Osteopathic emergency medicine programs infrequently publish in high-impact emergency medicine journals.

Science.gov (United States)

Baskin, Sean M; Lin, Christina; Carlson, Jestin N

2014-11-01

Both the Accreditation Council for Graduate Medical Education (ACGME) and the American Osteopathic Association (AOA) require core faculty to engage in scholarly work, including publication in peer-reviewed journals. With the ACGME/AOA merger, we sought to evaluate the frequency of publication in high-impact peer-reviewed EM journals from authors affiliated with osteopathic emergency medicine (EM) programs. We performed a retrospective literature review using the Journal Citation Report database and identified the top five journals in the category of 'Emergency Medicine' by their 2011 Impact Factor. We examined all publications from each journal for 2011. For each article we recorded article type, authors' names, position of authorship (first, senior or other), the author's degree and affiliated institution. We present the data in raw numbers and percentages. The 2011 EM journals with the highest impact factor were the following: Annals of Emergency Medicine, Resuscitation, Journal of Trauma, Injury, and Academic Emergency Medicine. Of the 9,298 authors published in these journals in 2011; 1,309 (15%) claimed affiliation with U.S.-based EM programs, of which 16 (1%) listed their affiliations with eight different osteopathic EM programs. The 16 authors claimed affiliation with 8 of 46 osteopathic EM programs (17%), while 1,301 authors claimed affiliation with 104 of 148 (70%) U.S.-based allopathic programs. Authors from osteopathic EM programs are under-represented in the top EM journals. With the pending ACGME/AOA merger, there is a significant opportunity for improvement in the rate of publication of osteopathic EM programs in top tier EM journals.

The state of radiologic teaching practice in preclinical medical education: survey of American medical, osteopathic, and podiatric schools.

Science.gov (United States)

Rubin, Zachary; Blackham, Kristine

2015-04-01

This study describes the state of preclinical radiology curricula in North American allopathic, osteopathic, and podiatric medical schools. An online survey of teaching methods, radiology topics, and future plans was developed. The Associations of American Medical Colleges, Colleges of Osteopathic Medicine, and Colleges of Podiatric Medicine listing for all US, Canadian, and Puerto Rican schools was used for contact information for directors of anatomy and/or radiology courses. Letters were sent via e-mail to 198 schools, with a link to the anonymous survey. Of 198 schools, 98 completed the survey (48%). Radiology curricula were integrated with other topics (91%), and taught by anatomists (42%) and radiologists (43%). The majority of time was spent on the topic of anatomy correlation (35%). Time spent teaching general radiology topics in the curriculum, such as physics (3%), modality differences (6%), radiation safety (2%), and contrast use (2%) was limited. Most schools had plans to implement an innovative teaching method in the near future (62%). The major challenges included limits on: time in the curriculum (73%); resources (32%); and radiology faculty participation (30%). A total of 82% reported that their curriculum did not model the suggestions made by the Alliance of Medical Student Educators in Radiology. This survey describes the current state of preclinical radiology teaching: curricula were nonstandard, integrated into other courses, and predominantly used for anatomy correlation. Other important contextual principles of the practice of radiology were seldom taught. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

A call to include medical humanities in the curriculum of colleges of osteopathic medicine and in applicant selection.

Science.gov (United States)

Hoff, Gary; Hirsch, Norma J; Means, J Jeffrey; Streyffeler, Lisa

2014-10-01

Medicine stands at a crossroad. Disruptive physician behavior has increased, and patient satisfaction has decreased. A growing body of knowledge demonstrates that the medical humanities assist in the creation of compassionate, resilient physicians. Incorporating medical humanities into the medical school curriculum promotes the development of compassionate, culturally sensitive physicians, and also encourages the development of resilience in health care professionals at a time when internal and external pressures on physicians are increasing. © 2014 The American Osteopathic Association.

Development of Peer Tutoring Services to Support Osteopathic Medical Students' Academic Success.

Science.gov (United States)

Swindle, Nicholas; Wimsatt, Leslie

2015-11-01

Peer tutoring can benefit both tutors and tutored students, but information is lacking regarding establishing and measuring outcomes of such a program at new medical schools. To examine the outcomes of a pilot peer tutoring initiative and explore the implications for long-term program development. Fifty-one osteopathic medical students who participated in a pilot peer tutoring program during the 2013-2014 academic year were surveyed regarding satisfaction with the program. Course grade means for the tutors (all courses) and tutored students (specific courses) were analyzed before and after participating in the tutoring experience. Data analyses were performed using frequency distributions, t tests, and qualitative assessment of emergent themes. The survey had a 76% response rate (39 of 51 students). Both tutored students and tutors were satisfied with the tutoring program. Statistically significant changes in course grades for the tutored courses were noted at 3 to 4 and 8 to 9 months among the tutored students who were most at risk for failure (P=.001). Tutor course grades showed no significant changes for any of the courses in which they were enrolled (P=.445). Learning gains were realized by the students at greatest academic risk. Additional research is needed to evaluate long-term outcomes.

Learning With Reflection: Practices in an Osteopathic Surgery Clinical Clerkship Through an Online Module.

Science.gov (United States)

Lewis, Kadriye O; Farber, Susan; Chen, Haiqin; Peska, Don N

2015-11-01

The value of reflective practices has gained momentum in osteopathic medical education. However, the use of reflective pedagogies has not been explored in the larger context of medical course delivery and design, to the authors' knowledge. To determine the types of reflection demonstrated by osteopathic medical students on an online discussion board and to explore differences in discussion engagement caused by the use of a reflective learning self-assessment tool. Using a mixed-method approach, reflection processes in an osteopathic surgery clinical clerkship online module were investigated in third-year osteopathic medical students. Discussion board messages were captured and coded. Both manual coding techniques and automated interrogation using NVivo9 (a computer program) for qualitative data were applied. Correlations of scores across 4 case-based discussion tasks and scores for self-reflection were computed as quantitative data. Twenty-eight students were included. Four main types of reflection (ie, content, contextual, dialogic, and personal) along with corresponding differentiated subthemes for each type of case-based discussion board group message were identified. Group collaboration revealed insights about the reflection process itself and also about the evidence of collective efforts, group engagements, and intragroup support among students. Student preparation revealed that students' metacognition was triggered when they judged their own contributions to group work. Challenges in completing readings and meeting deadlines were related to the students' long work hours. Reflective practices are essential to the practice of osteopathic medicine and medical education. Curricula can promote the development of reflective skills by integrating these deliberate practices in educational activities.

Preventive osteopathic manipulative treatment and stress fracture incidence among collegiate cross-country athletes.

Science.gov (United States)

Brumm, Lynn F; Janiski, Carrie; Balawender, Jenifer L; Feinstein, Adam

2013-12-01

Stress fractures are common among athletes, particularly distance runners, with many theories regarding the etiologic process of stress fractures and various studies identifying risk factors or suggesting preventive techniques. To our knowledge, no previous studies have discussed the possible causative effects of somatic dysfunction or the preventive capabilities of osteopathic manipulative treatment (OMT). To apply a preventive OMT protocol for cross-country athletes to reduce the incidence of stress fractures. Cohort study. Examinations of cross-country athletes at an NCAA (National Collegiate Athletic Association) Division I university were performed by supervising physician-examiners and first- and second-year osteopathic medical students during several consecutive academic years. Athletes re-enrolled in the study each year they continued to be eligible. The intervention included osteopathic structural examination and OMT that focused on somatic dysfunction identified in the pelvis, sacrum, and lower extremities. More than 1800 participant examinations were performed on 124 male and female participants by 3 supervising physician-examiners and 141 osteopathic medical students over the course of 5 consecutive academic years (2004-2005 to 2008-2009). Data from these academic years were compared with data from the previous 8 academic years (1996-1997 to 2003-2004). An average of 20 new participants enrolled yearly. The number of annual stress fractures per team ranged from 0 to 6 for male participants and 1 to 6 for female participants. The cumulative annual incidence of stress fractures for male participants demonstrated a statistically significant decrease from 13.9% (20 of 144) before intervention to 1.0% (1 of 105) after intervention, resulting in a 98.7% relative reduction in stress-fracture diagnosis (P=.019). The cumulative annual incidence for female participants showed a minimal decrease from 12.9% (23 of 178) before intervention to 12.0% (17 of 142) after

Trainer-to-student ratios for teaching psychomotor skills in health care fields, as applied to osteopathic manipulative medicine.

Science.gov (United States)

Snider, Karen T; Seffinger, Michael A; Ferrill, Heather P; Gish, Eric E

2012-04-01

The hallmark of osteopathic medical education is the inclusion of hands-on instruction in osteopathic manipulative medicine (OMM), which includes palpatory diagnosis and osteopathic manipulative treatment (OMT). This OMM training typically involves a primary instructor presenting theory and techniques with step-by-step demonstrations to a large group of first- and second-year osteopathic medical students. Additional instructors, referred to as table trainers, assist the primary instructor by supervising the students as they practice the presented techniques. To the authors' knowledge, there is no currently accepted standard for a table trainer-to-student ratio in OMM skills laboratories within osteopathic medical schools in the United States. However, through a Google Web search and PubMed literature review, the authors identified published trainer-to-student ratios used in other health care skills training curricula. Psychomotor skills training courses in health care fields typically have a table trainer-to-student ratio of 1 trainer to 8 or fewer students. On the basis of these findings and psychomotor skills learning theory, the authors conclude that this ratio is likely sufficient for OMM skills training.

Osteopathic Emergency Medicine Programs Infrequently Publish in High-Impact Emergency Medicine Journals

OpenAIRE

Baskin, Sean M; Lin, Christina; Carlson, Jestin N

2014-01-01

Introduction: Both the Accreditation Council for Graduate Medical Education (ACGME) and the American Osteopathic Association (AOA) require core faculty to engage in scholarly work, including publication in peer-reviewed journals. With the ACGME/AOA merger, we sought to evaluate the frequency of publication in high-impact peer-reviewed EM journals from authors affiliated with osteopathic emergency medicine (EM) programs. Methods: We performed a retrospective literature re...

American Osteopathic College of Dermatology

Science.gov (United States)

... Online Store Welcome Calendar of Events Find a Dermatology DO Osteopathic Medicine Disease Database Contributors Doctor Derm ... of Trustees Contact Us Ethics Foundation for Osteopathic Dermatology What is the FOD? Foundation Levels of Giving ...

Thanks, but no thanks: how denial of osteopathic service in World War I and World War II shaped the profession.

Science.gov (United States)

Silver, Shawn A

2012-02-01

Osteopathic physicians were denied the same rights and privileges that were granted to allopathic physicians by the US government regarding voluntary and compulsory service in World War I and World War II. Even after changes to the examination process allowed osteopathic physicians to take the examinations required to obtain commission as a physician in the army, osteopathic physicians' service was still rejected. The US government's decision to ban DOs from serving in the war was a blessing in disguise that led to tremendous changes in osteopathic medicine, education, and public acceptance of osteopathic physicians. Using primary documents from military officials, congressional hearings, and archived publications of the American Osteopathic Association, the author recounts the battle osteopathic physicians fought to serve their country during war and the challenges they faced while obtaining both legal and social equality in the eyes of the government and the public.

Competition within the physicians' services industry: osteopaths and allopaths.

Science.gov (United States)

Blackstone, E A

1982-01-01

Within the physicians' services industry, doctors of osteopathy are the only "full line" competitors of medical doctors. Given the current interest in merger of the two schools of practice, this Article examines the benefits of having an independent osteopathic school. These benefits include: (1) reduction of the monopoly power of medical doctors in malpractice litigation, fee negotiations with third party payors and the formulation of health policy; (2) greater satisfaction of consumer desires; and (3) diversity and innovation in physicians' training and methods of practice. The Article concludes that society has an interest in discouraging merger of the two groups; osteopathy should be maintained as an independent school of practice. To this end, society should carefully consider the impact of legislation and regulatory policies that may have the unintended effect of eliminating osteopathy as an independent competitor.

OSTMED.DR®, an Osteopathic Medicine Digital Library.

Science.gov (United States)

Fitterling, Lori; Powers, Elaine; Vardell, Emily

2018-01-01

The OSTMED.DR® database provides access to both citation and full-text osteopathic literature, including the Journal of the American Osteopathic Association. Currently, it is a free database searchable using basic and advanced search features.

The Educational Model of Private Colleges of Osteopathic Medicine: Revisited for 2003-2013.

Science.gov (United States)

Cummings, Mark

2015-12-01

Trends in the development of new private colleges of osteopathic medicine (COMs) described by the author in 2003 have accelerated in the ensuing decade. During 2003 to 2013, 10 new COMs as well as 2 remote teaching sites and 4 new branch campuses at private institutions were accredited, leading to a 98% increase in the number of students enrolled in private COMs. The key features of the private COM educational model during this period were a reliance on student tuition, the establishment of health professions education programs around the medical school, the expansion of class size, the creation of branch campuses and remote teaching sites, an environment that emphasizes teaching over research, and limited involvement in facilities providing clinical services to patients. There is institutional ownership of preclinical instruction, but clinical instruction occurs in affiliated hospitals and medical institutions where students are typically taught by volunteer and/or adjunct faculty.Between 2003 and 2013, this model attracted smaller universities and organizations, which implemented the strategies of established private COMs in initiating new private COMs, branch campuses, and remote teaching sites. The new COMs have introduced changes to the osteopathic profession and private COM model by expanding to new parts of the country and establishing the first for-profit medical school accredited in the United States in modern times. They have also increased pressure on the system of osteopathic graduate medical education, as the number of funded GME positions available to their graduates is less than the need.

Quantitative Description of Medical Student Interest in Neurology and Psychiatry.

Science.gov (United States)

Ramos, Raddy L; Cuoco, Joshua A; Guercio, Erik; Levitan, Thomas

2016-07-01

Given the well-documented shortage of physicians in primary care and several other specialties, quantitative understanding of residency application and matching data among osteopathic and allopathic medical students has implications for predicting trends in the physician workforce. To estimate medical student interest in neurology and psychiatry based on numbers of applicants and matches to neurology and psychiatry osteopathic and allopathic residency programs. Also, to gauge students' previous academic experience with brain and cognitive sciences. The number of available postgraduate year 1 positions, applicants, and matches from graduating years 2011 through 2015 were collected from the National Matching Services Inc and the American Association of Colleges of Osteopathic Medicine for osteopathic programs and the National Resident Matching Program and the Association of American Medical Colleges for allopathic programs. To determine and compare osteopathic and allopathic medical students' interest in neurology and psychiatry, the number of positions, applicants, and matches were analyzed considering the number of total osteopathic and allopathic graduates in the given year using 2-tailed χ2 analyses with Yates correction. In addition, osteopathic and allopathic medical schools' websites were reviewed to determine whether neurology and psychiatry rotations were required. Osteopathic medical students' reported undergraduate majors were also gathered. Compared with allopathic medical students, osteopathic medical students had significantly greater interest (as measured by applicants) in neurology (χ21=11.85, Pneurology and psychiatry residency programs. Approximately 6% of osteopathic vs nearly 85% of allopathic medical schools had required neurology rotations. Nearly 10% of osteopathic applicants and matriculants had undergraduate coursework in brain and cognitive sciences. Osteopathic medical students demonstrated greater interest than allopathic medical

Experiences of intervertebral motion palpation in osteopathic practice - A qualitative interview study among Swedish osteopaths.

Science.gov (United States)

Sposato, Niklas S; Bjerså, Kristofer

2017-01-01

Assessment in manual therapy includes quantitative and qualitative procedures, and intervertebral motion palpation (IMP) is one of the core assessment methods in osteopathic practice. The aim of this study was to explore osteopathic practitioners' experiences of clinical decision-making and IMP as a diagnostic tool for planning and evaluation of osteopathic interventions. The study was conducted with semi-structured interviews that included eight informants. Content analysis was used as the analytical procedure. In total, three categories emerged from the analysis: strategic decision-making, diagnostic usability of IMP, and treatment applicability of IMP. The study indicated that IMP was considered relevant and was given particular importance in cases where IMP findings confirmed clinical information attained from other stages in the diagnostic process as a whole. However, IMP findings were experienced as less important if they were not correlated to other findings. Copyright © 2016 Elsevier Ltd. All rights reserved.

Teaching and Assessment of High-Velocity, Low-Amplitude Techniques for the Spine in Predoctoral Medical Education.

Science.gov (United States)

Channell, Millicent King

2016-09-01

Although national didactic criteria have been set for predoctoral education and assessment in osteopathic manipulative treatment, there is no criterion standard for teaching methods and assessments of osteopathic manipulative treatment competence in colleges of osteopathic medicine. This issue is more pressing with the creation of the single graduate medical education accreditation system by the American Osteopathic Association and Accreditation Council for Graduate Medical Education, which introduced the creation of "osteopathic recognition" for residencies that want to incorporate osteopathic principles and practice into their programs. Residencies with osteopathic recognition may include both osteopathic and allopathic graduates. Increased standardization at the predoctoral level, however, is recommended as osteopathic principles and practice training applications are expanded. The objectives of this article are to review the standards for teaching osteopathic medical students high-velocity, low-amplitude (HVLA) techniques for the spine; to review and discuss the methods used to assess medical students' proficiency in using HVLA; and to propose baseline standards for teaching and assessing HVLA techniques among medical students.

Billing and coding for osteopathic manipulative treatment.

Science.gov (United States)

Snider, Karen T; Jorgensen, Douglas J

2009-08-01

Some osteopathic physicians are not properly reimbursed by insurance companies after providing osteopathic manipulative treatment (OMT) to their patients. Common problems associated with lack of reimbursements include insurers bundling OMT with the standard evaluation and management service and confusing OMT with chiropractic manipulative treatment or physical therapy services. The authors suggest methods of appeal for denied reimbursement claims that will also prevent future payment denials.

Assessment of the influence of osteopathic myofascial techniques on normalization of the vocal tract functions in patients with occupational dysphonia.

Science.gov (United States)

Marszałek, Sławomir; Niebudek-Bogusz, Ewa; Woźnicka, Ewelina; Malińska, Joanna; Golusiński, Wojciech; Śliwińska-Kowalska, Mariola

2012-06-01

Occupational voice disorders are accompanied by increased tension of the external laryngeal muscle which changes the position of the larynx and consequently disturbs the conditions of functioning of the vocal tract. The aim of the study is to assess the use of osteopathic procedures in the diagnosis and treatment of occupational dysphonia. Study subjects included 40 teachers with chronic diseases of the voice organ (38 women and 2 men) aged from 39 to 59 (mean age: 48.25). Before and after the voice therapy the osteopathic examination according to Libermann's protocol was performed as well as phoniatric examination including laryngovideostroboscopy (LVSS), assessment of the maximum phonation time (MPT) and the Voice Handicap Index (VHI) score. The voice therapy, scheduled and supervised by a laryngologist-phoniatrician and conducted by a speech-language pathologist, was supplemented with osteopathic myofascial rehabilitation of the larynx. The chi-square McNemar test and non-parametric Wilcoxon matched pairs test were applied in the statistical assessment. The applied interdisciplinary treatment including osteopathic and vocal therapy resulted in a statistically significant decrease in tenderness of muscles raising the larynx (cricothyroid ligament, sternocleidomastoid muscles, and pharyngeal constrictor muscles) and in lowering the tonus (geniohyoid muscles, pharyngeal constrictor muscles and sternocleidomastoid muscles). A significant improvement was also observed in the case of dysfunction of the cricothyroid joint examined during glissando and yawning, as well as in asymmetry of the thyrohyoid apparatus. Moreover, the therapy resulted in significantly better normalization of the head position and better control of the centre of gravity of the body. Statistically significant post-therapy improvement was observed in the phoniatric examination, including VHI scores, MPT results and parameters of videostroboscopic examination. The use of osteopathic therapy helps

Patients' expectations of private osteopathic care in the UK: a national survey of patients.

Science.gov (United States)

Leach, C M Janine; Mandy, Anne; Hankins, Matthew; Bottomley, Laura M; Cross, Vinette; Fawkes, Carol A; Fiske, Adam; Moore, Ann P

2013-05-31

Patients' expectations of osteopathic care have been little researched. The aim of this study was to quantify the most important expectations of patients in private UK osteopathic practices, and the extent to which those expectations were met or unmet. The study involved development and application of a questionnaire about patients' expectations of osteopathic care. The questionnaire drew on an extensive review of the literature and the findings of a prior qualitative study involving focus groups exploring the expectations of osteopathic patients. A questionnaire survey of osteopathic patients in the UK was then conducted. Patients were recruited from a random sample of 800 registered osteopaths in private practice across the UK. Patients were asked to complete the questionnaire which asked about 51 aspects of expectation, and post it to the researchers for analysis.The main outcome measures were the patients-perceived level of expectation as assessed by the percentage of positive responses for each aspect of expectation, and unmet expectation as computed from the proportion responding that their expectation "did not happen". 1649 sets of patient data were included in the analysis. Thirty five (69%) of the 51 aspects of expectation were prevalent, with listening, respect and information-giving ranking highest. Only 11 expectations were unmet, the most often unmet were to be made aware that there was a complaints procedure, to find it difficult to pay for osteopathic treatment, and perceiving a lack of communication between the osteopath and their GP. The findings reflected the complexity of providing osteopathic care and meeting patients' expectations. The results provided a generally positive message about private osteopathic practice. The study identified certain gaps between expectations and delivery of care, which can be used to improve the quality of care. The questionnaire is a resource for future research.

Patients’ expectations of private osteopathic care in the UK: a national survey of patients

Science.gov (United States)

2013-01-01

Background Patients’ expectations of osteopathic care have been little researched. The aim of this study was to quantify the most important expectations of patients in private UK osteopathic practices, and the extent to which those expectations were met or unmet. Methods The study involved development and application of a questionnaire about patients’ expectations of osteopathic care. The questionnaire drew on an extensive review of the literature and the findings of a prior qualitative study involving focus groups exploring the expectations of osteopathic patients. A questionnaire survey of osteopathic patients in the UK was then conducted. Patients were recruited from a random sample of 800 registered osteopaths in private practice across the UK. Patients were asked to complete the questionnaire which asked about 51 aspects of expectation, and post it to the researchers for analysis. The main outcome measures were the patients-perceived level of expectation as assessed by the percentage of positive responses for each aspect of expectation, and unmet expectation as computed from the proportion responding that their expectation “did not happen”. Results 1649 sets of patient data were included in the analysis. Thirty five (69%) of the 51 aspects of expectation were prevalent, with listening, respect and information-giving ranking highest. Only 11 expectations were unmet, the most often unmet were to be made aware that there was a complaints procedure, to find it difficult to pay for osteopathic treatment, and perceiving a lack of communication between the osteopath and their GP. Conclusions The findings reflected the complexity of providing osteopathic care and meeting patients’ expectations. The results provided a generally positive message about private osteopathic practice. The study identified certain gaps between expectations and delivery of care, which can be used to improve the quality of care. The questionnaire is a resource for future research

Patients' expectations of osteopathic care: a qualitative study.

Science.gov (United States)

Cross, Vinette; Leach, C M Janine; Fawkes, Carol A; Moore, Ann P

2015-10-01

Research has shown that patients' expectations of health care and health-care practitioners are complex and may have a significant impact on outcomes of care. Little is known about the expectations of osteopathic patients. To explore osteopathic patients' expectations of private sector care. Focus groups and individual interviews with purposively selected patients; this was the qualitative phase of a mixed methods study, the final phase being a patient survey. A total of 34 adult patients currently attending for treatment at private osteopathic practices across the United Kingdom. Focus group discussions and individual interviews around expectations before, during and after osteopathic care. Thematic analysis of text data to identify topics raised by patients and to group these into broad themes. Many components of expectation were identified. A preliminary conceptual framework describing the way the therapeutic encounter is approached in osteopathy comprised five themes: individual agency, professional expertise, customer experience, therapeutic process and interpersonal relationship. The components of expectation identified in this phase of the study provided potential question topics for the survey questionnaire in the subsequent phase of the investigation. The model developed in this study may add a new perspective to existing evidence on expectations. Further research is recommended to test the findings both within private practice and the National Health Service. © 2013 John Wiley & Sons Ltd.

Profile of osteopathic practice in Spain: results from a standardized data collection study.

Science.gov (United States)

Alvarez Bustins, Gerard; López Plaza, Pedro-Victor; Carvajal, Sonia Roura

2018-04-11

There is limited research regarding patients' profiles and consumer attitudes and habits of osteopathy in Spain. The purpose of this study was to profile patients who regularly receive osteopathic care in Spain using an internationally developed standardized data collection tool. During the period between April 2014 and December 2015, a UK-developed standardized data collection tool was distributed to Spanish osteopaths who voluntarily agreed to participate in this cross-sectional study. Thirty-six osteopaths participated in this study and returned a total of 314 completed datasets. Of 314 patients, 61% were women and 39% were men, with a mean age of 40 years (SD 17.02 years, range 0 to 83 years). Forty-four percent were full-time salaried workers, and in 78% of cases, receiving osteopathic treatment was the patient's own choice. Chronic spinal pain presentations were the most frequent reasons for consultation. Seventy-five percent of patients presented with a coexisting condition, mainly gastrointestinal disorders and headaches. The main treatment approach consisted of mobilization techniques, followed by soft tissue, cranial and high velocity thrust techniques. Improvement or resolution of the complaint was experienced by 93% of patients after a small number of sessions. Adverse events were minor and occurred in 7% of all cases. This is the first study carried out in Spain analyzing the profile of patients who receive osteopathic care. The typical patient who receives osteopathic care in Spain is middle-aged, presents mainly with chronic spinal pain, and voluntarily seeks osteopathic treatment. Osteopathic treatment produces a significant improvement in the majority of cases with a low rate of minor adverse events reported.

Effectiveness of osteopathic manipulative treatment versus osteopathy in the cranial field in temporomandibular disorders - a pilot study.

Science.gov (United States)

Gesslbauer, Christina; Vavti, Nadja; Keilani, Mohammad; Mickel, Michael; Crevenna, Richard

2018-03-01

Temporomandibular disorders are a common musculoskeletal condition causing severe pain, physical and psychological disability. The effect and evidence of osteopathic manipulative treatment and osteopathy in the cranial field is scarce and their use are controversial. The purpose of this pilot study was to evaluate the effectiveness of osteopathic manipulative treatment and osteopathy in the cranial field in temporomandibular disorders. A randomized clinical trial in patients with temporomandibular disorders was performed. Forty female subjects with long-term temporomandibular disorders (>3 months) were included. At enrollment, subjects were randomly assigned into two groups: (1) osteopathic manipulative treatment group (20 female patients) and (2) osteopathy in the cranial field group (20 female patients). Examination was performed at baseline (E0) and at the end of the last treatment (E1), consisting of subjective pain intensity with the Visual Analog Scale, Helkimo Index and SF-36 Health Survey. Subjects had five treatments, once a week. 36 subjects completed the study (33.7 ± 10.3 y). Patients in both groups showed significant reduction in Visual Analog Scale score (osteopathic manipulative treatment group: p = 0.001; osteopathy in the cranial field group: posteopathy in the cranial field group: p = 0.003) and a significant improvement in the SF-36 Health Survey - subscale "Bodily Pain" (osteopathic manipulative treatment group: p = 0.04; osteopathy in the cranial field group: p = 0.007) after five treatments (E1). All subjects (n = 36) also showed significant improvements in the above named parameters after five treatments (E1): Visual Analog Scale score (posteopathy in the cranial field as an effective treatment modality in patients with temporomandibular disorders. The positive results in both treatment groups should encourage further research on osteopathic manipulative treatment and osteopathy in the cranial field and support the

Important characteristics of a director of medical education.

Science.gov (United States)

Powell, V D; George, R J

1993-11-01

In osteopathic graduate medical education programs, the Director of Medical Education (DME) plays the key leadership role. This article outlines critical characteristics and skills that the DME should possess to successfully perform in this role. Central to this success is a passionate commitment to osteopathic medical education and a commitment to justice and fairness.

Pilot trial of osteopathic manipulative therapy for patients with frequent episodic tension-type headache.

Science.gov (United States)

Rolle, Guido; Tremolizzo, Lucio; Somalvico, Francesco; Ferrarese, Carlo; Bressan, Livio C

2014-09-01

Osteopathic manipulative therapy (OMTh; manipulative care provided by foreign-trained osteopaths) may be used for managing headache pain and related disability, but there is a need for high-quality randomized controlled trials to assess the effectiveness of this intervention. To explore the efficacy of OMTh for pain management in frequent episodic tension-type headache (TTH). Single-blind randomized placebo-controlled pilot study. Patients were recruited from 5 primary care settings. Forty-four patients who were affected by frequent episodic TTH and not taking any drugs for prophylactic management of episodic TTH were recruited. Patients were randomly allocated to an experimental or control group. The experimental group received corrective OMTh techniques, tailored for each patient; the control group received assessment of the cranial rhythmic impulse (sham therapy). The study included a 1-month baseline period, a 1-month treatment period, and a 3-month follow-up period. The primary outcome was the change in patient-reported headache frequency, and secondary outcomes included changes in headache pain intensity (discrete score, 1 [lowest perceived pain] to 5 [worst perceived pain]), over-the-counter medication use, and Headache Disability Inventory score. Forty patients completed the study (OMTh, n=21; control, n=19). The OMTh group had a significant reduction in headache frequency over time that persisted 1 month (approximate reduction, 40%; Ptreatment. Moreover, there was an absolute difference between the 2 treatment groups at the end of the study, with a 33% lower frequency of headache in the OMTh group (Ptreatment modalities and may benefit patients who have adverse effects to medications or who have difficulty complying with pharmacologic regimens. This protocol may serve as a model for future studies. © 2014 The American Osteopathic Association.

A workforce survey of Australian osteopathy: analysis of a nationally-representative sample of osteopaths from the Osteopathy Research and Innovation Network (ORION) project.

Science.gov (United States)

Adams, Jon; Sibbritt, David; Steel, Amie; Peng, Wenbo

2018-05-10

Limited information is available regarding the profile and clinical practice characteristics of the osteopathy workforce in Australia. This paper reports such information by analysing data from a nationally-representative sample of Australian osteopaths. Data was obtained from a workforce survey of Australian osteopathy, investigating the characteristics of the practitioner, their practice, clinical management features and perceptions regarding research. The survey questionnaire was distributed to all registered osteopaths across Australia in 2016 as part of the Osteopathy Research and Innovation Network (ORION) project. A total of 992 Australian osteopaths participated in this study representing a response rate of 49.1%. The average age of the participants was 38.0 years with 58.1% being female and the majority holding a Bachelor or higher degree qualification related to the osteopathy professional. Approximately 80.0% of the osteopaths were practicing in an urban area, with most osteopaths working in multi-practitioner locations, having referral relationships with a range of health care practitioners, managing patients a number of musculoskeletal disorders, and providing multi-model treatment options. A total of 3.9 million patients were estimated to consult with osteopaths every year and an average of approximate 3.0 million hours were spent delivering osteopathy services per year. Further research is required to provide rich, in-depth examination regarding a range of osteopathy workforce issues which will help ensure safe, effective patient care to all receiving and providing treatments as part of the broader Australian health system.

Still in the closet: the invisible minority in medical education

Science.gov (United States)

2014-01-01

Background To investigate the relationship between sexual orientation and gender identity in regard to levels of depression; levels of perceived social support; comfort with disclosure of orientation; and the lesbian, gay, bisexual, and transgender (LGBT) campus climate. Methods E-mail invitations to participate in the current cross-sectional questionnaire-based study were sent to all thirty US osteopathic medical schools in August 2012; six schools responded and disseminated the survey to their students. Participating students completed an anonymous web-based survey, and informed consent was obtained when they accessed the survey. The survey was designed specifically for the current study but contained scales used with permission from previously published research. Analysis procedures included nonparametric tests, one-way analysis of variance and Pearson’s correlations. Results Of the 4112 students invited to participate in the survey, 1334 (32.4%) completed it. Approximately 85% of respondents self-identified as heterosexual only. No respondents identified as transgender. In general, LGB students indicated higher levels of depression (P LGBT campus climate in osteopathic medical students. In the future, osteopathic medical schools should consider closely examining their campus culture in order to create a more positive and inclusive environment for all its students. PMID:25128252

Osteopathic manipulative treatment (OMT) for lower urinary tract symptoms (LUTS) in women.

Science.gov (United States)

Franke, Helge; Hoesele, Klaus

2013-01-01

Because of its prevalence and impact on women's well-being, and its high financial costs, female LUTS is an important health problem that requires serious attention from health professionals. The objective of this review was to determine the clinical effects of osteopathic treatment on female lower urinary tract disorders. A systematic literature search was performed in May 2011 in the electronic databases Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, CINAHL, PEDro, OSTMED-DR, OSTEOPATHIC WEBRESEARCH and databases of ongoing trials. A manual search in reference lists and a personal communication with experts in the field of osteopathy was also conducted to identify additional studies. Only randomized clinical studies (RCT) or controlled clinical studies (CCT) were included. Inclusion criteria of the participants were female, at least 18 years old and a diagnosed female urinary tract disorder. Exclusion criteria were neurologic disorders, tumors, urinary tract infections or antibiotic treatment, and pregnancy. Two review authors independently extracted the data of the studies using a standardized data extraction form. The updated Cochrane Risk of bias tool from 2011 was used to assess the methodological quality. The quantitative analysis shows a statistically significant and clinically relevant improvement when the osteopathic intervention was compared to an untreated group. Two studies which compare OMT with the pelvic floor muscle training as a reference treatment document almost the same therapeutic effect. The findings of this systematic review and meta-analysis are promising and encouraging to conduct larger, rigorous osteopathic intervention studies for female urination disorders. Future studies should compare the osteopathic treatment with established standard procedures in the control group. Copyright © 2012 Elsevier Ltd. All rights reserved.

OSTEOPATHIC APPROACH: LEG LENGTH DISCREPANCY AND LOW BACK PAIN

Directory of Open Access Journals (Sweden)

Taner AYDIN

2015-12-01

Full Text Available Leg length discrepancy (LLD is a biomechanical impediment, which is a potential factor in affecting musculoskeletal disorders in the rest of life, such as scoliosis, osteoarthritis and muscle tightness, or even tenderness in lumbar and pelvic area. Athletes who have developed LLD have symptoms in gait, running, standing posture. Skeletal regions related to the disorder are the lumbar spine, ilium, hip joint, greater trochanter and knee, or even ankle and plantar region. Muscles involved in these areas are numeous. In osteopathic management, the manual practitioner can use a lot of basic techniques to handle these dysfunctions. To cope with musculoskeletal problems, osteopathic manipulation techniques would be an ideal modality to alleviate the LLD syndrome. An overview of the mentioned topics of concern will be discussed in the review.

Descriptive study of interprofessional collaboration between physicians and osteopaths for the pediatric population in Quebec, Canada

Directory of Open Access Journals (Sweden)

Chantal Morin

2017-11-01

Full Text Available Abstract Background Osteopathy is an increasingly popular healthcare approach that uses a wide variety of therapeutic manual techniques to address pain and somatic dysfunction. In Quebec, Canada, osteopathy is the complementary medicine most often recommended by family physicians. However, factors fostering the development of interprofessional collaboration (IPC between physicians and osteopaths are unknown. This study aimed to describe the current situation in terms of IPC among practitioners working with pediatric patients. Methods A self-administered questionnaire was sent to osteopaths, family physicians, and pediatricians involved with pediatric patients in the province of Quebec. The postal questionnaire captured general knowledge about osteopathy and its practice parameters and role, sources of information, communication aspects including having a professional relationship and referrals, and influence of the upcoming government regulation. Quantitative data from the questionnaires were analyzed using descriptive statistics. Logistic regression model for factors associated with osteopathic referrals and multiple linear regression analyses for the number of correct answers about general osteopathic practice parameters were performed. Results A total of 274 physicians (155 family physicians (response rate 13% and 119 pediatricians (17% and 297 osteopaths (42% completed the survey. According to physicians, osteopathy was most appropriate for musculoskeletal pain (241; 91% and plagiocephaly (235; 88%. Osteopathic referral was positively associated with having a professional relationship (odds ratio [OR] 4.10 (95% confidence interval [CI] 2.12; 7.95, p < 0.001, personal consultation (OR 2.58 (95% CI 1.35; 4.93, p = 0.004, community-based practice (OR 1.89 (95% CI 1.03; 3.47, p = 0.040, and belief in the active role of osteopathy for pediatric conditions (OR 1.22 (95% CI 1.01; 1.47, p = 0.042. The majority of physicians (72% and

Effect of Osteopathic Cranial Manipulative Medicine on Visual Function.

Science.gov (United States)

Sandhouse, Mark E; Shechtman, Diana; Fecho, Gregory; Timoshkin, Elena M

2016-11-01

The effects of osteopathic cranial manipulative medicine (OCMM) on visual function have been poorly characterized in the literature. Based on a pilot study conducted by their research group, the authors conducted a study that examined whether OCMM produced a measurable change in visual function in adults with cranial asymmetry. Randomized, controlled, double-blinded clinical trial. The intervention and control (sham therapy) were applied during 8 weekly visits, and participants in both groups received 8 weekly follow-up visits. Adult volunteers aged between 18 and 35 years with unremarkable systemic or ocular history were recruited. Inclusion criteria were refractive error between 6 diopters of myopia and 5 diopters of hyperopia, regular astigmatism of any amount, and cranial somatic dysfunction. All participants were evaluated for cranial asymmetry and randomly assigned to the treatment or sham therapy group. The treatment group received OCMM to correct cranial dysfunctions, and the sham therapy group received light pressure applied to the cranium. Preintervention and postintervention ophthalmic examinations consisted of distance visual acuity testing, accommodative system testing, local stereoacuity testing, pupillary size measurements, and vergence system testing. A χ2 analysis was performed to determine participant masking. Analysis of variance was performed for all ophthalmic measures. Eighty-nine participants completed the trial, with 47 in the treatment group and 42 in the sham therapy group. A hierarchical analysis of variance revealed statistically significant within-groups effects (Psize under bright light in the left eye and in near point of convergence break. Osteopathic cranial manipulative medicine may affect visual function in adults with cranial asymmetry. Active motion testing of the cranium for somatic dysfunction may affect the cranial system to a measurable level and explain interrater reliability issues in cranial studies. (Clinical

The effectiveness of osteopathic manipulative treatment in an abnormal uterine bleeding related pain and health related quality of life (HR-QoL) - A case report.

Science.gov (United States)

Goyal, Kanu; Goyal, Manu; Narkeesh, Kanimozhi; John Samuel, Asir; Sharma, Sorabh; Chatterjee, Subhasish; Arumugam, Narkeesh

2017-07-01

Abnormal uterine bleeding is characterized by painful and/or excessive menorrhea, chronic pelvic pain due to the endometriosis (Em). Osteopathic treatment is commonly used in the gynecological dysfunctions. The aim of the present case study was to explore the effect of osteopathic treatment (OT) for a woman with abnormal uterine bleeding related pain and quality of life (QoL). We reported a case of 29 year old female who presented with chief complaints of increased flow during periods, lower abdominal pain, leukorrhoea, lower back pain and with occasional constipation for the last 3 years. Patient is a mother of 6 years old male child born with normal delivery. On diagnostic ultrasonography the uterus was found bulky with insignificant endometriosis and no other abnormality was detected. She did not have any relevant past medical and surgical history. The pre and post osteopathic treatment measurements were measured using Visual Analog Scale (VAS) and the health related quality of life (HR-QoL) questionnaire called short form Endometriosis Health Profile Questionnaire (EHP) - 5. In the present case the pain due to the endometriosis was treated with the osteopathic treatment consists of all the major diaphragms' release (release of pelvic diaphragm, abdominal diaphragm, thoracic outlet release and hyoid diaphragm) during the first session and in the second session gastro-esophageal (GE) junction release, sigmoid colon release, cranial therapy to the occiput, sacral release and dural tube rocking. Following that improvement of pain from VAS 8.3/10 to 3.9/10 and QoL improvement from EHP-5, 72/100 to 26/100 was noted. Osteopathic manipulative approach (OMA) in the patient with Em might improve the abnormal uterine bleeding related pain and health related quality of life (HR-QoL). Copyright © 2016 Elsevier Ltd. All rights reserved.

The establishment of the Chiropractic & Osteopathic College of Australasia in Queensland (1996–2002

Directory of Open Access Journals (Sweden)

Walker Bruce F

2005-04-01

Full Text Available Abstract Introduction For chiropractors and osteopaths after graduation, the learning process continues by way of experience and continuing education (CE. The provision of CE and other vocational services in Queensland between 1996 and 2002 is the subject of this paper. Methods The Chiropractic & Osteopathic College of Australasia (COCA implemented a plan, which involved continuing education, with speakers from a broad variety of health provider areas; and the introduction of the concepts of evidence-based practice. The plan also involved building membership. Results Membership of COCA in Queensland grew from 3 in June 1996 to 167 in 2002. There were a total of 25 COCA symposia in the same period. Evidence-based health care was introduced and attendees were generally satisfied with the conferences. Discussion The development of a vocational body (COCA for chiropractors and osteopaths in Queensland was achieved. Registrants in the field have supported an organisation that concentrates on the vocational aspects of their practice.

The Glymphatic-Lymphatic Continuum: Opportunities for Osteopathic Manipulative Medicine.

Science.gov (United States)

Hitscherich, Kyle; Smith, Kyle; Cuoco, Joshua A; Ruvolo, Kathryn E; Mancini, Jayme D; Leheste, Joerg R; Torres, German

2016-03-01

The brain has long been thought to lack a lymphatic drainage system. Recent studies, however, show the presence of a brain-wide paravascular system appropriately named the glymphatic system based on its similarity to the lymphatic system in function and its dependence on astroglial water flux. Besides the clearance of cerebrospinal fluid and interstitial fluid, the glymphatic system also facilitates the clearance of interstitial solutes such as amyloid-β and tau from the brain. As cerebrospinal fluid and interstitial fluid are cleared through the glymphatic system, eventually draining into the lymphatic vessels of the neck, this continuous fluid circuit offers a paradigm shift in osteopathic manipulative medicine. For instance, manipulation of the glymphatic-lymphatic continuum could be used to promote experimental initiatives for nonpharmacologic, noninvasive management of neurologic disorders. In the present review, the authors describe what is known about the glymphatic system and identify several osteopathic experimental strategies rooted in a mechanistic understanding of the glymphatic-lymphatic continuum.

The fascial system and exercise intolerance in patients with chronic heart failure: hypothesis of osteopathic treatment

Directory of Open Access Journals (Sweden)

Bordoni B

2015-10-01

Full Text Available Bruno Bordoni,1–3 F Marelli2,3 1Don Carlo Gnocchi Foundation, Department of Cardiology, IRCCS Santa Maria Nascente, Milan, Italy; 2School CRESO, Osteopathic Centre for Research and Studies, Falconara Marittima, AN, Italy; 3School CRESO, Osteopathic Centre for Research and Studies, Castellanza, VA, Italy Abstract: Chronic heart failure is a progressive, debilitating disease, resulting in a decline in the quality of life of the patient and incurring very high social economic costs. Chronic heart failure is defined as the inability of the heart to meet the demands of oxygen from the peripheral area. It is a multi-aspect complex disease which impacts negatively on all of the body systems. Presently, there are no texts in the modern literature that associate the symptoms of exercise intolerance of the patient with a dysfunction of the fascial system. In the first part of this article, we will discuss the significance of the disease, its causes, and epidemiology. The second part will explain the pathological adaptations of the myofascial system. The last section will outline a possible osteopathic treatment for patients with heart failure in order to encourage research and improve the general curative approach for the patient. Keywords: manual therapy, fatigue, chronic heart failure, osteopathic

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.…

Pregnancy Research on Osteopathic Manipulation Optimizing Treatment Effects: the PROMOTE study.

Science.gov (United States)

Hensel, Kendi L; Buchanan, Steve; Brown, Sarah K; Rodriguez, Mayra; Cruser, des Anges

2015-01-01

The purpose of this study was to evaluate the efficacy of osteopathic manipulative treatment (OMT) to reduce low back pain and improve functioning during the third trimester in pregnancy and to improve selected outcomes of labor and delivery. Pregnancy research on osteopathic manipulation optimizing treatment effects was a randomized, placebo-controlled trial of 400 women in their third trimester. Women were assigned randomly to usual care only (UCO), usual care plus OMT (OMT), or usual care plus placebo ultrasound treatment (PUT). The study included 7 treatments over 9 weeks. The OMT protocol included specific techniques that were administered by board-certified OMT specialists. Outcomes were assessed with the use of self-report measures for pain and back-related functioning and medical records for delivery outcomes. There were 136 women in the OMT group: 131 women in the PUT group and 133 women in the UCO group. Characteristics at baseline were similar across groups. Findings indicate significant treatment effects for pain and back-related functioning (P < .001 for both groups), with outcomes for the OMT group similar to that of the PUT group; however, both groups were significantly improved compared with the UCO group. For secondary outcome of meconium-stained amniotic fluid, there were no differences among the groups. OMT was effective for mitigating pain and functional deterioration compared with UCO; however, OMT did not differ significantly from PUT. This may be attributed to PUT being a more active treatment than intended. There was no higher likelihood of conversion to high-risk status based on treatment group. Therefore, OMT is a safe, effective adjunctive modality to improve pain and functioning during the third trimester. Copyright © 2015 Elsevier Inc. All rights reserved.

Recovery From Chronic Low Back Pain After Osteopathic Manipulative Treatment: A Randomized Controlled Trial.

Science.gov (United States)

Licciardone, John C; Gatchel, Robert J; Aryal, Subhash

2016-03-01

Little is known about recovery after spinal manipulation in patients with low back pain (LBP). To assess recovery from chronic LBP after a short regimen of osteopathic manipulative treatment (OMT) in a responder analysis of the OSTEOPAThic Health outcomes In Chronic low back pain (OSTEOPATHIC) Trial. A randomized double-blind, sham-controlled trial was conducted to determine the efficacy of 6 OMT sessions over 8 weeks. Recovery was assessed at week 12 using a composite measure of pain recovery (10 mm or less on a 100-mm visual analog scale) and functional recovery (2 or less on the Roland-Morris Disability Questionnaire for back-specific functioning). The RRs and numbers-needed-to-treat (NNTs) for recovery with OMT were measured, and corresponding cumulative distribution functions were plotted according to baseline LBP intensity and back-specific functioning. Multiple logistic regression was used to compute the OR for recovery with OMT while simultaneously controlling for potential confounders. Sensitivity analyses were performed to corroborate the primary results. There were 345 patients who met neither of the recovery criteria at baseline in the primary analyses and 433 patients who met neither or only 1 of these criteria in the sensitivity analyses. There was a large treatment effect for recovery with OMT (RR, 2.36; 95% CI, 1.31-4.24; P=.003), which was associated with a clinically relevant NNT (8.9; 95% CI, 5.4-25.5). This significant finding persisted after adjustment for potential confounders (OR, 2.92; 95% CI, 1.43-5.97; P=.003). There was also a significant interaction effect between OMT and comorbid depression (P=.02), indicating that patients without depression were more likely to recover from chronic LBP with OMT (RR, 3.21; 95% CI, 1.59-6.50; Pback-specific dysfunction at baseline. Similar results were observed in the sensitivity analyses. The OMT regimen was associated with significant and clinically relevant measures for recovery from chronic LBP. A

Person-centered osteopathic practice: patients' personality (body, mind, and soul) and health (ill-being and well-being).

Science.gov (United States)

Fahlgren, Elin; Nima, Ali A; Archer, Trevor; Garcia, Danilo

2015-01-01

Background. Osteopathic philosophy and practice are congruent with the biopsychosocial model, a patient-centered approach when treating disease, and the view of the person as a unity (i.e., body, mind, and soul). Nevertheless, a unity of being should involve a systematic person-centered understanding of the patient's personality as a biopsychosociospiritual construct that influences health (i.e., well-being and ill-being). We suggest Cloninger's personality model, comprising temperament (i.e., body) and character (i.e., mind and soul), as a genuine paradigm for implementation in osteopathic practice. As a first step, we investigated (1) the relationships between personality and health among osteopathic patients, (2) differences in personality between patients and a control group, and (3) differences in health within patients depending on the presenting problem and gender. Method. 524 osteopathic patients in Sweden (age mean = 46.17, SD = 12.54, 388 females and 136 males) responded to an online survey comprising the Temperament and Character Inventory and measures of health (well-being: life satisfaction, positive affect, harmony in life, energy, and resilience; ill-being: negative affect, anxiety, depression, stress, and dysfunction and suffering associated to the presenting problem). We conducted two structural equation models to investigate the association personality-health; graphically compared the patients' personality T-scores to those of the control group and compared the mean raw scores using t-tests; and conducted two multivariate analyses of variance, using age as covariate, to compare patients' health in relation to their presenting problem and gender. Results. The patients' personality explained the variance of all of the well-being (R (2) between .19 and .54) and four of the ill-being (R (2) between .05 and .43) measures. Importantly, self-transcendence, the spiritual aspect of personality, was associated to high levels of positive emotions and

Person-centered osteopathic practice: patients’ personality (body, mind, and soul and health (ill-being and well-being

Directory of Open Access Journals (Sweden)

Elin Fahlgren

2015-10-01

Full Text Available Background. Osteopathic philosophy and practice are congruent with the biopsychosocial model, a patient-centered approach when treating disease, and the view of the person as a unity (i.e., body, mind, and soul. Nevertheless, a unity of being should involve a systematic person-centered understanding of the patient’s personality as a biopsychosociospiritual construct that influences health (i.e., well-being and ill-being. We suggest Cloninger’s personality model, comprising temperament (i.e., body and character (i.e., mind and soul, as a genuine paradigm for implementation in osteopathic practice. As a first step, we investigated (1 the relationships between personality and health among osteopathic patients, (2 differences in personality between patients and a control group, and (3 differences in health within patients depending on the presenting problem and gender.Method. 524 osteopathic patients in Sweden (age mean = 46.17, SD = 12.54, 388 females and 136 males responded to an online survey comprising the Temperament and Character Inventory and measures of health (well-being: life satisfaction, positive affect, harmony in life, energy, and resilience; ill-being: negative affect, anxiety, depression, stress, and dysfunction and suffering associated to the presenting problem. We conducted two structural equation models to investigate the association personality-health; graphically compared the patients’ personality T-scores to those of the control group and compared the mean raw scores using t-tests; and conducted two multivariate analyses of variance, using age as covariate, to compare patients’ health in relation to their presenting problem and gender.Results. The patients’ personality explained the variance of all of the well-being (R2 between .19 and .54 and four of the ill-being (R2 between .05 and .43 measures. Importantly, self-transcendence, the spiritual aspect of personality, was associated to high levels of positive emotions

New York College of Osteopathic Medicine Learning Outcomes Assessment 2009-2010

Science.gov (United States)

McCarthy, John R.; Mead, Pelham; Achziger, Mary Ann; Bruno, Felicia; Bryant, Claire; Goldstein, Leonard; Jeger, Abraham; Zaika, Rodika; Portanova, Ron

2009-01-01

This is a document that lays out the Mission of the NY College of Osteopathic Medicine's Mission Statement, It's 13 Goals and subsequent Objectives of Learning Outcomes. Benchmarks were established for each Educational Goal and defined further in Objectives. This document represents an historic attempt by NYCOM to address it's need for complete…

Osteopathic manipulative treatment is effective on pain control associated to spinal cord injury.

Science.gov (United States)

Arienti, C; Daccò, S; Piccolo, I; Redaelli, T

2011-04-01

This study was designed as an experimental study (trial). To verify the effects of the association between conventional pharmacological treatment and osteopathic manipulative treatment (OMT) for chronic pain management in spinal cord injury (SCI). This study was carried out at Spinal Unit, Ospedale Niguarda Ca' Granda, Milan, Italy. Istituto Superiore di Osteopatia, Milan, Italy. We enrolled 47 patients with SCI, 26 with pain of both nociceptive and neuropathic origin, and 21 with pure neuropathic pain. In all, 33 patients had a complete spinal cord lesion (ASIA level A) and 14 had incomplete lesion (ASIA level B, C and D). The patients were subdivided in a pharmacological group (Ph), a pharmacological osteopathic (PhO) group and a osteopathic (Os) group. The verbal numeric scale (VNS) was used at various time intervals to evaluate treatment outcomes. Ph patients reached a 24% improvement in their pain perception, assessed by the VNS scale after 3 weeks of treatment, whereas Os patients reached a 16% improvement in their pain perception for the same weeks. Both treatments per se failed to induce further improvements at later time points. In contrast, the combination of the two approaches yielded a significantly better pain relief both in patients with nociceptive or pure neuropathic pain in the PhO group. Our results suggest the OMT is a feasible approach in patients in whom available drugs cannot be used. Moreover, a benefit can be expected by the association of OMT in patients treated according to existing pharmacological protocols.

Osteopathic manual therapy in heart failure patients: A randomized clinical trial.

Science.gov (United States)

Thomaz, Sergio R; Teixeira, Felipe A; de Lima, Alexandra C G B; Cipriano Júnior, Gerson; Formiga, Magno F; Cahalin, Lawrence Patrick

2018-04-01

Heart Failure (HF) patients usually present with increased arterial resistance and reduced blood pressure (BP) leading to an impaired functional capacity. Osteopathic Manual Therapy (OMT) focused on myofascial release techniques (MRT) and in the balancing of diaphragmatic tensions, has been shown to improve blood flow in individuals using the resistive index (RI). However, its effects in HF patients have not been examined. To evaluate the acute response of selected osteopathic techniques on RI, heart rate (HR), and BP in patients with HF. Randomized-controlled clinical trial of HF patients assigned to MRT (six different techniques with three aimed at the pelvis, two at the thorax, and one at the neck for 15 min) or Control group (subjects in supine position for 15 min without intervention). The RI of the femoral, brachial and carotid arteries was measured via doppler ultrasound while HR and BP were measured via sphygmomanometry before and after a single MRT or control intervention. Twenty-two HF patients equally distributed (50% male, mean age 53 years; range 32-69 years) (ejection fraction = 35.6%, VO 2peak : 12.9 mL/kg -1 min -1 ) were evaluated. We found no intra or inter group differences in RI of the carotid (Δ MRT : 0.07% vs Δ Control :11.8%), brachial (Δ MRT :0.17% vs Δ Control : 2.9%), or femoral arteries (Δ MRT :1.65% vs Δ Control : 0.97%) (P > 0.05) and no difference in HR or BP (Δ MRT :0.6% vs Δ Control : 3%), (P > 0.05). A single MRT session did not significantly change the RI, HR, or BP of HF patients. Copyright © 2017 Elsevier Ltd. All rights reserved.

Developing technology-enhanced active learning for medical education: challenges, solutions, and future directions.

Science.gov (United States)

McCoy, Lise; Pettit, Robin K; Lewis, Joy H; Bennett, Thomas; Carrasco, Noel; Brysacz, Stanley; Makin, Inder Raj S; Hutman, Ryan; Schwartz, Frederic N

2015-04-01

Growing up in an era of video games and Web-based applications has primed current medical students to expect rapid, interactive feedback. To address this need, the A.T. Still University-School of Osteopathic Medicine in Arizona (Mesa) has developed and integrated a variety of approaches using technology-enhanced active learning for medical education (TEAL-MEd) into its curriculum. Over the course of 3 years (2010-2013), the authors facilitated more than 80 implementations of games and virtual patient simulations into the education of 550 osteopathic medical students. The authors report on 4 key aspects of the TEAL-MEd initiative, including purpose, portfolio of tools, progress to date regarding challenges and solutions, and future directions. Lessons learned may be of benefit to medical educators at academic and clinical training sites who wish to implement TEAL-MEd activities.

Use of the SMART Balance Master to quantify the effects of osteopathic manipulative treatment in patients with dizziness.

Science.gov (United States)

Fraix, Marcel; Gordon, Ashlynn; Graham, Victoria; Hurwitz, Eric; Seffinger, Michael A

2013-05-01

Dizziness is the third most common complaint among outpatients and the most common complaint in patients aged 75 years or older. It can be incapacitating for patients, affecting both productivity and quality of life. To evaluate the effect of osteopathic manipulative treatment (OMT) for spinal somatic dysfunction in patients with dizziness lasting longer than 3 months. A prospective clinical cohort study that took place in 2011. Department of Physical Therapy laboratory at the Western University of Health Sciences College of Osteopathic Medicine in Pomona, California. Sixteen participants (2 male, 14 female; mean [range] age, 49 [13-75] years) with dizziness lasting at least 3 months (mean duration of symptoms, 84 months) and spinal somatic dysfunction, but no history of known stroke or brain disease, were recruited from the local community and evaluated for postural balance control before, immediately after, and 1 week after OMT. Four osteopathic physicians board certified in neuromusculoskeletal medicine/osteopathic manipulative medicine provided OMT, including muscle energy; high-velocity, low-amplitude; counterstrain; myofascial release; balanced ligamentous release; and cranial OMT techniques. Outcomes were assessed with the SMART Balance Master (NeuroCom), a validated instrument that provides graphic and quantitative analyses of sway and balance, and the Dizziness Handicap Inventory (DHI), a self-assessment inventory designed to assess precipitating physical factors associated with dizziness and functional and emotional consequences of vestibular disease. Paired t tests, performed to assess changes in mean composite scores for all challenge tests, revealed that balance was significantly improved both immediately and 1 week after OMT (both P<.001), with no significant difference between immediate and 1-week post-OMT scores (P=.20). The DHI scores, both total and subscale, improved significantly after OMT (P<.001), and changes in composite and DHI scores were

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...

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...

The Single Graduate Medical Education (GME) Accreditation System Will Change the Future of the Family Medicine Workforce.

Science.gov (United States)

Peabody, Michael R; O'Neill, Thomas R; Eden, Aimee R; Puffer, James C

2017-01-01

Due to the Accreditation Council for Graduate Medical Education (ACGME)/American Osteopathic Association (AOA) single-accreditation model, the specialty of family medicine may see as many as 150 programs and 500 trainees in AOA-accredited programs seek ACGME accreditation. This analysis serves to better understand the composition of physicians completing family medicine residency training and their subsequent certification by the American Board of Family Medicine. We identified residents who completed an ACGME-accredited or dual-accredited family medicine residency program between 2006 and 2016 and cross-tabulated the data by graduation year and by educational background (US Medical Graduate-MD [USMG-MD], USMG-DO, or International Medical Graduate-MD [IMG-MD]) to examine the cohort composition trend over time. The number and proportion of osteopaths completing family medicine residency training continues to rise concurrent with a decline in the number and proportion of IMGs. Take Rates for USMG-MDs and USMG-IMGs seem stable; however, the Take Rate for the USMG-DOs has generally been rising since 2011. There is a clear change in the composition of graduating trainees entering the family medicine workforce. As the transition to a single accreditation system for graduate medical education progresses, further shifts in the composition of this workforce should be expected. © Copyright 2017 by the American Board of Family Medicine.

Effect of synchronized or desynchronized music listening during osteopathic treatment: an EEG study.

Science.gov (United States)

Mercadié, Lolita; Caballe, Julie; Aucouturier, Jean-Julien; Bigand, Emmanuel

2014-01-01

While background music is often used during osteopathic treatment, it remains unclear whether it facilitates treatment, and, if it does, whether it is listening to music or jointly listening to a common stimulus that is most important. We created three experimental situations for a standard osteopathic procedure in which patients and practitioner listened either to silence, to the same music in synchrony, or (unknowingly) to different desynchronized montages of the same material. Music had no effect on heart rate and arterial pressure pre- and posttreatment compared to silence, but EEG measures revealed a clear effect of synchronized versus desynchronized listening: listening to desynchronized music was associated with larger amounts of mu-rhythm event-related desynchronization (ERD), indicating decreased sensorimotor fluency compared to what was gained in the synchronized music listening condition. This result suggests that, if any effect can be attributed to music for osteopathy, it is related to its capacity to modulate empathy between patient and therapist and, further, that music does not systematically create better conditions for empathy than silence. Copyright © 2013 Society for Psychophysiological Research.

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. ...

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...

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...

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...

Learning by Living: Life-Altering Medical Education through Nursing Home-Based Experiential Learning

Science.gov (United States)

Gugliucci, Marilyn R.; Weiner, Audrey

2013-01-01

The University of New England College of Osteopathic Medicine Learning by Living Project (referred to as Learning by Living) was piloted in 2006 as an experiential medical education learning model. Since its inception, medical and other health professions students have been "admitted" into nursing homes to live the life of an older adult nursing…

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.)

Fibromyalgia with Gabapentin and Osteopathic Manipulative Medicine: A Pilot Study.

Science.gov (United States)

Marske, Cynthia; Bernard, Natasha; Palacios, Alison; Wheeler, Cary; Preiss, Ben; Brown, Mackenzie; Bhattacharya, Saveri; Klapstein, Gloria

2018-04-01

This pilot study compares the safety and efficacy of three treatments in reducing pain and improving fibromyalgia symptoms. This study was an 8-week prospective, single center feasibility study. Forty subjects were recruited from Solano, Sonoma, and Contra Costa counties of California in 2006-2009. Subjects were aged 18-65 and met the American College of Rheumatology (ACR) 1990 criteria for fibromyalgia. This study had three treatment arms: gabapentin only (900 mg/day), osteopathic manipulative medicine (OMM) only, and combined treatment of gabapentin plus OMM. OMM treatment was administered by advanced medical students for 30 min, once a week. The trial lasted for 8 weeks, which included 6 weeks of treatment plus initial and final visits. Key outcome measures included Wong-Baker FACES Pain Rating Scale (WBF), Clinical Global Impression of Health (CGI), Fibromyalgia Impact Questionnaire (FIQ), and number of tender points. Twenty-nine subjects completed the trial; 8 subjects received gabapentin only, 11 patients received OMM only, and 10 patients received gabapentin plus OMM. Subjects receiving OMM alone and subjects receiving the combined treatment of OMM and gabapentin displayed clinical improvements based on WBF (p treatment and gabapentin are safe and clinically efficacious treatment of pain and other constitutional and somatic symptoms associated with fibromyalgia. A larger trial using the new ACR 2010 Fibromyalgia criteria is needed to confirm these findings.

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...

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)

Effectiveness of osteopathic manipulative treatment in neonatal intensive care units: protocol for a multicentre randomised clinical trial

Science.gov (United States)

Cerritelli, Francesco; Pizzolorusso, Gianfranco; Renzetti, Cinzia; D'Incecco, Carmine; Fusilli, Paola; Perri, Paolo Francesco; Tubaldi, Lucia; Barlafante, Gina

2013-01-01

Introduction Neonatal care has been considered as one of the first priorities for improving quality of life in children. In 2010, 10% of babies were born prematurely influencing national healthcare policies, economic action plans and political decisions. The use of complementary medicine has been applied to the care of newborns. One previous study documented the positive effect of osteopathic manipulative treatment (OMT) in reducing newborns’ length of stay (LOS). Aim of this multicentre randomised controlled trial is to examine the association between OMT and LOS across three neonatal intensive care units (NICUs). Methods and analysis 690 preterm infants will be recruited from three secondary and tertiary NICUs from north and central Italy and allocated into two groups, using permuted-block randomisation. The two groups will receive standard medical care and OMT will be applied, twice a week, to the experimental group only. Outcome assessors will be blinded of study design and group allocation. The primary outcome is the mean difference in days between discharge and entry. Secondary outcomes are difference in daily weight gain, number of episodes of vomit, regurgitation, stooling, use of enema, time to full enteral feeding and NICU costs. Statistical analyses will take into account the intention-to-treat method. Missing data will be handled using last observation carried forward (LOCF) imputation technique. Ethics and dissemination Written informed consent will be obtained from parents or legal guardians at study enrolment. The trial has been approved by the ethical committee of Macerata hospital (n°22/int./CEI/27239) and it is under review by the other regional ethics committees. Results Dissemination of results from this trial will be through scientific medical journals and conferences. Trial registration This trial has been registered at http://www.clinicaltrials.org (identifier NCT01645137). PMID:23430598

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

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...

Echinacea purpurea and osteopathic manipulative treatment in children with recurrent otitis media: a randomized controlled trial

Directory of Open Access Journals (Sweden)

Worden Katherine A

2008-10-01

Full Text Available Abstract Background Recurrent otitis media is a common problem in young children. Echinacea and osteopathic manipulative treatment have been proposed as preventive measures, but have been inadequately studied. This study was designed to assess the efficacy of Echinacea purpurea and/or osteopathic manipulative treatment (OMT for prevention of acute otitis media in otitis-prone children. Methods A randomized, placebo-controlled, two-by-two factorial trial with 6-month follow-up, conducted 1999 – 2002 in Tucson, Arizona. Patients were aged 12–60 months with recurrent otitis media, defined as three or more separate episodes of acute otitis media within six months, or at least four episodes in one year. Ninety children (44% white non-Hispanic, 39% Hispanic, 57% male were enrolled, of which 84 had follow-up for at least 3 months. Children were randomly assigned to one of four protocol groups: double placebo, echinacea plus sham OMT, true OMT (including cranial manipulation plus placebo echinacea, or true echinacea plus OMT. An alcohol extract of Echinacea purpurea roots and seeds (or placebo was administered for 10 days at the first sign of each common cold. Five OMT visits (or sham treatments were offered over 3 months. Results No interaction was found between echinacea and OMT. Echinacea was associated with a borderline increased risk of having at least one episode of acute otitis media during 6-month follow-up compared to placebo (65% versus 41%; relative risk, 1.59, 95% CI 1.04, 2.42. OMT did not significantly affect risk compared to sham (44% versus 61%; relative risk, 0.72, 95% CI 0.48, 1.10. Conclusion In otitis-prone young children, treating colds with this form of echinacea does not decrease the risk of acute otitis media, and may in fact increase risk. A regimen of up to five osteopathic manipulative treatments does not significantly decrease the risk of acute otitis media. Trial registration ClinicalTrials.gov Identifier: NCT00010465

Predicting risk for disciplinary action by a state medical board.

Science.gov (United States)

Cardarelli, Roberto; Licciardone, John C; Ramirez, Gilbert

2004-01-01

Disciplinary actions taken against physicians in the United States have been increasing over the last decade, yet the factors that place physicians at risk have not been well identified. The objective of this study is to identify predictors of physician disciplinary action. This case-control study used data from the Texas State Board of Medical Examiners from January 1989 through December 1998. Characteristics of disciplined physicians and predictors of disciplinary action for all violations and by type of violation were the main outcome descriptors. Years in practice, black physicians, and osteopathic graduates were positive predictors for disciplinary action. In contrast, female physicians, international medical graduates, and Hispanic and Asian physicians were less likely to receive disciplinary action compared with male, US allopathic, and white physicians, respectively. Most specialists, except psychiatrists and obstetrician-gynecologists, were less likely to be disciplined than were family practitioners, whereas general practitioners were more likely to be disciplined. More studies are needed to corroborate these findings.

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 ...

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

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...

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...

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.)

Osteopathic Manipulative Treatment Limits Chronic Constipation in a Child with Pitt-Hopkins Syndrome

Directory of Open Access Journals (Sweden)

Alessandro Aquino

2017-01-01

Full Text Available Pitt-Hopkins Syndrome (PTHS is a rare genetic disorder caused by insufficient expression of the TCF4 gene. Children with PTHS typically present with gastrointestinal disorders and early severe chronic constipation is frequently found (75%. Here we describe the case of a PTHS male 10-year-old patient with chronic constipation in whom Osteopathic Manipulative Treatment (OMT resulted in improved bowel functions, as assessed by the diary, the QPGS-Form A Section C questionnaire, and the Paediatric Bristol Stool Form Scale. The authors suggested that OMT may be a valid tool to improve the defecation frequency and reduce enema administration in PTHS patients.

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)

Low back pain and kidney mobility: local osteopathic fascial manipulation decreases pain perception and improves renal mobility.

Science.gov (United States)

Tozzi, P; Bongiorno, D; Vitturini, C

2012-07-01

a) To calculate and compare a Kidney Mobility Score (KMS) in asymptomatic and Low Back Pain (LBP) individuals through real-time Ultrasound (US) investigation. b) To assess the effect of Osteopathic Fascial Manipulation (OFM), consisting of Still Technique (ST) and Fascial Unwinding (FU), on renal mobility in people with non-specific LBP. c) To evaluate 'if' and 'to what degree' pain perception may vary in patients with LBP, after OFM is applied. 101 asymptomatic people (F 30; M 71; mean age 38.9 ± 8) were evaluated by abdominal US screening. The distance between the superior renal pole of the right kidney and the ipsilateral diaphragmatic pillar was calculated in both maximal expiration (RdE) and maximal inspiration (RdI). The mean of the RdE-RdI ratios provided a Kidney Mobility Score (KMS) in the cohort of asymptomatic people. The same procedure was applied to 140 participants (F 66; M 74; mean age 39.3 ± 8) complaining of non-specific LBP: 109 of whom were randomly assigned to the Experimental group and 31 to the Control group. For both groups, a difference of RdE and RdI values was calculated (RD = RdE-RdI), before (RD-T0) and after (RD-T1) treatment was delivered, to assess the effective range of right kidney mobility. A blind assessment of each patient was carried using US screening. Both groups completed a Short-Form McGill Pain Assessment Questionnaire (SF-MPQ) on the day of recruitment (SF-MPQ T0) as well as on the third day following treatment (SF-MPQ T1). An Osteopathic assessment of the thoraco-lumbo-pelvic region to all the Experimental participants was performed, in order to identify specific areas of major myofascial tension. Each individual of the Experimental group received OFM by the same Osteopath who had previously assessed them. A sham-treatment was applied to the Control group for the equivalent amount of time. a) The factorial ANOVA test showed a significant difference (p-value < 0.05) between KMS in asymptomatic individuals (1.92�

Tool for Predicting Medical Student Burnout From Sustained Stress Levels: Factor Analysis of the Medical Education Hassles Scale-R.

Science.gov (United States)

Johnson, Jane C; Degenhardt, Brian F; Smith, Carol K; Wolf, Thomas M; Peterson, D Fred

2018-03-01

Acute stress during medical school affects the health of students and is associated with burnout. The Medical Education Hassles Scale-R (MEHS-R) is designed to measure acute stress among medical students. Researchers using the MEHS-R primarily report overall hassles scores, which are unable to discriminate between different categories of hassles encountered. The present study examined the factor structure of the MEHS-R to identify subscales that would be useful to categorize hassles for research and assessment purposes. Longitudinal, observational study. Two osteopathic medical schools. Five hundred six first-year medical students. The MEHS-R was administered at orientation and 9 to 10 times throughout the first year, classified into examination, vacation, and routine medical school activity periods. Students rated the 101 items on a 4-point scale (0=none to 3=a great deal) to indicate how much of a hassle each item had been during the previous week. Demographic subgroups were males, females, married students, single students, whites, and ethnic minorities. Exploratory factor analysis was conducted on data collected at the first school during orientation. Seven subscales were identified: Academic and Time Pressures, Financial, Social, External Influences, Day-to-Day Functioning, Relationships With Immediate Family, and Health. Cronbach α were ≥0.75. Stability of these subscales was examined using confirmatory factor analysis. Both of the fit indices used indicated the 7-subscale model for the MEHS-R adequately fit the data obtained during examination and routine medical school activity periods, one fit index indicated adequate fit for the vacation period, and neither indicated adequate fit for the data from the second school. Of the 7 subscales, 5 had a strong correspondence with categories identified by the scale developers. Fit indices also indicated the 7-subscale model was adequately generalizable to the demographic subgroups with the exception of the ethnic

Assessment of cervical stiffness in axial rotation among chronic neck pain patients: A trial in the framework of a non-manipulative osteopathic management.

Science.gov (United States)

Dugailly, P-M; Coucke, A; Salem, W; Feipel, V

2018-03-01

Cervical stiffness is a clinical feature commonly appraised during the functional examination of cervical spine. Measurements of cervical stiffness in axial rotation have not been reported for patients with neck pain. The purpose of this study was to investigate cervical spine stiffness in axial rotation among neck pain patients and asymptomatic subjects, and to analyze the impact of osteopathic management. Thirty-five individuals (17 patients) were enrolled. Measurements were carried out for left-right axial rotation using a torque meter device, prior and after intervention. Passive range of motion, stiffness, and elastic-and neutral zone magnitudes were analyzed. Pain intensity was also collected for patients. The intervention consisted in one single session of non-manipulative osteopathic treatment performed in both groups. A significant main effect of intervention was found for total range of motion and neutral zone. Also, treatment by group interaction was demonstrated for neutral-, elastic zone, stiffness in right axial rotation, and for total neutral zone. Significant changes were observed in the clinical group after intervention, indicating elastic zone decrease and neutral zone increase. In contrast, no significant alteration was detected for the control group. Stiffness characteristics of the cervical spine in axial rotation are prone to be altered in patients with neck pain, but seem to be relieved after a session of non-manipulative manual therapeutic techniques. Further investigations, including randomized clinical trials with various clinical populations and therapeutic modalities, are needed to confirm these preliminary findings. Copyright © 2018 Elsevier Ltd. All rights reserved.

Learning and study strategies correlate with medical students' performance in anatomical sciences.

Science.gov (United States)

Khalil, Mohammed K; Williams, Shanna E; Gregory Hawkins, H

2018-05-06

Much of the content delivered during medical students' preclinical years is assessed nationally by such testing as the United States Medical Licensing Examination ® (USMLE ® ) Step 1 and Comprehensive Osteopathic Medical Licensing Examination ® (COMPLEX-USA ® ) Step 1. Improvement of student study/learning strategies skills is associated with academic success in internal and external (USMLE Step 1) examinations. This research explores the strength of association between the Learning and Study Strategies Inventory (LASSI) scores and student performance in the anatomical sciences and USMLE Step 1 examinations. The LASSI inventory assesses learning and study strategies based on ten subscale measures. These subscales include three components of strategic learning: skill (Information processing, Selecting main ideas, and Test strategies), will (Anxiety, Attitude, and Motivation) and self-regulation (Concentration, Time management, Self-testing, and Study aid). During second year (M2) orientation, 180 students (Classes of 2016, 2017, and 2018) were administered the LASSI survey instrument. Pearson Product-Moment correlation analyses identified significant associations between five of the ten LASSI subscales (Anxiety, Information processing, Motivation, Selecting main idea, and Test strategies) and students' performance in the anatomical sciences and USMLE Step 1 examinations. Identification of students lacking these skills within the anatomical sciences curriculum allows targeted interventions, which not only maximize academic achievement in an aspect of an institution's internal examinations, but in the external measure of success represented by USMLE Step 1 scores. Anat Sci Educ 11: 236-242. © 2017 American Association of Anatomists. © 2017 American Association of Anatomists.

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...

Using Simulation-Based Medical Education to Meet the Competency Requirements for the Single Accreditation System.

Science.gov (United States)

Riley, Bernadette

2015-08-01

Simulation-based medical education can provide medical training in a nonjudgmental, patient-safe, and effective environment. Although simulation has been a relatively new addition to medical education, the aeronautical, judicial, and military fields have used simulation training for hundreds of years, with positive outcomes. Simulation-based medical education can be used in a variety of settings, such as hospitals, outpatient clinics, medical schools, and simulation training centers. As the author describes in the present article, residencies currently accredited by the American Osteopathic Association can use a simulation-based medical education curriculum to meet training requirements of the 6 competencies identified by the Accreditation Council for Graduate Medical Education. The author also provides specific guidance on providing training and assessment in the professionalism competency.

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...

Themes Underlying Australian General Practitioner Views towards Chiropractic and Osteopathy: An Assessment of Free Text Data from a Cross-Sectional Survey

Directory of Open Access Journals (Sweden)

Sandra Grace

2018-01-01

Full Text Available The Australian chiropractic and osteopathic professions underwent a period of significant transformation between 1960 and 2000. This resulted in an improvement in the views held by the medical profession towards the two professions. However, a recent survey of Australian general practitioners (GPs reported that a number of GPs still hold negative views towards chiropractors and osteopaths. This paper examines these views from the perspective of critical realism and explores the generative mechanisms that can influence the willingness of health practitioners to collaborate over patient care. A qualitative analysis of open-ended responses to a survey of 630 Australian GPs was conducted. Unfavourable attitudes of GPs towards chiropractors and osteopaths included perceived lack of safety, efficacy, and inadequacy of training, despite chiropractic’s and osteopathy’s reliance on the same evidence base and similar training to those of other manual therapy professions such as physiotherapy. These attitudes may be underpinned by the professional biases against chiropractic and osteopathy that continue to marginalise the professions within the Australian healthcare system. Continued investment in the research base for chiropractic and osteopathic practice is required, along with raising the awareness of GPs about the education and skills of chiropractors and osteopaths.

Osteopathic Manipulative Treatment of Primary Dysmenorrhea and Related Factors: A Randomized Controlled Trial

Directory of Open Access Journals (Sweden)

Dario Zecchillo

2017-11-01

Full Text Available Objectives: This study is aimed to evaluate if the osteopathic manipulative treatment (OMT is effective in patients with primary dysmenorrhea (PD. Methods: Randomized single-blinded controlled trial with OMT group and lighttouch treatment (LTT group. Recruited women were 18-40 years (mean age 27 years, with regular menstrual cycle, normal body mass index (BMI, and a medical diagnosis of PD. Intervention: Patients received five OMT or five LTT over a menstrual cycle. The primary outcomes were average menstrual pain assessed by the numeric rating scale (NRS, the duration of pain, and quality of life (QoL assessed by the SF-12 Short Form Health Survey and Patient Global Impression Change (PGIC. The secondary outcomes were NSAIDs intake, hours of absence from school/work, and menstrual-related symptoms. Results: 31 subjects were enrolled, of which five were excluded and the remaining 26 were randomized. Patients in OMT group had significant improvement in every outcome, including the average menstrual pain that decreased from 5.35 ± 0.28 to 1.98 ± 0.24 (-63.0%; p<0.001. The mean SF-12 physical component score (PCS improved from 31.35 ± 1.70 to 49.56 ± 1.92 (+58.1%, p<0.001, the mean SF-12 mental component score (MCS improved from 38.36 ± 1.16 to 52.04 ± 0.94 (+35.7%; p<0.001. LTT group showed no improvements. Conclusion: OMT was effective in reducing menstrual pain and improving Quality of Life of dysmenorrheic women.

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

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.

Authorship Trends of Emergency Medicine Publications over the Last Two Decades.

Science.gov (United States)

Lammers, Richard; Simunich, Thomas; Ashurst, John

2016-05-01

With the recent merger of the American Osteopathic Association (AOA) and the Accreditation Council for Graduate Medical Education (ACGME) a heightened pressure for publication may become evident. Our objective was to determine whether there was a gap in the type of both medical degree designation and advanced degree designation among authorship in three United States-based academic emergency medicine journals. We reviewed the Journal of Emergency Medicine, Academic Emergency Medicine and Annals of Emergency Medicine for the type of degree designation that the first and senior authors had obtained for the years 1995, 2000, 2005, 2010 and 2014. A total of 2.48% of all authors held a degree in osteopathic medicine. Osteopathic physician first authors contributed to 3.26% of all publications while osteopathic physician senior authors contributed 1.53%. No statistical trend could be established for the years studied for osteopathic physicians. However, we noted an overall trend for increased publication for allopathic senior authors (p=0.001), allopathic first authors with a dual degree (p=0.003) and allopathic senior authors with a dual degree (p=0.005). For each journal studied, no statistical trend could be established for osteopathic first or senior authors but a trend was noted for allopathic first and senior authors in the Journal of Emergency Medicine (p-value=0.020 and 0.006). Of those with dual degrees, osteopathic physicians were in the minority with 1.85% of osteopathic first authors and 0.60% of osteopathic senior authors attaining a dual degree. No statistical trend could be established for increased dual degree publications for osteopathic physicians over the study period, nor could a statistical trend be established for any of the journals studied. Very few osteopathic physicians have published in the Journal of Emergency Medicine, Academic Emergency Medicine or Annals of Emergency Medicine over the last two decades. Despite a trend for increased

Variations of high frequency parameter of heart rate variability following osteopathic manipulative treatment in healthy subjects compared to control group and sham therapy: randomized controlled trial

Directory of Open Access Journals (Sweden)

Nuria eRuffini

2015-08-01

Full Text Available Context: Heart Rate Variability (HRV indicates how heart rate changes in response to inner and external stimuli. HRV is linked to health status and it is an indirect marker of the autonomic nervous system (ANS function. Objective: To investigate the influence of osteopathic manipulative treatment (OMT on ANS activity through changes of High Frequency, a heart rate variability index indicating the parasympathetic activity, in healthy subjects, compared with sham therapy and control group.Methods: Sixty-six healthy subjects, both male and female, were included in the present 3-armed randomized placebo controlled within subject cross-over single blinded study. Participants were asymptomatic adults, both smokers and non-smokers and not on medications. At enrollment subjects were randomized in 3 groups: A, B, C. Standardized structural evaluation followed by a patient need-based osteopathic treatment was performed in the first session of group A and in the second session of group B. Standardized evaluation followed by a protocoled sham treatment was provided in the second session of group A and in the first session of group B. No intervention was performed in the two sessions of group C, acting as a time-control. The trial was registered on clinicaltrials.gov identifier: NCT01908920.Main Outcomes Measures: HRV was calculated from electrocardiography before, during and after the intervention, for a total amount time of 25 minutes.Results: OMT engendered a statistically significant increase of parasympathetic activity, as shown by High Frequency rate (p<0.001, and decrease of sympathetic activity, as revealed by Low Frequency rate (p<0.01; results also showed a reduction of Low Frequency/High Frequency ratio (p<0.001 and Detrended fluctuation scaling exponent (p<0.05. Conclusions: Findings suggested that OMT can influence ANS activity increasing parasympathetic function and decreasing sympathetic activity, compared to sham therapy and control group.

Upper airway stabilization by osteopathic manipulation of the sphenopalatine ganglion versus sham manipulation in OSAS patients: a proof-of-concept, randomized, crossover, double-blind, controlled study.

Science.gov (United States)

Jacq, Olivier; Arnulf, Isabelle; Similowski, Thomas; Attali, Valérie

2017-12-20

Osteopathic manipulative treatment (OMT) of the sphenopalatine ganglion (SPG) is used empirically for the treatment of rhinitis and snoring and is thought to increase pharyngeal stability. This trial was designed to study the effects of this treatment on pharyngeal stability evaluated by critical closing pressure in obstructive sleep apnoea syndrome. This single-centre, randomized, crossover, double-blind study compared active manipulation and sham manipulation of the SPG. Randomization was computer-generated. Patients each received one active manipulation and one sham manipulation at an interval of 21 days and were evaluated 30 min and 48 h after each session administered by a qualified osteopath. Neither the patients, nor the investigator performing the evaluations were informed about the order of the two techniques (double-blind). The primary endpoint was the percentage of responding patients presenting increased pharyngeal stability defined by a variation of critical closing pressure (Pcrit) of at least -4 cmH 2 O at 30 min. Secondary endpoints were the variation of Pcrit in absolute values, sleepiness and snoring. Others endpoints were lacrimation (Schirmer's test), induced pain, sensations experienced during OMT. Ten patients were included and nine (57 [50; 58] years, comprising 7 men, with an apnoea-hypopnoea index of 31.0 [25.5; 33.2]/h; (values are median [quartiles])) were analysed. Seven patients were analysed for the primary endpoint and nine patients were analysed for secondary endpoints. Five patients responded after active manipulation versus no patients after sham manipulation (p = 0.0209). Active manipulation induced more intense pain (p = 0.0089), increased lacrimation (ns) and more tactile, nociceptive and gustatory sensations (13 versus 1) compared to sham manipulation. No significant difference was observed for the other endpoints. Osteopathic manipulative treatment of the SPG may improve pharyngeal stability in obstructive sleep

Hypnosis and Osteopathic Manipulative Treatment for Visual Disorders During Pregnancy: A Case Report.

Science.gov (United States)

Russo, Giancarlo; Remonato, Alessandro; Remonato, Roberto; Zanier, Emiliano

2017-01-01

Context • Pregnancy causes physiological alterations to the visual system, particularly in relation to retinal vascularization, with a consequent increase of intraocular pressure, and to the lacrimal fluid, with a consequent ocular dryness, which both can lead to a reduction in visual acuity. Numerous case reports refer to the employment of hypnotic treatment in cases of myopia, but the literature does not report any case of decreased visual acuity postpartum that was treated with hypnosis. Objective • For women with visual disorders that had appeared during pregnancy or were preexisting, the study intended to evaluate the benefits of treatment of the diaphragm by hypnotherapy and osteopathy to modify intracorporeal pressure and restore the women's visual function. Design • The research team performed a case study. Setting • The setting was a private osteopathic clinic. Participant • The participant was a 35-y-old woman lacking visual acuity postpartum. Intervention • The study took place during a period of 1 d. The participant first took part in a hypnotherapy session, the first intervention, and then participated in an osteopathic session, the second intervention. Outcome Measures • For the first evaluation of visual function at baseline, 3 tests were performed: (1) a visual acuity test; (2) a cover test for near and distance vision; and (3) a test for near point convergence. The visual function evaluation (all 3 tests) occurred after the 2 types of treatment (T1, T2). Finally, a visual function evaluation (all 3 tests) occurred at a follow-up session 1 mo after the end of treatment (T3). Results • The intervention produced a significant improvement in visual acuity, due to the multidisciplinary approach of treatment with hypnotherapy and osteopathy, and achieved a result that was maintained in the medium term. Conclusions • Hypnosis and osteopathy produced a significant improvement in visual acuity and the result was maintained in the medium

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.

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:…

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.

Integrating complementary/alternative medicine into primary care: evaluating the evidence and appropriate implementation

Directory of Open Access Journals (Sweden)

Wainapel SF

2015-12-01

Full Text Available Stanley F Wainapel,1 Stephanie Rand,1 Loren M Fishman,2 Jennifer Halstead-Kenny1 1The Arthur S Abramson Department of Physical Medicine and Rehabilitation, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, 2Department of Rehabilitation and Regenerative Medicine, College of Physicians and Surgeons, Columbia University, New York, NY, USA Abstract: The frequency with which patients utilize treatments encompassed by the term complementary/alternative medicine (CAM is well documented. A number of these therapies are beginning to be integrated into contemporary medical practice. This article examines three of them: osteopathic manipulation, yoga, and acupuncture, with a focus on their physiological effects, efficacy in treating medical conditions commonly encountered by practitioners, precautions or contraindications, and ways in which they can be incorporated into clinical practice. Physicians should routinely obtain information about use of CAM as part of their patient history and should consider their role based on physiological effects and clinical research results. Keywords: integrative medicine, osteopathic manipulation, yoga, acupuncture therapy

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.

The role of social networking web sites in influencing residency decisions.

Science.gov (United States)

Schweitzer, Justin; Hannan, Alexander; Coren, Joshua

2012-10-01

Social networking Web sites such as Facebook have grown rapidly in popularity. It is unknown how such sites affect the ways in which medical trainees investigate and interact with graduate medical education (GME) programs. To evaluate the use of social networking Web sites as a means for osteopathic medical students, interns, residents, and fellows to interact with GME programs and report the degree to which that interaction impacts a medical trainee's choice of GME program. An anonymous, 10-item electronic survey on social networking Web sites was e-mailed to osteopathic medical student, intern, resident, and fellow members of the American College of Osteopathic Family Physicians. The weighted least squares test and the Fisher exact test were used for data analysis. A total of 9606 surveys were distributed, and 992 (10%) were completed. Nine hundred twenty-eight (93%) of the respondents used social networking Web sites, with the most popular services being Facebook (891 [90%]; P=.03), the Student Doctor Network (278 [28%]), and LinkedIn (89 [9%]; P=.03). Three hundred fifty-three respondents (36%; P=.52) were connected with a professional organization and 673 (68%; P=.73) used social networking Web sites for job searching related to GME programs or postresidency employment. Within the population of 497 third-, fourth-, and fifth-year osteopathic medical students, 136 (27%) reported gleaning information about programs through social networking Web sites (P=.01). Within the total population, 100 of 992 (10%) reported that this information influenced their decisions (P=.07). Of note, 144 (14%) of the total 992 respondents reported that the programs they applied to did not have any presence on social networking Web sites (P=.05). Our results indicate that social networking Web sites have a present and growing influence on how osteopathic medical students, interns, residents, and fellows learn about and select a GME program.

Relationships between high-stakes clinical skills exam scores and program director global competency ratings of first-year pediatric residents

Science.gov (United States)

Langenau, Erik E.; Pugliano, Gina; Roberts, William L.

2011-01-01

Background Responding to mandates from the Accreditation Council for Graduate Medical Education (ACGME) and American Osteopathic Association (AOA), residency programs have developed competency-based assessment tools. One such tool is the American College of Osteopathic Pediatricians (ACOP) program directors’ annual report. High-stakes clinical skills licensing examinations, such as the Comprehensive Osteopathic Medical Licensing Examination Level 2-Performance Evaluation (COMLEX-USA Level 2-PE), also assess competency in several clinical domains. Objective The purpose of this study is to investigate the relationships between program director competency ratings of first-year osteopathic residents in pediatrics and COMLEX-USA Level 2-PE scores from 2005 to 2009. Methods The sample included all 94 pediatric first-year residents who took COMLEX-USA Level 2-PE and whose training was reviewed by the ACOP for approval of training between 2005 and 2009. Program director competency ratings and COMLEX-USA Level 2-PE scores (domain and component) were merged and analyzed for relationships. Results Biomedical/biomechanical domain scores were positively correlated with overall program director competency ratings. Humanistic domain scores were not significantly correlated with overall program director competency ratings, but did show moderate correlation with ratings for interpersonal and communication skills. The six ACGME or seven AOA competencies assessed empirically by the ACOP program directors’ annual report could not be recovered by principal component analysis; instead, three factors were identified, accounting for 86% of the variance between competency ratings. Discussion A few significant correlations were noted between COMLEX-USA Level 2-PE scores and program director competency ratings. Exploring relationships between different clinical skills assessments is inherently difficult because of the heterogeneity of tools used and overlap of constructs within the AOA

Relationships between high-stakes clinical skills exam scores and program director global competency ratings of first-year pediatric residents

Directory of Open Access Journals (Sweden)

Erik E. Langenau

2011-09-01

Full Text Available Responding to mandates from the Accreditation Council for Graduate Medical Education (ACGME and American Osteopathic Association (AOA, residency programs have developed competency-based assessment tools. One such tool is the American College of Osteopathic Pediatricians (ACOP program directors’ annual report. High-stakes clinical skills licensing examinations, such as the Comprehensive Osteopathic Medical Licensing Examination Level 2-Performance Evaluation (COMLEX-USA Level 2-PE, also assess competency in several clinical domains.The purpose of this study is to investigate the relationships between program director competency ratings of first-year osteopathic residents in pediatrics and COMLEX-USA Level 2-PE scores from 2005 to 2009.The sample included all 94 pediatric first-year residents who took COMLEX-USA Level 2-PE and whose training was reviewed by the ACOP for approval of training between 2005 and 2009. Program director competency ratings and COMLEX-USA Level 2-PE scores (domain and component were merged and analyzed for relationships.Biomedical/biomechanical domain scores were positively correlated with overall program director competency ratings. Humanistic domain scores were not significantly correlated with overall program director competency ratings, but did show moderate correlation with ratings for interpersonal and communication skills. The six ACGME or seven AOA competencies assessed empirically by the ACOP program directors’ annual report could not be recovered by principal component analysis; instead, three factors were identified, accounting for 86% of the variance between competency ratings.A few significant correlations were noted between COMLEX-USA Level 2-PE scores and program director competency ratings. Exploring relationships between different clinical skills assessments is inherently difficult because of the heterogeneity of tools used and overlap of constructs within the AOA and ACGME core competencies.

Contraceptive usage patterns in North American medical students

Science.gov (United States)

Rowen, Tami S.; Smith, James F.; Eisenberg, Michael L.; Breyer, Benjamin N.; Drey, Eleanor A.; Shindel, Alan W.

2013-01-01

Background Previous studies indicate that the sexual beliefs and mores of students in medical professions may influence their capacity to care for patients’ sexuality and contraception issues. Students also represent a large sample of reproductive-age individuals. In this study, we examined contraceptive usage patterns in North American medical students. Study Design Students using online medical student social and information networks enrolled in allopathic and osteopathic medical schools in North America between February and July of 2008 were invited to participate via email and published announcements in an Internet-based survey consisting of a questionnaire that assessed ethnodemographic factors, year in school and sexual history. We also collected information about current use of contraceptive and barrier methods. Descriptive statistics and logistic regression were utilized to analyze responses. Results Among our 2269 complete responses, at least one form of contraception was being utilized by 71% of men and 76% of women. Condoms were the most popular form of contraceptive, utilized by 1011 respondents (50% of men and 40% of women). Oral contraceptive pills were the contraceptive of choice for 34% of men and 41% of women. Decreased rates of contraception use were associated with being black or Asian, not being in a relationship and having more sexual dysfunction in female respondents. Students who reported comfort discussing sexual issues with patients were more likely to use effective contraceptive methods themselves. Ten percent of this of sexually active medical students was not currently using contraception. Conclusions There are significant differences in contraceptive use based on demographics, even at the highest education levels. The personal contraception choices of medical students may influence their ability to accurately convey information about contraception to their patients. In addition, medical students may personally benefit from improved

What millennial medical students say about flipped learning

Directory of Open Access Journals (Sweden)

Pettit RK

2017-07-01

Full Text Available Robin K Pettit, Lise McCoy, Marjorie Kinney School of Osteopathic Medicine in Arizona, A. T. Still University, Mesa, AZ, USA Abstract: Flipped instruction is gaining popularity in medical schools, but there are unanswered questions such as the optimum amount of the curriculum to flip and whether flipped sessions should be mandatory. We were in a unique position to evaluate feedback from first-year medical students who had experienced both flipped and lecture-based courses during their first semester of medical school. A key finding was that the students preferred a variety of different learning formats over an “all or nothing” learning format. Learning format preferences did not necessarily align with perceptions of which format led to better course exam performance. Nearly 70% of respondents wanted to make their own decisions regarding attendance. Candid responses to open-ended survey prompts reflected millennial preferences for choice, flexibility, efficiency, and the ability to control the pace of their learning, providing insight to guide ­curricular improvements. Keywords: flipped classroom, mandatory attendance, medical education, lecture-based, variety

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…

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.

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...

42 CFR 62.6 - How will individuals be selected to participate in the scholarship program?

Science.gov (United States)

2010-10-01

...) academic performance. (2) Special consideration will be given to (i) medical and osteopathic students who indicate their intention to enter family practice, internal medicine, pediatrics, or osteopathic general... this part for a period of 1 school year. (e) Continuation awards. Subject to the availability of funds...

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.

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

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...

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

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.

Doctors of Osteopathy Licensed in Washington.

Science.gov (United States)

Senters, Jo

Based on information gathered by the Health Manpower Project through a survey cosponsored with the Washington Osteopathic Medical Association, this report begins with a statement of philosophy of osteopathic medicine and proceeds to comment on where such professional education is available. Remarks on the type of educational background of the…

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

Directory of Open Access Journals (Sweden)

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.

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

[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.

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.

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.

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...

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.

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.

Time-variable medical education innovation in context

Directory of Open Access Journals (Sweden)

Stamy CD

2018-06-01

Full Text Available Christopher D Stamy,1 Christine C Schwartz,1 Danielle A Phillips,2 Aparna S Ajjarapu,3 Kristi J Ferguson,4,5 Debra A Schwinn6–8 1University of Iowa Carver College of Medicine, Iowa City, 2Des Moines University Osteopathic Medical Center, Des Moines, 3University of Iowa, 4Office of Consultation & Research in Medical Education, University of Iowa Carver College of Medicine, 5Department of Internal Medicine, 6Department of Anesthesia, 7Department of Biochemistry, 8Department of Pharmacology, University of Iowa Health Care, Iowa City, IA, USA Background: Medical education is undergoing robust curricular reform with several innovative models emerging. In this study, we examined current trends in 3-year Doctor of Medicine (MD education and place these programs in context. Methods: A survey was conducted among Deans of U.S. allopathic medical schools using structured phone interview regarding current availability of a 3-year MD pathway, and/or other variations in curricular innovation, within their institution. Those with 3-year programs answered additional questions. Results: Data from 107 institutions were obtained (75% survey response rate. The most common variation in length of medical education today is the accelerated 3-year pathway. Since 2010, 9 medical schools have introduced parallel 3-year MD programs and another 4 are actively developing such programs. However, the total number of students in 3-year MD tracks remains small (n=199 students, or 0.2% total medical students. Family medicine and general internal medicine are the most common residency programs selected. Benefits of 3-year MD programs generally include reduction in student debt, stability of guaranteed residency positions, and potential for increasing physician numbers in rural/underserved areas. Drawbacks include concern about fatigue/burnout, difficulty in providing guaranteed residency positions, and additional expense in teaching 2 parallel curricula. Four vignettes of

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.

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

The State of Disability Awareness in American Medical Schools.

Science.gov (United States)

Seidel, Erica; Crowe, Scott

2017-09-01

This study was designed to: (1) determine how many American medical schools include disability awareness in their curriculum, (2) explore the format of disability awareness programs in existence, and (3) understand why some schools do not include disability awareness in their curriculum. An online survey was sent to deans of medical education (or equivalent positions) at accredited allopathic and osteopathic American medical schools (N = 167) in 2015. Seventy-five schools (45%) completed surveys. Fifty-two percent (39/75) reported having a disability awareness program. The most common format was people with disabilities or caregivers speaking in a large group setting. Programs were most likely to focus on adults with physical disabilities. Among schools without a program, the top barriers were no one advocating for inclusion in the curriculum and time constraints. Nearly half of schools without a program expressed interest in adopting an awareness curriculum if one was made available. Such results indicate that efforts should be made to increase the number of schools that provide disability awareness education through increased advocacy and providing additional resources to schools without a curriculum.

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.

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.)

The Effect of Optimally Timed Osteopathic Manipulative Treatment on Length of Hospital Stay in Moderate and Late Preterm Infants: Results from a RCT

Directory of Open Access Journals (Sweden)

Gianfranco Pizzolorusso

2014-01-01

Full Text Available Introduction. Little research has been conducted looking at the effects of osteopathic manipulative treatment (OMT on preterm infants. Aim of the Study. This study hypothesized that osteopathic care is effective in reducing length of hospital stay and that early OMT produces the most pronounced benefit, compared to moderately early and late OMT. A secondary outcome was to estimate hospital cost savings by the use of OMT. Methods. 110 newborns ranging from 32- to 37-week gestation were randomized to receive either OMT or usual pediatric care. Early, moderately early, and late OMT were defined as <4, <9, and <14 days from birth, respectively. Result. Hospital stay was shorter in infants receiving late OMT (−2.03; 95% CI −3.15, −0.91; P<0.01 than controls. Subgroup analysis of infants receiving early and moderately early OMT resulted in shorter LOS (early OMT: −4.16; −6.05, −2.27; P<0.001; moderately early OMT: −3.12; −4.36, −1.89; P<0.001. Costs analysis showed that OMT significantly produced a net saving of €740 (−1309.54, −170.33; P=0.01 per newborn per LOS. Conclusions. This study shows evidence that the sooner OMT is provided, the shorter their hospital stay is. There is also a positive association of OMT with overall reduction in cost of care.

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

The Community Preceptor Crisis: Recruiting and Retaining Community-Based Faculty to Teach Medical Students-A Shared Perspective From the Alliance for Clinical Education.

Science.gov (United States)

Christner, Jennifer G; Dallaghan, Gary Beck; Briscoe, Gregory; Casey, Petra; Fincher, Ruth Marie E; Manfred, Lynn M; Margo, Katherine I; Muscarella, Peter; Richardson, Joshua E; Safdieh, Joseph; Steiner, Beat D

2016-01-01

Community-based instruction is invaluable to medical students, as it provides "real-world" opportunities for observing and following patients over time while refining history taking, physical examination, differential diagnosis, and patient management skills. Community-based ambulatory settings can be more conducive to practicing these skills than highly specialized, academically based practice sites. The Association of American Medical Colleges and other national medical education organizations have expressed concern about recruitment and retention of preceptors to provide high-quality educational experiences in community-based practice sites. These concerns stem from constraints imposed by documentation in electronic health records; perceptions that student mentoring is burdensome resulting in decreased clinical productivity; and competition between allopathic, osteopathic, and international medical schools for finite resources for medical student experiences. In this Alliance for Clinical Education position statement, we provide a consensus summary of representatives from national medical education organizations in 8 specialties that offer clinical clerkships. We describe the current challenges in providing medical students with adequate community-based instruction and propose potential solutions. Our recommendations are designed to assist clerkship directors and medical school leaders overcome current challenges and ensure high-quality, community-based clinical learning opportunities for all students. They include suggesting ways to orient community clinic sites for students, explaining how students can add value to the preceptor's practice, focusing on educator skills development, recognizing preceptors who excel in their role as educators, and suggesting forms of compensation.

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

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.

American Osteopathic Association

Science.gov (United States)

... help physicians and medical students determine which practice style might fit best with their personality and desires. TAKE THE QUIZ Focus on Leadership Jan. 25-26 in Austin: Gather with leaders ...

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...

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.

Osteopathic Manipulative Treatment

Science.gov (United States)

... this site from a secured browser on the server. Please enable scripts and reload this page. Physicians ... Media Center The DO JAOA AOA Health Watch Professional Development AOA Board Certification Continuing Medical Education Research ...

[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.

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

Lesbian, gay, bisexual, and transgender-related content in undergraduate medical education.

Science.gov (United States)

Obedin-Maliver, Juno; Goldsmith, Elizabeth S; Stewart, Leslie; White, William; Tran, Eric; Brenman, Stephanie; Wells, Maggie; Fetterman, David M; Garcia, Gabriel; Lunn, Mitchell R

2011-09-07

Lesbian, gay, bisexual, and transgender (LGBT) individuals experience health and health care disparities and have specific health care needs. Medical education organizations have called for LGBT-sensitive training, but how and to what extent schools educate students to deliver comprehensive LGBT patient care is unknown. To characterize LGBT-related medical curricula and associated curricular development practices and to determine deans' assessments of their institutions' LGBT-related curricular content. Deans of medical education (or equivalent) at 176 allopathic or osteopathic medical schools in Canada and the United States were surveyed to complete a 13-question, Web-based questionnaire between May 2009 and March 2010. Reported hours of LGBT-related curricular content. Of 176 schools, 150 (85.2%) responded, and 132 (75.0%) fully completed the questionnaire. The median reported time dedicated to teaching LGBT-related content in the entire curriculum was 5 hours (interquartile range [IQR], 3-8 hours). Of the 132 respondents, 9 (6.8%; 95% CI, 2.5%-11.1%) reported 0 hours taught during preclinical years and 44 (33.3%; 95% CI, 25.3%-41.4%) reported 0 hours during clinical years. Median US allopathic clinical hours were significantly different from US osteopathic clinical hours (2 hours [IQR, 0-4 hours] vs 0 hours [IQR, 0-2 hours]; P = .008). Although 128 of the schools (97.0%; 95% CI, 94.0%-99.9%) taught students to ask patients if they "have sex with men, women, or both" when obtaining a sexual history, the reported teaching frequency of 16 LGBT-specific topic areas in the required curriculum was lower: at least 8 topics at 83 schools (62.9%; 95% CI, 54.6%-71.1%) and all topics at 11 schools (8.3%; 95% CI, 3.6%-13.0%). The institutions' LGBT content was rated as "fair" at 58 schools (43.9%; 95% CI, 35.5%-52.4%). Suggested successful strategies to increase content included curricular material focusing on LGBT-related health and health disparities at 77 schools (58

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.

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...

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

Science.gov (United States)

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

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.

[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.

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...

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.

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.

Addressing the primary care physician shortage in an evolving medical workforce

Directory of Open Access Journals (Sweden)

Lakhan Shaheen E

2009-05-01

Full Text Available Abstract Background Primary care physicians have been shown to play an important role in the general health of the communities in which they serve. In spite of their importance, however, there has been a decrease in the number of physicians interested in pursuing primary care fields, while the proportion of specialists continues to increase. The prediction of an overall physician shortage only augments this issue in the US, where this uneven distribution is particularly evident. As such, serious effort to increase the number of practicing primary care physicians is both necessary and beneficial for meeting this country's health care needs. Discussion There are several factors at play which contribute to the decrease in the number of practicing physicians in primary specialties. Lifestyle concerns, such as schedule and income, as well as the lack of prestige associated with this field seem to be among the most prevalent reasons cited for the diminishing interest. Multifaceted concerns such as these, however, are difficult to adequately invalidate; doing so would not only require a great deal research, but also a good deal of time – a resource which is in short supply given the current physician shortage being faced. Thus, a more immediate solution may lie in the increased recruitment and continued support of those individuals who are already associated with primary care service. This is particularly relevant given the Association of American Medical College's goal of increasing medical school enrollment by 15% over the next 10 years. Several groups have been shown to be large contributors to primary care in the US. Here, we focus on three such groups: minority students, International Medical Graduates (IMGs and Osteopathic Physicians (DOs. Although these groups are highly diverse individually, they all share the distinction of being underutilized in regard to the current primary care shortages faced. Thus, through more fully accentuating these

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.

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

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)

[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).

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

Investigation of four self-report instruments (FABT, TSK-HC, Back-PAQ, HC-PAIRS) to measure healthcare practitioners' attitudes and beliefs toward low back pain: Reliability, convergent validity and survey of New Zealand osteopaths and manipulative physiotherapists.

Science.gov (United States)

Moran, Robert W; Rushworth, Wendy M; Mason, Jesse

2017-12-01

Healthcare practitioner beliefs influence advice and management provided to patients with back pain. Several instruments measuring practitioner beliefs have been developed but psychometric properties for some have not been investigated. To investigate internal consistency, test-retest reliability and convergent validity of the Fear Avoidance Beliefs Tool (FABT), the Tampa Scale of Kinesiophobia for Health Care Providers (TSK-HC), the Back Pain Attitudes Questionnaire (Back-PAQ), and the Health Care Pain and Impairment Relationship Scale (HC-PAIRS). A secondary aim was to explore beliefs of New Zealand osteopaths and physiotherapists regarding low back pain. FABT, TSK-HC, Back-PAQ, and HC-PAIRS were administered twice, 14 days apart. Data from 91 osteopaths and 35 physiotherapists were analysed. The FABT, TSK-HC and Back-PAQ each demonstrated excellent internal consistency, (Cronbach's α = 0.92, 0.91, and 0.91 respectively), and excellent test-retest reliability (lower limit of 95% CI for intraclass correlation coefficient >0.75). Correlations between instruments (Pearson's r = 0.51 to 0.77, p  0.47) for mean differences in scores, for all instruments, between professions. This study found excellent internal consistency, test-retest reliability and good convergent validity for the FABT, TSK-HC, and Back-PAQ. Previously reported internal consistency, test-retest and convergent validity of the HC-PAIRS were confirmed, and test-retest reliability was excellent. There were significant scoring differences on each instrument between professions, and while both groups demonstrated fear avoidant beliefs, physiotherapist respondent scores indicated that as a group, they held fewer fear-avoidant beliefs than osteopath respondents. Copyright © 2017 Elsevier Ltd. All rights reserved.

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.

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.

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)

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

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.

[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.

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.

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…

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.

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.)

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.

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)

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)

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...

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)

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)

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.

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.)

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)

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)

42 CFR 60.50 - Which schools are eligible to be HEAL schools?

Science.gov (United States)

2010-10-01

... Medical Education. (B) American Osteopathic Association. (C) Commission on Dental Accreditation. (D) Council on Education of American Veterinary Medical Association. (E) Council on Optometric Education. (F... for Health Services Administration. (K) Committee on Accreditation of American Psychological...

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.

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

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.

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...

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.

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

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.

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.

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.

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

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...

A systematic review of service-learning in medical education: 1998-2012.

Science.gov (United States)

Stewart, Trae; Wubbena, Zane C

2015-01-01

PHENOMENON: In the United States, the Affordable Care Act has increased the need for community-centered pedagogy for medical education such as service-learning, wherein students connect academic curriculum and reflections to address a community need. Yet heterogeneity among service-learning programs suggests the need for a framework to understand variations among service-learning programs in medical education. A qualitative systematic review of literature on service-learning and medical education was conducted for the period between 1998 and 2012. A two-stage inclusion criteria process resulted in articles (n = 32) on service-learning and Doctor of Medicine or Doctor of Osteopathic Medicine being included for both coding and analysis. Focused and selective coding were employed to identify recurring themes and subthemes from the literature. The findings of the qualitative thematic analysis of service-learning variation in medical education identified a total of seven themes with subthemes. The themes identified from the analysis were (a) geographic location and setting, (b) program design, (c) funding, (d) participation, (e) program implementation, (f) assessment, and (g) student outcomes. Insights: This systematic review of literature confirmed the existence of program heterogeneity among service-learning program in medical education. However, the findings of this study provide key insights into the nature of service-learning in medical education building a framework for which to organize differences among service-learning programs. A list of recommendations for future areas of inquiry is provided to guide future research.

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...

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...

Libraries in New Jersey: MedlinePlus

Science.gov (United States)

... deborah.org/ Camden Cooper University Hospital Cooper Medical School of Rowan University Library 1 Cooper Plaza Camden, NJ 08103 856-342- ... 8285 http://www.valleyhealth.com Stratford Rowan University School of Osteopathic Medicine ... Library 1 Medical Center Drive Stratford, NJ 08084-1504 ...

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.

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.

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

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

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

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.

[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.

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.

Professional ballet dancers' experience of injury and osteopathic treatment in the UK: A qualitative study.

Science.gov (United States)

Pollard-Smith, Tobias; Thomson, Oliver P

2017-01-01

Professional dancers suffer significant musculoskeletal injuries during the course of their careers. Treatment-seeking behaviour is important in all patient populations, yet is rarely investigated amongst professional dancers. This qualitative study aimed to form a better understanding of how dancers decide to seek treatment, and in particular to explore their experiences of receiving osteopathic care for their injuries. A qualitative study design using grounded theory was used as a methodological framework for data collection and analysis. Semi-structured interviews were used to explore professional dancers' experience of injury and decision-making to seek professional healthcare. Five themes were constructed that explain and describe dancers' experience of injuries and their views and perspectives of treatment, these were; the growing dancer, the fear factor, learning to cope, effective treatment, and returning autonomy. The personal development of each dancer consisted of an amalgam of internal and external pressures. These pressures combine with experiences of pain and injury to influence a dancer's decision-making behaviour when injured and deciding to seek treatment. The study also provide factors relevant in the effective treatment of dancers, and outlined participants' preference for a global physical approach to assessment and treatment of their musculoskeletal pain. Copyright © 2016 Elsevier Ltd. All rights reserved.

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.

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.

Perceptions of University Mission Statement and Person-Environment Fit by Osteopathic Medical School Faculty and Staff

Science.gov (United States)

Poppre, Beth Anne Edwards

2017-01-01

Understanding how university medical school faculty and staff perceive the institution's mission statement, in conjunction with their person-environment fit, can provide administration with useful insight into: employee's match to the institution's mission statement, employee level of organizational commitment, and reasons for retention. This…

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.

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

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)

The Internet School of Medicine: use of electronic resources by medical trainees and the reliability of those resources.

Science.gov (United States)

Egle, Jonathan P; Smeenge, David M; Kassem, Kamal M; Mittal, Vijay K

2015-01-01

Electronic sources of medical information are plentiful, and numerous studies have demonstrated the use of the Internet by patients and the variable reliability of these sources. Studies have investigated neither the use of web-based resources by residents, nor the reliability of the information available on these websites. A web-based survey was distributed to surgical residents in Michigan and third- and fourth-year medical students at an American allopathic and osteopathic medical school and a Caribbean allopathic school regarding their preferred sources of medical information in various situations. A set of 254 queries simulating those faced by medical trainees on rounds, on a written examination, or during patient care was developed. The top 5 electronic resources cited by the trainees were evaluated for their ability to answer these questions accurately, using standard textbooks as the point of reference. The respondents reported a wide variety of overall preferred resources. Most of the 73 responding medical trainees favored textbooks or board review books for prolonged studying, but electronic resources are frequently used for quick studying, clinical decision-making questions, and medication queries. The most commonly used electronic resources were UpToDate, Google, Medscape, Wikipedia, and Epocrates. UpToDate and Epocrates had the highest percentage of correct answers (47%) and Wikipedia had the lowest (26%). Epocrates also had the highest percentage of wrong answers (30%), whereas Google had the lowest percentage (18%). All resources had a significant number of questions that they were unable to answer. Though hardcopy books have not been completely replaced by electronic resources, more than half of medical students and nearly half of residents prefer web-based sources of information. For quick questions and studying, both groups prefer Internet sources. However, the most commonly used electronic resources fail to answer clinical queries more than half

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

Directory of Open Access Journals (Sweden)

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

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.

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

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

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.

Using standardized patients to assess the communication skills of graduating physicians for the comprehensive osteopathic medical licensing examination (COMLEX) level 2-performance evaluation (level 2-PE).

Science.gov (United States)

Weidner, Angela C; Gimpel, John R; Boulet, John R; Solomon, Mia

2010-01-01

Standardized patients can be trained to assess the communication and interpersonal skills of medical students and graduates. The purpose of this study is to present data to support the psychometric adequacy of the communication ratings provided by standardized patients. Using the data from testing of 3, 450 examinees over a 1-year period, a number of psychometric analyses were undertaken. These included a variance component analysis, the calculation of various validity coefficients, the comparison of communication ratings for select examinee cohorts and case characteristics, and the investigation of some potential sources of score invalidity. Communication skills scores are moderately correlated to other competencies (knowledge, skills) and may be influenced by candidate characteristics such as gender and English language proficiency. They are not dependant on the age of the examinees, the clinical case content, or the gender of the standardized patients. For a multistation assessment, a reasonably precise and valid estimate of a candidate's communication ability can be obtained from trained standardized patients.

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

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.

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

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.

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.

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

Science.gov (United States)

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).

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

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.

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.

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.

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.

Lesbian, Gay, Bisexual, and Transgender Patient Care: Medical Students' Preparedness and Comfort.

Science.gov (United States)

White, William; Brenman, Stephanie; Paradis, Elise; Goldsmith, Elizabeth S; Lunn, Mitchell R; Obedin-Maliver, Juno; Stewart, Leslie; Tran, Eric; Wells, Maggie; Chamberlain, Lisa J; Fetterman, David M; Garcia, Gabriel

2015-01-01

Phenomenon: Lesbian, gay, bisexual, and transgender (LGBT) individuals face significant barriers in accessing appropriate and comprehensive medical care. Medical students' level of preparedness and comfort caring for LGBT patients is unknown. An online questionnaire (2009-2010) was distributed to students (n = 9,522) at 176 allopathic and osteopathic medical schools in Canada and the United States, followed by focus groups (2010) with students (n = 35) at five medical schools. The objective of this study was to characterize LGBT-related medical curricula, to determine medical students' assessments of their institutions' LGBT-related curricular content, and to evaluate their comfort and preparedness in caring for LGBT patients. Of 9,522 survey respondents, 4,262 from 170 schools were included in the final analysis. Most medical students (2,866/4,262; 67.3%) evaluated their LGBT-related curriculum as "fair" or worse. Students most often felt prepared addressing human immunodeficiency virus (HIV; 3,254/4,147; 78.5%) and non-HIV sexually transmitted infections (2,851/4,136; 68.9%). They felt least prepared discussing sex reassignment surgery (1,061/4,070; 26.1%) and gender transitioning (1,141/4,068; 28.0%). Medical education helped 62.6% (2,669/4,262) of students feel "more prepared" and 46.3% (1,972/4,262) of students feel "more comfortable" to care for LGBT patients. Four focus group sessions with 29 students were transcribed and analyzed. Qualitative analysis suggested students have significant concerns in addressing certain aspects of LGBT health, specifically with transgender patients. Insights: Medical students thought LGBT-specific curricula could be improved, consistent with the findings from a survey of deans of medical education. They felt comfortable, but not fully prepared, to care for LGBT patients. Increasing curricular coverage of LGBT-related topics is indicated with emphasis on exposing students to LGBT patients in clinical settings.

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…

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...

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.

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.

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.

Renal epithelioid angiomyolipoma presenting clinically as renal cell ...

African Journals Online (AJOL)

M.S. Johnson

a Detroit Medical Center, Michigan State University School of Osteopathic Medicine, Detroit, MI, USA .... Immunohistochemically, the tumor cells stained strongly positive .... [10] Cao Q, Liu F, Xiao P, Tian X, Li B, Li Z. Coexistence of renal.

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.)

Medical Student Sexuality: How Sexual Experience and Sexuality Training Impact U.S. and Canadian Medical Students’ Comfort in Dealing with Patients’ Sexuality in Clinical Practice

Science.gov (United States)

Shindel, Alan W.; Ando, Kathryn A.; Nelson, Christian J.; Breyer, Benjamin N.; Lue, Tom F.; Smith, James F.

2013-01-01

Purpose To determine factors associated with students’ comfort in addressing patients’ sexuality in the clinical context. Method The authors invited students enrolled in MD-degree-granting and osteopathic medical schools in the United States and Canada to participate in an anonymous Internet survey between February and July 2008. The survey assessed ethnodemographic factors and sexual history. Respondents also completed the Center for Epidemiologic Studies Depression Scale. Male respondents completed the International Index of Erectile Function and the Premature Ejaculation Diagnostic Tool. Female respondents completed the Female Sexual Function Index and the Index of Sex Life. The authors used descriptive statistics, ANOVA, and multivariable logistic regression to analyze responses. Results The authors’ analyses included 2,261 completed survey responses: 910 from men, 1,343 from women, and 8 from individuals who self-identified as “other” gendered. Over 53% of respondents (n = 1,206) stated that they felt they had not received sufficient training in medical school to address sexual concerns clinically. Despite this, 81% of students (n = 1,827) reported feeling comfortable dealing with their patients’ sexuality issues. Students with limited sexual experience, students at risk for sexual problems, and students who felt that they had not been trained adequately were less likely to report being comfortable talking to patients about sexual health issues. Conclusions Perception of inadequate sexuality training in medical school and personal issues pertaining to sex may be associated with students’ difficulty in addressing patients’ sexuality. Adequate training is preeminently associated with feeling comfortable addressing patients’ sexuality and should be a priority for medical education. PMID:20671459

Medical student sexuality: how sexual experience and sexuality training impact U.S. and Canadian medical students' comfort in dealing with patients' sexuality in clinical practice.

Science.gov (United States)

Shindel, Alan W; Ando, Kathryn A; Nelson, Christian J; Breyer, Benjamin N; Lue, Tom F; Smith, James F

2010-08-01

To determine factors associated with students' comfort in addressing patients' sexuality in the clinical context. The authors invited students enrolled in MD-degree-granting and osteopathic medical schools in the United States and Canada to participate in an anonymous Internet survey between February and July 2008. The survey assessed ethnodemographic factors and sexual history. Respondents also completed the Center for Epidemiologic Studies Depression Scale. Male respondents completed the International Index of Erectile Function and the Premature Ejaculation Diagnostic Tool. Female respondents completed the Female Sexual Function Index and the Index of Sex Life. The authors used descriptive statistics, ANOVA, and multivariable logistic regression to analyze responses. The authors' analyses included 2,261 completed survey responses: 910 from men, 1,343 from women, and 8 from individuals who self-identified as "other" gendered. Over 53% of respondents (n = 1,206) stated that they felt they had not received sufficient training in medical school to address sexual concerns clinically. Despite this, 81% of students (n = 1,827) reported feeling comfortable dealing with their patients' sexuality issues. Students with limited sexual experience, students at risk for sexual problems, and students who felt that they had not been trained adequately were less likely to report being comfortable talking to patients about sexual health issues. Perception of inadequate sexuality training in medical school and personal issues pertaining to sex may be associated with students' difficulty in addressing patients' sexuality. Adequate training is preeminently associated with feeling comfortable addressing patients' sexuality and should be a priority for medical education.

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...

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

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.

Incidence of concussions in youth ice hockey players

OpenAIRE

Linzmeier, Kathleen A.; LaBella, Cynthia R.

2016-01-01

Investigators from the University of Pittsburg, University of Arkansas, Lake Erie College of Osteopathic Medicine, and Boston Children’s Hospital/Harvard Medical College researched the incidence of concussions in youth hockey in relation to age and activity setting.

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...

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...

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.

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.

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.

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.)

The journal 'chiropractic & osteopathy' changes its title to 'chiropractic & manual therapies'. a new name, a new era

Directory of Open Access Journals (Sweden)

Walker Bruce F

2011-01-01

Full Text Available Abstract Chiropractic & Osteopathy changes its title to Chiropractic & Manual Therapies in January 2011. This change reflects the expanding base of submissions from clinical scientists interested in the discipline of manual therapy. It is also in accord with the findings of a review of the journal content and a joint venture between the original parent organisation the Chiropractic and Osteopathic College of Australasia and a new partner the European Academy of Chiropractic, which is a subsidiary body of the European Chiropractors' Union. The title change should encourage submissions from all professionals interested in manual therapy including chiropractors, osteopaths, physiotherapists, medical doctors and scientists interested in this field.

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

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)

Concussions in Collision Youth Sports

Directory of Open Access Journals (Sweden)

Kathleen A. Linzmeier

2016-03-01

Full Text Available Investigators from the University of Pittsburg, University of Arkansas, Lake Erie College of Osteopathic Medicine, and Boston Children’s Hospital/Harvard Medical College researched the incidence of concussions in youth hockey in relation to age and activity setting.

Afican Health Sciences Vol 9 No 2.pmd

African Journals Online (AJOL)

Administrator

Seizure activity and neurological sequelae in Ugandan children who ... and Child Health, Mulago Hospital/Makerere University Medical School, ... Program, College of Osteopathic Medicine, Michigan State University, East .... incorporating a checklist of material possessions, quality ... Nutrition (weight for age z-score).

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.

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.

Osteopathic Medicine: What is a DO?

Science.gov (United States)

... this site from a secured browser on the server. Please enable scripts and reload this page. Physicians ... Media Center The DO JAOA AOA Health Watch Professional Development AOA Board Certification Continuing Medical Education Research ...

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

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.

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

Pass/fail patterns of candidates who failed COMLEX-USA level 2-PE because of misrepresentation of clinical findings on postencounter notes.

Science.gov (United States)

Langenau, Erik E; Sandella, Jeanne M

2011-07-01

In 2007, The National Board of Osteopathic Medical Examiners (NBOME) instituted a policy to address the accuracy and integrity of postencounter written documentation recorded during the Comprehensive Osteopathic Medical Licensing Examination Level 2-Performance Evaluation (COMLEX-USA Level 2-PE). This policy was instituted not only to protect the integrity of the examination, but also to highlight that overdocumentation of clinical findings not obtained during patient encounters may jeopardize patient safety. To investigate overall and domain pass/fail patterns of candidates who misrepresented clinical findings with regard to past and subsequent performance on COMLEX-USA Level 2-PE. Specifically, to investigate what percentage of candidates failed because of misrepresentation on first attempts and how they performed on subsequent administrations, as well as the previous performance patterns of candidates who failed because of misrepresentation on examination retakes. Historical records from NBOME's COMLEX-USA Level 2-PE database (testing cycles 2007-2008, 2008-2009, and 2009-2010) were used to analyze overall and domain pass/fail patterns of candidates who failed at least once because of misrepresentation of clinical findings. Of the 24 candidates who failed because of misrepresentation of postencounter (SOAP) notes, 20 candidates (83%) were first-time examinees. Four candidates (17%) were repeating the examination, 2 of whom were making a third attempt to pass. Among these 20 candidates who failed because of misrepresentation of clinical findings on their first attempt, 19 passed on their next attempt. At the time of study analysis, all but 2 candidates eventually passed the examination in subsequent attempts. Among candidates found to have misrepresented clinical findings on postencounter written documentation on COMLEX-USA Level 2-PE, no pattern existed between their past or subsequent performance with regard to overall or domain pass/fail results. The vast

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.)

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

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.

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.

Pain research in complementary and alternative medicine in Australia: a critical review.

Science.gov (United States)

Zheng, Zhen; Xue, Charlie C L

2013-02-01

Sixty percent (60%) to 80% of patients who visit chiropractic, osteopathic, or Chinese medicine practitioners are seeking pain relief. This article aimed to identify the amount, quality, and type of complementary and alternative medicine (CAM) pain research in Australia by systematically and critically reviewing the literature. PubMed, Scopus, Australasian Medical Index, and Cochrane library were searched from their inception to July 2009. Australian and New Zealand Clinical Trial Registration and National Health and Medical Research Council databases were searched for human studies yet to be completed. Predefined search terms and selection criteria were used for data identification. Of 204 studies selected, 54% were on chiropractic, 27% on Chinese medicine, 15% about multitherapy, and 4% on osteopathy. Chronic spinal pain was the most studied condition, with visceral pain being the least studied. Half of the articles in Chinese medicine or multitherapy were systematic reviews or randomized control trials. In comparison, only 5% of chiropractic and none of osteopathy studies were in these categories. Government funding was rare, and most studies were self-funded or internally funded. All chiropractic, osteopathic, and Chinese herbal medicine studies were conducted by the researchers of the professions. In contrast, half of the acupuncture studies and all t'ai chi studies were conducted by medical doctors or physiotherapists. Multidisciplinary collaboration was uncommon. The quantity and the quality of CAM pain research in Australia are inconsistent with the high utilization of the relevant CAM therapies by Australians. A substantial increase in government funding is required. Collaborative research examining the multimodality or multidisciplinary approach is needed.

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

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.

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

Thermography Examination of Abdominal Area Skin Temperatures in Individuals With and Without Focal-Onset Epilepsy.

Science.gov (United States)

King, Hollis H; Cayce, Charles Thomas; Herrin, Jeph

Early osteopathic theory and practice, and the work of the medical intuitive Edgar Cayce suggested that the abdominal areas of individuals with epilepsy would manifest "cold spots." The etiology for this phenomenon was thought to be abdominal adhesions caused by inflammation and viscero-somatic reflexes caused by adhesions or injury to visceral or musculoskeletal system structures. Indeed, until that advent of electroencephalography in the 1930s, medical practice regarding epilepsy focused on abdominal neural and visceral structures. Following two hypotheses were formulated to evaluate any abdominal temperature phenomena: (1) an abdominal quadrant division analysis would find one or more quadrants "colder" in the focal-onset epilepsy group (ICD9-CM 345.4 and 345.5) compared to controls. (2) Total abdominal areas of individuals with focal-onset epilepsy wound be colder than a control group. Overall, 50 patients with the diagnosis of focal-onset epilepsy were recruited from the office of the Epilepsy Foundation of Florida and 50 control subjects with no history of epilepsy were recruited through advertising to the public. Under controlled room conditions all subjects had infrared thermographic images made and recorded by Med-Hot Model MH-731 FLIR equipment. There were no significant demographic difference between experimental patients and control subjects, though the control group tended to be younger and more often male; however, these were controlled for in all analyses. In the quadrant analysis, there were significant differences in that more epileptic patients had colder left upper abdominal quadrant temperatures than the control group (66.8% versus 44.9%; P = .030). In the total abdominal analysis, however, there were no significant differences. The results support the hypothesis that individuals with focal-onset epilepsy have colder abdominal areas. If substantiated in further research, present study results will require further examination of the mechanisms of

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.

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

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.

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

The family medicine curriculum resource project structural framework.

Science.gov (United States)

Stearns, Jeffrey A; Stearns, Marjorie A; Davis, Ardis K; Chessman, Alexander W

2007-01-01

In the original contract for the Family Medicine Curricular Resource Project (FMCRP), the Health Resources and Services Administration (HRSA), Division of Medicine and Dentistry, charged the FMCRP executive committee with reviewing recent medical education reform proposals and relevant recent curricula to develop an analytical framework for the project. The FMCRP executive and advisory committees engaged in a review and analysis of a variety of curricular reform proposals generated during the last decade of the 20th century. At the same time, in a separate and parallel process, representative individuals from all the family medicine organizations, all levels of learners, internal medicine and pediatric faculty, and the national associations of medical and osteopathic colleges (Association of American Medical Colleges and the American Association of Colleges of Osteopathic Medicine) were involved in group discussions to identify educational needs for physicians practicing in the 21st century. After deliberation, a theoretical framework was chosen for this undergraduate medical education resource that mirrors the Accreditation Council for Graduate Medical Education (ACGME) competencies, a conceptual design originated for graduate medical education. In addition to reflecting the current environment calling for change and greater accountability in medical education, use of the ACGME competencies as the theoretical framework for the FMCR provides a continuum of focus between the two major segments of physician education: medical school and residency.

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.)

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.

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.

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.

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.

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.

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.

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...

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...

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

Expert Systems Based Clinical Assessment and Tutorial Project.

Science.gov (United States)

Papa, Frank; Shores, Jay

This project at the Texas College of Osteopathic Medicine (Fort Worth) evaluated the use of an artificial-intelligence-derived measure, "Knowledge-Based Inference Tool" (KBIT), as the basis for assessing medical students' diagnostic capabilities and designing instruction to improve diagnostic skills. The instrument was designed to…

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.

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

Blended Learning Educational Format for Third-Year Pediatrics Clinical Rotation.

Science.gov (United States)

Langenau, Erik E; Lee, Robert; Fults, Marci

2017-04-01

Traditional medical education is shifting to incorporate learning technologies and online educational activities with traditional face-to-face clinical instruction to engage students, especially at remote clinical training sites. To describe and evaluate the effectiveness of the blended learning format (combining online and face-to-face instruction) for third-year osteopathic medical students during their pediatric rotation. Third-year medical students who completed the 4-week clerkship in pediatrics during the 2014-2015 academic year were divided into a standard learning group and a blended learning group with online activities (discussion boards, blogs, virtual patient encounters, narrated video presentations, and online training modules). Comprehensive Osteopathic Medical Achievement Test scores and final course grades were compared between the standard learning and blended learning groups. Students in the blended learning group completed a postsurvey regarding their experiences. Of 264 third-year students who completed the 4-week clerkship in pediatrics during the 2014-2015 academic year, 78 (29.5%) participated in the blended learning supplement with online activities. Of 53 students who completed the postsurvey in the blended learning group, 44 (83.0%) agreed or strongly agreed that "The integration of e-learning and face-to-face learning helped me learn pediatrics." Open-ended comments supported this overall satisfaction with the course format; however, 26 of 100 comments reflected a desire to increase the amount of clinical exposure and face-to-face time with patients. No statistical differences were seen between the standard learning (n=186) and blended learning (n=78) groups with regard to Comprehensive Osteopathic Medical Achievement Test scores (P=.321). Compared with the standard learning group, more students in the blended learning group received a final course grade of honors (P=.015). Results of this study support the use of blended learning in a

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).

International Medical Graduates in Radiation Oncology: Historical Trends and Comparison With Other Medical Specialties

Energy Technology Data Exchange (ETDEWEB)

Verma, Vivek, E-mail: vivek333@gmail.com [Department of Radiation Oncology, University of Nebraska Medical Center, Omaha, Nebraska (United States); Shah, Chirag [Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio (United States); Lautenschlaeger, Tim [Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, Indiana (United States); Lin, Chi [Department of Radiation Oncology, University of Nebraska Medical Center, Omaha, Nebraska (United States); Beriwal, Sushil [Department of Radiation Oncology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (United States); Zhen, Weining [Department of Radiation Oncology, University of Nebraska Medical Center, Omaha, Nebraska (United States); Mehta, Minesh P. [Department of Radiation Oncology, Miami Cancer Institute, Coral Gables, Florida (United States); Zietman, Anthony L. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States)

2016-07-15

Purpose: This is the first National Resident Matching Program analysis evaluating historical patterns of international medical graduates (IMGs) in radiation oncology (RO) and providing comparison with American (MD) medical graduates (AMGs), osteopathic students (DOs), unfilled positions, and other specialties. Methods and Materials: National Resident Matching Program data for IMGs were available from 2003 to 2015, with limited data for other specialty matches. The following RO-specific figures were obtained per year: total positions available; total matched positions; number of unfilled positions; and number of IMG, AMG, and DO matches. In addition, the number of IMG matches and total matched positions were obtained for 19 other specialties. Fisher exact tests and χ{sup 2} tests were considered significant at α <.05. Results: From 2010 to 2015, 0.8% of RO matches were IMGs, a decline from 2.4% in 2003 to 2009 (P=.006). Proportions of DO matches during these intervals increased by 40% (from 1.0% to 1.4%), significantly lower than IMGs for 2003 to 2009 (P=.03) but not 2010 to 2015 (P=.26). From 2003 to 2015, the percentage of IMG matches, at 1.5%, was significantly lower than the percentage of unfilled seats, at 3.5% (P<.001). In comparison with other specialties (2003-2015), RO had the fewest IMG matches (1.5%), followed by otolaryngology (1.9%) and orthopedics (2.2%); specialties with the highest IMG proportions were internal medicine (37.1%), family medicine (35.7%), and neurology (31.1%). Conclusions: Presently, IMGs represent <1% of RO matches, the lowest among major specialties. There are several speculative factors associated with this low proportion. There are significantly more unfilled positions than those filled by IMGs; programs at risk of not matching could weigh the advantages and disadvantages of interviewing IMGs.

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.)

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.).

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.

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

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.)

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.).

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.

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

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

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.

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.

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.

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.

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

"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.

Evaluating medical student engagement during virtual patient simulations: a sequential, mixed methods study.

Science.gov (United States)

McCoy, Lise; Pettit, Robin K; Lewis, Joy H; Allgood, J Aaron; Bay, Curt; Schwartz, Frederic N

2016-01-16

Student engagement is an important domain for medical education, however, it is difficult to quantify. The goal of this study was to investigate the utility of virtual patient simulations (VPS) for increasing medical student engagement. Our aims were specifically to investigate how and to what extent the VPS foster student engagement. This study took place at A.T. Still University School of Osteopathic Medicine in Arizona (ATSU-SOMA), in the USA. First year medical students (n = 108) worked in teams to complete a series of four in-class virtual patient case studies. Student engagement was measured, defined as flow, interest, and relevance. These dimensions were measured using four data collection instruments: researcher observations, classroom photographs, tutor feedback, and an electronic exit survey. Qualitative data were analyzed using a grounded theory approach. Triangulation of findings between the four data sources indicate that VPS foster engagement in three facets: 1) Flow. In general, students enjoyed the activities, and were absorbed in the task at hand. 2) Interest. Students demonstrated interest in the activities, as evidenced by enjoyment, active discussion, and humor. Students remarked upon elements that caused cognitive dissonance: excessive text and classroom noise generated by multi-media and peer conversations. 3) Relevance. VPS were relevant, in terms of situational clinical practice, exam preparation, and obtaining concrete feedback on clinical decisions. Researchers successfully introduced a new learning platform into the medical school curriculum. The data collected during this study were also used to improve new learning modules and techniques associated with implementing them in the classroom. Results of this study assert that virtual patient simulations foster engagement in terms of flow, relevance, and interest.

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

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.

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.

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.

Osteopathic manipulative treatment results in sustained relief from spinal pain in older patients: A pilot crossover study

Directory of Open Access Journals (Sweden)

Pannunzio A

2016-01-01

Full Text Available Osteopathic Manipulative Treatment is commonly used to complement conventional treatment of back pain. The present study verified whether OMT, associated with training program, reduces spinal pain in older. A pilot randomized, double-blind crossover study was conducted at Sport Association of Milan, Italy. We recruited 19 subjects above 60 years old, with presence of SP for more than 3 weeks and with intensity score higher than 3 (NRS score. All patients underwent a multi-component group exercise program for older adults and were randomized in two groups: in the study group (SG OMT was added, while the control group (CG continued with the exercise only. After 6 weeks a crossover was applied to the 2 groups and OMT was added to CG, while SG continued with the exercise only. Self-reported measures: the Numeric Rating Scale (NRS was used at each time to evaluate treatment outcomes. At pre-crossover, SG had a significant improvement in pain perception (p<0.05, while CG had a not significate improvement in pain perception (p=0.33.At post-crossover, the SG remains relatively stable (p=0.37, while CG after OMT addition have a significant benefit on pain perception (p=0.001. At follow-up, pain improvement is sustained (p=0.32. OMT associated to exercise reduce spinal pain in older patients. Our study suggests that OMT associated to exercise leads to significant improvement on pain relief in patients with chronic SP in a short term and the exercise allows to maintain these improvements for several months

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.

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.)

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.)

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...

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.

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.

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

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

Survey of billing and coding for counterstrain tender points.

Science.gov (United States)

Snider, Karen T; Johnson, Jane C

2012-06-01

The names of certain counterstrain tender points are incongruent with their physical locations because of an assumption that these points are reflective of dysfunction in neighboring body areas. Because the body area that is physically examined does not always match the body region in which somatic dysfunction is diagnosed for these tender points, it is not always clear which evaluation and management service codes should be used for billing physician services. To assess the attitudes of osteopathic physicians toward the billing and coding of incongruent counterstrain tender points. Physician members of the American Academy of Osteopathy who use counterstrain in clinical practice were surveyed regarding the body area that they would physically examine when assessing for incongruent tender points and, if tender points were present, the body regions to which they would assign somatic dysfunction for billing and coding purposes. Physician responses were categorized as indicating a structural approach (ie, reflective of anatomic location) or a functional approach (ie, reflective of dysfunction in neighboring body areas) to tender point examination and treatment. Associations between sex, specialty, and years in practice with the approach chosen were also examined. Of 175 physicians who responded to the survey, 156 met the study criteria. Respondents were primarily board-certified in neuromusculoskeletal medicine/osteopathic manipulative medicine (98 [63%]), special proficiency in osteopathic manipulative medicine (30 [19%]), or family practice/family practice and osteopathic manipulative treatment (94 [60%]). Ninety percent of physicians predominantly chose responses indicating a structural approach to the physical examination of tender points and 21% predominantly chose responses indicating a functional approach to somatic dysfunction diagnosis. There were inconsistencies among individual respondents regarding the type of approach chosen for a single tender point. For

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.…

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)

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…

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.

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

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

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.

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.

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.

Impact of the clinical ultrasound elective course on retention of anatomical knowledge by second-year medical students in preparation for board exams.

Science.gov (United States)

Kondrashov, Peter; Johnson, Jane C; Boehm, Karl; Rice, Daris; Kondrashova, Tatyana

2015-03-01

Ultrasound has been integrated into a gross anatomy course taught during the first year at an osteopathic medical school. A clinical ultrasound elective course was developed to continue ultrasound training during the second year of medical school. The purpose of this study was to evaluate the impact of this elective course on the understanding of normal anatomy by second-year students. An anatomy exam was administered to students enrolled in the clinical ultrasound elective course before the start of the course and after its conclusion. Wilcoxon signed ranks tests were used to determine whether exam scores changed from the pre-test to the post-test. Scores from two classes of second-year students were analyzed. Students who took the elective course showed significant improvement in the overall anatomy exam score between the pre-test and post-test (P students with an important review of key anatomical concepts while preparing them for board exams. Our results suggested that more emphasis should be placed on head and neck ultrasound to improve student performance in those areas. Musculoskeletal, abdominal, and heart ultrasound labs were more successful for retaining relevant anatomical information. © 2014 Wiley Periodicals, Inc.

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...

Understanding clinical reasoning in osteopathy: a qualitative research approach.

Science.gov (United States)

Grace, Sandra; Orrock, Paul; Vaughan, Brett; Blaich, Raymond; Coutts, Rosanne

2016-01-01

Clinical reasoning has been described as a process that draws heavily on the knowledge, skills and attributes that are particular to each health profession. However, the clinical reasoning processes of practitioners of different disciplines demonstrate many similarities, including hypothesis generation and reflective practice. The aim of this study was to understand clinical reasoning in osteopathy from the perspective of osteopathic clinical educators and the extent to which it was similar or different from clinical reasoning in other health professions. This study was informed by constructivist grounded theory. Participants were clinical educators in osteopathic teaching institutions in Australia, New Zealand and the UK. Focus groups and written critical reflections provided a rich data set. Data were analysed using constant comparison to develop inductive categories. According to participants, clinical reasoning in osteopathy is different from clinical reasoning in other health professions. Osteopaths use a two-phase approach: an initial biomedical screen for serious pathology, followed by use of osteopathic reasoning models that are based on the relationship between structure and function in the human body. Clinical reasoning in osteopathy was also described as occurring in a number of contexts (e.g. patient, practitioner and community) and drawing on a range of metaskills (e.g. hypothesis generation and reflexivity) that have been described in other health professions. The use of diagnostic reasoning models that are based on the relationship between structure and function in the human body differentiated clinical reasoning in osteopathy. These models were not used to name a medical condition but rather to guide the selection of treatment approaches. If confirmed by further research that clinical reasoning in osteopathy is distinct from clinical reasoning in other health professions, then osteopaths may have a unique perspective to bring to multidisciplinary

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.

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.

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

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.

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.)

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.)

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.

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

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.

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.

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.)

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

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

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

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.

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...

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

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.

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...

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)

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.)

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.

Knowledge, Practices, and Barriers to HIV Pre-Exposure Prophylaxis (PrEP) Prescribing Among Washington State Medical Providers.

Science.gov (United States)

Wood, Brian R; McMahan, Vanessa M; Naismith, Kelly; Stockton, Jonathan B; Delaney, Lori A; Stekler, Joanne D

2018-01-04

We aimed to assess HIV pre-exposure prophylaxis (PrEP) awareness and prescribing practices among Washington State medical providers from diverse professional disciplines and practice types. In May 2016, we administered an anonymous online survey to licensed medical practitioners who provide primary, longitudinal, walk-in, emergency, obstetric, gynecologic, sexually transmitted infection (STI), or family planning care. Of 735 eligible providers, 64.8% had heard of PrEP. Younger providers and providers with a Doctor of Medicine (MD) degree were more likely to be aware of PrEP compared to older providers (p=0.0001) and providers of other training backgrounds (Advanced Registered Nurse Practitioner [ARNP], Doctor of Osteopathic Medicine [DO], or Physician Assistant [PA]) (p=0.04). Among providers aware of PrEP, most frequent reported concerns about prescribing were adherence (46.0%) and costs (42.9%). Providers felt very (20.1%) or somewhat (33.8%) comfortable discussing PrEP overall, but very (26.8%) or somewhat (44.7%) uncomfortable discussing cost and insurance issues. The 124 PrEP prescribers reported a median of 2 (range 1-175, total 1,142) patients prescribed PrEP. Prior authorizations and insurance denials had prevented prescriptions for 28.7% and 12.1% of prescribers, respectively. Interventions to improve PrEP access should include education to inform medical providers about PrEP, with particular attention to provider types less likely to be aware. Continued efforts to eliminate cost and insurance barriers and educate providers regarding financial resources would help improve PrEP access.

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.

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.

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)

[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.

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

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.)

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.)

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

Predictors of sexual bother in a population of male North American medical students.

Science.gov (United States)

Smith, James F; Breyer, Benjamin N; Shindel, Alan W

2011-12-01

The prevalence and associations of sexual bother in male medical students has not been extensively studied. The aim of this study is to analyze predictors of sexual bother in a survey of male North American medical students. Students enrolled in allopathic and osteopathic medical schools in North America between February 2008 and July 2008 were invited to participate in an internet-based survey of sexuality and sexual function. The principle outcome measure was a single-item question inquiring about global satisfaction with sexual function. The survey also consisted of a questionnaire that included ethnodemographic factors, student status, sexual history, and a validated scale for the assessment of depression. Respondents completed the International Index of Erectile Function, the premature ejaculation diagnostic tool, and the Self-Esteem and Relationship Quality survey (SEAR). Descriptive statistics, analysis of variance, and multivariable logistic regression were utilized to analyze responses. There were 480 male subjects (mean age 26.3 years) with data sufficient for analysis. Forty-three (9%) reported sexual bother. Sexual bother was significantly more common in men with erectile dysfunction (ED), high risk of premature ejaculation (HRPE), depressive symptoms, and lower sexual frequency. However, after multivariate analysis including SEAR scores, ED, and HRPE were no longer independently predictive of sexual bother. Higher scores for all domains of the SEAR were associated with lower odds of sexual bother. ED and HRPE are associated with sexual bother in this young and presumably healthy population. However, after controlling for relationship factors neither ED nor HRPE independently predicted sexual bother. It is plausible to hypothesize that sexual dysfunction from organic causes is rare in this population and is seldom encountered outside of relationship perturbations. Attention to relationship and psychological factors is likely of key importance in

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.

Learning Environment, Preparedness and Satisfaction in Osteopathy in Europe: The PreSS Study.

Directory of Open Access Journals (Sweden)

Emanuele Luciani

Full Text Available 1 to assess the preparedness to practice and satisfaction in learning environment amongst new graduates from European osteopathic institutions; 2 to compare the results of preparedness to practice and satisfaction in learning environment between and within countries where osteopathy is regulated and where regulation is still to be achieved; 3 to identify possible correlations between learning environment and preparedness to practice.Osteopathic education providers of full-time education located in Europe were enrolled, and their final year students were contacted to complete a survey. Measures used were: Dundee Ready Educational Environment Measure (DREEM, the Association of American Medical Colleges (AAMC and a demographic questionnaire. Scores were compared across institutions using one-way ANOVA and generalised linear model.Nine European osteopathic education institutions participated in the study (4 located in Italy, 2 in the UK, 1 in France, 1 in Belgium and 1 in the Netherlands and 243 (77% of their final-year students completed the survey. The DREEM total score mean was 121.4 (SEM: 1.66 whilst the AAMC was 17.58 (SEM:0.35. A generalised linear model found a significant association between not-regulated countries and total score as well as subscales DREEM scores (p<0.001. Learning environment and preparedness to practice were significantly positively correlated (r=0.76; p<0.01.A perceived higher level of preparedness and satisfaction was found amongst students from osteopathic institutions located in countries without regulation compared to those located in countries where osteopathy is regulated; however, all institutions obtained a 'more positive than negative' result. Moreover, in general, cohorts with fewer than 20 students scored significantly higher compared to larger student cohorts. Finally, an overall positive correlation between students' preparedness and satisfaction were found across all institutions recruited.

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.

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.

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.

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

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

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

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

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

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 ...

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…

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.

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…

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

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.)

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.)

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...

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…

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.)

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...

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...

[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.

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

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.)

Dermatology Terms

Science.gov (United States)

... Online Store Welcome Calendar of Events Find a Dermatology DO Osteopathic Medicine Disease Database Contributors Doctor Derm ... of Trustees Contact Us Ethics Foundation for Osteopathic Dermatology What is the FOD? Foundation Levels of Giving ...

Dermatology Procedures

Science.gov (United States)

... Online Store Welcome Calendar of Events Find a Dermatology DO Osteopathic Medicine Disease Database Contributors Doctor Derm ... of Trustees Contact Us Ethics Foundation for Osteopathic Dermatology What is the FOD? Foundation Levels of Giving ...

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.

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...

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.

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.

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…

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.

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.)

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

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.

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)

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...

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.)

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…

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

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...

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

Report on the results of the fifth medical examination of atomic bomb survivors resident in the United States and Canada