aware of the effects of medical tourism on health worker flows both into and out of medical tourism destinations and work to ensure that the potential harms of these worker flows to both groups are mitigated. PMID:25865122

  4. Occupational medical prophylaxis for the musculoskeletal system: A function-oriented system for physical examination of the locomotor system in occupational medicine (fokus(C

    Directory of Open Access Journals (Sweden)

    Schwarze Sieglinde

    2007-10-01

    Full Text Available Abstract Occupational physicians are very often confronted with questions as to the fitness of the postural and locomotor systems, especially the spinal column. Occupational medical assessment and advice can be required by patients with acute symptoms, at routine check-ups, by persons who have problems doing certain jobs, and for expert medical reports as to the fitness of persons with chronic disorders or after operations. Therefore, for occupational medical purposes a physical examination must aim primarily to investigate functions and not structures or radiologic evidence. The physical examination should be structured systematically and according to regions of the body and, together with a specific (pain anamnesis should provide a basis for the medical assessment. This paper presents a function-oriented system for physical examination of the locomotor system, named fokus(C (Funktionsorientierte Koerperliche Untersuchungssystematik, also available on DVD. fokus(C has been developed with a view to its relevance for occupational medical practice and does not aim primarily to provide a precise diagnosis. Decisive for an occupational medical assessment of disorders of the musculoskeletal system is rather information about functional disorders and any impairment of performance or mobility which they can cause. The division of the physical examination into a rapid screening phase and a subsequent more intensive functional diagnostic phase has proved its practicability in many years of day-to-day use. Here, in contrast to the very extensive measures recommended for orthopaedic and manual diagnosis, for reasons of efficiency and usability of the system in routine occupational medical examinations the examination is structured according to the findings. So it is reduced to that which is most necessary and feasible.

  5. Medicare Program; End-Stage Renal Disease Prospective Payment System, Coverage and Payment for Renal Dialysis Services Furnished to Individuals With Acute Kidney Injury, End-Stage Renal Disease Quality Incentive Program, Durable Medical Equipment, Prosthetics, Orthotics and Supplies Competitive Bidding Program Bid Surety Bonds, State Licensure and Appeals Process for Breach of Contract Actions, Durable Medical Equipment, Prosthetics, Orthotics and Supplies Competitive Bidding Program and Fee Schedule Adjustments, Access to Care Issues for Durable Medical Equipment; and the Comprehensive End-Stage Renal Disease Care Model. Final rule.

    Science.gov (United States)

    2016-11-04

    This rule updates and makes revisions to the End-Stage Renal Disease (ESRD) Prospective Payment System (PPS) for calendar year 2017. It also finalizes policies for coverage and payment for renal dialysis services furnished by an ESRD facility to individuals with acute kidney injury. This rule also sets forth requirements for the ESRD Quality Incentive Program, including the inclusion of new quality measures beginning with payment year (PY) 2020 and provides updates to programmatic policies for the PY 2018 and PY 2019 ESRD QIP. This rule also implements statutory requirements for bid surety bonds and state licensure for the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program (CBP). This rule also expands suppliers' appeal rights in the event of a breach of contract action taken by CMS, by revising the appeals regulation to extend the appeals process to all types of actions taken by CMS for a supplier's breach of contract, rather than limit an appeal for the termination of a competitive bidding contract. The rule also finalizes changes to the methodologies for adjusting fee schedule amounts for DMEPOS using information from CBPs and for submitting bids and establishing single payment amounts under the CBPs for certain groupings of similar items with different features to address price inversions. Final changes also are made to the method for establishing bid limits for items under the DMEPOS CBPs. In addition, this rule summarizes comments on the impacts of coordinating Medicare and Medicaid Durable Medical Equipment for dually eligible beneficiaries. Finally, this rule also summarizes comments received in response to a request for information related to the Comprehensive ESRD Care Model and future payment models affecting renal care.

  6. An examination of medical linear accelerator ion-chamber performance

    International Nuclear Information System (INIS)

    Karolis, C.; Lee, C.; Rinks, A.

    1996-01-01

    Full text: The company ( Radiation Oncology Physics and Engineering Services Pty Ltd) provides medical physics services to four radiotherapy centres in NSW with a total of 6 high energy medical linear accelerators manufactured by three different companies. As part of the services, the stability of the accelerator ion chamber system is regularly examined for constancy and periodically for absolute calibration. Each accelerator ion chamber has exhibited undesirable behaviour from time to time, sometimes leading to its replacement. This presentation describes the performance of the ion chambers for some of the linacs over a period of 12-18 months and the steps taken by the manufacturer to address the problems encountered. As part of our commissioning procedure of new linacs, an absolute calibration of the accelerator output (photon and electron beams) is repeated several times over the period following examination of the physical properties of the radiation beams. These calibrations were undertaken in water using the groups calibrated ion chamber/electrometer system and were accompanied by constancy checks using an acrylic phantom and field instruments. Constancy checks were performed daily for a period of 8 weeks during the initial life of the accelerator and thereafter weekly. For one accelerator, the ion chamber was replaced 6 times in the first eighteen months of its life due to severe drifts in output, found to be due to pressure changes in one half of the chamber In another accelerator, erratic swings of 2% were observed for a period of nine months, particularly with the electron beams, before the manufacturer offered to change the chamber with another constructed from different materials. In yet another accelerator the ion chamber has shown consistent erratic behaviour, but this has not been addressed by the manufacturer. In another popular accelerator, the dosimetry was found to be very stable until some changes in the tuning were introduced resulting in small

  7. Conducting Integrated Objective Structured Clinical Examination: Experiences at KIST Medical College, Nepal

    Directory of Open Access Journals (Sweden)

    Rano Mal Piryani

    2013-01-01

    Full Text Available Background: Objective structured clinical examination (OSCE, an important tool for assessment of clinical skills, introduced more than 4 decades ago. KIST Medical College, a new medical school of Nepal, affiliated to Tribhuvan University Institute of Medicine, has made learning of physical examination skills structured and integrated with greater involvement of different clinical science departments. Students learn physical examination skills in second year MBBS as a part of early clinical exposure. Objective: To share the experiences regarding implementation of integrated OSCE. Materials and Methods: At the end of clinical posting of learning of physical examination skills, assessment was done with OSCE. Fifteen OSCE stations including each of 5 minutes were developed and arranged. Standardized patients and validated checklist were used. OSCE was conducted in novel way. Prior to the OSCE session: Suitable venue was selected, assessors were identified, standardized patients were selected, running order of the stations in circuit was developed, list of equipments/instruments required was prepared, and tasks, checklists, feedback questionnaires were printed. The day before the OSCE session: OSCE stations were inspected and clearly labeled, condition of required equipments/instruments was checked, a pack of the documents for each OSCE station were made available, and signs were displayed at proper places. On the day of the OSCE session: Reliable stop watch and loud manual bell were used, support staffs were placed to direct the candidates, examiners, and standardized patients (SPs, assessors explained SPs, students were briefed, supervisors observed the session, and feedback were taken from students, assessors, and SPs. At the end of the OSCE session: Checklists and feedback questionnaires were collected, token money was paid to SPs, and a contribution of everyone was appreciated. After the OSCE session: Score was compiled and result declared, and

  8. A comparison of performances of consultant surgeons, NCHDs and medical students in a modified HPAT examination.

    LENUS (Irish Health Repository)

    Quinn, A

    2010-06-01

    Following the implementation of the Fottrell report, entry to medical school in Ireland has undergone significant change. Medical school studentship is now awarded based on a combination of points obtained from the final examination of Irish secondary schools (the leaving certificate) combined with HPAT scores (Health Professions Admissions Test). The HPAT is designed to test a candidate\\'s knowledge in several different fields including problem solving skills, logical and non verbal reasoning. A sample HPAT was administered to a test group composed of consultant surgeons, non consultant hospital doctors, and medical students. Statistical analysis was performed and no significant difference was found between the performances of the groups. This is surprising as it was expected that groups with greater experience at medical problem solving would have translated to higher scores. This exposes a flaw within the HPAT system and a potential weakness in the process of doctor selection.

  9. How to use pre-employment medical examinations and comply with Anti-Discrimination legislation

    Energy Technology Data Exchange (ETDEWEB)

    Scholz, D. [Sparke Helmore Solicitors and Notaries, Sydney, NSW (Australia)

    1998-12-31

    The law including legislation such as the Occupational Health and Safety Act 1983 imposes stringent obligations on employers to ensure the health and safety of their employees. The use of pre-employment medical examinations is one tool that employers can use to assess the suitability of applicant for a particular position and protect themselves from persecution or claims for compensation or damages. At the same time, however, legislation such as The Disability Discrimination Act 1992 (Commonwealth) (DDA) and The Anti-Discrimination Act 1977 (New South wales) (ADA) affords protection to individuals against discrimination. This legislation is intended to ensure, as far as is practicable, that people with disabilities are treated equally to other members of the community and are brought into the mainstream of our society as far as possible. It makes it unlawful for employers to discriminate against prospective employees because of their disability. In the context of pre-employment medicals, the protection from discrimination is designed to ensure that job applicants with disabilities have as much opportunity to obtain employment as able bodied applicants. Employers must ensure that they use pre-employment medical examinations in a way that is both relevant for their workplace and complies with the requirements of Anti-Discrimination legislation. The definition of discrimination in the Federal and State Acts is virtually identical except for variations in the type and extent of various exceptions. Complainants are free to choose between State and Federal jurisdiction in situations which are covered by both. While the Equal Opportunity Tribunal (State) cannot order damages in excess of 40,000,000 dollars there is no limit on the amount of damages the Human Rights and Equal Opportunity Commission (Federal) can award.

  10. EXAMINATION OF THE EMERGENCY MEDICAL RESPONSE SYSTEM IN KOREA AND SUGGESTIONS FOR IMPROVEMENTS RELATING TO TRANSPORT

    Directory of Open Access Journals (Sweden)

    Sei-Chang OH, Ph.D.

    2004-01-01

    This research focuses on the examination of current emergency medical response system related to the transport of emergency vehicles and suggests some transport-related ideas to improve the system in Korea. The study aimed to investigate the present emergency medical response system and identify problems, questionnaire survey and literature review were carried. The ideas include the improvement of emergency information flow and the development of preferential treatment methods for emergency vehicles. To improve the emergency information flow, this research studied the bridge between emergency medical information center and traffic information center and proposed the efficient utilization of traffic information for the better treatment of an emergency. When it comes to the movement of emergency vehicles, various preferential treatment methods were suggested.

  11. Randomised controlled trial examining the effect of exercise in people with rheumatoid arthritis taking anti-TNFα therapy medication.

    LENUS (Irish Health Repository)

    Reid, Angela

    2011-01-01

    Substantial progress has been made in the medical management of rheumatoid arthritis (RA) over the past decade with the introduction of biologic therapies, including anti-tumour necrosis factor alpha (anti-TNFα) therapy medications. However, individuals with RA taking anti-TNFα medication continue to experience physical, psychological and functional consequences, which could potentially benefit from rehabilitation. There is evidence that therapeutic exercise should be included as an intervention for people with RA, but to date there is little evidence of the benefits of therapeutic exercise for people with RA on anti-TNFα therapy medication. A protocol for a multicentre randomised controlled three-armed study which aims to examine the effect of dynamic group exercise therapy on land or in water for people with RA taking anti-TNFα therapy medication is described.

  12. Medical students' perception of objective structured clinical examination: a feedback for process improvement.

    Science.gov (United States)

    Nasir, Abdulrasheed A; Yusuf, Ayodeji S; Abdur-Rahman, Lukman O; Babalola, Olasunkanmi M; Adeyeye, Ademola A; Popoola, Ademola A; Adeniran, James O

    2014-01-01

    Medical educators have always been desirous of the best methods for formative and summative evaluation of trainees. The Objective Structured Clinical Examination (OSCE) is an approach for student assessment in which aspects of clinical competence are evaluated in a comprehensive, consistent, and structured manner with close attention to the objectivity of the process. Though popular in most medical schools globally, its use in Nigeria medical schools appears limited. This study was conceived to explore students' perception about the acceptability of OSCE process and to provide feedback to be used to improve the assessment technique. A cross-sectional survey was conducted on final-year medical students, who participated in the final MBBS surgery examination in June 2011. A 19-item self-administered structured questionnaire was employed to obtain relevant data on demographics of respondents and questions evaluating the OSCE stations in terms of the quality of instructions and organization, learning opportunities, authenticity and transparency of the process, and usefulness of the OSCE as an assessment instrument compared with other formats. Students' responses were based on a 5-point Likert scales ranging from strongly disagree to strongly agree. The data were analyzed using SPSS, version 15 (SPSS, Inc, Chicago, IL). The study took place at the University of Ilorin, College of Health Science. A total of 187 final-year medical students were enrolled in to the survey. Of 187 eligible students, 151 completed the self-administered questionnaire representing 80.7% response rate. A total of 61 (40.4%) students felt that it was easy to understand written instructions at the OSCE stations. In total, 106 (70.2%) students felt that the time allocated to each station was adequate. A total of 89 (58.9%) students agreed that the OSCE accurately measured their knowledge and skill, and 85 (56.3%) reported that OSCE enhanced their communication skill. Of the respondents, 80 (53

  13. "Heidelberg standard examination" and "Heidelberg standard procedures" - Development of faculty-wide standards for physical examination techniques and clinical procedures in undergraduate medical education.

    Science.gov (United States)

    Nikendei, C; Ganschow, P; Groener, J B; Huwendiek, S; Köchel, A; Köhl-Hackert, N; Pjontek, R; Rodrian, J; Scheibe, F; Stadler, A-K; Steiner, T; Stiepak, J; Tabatabai, J; Utz, A; Kadmon, M

    2016-01-01

    The competent physical examination of patients and the safe and professional implementation of clinical procedures constitute essential components of medical practice in nearly all areas of medicine. The central objective of the projects "Heidelberg standard examination" and "Heidelberg standard procedures", which were initiated by students, was to establish uniform interdisciplinary standards for physical examination and clinical procedures, and to distribute them in coordination with all clinical disciplines at the Heidelberg University Hospital. The presented project report illuminates the background of the initiative and its methodological implementation. Moreover, it describes the multimedia documentation in the form of pocketbooks and a multimedia internet-based platform, as well as the integration into the curriculum. The project presentation aims to provide orientation and action guidelines to facilitate similar processes in other faculties.

  14. Correlation of the National Board of Medical Examiners Emergency Medicine Advanced Clinical Examination given in July to intern American Board of Emergency Medicine in-training examination scores, a predictor of performance?

    Directory of Open Access Journals (Sweden)

    Katherine Hiller

    2015-11-01

    Full Text Available Introduction: There is great variation in the knowledge base of Emergency Medicine (EM interns in July. The first objective knowledge assessment during residency does not occur until eight months later, in February, when the American Board of EM (ABEM administers the in-training examination (ITE. In 2013, the National Board of Medical Examiners (NBME released the EM Advanced Clinical Examination (EM-ACE, an assessment intended for fourth-year medical students. Administration of the EM-ACE to interns at the start of residency may provide an earlier opportunity to assess the new EM residents’ knowledge base. The primary objective of this study was to determine the correlation of the NBME EM-ACE, given early in residency, with the EM ITE. Secondary objectives included determination of the correlation of the United States Medical Licensing Examination (USMLE Step 1 or 2 scores with early intern EM-ACE and ITE scores and the effect, if any, of clinical EM experience on examination correlation. Methods: This was a multi-institutional, observational study. Entering EM interns at six residencies took the EM-ACE in July 2013 and the ABEM ITE in February 2014. We collected scores for the EMACE and ITE, age, gender, weeks of clinical EM experience in residency prior to the ITE, and USMLE Step 1 and 2 scores. Pearson’s correlation and linear regression were performed. Results: Sixty-two interns took the EM-ACE and the ITE. The Pearson’s correlation coefficient between the ITE and the EM-ACE was 0.62. R-squared was 0.5 (adjusted 0.4. The coefficient of determination was 0.41 (95% CI [0.3-0.8]. For every increase of one in the scaled EM-ACE score, we observed a 0.4% increase in the EM in-training score. In a linear regression model using all available variables (EM-ACE, gender, age, clinical exposure to EM, and USMLE Step 1 and Step 2 scores, only the EM-ACE score was significantly associated with the ITE (p<0.05. We observed significant colinearity

  15. Step Up-Not On-The Step 2 Clinical Skills Exam: Directors of Clinical Skills Courses (DOCS) Oppose Ending Step 2 CS.

    Science.gov (United States)

    Ecker, David J; Milan, Felise B; Cassese, Todd; Farnan, Jeanne M; Madigosky, Wendy S; Massie, F Stanford; Mendez, Paul; Obadia, Sharon; Ovitsh, Robin K; Silvestri, Ronald; Uchida, Toshiko; Daniel, Michelle

    2018-05-01

    Recently, a student-initiated movement to end the United States Medical Licensing Examination Step 2 Clinical Skills and the Comprehensive Osteopathic Medical Licensing Examination Level 2-Performance Evaluation has gained momentum. These are the only national licensing examinations designed to assess clinical skills competence in the stepwise process through which physicians gain licensure and certification. Therefore, the movement to end these examinations and the ensuing debate merit careful consideration. The authors, elected representatives of the Directors of Clinical Skills Courses, an organization comprising clinical skills educators in the United States and beyond, believe abolishing the national clinical skills examinations would have a major negative impact on the clinical skills training of medical students, and that forfeiting a national clinical skills competency standard has the potential to diminish the quality of care provided to patients. In this Perspective, the authors offer important additional background information, outline key concerns regarding the consequences of ending these national clinical skills examinations, and provide recommendations for moving forward: reducing the costs for students, exploring alternatives, increasing the value and transparency of the current examinations, recognizing and enhancing the strengths of the current examinations, and engaging in a national dialogue about the issue.

  16. Estimation of population doses from diagnostic medical examinations in Japan, 1974. II. Estimation of genetically significant dose

    Energy Technology Data Exchange (ETDEWEB)

    Hashizume, T; Maruyama, T; Kumamoto, Y [National Inst. of Radiological Sciences, Chiba (Japan)

    1976-03-01

    The genetically significant dose from radiographic and fluoroscopic examination in Japan has been estimated based on a 1974 nation wide survey of randomly sampled hospitals and clinics. The gonad dose during x-ray diagnosis was determined with an ionization chamber placed at the positions of ovary and testis in a Rando phantom. The instrumented phantom was irradiated with medical diagnostic x-rays on the basis of the exposure data on the patients selected in the nation wide survey. In the calculation of the genetically significant dose, the child expectancy of the patients that undergo each particular type of examination was assumed to be same as that of the general population. The resultant genetically significant dose was 11.1 and 5.43 mrad per person per year for radiography and fluoroscopy, respectively. These values were compared with those of 1960 and 1969. Though the number of examinations per year shows a yearly increase, the genetically significant dose is gradually on the decrease. This may be due to technical improvements in medical radiological practices.

  17. Use of computer-based clinical examination to assess medical students in surgery.

    Science.gov (United States)

    El Shallaly, Gamal E H A; Mekki, Abdelrahman M

    2012-01-01

    To improve the viewing of the video-projected structured clinical examination (ViPSCE), we developed a computerized version; the computer-based clinical examination (CCE). This was used to assess medical students' higher knowledge and problem solving skills in surgery. We present how we did this, test score descriptive statistics, and the students' evaluation of the CCE. A CCE in surgery was administered to assess a class of 43 final year medical students at the end of their surgical clerkship. Like the ViPSCE, the exam was delivered as a slide show, using a PowerPoint computer program. However, instead of projecting it onto a screen, each student used a computer. There were 20 slides containing either still photos or short video clips of clinical situations in surgery. The students answered by hand writing on the exam papers. At the end, they completed evaluation forms. The exam papers were corrected manually. Test score descriptive statistics were calculated and correlated with the students' scores in other exams in surgery. Administration of the CCE was straightforward. The test scores were normally distributed (mean = median = 4.9). They correlated significantly with the total scores obtained by the students in surgery (r = 0.68), and with each of the other exam modalities in surgery, such as the multiple choice and structured essay questions. Acceptability of the CCE to the students was high and they recommended the use of the CCE in other departments. CCE is feasible and popular with students. It inherits the validity and reliability of the ViPSCE with the added advantage of improving the viewing of the slides.

  18. Can physicians be replaced with gynecological teaching women to train medical students in their first pelvic examination? A pilot study from Northern Sweden.

    Science.gov (United States)

    Grankvist, Olov; Olofsson, Anders D; Isaksson, Rose-Marie

    2014-07-01

    The main objective was to gain a deeper understanding of how medical students perceive and experience learning from gynecological teaching women (GTW) instead of physicians in their first pelvic examination. A second aim was to describe how the women experience their roles as GTW. Data were collected from individual interviews with 24 medical students from a medical school in Sweden and with 5 GTW. Discourse analysis was performed to acquire a deeper understanding of the informants' experiences and to understand social interactions. Five themes revealed in the medical students' experiences: "Hoping that anxiety will be replaced with security," "Meeting as equals creates a sense of calm," "Succeeding creates a sense of security for the future," "Wanting but not having the opportunity to learn more," and "Feeling relieved and grateful." One theme revealed in the GTW experiences: "Hoping to relate in a trustworthy way." To replace physicians with GTW may facilitate the learning process and may also help medical students improve their communicative skills. Using GTW will hopefully further improve students' basic medical examination techniques and physician-patient relationships. Since GTW seems to increase self-confidence and skills of medical students performing their first pelvic examination we recommend that the use of GTW is considered in the training of medical students. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  19. Development of a Hospital-based Massage Therapy Course at an Academic Medical Center.

    Science.gov (United States)

    Dion, Liza J; Cutshall, Susanne M; Rodgers, Nancy J; Hauschulz, Jennifer L; Dreyer, Nikol E; Thomley, Barbara S; Bauer, Brent

    2015-03-01

    Massage therapy is offered increasingly in US medical facilities. Although the United States has many massage schools, their education differs, along with licensure and standards. As massage therapy in hospitals expands and proves its value, massage therapists need increased training and skills in working with patients who have various complex medical concerns, to provide safe and effective treatment. These services for hospitalized patients can impact patient experience substantially and provide additional treatment options for pain and anxiety, among other symptoms. The present article summarizes the initial development and description of a hospital-based massage therapy course at a Midwest medical center. A hospital-based massage therapy course was developed on the basis of clinical experience and knowledge from massage therapists working in the complex medical environment. This massage therapy course had three components in its educational experience: online learning, classroom study, and a 25-hr shadowing experience. The in-classroom study portion included an entire day in the simulation center. The hospital-based massage therapy course addressed the educational needs of therapists transitioning to work with interdisciplinary medical teams and with patients who have complicated medical conditions. Feedback from students in the course indicated key learning opportunities and additional content that are needed to address the knowledge and skills necessary when providing massage therapy in a complex medical environment. The complexity of care in medical settings is increasing while the length of hospital stay is decreasing. For this reason, massage provided in the hospital requires more specialized training to work in these environments. This course provides an example initial step in how to address some of the educational needs of therapists who are transitioning to working in the complex medical environment.

  20. Associations between formative practice quizzes and summative examination outcomes in a medical anatomy course.

    Science.gov (United States)

    McNulty, John A; Espiritu, Baltazar R; Hoyt, Amy E; Ensminger, David C; Chandrasekhar, Arcot J

    2015-01-01

    Formative practice quizzes have become common resources for self-evaluation and focused reviews of course content in the medical curriculum. We conducted two separate studies to (1) compare the effects of a single or multiple voluntary practice quizzes on subsequent summative examinations and (2) examine when students are most likely to use practice quizzes relative to the summative examinations. In the first study, providing a single on-line practice quiz followed by instructor feedback had no effect on examination average grades compared to the previous year or student performances on similar questions. However, there were significant correlations between student performance on each practice quiz and each summative examination (r = 0.42 and r = 0.24). When students were provided multiple practice quizzes with feedback (second study), there were weak correlations between the frequency of use and performance on each summative examination (r = 0.17 and r = 0.07). The frequency with which students accessed the practice quizzes was greatest the day before each examination. In both studies, there was a decline in the level of student utilization of practice quizzes over time. We conclude that practice quizzes provide some predictive value for performances on summative examinations. Second, making practice quizzes available for longer periods prior to summative examinations does not promote the use of the quizzes as a study strategy because students appear to use them mostly to assess knowledge one to two days prior to examinations. © 2014 American Association of Anatomists.

  1. Estimation of population dose from medical X-ray diagnosis and in vivo nuclear medicine examinations in Taiwan

    International Nuclear Information System (INIS)

    Liu, W.H.; Kusama, T.; Kai, M.; Aoki, Y.; Wada, O.; Chen, F.D.

    1993-01-01

    A national survey of radiation exposure had been conducted in Taiwan from May 3 to May 9, 1993, to establish the population dose. We investigated the frequency, type of examination, age and sex distribution of the X-ray diagnosis examination. We investigated 9 medical centers (75% of the total), 15 area hospitals (34% of the total) and 52 local hospitals (10.3% of the total) in Taiwan,. Details of 54,000 X-ray examinations were collected. Total numbers of 5162 X-ray examinations were performed annually per 10,000 inhabitants in Taiwan. The chest examination was the largest contribution, 45%, of all X-ray examinations, Different types of hospitals showed different frequencies and different distributions of age and sex of X-ray diagnosis. (3 figs., 3 tabs.)

  2. Estimation of population doses from diagnostic medical examinations in Japan, 1974, (4)

    International Nuclear Information System (INIS)

    Hashizume, Tadashi; Maruyama, Takashi; Kumamoto, Yoshikazu

    1976-01-01

    In fetus exposed in utero to diagnostic x-rays for the medical examinations of the mother, the absorbed dose has been estimated on the basis of a 1974 nation wide radiological survey. The results of the survey showed that the number of radiographs per year connected with pregnant women was 0.32 million for chest examination excluding mass surveys. 0.29 million for obstetrical examinations including pelvimetry, and 0.21 million for abdominal and pelvic examinations with a total of 0.82 million. The dose absorbed in the fetus was measured with an ionization chamber placed at the hypothetical center of the fetus in an ''average woman'' Rando phantom in which a maternal body was simulated by adding MixDp materials. ''The collective dose'' to the fetus in the pregnant women receiving a given type of examination was calculated from the number of radiographs per year connected with the pregnant women and the fetal doses. The percapita mean marrow dose (CMD), the leukemia significant dose (LSD) and the genetically significant dose (GSD) for the fetus were determined from the collective dose, taking into account the birth expectancy, the child expectancy, life expectancy and significant factor for the fetus. The collective dose to the fetus was estimated to be 9.3 x 10 4 man rad per year. The resultant values of CMD, LSD and GSD were 0.81 mrad per year, 0.79 mrad per person per year and 1.44 mrad per person per year, respectively. (Evans, J.)

  3. 41 CFR 60-250.23 - Medical examinations and inquiries.

    Science.gov (United States)

    2010-07-01

    ... with reasonable accommodations as required in this part. (c) Invitation to self-identify. The... separate forms and in separate medical files and treated as a confidential medical record, except that: (i... engaged in enforcing the laws administered by OFCCP, including this part, or enforcing the Americans with...

  4. Pre-employment medical examination of Indonesian domestic helpers in a private clinic in Johor Bahru--an eight year review.

    Science.gov (United States)

    Leong, C C

    2006-12-01

    On review of 3117 patients' records (all were female Indonesian foreign workers over the span of eight years (1997 to 2004 in a private clinic in Johor Bahru, 223 cases (7.2%) were found to have various medical problems. These 3117 foreigners were to be employed as domestic helpers in Malaysia. They were examined upon arrival in Johor Bahru even though our government did not require this pre-requisite (before 1st August 2005) as they were examined and certified fit in their country of origin before embarking to Malaysia. The proportion of female Indonesian foreign workers who were afflicted with category 1 conditions was 55.6% (which rendered them unfit for employment) and category 2 conditions was 44.4%. The medical problem detected most frequently was hypertension. Sixty-one (80.3%) out of 76 workers had stage 2 hypertension (JNC 7 report). Pulmonary tuberculosis ranked second in this review and is a category 1 condition. This paper supports the recent move by the Malaysian Ministry of Health to implement mandatory medical examinations for all foreign workers arriving in Malaysia within one month of arrival regardless of whether or not they are certified fit in their countries of origin.

  5. On-Line Booking Policies and Competitive Analysis of Medical Examination in Hospital

    Directory of Open Access Journals (Sweden)

    Li Luo

    2014-01-01

    Full Text Available From the on-line point, we consider the hospital’s medical examination appointment problem with hierarchical machines. This approach eliminates the need for both demand forecasts and a risk-neutrality assumption. Due to different unit revenue, uncertain demand, and arrival of patients, we design on-line booking policies for two kinds of different situations from the perspective of on-line policy and competitive analysis. After that, we prove the optimal competitive ratios. Through numerical examples, we compare advantages and disadvantages between on-line policies and traditional policies, finding that there is different superiority for these two policies under different arrival sequences.

  6. An evaluation of the performance in the UK Royal College of Anaesthetists primary examination by UK medical school and gender

    Science.gov (United States)

    Bowhay, Andrew R; Watmough, Simon D

    2009-01-01

    Background There has been comparatively little consideration of the impact that the changes to undergraduate curricula might have on postgraduate academic performance. This study compares the performance of graduates by UK medical school and gender in the Multiple Choice Question (MCQ) section of the first part of the Fellowship of the Royal College of Anaesthetists (FRCA) examination. Methods Data from each sitting of the MCQ section of the primary FRCA examination from June 1999 to May 2008 were analysed for performance by medical school and gender. Results There were 4983 attempts at the MCQ part of the examination by 3303 graduates from the 19 United Kingdom medical schools. Using the standardised overall mark minus the pass mark graduates from five medical schools performed significantly better than the mean for the group and five schools performed significantly worse than the mean for the group. Males performed significantly better than females in all aspects of the MCQ – physiology, mean difference = 3.0% (95% CI 2.3, 3.7), p < 0.001; pharmacology, mean difference = 1.7% (95% CI 1.0, 2.3), p < 0.001; physics with clinical measurement, mean difference = 3.5% (95% CI 2.8, 4.1), p < 0.001; overall mark, mean difference = 2.7% (95% CI 2.1, 3.3), p < 0.001; and standardised overall mark minus the pass mark, mean difference = 2.5% (95% CI 1.9, 3.1), p < 0.001. Graduates from three medical schools that have undergone the change from Traditional to Problem Based Learning curricula did not show any change in performance in any aspects of the MCQ pre and post curriculum change. Conclusion Graduates from each of the medical schools in the UK do show differences in performance in the MCQ section of the primary FRCA, but significant curriculum change does not lead to deterioration in post graduate examination performance. Whilst females now outnumber males taking the MCQ, they are not performing as well as the males. PMID:19563655

  7. Performance of Physical Examination Skills in Medical Students during Diagnostic Medicine Course in a University Hospital of Northwest China

    Science.gov (United States)

    Li, Yan; Li, Na; Han, Qunying; He, Shuixiang; Bae, Ricard S.; Liu, Zhengwen; Lv, Yi; Shi, Bingyin

    2014-01-01

    This study was conducted to evaluate the performance of physical examination (PE) skills during our diagnostic medicine course and analyze the characteristics of the data collected to provide information for practical guidance to improve the quality of teaching. Seventy-two fourth-year medical students were enrolled in the study. All received an assessment of PE skills after receiving a 17-week formal training course and systematic teaching. Their performance was evaluated and recorded in detail using a checklist, which included 5 aspects of PE skills: examination techniques, communication and care skills, content items, appropriateness of examination sequence, and time taken. Error frequency and type were designated as the assessment parameters in the survey. The results showed that the distribution and the percentage in examination errors between male and female students and among the different body parts examined were significantly different (pexaminations was higher than in abdominal (0.867) and head, neck and nervous system examinations (0.917). Female students had a lower average error frequency than males in cardiac examinations (p = 0.041). Additionally, error in examination techniques was the highest type of error among the 5 aspects of PE skills irrespective of participant gender and assessment content (pexaminations and examination techniques may be included in the main focus of improving the teaching of diagnostics in these medical students. PMID:25329685

  8. Forensic Impact of the Child Sexual Abuse Medical Examination.

    Science.gov (United States)

    Myers, John E. B.

    1998-01-01

    This commentary on an article (EC 619 279) about research issues at the interface of medicine and law concerning medical evaluation for child sexual abuse focuses on empirically testable questions: (1) the medical history--its accuracy, interviewing issues, and elicitation and preservation of verbal evidence of abuse; and, (2) expert testimony.…

  9. Medical examination of the workers occupationally exposed to ionizing radiation

    International Nuclear Information System (INIS)

    Kato, Toshio

    1991-01-01

    The hazardous effects of ionizing radiation to man are well recognized, and they are divided into two groups, the stochastic effects (hereditary and carcinogenic effect) and non-stochastic effects (somatic effects such as depression of hematopoiesis, chronic dermatitis and cataracta). The basic framework of the International Commission on Radiological Protection (ICRP) is intended to prevent the occurrence of non-stochastic effects, by keeping doses below the relevant thresholds, and to ensure that all reasonable aspects are taken to reduce the incidence of stochastic effects. In Japan, the regulatory provisions of radiological protection of the workers occupationally exposed to ionizing radiation are based on the recommendation of ICRP adopted in 1977. According to these regulations, the dose equivalent limits of occupational exposure of man has been decided at 50 mSv/year. The monitoring of exposure to the individual and the procedure of medical examination of the workers are briefly described and discussed. (author)

  10. Medical Students' Knowledge about Alcohol and Drug Problems: Results of the Medical Council of Canada Examination

    Science.gov (United States)

    Kahan, Meldon; Midmer, Deana; Wilson, Lynn; Borsoi, Diane

    2006-01-01

    Purpose: To determine knowledge of a national sample of medical students about substance withdrawal, screening and early intervention, medical and psychiatric complications of addiction, and treatment options. Methods: Based on learning objectives developed by medical faculty, twenty-two questions on addictions were included in the 1998 Canadian…

  11. Validating the standard for the National Board Dental Examination Part II.

    Science.gov (United States)

    Tsai, Tsung-Hsun; Neumann, Laura M; Littlefield, John H

    2012-05-01

    As part of the overall exam validation process, the Joint Commission on National Dental Examinations periodically reviews and validates the pass/fail standard for the National Board Dental Examination (NBDE), Parts I and II. The most recent standard-setting activities for NBDE Part II used the Objective Standard Setting method. This report describes the process used to set the pass/fail standard for the 2009 exam. The failure rate on the NBDE Part II increased from 5.3 percent in 2008 to 13.7 percent in 2009 and then decreased to 10 percent in 2010. This article describes the Objective Standard Setting method and presents the estimated probabilities of classification errors based on the beta binomial mathematical model. The results show that the probability of correct classifications of candidate performance is very high (0.97) and that probabilities of false negative and false positive errors are very small (.03 and <0.001, respectively). The low probability of classification errors supports the conclusion that the pass/fail score on the NBDE Part II is a valid guide for making decisions about candidates for dental licensure.

  12. Developing job-related preplacement medical examinations.

    Science.gov (United States)

    Hogan, J C; Bernacki, E J

    1981-07-01

    Federal regulations prohibiting discrimination in hiring require that employment selection procedures to evaluate applicants be based on job-related criteria. The preplacement physical examination used in employment, particularly in the placement of handicapped persons, must also be conducted in a job-related manner. This paper discusses the development and use of the physical examination in selecting and placing applicants for jobs in the workplace with special reference to handicapped persons and disabled veterans. It presents and justifies a method of performing these examinations in a manner consistent with humanistic and business goals as well as the goals of federal regulatory agencies prohibiting employment discrimination.

  13. Quality Assessment of Hepatic Ultrasound Images Examined After a Medical Check-up

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Pyo Nyun; Kim, Kyung Won; Byun, Jae Ho [University of Ulsan College of Medicine, Asan Medical Center, Seoul (Korea, Republic of)

    2009-03-15

    This study was designed to determine problems associated with liver ultrasonography for healthy individuals after a medical examination by the evaluation of sonographic images. A total of 353 patients randomly selected from 341 institutions underwent liver ultrasonography. Among the patients, 14 patients were excluded from the study as they possessed digital images that were not accessible (n = 10) or underwent ultrasonography (n = 4) that did not involve the liver. Two experts each with a ten-year experience in the interpretation of ultrasonography analyzed the images with consensus based on the assessment of liver ultrasonography established by the Korean Society of Ultrasound in Medicine. The images of 339 patients consisted of digital images (n =135), films (n = 14) and prints on paper (n = 190). A total of 3514 images (range, 1-39: mean number of images per patient,10.4) were obtained from 339 patients. Of the patients, there were 232 (68.4%) patients with eight good images and 231 patients had a score greater than 60 points. The mean percent score was 64.9 for general information, 63.8 for technical information and 50.5 for a standard examination. The mean percent score for a longitudinal scan of the common bile duct and vertical scan of the left lobe were low at 20.1 and 28.9, respectively. The number of good images was sufficient at 10.4, but patient information was not exact, ultrasonographic equipment was not adjusted and a standard examination was not applied. As these findings were based on examiner ignorance and indifference, education or certification for examiners should be required

  14. Quality Assessment of Hepatic Ultrasound Images Examined After a Medical Check-up

    International Nuclear Information System (INIS)

    Kim, Pyo Nyun; Kim, Kyung Won; Byun, Jae Ho

    2009-01-01

    This study was designed to determine problems associated with liver ultrasonography for healthy individuals after a medical examination by the evaluation of sonographic images. A total of 353 patients randomly selected from 341 institutions underwent liver ultrasonography. Among the patients, 14 patients were excluded from the study as they possessed digital images that were not accessible (n = 10) or underwent ultrasonography (n = 4) that did not involve the liver. Two experts each with a ten-year experience in the interpretation of ultrasonography analyzed the images with consensus based on the assessment of liver ultrasonography established by the Korean Society of Ultrasound in Medicine. The images of 339 patients consisted of digital images (n =135), films (n = 14) and prints on paper (n = 190). A total of 3514 images (range, 1-39: mean number of images per patient,10.4) were obtained from 339 patients. Of the patients, there were 232 (68.4%) patients with eight good images and 231 patients had a score greater than 60 points. The mean percent score was 64.9 for general information, 63.8 for technical information and 50.5 for a standard examination. The mean percent score for a longitudinal scan of the common bile duct and vertical scan of the left lobe were low at 20.1 and 28.9, respectively. The number of good images was sufficient at 10.4, but patient information was not exact, ultrasonographic equipment was not adjusted and a standard examination was not applied. As these findings were based on examiner ignorance and indifference, education or certification for examiners should be required

  15. Inadequacies of Physical Examination as a Cause of Medical Errors and Adverse Events: A Collection of Vignettes.

    Science.gov (United States)

    Verghese, Abraham; Charlton, Blake; Kassirer, Jerome P; Ramsey, Meghan; Ioannidis, John P A

    2015-12-01

    Oversights in the physical examination are a type of medical error not easily studied by chart review. They may be a major contributor to missed or delayed diagnosis, unnecessary exposure to contrast and radiation, incorrect treatment, and other adverse consequences. Our purpose was to collect vignettes of physical examination oversights and to capture the diversity of their characteristics and consequences. A cross-sectional study using an 11-question qualitative survey for physicians was distributed electronically, with data collected from February to June of 2011. The participants were all physicians responding to e-mail or social media invitations to complete the survey. There were no limitations on geography, specialty, or practice setting. Of the 208 reported vignettes that met inclusion criteria, the oversight was caused by a failure to perform the physical examination in 63%; 14% reported that the correct physical examination sign was elicited but misinterpreted, whereas 11% reported that the relevant sign was missed or not sought. Consequence of the physical examination inadequacy included missed or delayed diagnosis in 76% of cases, incorrect diagnosis in 27%, unnecessary treatment in 18%, no or delayed treatment in 42%, unnecessary diagnostic cost in 25%, unnecessary exposure to radiation or contrast in 17%, and complications caused by treatments in 4%. The mode of the number of physicians missing the finding was 2, but many oversights were missed by many physicians. Most oversights took up to 5 days to identify, but 66 took longer. Special attention and skill in examining the skin and its appendages, as well as the abdomen, groin, and genitourinary area could reduce the reported oversights by half. Physical examination inadequacies are a preventable source of medical error, and adverse events are caused mostly by failure to perform the relevant examination. Copyright © 2015 Elsevier Inc. All rights reserved.

  16. Examination performances of German and international medical students in the preclinical studying-term--a descriptive study.

    Science.gov (United States)

    Huhn, D; Resch, F; Duelli, R; Möltner, A; Huber, J; Karimian Jazi, K; Amr, A; Eckart, W; Herzog, W; Nikendei, C

    2014-01-01

    Medical students with a migration background face several specific problems during their studies. International surveys show first indications that this group of students performs worse in written, oral or practical exams. However, so far, nothing is known about the performance of international students in written pre-clinical tests as well as in pre-clinical State Examinations for German-speaking countries. A descriptive, retrospective analysis of the exam performances of medical students in the pre-clinical part of their studies was conducted at the Faculty of Medicine of Heidelberg in for the year 2012. Performance in written tests of the final exams in the second (N=276), third (N=292) and fourth semester (N=285) were compared between German students, students from EU countries and students from non-EU countries. Same comparison was drawn for the performance in the oral exam of the First State Examination in the period from 2009 - 2012 (N=1137). German students performed significantly better than students with a non-EU migration background both in all written exams and in the oral State Examination (all pstudents with an EU migration background was significantly better than that of students with a non-EU background in the written exam at the end of the third and fourth semester (pstudents completed the oral exam of the First State Examination significantly earlier than students with a non-EU migration background (students with a country of origin outside of the European Union has to be seen as a high-risk group among students with a migration background. For this group, there is an urgent need for early support to prepare for written and oral examinations.

  17. Characteristics of sudden bath-related death investigated by medical examiners in Tokyo, Japan.

    Science.gov (United States)

    Suzuki, Hideto; Hikiji, Wakako; Tanifuji, Takanobu; Abe, Nobuyuki; Fukunaga, Tatsushige

    2015-01-01

    Sudden bath-related deaths occur frequently in Japan, particularly among elderly people. However, the precise mechanism of bath-related death remains uncertain, and effective prevention strategies have not been established. Cases of bath-related deaths (n = 3289) were selected from all cases handled by the Tokyo Medical Examiner's Office from 2009 to 2011 (N = 41 336). The ages and occurrence dates were examined, and major autopsy findings, including toxicological analysis, were evaluated for the autopsied cases (n = 550). Most cases occurred in individuals older than 60 years of age during winter. Analysis of autopsy findings revealed water inhalation signs in many cases (n = 435, 79.1%). Circulatory system diseases constituted more than half of the pathological findings regarding factors that may have contributed significantly to death (n = 300, 54.5%), and cardiac lesions were the most common pathological finding (n = 250, 45.5%). However, approximately one-third of the cases exhibited no remarkable pathological findings (n = 198, 36.0%). A quarter of all cases involved blood ethanol levels that exceeded 0.5 mg/mL (n = 140). The results suggested that drowning plays an important role in the final process of bath-related death. Circulatory system diseases may be the primary underlying pathology; however, there were variations in the medical histories and pathologies of cases of bath-related death. From a preventive perspective, family members should pay attention to elderly people with circulatory system diseases during bathing, particularly in winter. Additionally, the notion that ill or inebriated individuals should not take baths should be reinforced.

  18. Validity of the SMS, Phone, and medical staff Examination sports injury surveillance system for time-loss and medical attention injuries in sports

    DEFF Research Database (Denmark)

    Møller, M; Wedderkopp, N; Myklebust, Grete

    2018-01-01

    The accurate measurement of sport exposure time and injury occurrence is key to effective injury prevention and management. Current measures are limited by their inability to identify all types of sport-related injury, narrow scope of injury information, or lack the perspective of the injured...... by trained on-field observers and medical staff (comparison method). We followed 24 elite adolescent handball players over 12 consecutive weeks. Eighty-six injury registrations were obtained by the SPEx and comparison methods. Of them, 35 injury registrations (41%) were captured by SPEx only, 10 injury...... athlete. The aims of the study were to evaluate the proportion of injuries and the agreement between sport exposures reported by the SMS messaging and follow-up telephone part of the SMS, Phone, and medical staff Examination (SPEx) sports injury surveillance system when compared to measures obtained...

  19. 76 FR 12073 - Extension of Web-Based TRICARE Assistance Program Demonstration Program

    Science.gov (United States)

    2011-03-04

    ... licensure (e.g., spouse abuse). Participant confidentiality is protected, as no medical record entry is made. Calls per month to the TRIAP line since the demonstration was extended and an aggressive marketing...

  20. Examining the link between burnout and medical error: A checklist approach

    Directory of Open Access Journals (Sweden)

    Evangelia Tsiga

    2017-09-01

    Conclusions: The Medical Error Checklists developed in this study advance the study of medical errors by proposing a comprehensive, valid and reliable self-assessment tool. The results highlight the importance of hospital organizational factors in preventing medical errors.

  1. Hypothesis-driven physical examination curriculum.

    Science.gov (United States)

    Allen, Sharon; Olson, Andrew; Menk, Jeremiah; Nixon, James

    2017-12-01

    Medical students traditionally learn physical examination skills as a rote list of manoeuvres. Alternatives like hypothesis-driven physical examination (HDPE) may promote students' understanding of the contribution of physical examination to diagnostic reasoning. We sought to determine whether first-year medical students can effectively learn to perform a physical examination using an HDPE approach, and then tailor the examination to specific clinical scenarios. Medical students traditionally learn physical examination skills as a rote list of manoeuvres CONTEXT: First-year medical students at the University of Minnesota were taught both traditional and HDPE approaches during a required 17-week clinical skills course in their first semester. The end-of-course evaluation assessed HDPE skills: students were assigned one of two cardiopulmonary cases. Each case included two diagnostic hypotheses. During an interaction with a standardised patient, students were asked to select physical examination manoeuvres in order to make a final diagnosis. Items were weighted and selection order was recorded. First-year students with minimal pathophysiology performed well. All students selected the correct diagnosis. Importantly, students varied the order when selecting examination manoeuvres depending on the diagnoses under consideration, demonstrating early clinical decision-making skills. An early introduction to HDPE may reinforce physical examination skills for hypothesis generation and testing, and can foster early clinical decision-making skills. This has important implications for further research in physical examination instruction. © 2016 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

  2. An Interagency Collaboration to Facilitate Development of Filovirus Medical Countermeasures

    Directory of Open Access Journals (Sweden)

    Edwin O. Nuzum

    2012-10-01

    Full Text Available The Filovirus Animal Non-Clinical Group (FANG is a US interdepartmental and interagency group established to support and facilitate the advanced development of filovirus Medical Countermeasures (MCM, both vaccines and therapeutics. It is co-led by one representative from the Department of Defense (DoD, the first author, and one from the Department of Health and Human Services (HHS, the second author. The FANG membership includes operational level program staff and Subject Matter Experts (SME from performing organizations as well as scientific staff and program managers from DoD and HHS funding and regulatory agencies. Focus areas include animal models, assays, reagents, product manufacture and characterization, and other interagency product development issues that will support Food and Drug Administration (FDA licensure of safe and effective filovirus MCMs. The FANG continues to develop strategies to address broadly applicable and interagency product development challenges relevant to filovirus MCM development. This paper summarizes FANG structure and accomplishments and is meant to heighten community awareness of this government-led collaborative effort.

  3. Evaluation of structured oral examination format used in the assessment of undergraduate medical course (MBBS of the University of Dhaka

    Directory of Open Access Journals (Sweden)

    Md Shah Alam

    2015-01-01

    Full Text Available Objectives of this cross sectional descriptive study was to evaluate critically the current status of structured oral examination (SOE format as practiced in the professional examination of undergraduate medical course (MBBS and views of the faculties regarding the concept of SOE as an assessment tool. The study was conducted in 9 medical college examination centers of Dhaka University in July 2007. There were 36 examiners in 18 SOE board, 26 of them were interviewed with a semi-structured questionnaire and SOE boards were observed with a checklist. A total of 2455 questions used in SOE to assess 123 students, were recorded and analyzed using another checklist. These questions were used to assess learning hierarchy and content coverage using forensic medicine as a reference subject. Analysis of the questions revealed majority (97% were of recall type, only 3% were interpretation and problem solving types. The questions for 119 (97% examinee did not address 10%-50% content area. About 38% examiners responded that they had no clear idea regarding learning objectives and none had idea regarding test blueprint.The examiners marked the domain of learning measured by SOE in favor of cognitive skill (61%, communication skill (38.5%, motor skill (11.5%, behavior and attitude (19%. No examiner prepared model answer of SOE questions by consensus with other examiner. Though more than 80% examiner agreed with the statement that pre-selection of accepted model answer is an important element for success of SOE. But no examiners of any SOE boards practiced it. Similarly, none of the examiners of SOE board kept records of individual question and the answer of the examinees. No boards maintained equal time for a candidate during SOE by using timer or stop watch. Examiners of 8 boards (44% did not use recommended rating scale to score individual response of examinee rather scored in traditional consolidated way at the end of the candidate’s examination

  4. Can Periodical Examinations of Employees Be Useful in Detection of Glycaemia Impairment and Improving Patients’ Adherence to Medical Recommendations?

    Directory of Open Access Journals (Sweden)

    Andrzej Marcinkiewicz

    2018-03-01

    Full Text Available Worldwide epidemiological data indicates insufficient diagnosis of diabetes as an increasing public health problem. In the search for solutions to this disadvantageous situation, occupational medicine health services seem to open up a unique opportunity to recognize some abnormalities in the early stages, especially among the asymptomatic working-age population. 316 workers underwent obligatory prophylactic examinations. In patients with twice assayed FGL ≥ 126 mg/dL (7.0 mmol/L an additional intervention was implemented, including further diagnostic processes and therapy in General Practice (GP, followed by examination by an occupational health specialist within 3 months. The diagnosis of previously unknown diabetes was established among 2.5% of examined workers. All patients referred to the GP due to detected glycaemia impairment visited their doctor and finished the diagnostic process, took up therapy constrained by the occupational health physician to show the effects of intervention within 3 months. Prophylactic medical check-ups allow improved compliance and medical surveillance over glycaemia impairment in patients with prediabetes states, unknown diabetes or uncontrolled clinical course of diabetes. Considering fasting glucose level during mandatory prophylactic examination helps effective prevention of diabetes and its complications and thus provides public health system benefits.

  5. Occupational exposure of medical staff due to diagnostic X-ray examinations in veterinary medicine

    International Nuclear Information System (INIS)

    Mergel, E.; Feige, S.; Haeusler, U.

    2007-01-01

    The implementation of the Council directive 96/29 EURATOM and the corresponding national Radiation Protection Ordinance and the X-ray Protection Ordinance coming subsequently into effect led to a changed situation regarding the occupational radiation protection in the medical sector. To reduce the occupational exposure of veterinarians and assisting staff in veterinary radiography is particularly challenging as, in opposite to human radiological examination, the presence of staff is indispensable to restrain the patient. Beyond that the relevant literature reports about too high and/or about unnecessary radiation exposures. To gain a comprehensive knowledge upon the possible exposure of involved staff, the variety of typical examination methods in veterinary clinics and at practitioners had been investigated during the daily routine. Dose measurements were performed for different employees during the examinations taking into account several places of exposure (lens, thyroid, chest, hand, gonad, and feet). Veterinary X-ray diagnostic examinations for pets as well as in equine radiography had been accounted for this study. In total, 101 examination methods, 4.484 accompanied examinations and 53.892 single dose readings resulted in a reliable statistical base to set up a 'Job-Exposure-Matrix' allowing the dose assessment for a variable number and kind of examinations. The 'Job-Exposure-Matrix' is believed to be a useful tool for optimization of occupational radiation exposure of veterinarians by appraising the height of a possible dose, forcing a review of the status quo and triggering the improvement of personal protection by establishing adequate measures. (orig.)

  6. Occupational exposure of medical staff due to diagnostic X-ray examinations in veterinary medicine

    Energy Technology Data Exchange (ETDEWEB)

    Mergel, E.; Feige, S. [Gesellschaft fuer Anlagen- und Reaktorsicherheit mbH (GRS) (Germany); Haeusler, U. [Bundesamt fuer Strahlenschutz (BfS), Salzgitter (Germany)

    2007-07-01

    The implementation of the Council directive 96/29 EURATOM and the corresponding national Radiation Protection Ordinance and the X-ray Protection Ordinance coming subsequently into effect led to a changed situation regarding the occupational radiation protection in the medical sector. To reduce the occupational exposure of veterinarians and assisting staff in veterinary radiography is particularly challenging as, in opposite to human radiological examination, the presence of staff is indispensable to restrain the patient. Beyond that the relevant literature reports about too high and/or about unnecessary radiation exposures. To gain a comprehensive knowledge upon the possible exposure of involved staff, the variety of typical examination methods in veterinary clinics and at practitioners had been investigated during the daily routine. Dose measurements were performed for different employees during the examinations taking into account several places of exposure (lens, thyroid, chest, hand, gonad, and feet). Veterinary X-ray diagnostic examinations for pets as well as in equine radiography had been accounted for this study. In total, 101 examination methods, 4.484 accompanied examinations and 53.892 single dose readings resulted in a reliable statistical base to set up a 'Job-Exposure-Matrix' allowing the dose assessment for a variable number and kind of examinations. The 'Job-Exposure-Matrix' is believed to be a useful tool for optimization of occupational radiation exposure of veterinarians by appraising the height of a possible dose, forcing a review of the status quo and triggering the improvement of personal protection by establishing adequate measures. (orig.)

  7. Use of Addenbrooke’s cognitive examination-revised to evaluate the patients’ state in general medical practice

    Directory of Open Access Journals (Sweden)

    Nikolai Nikolayevich Ivanets

    2012-01-01

    Full Text Available The differential diagnosis of cognitive impairments is of great importance in mental disorders detectable in general medical practice. Objective: to study whether Addenbrooke's Cognitive Examination — Revised (ACE-R may be used in these patients. Patients and methods. The study was conducted in two steps at somatic hospitals and city polyclinics. It enrolled 130patients (36 men and 94 women with anxiety-depression spectrum disorders (ADSD, mild cognitive disorders (MCD and a concurrence of these conditions. The authors used the following psychometric scales: the hospital anxiety and depression scale; the mini-mental state examination; the frontal assessment battery; ACE-R; ten words learning test. The psychometric characteristics of ACE-R and the possibilities of its use were estimated to detect MCD. The differences in the spectrum of cognitive impairments were analyzed in patients with different types of ADSD. Results. ACE-R is shown to be an effective neuropsychological tool for the primary diagnosis, detection, and evaluation of MCD in the general medical network. The results of ACE-R use indicate that the spectrum of cognitive impairments has substantial differences in patients with different types of non-psychotic disorders.

  8. 23081 - Royal Decree No. 1132 of 14 September 1990 laying down basic measures for radiation protection of persons undergoing medical examination or treatment

    International Nuclear Information System (INIS)

    1990-01-01

    This Royal Decree incorporates into Spanish regulations Directive 84/466 Euratom which lays down basic measures for the radiation protection of persons undergoing medical examination or treatment. Any exposure to radiation for medical purposes must be medically justified and be conducted under the responsibility of a medical or dental practitioner adequately trained in the radiation protection field. All relevant facilities must be recorded in the national inventories to avoid unnecessary proliferation of such equipment [fr

  9. Educational value of pocket-sized ultrasound devices to improve understanding of ultrasound examination principles and sonographic anatomy for medical student.

    Directory of Open Access Journals (Sweden)

    Eun Young Kim

    Full Text Available Medical students must understand the principles of ultrasonography (US, because US examinations are an important component of patient care in clinical practice. Pocket-sized ultrasound devices have the benefits of accessibility and ease of use. The primary objective of the present study was to evaluate the educational value of these devices in terms of improving medical student interest and understanding of US and sonographic anatomy.We added a US training program comprised of a self-study learning module and a hands-on training session to a two-week block curriculum of medical imaging for first year medical students (n = 40. Multiple pocket-sized US devices were used on a small-group basis during a single afternoon. Students were asked to complete a questionnaire before and after the US training session; these two questionnaires contained 6 and 10 questions, respectively, which were rated by students using a five-point Likert scale. In addition, understanding of sonographic anatomy was tested before and after the training program.Forty students completed the two questionnaires and the anatomy-related tests. Students found the program educationally valuable (4.37 ± 0.54 of 5 and reported that US practice was useful for improving their understanding of the principles of US examinations (4.23 ± 0.66 of 5 and sonographic anatomy (4.40 ± 0.55 of 5. Overall confidence at performing US examinations and understanding of sonographic anatomy were significantly increased after US training (increased overall confidence score, 1.87 ± 0.91 and improvement in sonographic anatomy score, 6.55 ± 1.55, p values < 0.001.US training using pocket-sized ultrasound devices was found to be educationally valuable for medical students in terms of improving understanding of US principles and familiarizing students with sonographic anatomy.

  10. Voluntary Medication Error Reporting by ED Nurses: Examining the Association With Work Environment and Social Capital.

    Science.gov (United States)

    Farag, Amany; Blegen, Mary; Gedney-Lose, Amalia; Lose, Daniel; Perkhounkova, Yelena

    2017-05-01

    Medication errors are one of the most frequently occurring errors in health care settings. The complexity of the ED work environment places patients at risk for medication errors. Most hospitals rely on nurses' voluntary medication error reporting, but these errors are under-reported. The purpose of this study was to examine the relationship among work environment (nurse manager leadership style and safety climate), social capital (warmth and belonging relationships and organizational trust), and nurses' willingness to report medication errors. A cross-sectional descriptive design using a questionnaire with a convenience sample of emergency nurses was used. Data were analyzed using descriptive, correlation, Mann-Whitney U, and Kruskal-Wallis statistics. A total of 71 emergency nurses were included in the study. Emergency nurses' willingness to report errors decreased as the nurses' years of experience increased (r = -0.25, P = .03). Their willingness to report errors increased when they received more feedback about errors (r = 0.25, P = .03) and when their managers used a transactional leadership style (r = 0.28, P = .01). ED nurse managers can modify their leadership style to encourage error reporting. Timely feedback after an error report is particularly important. Engaging experienced nurses to understand error root causes could increase voluntary error reporting. Published by Elsevier Inc.

  11. PCXMC. A PC-based Monte Carlo program for calculating patient doses in medical x-ray examinations

    International Nuclear Information System (INIS)

    Tapiovaara, M.; Lakkisto, M.; Servomaa, A.

    1997-02-01

    The report describes PCXMC, a Monte Carlo program for calculating patients' organ doses and the effective dose in medical x-ray examinations. The organs considered are: the active bone marrow, adrenals, brain, breasts, colon (upper and lower large intestine), gall bladder, heats, kidneys, liver, lungs, muscle, oesophagus, ovaries, pancreas, skeleton, skin, small intestine, spleen, stomach, testes, thymes, thyroid, urinary bladder, and uterus. (42 refs.)

  12. Assessing Communication Skills of Medical Students in Objective Structured Clinical Examinations (OSCE)--A Systematic Review of Rating Scales.

    Science.gov (United States)

    Cömert, Musa; Zill, Jördis Maria; Christalle, Eva; Dirmaier, Jörg; Härter, Martin; Scholl, Isabelle

    2016-01-01

    Teaching and assessment of communication skills have become essential in medical education. The Objective Structured Clinical Examination (OSCE) has been found as an appropriate means to assess communication skills within medical education. Studies have demonstrated the importance of a valid assessment of medical students' communication skills. Yet, the validity of the performance scores depends fundamentally on the quality of the rating scales used in an OSCE. Thus, this systematic review aimed at providing an overview of existing rating scales, describing their underlying definition of communication skills, determining the methodological quality of psychometric studies and the quality of psychometric properties of the identified rating scales. We conducted a systematic review to identify psychometrically tested rating scales, which have been applied in OSCE settings to assess communication skills of medical students. Our search strategy comprised three databases (EMBASE, PsycINFO, and PubMed), reference tracking and consultation of experts. We included studies that reported psychometric properties of communication skills assessment rating scales used in OSCEs by examiners only. The methodological quality of included studies was assessed using the COnsensus based Standards for the selection of health status Measurement INstruments (COSMIN) checklist. The quality of psychometric properties was evaluated using the quality criteria of Terwee and colleagues. Data of twelve studies reporting on eight rating scales on communication skills assessment in OSCEs were included. Five of eight rating scales were explicitly developed based on a specific definition of communication skills. The methodological quality of studies was mainly poor. The psychometric quality of the eight rating scales was mainly intermediate. Our results reveal that future psychometric evaluation studies focusing on improving the methodological quality are needed in order to yield psychometrically

  13. Examination performances of German and international medical students in the preclinical studying-term – A descriptive study

    Science.gov (United States)

    Huhn, D.; Resch, F.; Duelli, R.; Möltner, A.; Huber, J.; Karimian Jazi, K.; Amr, A.; Eckart, W.; Herzog, W.; Nikendei, C.

    2014-01-01

    Introduction: Medical students with a migration background face several specific problems during their studies. International surveys show first indications that this group of students performs worse in written, oral or practical exams. However, so far, nothing is known about the performance of international students in written pre-clinical tests as well as in pre-clinical State Examinations for German-speaking countries. Method: A descriptive, retrospective analysis of the exam performances of medical students in the pre-clinical part of their studies was conducted at the Faculty of Medicine of Heidelberg in for the year 2012. Performance in written tests of the final exams in the second (N=276), third (N=292) and fourth semester (N=285) were compared between German students, students from EU countries and students from non-EU countries. Same comparison was drawn for the performance in the oral exam of the First State Examination in the period from 2009 - 2012 (N=1137). Results: German students performed significantly better than students with a non-EU migration background both in all written exams and in the oral State Examination (all pstudents with an EU migration background was significantly better than that of students with a non-EU background in the written exam at the end of the third and fourth semester (pstudents completed the oral exam of the First State Examination significantly earlier than students with a non-EU migration background (students with a country of origin outside of the European Union has to be seen as a high-risk group among students with a migration background. For this group, there is an urgent need for early support to prepare for written and oral examinations. PMID:25228931

  14. What factors facilitate the engagement with flipped classrooms used in the preparation for postgraduate medical membership examinations?

    Directory of Open Access Journals (Sweden)

    Jesurasa A

    2017-06-01

    Full Text Available Amrita Jesurasa, Kelly Mackenzie, Hannah Jordan, Elizabeth C Goyder School of Health and Related Research (ScHARR, University of Sheffield, Regent Court, Sheffield, UK Background: The “flipped classroom,” a pedagogical model where typical lecture and homework elements are reversed, is being advocated in medical education to support the teaching of a large curriculum. However, research into the use of this model in postgraduate medical education, which requires the application of acquired knowledge, is limited. The aim of this study was to explore the barriers and facilitators to engagement with the flipped classroom model in preparation for the written element of postgraduate membership examinations. Methods: Three focus groups (n=14 were held between February and June 2016. Participants were drawn from a membership examination preparation course, run by the University of Sheffield. Two of the groups (n=10 involved “students” (public health registrars while the other focus group (n=4 was held with “tutors” (experienced registrars and consultants. The focus groups were audiorecorded and transcribed verbatim. Transcripts were thematically analyzed by using both predetermined and emergent themes. Results: Key themes that emerged from the data included variation in learning and teaching styles of individuals as well as the feasibility and flexibility of the overall course design. However, management of students’ expectations was found to be the fundamental factor, which underpinned the engagement. Conclusion: The complex interaction of factors affecting engagement in this study highlights the need to consider the appropriateness of the flipped classroom model. However, this must be balanced by the potential benefits of the approach for delivering a large curriculum. Recognizing the central importance of managing expectations at the outset would be useful when considering this model in postgraduate medical education. Keywords

  15. The Value of Outsourcing Selected Cases in a Medical Examiner Population: A 10-Year Experience.

    Science.gov (United States)

    McCleskey, Brandi C; Reilly, Stephanie D; Atherton, Dan

    2017-01-01

    Due to increasing caseloads and inadequate staffing, the burden on Coroner/Medical Examiner Offices to comply with recommended autopsy limits for forensic pathologists (FPs) has been difficult. Since 2006, pathologists at the University of Alabama at Birmingham have performed select autopsies for the Alabama Department of Forensic Sciences. Each case was reviewed by a state FP and scene investigator to determine appropriateness for referral. All referred cases received full postmortem examination including microscopic examination and collection of toxicological samples, and toxicology was ordered by the referring FP as appropriate. The final cause and manner of death were determined by the referring state FP after review of all findings. A majority of the 421 cases were ruled accidental deaths (233), most due to drug toxicity. Of the 178 natural deaths, 118 were attributed to cardiovascular disease. Outsourcing select forensic cases can be educational and an effective tool to manage workflow without compromising quality. © 2016 American Academy of Forensic Sciences.

  16. Incidence and cost of rotavirus hospitalizations in Denmark

    DEFF Research Database (Denmark)

    Fischer, Thea Kølsen; Nielsen, Nete Munk; Wohlfahrt, Jan

    2007-01-01

    In anticipation of licensure and introduction of rotavirus vaccine into the western market, we used modeling of national hospital registry data to determine the incidence and direct medical costs of annual rotavirus-associated admissions over >11 years in Denmark. Diarrhea-associated hospitalizat......In anticipation of licensure and introduction of rotavirus vaccine into the western market, we used modeling of national hospital registry data to determine the incidence and direct medical costs of annual rotavirus-associated admissions over >11 years in Denmark. Diarrhea......-associated hospitalizations coded as nonspecified viral or presumed infectious have demonstrated a marked winter peak similar to that of rotavirus-associated hospitalizations, which suggests that the registered rotavirus-coded admissions are grossly underestimated. We therefore obtained more realistic estimates by 2...... different models, which indicated 2.4 and 2.5 (for children rotavirus-associated admissions per 1,000 children per year, respectively. These admissions amount to associated direct medical costs of US $1.7-1.8 million per year. Using 2 simple...

  17. 5 CFR 339.303 - Examination procedures.

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Examination procedures. 339.303 Section... QUALIFICATION DETERMINATIONS Medical Examinations § 339.303 Examination procedures. (a) When an agency orders or offers a medical examination under this subpart, it must inform the applicant or employee in writing of...

  18. Mandatory HIV Screening Policy & Everyday Life: A Look Inside the Canadian Immigration Medical Examination

    Directory of Open Access Journals (Sweden)

    LAURA BISAILLON

    2011-11-01

    Full Text Available Findings that detail the social organization of day-to-day practices associated with the Canadian government policy of mandatory HIV testing of permanent residence applicants to Canada are reported. Institutional ethnography was used to investigate interactions between HIV-positive applicants and immigration physicians during the immigration medical examination. A composite narrative recounts details of a woman applicant's discovery through immigration testing that she was living with HIV. Mandatory HIV testing gives rise to serious difficulties for applicants to Canada living with HIV. Applicant, physician and federal state employee work practices associated with mandatory HIV testing are analysed. These practices contribute to the ideological work of the Canadian state, where interest bounds up in the examination serve the state and not the applicant. Findings should be useful for Canadian immigration policy makers who wish to develop constructive and functional strategies to address issues that matter in people's lives

  19. Guidelines examination of victims of sexual assault harmonization of forensic and medico-legal examination of persons.

    Science.gov (United States)

    Ludes, B; Geraut, A; Väli, M; Cusack, D; Ferrara, D; Keller, E; Mangin, P; Vieira, D N

    2018-02-21

    Sexual assault is a complex situation with medical, psychological, and legal aspects. Forensic experts play a major role in terms of forensic and gynecological medical examination and evidence collection in order to maintain the chain of custody. Victims should be examined by a specially trained medico-legal examiner in order to avoid multiple examinations in the surroundings that do not meet minimum health standards. The evolution and treatment of sexual assault victims are time-intensive and should optimally be provided by a team that includes a forensic medical doctor. These guidelines will be of interest to forensic medical doctors who will have responsibility for the examination and assessment of victims of sexual violence and can be used as a day-to-day service document and/or a guide to develop health service for victims of sexual violence.

  20. 21 CFR 880.6265 - Examination gown.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Examination gown. 880.6265 Section 880.6265 Food... § 880.6265 Examination gown. (a) Identification. An examination gown is a device intended for medical... covering during a medical examination. (b) Classification. Class I (general controls). The device is exempt...

  1. Gatekeepers as Care Providers: The Care Work of Patient-centered Medical Home Clerical Staff.

    Science.gov (United States)

    Solimeo, Samantha L; Ono, Sarah S; Stewart, Kenda R; Lampman, Michelle A; Rosenthal, Gary E; Stewart, Greg L

    2017-03-01

    International implementation of the patient-centered medical home (PCMH) model for delivering primary care has dramatically increased in the last decade. A majority of research on PCMH's impact has emphasized the care provided by clinically trained staff. In this article, we report our ethnographic analysis of data collected from Department of Veterans Affairs staff implementing PACT, the VA version of PCMH. Teams were trained to use within-team delegation, largely accomplished through attention to clinical licensure, to differentiate staff in providing efficient, patient-centered care. In doing so, PACT may reinforce a clinically defined culture of care that countermands PCMH ideals. Such competing rubrics for care are brought into relief through a focus on the care work performed by clerks. Ethnographic analysis identifies clerks' care as a kind of emotional dirty work, signaling important areas for future anthropological study of the relationships among patient-centered care, stigma, and clinical authority. © 2016 by the American Anthropological Association.

  2. Research on the radiation doses to adults receiving from main types of medical X-ray CT examinations

    International Nuclear Information System (INIS)

    Gao Linfeng; Wang Bin; Yao Jie; Qian Aijun; Zheng Junzheng; Zhuo Weihai; Qu Liangyong

    2013-01-01

    To study and master the doses to examinees receiving from the wide spread X-CT examinations, is a key issue for strengthening the medical radiation protection. In the studies of the medical exposure levels during the Eleventh Five-Year Plan period in Shanghai, based on the brands of X-CT scanners and their distributions in different levels of hospitals, a total of 45 sets (about 30% of all) of scanners were selected for the field study. Among the 8 commonly performed examinations, the scan parameters and their relevant dosimetry information for 500 adults were collected, and their typical effective doses were estimated with the dose conversion factors. The results showed that the averages of weighted CT dose index (CTDI w ) were 55.4, 12.5 and 18.4 mGy, and the dose length products (DLP) were averaged to be 603, 294 and 415 mGy·cm, for the skull, chest and abdomen X-CT scans, respectively. The typical effective doses were estimated to be 1.4, 5.3, and 7.5 mSv for adults in the head, chest and abdomen X-CT scans, respectively. The values of CTDI w for skull scans were generally higher than those for the ear canal, eye, or sinus examinations. It is clear that the optimization between the image quality and the radiation dose should be further strengthened. Particular attentions should be paid in selecting the scanning parameters for various types of X-CT scans, and the diagnostic reference levels for X-CT examinations should be continuously improved. (authors)

  3. View point of medical exposure

    International Nuclear Information System (INIS)

    Akahane, Keiichi

    2008-01-01

    This text contains the following subjects. (1) Introduction, (2) Progress of medical examinations by radiation, (2-1) Decision of applying radiation, (2-2) Irradiation method, (2-3) Irradiation dose, (3) Exposure at medical examinations by radiation, (3-1) Dose to express the exposure, (3-2) Dose at medical exposure, (4) Types of medical examinations by radiation, (4-1) Radiation diagnosis, (4-2) Radiation therapy, (4-3) Nuclear medicine, (5) Radiation effects, (5-1) Types of radiation effect, (5-2) Effects of medical exposure, (6) Present status of medical examination by radiation, (6-1) Actual status of medical exposure, (6-2) Medical examinations by radiation in Japan, (7) Assessment of medical exposure, (7-1) Exposure dose, (7-2) Papers on radiation risk, and (7-3) Radiation protection. (K.Y.)

  4. Prospects and perspectives for development of a vaccine against herpes simplex virus infections.

    Science.gov (United States)

    McAllister, Shane C; Schleiss, Mark R

    2014-11-01

    Herpes simplex viruses 1 and 2 are human pathogens that lead to significant morbidity and mortality in certain clinical settings. The development of effective antiviral medications, however, has had little discernible impact on the epidemiology of these pathogens, largely because the majority of infections are clinically silent. Decades of work have gone into various candidate HSV vaccines, but to date none has demonstrated sufficient efficacy to warrant licensure. This review examines developments in HSV immunology and vaccine development published since 2010, and assesses the prospects for improved immunization strategies that may result in an effective, licensed vaccine in the near future.

  5. Academic performance of day scholars versus boarders in pharmacology examinations of a medical school in Pakistan.

    Science.gov (United States)

    Faisal, Rizwan; Shinwari, Laiyla; Izzat, Saadia

    2016-09-01

    To compare the academic performance of day scholar and boarder students in Pharmacology examinations. This comparative study was conducted at Rehman Medical College, Peshawar, Pakistan, from June to September, 2015. It comprised third-year medical students of the sessions 2013-14 and 2014-15.The record of the results of examinations, which had already been conducted, were assessed. All the exams had two components, i.e. multiple-choice questions and short-essay questions. Students were categorised into 4 groups according to their academic performance: those who got 80% marks (Group 4). SPSS 20 was used for data analysis. Of the 200 students, 159(79.5%) were day scholars and 41(20.5%) were boarders. In multiple-choice questions, 29(70.7%) boarder students were in Group 2, while none of them was in Group 4. In short-essay questions, 11(26.8%) of them were in Group 1 and 17(41.5%) in Group 2. Results of day scholars' multiple-choice questions exams showed 93(58.5%) were in Group 2 and 2(1.3%) in Group 4. In short-essay questions, 63(39.6%) were in Group 2 (p>o.o5 each). No significant difference was found between the academic performance of boarders and day scholars.

  6. A near-peer teaching program designed, developed and delivered exclusively by recent medical graduates for final year medical students sitting the final objective structured clinical examination (OSCE

    Directory of Open Access Journals (Sweden)

    Sobowale Oluwaseun

    2011-03-01

    Full Text Available Abstract Background The General Medical Council states that teaching doctors and students is important for the care of patients. Our aim was to deliver a structured teaching program to final year medical students, evaluate the efficacy of teaching given by junior doctors and review the pertinent literature. Methods We developed a revision package for final year medical students sitting the Objective Structured Clinical Examination (OSCE. The package was created and delivered exclusively by recent medical graduates and consisted of lectures and small group seminars covering the core areas of medicine and surgery, with a focus on specific OSCE station examples. Students were asked to complete a feedback questionnaire during and immediately after the program. Results One hundred and eighteen completed feedback questionnaires were analysed. All participants stated that the content covered was relevant to their revision. 73.2% stated that junior doctors delivered teaching that is comparable to that of consultant - led teaching. 97.9% stated the revision course had a positive influence on their learning. Conclusions Our study showed that recent medical graduates are able to create and deliver a structured, formal revision program and provide a unique perspective to exam preparation that was very well received by our student cohort. The role of junior doctors teaching medical students in a formal structured environment is very valuable and should be encouraged.

  7. A snapshot of patients' awareness of radiation dose and risks associated with medical imaging examinations at an Australian radiology clinic.

    Science.gov (United States)

    Singh, N; Mohacsy, A; Connell, D A; Schneider, M E

    2017-05-01

    Cumulative radiation exposure is linked to increasing the lifetime attributable risk of cancer. To avoid unnecessary radiation exposure and facilitate shared decision making, patients should be aware of these issues. This paper examines patients' awareness of radiation dose and risks associated with medical imaging examinations. Consecutive patients attending a private radiology clinic over a nine week period in 2014 in Metropolitan Melbourne were surveyed while waiting to undergo an imaging examination. Patients who were under 18 years of age, did not speak English and/or were referred for interventional imaging procedures were excluded from participation. Survey questions addressed patients' awareness of radiation dose associated with various imaging modalities' and patients' experience and preferences regarding communication of information about radiation. Data was analysed using SPSS (Ver 20.1). A total of 242 surveys were completed. Most participants were male (143/239, 59.8%) and aged between 33 and 52 years (109/242, 45%). Over half of participants were not concerned about radiation from medical imaging (130/238, 54.6%). Only a third of participants (80/234, 34.2%) correctly reported that CT has a higher radiation dose than X-ray. Very few participants correctly identified mammography, DEXA, PET and PET/CT as radiation emitting examinations. The majority of participants (202/236, 85.6%) indicated that they were not informed about radiation dose and risks by their referring doctor in advance. This paper provides information relevant to a single private radiology clinic in Australia. Nevertheless, our results have shown that patients presenting for medical imaging have little awareness of radiation dose and risks associated with these examinations and received little information by their referring physicians or staff at the radiology clinic. Copyright © 2016 The College of Radiographers. Published by Elsevier Ltd. All rights reserved.

  8. Stochastic risk estimation from medical x-ray diagnostic examinations, 3

    International Nuclear Information System (INIS)

    Hashizume, Tadashi; Maruyama, Takashi; Noda, Yutaka; Iwai, Kazuo; Fukuhisa, Kenjiro

    1981-01-01

    The genetically significant dose (GSD), per Caput mean bone marrow dose (CMD), leukemia significant dose (LSD) and malignancy significant dose (MSD) from medical diagnostic X-ray examinations in Japan were estimated based on a 1979 nationwide survey of randomly sampled hospitals and clinics. The population risk estimates were carried out using the resultant values of GSD, LSD and MSD. In the risk estimates, the significant factors, namely, the relative child expectancy, the leukemia significant factor and the malignancy significant factor, for patients were assumed to be same as those of general population. The risk factors used were 185 x 10 -6 rad -1 for genetic risk of all generations, 20 x 10 -6 rad -1 for fatal leukemia and 165 x 10 -6 rad -1 for fatal malignant diseases, respectively. The resultant annual population doses per person were 15 mrad (0.15 mGy) for GSD, 107 mrad (1.07 mGy) for CMD, 86 mrad (0.86 mGy) for LSD and 43 mrad (0.43 mGy) for MSD, respectively. The present data other than the MSD were compared with the data in 1960, 1969 and 1974. For example, the GSD of 1979 was approximately same as that of 1974, although the annual number of examinations in 1979 increased by about 30 percent as compared with those of 1974. The population risks from X-ray diagnosis were estimated to be 260 persons per year for genetic risk of all generations, 192 person per year for fatal leukemic risk and 825 person per year for malignant risk, respectively, for the whole population in Japan, assuming that the X-ray diagnosis in 1979 will be performed continuously in the future. The average risks per one exposure for X-ray radiography were estimated using the weighted average of the significant factor and the organ or tissue dose with the number of radiographic exposures by age and by type of examination. The average risks per radiographic exposure were 176 x 10 -9 for genetic risk, 285 x 10 -9 for leukemic risk and 1.75 x 10 -6 for malignant risk respectively. (author)

  9. [Approaches to development and implementation of the medical information system for military-medical commission of the multidisciplinary military-medical organisation].

    Science.gov (United States)

    Kuvshinov, K E; Klipak, V M; Chaplyuk, A L; Moskovko, V M; Belyshev, D V; Zherebko, O A

    2015-06-01

    The current task of the implementation of medical information systems in the military and medical organizations is an automation of the military-medical expertise as one of the most important activities. In this regard, noteworthy experience of the 9th Medical Diagnostic Centre (9th MDC), where on the basis of medical information system "Interi PROMIS" for the first time was implemented the automation of the work of military medical commission. The given paper presents an algorithm for constructing of the information system for the military-medical examination; detailed description of its elements is given. According to military servicemen the implementation of the Military Medical Commission (MMC) subsystem of the medical information system implemented into the 9th MDC has reduced the time required for the MMC and paperwork, greatly facilitate the work of physicians and medical specialists on military servicemen examination. This software can be widely applied in ambulatory and hospital practice, especially in case of mass military-medical examinations.

  10. The structure of medical competence and results on an Objective Structured Clinical Examination

    NARCIS (Netherlands)

    Jacobs, A.; Denessen, E.J.P.G.; Postma, C.

    2004-01-01

    Background: Medical competence is a central concept in medical education. Educational efforts in medical training are directed at the achievement of a maximal medical competence. The concept of the structure of medical competence (multidimensional or one-dimensional with strongly interrelated

  11. Frequency of paediatric medical imaging examinations performed at a European teaching hospital over a 7-year period

    Energy Technology Data Exchange (ETDEWEB)

    Portelli, Jonathan L.; Bezzina, Paul [University of Malta, Department of Radiography, Faculty of Health Sciences, Msida (Malta); McNulty, Jonathan P.; Rainford, Louise [University College Dublin, Diagnostic Imaging, School of Medicine and Medical Science, Dublin (Ireland)

    2016-12-15

    The aim of this retrospective cohort study was to gain an insight into frequencies by which a range of medical imaging (MI) examinations were performed on paediatric patients at the main acute general teaching hospital in Malta between 2008 and 2014. Frequency data of MI examinations performed on paediatric patients were retrospectively collected from relevant information systems. All data was coded accordingly to facilitate data analysis. A total of 95,805 MI examinations were performed on 39,707 unique paediatric patients (<18 years) between 2008 and 2014. Overall, the total number of paediatric MI examinations performed decreased over time, with use varying depending on modality type and paediatric age. Coincidentally the use of ultrasound and MRI increased year after year. Some paediatric patients underwent at least three MI examinations involving the same anatomical region being scanned, and which may collectively contribute to effective doses exceeding 10 mSv. Knowledge of how MI examinations are used within the paediatric population can help practices evaluate and address any trends highlighted for particular examinations or age category of paediatric patients. Furthermore, awareness of current trends of MI in children can be helpful for the planning of future paediatric radiology departments. (orig.)

  12. Frequency of paediatric medical imaging examinations performed at a European teaching hospital over a 7-year period

    International Nuclear Information System (INIS)

    Portelli, Jonathan L.; Bezzina, Paul; McNulty, Jonathan P.; Rainford, Louise

    2016-01-01

    The aim of this retrospective cohort study was to gain an insight into frequencies by which a range of medical imaging (MI) examinations were performed on paediatric patients at the main acute general teaching hospital in Malta between 2008 and 2014. Frequency data of MI examinations performed on paediatric patients were retrospectively collected from relevant information systems. All data was coded accordingly to facilitate data analysis. A total of 95,805 MI examinations were performed on 39,707 unique paediatric patients (<18 years) between 2008 and 2014. Overall, the total number of paediatric MI examinations performed decreased over time, with use varying depending on modality type and paediatric age. Coincidentally the use of ultrasound and MRI increased year after year. Some paediatric patients underwent at least three MI examinations involving the same anatomical region being scanned, and which may collectively contribute to effective doses exceeding 10 mSv. Knowledge of how MI examinations are used within the paediatric population can help practices evaluate and address any trends highlighted for particular examinations or age category of paediatric patients. Furthermore, awareness of current trends of MI in children can be helpful for the planning of future paediatric radiology departments. (orig.)

  13. Evaluation of the acceptability of Peer Physical Examination (PPE) in medical and osteopathic students: a cross sectional survey.

    Science.gov (United States)

    Consorti, Fabrizio; Mancuso, Rosaria; Piccolo, Annalisa; Consorti, Giacomo; Zurlo, Joseph

    2013-08-22

    Peer physical examination (PPE) is a method of training in medical and osteopathic curricula. The aim of this study was to compare the acceptability of PPE in two classes of medical and osteopathic students after their first experience, to obtain comparative information useful for an understanding of the different professional approaches. The leading hypothesis was that osteopathic students enter the curriculum with a more positive attitude to bodily contact.As a secondary aim, this study validated the new version of a questionnaire to assess the acceptability of PPE. A new version of a previously validated questionnaire and an instrument from the literature (the Examining Fellow Student [EFS] questionnaire) were used for a cross-sectional survey in a class of 129 3rd year medical students and in two parallel classes of 1st year osteopathic students (total of 112 students). The mean score of the new questionnaire was significantly higher for the osteopathic students than for the medical students (53.4 ± 6.3 vs. 43.4 ± 8.9; p student. The EFS mean score also showed a significant difference between the osteopathic and medical students (30.76 ± 2.9 vs. 27.85 ± 4.3; p accounting for 62.8% of the variance. Criterion validity was assessed by correlation with the EFS (Pearson's r coefficient = 0.61). Reliability was expressed in terms of Cronbach's alpha coefficient, which equals 0.86. These quantitative results are consistent with previous qualitative research on the process of embodiment both in medicine and osteopathy. The new questionnaire proved to be valid and reliable. The objective assessment of the acceptability of PPE is a way to determine differences in students' attitudes towards contact with the body and can be used for counselling students regarding career choice. This study can also highlight differences between students from different professions and serve as a basis for reflection for improved mutual interprofessional understanding and future

  14. Assessing Communication Skills of Medical Students in Objective Structured Clinical Examinations (OSCE) - A Systematic Review of Rating Scales

    Science.gov (United States)

    Cömert, Musa; Zill, Jördis Maria; Christalle, Eva; Dirmaier, Jörg; Härter, Martin; Scholl, Isabelle

    2016-01-01

    Background Teaching and assessment of communication skills have become essential in medical education. The Objective Structured Clinical Examination (OSCE) has been found as an appropriate means to assess communication skills within medical education. Studies have demonstrated the importance of a valid assessment of medical students’ communication skills. Yet, the validity of the performance scores depends fundamentally on the quality of the rating scales used in an OSCE. Thus, this systematic review aimed at providing an overview of existing rating scales, describing their underlying definition of communication skills, determining the methodological quality of psychometric studies and the quality of psychometric properties of the identified rating scales. Methods We conducted a systematic review to identify psychometrically tested rating scales, which have been applied in OSCE settings to assess communication skills of medical students. Our search strategy comprised three databases (EMBASE, PsycINFO, and PubMed), reference tracking and consultation of experts. We included studies that reported psychometric properties of communication skills assessment rating scales used in OSCEs by examiners only. The methodological quality of included studies was assessed using the COnsensus based Standards for the selection of health status Measurement INstruments (COSMIN) checklist. The quality of psychometric properties was evaluated using the quality criteria of Terwee and colleagues. Results Data of twelve studies reporting on eight rating scales on communication skills assessment in OSCEs were included. Five of eight rating scales were explicitly developed based on a specific definition of communication skills. The methodological quality of studies was mainly poor. The psychometric quality of the eight rating scales was mainly intermediate. Discussion Our results reveal that future psychometric evaluation studies focusing on improving the methodological quality are needed

  15. The health of the American slave examined by means of Union Army medical statistics.

    Science.gov (United States)

    Freemon, F R

    1985-01-01

    The health status of the American slave in the 19th century remains unclear despite extensive historical research. Better knowledge of slave health would provide a clearer picture of the life of the slave, a better understanding of the 19th-century medicine, and possibly even clues to the health problems of modern blacks. This article hopes to contribute to the literature by examining another source of data. Slaves entering the Union Army joined an organization with standardized medical care that generated extensive statistical information. Review of these statistics answers questions about the health of young male blacks at the time American slavery ended.

  16. Assessment of ADHD Documentation from Candidates Requesting Americans with Disabilities Act (ADA) Accommodations for the National Board of Osteopathic Medical Examiners COMLEX Exam

    Science.gov (United States)

    Joy, Javed A.; Julius, Rose J.; Akter, Rashida; Baron, David A.

    2010-01-01

    Purpose: Every year increasing numbers of candidates request special accommodations for high-stakes medical licensing examinations, due to ADHD, on the basis of the Americans with Disabilities Act (ADA). This poses significant challenges for both the applicant and the medical boards and has significant financial, legal, and ethical implications.…

  17. Assessing clinical reasoning abilities of medical students using clinical performance examination

    Directory of Open Access Journals (Sweden)

    Sunju Im

    2016-03-01

    Full Text Available Purpose: The purpose of this study is to investigate the reliability and validity of new clinical performance examination (CPX for assessing clinical reasoning skills and evaluating clinical reasoning ability of the students. Methods: Third-year medical school students (n=313 in Busan-Gyeongnam consortium in 2014 were included in the study. One of 12 stations was developed to assess clinical reasoning abilities. The scenario and checklists of the station were revised by six experts. Chief complaint of the case was rhinorrhea, accompanied by fever, headache, and vomiting. Checklists focused on identifying of the main problem and systematic approach to the problem. Students interviewed the patient and recorded subjective and objective findings, assessments, plans (SOAP note for 15 minutes. Two professors assessed students simultaneously. We performed statistical analysis on their scores and survey. Results: The Cronbach α of subject station was 0.878 and Cohen κ coefficient between graders was 0.785. Students agreed on CPX as an adequate tool to evaluate students’ performance, but some graders argued that the CPX failed to secure its validity due to their lack of understanding the case. One hundred eight students (34.5% identified essential problem early and only 58 (18.5% performed systematic history taking and physical examination. One hundred seventy-three of them (55.3% communicated correct diagnosis with the patient. Most of them had trouble in writing SOAP notes. Conclusion: To gain reliability and validity, interrater agreement should be secured. Students' clinical reasoning skills were not enough. Students need to be trained on problem identification, reasoning skills and accurate record-keeping.

  18. Examining the application of Web 2.0 in medical-related organisations.

    Science.gov (United States)

    Chu, Samuel Kai Wah; Woo, Matsuko; King, Ronnel B; Choi, Stephen; Cheng, Miffy; Koo, Peggy

    2012-03-01

    This study surveyed Web 2.0 application in three types of selected health or medical-related organisations such as university medical libraries, hospitals and non-profit medical-related organisations. Thirty organisations participated in an online survey on the perceived purposes, benefits and difficulties in using Web 2.0. A phone interview was further conducted with eight organisations (26.7%) to collect information on the use of Web 2.0. Data were analysed using both quantitative and qualitative approaches. Results showed that knowledge and information sharing and the provision of a better communication platform were rated as the main purposes of using Web 2.0. Time constraints and low staff engagement were the most highly rated difficulties. In addition, most participants found Web 2.0 to be beneficial to their organisations. Medical-related organisations that adopted Web 2.0 technologies have found them useful, with benefits outweighing the difficulties in the long run. The implications of this study are discussed to help medical-related organisations make decisions regarding the use of Web 2.0 technologies. © 2011 The authors. Health Information and Libraries Journal © 2011 Health Libraries Group.

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

    Science.gov (United States)

    Kitano, Masami

    2007-09-01

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

  20. Factors Influencing Learner Permit Duration

    Directory of Open Access Journals (Sweden)

    Johnathon P. Ehsani

    2016-12-01

    Full Text Available An increasing number of countries are requiring an extended learner permit prior to independent driving. The question of when drivers begin the learner permit period, and how long they hold the permit before advancing to independent licensure has received little research attention. Licensure timing is likely to be related to “push” and “pull” factors which may encourage or inhibit the process. To examine this question, we recruited a sample of 90 novice drivers (49 females and 41 males, average age of 15.6 years soon after they obtained a learner permit and instrumented their vehicles to collect a range of driving data. Participants completed a series of surveys at recruitment related to factors that may influence licensure timing. Two distinct findings emerged from the time-to-event analysis that tested these push and pull factors in relation to licensure timing. The first can be conceptualized as teens’ motivation to drive (push, reflected in a younger age when obtaining a learner permit and extensive pre-permit driving experience. The second finding was teens’ perceptions of their parents’ knowledge of their activities (pull; a proxy for a parents’ attentiveness to their teens’ lives. Teens who reported higher levels of their parents’ knowledge of their activities took longer to advance to independent driving. These findings suggest time-to-licensure may be related to teens’ internal motivation to drive, and the ability of parents to facilitate or impede early licensure.

  1. Evaluation of dose to tooth enamel from medical diagnostic X-ray examinations at Mayak PA

    Energy Technology Data Exchange (ETDEWEB)

    Wieser, A., E-mail: wieser@helmholtz-muenchen.de [Helmholtz Zentrum Muenchen - German Research Center for Environmental Health, Institute of Radiation Protection, D-85764 Neuherberg (Germany); Vasilenko, E. [Mayak Production Association, 456780 Ozyorsk (Russian Federation); Zankl, M.; Greiter, M.; Ulanovsky, A. [Helmholtz Zentrum Muenchen - German Research Center for Environmental Health, Institute of Radiation Protection, D-85764 Neuherberg (Germany); Sabayev, A.; Knyazev, V.; Zahrov, P. [Mayak Production Association, 456780 Ozyorsk (Russian Federation)

    2011-09-15

    The nuclear workers of the Mayak Production Association had regular check-ups including medical diagnostic X-ray examinations since start of the production lines in 1948. Doses from diagnostic examinations need to be considered in reconstruction of occupational doses of the workers with electron paramagnetic resonance (EPR) of tooth enamel. The numbers and types of examinations of an individual worker can be assessed from the Mayak PA archives but no information was available on doses delivered to teeth by a single specific examination. Of the twenty one applied examination procedures only three affected the teeth, these being X-ray examinations of teeth, skull and cervical spine. For these three kinds of examinations operational procedures and operating modes of X-ray units were compiled from the archive and photon spectra were obtained from a catalog of spectral data for diagnostic X-rays. Entrance doses in air kerma were calculated using the fluence of photon spectra and absorbed dose in tooth enamel for various tooth positions and exposure geometry was then calculated using dose conversion coefficients obtained from Monte Carlo simulations. Doses were calculated for examinations in 1948-2000. Except for examination of the skull, absorbed doses in enamel of incisors were found to be about twice as large as in enamel of molars. In the period before 1970 the largest mean absorbed doses in tooth enamel were due to X-ray examination of teeth, with 64 mGy and 34 mGy calculated for incisors and molars, respectively. In the same period the lowest mean doses were due to X-ray examination of the skull, with 11 mGy and 12 mGy calculated for incisors and molars, respectively. In the period from 1970 to 2000, largest mean doses in enamel were due to X-ray examination of cervical spine, with 23 mGy and 12 mGy calculated for incisors and molars, respectively.

  2. Cardiovascular Risk Factors in Airline Pilots.

    Science.gov (United States)

    Lord, Dana; Conlon, Helen Acree

    2018-02-01

    The health of an airline pilot is imperative to the safe travels of millions of people worldwide. Medical providers evaluate the cardiovascular risks for airline pilots and the medical requirements to obtain and maintain licensure as an airline pilot. It is the role of the occupational health nurse practitioner to evaluate and reduce the risk of cardiovascular disease in this population.

  3. Examining educators of the deaf as "highly qualified" teachers: roles and responsibilities under IDEA and NCLB.

    Science.gov (United States)

    Luft, Pamela

    2008-01-01

    Educators of the deaf were long considered "highly qualified" if they obtained state licensure from approved deaf education programs. But the No Child Left Behind Act (2001) redefined qualifications based on core academic content areas, without recognizing disability-specific expertise. NCLB's reauthorization will provide opportunities for examining definitions of "highly qualified" and ensuring that both general and special educators are appropriately prepared. Under the Individuals With Disabilities Education Act, educators of the deaf are primarily responsible for supporting implementation of each assigned student's individualized education program. When done skillfully and knowledgeably, IEP execution maximizes learning outcomes, and therefore would support NCLB mandates for improved student achievement. Instead of academic attainment alone, the primary "qualification" of educators of the deaf should be training and expertise in providing communication, learning, and assistive technology supports that allow access to academic content and, ultimately, address deaf students' historical underachievement.

  4. What factors facilitate the engagement with flipped classrooms used in the preparation for postgraduate medical membership examinations?

    Science.gov (United States)

    Jesurasa, Amrita; Mackenzie, Kelly; Jordan, Hannah; Goyder, Elizabeth C

    2017-01-01

    Background The “flipped classroom,” a pedagogical model where typical lecture and homework elements are reversed, is being advocated in medical education to support the teaching of a large curriculum. However, research into the use of this model in postgraduate medical education, which requires the application of acquired knowledge, is limited. The aim of this study was to explore the barriers and facilitators to engagement with the flipped classroom model in preparation for the written element of postgraduate membership examinations. Methods Three focus groups (n=14) were held between February and June 2016. Participants were drawn from a membership examination preparation course, run by the University of Shef-field. Two of the groups (n=10) involved “students” (public health registrars) while the other focus group (n=4) was held with “tutors” (experienced registrars and consultants). The focus groups were audiorecorded and transcribed verbatim. Transcripts were thematically analyzed by using both predetermined and emergent themes. Results Key themes that emerged from the data included variation in learning and teaching styles of individuals as well as the feasibility and flexibility of the overall course design. However, management of students’ expectations was found to be the fundamental factor, which underpinned the engagement. Conclusion The complex interaction of factors affecting engagement in this study highlights the need to consider the appropriateness of the flipped classroom model. However, this must be balanced by the potential benefits of the approach for delivering a large curriculum. Recognizing the central importance of managing expectations at the outset would be useful when considering this model in postgraduate medical education. PMID:28721116

  5. Job-specific mandatory medical examinations for the police force.

    Science.gov (United States)

    Boschman, J S; Hulshof, C T J; Frings-Dresen, M H W; Sluiter, J K

    2017-08-01

    Mandatory medical examinations (MMEs) of workers should be based on the health and safety requirements that are needed for effectively performing the relevant work. For police personnel in the Netherlands, no job-specific MME exists that takes the specific tasks and duties into account. To provide the Dutch National Police with a knowledge base for job-specific MMEs for police personnel that will lead to equitable decisions from an occupational health perspective about who can perform police duties. We used a stepwise mixed-methods approach in which we included interviews with employees and experts and a review of the national and international literature. We determined the job demands for the various police jobs, determined which were regarded as specific job demands and formulated the matching health requirements as specific as possible for each occupation. A total of 21 specific job demands were considered relevant in different police jobs. These included biomechanical, physiological, physical, emotional, psychological/cognitive and sensory job demands. We formulated both police-generic and job-specific health requirements based on the specific job demands. Two examples are presented: bike patrol and criminal investigation. Our study substantiated the need for job-specific MMEs for police personnel. We found specific job demands that differed substantially for various police jobs. The corresponding health requirements were partly police-generic, and partly job-specific. © The Author 2017. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com

  6. Dosimetry in endoscopic examinations

    International Nuclear Information System (INIS)

    Aldred, Martha Aurelia; Paes, Walter Siqueira; Fausto, Agnes M.F.; Nucci, Jose Roberto; Yoshimura, Elisabeth Mateus; Okuno, Emico; Maruta, Luis Massuo

    1996-01-01

    Equivalent and effective doses in occupational exposures are evaluated considering that some specific endoscopic examinations, radiographic and fluoroscopic images of patients are taken with the medical staff near to the radiation field. Examinations are simulated using an anthropomorphic phantom as a member of the medical staff. Thermoluminescent dosemeters are attached in several positions of the phantom in order to determine some organ doses. From the comparison between the doses experimentally determined and the International and the Brazilian recommended occupational dose limits, the maximum number of examination that any member of the staff can perform was calculated

  7. Resitting a high-stakes postgraduate medical examination on multiple occasions: nonlinear multilevel modelling of performance in the MRCP(UK examinations

    Directory of Open Access Journals (Sweden)

    McManus IC

    2012-06-01

    Full Text Available Abstract Background Failure rates in postgraduate examinations are often high and many candidates therefore retake examinations on several or even many times. Little, however, is known about how candidates perform across those multiple attempts. A key theoretical question to be resolved is whether candidates pass at a resit because they have got better, having acquired more knowledge or skills, or whether they have got lucky, chance helping them to get over the pass mark. In the UK, the issue of resits has become of particular interest since the General Medical Council issued a consultation and is considering limiting the number of attempts candidates may make at examinations. Methods Since 1999 the examination for Membership of the Royal Colleges of Physicians of the United Kingdom (MRCP(UK has imposed no limit on the number of attempts candidates can make at its Part 1, Part2 or PACES (Clinical examination. The present study examined the performance of candidates on the examinations from 2002/2003 to 2010, during which time the examination structure has been stable. Data were available for 70,856 attempts at Part 1 by 39,335 candidates, 37,654 attempts at Part 2 by 23,637 candidates and 40,303 attempts at PACES by 21,270 candidates, with the maximum number of attempts being 26, 21 and 14, respectively. The results were analyzed using multilevel modelling, fitting negative exponential growth curves to individual candidate performance. Results The number of candidates taking the assessment falls exponentially at each attempt. Performance improves across attempts, with evidence in the Part 1 examination that candidates are still improving up to the tenth attempt, with a similar improvement up to the fourth attempt in Part 2 and the sixth attempt at PACES. Random effects modelling shows that candidates begin at a starting level, with performance increasing by a smaller amount at each attempt, with evidence of a maximum, asymptotic level for

  8. Resitting a high-stakes postgraduate medical examination on multiple occasions: nonlinear multilevel modelling of performance in the MRCP(UK) examinations.

    Science.gov (United States)

    McManus, I C; Ludka, Katarzyna

    2012-06-14

    Failure rates in postgraduate examinations are often high and many candidates therefore retake examinations on several or even many times. Little, however, is known about how candidates perform across those multiple attempts. A key theoretical question to be resolved is whether candidates pass at a resit because they have got better, having acquired more knowledge or skills, or whether they have got lucky, chance helping them to get over the pass mark. In the UK, the issue of resits has become of particular interest since the General Medical Council issued a consultation and is considering limiting the number of attempts candidates may make at examinations. Since 1999 the examination for Membership of the Royal Colleges of Physicians of the United Kingdom (MRCP(UK)) has imposed no limit on the number of attempts candidates can make at its Part 1, Part 2 or PACES (Clinical) examination. The present study examined the performance of candidates on the examinations from 2002/2003 to 2010, during which time the examination structure has been stable. Data were available for 70,856 attempts at Part 1 by 39,335 candidates, 37,654 attempts at Part 2 by 23,637 candidates and 40,303 attempts at PACES by 21,270 candidates, with the maximum number of attempts being 26, 21 and 14, respectively. The results were analyzed using multilevel modelling, fitting negative exponential growth curves to individual candidate performance. The number of candidates taking the assessment falls exponentially at each attempt. Performance improves across attempts, with evidence in the Part 1 examination that candidates are still improving up to the tenth attempt, with a similar improvement up to the fourth attempt in Part 2 and the sixth attempt at PACES. Random effects modelling shows that candidates begin at a starting level, with performance increasing by a smaller amount at each attempt, with evidence of a maximum, asymptotic level for candidates, and candidates showing variation in starting

  9. An Examination of Contemporary Issues Relating to Medical Liability ...

    African Journals Online (AJOL)

    In Nigeria, cases of negligence are under-reported; consequently marginal compensations ... consent, the doctor retains the duty to do what is in the best interest of the patient. ... Keywords: Medical, liability, negligence, Bolam, standard of care ...

  10. Investigating Reports of Complex Regional Pain Syndrome: An Analysis of HPV-16/18-Adjuvanted Vaccine Post-Licensure Data

    Science.gov (United States)

    Huygen, Frank; Verschueren, Kristin; McCabe, Candida; Stegmann, Jens-Ulrich; Zima, Julia; Mahaux, Olivia; Van Holle, Lionel; Angelo, Maria-Genalin

    2015-01-01

    Complex regional pain syndrome (CRPS) is a chronic pain disorder that typically follows trauma or surgery. Suspected CRPS reported after vaccination with human papillomavirus (HPV) vaccines led to temporary suspension of proactive recommendation of HPV vaccination in Japan. We investigated the potential CRPS signal in relation to HPV-16/18-adjuvanted vaccine (Cervarix®) by database review of CRPS cases with independent expert confirmation; a disproportionality analysis and analyses of temporality; an observed versus expected analysis using published background incidence rates; systematic reviews of aggregate safety data, and a literature review. The analysis included 17 case reports of CRPS: 10 from Japan (0.14/100,000 doses distributed) and seven from the United Kingdom (0.08/100,000). Five cases were considered by independent experts to be confirmed CRPS. Quantitative analyses did not suggest an association between CRPS and HPV-16/18-adjuvanted vaccine. Observed CRPS incidence after HPV-16/18 vaccination was statistically significantly below expected rates. Systematic database reviews using search terms varying in specificity and sensitivity did not identify new cases. No CRPS was reported during clinical development and no unexpected results found in the literature. There is not sufficient evidence to suggest an increased risk of developing CRPS following vaccination with HPV-16/18-adjuvanted vaccine. Post-licensure safety surveillance confirms the acceptable benefit-risk of HPV-16/18 vaccination. PMID:26501109

  11. Examination of Job Satisfaction of the Medical Vocational High School Teachers

    Science.gov (United States)

    Bayraktar, Hatice Vatansever; Güney, Burcu

    2016-01-01

    The aim of this study is to determine the job satisfaction level of Medical Vocational High School teachers and whether it differs according to different variables. The research was organized in accordance with the screening model. The population of the research was composed of vocational course teachers who worked in Medical Vocational High…

  12. Examining the relationship between marijuana use, medical marijuana dispensaries, and abusive and neglectful parenting.

    Science.gov (United States)

    Freisthler, Bridget; Gruenewald, Paul J; Wolf, Jennifer Price

    2015-10-01

    The current study extends previous research by examining whether and how current marijuana use and the physical availability of marijuana are related to child physical abuse, supervisory neglect, or physical neglect by parents while controlling for child, caregiver, and family characteristics in a general population survey in California. Individual level data on marijuana use and abusive and neglectful parenting were collected during a telephone survey of 3,023 respondents living in 50 mid-size cities in California. Medical marijuana dispensaries and delivery services data were obtained via six websites and official city lists. Data were analyzed using negative binomial and linear mixed effects multilevel models with individuals nested within cities. Current marijuana use was positively related to frequency of child physical abuse and negatively related to physical neglect. There was no relationship between supervisory neglect and marijuana use. Density of medical marijuana dispensaries and delivery services was positively related to frequency of physical abuse. As marijuana use becomes more prevalent, those who work with families, including child welfare workers must screen for how marijuana use may affect a parent's ability to provide for care for their children, particularly related to physical abuse. Copyright © 2015 Elsevier Ltd. All rights reserved.

  13. Supporting Accomplished Facilitation: Examining the Use of Sppreciative Inquiry to Inform the Development of Learning Resources for Medical Educators

    Science.gov (United States)

    McIntosh, Paul; Freeth, Della; Berridge, Emma Jane

    2013-01-01

    This paper examines the use of appreciative inquiry (AI) to guide development of web-based learning resources for medical educators who facilitate simulation-based learning experiences for doctors-in-training. AI can be viewed as a positive form of action research, which seeks to avoid deficit-based analyses and solutions, and commonly associated…

  14. Immigration, Statecraft and Public Health: The 1920 Aliens Order, Medical Examinations and the Limitations of the State in England

    Science.gov (United States)

    Taylor, Becky

    2016-01-01

    This article considers the medical measures of the 1920 Aliens Order barring aliens from Britain. Building on existing local and port public health inspection, the requirement for aliens to be medically inspected before landing significantly expanded the duties of these state agencies and necessitated the creation of a new level of physical infrastructure and administrative machinery. This article closely examines the workings and limitations of alien medical inspection in two of England’s major ports—Liverpool and London—and sheds light on the everyday working of the Act. In doing so it reflects on the ambitions, actions and limitations of the state and so extends research by historians of the nineteenth and early twentieth century on the disputed histories of public health and the complexities of statecraft. Overall it suggests the importance of developing nuanced understandings of the gaps and failures arising from the translation of legislation into practice. PMID:27482146

  15. Report on the results of the seventh medical examination of atomic bomb survivors in the South America

    International Nuclear Information System (INIS)

    Ishioka, Shinichi; Ohta, Nobuhiro; Taguchi, Atsushi; Okada, Fumio; Hara, Tokihiro; Ueno, Kouki.

    1997-01-01

    The medical examination was carried out in Brazil, Paraguay, Bolivia, Argentina and Peru on 80, 4, 7, 11 and 3 survivors, respectively, from Oct. 30 to Nov. 15, 1996. They (43 males and 62 females) were 66.5 years old in average. The examination involved physical measurements, blood and urine analyses, electrocardiography, health questionnaire and consultation with blood pressure measurement. Results were as follows: Anamnesis; hypertension (51.4%), heart diseases (23.8%), cancer (21.0%), diabetes (19.0%), hemorrhoids (19.0%), stroke (18.1%), stomach ulcer (12.4%) and others: Present major disease; hypertension (23.8%), diabetes (6.7%), heart diseases (6.7%), cancer (6.7%) and others. Loss of vigor (63.8%), complete exhaustion or fatigue (63.8%), heat intolerance (60.0%), numbness or tingling (43.8%), failure of memory (42.9%) and many others were recognized as subjective symptoms. Blood pressure measurement gave hypertensive findings in 31.4%. Normal ECG was found in 67.7%. Cases judged to be necessary for further examinations or for treatment were in 46.7%. This examination was concluded to be continued. (K.H.)

  16. Report on the results of the seventh medical examination of atomic bomb survivors in the South America

    Energy Technology Data Exchange (ETDEWEB)

    Ishioka, Shinichi [Hiroshima Univ. (Japan). School of Medicine; Ohta, Nobuhiro; Taguchi, Atsushi; Okada, Fumio; Hara, Tokihiro; Ueno, Kouki

    1997-06-01

    The medical examination was carried out in Brazil, Paraguay, Bolivia, Argentina and Peru on 80, 4, 7, 11 and 3 survivors, respectively, from Oct. 30 to Nov. 15, 1996. They (43 males and 62 females) were 66.5 years old in average. The examination involved physical measurements, blood and urine analyses, electrocardiography, health questionnaire and consultation with blood pressure measurement. Results were as follows: Anamnesis; hypertension (51.4%), heart diseases (23.8%), cancer (21.0%), diabetes (19.0%), hemorrhoids (19.0%), stroke (18.1%), stomach ulcer (12.4%) and others: Present major disease; hypertension (23.8%), diabetes (6.7%), heart diseases (6.7%), cancer (6.7%) and others. Loss of vigor (63.8%), complete exhaustion or fatigue (63.8%), heat intolerance (60.0%), numbness or tingling (43.8%), failure of memory (42.9%) and many others were recognized as subjective symptoms. Blood pressure measurement gave hypertensive findings in 31.4%. Normal ECG was found in 67.7%. Cases judged to be necessary for further examinations or for treatment were in 46.7%. This examination was concluded to be continued. (K.H.)

  17. 77 FR 24103 - National Registry of Certified Medical Examiners

    Science.gov (United States)

    2012-04-20

    ... competence through periodic training and testing. Following establishment of the National Registry and a... they can determine effectively whether a CMV driver's medical fitness for duty meets FMCSA's standards... understanding of those standards, and maintain and demonstrate competence through periodic training and testing...

  18. Anatomy and Humanity: Examining the Effects of a Short Documentary Film and First Anatomy Laboratory Experience on Medical Students

    Science.gov (United States)

    Dosani, Farah; Neuberger, Lindsay

    2016-01-01

    Medical students begin their education inside a laboratory dissecting cadavers to learn human gross anatomy. Many schools use the course experience as a way to instill empathy and some have begun integrating video and recorded interviews with body donors to humanize the experience, but their impact has yet to be measured. This study examines the…

  19. Report on the results of the eleventh medical examination of atomic bomb survivors resident in North America

    International Nuclear Information System (INIS)

    Yamakido, Michio; Dohy, Hiroo; Neriishi, Kazuo

    1998-01-01

    The 11th medical examination of A-bomb survivors was conducted in 1997. Two medical teams conducted health examinations in Los Angeles and Seattle, and in San Francisco and Hawaii, respectively. The total number of A-bomb survivors resident in North America as of the end of July 1997 was 1,060, an increase of 17 over that confirmed in 1995. The number of survivors exposed <2,000-m from the hypocenter was 234, accounting for 22.1% of the total. The confirmed number of in-utero exposed survivors was 26. As to the past medical history information, breast cancer, thyroid cancer, and heart disease were frequently observed in the <2,000-m group. Frequent subjective symptoms include complete exhaustion or fatigue, loss of vigor, blurring of vision, itching of the skin, which were reported in more than 40% of the survivors. The frequencies of nocturia, nervousness, severe headache, and excessive sweating in cold weather were higher in the <2,000-m group. Chest pain was seen frequently in the <2,000-m group for males, but no difference was observed in females. Nocturia was observed in more than half of the males in the <2,000-m group. There were 99 cases (22.8%) with fasting plasma glucose level of 110 mg/dl or above, consisting of 39 males (32.0%) and 60 females (19.2%). Abnormal HbA1c levels were observed in 33 cases (7.6%), including 12 males (9.8%) and 11 females (6.7%). The proportion of cases with abnormal HbA1c levels was higher in males. No difference by exposure status was observed either for fasting plasma glucose or HbA1c. The disease of the highest prevalence was hyperlipidemia (57.4%), followed by hypertension (35.0%), obesity (27.2%), liver disease (21.9%), thyroid disease (20.0%), gastrointestinal disease (20.7%), heart disease (13.4%) and urological disease (12.9%). Malignant tumors were observed in two cases in L.A., two in Seattle, and one in S.F. Cancer will be important issue in the future examinations. (K.H.)

  20. 5 CFR 339.302 - Authority to offer examinations.

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Authority to offer examinations. 339.302... QUALIFICATION DETERMINATIONS Medical Examinations § 339.302 Authority to offer examinations. An agency may, at its option, offer a medical examination (including a psychiatric evaluation) in any situation where...

  1. 41 CFR 60-300.23 - Medical examinations and inquiries.

    Science.gov (United States)

    2010-07-01

    ... in this part. (c) Invitation to self-identify. The contractor shall invite applicants to self... treated as a confidential medical record, except that: (i) Supervisors and managers may be informed... require emergency treatment; and (iii) Government officials engaged in enforcing the laws administered by...

  2. [Effective Techniques to Reduce Radiation Exposure to Medical Staff during Assist of X-ray Computed Tomography Examination].

    Science.gov (United States)

    Miyajima, Ryuichi; Fujibuchi, Toshioh; Miyachi, Yusuke; Tateishi, Satoshi; Uno, Yoshinori; Amakawa, Kazutoshi; Ohura, Hiroki; Orita, Shinichi

    2018-01-01

    Medical staffs like radiological technologists, doctors, and nurses are at an increased risk of exposure to radiation while assisting the patient in a position or monitor contrast medium injection during computed tomography (CT). However, methods to protect medical staff from radiation exposure and protocols for using radiological protection equipment have not been standardized and differ among hospitals. In this study, the distribution of scattered X-rays in a CT room was measured by placing electronic personal dosimeters in locations where medical staff stands beside the CT scanner gantry while assisting the patient and the exposure dose was measured. Moreover, we evaluated non-uniform exposure and revealed effective techniques to reduce the exposure dose to medical staff during CT. The dose of the scattered X-rays was the lowest at the gantry and at the examination table during both head and abdominal CT. The dose was the highest at the trunk of the upper body of the operator corresponding to a height of 130 cm during head CT and at the head corresponding to a height of 150 cm during abdominal CT. The maximum dose to the crystalline lens was approximately 600 μSv during head CT. We found that the use of volumetric CT scanning and X-ray protective goggles, and face direction toward the gantry reduced the exposure dose, particularly to the crystalline lens, for which lower equivalent dose during CT scan has been recently recommended in the International Commission on Radiological Protection Publication 118.

  3. Predictive validity of the comprehensive basic science examination mean score for assessment of medical students' performance

    Directory of Open Access Journals (Sweden)

    Firouz Behboudi

    2002-04-01

    Full Text Available Background Medical education curriculum improvements can be achieved bye valuating students performance. Medical students have to pass two undergraduate comprehensive examinations, basic science and preinternship, in Iran. Purpose To measure validity of the students' mean score in comprehensive basic science exam (CBSE for predicting their performance in later curriculum phases. Methods This descriptive cross-sectional study was conducted on 95 (38 women and 55 men Guilan medical university students. Their admission to the university was 81% by regional quota and 12% by shaheed and other organizations' share. They first enrolled in 1994 and were able to pass CBS£ at first try. Data on gender, regional quota, and average grades of CBS£, PC, and CPIE were collected by a questionnaire. The calculations were done by SPSS package. Results The correlation coefficient between CBS£ and CPIE mean scores (0.65 was higher than correlation coefficient between CBS£ and PC mean scores (0.49. The predictive validity of CBS£ average grade was significant for students' performance in CPIE; however, the predictive validity of CBSE mean scores for students I pe1jormance in PC was lower. Conclusion he students' mean score in CBSE can be a good denominator for their further admission. We recommend further research to assess the predictive validity for each one of the basic courses. Keywords predictive validity, comprehensive basic exam

  4. X-ray examination apparatus

    International Nuclear Information System (INIS)

    Bernstein, S.; Griswa, P.J.; Halter, P. Jr.; Kidd, H.J.

    1980-01-01

    Apparatus for x-ray cardiovascular examination and which can also be used for general purpose examination is described. An advantage of the system is that there is no mechanical connection between the image intensifier and source to interfere with the medical examiner or emergency procedures. (U.K.)

  5. Practice-related examinations are feasible

    Directory of Open Access Journals (Sweden)

    Schrauth, Markus

    2005-04-01

    Full Text Available The 9th Revision of the German Federal Medical Training Regulations demands a practice-related assessment of medical students. On the way to these new regulations German faculties face as well problems related to a lack of experience of lecturers, tutors, examiners, and students with the required examination procedures as strains of a financial and logistic kind. How to succeed in introducing suitable examinations at short notice and which positive effects can be achieved is shown by the Faculty of Medicine of the university of Tübingen.

  6. 41 CFR 60-741.23 - Medical examinations and inquiries.

    Science.gov (United States)

    2010-07-01

    ...) Invitation to self-identify. The contractor shall invite the applicant to self-identify as an individual with... employee shall be collected and maintained on separate forms and in separate medical files and treated as a... treatment; and (iii) Government officials engaged in enforcing the laws administered by OFCCP, including...

  7. Value of post-licensure data on benefits and risks of vaccination to inform vaccine policy: The example of rotavirus vaccines.

    Science.gov (United States)

    Parashar, Umesh D; Cortese, Margaret M; Payne, Daniel C; Lopman, Benjamin; Yen, Catherine; Tate, Jacqueline E

    2015-11-27

    In 1999, the first rhesus-human reassortant rotavirus vaccine licensed in the United States was withdrawn within a year of its introduction after it was linked with intussusception at a rate of ∼1 excess case per 10,000 vaccinated infants. While clinical trials of 60,000-70,000 infants of each of the two current live oral rotavirus vaccines, RotaTeq (RV5) and Rotarix (RV1), did not find an association with intussusception, post-licensure studies have documented a risk in several high and middle income countries, at a rate of ∼1-6 excess cases per 100,000 vaccinated infants. However, considering this low risk against the large health benefits of vaccination that have been observed in many countries, including in countries with a documented vaccine-associated intussusception risk, policy makers and health organizations around the world continue to support the routine use of RV1 and RV5 in national infant immunization programs. Because the risk and benefit data from affluent settings may not be directly applicable to developing countries, further characterization of any associated intussusception risk following rotavirus vaccination as well as the health benefits of vaccination is desirable for low income settings. Copyright © 2015 American Journal of Preventive Medicine. Published by Elsevier Ltd.. All rights reserved.

  8. Professional identity in medical students: pedagogical challenges to medical education.

    Science.gov (United States)

    Wilson, Ian; Cowin, Leanne S; Johnson, Maree; Young, Helen

    2013-01-01

    Professional identity, or how a doctor thinks of himself or herself as a doctor, is considered to be as critical to medical education as the acquisition of skills and knowledge relevant to patient care. This article examines contemporary literature on the development of professional identity within medicine. Relevant theories of identity construction are explored and their application to medical education and pedagogical approaches to enhancing students' professional identity are proposed. The influence of communities of practice, role models, and narrative reflection within curricula are examined. Medical education needs to be responsive to changes in professional identity being generated from factors within medical student experiences and within contemporary society.

  9. Examining Burnout, Depression, and Attitudes Regarding Drug Use Among Lebanese Medical Students During the 4 Years of Medical School.

    Science.gov (United States)

    Talih, Farid; Daher, Michel; Daou, Dayane; Ajaltouni, Jean

    2018-04-01

    This study aims to evaluate the prevalence of burnout, depressive symptoms, and anxiety symptoms and attitudes toward substance use in medical students as well as their evolution during the 4 years of medical school. A cross-sectional study was carried out at the American University of Beirut Medical Center (AUBMC) between September and December 2016. In total, 176 out of 412 eligible medical students responded. The survey was anonymous and administered via e-mail link to an electronic form. The study included general socio-demographic questions and standardized validated tools to measure depressive symptomatology (PHQ-9), burnout (Burnout Measure), anxiety (GAD-7), alcohol use (AUDIT), and substance abuse (DAST-10) as well as questions pertaining to attitudes toward recreational substance use. Overall, 23.8% of medical students reported depressive symptomatology, with 14.5% having suicidal ideations. Forty-three percent were found to have burnout. Those who screened positive for burnout were more likely to be males, to be living away from their parents, and to have experienced a stressful life event during the last year. With the exception of burnout, there was no significant difference in the prevalence of depression or anxiety among the 4 years of medical school. There was a significant difference in alcohol use, illicit substance use, and marijuana use during the four medical school years. The results of this study show high rates of depression, burnout, and suicidal ideation among medical students from the Middle East region. Increased rates of substance use were detected as well as a more tolerant attitude toward substance use in general, specifically cannabis. It is crucial that medical educators and policymakers keep tackling the complex multifactorial mental health issues affecting medical students and design effective solutions and support systems.

  10. Ideas for Medical Education: The Quarterly Profile Examination.

    Science.gov (United States)

    Arnold, Louise; Willoughby, T. Lee

    1990-01-01

    The school of medicine of the University of Missouri--Kansas City developed the Quarterly Profile Examination, a schoolwide, longitudinal comprehensive examination of knowledge acquisition and retention, to satisfy internal and external requirements for assessment. The system is seen as effective in fostering problem-based and independent learning…

  11. A study of the academic performance of medical students in the comprehensive examination of the basic sciences according to the indices of emotional intelligence and educational status.

    Science.gov (United States)

    Moslehi, Mohsen; Samouei, Rahele; Tayebani, Tayebeh; Kolahduz, Sima

    2015-01-01

    Considering the increasing importance of emotional intelligence (EI) in different aspects of life, such as academic achievement, the present survey is aimed to predict academic performance of medical students in the comprehensive examination of the basic sciences, according to the indices of emotional intelligence and educational status. The present survey is a descriptive, analytical, and cross-sectional study performed on the medical students of Isfahan, Tehran, and Mashhad Universities of Medical Sciences. Sampling the universities was performed randomly after which selecting the students was done, taking into consideration the limitation in their numbers. Based on the inclusion criteria, all the medical students, entrance of 2005, who had attended the comprehensive basic sciences examination in 2008, entered the study. The data collection tools included an Emotional Intelligence Questionnaire (standardized in Isfahan), the average score of the first to fifth semesters, total average of each of the five semesters, and the grade of the comprehensive basic sciences examination. The data were analyzed through stepwise regression coefficient by SPSS software version 15. The results indicated that the indicators of independence from an emotional intelligence test and average scores of the first and third academic semesters were significant in predicting the students' academic performance in the comprehensive basic sciences examination. According to the obtained results, the average scores of students, especially in the earlier semesters, as well as the indicators of independence and the self-esteem rate of students can influence their success in the comprehensive basic sciences examination.

  12. Medical Surveillance Monthly Report (MSMR). Volume 17, Number 06, June 2010

    Science.gov (United States)

    2010-06-01

    of vaccine safety and effi cacy trials, and advocacy for U.S. licensure of JE vaccines .9 During World War II, LTC Albert Sabin conducted pioneering...the improved safety profi le of second-generation vaccines , and the geographic spread of JE virus over the past 50 years warrant continued...control of JE, including characterization of the ecology of JEV, development of fi rst and second generation vaccines and diagnostic assays, conduct

  13. Report on the results of the ninth medical examination of atomic bomb survivors in South America

    International Nuclear Information System (INIS)

    Ohta, Michiya; Hiyama, Keiko; Matsuo, Kakaru; Yamamoto, Hiroki; Nishida, Masashi; Sasaki, Yoshinobu

    2001-01-01

    The results of the ninth medical examination are reported. Atomic bomb survivors who had emigrated to South America as of November 2000 totaled 180 (153 to Brazil, 4 to Paraguay, 7 to Bolivia, 13 to Argentina, and 3 to Peru). Eighty persons (44.4%) were examined (62 in Brazil, 2 in Paraguay, 6 in Bolivia, 7 in Argentina, and 3 in Peru). The mean age of the males was 71.3 years, and the mean age of the females was 69.7 years. They had hypertension (24.1%), diabetes (10.1%), cancer (8.9%), heart disease (7.6%), and thyroid disease (2.5%). The most common manifestations of illness were fatigue (69.6%), loss of vigor (65.8%), taking medicine (55.7%), and heat intolerance (53.2%). The incident rates of electrocardiographic abnormalities and urine, blood, and biochemical tests abnormalities were almost the same as at the previous examination, and there was no change in the percentage of those who required detailed tests and treatment. When independence in daily life was judged by the criteria of the nursing care insurance system, 68 persons were judged ''independent'', and 7 persons ''handicapped.'' (K.H.)

  14. Are chest radiographs justified in pre-employment examinations. Presentation of legal position and medical evidence based on 1760 cases

    International Nuclear Information System (INIS)

    Ladd, S.C.; Krause, U.; Ladd, M.E.

    2006-01-01

    The legal and medical basis for chest radiographs as part of pre-employment examinations (PEE) at a University Hospital is evaluated. The radiographs are primarily performed to exclude infectious lung disease. A total of 1760 consecutive chest radiographs performed as a routine part of PEEs were reviewed retrospectively. Pathologic findings were categorized as ''nonrelevant'' or ''relevant.'' No positive finding with respect to tuberculosis or any other infectious disease was found; 94.8% of the chest radiographs were completely normal. Only five findings were regarded as ''relevant'' for the individual. No employment-relevant diagnosis occurred. The performance of chest radiography as part of a PEE is most often not justified. The practice is expensive, can violate national and European law, and lacks medical justification. (orig.) [de

  15. Teaching musculoskeletal examination skills to UK medical students: a comparative survey of Rheumatology and Orthopaedic education practice.

    Science.gov (United States)

    Blake, Tim

    2014-03-28

    Specialists in Rheumatology and Orthopaedics are frequently involved in undergraduate teaching of musculoskeletal (MSK) examination skills. Students often report that specialty-led teaching is inconsistent, confusing and bears little resemblance to the curricula. The Gait, Arms, Legs and Spine (GALS) is a MSK screening tool that provides a standardised approach to examination despite it being fraught with disapproval and low uptake. Recent studies would appear to support innovative instructional methods of engaging learners such as patient educators and interactive small group teaching. This comparative cross-sectional survey evaluates the current state of undergraduate teaching in Rheumatology and Orthopaedics, including preferred teaching methods, attitudes towards GALS, and barriers to effective teaching. An electronic questionnaire was sent to specialist trainees and Consultants in the East and West Midlands region, representing 5 UK medical schools. Descriptive statistical data analysis was performed. There were 76 respondents representing 5 medical schools. There was a request for newer teaching methodologies to be used: multi-media computer-assisted learning (35.5%), audio-visual aids (31.6%), role-playing (19.7%), and social media (3.9%). It is evident that GALS is under-utilised with 50% of clinicians not using GALS in their teaching. There is a genuine desire for clinical educators to improve their teaching ability, collaborate more with curriculum planners, and feel valued by institutions. There remains a call for implementing a standardised approach to MSK clinical teaching to supersede GALS.

  16. Medical radiation

    International Nuclear Information System (INIS)

    1992-01-01

    This leaflet in the At-a-Glance Series describes the medical use of X-rays, how X-rays help in diagnosis, radiation protection of the patient, staff protection, how radioactive materials in nuclear medicine examinations help in diagnosis and the use of radiation in radiotherapy. Magnetic resonance imaging, a diagnostic technique involving no ionizing radiation, is also briefly examined. The role of the NRPB in the medical use of radiation is outlined. (UK)

  17. 2012 aerospace medical certification statistical handbook.

    Science.gov (United States)

    2013-12-01

    The annual Aerospace Medical Certification Statistical Handbook reports descriptive : characteristics of all active U.S. civil aviation airmen and the aviation medical examiners (AMEs) that : perform the required medical examinations. The 2012 annual...

  18. Report on the results of the seventh medical examination of atomic bomb survivors resident in North America

    International Nuclear Information System (INIS)

    Ito, Chikako; Kodama, Kazunori; Sasaki, Hideo; Ishibashi, Shinzo; Dote, Keigo; Watanabe, Tadaaki; Hirata, Katsumi; Sugimoto, Sumio.

    1990-01-01

    During a one-month period from June 13 through July 13, 1989, the seventh medical examination was conducted at five cities, including San Francisco, Los Angeles, Seattle, Wailuku and Honolulu, for A-bomb survivors residents in North America. Nine hundred and eighteen A-bomb survivors, including 21 living in Canada, were confirmed, consisting of 234 men and 684 women as of the end of July 1989. The number was increased by 167, compared with that as of the end of July 1987. During the past three years, there were 40 deaths; and 878 A-bomb survivors (223 men and 655 women) are still alive. Ninety percent of the survivors came from Hiroshima. U.S. nationality was seen in 61% and Japanese nationality with permanent U.S. residency rights was seen in 32%. The majority (39%) of the A-bomb survivors were in their fifties, with an average age of 59.4 years. The survivors were residing in 26 states in the USA and in 3 provinces in Canada. The acquisition rate of the A-bomb survivors' health handbook was 52%. Four hundred and six A-bomb survivors participated in the medical examination, including one male and 8 female children born to A-bomb survivors. Questionnaire survey revealed a history of surgical resection for cancer in 21 survivors. Subjective symptoms included complete exhaustion or fatigue, heat intolerance, loss of vigor, and numbness of the body. Overall evaluation revealed the necessity of medical treatment or observation in 71%. This was independent of exposure status. Hypertension was the most common (27%), followed by obesity, hyperlipidemia, heart disease, and diabetes mellitus. Malignant tumors were seen in 9 survivors, consisting of 3 with breast cancer, 2 with colorectal cancer, and single survivors with lung cancer, Hodgkin's disease, cervical cancer, or hepatoma. Only 29% of them have had finantial guarantee for their health management according to the Japanese law. (N.K.)

  19. Correlation of United States Medical Licensing Examination and Internal Medicine In-Training Examination Performance

    Science.gov (United States)

    Perez, Jose A., Jr.; Greer, Sharon

    2009-01-01

    The Internal Medicine In-Training Examination (ITE) is administered during residency training in the United States as a self-assessment and program assessment tool. Performance on this exam correlates with outcome on the American Board of Internal Medicine Certifying examination. Internal Medicine Program Directors use the United States Medical…

  20. A study of the academic performance of medical students in the comprehensive examination of the basic sciences according to the indices of emotional intelligence and educational status

    Science.gov (United States)

    Moslehi, Mohsen; Samouei, Rahele; Tayebani, Tayebeh; Kolahduz, Sima

    2015-01-01

    Background: Considering the increasing importance of emotional intelligence (EI) in different aspects of life, such as academic achievement, the present survey is aimed to predict academic performance of medical students in the comprehensive examination of the basic sciences, according to the indices of emotional intelligence and educational status. Materials and Methods: The present survey is a descriptive, analytical, and cross-sectional study performed on the medical students of Isfahan, Tehran, and Mashhad Universities of Medical Sciences. Sampling the universities was performed randomly after which selecting the students was done, taking into consideration the limitation in their numbers. Based on the inclusion criteria, all the medical students, entrance of 2005, who had attended the comprehensive basic sciences examination in 2008, entered the study. The data collection tools included an Emotional Intelligence Questionnaire (standardized in Isfahan), the average score of the first to fifth semesters, total average of each of the five semesters, and the grade of the comprehensive basic sciences examination. The data were analyzed through stepwise regression coefficient by SPSS software version 15. Results: The results indicated that the indicators of independence from an emotional intelligence test and average scores of the first and third academic semesters were significant in predicting the students’ academic performance in the comprehensive basic sciences examination. Conclusion: According to the obtained results, the average scores of students, especially in the earlier semesters, as well as the indicators of independence and the self-esteem rate of students can influence their success in the comprehensive basic sciences examination. PMID:26430693

  1. 2011 aerospace medical certification statistical handbook.

    Science.gov (United States)

    2013-01-01

    The annual Aerospace Medical Certification Statistical Handbook reports descriptive characteristics of all active U.S. civil aviation airmen and the aviation medical examiners (AMEs) that perform the required medical examinations. The 2011 annual han...

  2. Medical cyclotron facilities

    International Nuclear Information System (INIS)

    1984-09-01

    This report examines the separate proposals from the Austin Hospital and the Australian Atomic Energy Commission for a medical cyclotron facility. The proponents have argued that a cyclotron facility would benefit Australia in areas of patient care, availability and export of radioisotopes, and medical research. Positron emission tomography (PET) and neutron beam therapy are also examined

  3. Effect of the teen driving plan on the driving performance of teenagers before licensure: a randomized clinical trial.

    Science.gov (United States)

    Mirman, Jessica H; Curry, Allison E; Winston, Flaura K; Wang, Wenli; Elliott, Michael R; Schultheis, Maria T; Fisher Thiel, Megan C; Durbin, Dennis R

    2014-08-01

    Many studies have failed to show an effect of parent-supervised practice driving on the driving performance of teenagers; nevertheless, most Graduated Driver Licensing programs have provisions that require supervised practice. To determine whether a web-based intervention, the Teen Driving Plan (TDP), can improve the driving performance of teenagers before licensure as measured by the Teen On-road Driving Assessment (tODA). Randomized, single-blind, clinical trial among 217 dyads (1 parent: 1 teenaged learner's-permit holder) to test TDP effectiveness on increasing the quantity and diversity of supervised practice and improving the teenagers' prelicensed driving performance. The study was conducted from December 2011 through January 2013 in Southeastern Pennsylvania. Dyads were randomized (3:2) to receive the TDP or the Pennsylvania driver's manual (control group). The TDP is a psychoeducational intervention designed to increase the quantity and diversity of parent-supervised practice. Materials are grouped by the following driving environments: empty parking lots, suburban residential streets, intermediate (1- or 2-lane) roads, highways, rural roads with curves and elevation changes, and commercial districts. The main outcomes were self-reported practice driving across 6 environments and 2 conditions and driving performance as measured by the teenagers' completion of the standardized and validated tODA 24 weeks after enrollment. Certified professional driving evaluators blinded to randomization status terminated the tODA if they determined that the teenager could not safely complete it. We examined mean differences in the quantity of supervised practice, differences in the overall proportion of teenagers in each group that had assessments terminated for unsafe driving, and the point of termination during the assessment. The TDP dyads reported more practice in 5 of the 6 environments and at night and in bad weather compared with the control dyads. Overall, 5 of 86

  4. Addressing the nation's physician workforce needs: The Society of General Internal Medicine (SGIM) recommendations on graduate medical education reform.

    Science.gov (United States)

    Jackson, Angela; Baron, Robert B; Jaeger, Jeffrey; Liebow, Mark; Plews-Ogan, Margaret; Schwartz, Mark D

    2014-11-01

    The Graduate Medical Education (GME) system in the United States (US) has garnered worldwide respect, graduating over 25,000 new physicians from over 8,000 residency and fellowship programs annually. GME is the portal of entry to medical practice and licensure in the US, and the pathway through which resident physicians develop the competence to practice independently and further develop their career plans. The number and specialty distribution of available GME positions shapes the overall composition of our national workforce; however, GME is failing to provide appropriate programs that support the delivery of our society's system of healthcare. This paper, prepared by the Health Policy Education Subcommittee of the Society of General Internal Medicine (SGIM) and unanimously endorsed by SGIM's Council, outlines a set of recommendations on how to reform the GME system to best prepare a physician workforce that can provide high quality, high value, population-based, and patient-centered health care, aligned with the dynamic needs of our nation's healthcare delivery system. These recommendations include: accurate workforce needs assessment, broadened GME funding sources, increased transparency of the use of GME dollars, and implementation of incentives to increase the accountability of GME-funded programs for the preparation and specialty selection of their program graduates.

  5. Report on the results of the fifth medical examination of atomic bomb survivors resident in the United States and Canada

    International Nuclear Information System (INIS)

    Ito, Chikako; Inamizu, Tsutomu; Sasaki, Hideo; Niimi, Masanobu; Yamada, Hiroaki; Doko, Fumio; Sugimoto, Sumio.

    1986-01-01

    The 5th medical examination of A-bomb survivors resident in North America was conducted from 11 June to 18 July 1985 in San Francisco, Los Angeles, Seattle, Maui, and Honolulu in the US and in Vancouver in Canada. A total of 682 A-bomb survivors (177 men and 505 women) were confirmed as of the end of July 1985, including 23 who died. Among them, 90.7 % were exposed to A-bombing in Hiroshima. By nationality, 60.8 % and 35.3 % of the survivors possessed US nationality and Japanese nationality with permanent US residency right, respectively. The mean age of the survivors was 56.4 years. By residence, 445 of 659 A-bomb survivors (67.5 %) were residing in California. The rate of health handbook acquisition was 33.2 %. Questionnaires performed in 350 survivors revealed a history of cancer in 16 survivors, and subjective symptoms, such as fatigue, heat intolerance, itching, loss of vigor, and chest pain, in high frequencies. The medical examination performed in 339 survivors, including 115 participating in it for the first time, revealed no abnormality in 12.3 %, and higher incidence of hypertension and heart diseases than those in the previous examinations. According to the Japanese law, health management allowance would be payable in 30.3 % of the survivors with a certain disease. (Namekawa, K.)

  6. Report on the results of the third medical examination of atomic bomb survivors resident in the South America

    International Nuclear Information System (INIS)

    Kamitsuna, Akimitsu; Kuramoto, Kiyoshi; Noguchi, Kyoichi; Inoue, Nobuhisa; Yokoyama, Yutaka; Oishi, Akinori.

    1989-01-01

    The third medical examination was performed among A-bomb survivors residing in Brazil, Argentina, Paraguay, Bolivia, and Peru during the period October 17- November 4, 1988. One hundred and eighty-five A-bomb survivors were comfirmed to reside in the five countries. One hundred and eighteen A-bomb survivors (64%) participated in the examination, consisting of 50 men and 68 women. Seventy seven (35 men and 42 women) and 41 (15 men and 26 women) A-bomb survivors came from Hiroshima and Nagasaki, respectively. An average age of participants was 56.1±9.7 years for men and 58.4±9.6 years for women. The acquisition rate of atomic bomb survivor's health handbook was 28.8%. A questionnaire survey for subjective symptoms revealed a high frequency of fatigue, decreased physical fitness, numbness, and dizziness. Fifty-four A-bomb survivors (47%) were needed to receive detailed examinations. Predominant diseases were hypertension, obesity, and urinary tract disease. (N.K.)

  7. Report on the results of the third medical examination of atomic bomb survivors resident in the South America

    Energy Technology Data Exchange (ETDEWEB)

    Kamitsuna, Akimitsu (Hiroshima Univ. (Japan). School of Medicine); Kuramoto, Kiyoshi; Noguchi, Kyoichi; Inoue, Nobuhisa; Yokoyama, Yutaka; Oishi, Akinori

    1989-08-01

    The third medical examination was performed among A-bomb survivors residing in Brazil, Argentina, Paraguay, Bolivia, and Peru during the period October 17- November 4, 1988. One hundred and eighty-five A-bomb survivors were comfirmed to reside in the five countries. One hundred and eighteen A-bomb survivors (64%) participated in the examination, consisting of 50 men and 68 women. Seventy seven (35 men and 42 women) and 41 (15 men and 26 women) A-bomb survivors came from Hiroshima and Nagasaki, respectively. An average age of participants was 56.1{plus minus}9.7 years for men and 58.4{plus minus}9.6 years for women. The acquisition rate of atomic bomb survivor's health handbook was 28.8%. A questionnaire survey for subjective symptoms revealed a high frequency of fatigue, decreased physical fitness, numbness, and dizziness. Fifty-four A-bomb survivors (47%) were needed to receive detailed examinations. Predominant diseases were hypertension, obesity, and urinary tract disease. (N.K.).

  8. A snapshot of patients' awareness of radiation dose and risks associated with medical imaging examinations at an Australian radiology clinic

    International Nuclear Information System (INIS)

    Singh, N.; Mohacsy, A.; Connell, D.A.; Schneider, M.E.

    2017-01-01

    Background: Cumulative radiation exposure is linked to increasing the lifetime attributable risk of cancer. To avoid unnecessary radiation exposure and facilitate shared decision making, patients should be aware of these issues. This paper examines patients' awareness of radiation dose and risks associated with medical imaging examinations. Methods: Consecutive patients attending a private radiology clinic over a nine week period in 2014 in Metropolitan Melbourne were surveyed while waiting to undergo an imaging examination. Patients who were under 18 years of age, did not speak English and/or were referred for interventional imaging procedures were excluded from participation. Survey questions addressed patients' awareness of radiation dose associated with various imaging modalities' and patients' experience and preferences regarding communication of information about radiation. Data was analysed using SPSS (Ver 20.1). Results: A total of 242 surveys were completed. Most participants were male (143/239, 59.8%) and aged between 33 and 52 years (109/242, 45%). Over half of participants were not concerned about radiation from medical imaging (130/238, 54.6%). Only a third of participants (80/234, 34.2%) correctly reported that CT has a higher radiation dose than X-ray. Very few participants correctly identified mammography, DEXA, PET and PET/CT as radiation emitting examinations. The majority of participants (202/236, 85.6%) indicated that they were not informed about radiation dose and risks by their referring doctor in advance. Conclusion: This paper provides information relevant to a single private radiology clinic in Australia. Nevertheless, our results have shown that patients presenting for medical imaging have little awareness of radiation dose and risks associated with these examinations and received little information by their referring physicians or staff at the radiology clinic. - Highlights: • Patients' awareness regarding

  9. Medical Student Attitudes about Mental Illness: Does Medical-School Education Reduce Stigma?

    Science.gov (United States)

    Korszun, Ania; Dinos, Sokratis; Ahmed, Kamran; Bhui, Kamaldeep

    2012-01-01

    Background: Reducing stigma associated with mental illness is an important aim of medical education, yet evidence indicates that medical students' attitudes toward patients with mental health problems deteriorate as they progress through medical school. Objectives: Authors examined medical students' attitudes to mental illness, as compared with…

  10. Forensic medical examinations conducted on complainants of sexual assault in the Forensic Medicine Institute, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, between 2006 and 2013

    Directory of Open Access Journals (Sweden)

    Piotr Engelgardt

    2015-02-01

    Full Text Available A total of 46 cases of alleged sexual assault were analysed from the years 2006–2013 where forensic medical examinations were conducted. The material was compared with data from literature. All the victims were female. In 9 cases (20% a sexual assault by sexual touching was alleged, 67% of complainants (31 cases had alleged non-consensual sexual intercourse, 6 complainants (13% had no recollection of events. Genital area injuries were reported in 26% of sexual assault victims. Injuries of other parts of the body were found in 73% of victims. None of the subjects were positive for severe injuries such as fractures, wounds, and head trauma with loss of consciousness. The majority of complainants (29 cases, 63% were examined within 24 hours after the incident and 6 examinees (13% were assessed between 24 and 48 hours after the alleged sexual assault. Eleven forensic medical examinations (24% were conducted after the lapse of more than 48 hours since the alleged incident. Twenty nine complainants admitted that they had washed their genital area after the sexual assault. Forensic swabs were taken during all forensic medical examinations.

  11. Report on the results of the ninth medical examination of atomic bomb survivors in South America

    Energy Technology Data Exchange (ETDEWEB)

    Ohta, Michiya [Hiroshima Atomic Bomb Hospital (Japan); Hiyama, Keiko; Matsuo, Kakaru; Yamamoto, Hiroki; Nishida, Masashi; Sasaki, Yoshinobu

    2001-06-01

    The results of the ninth medical examination are reported. Atomic bomb survivors who had emigrated to South America as of November 2000 totaled 180 (153 to Brazil, 4 to Paraguay, 7 to Bolivia, 13 to Argentina, and 3 to Peru). Eighty persons (44.4%) were examined (62 in Brazil, 2 in Paraguay, 6 in Bolivia, 7 in Argentina, and 3 in Peru). The mean age of the males was 71.3 years, and the mean age of the females was 69.7 years. They had hypertension (24.1%), diabetes (10.1%), cancer (8.9%), heart disease (7.6%), and thyroid disease (2.5%). The most common manifestations of illness were fatigue (69.6%), loss of vigor (65.8%), taking medicine (55.7%), and heat intolerance (53.2%). The incident rates of electrocardiographic abnormalities and urine, blood, and biochemical tests abnormalities were almost the same as at the previous examination, and there was no change in the percentage of those who required detailed tests and treatment. When independence in daily life was judged by the criteria of the nursing care insurance system, 68 persons were judged ''independent'', and 7 persons ''handicapped.'' (K.H.)

  12. History and development of medical physics and medical physicist in Japan

    International Nuclear Information System (INIS)

    Toyofuku, F.

    2014-01-01

    The history of medical physics in Japan dates back to the mid-1950's when radioisotope sources such as cobalt-60 were initiated into hospitals. In 1961, a total of about 30 medical physics researchers created a sub-committee of medical physics under the Japan Radiological Society (JRS), which flourished throughout the decade, and the number of members exceeded to more than 200 in 1970. Although there were great advances in medical technologies, the number of members of the medical physics community did not grow for the next two decades from 1980 to 2000. Then, the JRS began to officially recognize medical physicists as a professional group in 1987. Qualifications of candidacy for the examination included having the education equivalent of a Bachelor of Science/Engineering and being a member of the JRS. For the first official examination, 70 medical physicists were approved by the JRS. As of 2013, there are currently 700 medical physicists, however, the number of practicing clinical medical physicists remains only about 150. The main reason for this limited number of medical physicists is that the certification is not recognized as a national license and therefore is challenging to find professional employment as qualified medical personnel at hospitals. (author)

  13. Using the Theory of Planned Behaviour to examine health professional students' behavioural intentions in relation to medication safety and collaborative practice.

    Science.gov (United States)

    Lapkin, Samuel; Levett-Jones, Tracy; Gilligan, Conor

    2015-08-01

    Safe medication practices depend upon, not only on individual responsibilities, but also effective communication and collaboration between members of the medication team. However, measurement of these skills is fraught with conceptual and practical difficulties. The aims of this study were to explore the utility of a Theory of Planned Behaviour-based questionnaire to predict health professional students' behavioural intentions in relation to medication safety and collaborative practice; and to determine the contribution of attitudes, subjective norms, and perceived control to behavioural intentions. A descriptive cross-sectional survey based upon the Theory of Planned Behaviour was designed and tested. A convenience sample of 65 undergraduate pharmacy, nursing and medicine students from one semi-metropolitan Australian university were recruited for the study. Participants' behavioural intentions, attitudes, subjective norms, and perceived control to behavioural intentions in relation to medication safety were measured using an online version of the Theory of Planned Behaviour Medication Safety Questionnaire. The Questionnaire had good internal consistency with a Cronbach's alpha of 0.844. The three predictor variables of attitudes, subjective norms, and perceived control accounted for between 30 and 46% of the variance in behavioural intention; this is a strong prediction in comparison to previous studies using the Theory of Planned Behaviour. Data analysis also indicated that attitude was the most significant predictor of participants' intention to collaborate with other team members to improve medication safety. The results from this study provide preliminary support for the Theory of Planned Behaviour-Medication Safety Questionnaire as a valid instrument for examining health professional students' behavioural intentions in relation to medication safety and collaborative practice. Copyright © 2015 Elsevier Ltd. All rights reserved.

  14. Medical Identity

    DEFF Research Database (Denmark)

    Musaeus, Peter

    2015-01-01

    Purpose: To examine philosophical stances underpinning medical identity and assess the conceptual relationship between physician, medical practice and culture. Argument: Medical identity is about the ideals and moral positions that physicians take when justifying themselves. Medical identity...... hedonistic versus sentimentalist approaches to medical identity. The sociocultural philosophical analysis of medical identity can shed light on what it means conceptually for a physician to harbor beliefs associated with him/her being taken to be an autonomous professional. It is important because it touches...... on the meaning of being a compassionate, good and skilled physician, making its relevance to person-centered medicine self-evident. Conclusion: Medical identity should be analyzed with reference to literature, philosophy and medical practice in order for the physician to exercise a reflective position...

  15. Post mortem examination report concerning Nadim Nuwwara

    DEFF Research Database (Denmark)

    Leth, Peter Mygind

    2014-01-01

    Post mortem examination report concerning Nadim Nuwawara, 17-years old, who was killed may 15 2014 in Beitunia near Rahmallah, Palestine. The examination was performed by an international team consisting of dr. Saber Al-Aloul, director of the Medico Legal Institute at Quds University, dr. Marc A....... Krouse, Deputy Chief Medical Examiner, Office of Chief Medical Examiner, Fort Worth, Texas, USA, dr. Chen Kugel, Chief Forensic Pathologist, Abu Kabir Institute of Forensic Medicine, Tel Aviv, dr. Ricardo Pablo Nachman, forensic expert at Abu Kabir Institute of Forensic Medicine, Tel Aviv and dr. Peter...

  16. An Inquiry of How Art Education Policies Are Reflected in Art Teacher Preparation: Examining the Standards for Visual Arts and Art Teacher Certification

    Science.gov (United States)

    Lim, Kyungeun

    2017-01-01

    Policy changes influence various aspects of art education such as K-12 art education curricula, state licensure systems, and contexts of art teacher preparation. Despite strong relationships between art education policy and practical fields, few studies have attempted to understand art education from the perspective of policy analysis. This study…

  17. NBME subject examination in surgery scores correlate with surgery clerkship clinical experience.

    Science.gov (United States)

    Myers, Jonathan A; Vigneswaran, Yalini; Gabryszak, Beth; Fogg, Louis F; Francescatti, Amanda B; Golner, Christine; Bines, Steven D

    2014-01-01

    Most medical schools in the United States use the National Board of Medical Examiners Subject Examinations as a method of at least partial assessment of student performance, yet there is still uncertainty of how well these examination scores correlate with clinical proficiency. Thus, we investigated which factors in a surgery clerkship curriculum have a positive effect on academic achievement on the National Board of Medical Examiners Subject Examination in Surgery. A retrospective analysis of 83 third-year medical students at our institution with 4 unique clinical experiences on the general surgery clerkship for the 2007-2008 academic year was conducted. Records of the United States Medical Licensing Examination Step 1 scores, National Board of Medical Examiners Subject Examination in Surgery scores, and essay examination scores for the groups were compared using 1-way analysis of variance testing. Rush University Medical Center, Chicago IL, an academic institution and tertiary care center. Our data demonstrated National Board of Medical Examiners Subject Examination in Surgery scores from the group with the heavier clinical loads and least time for self-study were statistically higher than the group with lighter clinical services and higher rated self-study time (p = 0.036). However, there was no statistical difference of National Board of Medical Examiners Subject Examination in Surgery scores between the groups with equal clinical loads (p = 0.751). Students experiencing higher clinical volumes on surgical services, but less self-study time demonstrated statistically higher academic performance on objective evaluation, suggesting clinical experience may be of higher value than self-study and reading. Copyright © 2014 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  18. Physical examination education in graduate medical education--a systematic review of the literature.

    Science.gov (United States)

    Mookherjee, Somnath; Pheatt, Lara; Ranji, Sumant R; Chou, Calvin L

    2013-08-01

    There is widespread recognition that physical examination (PE) should be taught in Graduate Medical Education (GME), but little is known regarding how to best teach PE to residents. Deliberate practice fosters expertise in other fields, but its utility in teaching PE is unknown. We systematically reviewed the literature to determine the effectiveness of methods to teach PE in GME, with attention to usage of deliberate practice. We searched PubMed, ERIC, and EMBASE for English language studies regarding PE education in GME published between January 1951 and December 2012. Seven eligibility criteria were applied to studies of PE education: (1) English language; (2) subjects in GME; (3) description of study population; (4) description of intervention; (5) assessment of efficacy; (6) inclusion of control group; and (7) report of data analysis. We extracted data regarding study quality, type of PE, study population, curricular features, use of deliberate practice, outcomes and assessment methods. Tabulated summaries of studies were reviewed for narrative synthesis. Fourteen studies met inclusion criteria. The mean Medical Education Research Study Quality Instrument (MERSQI) score was 9.0 out of 18. Most studies (n = 8) included internal medicine residents. Half of the studies used resident interaction with a human examinee as the primary means of teaching PE. Three studies "definitely" and four studies "possibly" used deliberate practice; all but one of these studies demonstrated improved educational outcomes. We used a non-validated deliberate practice assessment. Given the heterogeneity of assessment modalities, we did not perform a meta-analysis. No single strategy for teaching PE in GME is clearly superior to another. Following the principles of deliberate practice and interaction with human examinees may be beneficial in teaching PE; controlled studies including these educational features should be performed to investigate these exploratory findings.

  19. Validity Evidence and Scoring Guidelines for Standardized Patient Encounters and Patient Notes From a Multisite Study of Clinical Performance Examinations in Seven Medical Schools.

    Science.gov (United States)

    Park, Yoon Soo; Hyderi, Abbas; Heine, Nancy; May, Win; Nevins, Andrew; Lee, Ming; Bordage, Georges; Yudkowsky, Rachel

    2017-11-01

    To examine validity evidence of local graduation competency examination scores from seven medical schools using shared cases and to provide rater training protocols and guidelines for scoring patient notes (PNs). Between May and August 2016, clinical cases were developed, shared, and administered across seven medical schools (990 students participated). Raters were calibrated using training protocols, and guidelines were developed collaboratively across sites to standardize scoring. Data included scores from standardized patient encounters for history taking, physical examination, and PNs. Descriptive statistics were used to examine scores from the different assessment components. Generalizability studies (G-studies) using variance components were conducted to estimate reliability for composite scores. Validity evidence was collected for response process (rater perception), internal structure (variance components, reliability), relations to other variables (interassessment correlations), and consequences (composite score). Student performance varied by case and task. In the PNs, justification of differential diagnosis was the most discriminating task. G-studies showed that schools accounted for less than 1% of total variance; however, for the PNs, there were differences in scores for varying cases and tasks across schools, indicating a school effect. Composite score reliability was maximized when the PN was weighted between 30% and 40%. Raters preferred using case-specific scoring guidelines with clear point-scoring systems. This multisite study presents validity evidence for PN scores based on scoring rubric and case-specific scoring guidelines that offer rigor and feedback for learners. Variability in PN scores across participating sites may signal different approaches to teaching clinical reasoning among medical schools.

  20. Why Not Wait? Eight Institutions Share Their Experiences Moving United States Medical Licensing Examination Step 1 After Core Clinical Clerkships.

    Science.gov (United States)

    Daniel, Michelle; Fleming, Amy; Grochowski, Colleen O'Conner; Harnik, Vicky; Klimstra, Sibel; Morrison, Gail; Pock, Arnyce; Schwartz, Michael L; Santen, Sally

    2017-11-01

    The majority of medical students complete the United States Medical Licensing Examination Step 1 after their foundational sciences; however, there are compelling reasons to examine this practice. This article provides the perspectives of eight MD-granting medical schools that have moved Step 1 after the core clerkships, describing their rationale, logistics of the change, outcomes, and lessons learned. The primary reasons these institutions cite for moving Step 1 after clerkships are to foster more enduring and integrated basic science learning connected to clinical care and to better prepare students for the increasingly clinical focus of Step 1. Each school provides key features of the preclerkship and clinical curricula and details concerning taking Steps 1 and 2, to allow other schools contemplating change to understand the landscape. Most schools report an increase in aggregate Step 1 scores after the change. Despite early positive outcomes, there may be unintended consequences to later scheduling of Step 1, including relatively late student reevaluations of their career choice if Step 1 scores are not competitive in the specialty area of their choice. The score increases should be interpreted with caution: These schools may not be representative with regard to mean Step 1 scores and failure rates. Other aspects of curricular transformation and rising national Step 1 scores confound the data. Although the optimal timing of Step 1 has yet to be determined, this article summarizes the perspectives of eight schools that changed Step 1 timing, filling a gap in the literature on this important topic.

  1. Constipation - prevalence and incidence among medical patients acutely admitted to hospital with a medical condition

    DEFF Research Database (Denmark)

    Noiesen, Eline; Trosborg, Ingelise; Bager, Louise

    2014-01-01

    To examine the prevalence and incidence of patient-reported symptoms of constipation in acutely hospitalised medical patients.......To examine the prevalence and incidence of patient-reported symptoms of constipation in acutely hospitalised medical patients....

  2. Undergraduate medical education in emergency medical care: a nationwide survey at German medical schools.

    Science.gov (United States)

    Beckers, Stefan K; Timmermann, Arnd; Müller, Michael P; Angstwurm, Matthias; Walcher, Felix

    2009-05-12

    Since June 2002, revised regulations in Germany have required "Emergency Medical Care" as an interdisciplinary subject, and state that emergency treatment should be of increasing importance within the curriculum. A survey of the current status of undergraduate medical education in emergency medical care establishes the basis for further committee work. Using a standardized questionnaire, all medical faculties in Germany were asked to answer questions concerning the structure of their curriculum, representation of disciplines, instructors' qualifications, teaching and assessment methods, as well as evaluation procedures. Data from 35 of the 38 medical schools in Germany were analysed. In 32 of 35 medical faculties, the local Department of Anaesthesiology is responsible for the teaching of emergency medical care; in two faculties, emergency medicine is taught mainly by the Department of Surgery and in another by Internal Medicine. Lectures, seminars and practical training units are scheduled in varying composition at 97% of the locations. Simulation technology is integrated at 60% (n = 21); problem-based learning at 29% (n = 10), e-learning at 3% (n = 1), and internship in ambulance service is mandatory at 11% (n = 4). In terms of assessment methods, multiple-choice exams (15 to 70 questions) are favoured (89%, n = 31), partially supplemented by open questions (31%, n = 11). Some faculties also perform single practical tests (43%, n = 15), objective structured clinical examination (OSCE; 29%, n = 10) or oral examinations (17%, n = 6). Emergency Medical Care in undergraduate medical education in Germany has a practical orientation, but is very inconsistently structured. The innovative options of simulation technology or state-of-the-art assessment methods are not consistently utilized. Therefore, an exchange of experiences and concepts between faculties and disciplines should be promoted to guarantee a standard level of education in emergency medical care.

  3. Undergraduate medical education in emergency medical care: A nationwide survey at German medical schools

    Directory of Open Access Journals (Sweden)

    Timmermann Arnd

    2009-05-01

    Full Text Available Abstract Background Since June 2002, revised regulations in Germany have required "Emergency Medical Care" as an interdisciplinary subject, and state that emergency treatment should be of increasing importance within the curriculum. A survey of the current status of undergraduate medical education in emergency medical care establishes the basis for further committee work. Methods Using a standardized questionnaire, all medical faculties in Germany were asked to answer questions concerning the structure of their curriculum, representation of disciplines, instructors' qualifications, teaching and assessment methods, as well as evaluation procedures. Results Data from 35 of the 38 medical schools in Germany were analysed. In 32 of 35 medical faculties, the local Department of Anaesthesiology is responsible for the teaching of emergency medical care; in two faculties, emergency medicine is taught mainly by the Department of Surgery and in another by Internal Medicine. Lectures, seminars and practical training units are scheduled in varying composition at 97% of the locations. Simulation technology is integrated at 60% (n = 21; problem-based learning at 29% (n = 10, e-learning at 3% (n = 1, and internship in ambulance service is mandatory at 11% (n = 4. In terms of assessment methods, multiple-choice exams (15 to 70 questions are favoured (89%, n = 31, partially supplemented by open questions (31%, n = 11. Some faculties also perform single practical tests (43%, n = 15, objective structured clinical examination (OSCE; 29%, n = 10 or oral examinations (17%, n = 6. Conclusion Emergency Medical Care in undergraduate medical education in Germany has a practical orientation, but is very inconsistently structured. The innovative options of simulation technology or state-of-the-art assessment methods are not consistently utilized. Therefore, an exchange of experiences and concepts between faculties and disciplines should be promoted to guarantee a standard

  4. Education of dentists in China.

    Science.gov (United States)

    Komabayashi, Takashi; Zhu, Qiang; Jiang, Jin; Hu, De-Yu; Kim, Kang-Ju; Toda, Shinji; Tanne, Yuki; Tanimoto, Kotaro; Kirkland, Mark D; Bird, William F

    2006-10-01

    China is geographically located in the east of Asia and its population exceeds 1.3 billion. An understanding of dental education in China is thus of interest. However, as there is little published information on this topic, this paper provides information about China regarding its dental history, dental school system including curriculum and dental licensure. High school graduates take a nationwide entrance examination to apply for dental school, of which there are more than 50 in China. A five year dental education leads to the BDS degree. Dental school graduates must then pass the nationwide licensure examination to practise dentistry. Currently, there are not adequate numbers of dentists to provide the necessary oral health care for people living outside metropolitan areas.

  5. Medical and dermatology dictionaries: an examination of unstructured definitions and a proposal for the future.

    Science.gov (United States)

    DeVries, David Todd; Papier, Art; Byrnes, Jennifer; Goldsmith, Lowell A

    2004-01-01

    Medical dictionaries serve to describe and clarify the term set used by medical professionals. In this commentary, we analyze a representative set of skin disease definitions from 2 prominent medical dictionaries, Stedman's Medical Dictionary and Dorland's Illustrated Medical Dictionary. We find that there is an apparent lack of stylistic standards with regard to content and form. We advocate a new standard form for the definition of medical terminology, a standard to complement the easy-to-read yet unstructured style of the traditional dictionary entry. This new form offers a reproducible structure, paving the way for the development of a computer readable "dictionary" of medical terminology. Such a dictionary offers immediate update capability and a fundamental improvement in the ability to search for relationships between terms.

  6. Effect of grade point average and enrollment in a dental hygiene National Board review course on student performance on the National Board Examination.

    Science.gov (United States)

    DeWald, Janice P; Gutmann, Marylou E; Solomon, Eric S

    2004-01-01

    Passing the National Board Dental Hygiene Examination is a requirement for licensure in all but one state. There are a number of preparation courses for the examination sponsored by corporations and dental hygiene programs. The purpose of this study was to determine if taking a board review course significantly affected student performance on the board examination. Students from the last six dental hygiene classes at Baylor College of Dentistry (n = 168) were divided into two groups depending on whether they took a particular review course. Mean entering college grade point averages (GPA), exiting dental hygiene program GPAs, and National Board scores were compared for the two groups using a t-test for independent samples (p < 0.05). No significant differences were found between the two groups for entering GPA and National Board scores. Exiting GPAs, however, were slightly higher for those not taking the course compared to those taking the course. In addition, a strong correlation (0.71, Pearson Correlation) was found between exiting GPA and National Board score. Exiting GPA was found to be a strong predictor of National Board performance. These results do not appear to support this program's participation in an external preparation course as a means of increasing students' performance on the National Board Dental Hygiene Examination.

  7. Medical Ethics in Qiṣāṣ (Eye-for-an-Eye) Punishment: An Islamic View; an Examination of Acid Throwing.

    Science.gov (United States)

    Alishahi Tabriz, Amir; Dabbagh, Hossein; Koenig, Harold G

    2016-08-01

    Physicians in Islamic countries might be requested to participate in the Islamic legal code of qiṣāṣ, in which the victim or family has the right to an eye-for-an-eye retaliation. Qiṣāṣ is only used as a punishment in the case of murder or intentional physical injury. In situations such as throwing acid, the national legal system of some Islamic countries asks for assistance from physicians, because the punishment should be identical to the crime. The perpetrator could not be punished without a physician's participation, because there is no way to guarantee that the sentence would be carried out without inflicting more injury than the initial victim had suffered. By examining two cases of acid throwing, this paper discusses issues related to physicians' participation in qiṣāṣ from the perspective of medical ethics and Islamic Shari'a law. From the standpoint of medical ethics, physicians' participation in qiṣāṣ is not appropriate. First, qiṣāṣ is in sharp contrast to the Hippocratic Oath and other codes of medical ethics. Second, by physicians' participation in qiṣāṣ, medical practices are being used improperly to carry out government mandates. Third, physician participation in activities that cause intentional harm to people destroys the trust between patients and physicians and may adversely affect the patient-physician relationship more generally. From the standpoint of Shari'a, there is no consensus among Muslim scholars whether qiṣāṣ should be performed on every occasion. We argue that disallowing physician involvement in qiṣāṣ is necessary from the perspectives of both medical ethics and Shari'a law.

  8. The moderating impact of interacting with distressed families of decedents on trauma exposure in medical examiner personnel.

    Science.gov (United States)

    Coleman, Jennifer A; Delahanty, Douglas L; Schwartz, Joseph; Murani, Kristina; Brondolo, Elizabeth

    2016-11-01

    Prior research has examined the incidence of posttraumatic stress stemming from either direct or indirect trauma exposure in employees of high-risk occupations. However, few studies have examined the contribution of both direct and indirect trauma exposure in high-risk groups. One particularly salient indirect trauma often endorsed as the most stressful by many occupational groups is interacting with distressed family members of victims of crime, illness, or accidents. The present study examined the extent to which interacting with distressed families moderated the impact of cumulative potentially traumatic event (PTE) exposure on depression and posttraumatic stress disorder (PTSD) symptoms in 245 employees of medical examiner (ME) offices. Employees from 9 ME office sites in the United States participated in an online survey investigating the frequency of work place PTE exposures (direct and indirect) and mental health outcomes. Results revealed that cumulative PTE exposure was associated with higher PTSD symptoms (PTSS) for employees who had higher frequency of exposure to distressed family members. After controlling for cumulative and direct PTE exposure, gender, and office site, exposure to distressed families was significantly associated with depressive symptoms, but not PTSS. Findings of our research underscore the need for training employees in high-risk occupations to manage their reactions to exposure to distraught family members. Employee training may buffer risk for developing PTSD and depression. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  9. [The keys to success in French Medical National Ranking Examination: Integrated training activities in teaching hospital and medical school].

    Science.gov (United States)

    Gillois, Pierre; Fourcot, Marie; Genty, Céline; Morand, Patrice; Bosson, Jean-Luc

    2015-12-01

    The National Ranking Examination (NRE) is the key to the choice of career and specialty for future physicians; it lets them choose their place of employment in a specialty and an hospital for their internship. It seems interesting to model the success factors to this exam for the medical students from Grenoble University. For each of the medical students at Grenoble University who did apply to the NRE in 2012, data have been collected about their academic background and personal details from the administration of the University. A simple logistic regression with success set as being ranked in the first 2000 students, then a polytomous logistic regression, have been performed. The 191 students in the models are 59% female, 25 years old in average (SD 1.8). The factors associated to a ranking in the first 2000 are: not repeating the PCEM1 class (odds ratio [OR] 2.63, CI95: [1.26; 5.56]), performing nurse practice during internships (OR=1.27 [1.00; 1.62]), being ranked in the first half of the class for S3 pole (OR=6.04 [1.21; 30.20] for the first quarter, OR=5.65 [1.15; 27.74] for the second quarter) and being in the first quarter at T5 pole (OR=3.42 [1.08; 10.82]). Our study finds four factors independently contributing to the success at NRE: not repeating PCEM1, performing nurse practice and being ranked in the top of the class at certain academic fields. The AUC is 0.76 and student accuracy is more than 80%. However, some items, for example repeating DCEM4 or participating in NRE mock exams, have no influence on success. A different motivation should be a part of the explanation… As these analysed data are mainly institutional, they are accurate and reliable. The polytomic logistic model, sharing 3 factors with the simple logistic model, replace a performing nurse practice factor's by a grant recipient factor. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  10. Report on the results of the fourth medical examination of atomic bomb survivors resident in the South America

    International Nuclear Information System (INIS)

    Hasegawa, Kenji; Kuramoto, Kiyoshi; Mukai, Hideaki; Suga, Kentaro; Yamamoto, Yoshio; Kunihara, Michitoshi; Ishida, Shigeki.

    1991-01-01

    From October 21 through November 5, 1990, health examination was performed in atomic bomb survivors living in Brazil, Argentina, Bolivia, Peru, and Paraguay. A total of 194 persons were recognized as having been exposed to A-bombing. Among them, 122 atomic-bomb survivors (62.9%) participated in the present health examination, consisting of 55 men and 67 women. An average age was 61.5±9.0 years for men and 59.6±8.6 years for women. The acquisition rate of health handbook for atomic bomb survivors was 35.2%. Past history for cancer resection was seen in 4 atomic bomb survivors. The presenting subjective symptoms were fatigue, heat intolerance, decreased physical fitness, and unintentional weight loss. Laboratory findings included: a decreased value of hemoglobin (5 atomic-bomb survivors), hypertension (26), noticeable ECG findings (5), abnormal values of GOT (28) and GPT (14), hypercholesteremia (43), hyperuricemia (19), and fasting hyperglycemia (8). Overall evaluation showed that 48 atomic bomb survivors need to receive detailed medical examination for hypertension, heart disease, liver disease, and hyperlipemia. (N.K.)

  11. Report on the results of the fourth medical examination of atomic bomb survivors resident in the South America

    Energy Technology Data Exchange (ETDEWEB)

    Hasegawa, Kenji (Hiroshima Univ. (Japan). School of Medicine); Kuramoto, Kiyoshi; Mukai, Hideaki; Suga, Kentaro; Yamamoto, Yoshio; Kunihara, Michitoshi; Ishida, Shigeki

    1991-08-01

    From October 21 through November 5, 1990, health examination was performed in atomic bomb survivors living in Brazil, Argentina, Bolivia, Peru, and Paraguay. A total of 194 persons were recognized as having been exposed to A-bombing. Among them, 122 atomic-bomb survivors (62.9%) participated in the present health examination, consisting of 55 men and 67 women. An average age was 61.5{+-}9.0 years for men and 59.6{+-}8.6 years for women. The acquisition rate of health handbook for atomic bomb survivors was 35.2%. Past history for cancer resection was seen in 4 atomic bomb survivors. The presenting subjective symptoms were fatigue, heat intolerance, decreased physical fitness, and unintentional weight loss. Laboratory findings included: a decreased value of hemoglobin (5 atomic-bomb survivors), hypertension (26), noticeable ECG findings (5), abnormal values of GOT (28) and GPT (14), hypercholesteremia (43), hyperuricemia (19), and fasting hyperglycemia (8). Overall evaluation showed that 48 atomic bomb survivors need to receive detailed medical examination for hypertension, heart disease, liver disease, and hyperlipemia. (N.K.).

  12. Developing a Best-Evidence Pre-employment Medical Examination: An Example from the Construction Industry

    Directory of Open Access Journals (Sweden)

    Vincent Gouttebarge

    2014-09-01

    Full Text Available The Dutch construction industry has introduced a compulsory preemployment medical examination (PE-ME. Best-evidence contents related to specific job demands are, however, lacking and need to be gathered. After the identification of job demands and health problems in the construction industry (systematic literature search and expert meeting, specific job demands and related requirements were defined and instruments proposed. Finally, a work ability assessment was linked to the instruments' outcomes, resulting in the modular character of the developed PE-ME. Twenty-two specific job demands for all Dutch construction jobs were identified, including kneeling/squatting, working under time pressure, and exposure to hazardous substances. The next step was proposing self-report questions, screening questionnaires, clinical tests, and/or performance-based tests, leading to a work ability judgment. “Lifting/carrying” is described as an example. The new modular PE-ME enables a job-specific assessment of work ability to be made for more than 100 jobs in the Dutch construction industry.

  13. Driver Licensing Age and Lifestyle of 16 Year Olds.

    Science.gov (United States)

    Preusser, David F.; And Others

    1985-01-01

    The relationship of driver licensure rate to 16-year-old lifestyles was assessed in three states: Michigan (where 56% of 16-year-olds are licensed), New York (14% licensure), and New Jersey (2% licensure). For the most part, the differences in 16-year-old licensure and mobility were not reflected in lifestyle differences. (KH)

  14. The reach of Spanish-language YouTube videos on physical examinations made by undergraduate medical students.

    Science.gov (United States)

    Ramos-Rincón, José M; Belinchón-Romero, Isabel; Sánchez-Ferrer, Francisco; Torre, Guillermo Martínez-de la; Harris, Meggan; Sánchez-Fernández, Javier

    2017-01-01

    This study was conducted to evaluate the performance and reach of YouTube videos on physical examinations made by Spanish university students. We analyzed performance metrics for 4 videos on physical examinations in Spanish that were created by medical students at Miguel Hernández University (Elche, Spain) and are available on YouTube, on the following topics: the head and neck (7:30), the cardiovascular system (7:38), the respiratory system (13:54), and the abdomen (11:10). We used the Analytics application offered by the YouTube platform to analyze the reach of the videos from the upload date (February 17, 2015) to July 28, 2017 (2 years, 5 months, and 11 days). The total number of views, length of watch-time, and the mean view duration for the 4 videos were, respectively: 164,403 views (mean, 41,101 views; range, 12,389 to 94,573 views), 425,888 minutes (mean, 106,472 minutes; range, 37,889 to 172,840 minutes), and 2:56 minutes (range, 1:49 to 4:03 minutes). Mexico was the most frequent playback location, followed by Spain, Colombia, and Venezuela. Uruguay, Ecuador, Mexico, and Puerto Rico had the most views per 100,000 population. Spanish-language tutorials are an alternative tool for teaching physical examination skills to students whose first language is not English. The videos were especially popular in Uruguay, Ecuador, and Mexico.

  15. Good practice in occupational health services: Recommendations for prophylactic examinations and medical certifications in persons with diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Andrzej Marcinkiewicz

    2014-02-01

    Full Text Available The prevalence of diabetes and a significant proportion of unawareness of its risk among the patients indicate the need to include into general prophylactic examinations the standards of medical certification, which would prevent discrimination and ensure public safety. In certifying medical predispositions to work in a person with diabetes mellitus the key issue is to distinguish 2 categories of medical requirements: the higher - related to qualifying workers for jobs demanding psychophysical abilities, which affect the safety of the workers and their environment and the lower - related to qualifying workers for jobs characterized by harmful factors and nuisances, which might have a negative effect on the course of diabetes. The very fact of having diabetes cannot be the reason for the patient being disqualified and the decision on certifying the capacity to perform a particular job should always be based on an individual health assessment of the patient, taking into account the risk of hypoglycemia, metabolic control, the progression and dynamics of chronic complications, as well as the level of health awareness in patients. The objective assessment of the health status of the patient with diabetes involves the judgment of an attending physician, additionally supported by the consultation of a diabetes specialist to ensure that the patient is able to perform properly the job, requiring psychomotor abilities. Med Pr 2014;65(1:131–141

  16. Examination of occupational exposure to medical staff (primarily nurses) during 131I medical treatments

    International Nuclear Information System (INIS)

    Watanabe, Masayoshi; Ishikawa, Naofumi; Ito, Kunihiko; Ito, Koichi

    2004-01-01

    Recently, a new amendment to protect against radiation damage to humans has been enacted based on a 1990 recommendation by the International Commission on Radiological Protection (ICRP). Consequently, the dose limits of occupational exposure to medical staff were cut down sharply compared with conventional readjustments. This amended bill, however, may be triggering a reduction in the number of applicants, which hope to engage in radiotherapy. This being the case, we measured the dose levels of the occupational exposure to medical staff (doctor's group, nuclear medicine technologist's group, nurse's group and pharmacist's group) from 1999 to 2002. Moreover, we investigated what the main factor is in nurse's occupational exposure to 131 I. The highest doses of occupational exposure were 3.640 mSv to doctors, 7.060 mSv to nuclear medicine technologists, 1.486 mSv to nurses and 0.552 mSv to pharmacists. According to our results, it was clear that the highest doses in each group were far below the legally mandated upper limits of exposure doses. Although we investigated the correlations between the factors of nurse's occupational exposure to 131 I with the number of inpatients, the amount of 131 I and the number of servicing times for patients, there were no correlations found. Furthermore, to analyzing the factors in detail, it became clear that the main factor in the nurse's occupational exposure was due to the existence of patients who needed many more servicing times for their care than ordinary patients. (author)

  17. Examination to assess the clinical examination and documentation of spine pathology among orthopedic residents.

    Science.gov (United States)

    Haglin, Jack M; Zeller, John L; Egol, Kenneth A; Phillips, Donna P

    2017-12-01

    The Accreditation Council for Graduate Medical Education (ACGME) guidelines requires residency programs to teach and evaluate residents in six overarching "core competencies" and document progress through educational milestones. To assess the progress of orthopedic interns' skills in performing a history, physical examination, and documentation of the encounter for a standardized patient with spinal stenosis, an objective structured clinical examination (OSCE) was conducted for 13 orthopedic intern residents, following a 1-month boot camp that included communications skills and curriculum in history and physical examination. Interns were objectively scored based on their performance of the physical examination, communication skills, completeness and accuracy of their electronic medical record (EMR), and their diagnostic conclusions gleaned from the patient encounter. The purpose of this study was to meaningfully assess the clinical skills of orthopedic post-graduate year (PGY)-1 interns. The findings can be used to develop a standardized curriculum for documenting patient encounters and highlight common areas of weakness among orthopedic interns with regard to the spine history and physical examination and conducting complete and accurate clinical documentation. A major orthopedic specialty hospital and academic medical center. Thirteen PGY-1 orthopedic residents participated in the OSCE with the same standardized patient presenting with symptoms and radiographs consistent with spinal stenosis. Videos of the encounters were independently viewed and objectively evaluated by one investigator in the study. This evaluation focused on the completeness of the history and the performance and completion of the physical examination. The standardized patient evaluated the communication skills of each intern with a separate objective evaluation. Interns completed these same scoring guides to evaluate their own performance in history, physical examination, and communications

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

    Science.gov (United States)

    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.

  19. Impact of Child Sexual Abuse Medical Examinations on the Dependency and Criminal Systems.

    Science.gov (United States)

    De Jong, Allan R.

    1998-01-01

    Reviews previous research on the sociolegal impact of medical evaluations for child sexual abuse; offers a recommended menu of research questions, concerning process and outcomes of these evaluations, interviewing techniques, the use of medical evidence in prosecution, and knowledge level of professionals in the criminal and dependency systems.…

  20. Telemedicine: the invisible legal barriers to the health care of the future.

    Science.gov (United States)

    Daly, H L

    2000-01-01

    Telemedicine has the potential to transform the world of health care just as the Internet transformed the world of commerce. Ms. Daly examines two legal obstacles to expanding the use of telemedicine: licensure and liability. She defines telemedicine and discusses its common applications and significant benefits. Licensure laws and liability rules result in formidable barriers to the expanded use of telemedicine, while also failing to provide sufficient protection for consumers. Ms. Daly argues that for the benefits of telemedicine to reach those most in need, mutual recognition of licensing laws coupled with a universal standard of care is necessary.

  1. Using therapeutic jurisprudence and preventive law to examine disputants' best interests in mediating cases about physicians' practices: a guide for medical regulators.

    Science.gov (United States)

    Ferris, Lorraine E

    2004-01-01

    Therapeutic jurisprudence (TJ) and preventive law (PL) are used as two theoretical perspectives from which to examine the best interests of parties in mediation because of a dispute about a physician's practice. The focus is mediation provided by and/or for the medical regulator. The paper reviews the literature on TJ and PL, and their relationship to mediation, and demonstrates how medical regulators could benefit by working within a framework reflecting both these perspectives providing it does not involve an egregious matter. A TJ and PL framework would be of particular value in identifying cases for mediation and in evaluating resolutions to mediated disputes.

  2. Associations of Pass-Fail Outcomes with Psychological Health of First-Year Medical Students in a Malaysian Medical School

    Directory of Open Access Journals (Sweden)

    Muhamad S. B. Yusoff

    2013-02-01

    Full Text Available Objectives: The demanding and intense environment of medical training can create excessive pressures on medical students that eventually lead to unfavorable consequences, either at a personal or professional level. These consequences can include poor academic performance and impaired cognitive ability. This study was designed to explore associations between pass-fail outcome and psychological health parameters (i.e. stress, anxiety, and depression symptoms. Methods: A cross-sectional study was conducted on a cohort of first-year medical students in a Malaysian medical school. The depression anxiety stress scale 21-item assessment (DASS-21 was administered to them right after the final paper of the first-year final examination. Their final examination outcomes (i.e. pass or fail were traced by using their student identity code (ID through the Universiti Sains Malaysia academic office. Results: A total of 194 (98.0% of medical students responded to the DASS-21. An independent t-test showed that students who passed had significantly lower stress, anxiety, and depression symptoms than those who failed the first-year final examination (P <0.05. Those who experienced moderate to high stress were at 2.43 times higher risk for failing the examination than those who experienced normal to mild stress. Conclusion: Medical students whofailed in the final examination had higher psychological distress than those who passed the examination. Those who experienced high stress levels were more likely to fail than those who did not. Reducing the psychological distress of medical students prior to examination may help them to perform better in the examination.

  3. From patient care to research: a validation study examining the factors contributing to data quality in a primary care electronic medical record database.

    Science.gov (United States)

    Coleman, Nathan; Halas, Gayle; Peeler, William; Casaclang, Natalie; Williamson, Tyler; Katz, Alan

    2015-02-05

    Electronic Medical Records (EMRs) are increasingly used in the provision of primary care and have been compiled into databases which can be utilized for surveillance, research and informing practice. The primary purpose of these records is for the provision of individual patient care; validation and examination of underlying limitations is crucial for use for research and data quality improvement. This study examines and describes the validity of chronic disease case definition algorithms and factors affecting data quality in a primary care EMR database. A retrospective chart audit of an age stratified random sample was used to validate and examine diagnostic algorithms applied to EMR data from the Manitoba Primary Care Research Network (MaPCReN), part of the Canadian Primary Care Sentinel Surveillance Network (CPCSSN). The presence of diabetes, hypertension, depression, osteoarthritis and chronic obstructive pulmonary disease (COPD) was determined by review of the medical record and compared to algorithm identified cases to identify discrepancies and describe the underlying contributing factors. The algorithm for diabetes had high sensitivity, specificity and positive predictive value (PPV) with all scores being over 90%. Specificities of the algorithms were greater than 90% for all conditions except for hypertension at 79.2%. The largest deficits in algorithm performance included poor PPV for COPD at 36.7% and limited sensitivity for COPD, depression and osteoarthritis at 72.0%, 73.3% and 63.2% respectively. Main sources of discrepancy included missing coding, alternative coding, inappropriate diagnosis detection based on medications used for alternate indications, inappropriate exclusion due to comorbidity and loss of data. Comparison to medical chart review shows that at MaPCReN the CPCSSN case finding algorithms are valid with a few limitations. This study provides the basis for the validated data to be utilized for research and informs users of its

  4. The Last State to Grant Nurse Practitioners DEA Licensure: An Education Improvement Initiative on the Florida Prescription Drug Monitoring Program.

    Science.gov (United States)

    Kellams, Joni R; Maye, John P

    Nurse practitioners (NPs) now have prescriptive authority for controlled substances in all 50 states in the United States. Florida, the last state to grant NPs DEA licensure, has been wrought with prescription diversion practices for a number of years as pill mills, doctor shopping, and overprescribing proliferated. Prescription Drug Monitoring Programs (PDMPs) help curb drug diversion activity and play a key role in reducing the abuse of controlled substances. The primary objective of this education improvement initiative was to increase knowledge of actively licensed NPs in the state of Florida regarding the state's PDMP. The main themes included the drug abuse problem, description and progression of the PDMP, and how to use the Florida PDMP. Upon approval from the institutional review board, this education improvement initiative gauged NP knowledge of the PDMP and main themes before and after an educational PowerPoint intervention. A pretest/posttest questionnaire was administered for assessment of all knowledge questions. One hundred forty-five NPs with active advanced registered NP licenses in Florida completed both the pretest and posttest questionnaires. Descriptive statistics and paired t tests were used for statistical significance testing. Knowledge of the PDMP and the main themes of the education improvement initiative significantly increased (p < .001) from pretest to posttest results. This education improvement initiative had positive effects for NPs on the knowledge of the Florida PDMP and the main themes. This indicated that Florida NPs are able to acquire greater comprehension of the PDMP by an education intervention.

  5. Report on the results of the second medical examination of atomic bomb survivors resident in the South America

    International Nuclear Information System (INIS)

    Kamitsuna, Akimitsu; Monzen, Tetsuo; Oguma, Nobuo; Sakuma, Saburo; Takata, Yoshiki; Nakashima, Yoshiaki; Sakata, Morimitsu.

    1987-01-01

    In October 9 - 31, 1986, the second medical examination for A-bomb survivors was undertaken in Brazil, Argentina, Paraguay, Bolivia, and Peru. Among 173 recognized A-bomb survivors in the five countries, 126 (73 %) participated in the examination, consisting of 61 men and 65 women. Seventy-eight A-bomb survivors came from Hiroshima and 48 from Nagasaki. The average age was 55.6 +- 9.7 years for men and 56.5 +- 9.8 years for women. The acquisition rate of ''Survivor's Health Handbook'' was 34 %. Gastric cancer was observed in two survivors and cervical cancer in one survivor. Major subjective symptoms were: fatigue, sensation of paralysis, heat intolerance, decreased physical strength, and itching. None of the abnormal findings were observed in 33 %. The incidence of hypertension, obesity, cardiac disease, and liver disease was high. The incidence of hypercholesteremia and diabetes mellitus was lower than that in the USA. (Namekawa, K.)

  6. Use of medical tourism for hip and knee surgery in osteoarthritis: a qualitative examination of distinctive attitudinal characteristics among Canadian patients.

    Science.gov (United States)

    Crooks, Valorie A; Cameron, Keri; Chouinard, Vera; Johnston, Rory; Snyder, Jeremy; Casey, Victoria

    2012-11-21

    Medical tourism is the term that describes patients' international travel with the intention of seeking medical treatment. Some medical tourists go abroad for orthopaedic surgeries, including hip and knee resurfacing and replacement. In this article we examine the findings of interviews with Canadian medical tourists who went abroad for such surgeries to determine what is distinctive about their attitudes when compared to existing qualitative research findings about patients' decision-making in and experiences of these same procedures in their home countries. Fourteen Canadian medical tourists participated in semi-structured phone interviews, all of whom had gone abroad for hip or knee surgery to treat osteoarthritis. Transcripts were coded and thematically analysed, which involved comparing emerging findings to those in the existing qualitative literature on hip and knee surgery. Three distinctive attitudinal characteristics among participants were identified when interview themes were compared to findings in the existing qualitative research on hip and knee surgery in osteoarthritis. These attitudinal characteristics were that the medical tourists we spoke with were: (1) comfortable health-related decision-makers; (2) unwavering in their views about procedure necessity and urgency; and (3) firm in their desires to maintain active lives. Compared to other patients reported on in the existing qualitative hip and knee surgery literature, medical tourists are less likely to question their need for surgery and are particularly active in their pursuit of surgical intervention. They are also comfortable with taking control of health-related decisions. Future research is needed to identify motivators behind patients' pursuit of care abroad, determine if the attitudinal characteristics identified here hold true for other patient groups, and ascertain the impact of these attitudinal characteristics on surgical outcomes. Arthritis care providers can use the attitudinal

  7. Use of medical tourism for hip and knee surgery in osteoarthritis: a qualitative examination of distinctive attitudinal characteristics among Canadian patients

    Directory of Open Access Journals (Sweden)

    Crooks Valorie A

    2012-11-01

    Full Text Available Abstract Background Medical tourism is the term that describes patients’ international travel with the intention of seeking medical treatment. Some medical tourists go abroad for orthopaedic surgeries, including hip and knee resurfacing and replacement. In this article we examine the findings of interviews with Canadian medical tourists who went abroad for such surgeries to determine what is distinctive about their attitudes when compared to existing qualitative research findings about patients’ decision-making in and experiences of these same procedures in their home countries. Methods Fourteen Canadian medical tourists participated in semi-structured phone interviews, all of whom had gone abroad for hip or knee surgery to treat osteoarthritis. Transcripts were coded and thematically analysed, which involved comparing emerging findings to those in the existing qualitative literature on hip and knee surgery. Results Three distinctive attitudinal characteristics among participants were identified when interview themes were compared to findings in the existing qualitative research on hip and knee surgery in osteoarthritis. These attitudinal characteristics were that the medical tourists we spoke with were: (1 comfortable health-related decision-makers; (2 unwavering in their views about procedure necessity and urgency; and (3 firm in their desires to maintain active lives. Conclusions Compared to other patients reported on in the existing qualitative hip and knee surgery literature, medical tourists are less likely to question their need for surgery and are particularly active in their pursuit of surgical intervention. They are also comfortable with taking control of health-related decisions. Future research is needed to identify motivators behind patients’ pursuit of care abroad, determine if the attitudinal characteristics identified here hold true for other patient groups, and ascertain the impact of these attitudinal characteristics on

  8. [Career planning for explanation of clinical test results and program of inspections: developing medical technologists for team medical care].

    Science.gov (United States)

    Uchida, Misuko

    2013-04-01

    Current medical care is subdivided according to medical advances, and sophistication and new techniques are necessary. In this setting, doctors and nurses have been explaining to and consulting patients about their medical examinations; however, in recent years, medical technologists have performed these duties at the start of the team's medical care. Therefore, we think it is possible for patients to receive clear and convincing explanations. Most patients cannot understand their examination data, which are written using numbers and charts, etc. Recently, the Nagano Medical Technologist Society has been developing technologists who could explain examination results to patients. This development training included hospitality and communication. The certificate of completion will be issued in March when the program starts.

  9. Novice drivers' exposure to known risk factors during the first 18 months of licensure: the effect of vehicle ownership.

    Science.gov (United States)

    Klauer, Sheila G; Simons-Morton, Bruce; Lee, Suzanne E; Ouimet, Marie Claude; Howard, E Henry; Dingus, Thomas A

    2011-04-01

    Though there is ample research indicating that nighttime, teen passengers, and speeding increase the risk of crash involvement, there is little research about teen drivers' exposure to these known risk factors. Three research questions were assessed in this article: (1) Does exposure to known risk factors change over time? (2) Do teenage drivers experience higher rates of exposure to known risk factors than adult drivers? (3) Do teenage drivers who own a vehicle experience higher rates of exposure to risk factors than those who share a family vehicle? Forty-one newly licensed teenage drivers and at least one parent (adult) were recruited at licensure. Driving data were recorded for 18 months. Average vehicle miles traveled (VMT) or average nighttime VMT for teens did not increase over time. Teenagers consistently drove 24 percent of VMT at night, compared with 18 percent for adults. Teenagers drove 62 percent of VMT with no passengers, 29 percent of VMT with one passenger, and less than 10 percent of VMT with multiple passengers. Driving with no passengers increased with driving experience for these teens. Teenage drivers who owned their vehicles, relative to those who shared a vehicle, sped 4 times more frequently overall and more frequently at night and with multiple teen passengers. These findings are among the first objective data documenting the nature of teenage driving exposure to known risk factors. The findings provide evidence that vehicle access is related to risk and suggest the potential safety benefit of parental management of novice teenage driving exposure.

  10. Novice Drivers' Exposure to Known Risk Factors During the First 18 Months of Licensure: The Effect of Vehicle Ownership

    Science.gov (United States)

    Klauer, Sheila G.; Simons-Morton, Bruce; Lee, Suzanne E.; Ouimet, Marie Claude; Howard, E. Henry; Dingus, Thomas A.

    2014-01-01

    Objective Though there is ample research indicating that nighttime, teen passengers, and speeding increase the risk of crash involvement, there is little research about teen drivers' exposure to these known risk factors. Three research questions were assessed in this article: (1) Does exposure to known risk factors change over time? (2) Do teenage drivers experience higher rates of exposure to known risk factors than adult drivers? (3) Do teenage drivers who own a vehicle experience higher rates of exposure to risk factors than those who share a family vehicle? Methods Forty-one newly licensed teenage drivers and at least one parent (adult) were recruited at licensure. Driving data were recorded for 18 months. Results Average vehicle miles traveled (VMT) or average nighttime VMT for teens did not increase over time. Teenagers consistently drove 24 percent of VMT at night, compared with 18 percent for adults. Teenagers drove 62 percent of VMT with no passengers, 29 percent of VMT with one passenger, and less than 10 percent of VMT with multiple passengers. Driving with no passengers increased with driving experience for these teens. Teenage drivers who owned their vehicles, relative to those who shared a vehicle, sped 4 times more frequently overall and more frequently at night and with multiple teen passengers. Conclusion These findings are among the first objective data documenting the nature of teenage driving exposure to known risk factors. The findings provide evidence that vehicle access is related to risk and suggest the potential safety benefit of parental management of novice teenage driving exposure. PMID:21469023

  11. An intercalated BSc degree is associated with higher marks in subsequent medical school examinations

    OpenAIRE

    Cleland, Jennifer A; Milne, Andrew; Sinclair, Hazel; Lee, Amanda J

    2009-01-01

    Abstract Background To compare medical students on a modern MBChB programme who did an optional intercalated degree with their peers who did not intercalate; in particular, to monitor performance in subsequent undergraduate degree exams. Methods This was a retrospective, observational study of anonymised databases of medical student assessment outcomes. Data were accessed for graduates, University of Aberdeen Medical School, Scotland, UK, from the years 2003 to 2007 (n = 861). The main outcom...

  12. Furthering Medical Education in Texas.

    Science.gov (United States)

    Varma, Surendra K; Jennings, John

    2016-02-01

    Medical education in Texas is moving in the right direction. The Texas Medical Association has been a major partner in advancing medical education initiatives. This special symposium issue on medical education examines residency training costs, the Next Accreditation System, graduate medical education in rural Texas, Texas' physician workforce needs, the current state of education reform, and efforts to retain medical graduates in Texas.

  13. Associations of pass-fail outcomes with psychological health of first-year medical students in a malaysian medical school.

    Science.gov (United States)

    Yusoff, Muhamad S B

    2013-02-01

    The demanding and intense environment of medical training can create excessive pressures on medical students that eventually lead to unfavorable consequences, either at a personal or professional level. These consequences can include poor academic performance and impaired cognitive ability. This study was designed to explore associations between pass-fail outcome and psychological health parameters (i.e. stress, anxiety, and depression symptoms). A cross-sectional study was conducted on a cohort of first-year medical students in a Malaysian medical school. The depression anxiety stress scale 21-item assessment (DASS-21) was administered to them right after the final paper of the first-year final examination. Their final examination outcomes (i.e. pass or fail) were traced by using their student identity code (ID) through the Universiti Sains Malaysia academic office. A total of 194 (98.0%) of medical students responded to the DASS-21. An independent t-test showed that students who passed had significantly lower stress, anxiety, and depression symptoms than those who failed the first-year final examination (P passed the examination. Those who experienced high stress levels were more likely to fail than those who did not. Reducing the psychological distress of medical students prior to examination may help them to perform better in the examination.

  14. From Servicescape to Loyalty in the Medical Tourism Industry: A Medical Clinic’s Service Perspective

    OpenAIRE

    Kim, Minseong; Koo, Dong-Woo; Shin, Dong-Jin; Lee, Sae-Mi

    2017-01-01

    Medical tourism organizations have increasingly recognized that loyalty makes a medical clinic a marketing success. To increase understanding of the importance of medical clinics, this study examined the roles of servicescapes, emotions, and satisfaction in the development of customer loyalty toward medical clinics and destination. Data were collected among international medical tourists visiting Korea. Results identified that dimensions of medical clinics’ servicescape (ie, medical clinic en...

  15. The reach of Spanish-language YouTube videos on physical examinations made by undergraduate medical students

    Directory of Open Access Journals (Sweden)

    José M. Ramos-Rincón

    2017-12-01

    Full Text Available This study was conducted to evaluate the performance and reach of YouTube videos on physical examinations made by Spanish university students. We analyzed performance metrics for 4 videos on physical examinations in Spanish that were created by medical students at Miguel Hernández University (Elche, Spain and are available on YouTube, on the following topics: the head and neck (7:30, the cardiovascular system (7:38, the respiratory system (13:54, and the abdomen (11:10. We used the Analytics application offered by the YouTube platform to analyze the reach of the videos from the upload date (February 17, 2015 to July 28, 2017 (2 years, 5 months, and 11 days. The total number of views, length of watch-time, and the mean view duration for the 4 videos were, respectively: 164,403 views (mean, 41,101 views; range, 12,389 to 94,573 views, 425,888 minutes (mean, 106,472 minutes; range, 37,889 to 172,840 minutes, and 2:56 minutes (range, 1:49 to 4:03 minutes. Mexico was the most frequent playback location, followed by Spain, Colombia, and Venezuela. Uruguay, Ecuador, Mexico, and Puerto Rico had the most views per 100,000 population. Spanish-language tutorials are an alternative tool for teaching physical examination skills to students whose first language is not English. The videos were especially popular in Uruguay, Ecuador, and Mexico.

  16. The reach of Spanish-language YouTube videos on physical examinations made by undergraduate medical students

    Science.gov (United States)

    2017-01-01

    This study was conducted to evaluate the performance and reach of YouTube videos on physical examinations made by Spanish university students. We analyzed performance metrics for 4 videos on physical examinations in Spanish that were created by medical students at Miguel Hernández University (Elche, Spain) and are available on YouTube, on the following topics: the head and neck (7:30), the cardiovascular system (7:38), the respiratory system (13:54), and the abdomen (11:10). We used the Analytics application offered by the YouTube platform to analyze the reach of the videos from the upload date (February 17, 2015) to July 28, 2017 (2 years, 5 months, and 11 days). The total number of views, length of watch-time, and the mean view duration for the 4 videos were, respectively: 164,403 views (mean, 41,101 views; range, 12,389 to 94,573 views), 425,888 minutes (mean, 106,472 minutes; range, 37,889 to 172,840 minutes), and 2:56 minutes (range, 1:49 to 4:03 minutes). Mexico was the most frequent playback location, followed by Spain, Colombia, and Venezuela. Uruguay, Ecuador, Mexico, and Puerto Rico had the most views per 100,000 population. Spanish-language tutorials are an alternative tool for teaching physical examination skills to students whose first language is not English. The videos were especially popular in Uruguay, Ecuador, and Mexico. PMID:29278903

  17. [The Medical Examination - Between Desire and Reality - Analysis of Consensus Between the Second Part of the Medical Licensing Exam (IMPP) and the National Catalogue of Expertise-based Learning Goals in Surgery (NKLC)].

    Science.gov (United States)

    Sterz, Jasmina; Rüsseler, Miriam; Britz, Vanessa; Stefanescu, Christina; Hoefer, Sebastian H; Adili, Farzin; Schreckenbach, Teresa; Schleicher, Iris; Weber, Roxane; Hofmann, Hans-Stefan; Voß, Friedericke; König, Sarah; Heinemann, Markus K; Kadmon, Martina

    2017-12-01

    Background The working party of the German Society for Surgery (DGCH) on undergraduate surgical education has developed a national expertise-based catalogue of learning goals in surgery (NKLC). This study analyses the extent to which the questions of the German second medical licensing examination compiled by the IMPP are congruent with the NKLC and which thematic focus is emphasised. Materials and Methods Firstly, a guideline and evaluation sheet were developed in order to achieve documentation of the individual examination questions of the second licensing examination with respect to the learning goals of the NKLC. In a retrospective analysis from autumn 2009 to autumn 2014, eleven licensing examinations in human medicine were screened independently by three different reviewers. In accordance with the guideline, the surgical questions were identified and subsequently matched to the learning goals of the NKLC. The analysis included the number of surgical learning goals as well as the number of surgical questions for each examination, learning goal, and different levels of expertise (LE). Results Thirteen reviewers from six surgical disciplines participated in the analysis. On average, reviewers agreed on the differentiation between surgical and non-surgical questions in 79.1% of all 3480 questions from 11 licensing examinations. For each examination (n = 320 questions), 98.8 ± 22.6 questions (min.: 69, max.: 150) were rated as surgical. For each surgical learning goal addressed, 2.2 ± 0.3 questions (min.: 1, max.: 16) were asked. For each examination, 23.5 ± 6.3 questions (min.: 11; max.: 31) referred to learning goals of LE 3, 52.5 ± 16.7 questions (min.: 34; max.: 94) addressed learning goals of LE 2 and 22.8 ± 7.7 questions (min.: 9; max.: 34) were related to learning goals of LE 1. 64 learning goals (27.8% of all learning goals of the NKLC) were not reflected in the examinations. With a total of 70 questions, the most frequently

  18. Medical Rituals and Media Rituals

    OpenAIRE

    Zoltán Zsinkó-Szabó

    2013-01-01

    In the present article the author examines the ritual elements of theprofessionalization during medical studies, and its interference with media content of medical significance, comparing the role of medical and media rituals on the way of becoming a doctor. It is to be explored how these medical soap operas, medical dramas, medical thrillers or crime stories do exert influence on medical identity and role expectations. Do medical students and their relatives (withmedical expertise frequently...

  19. The effect of two grading systems on the performance of medical students during oral examinations

    DEFF Research Database (Denmark)

    Ba-Ali, Shakoor; Jemec, Gregor B E; Sander, Birgit

    2017-01-01

    group (p = 0.45). Moreover, the average mark was higher among the international students (mean = 10.3, on the seven-point grading scale) than in the Danish speaking classes (mean = 9.1). CONCLUSION: The seven-point grading scale seems to motivate students to yield a better performance; hence tiered......INTRODUCTION: Either a pass/fail approach or a seven-point grading scale are used to evaluate students at the Danish universities. The aim of this study was to explore any effect of the assessment methods on student performances during oral exams. METHODS: In a prospective study including 1......,037 examinations in three medical subjects, we investigated the difference in the test scores between the spring- and autumn semester. In the spring semester, the students could either pass or fail the subject (pass/fail) while in the following autumn semester, the students were assessed by tiered grading (seven...

  20. Psychiatry in American Medical Education: The Case of Harvard's Medical School, 1900-1945.

    Science.gov (United States)

    Abraham, Tara H

    2018-01-01

    As American psychiatrists moved from the asylum to the private clinic during the early twentieth century, psychiatry acquired a growing presence within medical school curricula. This shift in disciplinary status took place at a time when medical education itself was experiencing a period of reform. By examining medical school registers at Harvard University, records from the Dean's office of Harvard's medical school, and oral histories, this paper examines the rise in prominence of psychiatry in medical education. Three builders of Harvard psychiatry - Elmer E. Southard, C. Macfie Campbell, and Harry C. Solomon - simultaneously sought to mark territory for psychiatry and its relevance. In doing so, they capitalized on three related elements: the fluidity that existed between psychiatry and neurology, the new venues whereby medical students gained training in psychiatry, and the broader role of patrons, professional associations, and certification boards, which sought to expand psychiatry's influence in the social and cultural life of twentieth-century America.

  1. Digital rectal examination in Indian graduates.

    Science.gov (United States)

    Beena, Aishwarya; Jagadisan, Barath

    2018-02-12

    Digital rectal examination (DRE) is an important component of physical examination and an essential skill for medical graduates. DRE is often underutilised in clinical practice. The lack of confidence and expertise and also underutilization of DRE have been associated with inadequate training of medical students during their undergraduate studies. The training of Indian undergraduates in DRE has not been studied. A questionnaire on undergraduate training in DRE was administered to students from various medical colleges joining specialty postgraduate courses in Jawaharlal Institute of Postgraduate Medical Education and Research. A total of 101 out of 131 students participated in the survey. Ninety-one percent of students were taught DRE as undergraduates but only three-quarters had performed DRE on patients. Among the respondents who had performed DRE, two-thirds had performed fewer than five DREs before the completion of their medical education. Respondents who had performed fewer DREs were less confident about performing DRE (p importance given to DRE training of undergraduate students and huge gaps in imparting this clinical skill. Training may be improved by introducing manikins, changing attitudes to DRE by incorporating it in clinical problem solving, and with more frequent opportunities to practise under supervision. © 2018 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

  2. Current practices in library/informatics instruction in academic libraries serving medical schools in the Western United States: a three-phase action research study.

    Science.gov (United States)

    Eldredge, Jonathan D; Heskett, Karen M; Henner, Terry; Tan, Josephine P

    2013-09-04

    To conduct a systematic assessment of library and informatics training at accredited Western U.S. medical schools. To provide a structured description of core practices, detect trends through comparisons across institutions, and to identify innovative training approaches at the medical schools. Action research study pursued through three phases. The first phase used inductive analysis on reported library and informatics skills training via publicly-facing websites at accredited medical schools and the academic health sciences libraries serving those medical schools. Phase Two consisted of a survey of the librarians who provide this training to undergraduate medical education students at the Western U.S. medical schools. The survey revealed gaps in forming a complete picture of current practices, thereby generating additional questions that were answered through the Phase Three in-depth interviews. Publicly-facing websites reviewed in Phase One offered uneven information about library and informatics training at Western U.S. medical schools. The Phase Two survey resulted in a 77% response rate. The survey produced a clearer picture of current practices of library and informatics training. The survey also determined the readiness of medical students to pass certain aspects of the United States Medical Licensure Exam. Most librarians interacted with medical school curricular leaders through either curricula committees or through individual contacts. Librarians averaged three (3) interventions for training within the four-year curricula with greatest emphasis upon the first and third years. Library/informatics training was integrated fully into the respective curricula in almost all cases. Most training involved active learning approaches, specifically within Problem-Based Learning or Evidence-Based Medicine contexts. The Phase Three interviews revealed that librarians are engaged with the medical schools' curricular leaders, they are respected for their knowledge and

  3. Report on the results of the second medical examination of atomic bomb survivors resident in the South America

    Energy Technology Data Exchange (ETDEWEB)

    Kamitsuna, Akimitsu; Monzen, Tetsuo; Oguma, Nobuo; Sakuma, Saburo; Takata, Yoshiki; Nakashima, Yoshiaki; Sakata, Morimitsu.

    1987-06-01

    In October 9 - 31, 1986, the second medical examination for A-bomb survivors was undertaken in Brazil, Argentina, Paraguay, Bolivia, and Peru. Among 173 recognized A-bomb survivors in the five countries, 126 (73 %) participated in the examination, consisting of 61 men and 65 women. Seventy-eight A-bomb survivors came from Hiroshima and 48 from Nagasaki. The average age was 55.6 +- 9.7 years for men and 56.5 +- 9.8 years for women. The acquisition rate of ''Survivor's Health Handbook'' was 34 %. Gastric cancer was observed in two survivors and cervical cancer in one survivor. Major subjective symptoms were: fatigue, sensation of paralysis, heat intolerance, decreased physical strength, and itching. None of the abnormal findings were observed in 33 %. The incidence of hypertension, obesity, cardiac disease, and liver disease was high. The incidence of hypercholesteremia and diabetes mellitus was lower than that in the USA. (Namekawa, K.).

  4. Report on the results of the twelfth medical examination of atomic bomb survivors residing in North America

    Energy Technology Data Exchange (ETDEWEB)

    Yamamoto, Yasuji [Hiroshima Prefectural Medical Association (Japan); Ohama, Koso; Fujiwara, Saeko (and others)

    2000-06-01

    The twelfth medical examination of atomic bomb survivors residing in North America, was conducted in San Francisco and Seattle from May 20 through June 2 1999, and in Los Angeles and Hawaii from June 9 through 23 1999, The examination included an interview, measurement of height, weight, and blood pressure, an ECG, urine and stool tests, blood tests, a physical examination, examination of the breast, thyroid, and rectum by a surgeon, and screening for uterine cancer and a gynecological interview and examination by an obstetrician and gynecologist. The total confirmed number of A-bomb survivors residing in North America as of the end of June 1999 was 1076. Of the 1062 survivors that remained after excluding the 14 subjects whose survey was incomplete, 279 males and 654 females had been exposed in Hiroshima, and 10 males and 119 females in Nagasaki. The peak age at the time of exposure in both sexes was 15-19 years, followed by 10-14 years. The number of survivors exposed <2000 m from the hypocenter was 236, accounting for 21.9% of the total. The confirmed number of survivors exposed in utero was 26. The survivors' age (mean {+-}S.D.) was: 69.0{+-}8.69 years; males, 68.4{+-}80.5 years; females, 69.2{+-}8.91 years. A total of 414 survivors were examined (male 129; female 285; mean age 68.0 years). Approximately 80% of the examinees had experienced at least one general symptom. Many still complain of symptoms that suggest possible posttraumatic stress disorder as a result of exposure to the A-bomb. It will be necessary to consider providing mental health care by psychiatrists beginning with the next examination. The prevalence of life-style diseases has been gradually increased with age. A previous history of cancer was found in 9.2% of the examinees. The most prevalent was of breast cancer, followed by malignant tumors of the colon, rectum, uterus, brain, stomach, and thyroid. The need for cancer screening and promotion of life-style education was keenly felt. (K.H.)

  5. Examining assumptions regarding valid electronic monitoring of medication therapy: development of a validation framework and its application on a European sample of kidney transplant patients

    Directory of Open Access Journals (Sweden)

    Steiger Jürg

    2008-02-01

    Full Text Available Abstract Background Electronic monitoring (EM is used increasingly to measure medication non-adherence. Unbiased EM assessment requires fulfillment of assumptions. The purpose of this study was to determine assumptions needed for internal and external validity of EM measurement. To test internal validity, we examined if (1 EM equipment functioned correctly, (2 if all EM bottle openings corresponded to actual drug intake, and (3 if EM did not influence a patient's normal adherence behavior. To assess external validity, we examined if there were indications that using EM affected the sample representativeness. Methods We used data from the Supporting Medication Adherence in Renal Transplantation (SMART study, which included 250 adult renal transplant patients whose adherence to immunosuppressive drugs was measured during 3 months with the Medication Event Monitoring System (MEMS. Internal validity was determined by assessing the prevalence of nonfunctioning EM systems, the prevalence of patient-reported discrepancies between cap openings and actual intakes (using contemporaneous notes and interview at the end of the study, and by exploring whether adherence was initially uncharacteristically high and decreased over time (an indication of a possible EM intervention effect. Sample representativeness was examined by screening for differences between participants and non-participants or drop outs on non-adherence. Results Our analysis revealed that some assumptions were not fulfilled: 1 one cap malfunctioned (0.4%, 2 self-reported mismatches between bottle openings and actual drug intake occurred in 62% of the patients (n = 155, and 3 adherence decreased over the first 5 weeks of the monitoring, indicating that EM had a waning intervention effect. Conclusion The validity assumptions presented in this article should be checked in future studies using EM as a measure of medication non-adherence.

  6. Physical Examination for the Academic Psychiatrist: Primer and Common Clinical Scenarios.

    Science.gov (United States)

    Azzam, Pierre N; Gopalan, Priya; Brown, Jennifer R; Aquino, Patrick R

    2016-04-01

    As clinical psychiatry has evolved to mirror the patient care model followed in other medical specialties, psychiatrists are called upon increasingly to utilize general medical skills in routine practice. Psychiatrists who practice in academic settings are often required to generate broad differential diagnoses that include medical and neurologic conditions and, as a result, benefit from incorporating physical examination into their psychiatric assessments. Physical examination allows psychiatrists to follow and to teach patient-informed clinical practices and comprehensive treatment approaches. In this commentary, the authors encourage routine use of a targeted physical examination and outline common scenarios in which physical examination would be useful for the academic psychiatrist: delirium, toxidromes, and unexplained medical conditions (e.g., somatic symptom disorders).

  7. Heroin-related Deaths from the Hennepin County Medical Examiner's Office from 2004 Through 2015.

    Science.gov (United States)

    Love, Sara A; Lelinski, Jessica; Kloss, Julie; Middleton, Owen; Apple, Fred S

    2018-01-01

    Over the past two decades, prescription and illicit opioid use has led to changes in public health policy to address the increasing number of opioid-related deaths. The purpose of this study was to review cases from Hennepin County Medical Examiner's Office between 2004 through 2015 where heroin was listed as a significant contributor or as the cause of death. We identified 322 heroin-related deaths, which were predominantly male (255; 79%). 6-Monoacetylmorphine (6-MAM) median (range) concentrations were as follows: blood (n = 7), 0.010 (0.006-0.078) mg/L; urine (n = 30), 0.359 (0.009-1.75) mg/L; and vitreous humor (n = 31), 0.034 (0.004-0.24) mg/L. Free morphine was measurable in 273 cases and the percent free morphine (range), when grouped by COD, was opioid (n = 124), 28% (2.2%-92%), and mixed drug toxicity (n = 135), 35.3% (1.5%-100%); (p 26%, was useful in establishing heroin-related deaths. © 2017 American Academy of Forensic Sciences.

  8. Rejoinder: A Further Discussion of Job Analysis and Use of KSAs in Developing Licensure and Certification Examinations--A Response to LaDuca

    Science.gov (United States)

    Wang, Ning; Witt, Elizabeth A.; Schnipke, Deborah

    2006-01-01

    "In his commentary to our paper on the use of knowledge, skill, and ability statements in developing credentialing examinations (Wang, Schnipke, & Witt, 2005 )," Dr. LaDuca set forth his concerns while commending our paper for providing helpful insights into the importance of careful delineation of KSAs. We believe that there is little substantive…

  9. 20 CFR 416.919g - Who we will select to perform a consultative examination.

    Science.gov (United States)

    2010-04-01

    ... examination. (a) We will purchase a consultative examination only from a qualified medical source. The medical... training and experience to perform the type of examination or test we will request; the medical source must...

  10. Guide to correct use of medical imagery examinations. Recommendations for health personnel. Transposition of the 97/43 Euratom European directive

    International Nuclear Information System (INIS)

    Frija, Guy; Grenier, Philippe; Grellet, Jacques; Amiel, Michel; Cordoliani, Yves-Sebastien; Frija, Guy; Sirinelli, Dominique; Talbot, Jean-Noel; Bourguignon, Michel; Aucant, Denis; Silberman, Bruno; Verzaux, Laurent; Chagnon, Sophie; Dacher, Jean-Nicolas; Helenon, Olivier; Dosquet, Patrice; Hittinger, Marie-Claude; Xerri, Bertrand; Herrmann, Theodore; Pruvo, Jean-Pierre; Steinling, Marc; Brochet, Bruno; Depriester, Claude; Dousset, Vincent; Dormont, Didier; Dubois, Francois; Gauvrit, Jean-Yves; Mas, Jean-Louis; Meder, Jean-Francois; Moulin, Guy; Sulman, Charles; Gauthier, Helene; Martin-Duverneuil, Nadine; Bossard, Denis; Elmaleh, Monique; Treil, Jacques; Zanaret, Michel; Morvan, Gerard; Paycha, Frederic; Chastanet, Patrick; Dosch, Jean-Claude; Drape, Jean-Luc; Feydy, Antoine; Guilbeau, Jean-Charles; Sans, Nicolas; Beregi, Jean-Paul; Laissy, Jean-Pierre; Cassin, Patrice de; Heautot, Jean-Francois; Laroche, Jean-Pierre; Brauner, Michel; Bok, Bernard; Carette, Marie-France; Ferretti, Gilbert; Abehsera, Marc; Menu, Yves; Zerbib, Eric; Denys, Alban; Agostini, Serge; Sagui, Michel; Valette, Pierre-Jean; Djabban, Marjan; Drahi, Gilles; Tiah, Djamel; Roy, Catherine; Bellin, Marie-France; Prigent, Alain; Lemaitre, Laurent; Andre, Marc; Grenier, Nicolas; Robert, Yann; Kerrou, Khaldoun; Delattre, Christian; Garel, Catherine; Taieb, Sophie; Subtil, Damien; Stines, Joseph; Soler, Claude; Cambier, Luc; Digabel, Christine; Hagay, Charley; Tardivon, Anne; Le Dosseur, Patrick; Bonnin, Francois; Schmit, Pierre; Kalifa, Gabriel; Geoffray, Anne; Panuel, Michel; Guibaud, Laurent; Chateil, Jean-Francois; Clerc, Jerome; Tramalloni, Jean; Ernst, Olivier; Rocher, Laurence; Young, Jacques; Munera, Yves; Muller, Philippe; Stines, Joseph; Lumbroso, Jean; Frija, Jacques; Haioun, Corinne; Rahmouni, Alain; Menu, Yves; Dosch, Jean-Claude; Ducou le Pointe, Hubert; Taourel, Patrice; Schmutz, Gerard; Portier, Francois; Lopez, Francois-Michel; Guludec, Dominique le; Machecourt, Jacques; Chevalier, Bernard; Derumeaux, Genevieve; Py, Marie; Carrie, Didier; Revel, Didier

    2005-01-01

    This guide aims at indicating to the requesting physician the most appropriate imagery examination with respect to the explored pathology, by using either irradiation or non-irradiating techniques. This guide has several objectives: the radiation protection of patients, a practice rationalisation, interdisciplinary exchanges, and the organisation of clinical audits. After a description of the methodology adopted to elaborate this guide, the guide is made of a table of five columns which respectively indicate: the symptoms or pathology for which a medical imagery is required, the imagery modality, some indications related to the examination (diagnosis, peculiar cases, specialised or non-indicated), its grade of recommendation for the concerned clinical situation, comments regarding the usefulness of the examination, and the induced exposure level (from 0 to IV). Symptoms and pathologies are herein classified with respect to the concerned part of the body (head, neck, skeleton, musculoskeletal system, cardiovascular system, thorax, digestive tract, urogenital and adrenals, obstetrics and gynaecology), diseases (breast diseases, traumas, cancers) or practice (paediatrics, interventional radiology)

  11. Who Do Hospital Physicians and Nurses Go to for Advice About Medications? A Social Network Analysis and Examination of Prescribing Error Rates.

    Science.gov (United States)

    Creswick, Nerida; Westbrook, Johanna Irene

    2015-09-01

    To measure the weekly medication advice-seeking networks of hospital staff, to compare patterns across professional groups, and to examine these in the context of prescribing error rates. A social network analysis was conducted. All 101 staff in 2 wards in a large, academic teaching hospital in Sydney, Australia, were surveyed (response rate, 90%) using a detailed social network questionnaire. The extent of weekly medication advice seeking was measured by density of connections, proportion of reciprocal relationships by reciprocity, number of colleagues to whom each person provided advice by in-degree, and perceptions of amount and impact of advice seeking between physicians and nurses. Data on prescribing error rates from the 2 wards were compared. Weekly medication advice-seeking networks were sparse (density: 7% ward A and 12% ward B). Information sharing across professional groups was modest, and rates of reciprocation of advice were low (9% ward A, 14% ward B). Pharmacists provided advice to most people, and junior physicians also played central roles. Senior physicians provided medication advice to few people. Many staff perceived that physicians rarely sought advice from nurses when prescribing, but almost all believed that an increase in communication between physicians and nurses about medications would improve patient safety. The medication networks in ward B had higher measures for density, reciprocation, and fewer senior physicians who were isolates. Ward B had a significantly lower rate of both procedural and clinical prescribing errors than ward A (0.63 clinical prescribing errors per admission [95%CI, 0.47-0.79] versus 1.81/ admission [95%CI, 1.49-2.13]). Medication advice-seeking networks among staff on hospital wards are limited. Hubs of advice provision include pharmacists, junior physicians, and senior nurses. Senior physicians are poorly integrated into medication advice networks. Strategies to improve the advice-giving networks between senior

  12. Acceptability, Feasibility and Feedback Analysis of Perception for Objective Structured Practical Examination As an Assessment Tool in Undergraduate in Competency Based Medical Education

    Directory of Open Access Journals (Sweden)

    Harsha V. Patil

    2016-04-01

    Full Text Available Background: There is an increasing tendency to use Objective Structured Practical examination (OSPE as an evaluation tool of practical performance in medical education. Aim and Objectives: The objective of the present study was to determine the acceptability and feasibility of OSPE as an assessment tool of formative examination by feedback analysis in the microbiology nd subject in 2 year MBBS undergraduate students and to discuss the pros and cons of OSPE method. Material and Methods: A well organized comprehensive ten OSPE stations were arranged to assess the practical nd skills of 2 year MBBS students in the department of microbiology. The practical performance skill of 50 second year undergraduate MBBS students were assessed by OSPE for microbiology subject by creating 10 structured stations of OSPE. The stations were written so as to cover major important practical nd microbiology topics of 2 year MBBS. The practical tasks chosen for the OSPE were mapped as per learning objectives of the course and the expected level of learning of the students. Results: A qualitative feedback from the examiners/ observers and the students was taken to assess acceptability feasibility of OSPE assessment. The examiners and the students were asked to rate OSPE by five point Likert scale Questionnaires. For the majority of students (92% and examiners/ observers (100% OSPE session was acceptable (p < 0.001. All examiners perceived OSPE method as feasible assessment tool (p < 0.001. Majority of the examiners and the students were in agreement or strongly in agreement in Likert scale rating for feedback analysis of OSPE session. There was no significant statistical difference among students and examiners/observers (Chi-squre:1.5184; DF:5; p= 0.8234. Conclusions: The OSPE is reliable and reproducible practical assessment tool and yields dependable information about the practical performance capabilities and competence of individual student and can be used as an

  13. Organising medication discontinuation

    DEFF Research Database (Denmark)

    Nixon, Michael; Kousgaard, Marius Brostrøm

    2016-01-01

    medication? Methods: Twenty four GPs were interviewed using a maximum variation sample strategy. Participant observations were done in three general practices, for one day each, totalling approximately 30 consultations. Results: The results show that different discontinuation cues (related to the type...... a medication, in agreement with the patients, from a professional perspective. Three research questions were examined in this study: when does medication discontinuation occur in general practice, how is discontinuing medication handled in the GP’s practice and how do GPs make decisions about discontinuing...

  14. Perceptions of Cultural Competence among Urban School Social Workers: Does Experience Make a Difference?

    Science.gov (United States)

    Teasley, Martell L.; Baffour, Tiffany D.; Tyson, Edgar H.

    2005-01-01

    This exploratory study examined the contribution of social work experience and licensure to self-reported levels of cultural competence of social workers in urban public school systems. In addition, it examined the influence of practitioners race or ethnicity on perceived levels of culturally competent practice in urban schools. Using survey…

  15. Online examiner calibration across specialties.

    Science.gov (United States)

    Sturman, Nancy; Wong, Wai Yee; Turner, Jane; Allan, Chris

    2017-09-26

    Integrating undergraduate medical curricula horizontally across clinical medical specialties may be a more patient-centred and learner-centred approach than rotating students through specialty-specific teaching and assessment, but requires some interspecialty calibration of examiner judgements. Our aim was to evaluate the acceptability and feasibility of an online pilot of interdisciplinary examiner calibration. Fair clinical assessment is important to both medical students and clinical teachers METHODS: Clinical teachers were invited to rate video-recorded student objective structured clinical examination (OSCE) performances and join subsequent online discussions using the university's learning management system. Post-project survey free-text and Likert-scale participant responses were analysed to evaluate the acceptability of the pilot and to identify recommendations for improvement. Although 68 clinicians were recruited to participate, and there were 1599 hits on recordings and discussion threads, only 25 clinical teachers rated at least one student performance, and 18 posted at least one comment. Participants, including rural doctors, appeared to value the opportunity for interdisciplinary rating calibration and discussion. Although the asynchronous online format had advantages, especially for rural doctors, participants reported considerable IT challenges. Our findings suggest that fair clinical assessment is important to both medical students and clinical teachers. Interspecialty discussions about assessment may have the potential to enrich intraspecialty perspectives, enhance interspecialty engagement and collaboration, and improve the quality of clinical teacher assessment. Better alignment of university and hospital systems, a face to face component and other modifications may have enhanced clinician engagement with this project. Findings suggest that specialty assessment cultures and content expertise may not be barriers to pursuing more integrated

  16. Stochastic risk estimation from medical x-ray diagnostic examinations, 2. Risk estimates of individuals from x-ray diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Hashizume, T; Maruyama, T; Noda, Y; Iwai, K; Tateno, Y [National Inst. of Radiological Sciences, Chiba (Japan); Nishizawa, K

    1981-01-01

    The risks of genetic, leukemia and malignant diseases from medical X-ray diagnostic examinations were estimated using the frequency of radiographic and fluoroscopic exposures per diagnostic examination, child expectancy, leukemia and malignancy significant factors, and using a weighting factor determined on the basis of data concerning the cancer mortality among atomic bomb survivors in Nagasaki and of a recommendation of International Commission of Radiological Protection. The organ or tissue doses with respect to the stochastic risks were determined with ionization chambers and thermoluminescent dosimeters placed at the positions of the organs or tissues in a RANDO woman phantom which was exposed to diagnostic X-rays according to technical factors of typical radiographic and fluoroscopic examinations obtained from a nationwide survey. The resultant risks by age-group and type of radiographic and fluoroscopic examination are tabulated in terms of risk level of 10/sup -6/. In general, the total risk defined as the sum of genetic, leukemia and malignant risks was a high value for the X-ray diagnosis of digestive organs involving barium meal and barium enema. For example, the total risk for young age-group was 100 to 200 x 10/sup -6/ for the X-ray diagnosis of digestive organs. The total risk from the chest radiography was lower value as compared with the risk from the X-ray diagnosis of other organs or tissues. On the contrary, the risk from the chest tomography was comparable to the risk from the diagnosis of digestive organs. The total risk decreased with increasing of age for every X-ray diagnostic examination.

  17. The influence of risk labeling on risk perception and willingness to seek help in an experimental simulation of preventive medical examinations.

    Science.gov (United States)

    Nieuwenhuijsen, Karen; Hulshof, Carel T; Sluiter, Judith K

    2018-07-01

    To study the influence of the presentation of results of a preventive medical examination on risk perception and willingness to seek help for work-related fatigue or being overweight. A factorial design experiment was conducted, presenting workers (n = 82) with vignettes including eight scenarios of test results with and without an emphasis on the risk of a current or future health condition or a probe to seek help. Participants rated perceived risk and willingness to seek help (0-100 Visual Analogue Scale) as if these were their own results. Differences were tested with paired-sample t-tests. In scenarios emphasizing the risk of a current or future disorder, participants perceived higher risk and were more willing to seek help (p-values < .00). Slightly higher willingness to seek help scores was observed in all scenarios that included probes (p < .00). Risk perception and willingness to seek help of workers participating in a preventive medical examination were higher when they were told that the test results indicate a risk of a current or future disorder and after being advised to seek help. Healthcare providers should take the potential effects on risk perception and help-seeking into account in preventive settings. Copyright © 2018. Published by Elsevier B.V.

  18. Performance on the Cardiovascular In-Training Examination in Relation to the ABIM Cardiovascular Disease Certification Examination.

    Science.gov (United States)

    Indik, Julia H; Duhigg, Lauren M; McDonald, Furman S; Lipner, Rebecca S; Rubright, Jonathan D; Haist, Steven A; Botkin, Naomi F; Kuvin, Jeffrey T

    2017-06-13

    The American College of Cardiology In-Training Exam (ACC-ITE) is incorporated into most U.S. training programs, but its relationship to performance on the American Board of Internal Medicine Cardiovascular Disease (ABIM CVD) Certification Examination is unknown. ACC-ITE scores from third-year fellows from 2011 to 2014 (n = 1,918) were examined. Covariates for regression analyses included sex, age, medical school country, U.S. Medical Licensing Examination Step, and ABIM Internal Medicine Certification Examination scores. A secondary analysis examined fellows (n = 511) who took the ACC-ITE in the first and third years. ACC-ITE scores were the strongest predictor of ABIM CVD scores (p ITE scores from first to third year was a strong predictor of the ABIM CVD score (p ITE is strongly associated with performance on the ABIM CVD Certification Examination. Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  19. Medical examination of ''Minashi'' atomic bomb survivor in Hiroshima-city, 1

    International Nuclear Information System (INIS)

    Kumazawa, Toshihiko

    1978-01-01

    As it is about one year (three examination terms) since health examinations for ''Minashi'' a-bomb survivors has been carried out, conditions of these examinations are described. ''Minashi'' a-bomb survivors can receive an a-bomb survivor's health notebook when they suffer from 10 damages designated by the Ministry of Public Welfare, and the number of ''Minashi'' a-bomb survivors changes frequently. ''Minashi'' a-bomb survivors who received a certificate of a recipient of the examination were 2363 at the end of 1977, and by that time, 665 of them (28.1%) also received an a-bomb survivor's health notebook instead of the certificate. Accordingly, the number of persons recognized as ''Minashi'' a-bomb survivors at the end of the year was 1703 (688 men and 1015 women). ''Minashi'' a-bomb survivors underwent health examinations at the same time and under the same way as a-bomb survivors. There were no great differences in the undergoing rate of general health examinations, the necessity rate for detailed examinations, the undergoing rate of detailed examinations, the necessity rate for treatment, and kinds of diseases requiring treatment between ''Minashi'' a-bomb survivors and those in a-bomb survivors. The undergoing rate of general health examinations was 67.6%, (45.6% in a-bomb survivors), the necessity rate for detailed examinations, 43.1% (50.1%), the undergoing rate of detailed examinations, 91.3% (93.3%), and the necessity rate for treatment, 20.3% (29.0%). The undergoing rate of general health examinations in ''Minashi'' a-bomb survivors was higher than that in a-bomb survivors, but the necessity rate for detailed examinations, the undergoing rate of detailed examination, and the necessity rate for treatment in ''Minashi'' a-bomb survivors were lower than those in a-bomb survivors. (Tsunoda, M.)

  20. Deaths involving 1,1-difluoroethane at the San Diego County Medical Examiner's Office.

    Science.gov (United States)

    Vance, Chris; Swalwell, Christopher; McIntyre, Iain M

    2012-01-01

    Intentional abuse of 1,1-difluoroethane has been reported to cause transient symptoms such as confusion, tremors, pulmonary irritation, loss of consciousness and, rarely, coma. In the last five years, 17 cases from the San Diego County Medical Examiner's Office showed the presence of 1,1-difluoroethane in postmortem tissues, and the gas was cited in the cause of death in 13 of those cases. Detected during routine ethanol screening, 1,1-difluoroethane was evaluated for concentrations in peripheral blood, central blood and vitreous humor by a slightly modified method published by Avella et al. In many cases, death from abuse of 1,1-difluoroethane seemed to occur within minutes of intentional abuse; large concentrations (>100 mg/L) of the gas were still in the blood. It is important that forensic toxicology laboratories have routine screening procedures to detect 1,1-difluoroethane because cases exist in which evidence of use from cans may not be present in proximity to the decedent, or may be undiscovered in the debris of a motor vehicle accident. It is also important to quantify concentrations of 1,1-difluoroethane in both peripheral blood and central blood, whose ratio may be useful in interpreting how recently the use of the 1,1-difluoroethane occurred.

  1. Moving towards a better path? A mixed-method examination of China’s reforms to remedy medical corruption from pharmaceutical firms

    Science.gov (United States)

    Shi, Jianwei; Liu, Rui; Jiang, Hua; Wang, Chunxu; Xiao, Yue; Liu, Nana; Wang, Zhaoxin; Shi, Leiyu

    2018-01-01

    Objectives Few studies have systematically examined the effects of the existing regulations for alleviating corruption in China. This study assesses the effectiveness of China’s reforms to curb medical corruption. Methods We used mixed methods for the evaluation of existing countermeasures. First, qualitative informant interviews based on the Donabedian model were conducted to obtain experts’ evaluation of various kinds of countermeasures. Second, using data from ‘China Judgements Online’, we analysed the trend of occurrence and the characteristics of the medical corruption cases in recent years to reflect the overall effects of these countermeasures in China. Results Since 1990s, China has implemented three main categories of countermeasures to oppose medical corruption: fines and criminal penalties, health policy regulations, and reporting scheme policy. Information from the interviews showed that first the level of fines and criminal penalties for medical corruption behaviours may not be sufficient. Second, health policy regulations are also insufficient. Although the National Reimbursement Drug List and Essential Drug List were implemented, they were incomplete and created additional opportunities for corruption. Moreover, the new programme that centralised the purchase of pharmaceuticals found that most purchasing committees were not independent, and the selection criteria for bidding lacked scientific evidence. Third, the reporting scheme for commercial bribery records by the health bureau was executed poorly. In addition, quantitative online data showed no obvious decrease of institutional medical corruption in recent years, and most criminals have been committing crimes for a long time before getting detected, which further demonstrated the low effectiveness of the above countermeasures. Conclusions Although existing countermeasures have exerted certain effects according to Chinese experts, more rigorous legislation and well

  2. Moving towards a better path? A mixed-method examination of China's reforms to remedy medical corruption from pharmaceutical firms.

    Science.gov (United States)

    Shi, Jianwei; Liu, Rui; Jiang, Hua; Wang, Chunxu; Xiao, Yue; Liu, Nana; Wang, Zhaoxin; Shi, Leiyu

    2018-02-08

    Few studies have systematically examined the effects of the existing regulations for alleviating corruption in China. This study assesses the effectiveness of China's reforms to curb medical corruption. We used mixed methods for the evaluation of existing countermeasures. First, qualitative informant interviews based on the Donabedian model were conducted to obtain experts' evaluation of various kinds of countermeasures. Second, using data from 'China Judgements Online', we analysed the trend of occurrence and the characteristics of the medical corruption cases in recent years to reflect the overall effects of these countermeasures in China. Since 1990s, China has implemented three main categories of countermeasures to oppose medical corruption: fines and criminal penalties, health policy regulations, and reporting scheme policy. Information from the interviews showed that first the level of fines and criminal penalties for medical corruption behaviours may not be sufficient. Second, health policy regulations are also insufficient. Although the National Reimbursement Drug List and Essential Drug List were implemented, they were incomplete and created additional opportunities for corruption. Moreover, the new programme that centralised the purchase of pharmaceuticals found that most purchasing committees were not independent, and the selection criteria for bidding lacked scientific evidence. Third, the reporting scheme for commercial bribery records by the health bureau was executed poorly. In addition, quantitative online data showed no obvious decrease of institutional medical corruption in recent years, and most criminals have been committing crimes for a long time before getting detected, which further demonstrated the low effectiveness of the above countermeasures. Although existing countermeasures have exerted certain effects according to Chinese experts, more rigorous legislation and well-functioning administrative mechanisms are needed. Fundamentally

  3. Preventive medicines: vaccination, prophylaxis of infectious diseases, disinfectants.

    Science.gov (United States)

    Heininger, Ulrich

    2011-01-01

    Immunizations belong to the most successful interventions in medicine. Like other drugs, vaccines undergo long periods of pre-clinical development, followed by careful clinical testing through study Phases I, II, and III before they receive licensure. A successful candidate vaccine will move on to be an investigational vaccine to undergo three phases of pre-licensure clinical trials in a stepwise fashion before it can be considered for approval, followed by an optional fourth phase of post-marketing assessment. The overall risk-benefit assessment of a candidate vaccine is very critical in making the licensure decision for regulatory authorities, supported by their scientific committees. It includes analyses of immunogenicity, efficacy, reactogenicity or tolerability, and safety of the vaccine. Public trust in vaccines is a key to the success of immunization programs worldwide. Maintaining this trust requires knowledge of the benefits and scientific understanding of real or perceived risks of immunizations. Under certain circumstances, pre- or post-exposure passive immunization can be achieved by administration of immunoglobulines. In terms of prevention of infectious diseases, disinfection can be applied to reduce the risk of transmission of pathogens from patient to patient, health-care workers to patients, patients to health-care workers, and objects or medical devices to patients.

  4. Inappropriate self-medication among adolescents and its association with lower medication literacy and substance use.

    Directory of Open Access Journals (Sweden)

    Chun-Hsien Lee

    Full Text Available While self-medication is common, inappropriate self-medication has potential risks. This study assesses inappropriate self-medication among adolescents and examines the relationships among medication literacy, substance use, and inappropriate self-medication.In 2016, a national representative sample of 6,226 students from 99 primary, middle, and high schools completed an online self-administered questionnaire. Multiple logistic regression analysis was used to examine factors related to inappropriate self-medication.The prevalence of self-medication in the past year among the adolescents surveyed was 45.8%, and the most frequently reported drugs for self-medication included nonsteroidal anti-inflammatory drugs or pain relievers (prevalence = 31.1%, cold or cough medicines (prevalence = 21.6%, analgesics (prevalence = 19.3%, and antacids (prevalence = 17.3%. Of the participants who practiced self-medication, the prevalence of inappropriate self-medication behaviors included not reading drug labels or instructions (10.1%, using excessive dosages (21.6%, and using prescription and nonprescription medicine simultaneously without advice from a health provider (polypharmacy (30.3%. The results of multiple logistic regression analysis showed that after controlling for school level, gender, and chronic diseases, the participants with lower medication knowledge, lower self-efficacy, lower medication literacy, and who consumed tobacco or alcohol were more likely to engage in inappropriate self-medication.Lower medication literacy and substance use were associated with inappropriate self-medication among adolescents.