Eudaldo, T.; Millan, E.; Paredes, M.C.; Vano, E.; Peinado, F.; Nunez de Villavicencio, C.; Mateos, J.C.; Pena, J.J.
The aim of this paper is twofold. First, to revise some European Communities' recommendations regarding qualification, education and training of professionals involved in ionisation radiation practices, to respond to the Directive 97/43 EURATOM. And then, as Medical Physicists are directly concerned with these practices, to describe how the Spanish Society of Medical Physics deals with the challenge of improving the competence of Medical Physicists in order to assure the best patient protection against ionisation radiation. Therefore, to achieve the first aim, the point of view of the European Federation of Organisations on Medical Physics (EFOMP) concerning the introduction of the 'Medical Physics Expert' and their guidelines for Continuous Professional Development are reviewed, as well as the point of view of European Society for Therapeutic Radiation Oncology (ESTRO) in professional education matters. Referring to the second aim, after succeeding in the recognition of the Medical Physics Speciality in Spain in 1997, the SEFM is now promoting the Continuous Education and Training of their specialists through its Education Committee (Comision de Docencia de la SEFM), so that they can cope with all new professional challenges. Moreover, a number of SEFM members are also involved in education matters to others professionals: Medicine students, nurses, Radiation Technologists, etc. In conclusion, the SEFM has always been aware of the importance of specialisation and continuous education of all professionals involved in radiation ionisation practices, as a way to contribute to guarantee the best radiation protection to the patients. (author)
Schofferman, Jerome A; Eskay-Auerbach, Marjorie L; Sawyer, Laura S; Herring, Stanley A; Arnold, Paul M; Muehlbauer, Eric J
Recently the financial relationships between industry and professional medical associations have come under increased scrutiny because of the concern that industry ties may create real or perceived conflicts of interest. Professional medical associations pursue public advocacy as well as promote medical education, develop clinical practice guidelines, fund research, and regulate professional conduct. Therefore, the conflicts of interest of a professional medical association and its leadership can have more far-reaching effects on patient care than those of an individual physician. Few if any professional medical associations have reported their experience with implementing strict divestment and disclosure policies, and among the policies that have been issued, there is little uniformity. We describe the experience of the North American Spine Society (NASS) in implementing comprehensive conflicts of interest policies. A special feature article. We discuss financial conflicts of interest as they apply to professional medical associations rather than to individual physicians. We describe the current policies of disclosure and divestment adopted by the NASS and how these policies have evolved, been refined, and have had no detrimental impact on membership, attendance at annual meetings, finances, or leadership recruitment. No funding was received for this work. The authors report no potential conflict-of-interest-associated biases in the text. The NASS has shown that a professional medical association can manage its financial relationships with industry in a manner that minimizes influence and bias. The NASS experience can provide a template for other professional medical associations to help manage their own possible conflicts of interest issues. Copyright © 2013 Elsevier Inc. All rights reserved.
Simcoe, Donna; Juneja, Renu; Scott, Gayle Nicholas; Sridharan, Kanaka; Williams-Hughes, Celeste
During the 9th Annual Meeting of the International Society for Medical Publication Professionals (ISMPP, April 29-May 1, 2013 in Baltimore, MD), ∼650 participants attended two of 13 available roundtable sessions. Participants included medical publication professionals from industry, communication agencies, and journals. DISCUSSION TOPICS: Roundtable participants discussed how to best interpret and implement various guidances, such as Good Publication Practices 2 (GPP2), the International Committee of Medical Journal Editors (ICMJE) guidelines, and the Physician Payment Sunshine Act. The impact of and compliance with Corporate Integrity agreements (CIAs) on medical publication planning practices was debated. Roundtable participants also discussed ways of advancing both advocacy for the medical publication professional field and internal and external collaborations. The development of review manuscripts, publications from regions newly emerging in publication planning, medical devices publications, and real-world experience publications were discussed. Participants also considered the benefits and uncertainties of new technologies in medical publications such as multimedia and social media. This is the first ever article to be published following the well-attended ISMPP roundtable sessions. The objective of this manuscript is to summarize key learnings that will aid continued discussions about challenges and opportunities facing medical publication professionals.
Popescu, R A; Schäfer, R; Califano, R; Eckert, R; Coleman, R; Douillard, J-Y; Cervantes, A; Casali, P G; Sessa, C; Van Cutsem, E; de Vries, E; Pavlidis, N; Fumasoli, K; Wörmann, B; Samonigg, H; Cascinu, S; Cruz Hernández, J J; Howard, A J; Ciardiello, F; Stahel, R A; Piccart, M
The number of cancer patients in Europe is rising and significant advances in basic and applied cancer research are making the provision of optimal care more challenging. The concept of cancer as a systemic, highly heterogeneous and complex disease has increased the awareness that quality cancer care should be provided by a multidisciplinary team (MDT) of highly qualified healthcare professionals. Cancer patients also have the right to benefit from medical progress by receiving optimal treatment from adequately trained and highly skilled medical professionals. Built on the highest standards of professional training and continuing medical education, medical oncology is recognised as an independent medical specialty in many European countries. Medical oncology is a core member of the MDT and offers cancer patients a comprehensive and systemic approach to treatment and care, while ensuring evidence-based, safe and cost-effective use of cancer drugs and preserving the quality of life of cancer patients through the entire 'cancer journey'. Medical oncologists are also engaged in clinical and translational research to promote innovation and new therapies and they contribute to cancer diagnosis, prevention and research, making a difference for patients in a dynamic, stimulating professional environment. Medical oncologists play an important role in shaping the future of healthcare through innovation and are also actively involved at the political level to ensure a maximum contribution of the profession to Society and to tackle future challenges. This position paper summarises the multifarious and vital contributions of medical oncology and medical oncologists to today's and tomorrow's professional cancer care.
Gregory, Paul J; Robbins, Benjamin; Schwaitzberg, Steven D; Harmon, Larry
The current research evaluated the potential utility of a 360-degree survey feedback program for measuring leadership quality in potential committee leaders of a professional medical association (PMA). Emotional intelligence as measured by the extent to which self-other agreement existed in the 360-degree survey ratings was explored as a key predictor of leadership quality in the potential leaders. A non-experimental correlational survey design was implemented to assess the variation in leadership quality scores across the sample of potential leaders. A total of 63 of 86 (76%) of those invited to participate did so. All potential leaders received feedback from PMA Leadership, PMA Colleagues, and PMA Staff and were asked to complete self-ratings regarding their behavior. Analyses of variance revealed a consistent pattern of results as Under-Estimators and Accurate Estimators-Favorable were rated significantly higher than Over-Estimators in several leadership behaviors. Emotional intelligence as conceptualized in this study was positively related to overall performance ratings of potential leaders. The ever-increasing roles and potential responsibilities for PMAs suggest that these organizations should consider multisource performance reviews as these potential future PMA executives rise through their organizations to assume leadership positions with profound potential impact on healthcare. The current findings support the notion that potential leaders who demonstrated a humble pattern or an accurate pattern of self-rating scored significantly higher in their leadership, teamwork, and interpersonal/communication skills than those with an aggrandizing self-rating.
Banerjee, S; Califano, R; Corral, J; de Azambuja, E; De Mattos-Arruda, L; Guarneri, V; Hutka, M; Jordan, K; Martinelli, E; Mountzios, G; Ozturk, M A; Petrova, M; Postel-Vinay, S; Preusser, M; Qvortrup, C; Volkov, M N M; Tabernero, J; Olmos, D; Strijbos, M H
Burnout in health care professionals could have serious negative consequences on quality of patient care, professional satisfaction and personal life. Our aim was to investigate the burnout prevalence, work and lifestyle factors potentially affecting burnout amongst European oncologists ≤40 (YOs). A survey was conducted using the validated Maslach Burnout Inventory (MBI) and additional questions exploring work/lifestyle factors. Statistical analyses were carried out to identify factors associated with burnout. Total of 737 surveys (all ages) were collected from 41 European countries. Countries were divided into six regions. Results from 595 (81%) YOs were included (81% medical oncologists; 52% trainees, 62% women). Seventy-one percent of YOs showed evidence of burnout (burnout subdomains: depersonalization 50%; emotional exhaustion 45; low accomplishment 35%). Twenty-two percent requested support for burnout during training and 74% reported no hospital access to support services. Burnout rates were significantly different across Europe (P women (60% versus 45% P = 0.0001) and low accomplishment was highest in the 26-30 age group (P balance, access to support services, living alone and inadequate vacation time remained independent burnout factors (P balance, access to support services and adequate vacation time may reduce burnout levels. Raising awareness, support and interventional research are needed. © The Author 2017. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For Permissions, please email: email@example.com.
Relations between professional medical associations and healthcare industry, concerning scientific communication and continuing medical education: a policy statement from the European Society of Cardiology.
Physicians have an ethical duty to keep up-to-date with current knowledge. Professional medical associations such as the European Society of Cardiology (ESC) support these obligations. In Europe, the costs of continuing medical education (CME) are insufficiently supported from governments and employers; however, medical associations have been criticized for accepting alternative financial support from industry. Medical education and training in research include learning how to assess the quality and reliability of any information. There is some risk of bias in any form of scientific communication including intellectual, professional, and financial and it is essential that in particular, the latter must be acknowledged by full disclosure. It is essential that there is strong collaboration between basic and clinical researchers from academic institutions on the one hand, with engineers and scientists from the research divisions of device and pharmaceutical companies on the other. This is vital so that new diagnostic methods and treatments are developed. Promotion of advances by industry may accelerate their implementation into clinical practice. Universities now frequently exhort their academic staff to protect their intellectual property or commercialize their research. Thus, it is not commercial activity or links per se that have become the target for criticism but the perceived influence of commercial enterprises on clinical decision-making or on messages conveyed by professional medical organizations. This document offers the perspective of the ESC on the current debate, and it recommends how to minimize bias in scientific communications and CME and how to ensure proper ethical standards and transparency in relations between the medical profession and industry. Copyright © 2012. Published by Elsevier España.
Relations between professional medical associations and the health-care industry, concerning scientific communication and continuing medical education: a policy statement from the European Society of Cardiology.
Physicians have an ethical duty to keep up-to-date with current knowledge. Professional medical associations such as the European Society of Cardiology (ESC) support these obligations. In Europe, the costs of continuing medical education (CME) are insufficiently supported from governments and employers; however, medical associations have been criticized for accepting alternative financial support from industry. Medical education and training in research include learning how to assess the quality and reliability of any information. There is some risk of bias in any form of scientific communication including intellectual, professional, and financial and it is essential that in particular, the latter must be acknowledged by full disclosure. It is essential that there is strong collaboration between basic and clinical researchers from academic institutions on the one hand, with engineers and scientists from the research divisions of device and pharmaceutical companies on the other. This is vital so that new diagnostic methods and treatments are developed. Promotion of advances by industry may accelerate their implementation into clinical practice. Universities now frequently exhort their academic staff to protect their intellectual property or commercialize their research. Thus, it is not commercial activity or links per se that have become the target for criticism but the perceived influence of commercial enterprises on clinical decision-making or on messages conveyed by professional medical organizations. This document offers the perspective of the ESC on the current debate, and it recommends how to minimize bias in scientific communications and CME and how to ensure proper ethical standards and transparency in relations between the medical profession and industry.
The future of continuing medical education: the roles of medical professional societies and the health care industry: Position paper prepared with contributions from the European Society of Cardiology Committees for Advocacy, Education and Industry Relations, Endorsed by the Board of the European Society of Cardiology.
In recent years, wide ranging biomedical innovation has provided powerful new approaches for prevention, diagnosis and management of diseases. In order to translate such innovation into effective practice, physicians must frequently update their knowledge base and skills through continuing medical education and training. Medical Professional Societies, run as not-for-profit organizations led by peers, are uniquely placed to deliver balanced, disease oriented and patient centred education. The medical industry has a major role in the development of new, improved technology, devices and medication. In fact, the best innovations have been achieved through collaboration with scientists, clinical academics and practicing physicians. Industry has for many years been committed to ensure the optimal and safe application of its products by providing unrestricted support of medical education developed and delivered by international and national learned societies. Recently adopted Codes of Practice for the Pharmaceutical and Device industry were intended to enhance public trust in the relationship between biomedical industry and physicians. Unexpectedly, changes resulting from adoption of the Codes have limited the opportunity for unconditional industry support of balanced medical education in favour of a more direct involvement of industry in informing physicians about their products. We describe the need for continuing medical education in Cardiovascular Medicine in Europe, interaction between the medical profession and medical industry, and propose measures to safeguard the provision of high quality, balanced medical education.
Wilson, Ian; Cowin, Leanne S; Johnson, Maree; Young, Helen
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.
Sulović, V; Pavlović, B
In the second half of the last century and under the influence of the European civilization, Serbia abandoned the conservative and patriarchal way of life and began to introduce a new, contemporary political, cultural and social spirit into the country. The development of these civilizing features was under the influence of young intelectuals who, as former scholarship holders of the Serbian government, were educated in many European countries. Among them, there was a group of physicians who returned to the country after having completed their education. They were carriers and holders of the contemporary medical science in Serbia and the neighbouring areas. On April 22, 1872 a group of 15 physicians founded the Serbian Medical Society with the intention to offer an organized medical help and care to the population. The first president was Dr. Aćim Medović and the first secretary Dr. Vladan Dordević. At the meeting held on May 15, 1872 the text of the Statute of the Society was accepted and immediately submitted for approval to the Ministry of Internal Affairs. In the letter addressed to the minister of internal affairs the following reasons were cited: "... The Belgrade physicians feeling a need for having the main office for their professional and scientific meetings, for which they will find the opportunity and the funds, and in spite of their hard medical labor which requires almost all their time, decided to establish the Serbian Medical Society because they wish to be in trend and follow-up the medical progress and exchange the latest medical information not only among them but also with other graduated doctors living in areas with the Serblan population as well as with all scientists who are willing to contribute to the development of medical science in Serbia...". In the first year of its existence the Serbian Medical Society had 9 regular members, 1 honorary member and 34 corresponding members from Serbia, Slavic and other foreign countries. On August 5
Morton, Melinda J; Sonnad, Seema S
Membership on a professional medical society or journal editorial board is a marker of influence and prestige for those in academic medicine. This study presents the first comprehensive quantification of women on these boards and the implications for women in medicine. The numbers of women and men on professional society and journal editorial boards across 28 specialties (March 2004) were counted. The number of women holding multiple roles on these boards and the number of women holding top leadership positions on these boards were counted, and these proportions were compared. Three-thousand-four-hundred-seventy-three individuals on 39 professional medical society boards and 54 journal editorial boards were included. Eighty-three percent (2,884) of board members were male. Men occupied > 80% of top leadership positions on these boards. Thirty-five of the 589 women in the study held multiple roles. Anesthesiology (p women on boards in comparison to the total women in the specialty. Internal medicine, plastic surgery, cardiology and general surgery had nearly equivalent proportions; in otolaryngology and family medicine, female board members slightly exceeded the proportion of women in the field. Women's representation on society and editorial boards does not always reflect their presence in medical specialties, and it is critically lacking in certain specialties. Efforts should be made to attain parity of women leaders on these boards. Further efforts should be made to eliminate barriers to women's leadership in medicine.
Kim, Jang Han
What is medical professionalism and does it matter to the patients? Medical professionals take responsibility for their judgements and the consequences that ensue. Traditionally medical professionalism is defined as a set of values, behaviors, and relationships which support the trust the public has in doctors. The public is well aware that absence of professionalism is harmful to their interests. However, the exercise of medical professionalism is endangered by the political and cultural environment. The values of professionalism have been changed throughout the medical history and the meaning of it was also changed according to social theories. Traditional medical professionalism was based on the virtue of autonomy, self-regulation and competency etc. However, in the new millenium era, the meaning of professionalism has changed under the concept of responsibility which includes the classical virtues. The meaning of professionalism nowadays is only based on the structure and conflicting theories which cannot solve all the issues surrounding professionalism in medical practice. The conditions of medical practice are critical determinants for the future of professionalism. The interaction between doctor and patient is central to the medical care, and medical professionalism has roots in almost every aspect of medical care. I argue that doctors have responsibility to act according to the values which have been determined by the medical profession, history and surrounding society. The new millennium medical professionalism which based on the responsibility could initiate a public dialogue about the role of the doctor in creating a fairer society.
Matthews, Jacob H; Morley, Gabriella L; Crossley, Eleanor; Bhanderi, Shivam
All health care professionals in the UK are expected to have the medical leadership and management (MLM) skills necessary for improving patient care, as stipulated by the UK General Medical Council (GMC). Newly graduated doctors reported insufficient knowledge about leadership and quality improvement skills, despite all UK medical schools reporting that MLM is taught within their curriculum. A medical student society organised a series of extracurricular educational events focusing on leadership topics. The society recognised that the events needed to be useful and interesting to attract audiences. Therefore, clinical leaders in exciting fields were invited to talk about their experiences and case studies of personal leadership challenges. The emphasis on personal stories, from respected leaders, was a deliberate strategy to attract students and enhance learning. Evaluation data were collected from the audiences to improve the quality of the events and to support a business case for an intercalated degree in MLM. When leadership and management concepts are taught through personal stories, students find it interesting and are prepared to give up their leisure time to engage with the subject. Students appear to recognise the importance of MLM knowledge to their future careers, and are able to organise their own, and their peers', learning and development. Organising these events and collecting feedback can provide students with opportunities to practise leadership, management and quality improvement skills. These extracurricular events, delivered through a student society, allow for subjects to be discussed in more depth and can complement an already crowded undergraduate curriculum. Newly graduated doctors reported insufficient knowledge about leadership and quality improvement skills. © 2017 John Wiley & Sons Ltd and The Association for the Study of Medical Education.
Cruess, Richard L; Cruess, Sylvia R
As health care has become of great importance to both individual citizens and to society, it has become more important to understand medicine's relationship to the society it serves in order to have a basis for meaningful dialogue. During the past decade, individuals in the medical, legal, social sciences, and health policy fields have suggested that professionalism serves as the basis of medicine's relationship with society, and many have termed this relationship a social contract. However, the concept of medicine's social contract remains vague, and the implications of its existence have not been fully explored. This paper endorses the use of the term social contract, examines the origin of the concept and its relationship to professionalism, traces its evolution and application to medicine, describes the expectations of the various parties to the contract, and explores some of the implications of its use.
[Structure of pain management facilities in Germany : Classification of medical and psychological pain treatment services-Consensus of the Joint Commission of the Professional Societies and Organizations for Quality in Pain Medicine].
Müller-Schwefe, G H H; Nadstawek, J; Tölle, T; Nilges, P; Überall, M A; Laubenthal, H J; Bock, F; Arnold, B; Casser, H R; Cegla, T H; Emrich, O M D; Graf-Baumann, T; Henning, J; Horlemann, J; Kayser, H; Kletzko, H; Koppert, W; Längler, K H; Locher, H; Ludwig, J; Maurer, S; Pfingsten, M; Schäfer, M; Schenk, M; Willweber-Strumpf, A
On behalf of the Medical/Psychological Pain Associations, Pain Patients Alliance and the Professional Association of Pain Physicians and Psychologists, the Joint Commission of Professional Societies and Organizations for Quality in Pain Medicine, working in close collaboration with the respective presidents, has developed verifiable structural and process-related criteria for the classification of medical and psychological pain treatment facilities in Germany. Based on the established system of graded care in Germany and on existing qualifications, these criteria also argue for the introduction of a basic qualification in pain medicine. In addition to the first-ever comprehensive description of psychological pain facilities, the criteria presented can be used to classify five different levels of pain facilities, from basic pain management facilities, to specialized institutions, to the Centre for Interdisciplinary Pain Medicine. The recommendations offer binding and verifiable criteria for quality assurance in pain medicine and improved pain treatment.
As the American Nuclear Society (ANS) supports scientific and engineering disciplines with a responsibility to communicate with the public they serve, it has been and will continue to be involved in public awareness and public acceptance. Their efforts address two distinct audiences. This was not immediately apparent but time and experience have clarified the two publics concerned. The first of these is the significant audience, an unpolarized, undecided, confused and overwhelmed group which, in the USA, represents 80-90% of the population. This group has been bombarded by technological developments that have evolved at a rate exceeding the educational process and leaving the majority without the tools for understnading. Only the technologists can fill this void. The second public is a very polarized, anti-technology group, that has adopted an anti-nuclear character as one of its costumes. It is a vocal group of limited size, adamantly devoted to its cause. It has attracted the attention of the media and so appears larger than it is. Being strongly polarized, this group cannot be converted but it can be neutralised. It does not seek facts but wants to cultivate a public reaction; here the equally polarized pro-nuclear group must expend its effort. The ANS programmes are responding to these two publics. For the larger public, ANS tries to satisfy their need for information with publications that build on their inherent knowledge and provide information, perspective and assurance in understandable terms and examples. ANS has also organized its members to interface with the public. This interface is very important and the public welcomes it although the professionals have not yet recognized that it is essential. The major single measureable experience of ANS was in California where with Proposition 15 a legal attempt was made to limit nuclear power development. Similar efforts continue elsewhere in the USA but their effects have not been measured. The California
Olive, Kenneth E; Abercrombie, Caroline L
Professionalism represents a fundamental characteristic of physicians. Professional organizations have developed professionalism competencies for physicians and medical students. The aim of teaching medical professionalism is to ensure the development of a professional identity in medical students. Professional identity formation is a process developed through teaching principles and appropriate behavioral responses to the stresses of being a physician. Addressing lapses and critical reflection is an important part of the educational process. The "hidden curriculum" within an institution plays an important role in professional identity formation. Assessment of professionalism involves multiple mechanisms. Steps in remediating professionalism lapses include (1) initial assessment, (2) diagnosis of problems and development of an individualized learning plan, (3) instruction encompassing practice, feedback and reflection and (4) reassessment and certification of competence. No reliable outcomes data exist regarding the effectiveness of different remediation strategies. Copyright © 2017 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.
Matyas, Marsha Lakes; Ruedi, Elizabeth A.; Engen, Katie; Chang, Amy L.
The "Vision and Change in Undergraduate Biology Education" reports cite the critical role of professional societies in undergraduate life science education and, since 2008, have called for the increased involvement of professional societies in support of undergraduate education. Our study explored the level of support being provided by…
Medical romance fiction is a subgenre of popular romance fiction that features medical professionals in their work environment. This essay explores the way professionalism is portrayed in popular medical romance fiction written during the early twenty-first century, a period of significant disruption in both the public image and self-understanding of organized medicine. I analyze a selection of contemporary medical romance novels, published between 2008 and 2012, demonstrating that medical romance fiction is a form of public intervention in apparently insular debates over medical professionalism. I conclude that they promote "nostalgic professionalism," a vision of physicians as a select group of highly educated, self-regulated experts who provide, with a caring and altruistic attitude, a vitally important service to society, while at the same time generating implicit critiques of it.
Feingold, Ronald S.; Estes, Steven G.
This article analyzes various issues related to a professional society's having greater influence on governmental, societal, and global issues. Analysis of association/society missions and goals, support for enhanced connections with other groups and collaboration to other disciplines through scholarly research projects, plus greater relevance and…
Kieffer, S. W.; Palka, J. M.; Geissman, J. W.; Mogk, D. W.
Codes of Ethics (Conduct) for geoscientists are formulated primarily by professional societies and the codes must be viewed in the context of the Goals (Missions, Values) of the societies. Our survey of the codes of approximately twenty-five societies reveals that most codes enumerate principles centered on practical issues regarding professional conduct of individuals such as plagiarism, fabrication, and falsification, and the obligation of individuals to the profession and society at large. With the exception of statements regarding the ethics of peer review, there is relatively little regarding the ethical obligations of the societies themselves. In essence, the codes call for traditionally honorable behavior of individual members. It is striking, given that the geosciences are largely relevant to the future of Earth, most current codes of societies fail to address our immediate obligations to the environment and Earth itself. We challenge professional organizations to consider the ethical obligations to Earth in both their statements of goals and in their codes of ethics. Actions by societies could enhance the efforts of individual geoscientists to serve society, especially in matters related to hazards, resources and planetary stewardship. Actions we suggest to be considered include: (1) Issue timely position statements on topics in which there is expertise and consensus (some professional societies such as AGU, GSA, AAAS, and the AMS, do this regularly, yet others not at all.); (2) Build databases of case studies regarding geoethics that can be used in university classes; (3) Hold interdisciplinary panel discussions with ethicists, scientists, and policy makers at annual meetings; (4) Foster publication in society journals of contributions relating to ethical questions; and (5) Aggressively pursue the incorporation of geoethical issues in undergraduate and graduate curricula and in continuing professional development.
In 1986 a joint medical records project group was set up by the Institute of Health Services Management, the Association of Health Care Information and Medical Records Officers and the NHS Training Authority, with Mr Vic Peel as chairman. The group was supported by Arthur Andersen & Co, management consultants. The following is a shortened and edited version of an interim report drafted for the group by Dr Alastair Mason. It is intended for discussion and does not yet represent the definitive views of the sponsoring bodies.
Margaret C. Hardy
Full Text Available Academic, medical, and research communities are struggling to quickly and effectively address unethical conduct within their professional ranks. Without a policy in place, individuals and institutes are subject to convoluted procedures and unnecessary consequences. In addition to policies geared to prevent harassment and assault, it is important to protect the ethical basis for research and provide a set of guidelines for how professionals treat each other, students, and trainees. Since drafting a policy of this nature is complex, 10 guidelines are provided as a framework for how to draft, implement, and establish an ethical code of conduct. Further implications for nonprofit societies and professional societies in particular are discussed.
Fourteen physicians headed by Jan Evangelista Purkynĕ signed the proposed by-laws of the Czech medical society in october 1861. Emperor's approval was received 26th june 1862 and in july Purkynĕ was elected the first president. The same illuminated personalities were the founders of the Casopis lékarů ceských--the Czech medical Journal which has remained the most important Czech periodical until the present time. The aims of the Society were to cultivate medical science and promote Czech language in medicine. Weekly scientific sessions, medical periodical and publication of monographs related to medicine were the means how to achieve the aims. The Czech Medical Society became soon the centre of medical science in Bohemia. Its members were among the foremost fighters for the use of Czech language in Charles university and their relentless effort helped much to the establishment of the Czech Univerzity in 1882 and Czech medical faculty a year later. In subsequent years the Society was also involved in professional problems related to social health insurance, medical fees, ethical problems and other relevant questions such as the establishment of medical chambers. The activity of the Czech medical Society was never interrupted during its 130 years of existence, although there were several difficult periods in its life, mainly during the first and second world war and also in the past 40 years. In spite of the atomization of medicine the Czech medical Society has been continuing its eminent mission to create communication and establish close links between the medical science and practical medicine by systematically bringing new knowledge in medicine and biology to general physicians and by putting together physicians, surgeons and basic scientists. The task for the future is seen in optimal transfer of new knowledge and ideas from scientists to practicians and vice versa; and to take care of the highest possible moral and ethical standard required for humane
Observers and critics of the medical profession, both within and without, urge that more attention be paid to the moral sensibilities, the characters, of medical students. Passing on particular moral values and actions to physicians has always been an essential core of medical training, and this call for renewal is not new in modern medicine. Some of the structures and characteristics of modern medical education, however, often work directly against the professionalism that the education espouses. For example, medical students are socialized into a hierarchy that has broad implications for relations among health care professionals, other health care workers, and patients, and academic medicine has not promoted and taught critical reflection about the values and consequences of this hierarchy. Further, behind the formal curriculum lies the "hidden curriculum" of values that are unconsciously or half-consciously passed on from the faculty and older trainees. Two resources for thinking anew about professional development for medical students are feminist standpoint theory and critical multicultural theory, each of which raises important and fundamental questions about defining the role of medicine in society and the role of the physician in medicine. The author discusses these two theories and their implications for medical education, showing how they can be used to move discussions of professional development into analysis of the widespread social consequences of how a society organizes its health care and into critical reflection on the nature of medical knowledge.
Paul S. Mueller
Full Text Available Professionalism is a core competency of physicians. Clinical knowledge and skills (and their maintenance and improvement, good communication skills, and sound understanding of ethics constitute the foundation of professionalism. Rising from this foundation are behaviors and attributes of professionalism: accountability, altruism, excellence, and humanism, the capstone of which is professionalism. Patients, medical societies, and accrediting organizations expect physicians to be professional. Furthermore, professionalism is associated with better clinical outcomes. Hence, medical learners and practicing physicians should be taught and assessed for professionalism. A number of methods can be used to teach professionalism (e.g. didactic lectures, web-based modules, role modeling, reflection, interactive methods, etc.. Because of the nature of professionalism, no single tool for assessing it among medical learners and practicing physicians exists. Instead, multiple assessment tools must be used (e.g. multi-source feedback using 360-degree reviews, patient feedback, critical incident reports, etc.. Data should be gathered continuously throughout an individual’s career. For the individual learner or practicing physician, data generated by these tools can be used to create a “professionalism portfolio,” the totality of which represents a picture of the individual’s professionalism. This portfolio in turn can be used for formative and summative feedback. Data from professionalism assessments can also be used for developing professionalism curricula and generating research hypotheses. Health care leaders should support teaching and assessing professionalism at all levels of learning and practice and promote learning environments and institutional cultures that are consistent with professionalism precepts.
Future professionals will bear the brunt of creating sustainable societies. Equipping them for the task is the challenge of current educators. Educational experiences facilitating the development of sustainable habits of mind are needed. This research reports on the experiences of developing scientists and engineers engaged in a sustainable energy…
Otenko Vasyl I.
Full Text Available Unanticipated crises in various spheres of society are becoming a main object of attention of the mankind and civilization forming a new model of civilization – the risk society. Although this model is reflected in many works by scientists from different areas, methodological and practical justification of mechanisms for complex study of risks both at the society and enterprise level still remain relevant. The main resource for solving the problem of adaptation to life in the risk society is a person, who has both a high level of creativity and social responsibility. The unpredictability of enterprise risks can be overcome by developing professional mobility of its staff. This quality of a person is formed under the influence of a large number of external and internal factors. Among them the most difficult are the creative motivation of a person’s behavior and his/her internal mental set. In order to develop a methodological basis for formation of the staff professional mobility, it is necessary to formulate the main idea and hypothesis of a new theory, justify a list of disciplines studying certain aspects of the risk society and professional mobility, analyze paradigms of related sciences and choose ideas to form foundations of a new paradigm for creating a multidisciplinary system of concepts, principles and methods of research information support, rules of qualitative and quantitative assessment of its subject.
Nina V. Komleva
Full Text Available Now, there are processes of formation of a knowledge society – the Smart-society – are all the new features, which are characterized by obtaining a new effect from the use of information and communication technologies. The development of computers and communications creates the preconditions for moving the place of work out of the office space in the digital home. In these circumstances, more and more importance is given to the individual skills of the person, its ability to absorb a huge amount of diverse information, generate and innovate. Therefore, empowerment process for every professional who wants to be popular, it becomes continuous, becomes a constant need to learn and lifelong learning. In addition, requirements for the employees are changing, and the person must evaluate its relevance to society. This raises the question: how to evaluate the relevance? What is necessary for the Smart-society?What to learn or re-learn? Focus shifts from classical training to personal development. Traditional methods and approaches to learning have stopped covering the needs of the knowledge. Instead of selecting a limited number of the templates, each person is faced with the necessity to configure your own unique personality, to increasingly use informal learning, providing the individual development.The professional competence of the person in the Smart-society is formed in an interactive learning environment, using content from around the world, which is in the public domain. The assessment level of competence, identifying the need for professional development, early learning with the use of technology, provided by the Smart-education, are essential components of the formation process of professional competence of the person in the Smart-society. It is important to provide the compliance of the business metrics of employees to the content of the assessment test at the stage of internal validation for the purpose of timely identification of those
teaching community in a Kenyan context on how ... buttressed by the Mezirow's theory of transformative learning, especially .... programs with the other institutions, or like other medical ... “A career day where they bring different professionals:.
Sulović, V; Pavlović, B
Serbian Medical Society was founded on April 22, 1872. Foundation initiators were physicians of the following nationalities: 5 Serbs, 3 Czechs, 2 Poles, 3 Germans, 1 Slovak and 1 Greek. Josip Pancić was one of its founders as well, and the first president of the Serbian Academy of Sciences and Arts. Dr. Aćim Medović was elected its first President at the Inaugural Assembly, and Dr. Vladan Dordević its Secretary. Later, on October 17, 1874 Constitution of the Serbian Medical Society was passed and its was acknowledged by the Serbian Interior Minister. The first professional meeting was held on August 5, 1872, when they started the first medical journal named "Serbian Archives for All Physicians" ("Srpski arhiv za celokupno lekarstvo") that is being published regularly even today. At the proposal of SLD a Law on Medical Protection was passed (1881). This Law was translated into two European languages, German and French, and sent to be reconsidered by 400 towns throughout Europe. This Law included, beside the other things, the following: "...penny intended for health cannot be spent either by King, or by the Government or by any political party because it is intended for the health, tratement of the sick and doctors' salaries..." The first Congress of the Serbian physicians and scientists devoted to natural sciences was held in Belgrade from 5th to 7th of September, 1904, and it gahtered about 433 participants, among which over hundred were from abroad. In 1907 SLD organized in Belgrade "The First Scientific Conference of Yugoslav Doctors for Operating Surgery". Red Cross in Serbia was founded upon the initiative of SLD. The first initiative to establish the School of Medicine in Belgrade was given by SLD as well. Members of SLD proved their loyalty and devotion to their people, democracy and liberty during liberation wars in XIX and XX century by putting themselves in service of the sich and wrecked. Today, SLD realizes its professional activity through the work
McCammon, Susan D; Brody, Howard
We argue that a turn toward virtue ethics as a way of understanding medical professionalism represents both a valuable corrective and a missed opportunity. We look at three ways in which a closer appeal to virtue ethics could help address current problems or issues in professionalism education-first, balancing professionalism training with demands for professional virtues as a prerequisite; second, preventing demands for the demonstrable achievement of competencies from working against ideal professionalism education as lifelong learning; and third, avoiding temptations to dismiss moral distress as a mere "hidden curriculum" problem. As a further demonstration of how best to approach a lifelong practice of medical virtue, we will examine altruism as a mean between the extremes of self-sacrifice and selfishness.
This paper presents the perspective from a less developed country for broadening the horizon of medical imaging as an integral part of medical records and biomedical information. From the industrial to the information society, the number as well as the diversity of stakeholders in the medical records and medical information has grown. this call for a fresh outlook on medical radiography and medical imaging
Jauregui, Joshua; Gatewood, Medley O; Ilgen, Jonathan S; Schaninger, Caitlin; Strote, Jared
Medical professionalism is a core competency for emergency medicine (EM) trainees; but defining professionalism remains challenging, leading to difficulties creating objectives and performing assessment. Because professionalism is dynamic, culture-specific, and often taught by modeling, an exploration of trainees' perceptions can highlight their educational baseline and elucidate the importance they place on general conventional professionalism domains. To this end, our objective was to assess the relative value EM residents place on traditional components of professionalism. We performed a cross-sectional, multi-institutional survey of incoming and graduating EM residents at four programs. The survey was developed using the American Board of Internal Medicine's "Project Professionalism" and the Accreditation Council of Graduate Medical Education definition of professionalism competency. We identified 27 attributes within seven domains: clinical excellence, humanism, accountability, altruism, duty and service, honor and integrity, and respect for others. Residents were asked to rate each attribute on a 10-point scale. We analyzed data to assess variance across attributes as well as differences between residents at different training levels or different institutions. Of the 114 residents eligible, 100 (88%) completed the survey. The relative value assigned to different professional attributes varied considerably, with those in the altruism domain valued significantly lower and those in the "respect for others" and "honor and integrity" valued significantly higher (p<0.001). Significant differences were found between interns and seniors for five attributes primarily in the "duty and service" domain (p<0.05). Among different residencies, significant differences were found with attributes within the "altruism" and "duty and service" domains (p<0.05). Residents perceive differences in the relative importance of traditionally defined professional attributes and this may
The rise of the corporation within health care during the 1980s and early 1990s was met by organized medicine with a deluge of editorials, articles, and books that identified a singular enemy--commercialism--and depicted it as corrosive of, and antithetical to, medical professionalism. Medicine's ire proved prognostic as scores of highly publicized corporate-medical scandals began to crater the landscape of a rapidly emerging "medical marketplace." Medicine's main weapon in this counteroffensive was a renewed call to medical professionalism. Numerous organizations hosted conferences and underwrote initiatives to define, measure, and ultimately inculcate professionalism as a core medical competency. Nonetheless, an examination of medicine's overall response to the threat of commercialism reveals inconsistencies and schisms between these praiseworthy efforts and a parallel absence of action at the community practitioner and peer-review levels. The most recent salvo in this war on commercialism is a policy proposal by influential medical leaders who call for an end to the market incentives linking academic health centers and medical schools with industry. These forthright proposals nevertheless appear once again not to address the heartbeat of professional social control: community-based peer review, including a vigorous and proactive role by state medical boards. The author concludes by examining the implications of a professionalism bereft of peer review and explores the societal-level responsibilities of organized medicine to protect, nurture, and expand the role of the physician to maintain the values and ideals of professionalism against the countervailing social forces of the free market and bureaucracy.
Gollust, Sarah E; Dwyer, Anne M
Cancer experts engage in public communication whenever they promote their research or practice, respond to media inquiries, or use social media. In a changing communication landscape characterized by new technologies and heightened attention to cancer controversies, these activities may pose ethical challenges. This study was designed to evaluate existing resources to help clinicians navigate their public communication activities. We conducted a systematic, qualitative content analysis of codes of ethics, policy statements, and similar documents disseminated by professional medical and nursing societies for their members. We examined these documents for four types of content related to public communication: communication via traditional media; communication via social media; other communication to the public, policy, and legal spheres; and nonspecific language regarding public communication. We identified 46 documents from 23 professional societies for analysis. Five societies had language about traditional news media communication, five had guidance about social media, 11 had guidance about other communication domains, and 15 societies offered general language about public communication. The limited existing guidance focused on ethical issues related to patients (such as privacy violations) or clinicians (such as accuracy and professional boundaries), with less attention to population or policy impact of communication. Cancer-related professional societies might consider establishing more specific guidance for clinicians concerning their communication activities in light of changes to the communication landscape. Additional research is warranted to understand the extent to which clinicians face ethical challenges in public communication.
Gorrindo, Tristan; Groves, James E
The AMA's social media guidelines provide physicians with some basic rules for maintaining professional boundaries when engaging in online activities. Left unanswered are questions about how these guidelines are to be implemented by physicians of different generations. By examining the issues of privacy and technological skill through the eyes of digital natives and digital immigrants, the challenges associated with medical e-professionalism become clear.
Recupero, Patricia R
In child and adolescent psychiatry, medical records and professional communications raise important ethical concerns for the treating or consulting clinician. Although a distinction may be drawn between internal records (eg, medical records and psychotherapy notes) and external communications (eg, consultation reports and correspondence with pediatricians), several ethical principles apply to both types of documentation; however, specific considerations may vary, depending upon the context in which the records or communications were produced. Special care is due with regard to thoroughness and honesty, collaboration and cooperation, autonomy and dignity of the patient, confidentiality of the patient and family members, maintaining objectivity and neutrality, electronic communications media, and professional activities (eg, political advocacy). This article reviews relevant ethical concerns for child and adolescent psychiatrists with respect to medical records and professional communications, drawing heavily from forensic and legal sources, and offers additional recommendations for further reading for clarification and direction on ethical dilemmas.
Holcombe, Sarah Jane
Unsafe abortion is one of the three leading causes of maternal mortality in low-income countries; however, few countries have reformed their laws to permit safer, legal abortion, and professional medical associations have not tended to spearhead this type of reform. Support from a professional association typically carries more weight than does that from an individual medical professional. However, theory predicts and the empirical record largely reveals that medical associations shy from engagement in conflictual policymaking such as on abortion, except when professional autonomy or income is at stake. Using interviews with 10 obstetrician-gynaecologists and 44 other leaders familiar with Ethiopia's reproductive health policy context, as well as other primary and secondary sources, this research examines why, counter to theoretical expectations from the sociology of medical professions literature and experience elsewhere, the Ethiopian Society of Obstetricians & Gynecologists (ESOG) actively supported reform of national law on abortion. ESOG leadership participation was motivated by both individual and ESOG's organizational commitments to reducing maternal mortality and also by professional training and work experience. Further, typical constraints on medical society involvement in policymaking were relaxed or removed, including those related to ESOG's organizational structure and history, and to political environment. Findings do not contradict theory positing medical society avoidance of socially conflictual health policymaking, but rather identify how the expected restrictions were less present in Ethiopia, facilitating medical society participation. Results can inform efforts to encourage medical society participation in policy reform to improve women's health elsewhere in sub-Saharan Africa.
these basic principles will go a long way in reducing the ... medical practitioner must therefore be prepared at all ... physician accepts to see a patient, he must define in his ... tells the nurse who is doing daily ..... International Journal of Medical ...
Next steps: For many, the future of the medical profession lies in abandoning altruism as part of its defining qualities and adopting a new ethical definition of professionalism that fits with the complexities of modern society
Huddle, Thomas S
It is increasingly suggested that political advocacy is a core professional responsibility for physicians. The author argues that this is an error. Advocacy on behalf of societal goals, even those goals as unexceptionable as the betterment of human health, is inevitably political. Claims that political advocacy are a professional responsibility are mistaken, the author argues, because (1) civic virtues are outside the professional realm, (2) even if civic virtues were professionally obligatory, it is unclear that civic participation is necessary for such virtue, and (3) the profession of medicine ought not to require any particular political stance of its members. Claims that academic health centers should systematically foster advocacy are also deeply problematic. Although advocacy may coexist alongside the core university activities of research and education, insofar as it infects those activities, advocacy is likely to subvert them, as advocacy seeks change rather than knowledge. And official efforts on behalf of advocacy will undermine university aspirations to objectivity and neutrality.American society has conferred remarkable success and prosperity on its medical profession. Physicians are deserving of such success only insofar as they succeed in offering society excellence and dedication in professional work. Mandatory professional advocacy must displace such work but cannot substitute for it. The medical profession should steadfastly resist attempts to add advocacy to its essential professional commitments.
Full Text Available Introduction: Medical professionalism is a core competency for emergency medicine (EM trainees; but defining professionalism remains challenging, leading to difficulties creating objectives and performing assessment. Because professionalism is dynamic, culture-specific, and often taught by modeling, an exploration of trainees’ perceptions can highlight their educational baseline and elucidate the importance they place on general conventional professionalism domains. To this end, our objective was to assess the relative value EM residents place on traditional components of professionalism. Methods: We performed a cross-sectional, multi-institutional survey of incoming and graduating EM residents at four programs. The survey was developed using the American Board of Internal Medicine’s “Project Professionalism” and the Accreditation Council of Graduate Medical Education definition of professionalism competency. We identified 27 attributes within seven domains: clinical excellence, humanism, accountability, altruism, duty and service, honor and integrity, and respect for others. Residents were asked to rate each attribute on a 10-point scale. We analyzed data to assess variance across attributes as well as differences between residents at different training levels or different institutions. Results: Of the 114 residents eligible, 100 (88% completed the survey. The relative value assigned to different professional attributes varied considerably, with those in the altruism domain valued significantly lower and those in the “respect for others” and “honor and integrity” valued significantly higher (p<0.001. Significant differences were found between interns and seniors for five attributes primarily in the “duty and service” domain (p<0.05. Among different residencies, significant differences were found with attributes within the “altruism” and “duty and service” domains (p<0.05. Conclusion: Residents perceive differences in
Harrison, Rebecca; Busari, Jamiu; Dornan, Tim
Medical professionalism has become a core topic in medical education. As it has been considered mostly from a Western perspective, there is a need to examine how the same or similar concepts are reflected in a wider range of cultural contexts. To gain insights into medical professionalism concepts in Japanese culture, the authors compare the tenets of a frequently referenced Western guide to professionalism (the physician charter proposed by the American Board of Internal Medicine Foundation, American College of Physicians Foundation, and the European Federation of Internal Medicine) with the concepts of Bushido, a Japanese code of personal conduct originating from the ancient samurai warriors. The authors also present survey evidence about how a group of present-day Japanese doctors view the values of Bushido. Cultural scholars have demonstrated Bushido’s continuing influence on Japanese people today. The authors explain the seven main virtues of Bushido (e.g., rectitude), describe the similarities and differences between Bushido and the physician charter, and speculate on factors that may account for the differences, including the influence of religion, how much the group versus the individual is emphasized in a culture, and what emphasis is given to virtue-based versus duty-based ethics. The authors suggest that for those who are teaching and practicing in Japan today, Bushido’s virtues are applicable when considering medical professionalism and merit further study. They urge that there be a richer discussion, from the viewpoints of different cultures, on the meaning of professionalism in today’s health care practice. PMID:24556758
Fam Med). Senior Lecturer, Department of Family Medicine ... Keywords: Medical Professionalism, Patient welfare, Autonomy, Social justice, .... unenviable position of having to balance professionalism and ... Physicians should work actively.
Weiss, Daniel J; Turner, Leigh; Levine, Aaron D; Ikonomou, Laertis
Businesses marketing unproven stem cell interventions proliferate within the U.S. and in the larger global marketplace. There have been global efforts by scientists, patient advocacy groups, bioethicists, and public policy experts to counteract the uncontrolled and premature commercialization of stem cell interventions. In this commentary, we posit that medical societies and associations of health care professionals have a particular responsibility to be an active partner in such efforts. We review the role medical societies can and should play in this area through patient advocacy and awareness initiatives. Copyright © 2017 International Society for Cellular Therapy. Published by Elsevier Inc. All rights reserved.
Holloway, K J
Resistance by physicians, medical researchers, medical educators, and medical students to pharmaceutical industry influence in medicine is often based on the notion that physicians (guided by the ethics of their profession) and the industry (guided by profit) are in conflict. This criticism has taken the form of a professional movement opposing conflict of interest (COI) in medicine and medical education and has resulted in policies and guidelines that frame COI as the problem and outline measures to address this problem. In this paper, I offer a critique of this focus on COI that is grounded in a broader critique of neo-liberalism, arguing it individualizes the relationship between physicians and industry, too neatly delineates between the two entities, and reduces the network of social, economic, and political relations to this one dilemma.
Health care administration in many OECD countries has undergone substantial changes in recent years as a consequence of NPM reforms, rising costs, the pace of technological innovation, heightened competition for patients and resources, quality of managed care and demographic shifts. Hospitals...... especially have been reformed due to the high proportion of resources they absorb and the apparent difficulty of prioritizing and coordinating health care within hospitals. There is abundant research literature on the topic of reforming hospital management models. Lacking from the literature, however......, is insight into how we can understand and explain how medical professionals adapt hospital management over time in relation to changing hospital management models that are global in their influence in hospital organizations. The aim of this dissertation is to understand and explain how medical professionals...
Jaqueline Brito Vidal Batista; Thaíza Ferreira Costa; Jocerlânia Maria Dias de Morais; Eveline de Oliveira Barros; Patrícia Serpa de Souza Batista; Márcia Adriana Dias Meirelles Moreira; Jessyka Cibelly Minervina da Costa Silva; Débora Rodrigues Alves de Lima; Ana Hévila Marinho Bezerra; Irany Carvalho da Silva
This study aimed to investigate the understanding of medical teaching professionals about Burnout Syndrome. This is a qualitative, exploratory study, consisting of ten teaching physicians, who work at the hospital of a higher education institution. The data were collected from May to June 2013, through a form with questions pertinent to the proposed research objective, after approval by the Research Ethics Committee (Protocol No. 84022), and analyzed qualitatively, through the content analysi...
Williams, David; Edelman, Elazer R; Radisic, Milica; Laurencin, Cato; Untereker, Darrel
The medical-technology sector must educate society in an unbiased rational way about the successes and benefits of biotechnology innovation. Copyright © 2017, American Association for the Advancement of Science.
N. G. Osipova
Full Text Available The article deals with the problems associated with the construction of the ideal type of the modern physician, as well as the identification of the key aspects of professional deformations of his personality and the analysis of the effects of these strains on the principles of conduct in relation to a patient. The introduction of market relations in health care system caused the competition between medical institutions, forcing them to look for additional ways to attract patients and as a result, the range of medical services to the population has significantly expended. A positive consequence has become a trend, expressed in an effort to improve the skills of doctors, the quality of work with patients. On the other hand, liberal globalization has led to the devaluation of the structure of the individual doctor and the public interest has strengthened the role and importance of individualistic interests. The result was the alienation of the doctors from the patients took on a mass character, which led to a degradation of the professional medical community and health care system in general. The authors are regarded as normative characteristics of medical practice, and indicators related to the subjectivity of doctor’s behavior, which reflects the perceived boundaries of the doctor’s professional and personal effects to the patient; attitude toward himself as a person and a professional; professional attitude of the society to the doctors and to the prevailing social and historical traditions of healing. The main characteristics that allow to construct an ideal type of physician are: high professionalism and its use for the benefit of man and society; rules of communicating with people who are sick; ethics in relationships in a professional environment; moral principles and ethics of the individual and the social order: the observance of a number of limitations and restrictions. However, under the pressure of contemporary
Guideline on allergen-specific immunotherapy in IgE-mediated allergic diseases: S2k Guideline of the German Society for Allergology and Clinical Immunology (DGAKI), the Society for Pediatric Allergy and Environmental Medicine (GPA), the Medical Association of German Allergologists (AeDA), the Austrian Society for Allergy and Immunology (ÖGAI), the Swiss Society for Allergy and Immunology (SGAI), the German Society of Dermatology (DDG), the German Society of Oto- Rhino-Laryngology, Head and Neck Surgery (DGHNO-KHC), the German Society of Pediatrics and Adolescent Medicine (DGKJ), the Society for Pediatric Pneumology (GPP), the German Respiratory Society (DGP), the German Association of ENT Surgeons (BV-HNO), the Professional Federation of Paediatricians and Youth Doctors (BVKJ), the Federal Association of Pulmonologists (BDP) and the German Dermatologists Association (BVDD).
Pfaar, Oliver; Bachert, Claus; Bufe, Albrecht; Buhl, Roland; Ebner, Christof; Eng, Peter; Friedrichs, Frank; Fuchs, Thomas; Hamelmann, Eckard; Hartwig-Bade, Doris; Hering, Thomas; Huttegger, Isidor; Jung, Kirsten; Klimek, Ludger; Kopp, Matthias Volkmar; Merk, Hans; Rabe, Uta; Saloga, Joachim; Schmid-Grendelmeier, Peter; Schuster, Antje; Schwerk, Nicolaus; Sitter, Helmut; Umpfenbach, Ulrich; Wedi, Bettina; Wöhrl, Stefan; Worm, Margitta; Kleine-Tebbe, Jörg; Kaul, Susanne; Schwalfenberg, Anja
The present guideline (S2k) on allergen-specific immunotherapy (AIT) was established by the German, Austrian and Swiss professional associations for allergy in consensus with the scientific specialist societies and professional associations in the fields of otolaryngology, dermatology and venereology, pediatric and adolescent medicine, pneumology as well as a German patient organization (German Allergy and Asthma Association; Deutscher Allergie- und Asthmabund, DAAB) according to the criteria of the Association of the Scientific Medical Societies in Germany (Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften, AWMF). AIT is a therapy with disease-modifying effects. By administering allergen extracts, specific blocking antibodies, toler-ance-inducing cells and mediators are activated. These prevent further exacerbation of the allergen-triggered immune response, block the specific immune response and attenuate the inflammatory response in tissue. Products for SCIT or SLIT cannot be compared at present due to their heterogeneous composition, nor can allergen concentrations given by different manufacturers be compared meaningfully due to the varying methods used to measure their active ingredients. Non-modified allergens are used for SCIT in the form of aqueous or physically adsorbed (depot) extracts, as well as chemically modified allergens (allergoids) as depot extracts. Allergen extracts for SLIT are used in the form of aqueous solutions or tablets. The clinical efficacy of AIT is measured using various scores as primary and secondary study endpoints. The EMA stipulates combined symptom and medication scores as primary endpoint. A harmonization of clinical endpoints, e. g., by using the combined symptom and medication scores (CSMS) recommended by the EAACI, is desirable in the future in order to permit the comparison of results from different studies. The current CONSORT recommendations from the ARIA/GA2LEN group specify standards for the
Doukas, David J; McCullough, Laurence B; Wear, Stephen
Medical education accreditation organizations require medical ethics and humanities education to develop professionalism in medical learners, yet there has never been a comprehensive critical appraisal of medical education in ethics and humanities. The Project to Rebalance and Integrate Medical Education (PRIME) I Workshop, convened in May 2010, undertook the first critical appraisal of the definitions, goals, and objectives of medical ethics and humanities teaching. The authors describe assembling a national expert panel of educators representing the disciplines of ethics, history, literature, and the visual arts. This panel was tasked with describing the major pedagogical goals of art, ethics, history, and literature in medical education, how these disciplines should be integrated with one another in medical education, and how they could be best integrated into undergraduate and graduate medical education. The authors present the recommendations resulting from the PRIME I discussion, centered on three main themes. The major goal of medical education in ethics and humanities is to promote humanistic skills and professional conduct in physicians. Patient-centered skills enable learners to become medical professionals, whereas critical thinking skills assist learners to critically appraise the concept and implementation of medical professionalism. Implementation of a comprehensive medical ethics and humanities curriculum in medical school and residency requires clear direction and academic support and should be based on clear goals and objectives that can be reliably assessed. The PRIME expert panel concurred that medical ethics and humanities education is essential for professional development in medicine.
The article covers current problems of professional training of junior medical staff. The main disadvantages of Ukrainian system of medical education that impede the intention of improving quality of professional training of junior medical staff have been analyzed. European experience in organizing medical education, namely, in Great Britain,…
Jaqueline Brito Vidal Batista
Full Text Available This study aimed to investigate the understanding of medical teaching professionals about Burnout Syndrome. This is a qualitative, exploratory study, consisting of ten teaching physicians, who work at the hospital of a higher education institution. The data were collected from May to June 2013, through a form with questions pertinent to the proposed research objective, after approval by the Research Ethics Committee (Protocol No. 84022, and analyzed qualitatively, through the content analysis technique (Bardin. Among the 10 participants in the study, eight had adequate knowledge about Burnout Syndrome, while others showed insufficient knowledge. From the empirical material analysis, five thematic categories emerged: Syndrome characterized by physical and psychological exhaustion due to work stress; Physical and psychological signs and symptoms of Burnout Syndrome; Burnout syndrome and its implications for the worker’s health; The most vulnerable workers who develop Burnout Syndrome and Relation of Burnout Syndrome to the work of the teaching physician. The study showed that most participants in the research adequately understand Burnout Syndrome, but the subject is still little explored in academia. Therefore, intervention measures are necessary with the professionals of the risk group and new studies that contribute to expand the knowledge about that syndrome, aiming to improve the quality of life of the workers. Keywords: Worker’s Health; Professional Exhaustion; Doctors; Professors; Work Conditions. DOI: http://dx.doi.org/10.3823/2397
Conceptions of professionalism in medicine draw on social contract theory; its strengths and weaknesses play out in how we reason about professionalism. The social contract metaphor may be a heuristic device prompting reflection on social responsibility, and as such is appealing: it encourages reasoning about privilege and responsibility, the broader context and consequences of action, and diverse perspectives on medical practice. However, when this metaphor is elevated to the status of a theory, it has well-known limits: the assumed subject position of contractors engenders blind spots about privilege, not critical reflection; its tendency to dress up the status quo in the trappings of a theoretical agreement may limit social negotiation; its attempted reconciliation of social obligation and self-interest fosters the view that ethics and self-interest should coincide; it sets up false expectations by identifying appearance and reality in morality; and its construal of prima facie duties as conditional misdirects ethical attention in particular situations from current needs to supposed past agreements or reciprocities. Using philosophical ideas as heuristic devices in medical ethics is inevitable, but we should be conscious of their limitations. When they limit the ethical scope of debate, we should seek new metaphors.
Hoogland, Jan; Jochemsen, Henk
Professional autonomy is often described as a claim of professionals that has to serve primarily their own interests. However, it can also be seen as an element of a professional ideal that can function as a standard for professional, i.e. medical practice. This normative understanding of the
García-Guerrero, J; Vera-Remartínez, E J
To study the knowledge on professional deontology amongst doctors in prisons. Descriptive, transversal and multi-centre study. Labour, collegiate, social, demographic and deontological variables were collected. A descriptive analysis of the variables was performed. A bivariate analysis was made by binary logistic regression models, attending to the odds ratio, and assuming a 95% confidence interval. Data was processed by SPSS v.20 software. 118 doctors replied. 68 men (57.6%), with an average age of 51 years (50-53). 100 know about the Deontology Committee (84.7%), but just 77 (65.3%) know its functions properly. 42 (35.6%) know about the existence of the Deontological Code, and 37 (31.3%) have read and apply it. Those who made a correct definition of deontology do find more deontological issues in their daily work [23(46.9%) vs. 18(26.1%); OR: 2.506; IC95%: 1.153-5.451; p=0.020] and would denounce a colleague more often to the Medical Association [40(81.6%) vs. 42 (60.9%); OR: 2.857; IC95%: 1.197-6.819; p=0.018]. Older ones know more about the deontology commissions' functions [54(73%) vs. 23(52.3%); OR: 2.465; IC95%: 1.127-5.394; p=0.024] and have already denounced situations to the Medical Association [27(36.5% vs. 5(11.4%); OR: 4.481; IC95%: 1.577-12.733; p=0.005], but think that a different Care Ethics Committee is unnecessary [57(77%) vs. 42(95.5%); OR: 0.160; IC95%: 0.035- 0.729; p=0.018]. Prison doctors know little about what professional deontology really is. This knowledge increases with age in the profession and is associated with an increased perception of deontological issues in daily practice.
Roč. 9, - (2005), s. 269-274 ISSN 1335-2393. [YBERC 2005. Young Biomedical Engineers and Researchers Conference. Stará Lesná, 13.07.2005-15.07.2005] Institutional research plan: CEZ:AV0Z10300504 Keywords : medical informatics * information society * telemedicine * education * research and development Subject RIV: BD - Theory of Information
Brazeau, Chantal M L R; Schroeder, Robin; Rovi, Sue; Boyd, Linda
Medical student burnout is prevalent, and there has been much discussion about burnout and professionalism in medical education and the clinical learning environment. Yet, few studies have attempted to explore relationships between those issues using validated instruments. Medical students were surveyed at the beginning of their fourth year using the Maslach Burnout Inventory, the Jefferson Scale of Physician Empathy-Student Version, and the Professionalism Climate Instrument. The data were analyzed using Statistical Package for the Social Sciences, and Spearman correlation analysis was performed. Scores indicative of higher medical student burnout were associated with lower medical student empathy scores and with lower professionalism climate scores observed in medical students, residents, and faculty. Investigators observed relationships between medical student burnout, empathy, and professionalism climate. These findings may have implications for the design of curriculum interventions to promote student well-being and professionalism.
Full Text Available Objective: To study the knowledge on professional deontology amongst doctors in prisons. Materials and Method: Descriptive, transversal and multi-centre study. Labour, collegiate, social, demographic and deontological variables were collected. A descriptive analysis of the variables was performed. A bivariate analysis was made by binary logistic regression models, attending to the odds ratio, and assuming a 95% confidence interval. Data was processed by SPSS v.20 software. Results: 118 doctors replied. 68 men (57.6%, with an average age of 51 years (50-53. 100 know about the Deontology Committee (84.7%, but just 77 (65.3% know its functions properly. 42 (35.6% know about the existence of the Deontological Code, and 37 (31.3% have read and apply it. Those who made a correct definition of deontology do find more deontological issues in their daily work [23(46.9% vs. 18(26.1%; OR: 2.506; IC95%: 1.153-5.451; p=0.020] and would denounce a colleague more often to the Medical Association [40(81.6% vs. 42 (60.9%; OR: 2.857; IC95%: 1.197-6.819; p=0.018]. Older ones know more about the deontology commissions' functions [54(73% vs. 23(52.3%; OR: 2.465; IC95%: 1.127-5.394; p=0.024] and have already denounced situations to the Medical Association [27(36.5% vs. 5(11.4%; OR: 4.481; IC95%: 1.577-12.733; p=0.005], but think that a different Care Ethics Committee is unnecessary [57(77% vs. 42(95.5%; OR: 0.160; IC95%: 0.035- 0.729; p=0.018]. Conclusions: Prison doctors know little about what professional deontology really is. This knowledge increases with age in the profession and is associated with an increased perception of deontological issues in daily practice.
Rosenwald, Jean-Claude; Aventin, Christophe; Coste, Frederic; Francois, Pascal; Ginestet, Chantal; Perrin, Benedicte; Salvat, Cecile; Caselles, Olivier; Dedieu, Veronique; Dejean, Catherine; Batalla, Alain; Guillaume, Bonniaud; LeDu, Dominique; Lisbona, Albert; Marchesi, Vincent; Sarrazin, Thierry; Mazeron, Jean-Jacques; Lipinski, Francis; Vera, Pierre; Maximilien Vermandel; Ducou le Pointe, Hubert; Vidal, Vincent; Henry, Cecile; Mazeau-Woynar, Valerie; Prot, Camille; Valero, Marc; Aubert, Bernard; Etard, Cecile; Jimonet, Christine; Roue, Amelie; Sage, Julie; Bardies, Manuel; Beauvais, Helene; Bey, Pierre; Costa, Andre; Desblancs, Claire; Eudaldo, Teresa; Farman, Bardia; Ferrand, Regis; Garcia, Robin; Giraud, Jean-Yves; Husson, Francois; Koulibaly, Malick; Carlan, Loic de; Manens, Jean-Pierre; Naudy, Suzanne; Noel, Alain; Pilette, Pierre; Verdun, Francis
After a presentation of the methodological approach used to write this book, the first chapter addresses the profession of medical physicist: medical physics in France (history, evolution of the profession, of the education and of regulation), legal framework (related to the medical use of ionizing radiations, legal texts directly concerning medical physics, regulations impacting the professional practice of medical physicists), scopes of intervention of the medical physicist (context, missions, dose management, image quality, quality management and safety, relationship with the patient, education, training and research, relationships with industry, cost management), operating conditions, and good professional practices. The second chapter addresses the principles of management of quality and safety: quality management in medical physics, safety management, quality and safety in health care facilities. The third part addresses good practices in medical physics: general principles of working methods, equipment management, participation to clinic activities
Rosenwald, Jean-Claude; Aventin, Christophe; Coste, Frederic; Francois, Pascal; Ginestet, Chantal; Perrin, Benedicte; Salvat, Cecile; Caselles, Olivier; Dedieu, Veronique; Dejean, Catherine; Batalla, Alain; Guillaume, Bonniaud; Le Du, Dominique; Lisbona, Albert; Marchesi, Vincent; Sarrazin, Thierry; Mazeron, Jean-Jacques; Lipinski, Francis; Vera, Pierre; Vermandel, Maximilien; Ducou le Pointe, Hubert; Vidal, Vincent; Henry, Cecile; Mazeau-Woynar, Valerie; Prot, Camille; Valero, Marc; Aubert, Bernard; Etard, Cecile; Jimonet, Christine; Roue, Amelie; Sage, Julie; Bardies, Manuel; Beauvais, Helene; Bey, Pierre; Costa, Andre; Desblancs, Claire; Eudaldo, Teresa; Farman, Bardia; Ferrand, Regis; Garcia, Robin; Giraud, Jean-Yves; Husson, Francois; Koulibaly, Malick; Carlan, Loic de; Manens, Jean-Pierre; Naudy, Suzanne; Noel, Alain; Pilette, Pierre; Verdun, Francis; Bouette, Aurelien; Breen, Stephen; Bridier, Andre; Chauvenet, Bruno; Chavaudra, Jean; Gardin, Isabelle; Herlevin, Karine
After a presentation of the methodological approach used to write this book, the first chapter addresses the profession of medical physicist: medical physics in France (history, evolution of the profession, of the education and of regulation), legal framework (related to the medical use of ionizing radiations, legal texts directly concerning medical physics, regulations impacting the professional practice of medical physicists), scopes of intervention of the medical physicist (context, missions, dose management, image quality, quality management and safety, relationship with the patient, education, training and research, relationships with industry, cost management), operating conditions, and good professional practices. The second chapter addresses the principles of management of quality and safety: quality management in medical physics, safety management, quality and safety in health care facilities. The third part addresses good practices in medical physics: general principles of working methods, equipment management, participation to clinic activities
Medical education is about more than acquiring an appropriate level of knowledge and developing relevant skills. To practice medicine students need to develop a professional identity--ways of being and relating in professional contexts. This article conceptualises the processes underlying the formation and maintenance of medical students' professional identity drawing on concepts from social psychology. A multi-dimensional model of identity and identity formation, along with the concepts of identity capital and multiple identities, are presented. The implications for educators are discussed. Identity formation is mainly social and relational in nature. Educators, and the wider medical society, need to utilise and maximise the opportunities that exist in the various relational settings students experience. Education in its broadest sense is about the transformation of the self into new ways of thinking and relating. Helping students form, and successfully integrate their professional selves into their multiple identities, is a fundamental of medical education.
Stevens, Rosemary A
Professionalism in medicine is an ambiguous term. Discussions are hampered by understandings of the past that are counterproductive to today s debates. Three decades of criticism of physicians as self-interested and arrogant, and of professional organizations as unfairly monopolistic have shaken the confidence of professional leaders and their constituents in their ability to act as a positive social force, and left the concept of professional autonomy without a useful meaning. Inherited assumptions about conflict between the profession, government and the market have encouraged organizational policies to fight familiar enemies for short-term gains, rather than reinvent professionalism as a social force or seek new strategic alliances. This article stresses the importance of distancing the present from the past in re-inventing professionalism for the future, and lists eight fundamental goals.
Al-Abdulrazzaq, Dalia; Al-Fadhli, Amani; Arshad, Andleeb
Professionalism is a core competency in the medical profession worldwide. Numerous studies investigate how this competency is taught and learned. However, there are few reports on the students' views and experiences with professionalism especially in the Arab world. Our aim was to explore the experiences and views of Kuwait final-year medical students on professionalism. This was a questionnaire study of final-year medical students at Kuwait University (n = 95). Open- and close-ended questions were used to determine the students' experiences and views on: definition, teaching, learning, and assessment of professionalism. Eighty-five of the students completed the questionnaire (89.5%). A total of 252 attributes defining professionalism were listed by our respondents. The majority (98.0%) of these attributes were categorized under the CanMEDS theme describing professionalism as commitment to patients, profession, and society through ethical practice. The most helpful methods in learning about professionalism for the students were contact with positive role models, patients and families, and with their own families, relatives and peers. The students' rating of the quality and quantity of teaching professionalism in the institution was quite variable. Despite this, 68.2% of the students felt very or somewhat comfortable explaining the meaning of medical professionalism to junior medical students. Almost half of the students felt that their education had always or sometimes helped them deal with professionally-challenging situations. Majority (77.6%) of the students thought that their academic assessments should include assessment of professionalism and should be used as a selection criterion in their future academic careers (62.3%). Most of the students discussed and sought advice regarding professionally-challenging situations from their fellow medical students and colleagues. Seventy-five (88.2%) students did not know which organizational body in the institution
Robock, A.; Byrne, J.
The obfuscation of authentic science information in North America has reached epidemic proportions. The global warming debate is a classic example - there are a virtual unanimity and overwhelming evidence from scientific community that the Earth is warming rapidly and humans are an important cause, but there is confusion in the media and the public, partly as a result of disinformation campaigns by greenhouse gas polluters. Should the role of scientists in informing the public change in response to this? What should be the role of scientific societies, such as the American Geophysical Union, the American Meteorological Society, or the American Association for the Advancement of Science? Should we continue doing what we are doing, or be more proactive in using new technology to educate the public on important scientific issues? Should we devote resources to television advertisements? Should we support ads in the print media? This talk will discuss the pros and cons of individual and group actions in making the case in public for science, and suggest some new directions.
Doherty, Iain; Steel, Caroline; Parrish, Dominique
Professional societies, established to support academic and professional staff in higher education, need to be vigilant of regional and international trends that affect their core business. In this paper, we provide an analysis of political, economic, social and technological factors that are impacting upon the Australasian higher education…
Introduction: The teaching of professionalism worldwide is changing for effectiveness. Our aim was to explore the reflection of the surgical teaching community in a Kenyan context on how professionalism can be effectively inculcated through the socio-cultural concept of activity theory. Methods: A sequential mixed-methods ...
Homonyuk, Olena; Avramenko, Natalia
Professional broadcasting of future medical foreign workers in the medical sector is a compulsory component of their professional readiness. The diversity of professional broadcasting functions of foreign students, the skillful use of the entire range of speech functionality, its external expressive attributability of speech; these are the most…
Jacob M. Kolman
Full Text Available An ideological case study based on medical profession norms during the Third Reich will be used to exemplify the importance of diversity in the manifestations of professional ethics. The German professional medical community banned their Jewish colleagues from treating German citizens. This included legally mandated employment discrimination and outright censure which led to a professional ethic devoid of diverse voices. While the escalation to the T-4 program and medicalized genocide was influenced by many causes, the intentional, ethnocentric-based exclusion of voices was an important contributing element to the chronicled degradation of societal mores. For illustration, six core Jewish values—life, peace, justice, mercy, scholarship, and sincerity of intention—will be detailed for their potential to inspire health-care professionals to defend and protect minorities and for readers to think critically about the role of medical professionalism in Third Reich society. The Jewish teachings highlight the inherent professional obligations physicians have toward their patients in contrast to the Third Reich’s corruption of patient-centered professionalism. More fundamentally, juxtaposing Jewish and Nazi teachings exposes the loss of perspective when a profession’s identity spurns diversity. To ensure respect for persons in all vulnerable minorities, the first step is addressing professional inclusion of minority voices.
Kolman, Jacob M.; Miller, Susan M.
An ideological case study based on medical profession norms during the Third Reich will be used to exemplify the importance of diversity in the manifestations of professional ethics. The German professional medical community banned their Jewish colleagues from treating German citizens. This included legally mandated employment discrimination and outright censure which led to a professional ethic devoid of diverse voices. While the escalation to the T-4 program and medicalized genocide was influenced by many causes, the intentional, ethnocentric-based exclusion of voices was an important contributing element to the chronicled degradation of societal mores. For illustration, six core Jewish values—life, peace, justice, mercy, scholarship, and sincerity of intention—will be detailed for their potential to inspire health-care professionals to defend and protect minorities and for readers to think critically about the role of medical professionalism in Third Reich society. The Jewish teachings highlight the inherent professional obligations physicians have toward their patients in contrast to the Third Reich’s corruption of patient-centered professionalism. More fundamentally, juxtaposing Jewish and Nazi teachings exposes the loss of perspective when a profession’s identity spurns diversity. To ensure respect for persons in all vulnerable minorities, the first step is addressing professional inclusion of minority voices. PMID:29406846
Kolman, Jacob M; Miller, Susan M
An ideological case study based on medical profession norms during the Third Reich will be used to exemplify the importance of diversity in the manifestations of professional ethics. The German professional medical community banned their Jewish colleagues from treating German citizens. This included legally mandated employment discrimination and outright censure which led to a professional ethic devoid of diverse voices. While the escalation to the T-4 program and medicalized genocide was influenced by many causes, the intentional, ethnocentric-based exclusion of voices was an important contributing element to the chronicled degradation of societal mores. For illustration, six core Jewish values-life, peace, justice, mercy, scholarship, and sincerity of intention-will be detailed for their potential to inspire health-care professionals to defend and protect minorities and for readers to think critically about the role of medical professionalism in Third Reich society. The Jewish teachings highlight the inherent professional obligations physicians have toward their patients in contrast to the Third Reich's corruption of patient-centered professionalism. More fundamentally, juxtaposing Jewish and Nazi teachings exposes the loss of perspective when a profession's identity spurns diversity. To ensure respect for persons in all vulnerable minorities, the first step is addressing professional inclusion of minority voices.
Full Text Available Introduction: Today, development of professionalism is a critical aim of medical schools. Studies have demonstrated that medical students’ perceived level of professionalism is inadequate worldwide. This study aimed to investigate the medical students’ perceptions of their colleagues’ professional behavior. Methods: This study is a cross-sectional study with 280 medical students at Shiraz University of Medical Sciences in their fifth to seventh year of study as the sample. The study was performed during one month in 2013, using stratified random sampling method. The instrument of the study was the Persian version of the questionnaire of the American Board of Internal Medicine (ABIM.The questionnaire includes demographic information, questions about the meaning of the professionalism, history of medical ethics education programs and 12 behavioral questions. The data were analyzed using student t-test and Pearson correlation test. The significance level was set as 0.05. Results: Forty percent of respondents did not know the meaning of professionalism. The mean±SD score of behavioral questions was 5.91±1.2 on a scale from 0 to 10. The mean±SD score of excellence questions was 4.94±1.7. It was 7.05±1.9 for ‘honor/integrity’, and 6.07±2.1 for ‘altruism/respect’ questions. There was a significant association between gender and excellence score (p=0.007. Conclusion: Medical students assessed their colleagues’ professional behavior as poor. They did not have proper information about professionalism. Medical students are future general practitioners and respecting medical ethics by them is very important in a perfect health system. Universities should emphasize the importance of teaching professionalism to medical students and faculty members, using innovative education methods.
Morgan, Gilberto; Lambertini, Matteo; Kourie, Hampig Raphael
The European Society for Medical Oncology (ESMO) is one of the leading societies of oncology professionals in the world. Approximately 30% of the 13 000 ESMO members are below the age of 40 and thus meet the society's definition of young oncologists (YOs). ESMO has identified the training...... and development of YOs as a priority and has therefore established a comprehensive career development programme. This includes a leadership development programme to help identify and develop the future leaders in oncology. Well-trained and highly motivated future generations of multidisciplinary oncologists...... are essential to ensure the optimal evolution of the field of oncology with the ultimate goal of providing the best possible care to patients with cancer. ESMO's career development portfolio is managed and continuously optimised by several dedicated committees composed of ESMO officers and is directly...
In 2012, Health/Medical informatics profession celebrates five jubilees in Bosnia and Herzegovina: a) Thirty five years from the introduction of the first automatic manipulation of data; b) Twenty five years from establishing Society for Medical Informatics BiH; c) Twenty years from establishing scientific and professional journal of the Society for Medical Informatics of Bosnia and Herzegovina "Acta Informatica Medica"; d) Twenty years from establishing first Cathdra for Medical Informatics on biomedical faculties in Bosnia and Herzegovina and e) Ten years from the introduction of "Distance learning" in medical curriculum. All of the five mentioned activities in the area of Medical informatics had special importance and gave appropriate contribution in the development of Health/Medical informatics in Bosnia And Herzegovina.
Slade, Ingrid; Subramanian, Deepak N; Burton, Hilary
Genomics education in the UK is at an early stage of development, and its pace of evolution has lagged behind that of the genomics research upon which it is based. As a result, knowledge of genomics and its applications remains limited among non-specialist clinicians. In this review article, we describe the complex landscape for genomics education within the UK, and highlight the large number and variety of organisations that can influence, direct and provide genomics training to medical professionals. Postgraduate genomics education is being shaped by the work of the Health Education England (HEE) Genomics Education Programme, working in conjunction with the Joint Committee on Genomics in Medicine. The success of their work will be greatly enhanced by the full cooperation and engagement of the many groups, societies and organisations involved with medical education and training (such as the royal colleges). Without this cooperation, there is a risk of poor coordination and unnecessary duplication of work. Leadership from an organisation such as the HEE Genomics Education Programme will have a key role in guiding the formulation and delivery of genomics education policy by various stakeholders among the different disciplines in medicine. © 2016 Royal College of Physicians.
Winkler, A D
Recent government regulations on fraud and abuse have transformed the tradition of professional courtesy discounts into a legal minefield threatening to explode on the uninformed medical provider. This paper offers an understanding of the issues involved and provider options.
Full Text Available The article discusses the necessity of adoption of professional responsibility insurance act into the public health service. It is considered as the basic mechanism of compensation in case of damage to a patient at medical aid rendering
Joseph W. Clyde
Full Text Available Background: Use of social networking services (SNS is on the rise. While many users sign in for personal purposes, it is not uncommon for professionals to connect over SNSs with clients, students, and patients. Methods: The present study used an experimental approach to examine how medical doctors’ SNS profiles impacted potential patients’ impressions of professionalism. Participants (N=250 students were randomly assigned to view one of six Facebook profiles. Profiles were populated with 1 solely professional material, 2 personal material that was strictly healthy, or 3 personal material that included unhealthy behavior. Profiles portrayed a male or female physician resulting in a total of six experimental conditions. Medical professionalism was measured with the First Impressions of Medical Professionalism (FIMP scale, specifically developed for this study. Results: There was a large and statistically significant main effect for profile type, F(2, 250=54.77, p<0.001, ηp2=0.31. Post hoc tests indicated that personal profiles that contained healthy behavior were rated as most professional followed by profiles with strictly professional content. Personal unhealthy profiles were rated as least professional. Additionally, female profiles consistently received higher professionalism ratings across all three profile types [F(1, 250=5.04, p=0.026, ηp2=0.02]. Conclusion: Our results suggest that a physician's SNS profile affects a patient's perception of that physician's medical professionalism. A personal, healthy profile may augment a patient's perception of that physician's character virtues if the profile content upholds the decorum of the medical field.
Al-Eraky, Mohamed Mostafa
Review of studies published in medical education journals over the last decade reveals that teaching medical professionalism is essential, yet challenging. According to a recent Best Evidence in Medical Education (BEME) guide, there is no consensus on a theoretical or practical model to integrate the teaching of professionalism into medical education. The aim of this article is to outline a practical manual for teaching professionalism at all levels of medical education. Drawing from research literature and author's experience, Twelve Tips are listed and organised in four clusters with relevance to (1) the context, (2) the teachers, (3) the curriculum, and (4) the networking. With a better understanding of the guiding educational principles for teaching medical professionalism, medical educators will be able to teach one of the most challenging constructs in medical education.
Mount, K N; Daugherty, J
We researched factors related to the success or failure in working relationships between free-lance medical illustrators and artist's representatives. In the fall of 1992, surveys were mailed to 230 medical illustrators; 105 (46%) completed surveys were returned. Respondents were divided into three categories: 1) medical illustrators currently represented, 2) medical illustrators previously represented, and 3) medical illustrators who had never been represented. Comparisons made among illustrators from the three groups included business practices, clientele, experience, and self-promotion techniques. These comparisons revealed notable differences and similarities between the three groups and were subsequently analyzed to identify the characteristics of medical illustrators who would benefit from professional representation.
La Puma, John; Schiedermayer, David; Becker, Jennifer
Little isd known about how meals are chosen for medical meetings. We surveyed the annual meeting planners for 20 major specialty societies. Thirteen (65%) responded; all were currently planning their next meeting. Attendance in 2000 was reported at 113,477 physicians, with 2 million planned meals and snacks. No physician was named as responsible for food choices; the meeting planner and staff were primarily responsible for deciding what food to serve, excluding exhibit halls. Twelve (92%) respondents rated "available budget" as the most important factor. "Nutritional guidelines" were rated "very important" by eight of 13 (63%). However, no specific nutritional guidelines could be identified by any planner. All respondents indicated that members would attend a meeting if "healthy" food were the only option. For 2000, 100% of respondents indicated that for each lunch and for each dinner, a dessert had been included. No annual meeting and no planned 2001 meeting excluded potato chips, snack mixes, or candies at breaks; soda pop was offered at each break. Most respondents (89%) relied on a concluding questionnaire about the meeting facilities to evaluate the food. Respondents reported no difference in charges for "special meals," including vegetarian and kosher meals. Physicians may be unaware that some food served at medical meetings may impair learning, with excessive calorie, fat, and carbohydrate consumption. Small changes can improve the quality of food and beverages selected, without increased cost, and provide choices that conform to national nutritional guidelines. Medical meetings should serve flavorful, healthful food.
Bearman, Margaret; Lawson, Mary; Jones, Alison
The first year of practice after medical school is considered to be an essential part of becoming a medical practitioner in Australia. Previous qualitative investigations have investigated a number of significant aspects of this early stage of professional development. This qualitative study explores experiences and developing professional…
Helmich, Esther; Derksen, Els; Prevoo, Mathieu; Laan, Roland; Bolhuis, Sanneke; Koopmans, Raymond
Objectives The importance of early clinical experience for medical training is well documented. However, to our knowledge there are no studies that assess the influence of very early nursing attachments on the professional development and identity construction of medical students. Working as an
Helmich, E.; Derksen, E.; Prevoo, M.; Laan, R.F.J.M.; Bolhuis, S.; Koopmans, R.T.C.M.
OBJECTIVES: The importance of early clinical experience for medical training is well documented. However, to our knowledge there are no studies that assess the influence of very early nursing attachments on the professional development and identity construction of medical students. Working as an
Blakeley, C. [University of Salford (United Kingdom); Manchester Royal Infirmary (CMFT) (United Kingdom)], E-mail: firstname.lastname@example.org; Hogg, P. [University of Salford (United Kingdom)
This article is based partly upon the Presidential Address of the Manchester Medical Society (Imaging Section) in 2008. It reviews the development of radiology services in the Manchester (UK) area from their inception in 1896 to the installation of the first EMI body CT scanner in Europe. It considers some of the innovative people in the Manchester area and some milestone events that occurred in that area to help establish the role and value of X-ray in diagnostic imaging. In this article the first recorded case of when X-ray imaging was used in a forensic domiciliary case is also outlined; this occurred approximately 35 miles north of Manchester on 23rd April 1896. The article also explains some interesting background information on the development of the first EMI CT scanner, drawing particularly on the revenue stream generated by the music section of EMI through the success of The Beatles - a band which emanated 35 miles from Manchester in Liverpool.
Blakeley, C.; Hogg, P.
This article is based partly upon the Presidential Address of the Manchester Medical Society (Imaging Section) in 2008. It reviews the development of radiology services in the Manchester (UK) area from their inception in 1896 to the installation of the first EMI body CT scanner in Europe. It considers some of the innovative people in the Manchester area and some milestone events that occurred in that area to help establish the role and value of X-ray in diagnostic imaging. In this article the first recorded case of when X-ray imaging was used in a forensic domiciliary case is also outlined; this occurred approximately 35 miles north of Manchester on 23rd April 1896. The article also explains some interesting background information on the development of the first EMI CT scanner, drawing particularly on the revenue stream generated by the music section of EMI through the success of The Beatles - a band which emanated 35 miles from Manchester in Liverpool.
Yates, L R; Seoane, J; Le Tourneau, C; Siu, L L; Marais, R; Michiels, S; Soria, J C; Campbell, P; Normanno, N; Scarpa, A; Reis-Filho, J S; Rodon, J; Swanton, C; Andre, F
Precision medicine is rapidly evolving within the field of oncology and has brought many new concepts and terminologies that are often poorly defined when first introduced, which may subsequently lead to miscommunication within the oncology community. The European Society for Medical Oncology (ESMO) recognises these challenges and is committed to support the adoption of precision medicine in oncology. To add clarity to the language used by oncologists and basic scientists within the context of precision medicine, the ESMO Translational Research and Personalised Medicine Working Group has developed a standardised glossary of relevant terms. Relevant terms for inclusion in the glossary were identified via an ESMO member survey conducted in Autumn 2016, and by the ESMO Translational Research and Personalised Medicine Working Group members. Each term was defined by experts in the field, discussed and, if necessary, modified by the Working Group before reaching consensus approval. A literature search was carried out to determine which of the terms, 'precision medicine' and 'personalised medicine', is most appropriate to describe this field. A total of 43 terms are included in the glossary, grouped into five main themes-(i) mechanisms of decision, (ii) characteristics of molecular alterations, (iii) tumour characteristics, (iv) clinical trials and statistics and (v) new research tools. The glossary classes 'precision medicine' or 'personalised medicine' as technically interchangeable but the term 'precision medicine' is favoured as it more accurately reflects the highly precise nature of new technologies that permit base pair resolution dissection of cancer genomes and is less likely to be misinterpreted. The ESMO Precision Medicine Glossary provides a resource to facilitate consistent communication in this field by clarifying and raising awareness of the language employed in cancer research and oncology practice. The glossary will be a dynamic entity, undergoing
Kapustin, A V; Tomilin, V V; Ol'khovik, V P; Panfilenko, O A; Serebriakova, V G
The main and additional criteria used in evaluation (in percent) of loss of professional working capacity are characterized. Criteria common for forensic medical and medical social expert evaluations and differences between them are discussed. These differences are due to the fact that forensic medical expert evaluations are based on the Civil and Civil Processual Codes of the Russian Federation but not on the departamental norm-setting documents.
Full Text Available Objectives: Medical students and future physicians have chosen to pursue a profession that requires personal integrity, compassion and a constant awareness of the commitment made by them. Professionalism includes personal behaviors, knowledge, and competency. It includes the attitudes and values one holds and that run through the profession as a whole. Medical students learn professionalism during the course by either direct teaching or experiential learning. We conducted this study to estimate the self-reported level of practice of the core elements of professionalism by medical students and medical faculty and compared the two groups. Methods: One-hundred and nine students and 83 faculty members of Oman Medical College completed a professionalism questionnaire. The survey questions related to core elements of professionalism and were grouped under professional knowledge, professional skills, professional attitude, and qualities essential for professionalism. Results: The response rate was 65.6% (109 of 166 among students and 75.5% (83 of 110 from faculty members. Response to the questions on professional skills between the student and faculty group was significantly different (p < 0.001. Similarly, there was a significant difference in the responses related to professional attitude between the student and faculty group (p < 0.001. Students and faculty members have a significant difference in opinion regarding up to date knowledge of basic and clinical sciences and clinical competency (p = 0.024. Similarly, significant differences in opinion regarding up to date knowledge of basic and clinical sciences and clinical competency in clinical and basic sciences faculty members (p = 0.001. Students identified good communication skills (82.6%, and faculty staff identified up to date professional knowledge (62.7% as the most important aspect of professionalism. Conclusions: Both students and teaching faculty agreed that the top most professional
Shanahan, Madeleine; Herrington, Anthony; Herrington, Jan
Purpose: Updating professional knowledge is a central tenet of Continuing Professional Development (CPD) and professional reading is a common method health practitioners use to update their professional knowledge. This paper reports the level of professional reading by Medical Radiation Science (MRS) practitioners in Australia and examines organisational support for professional reading. Materials and Methods: Survey design was used to collect data from MRS practitioners. A questionnaire was sent to 1142 Australian practitioners, which allowed self-report data to be collected on the length of time practitioners engage in professional reading and the time workplaces allocate to practitioners for professional reading. Results: Of the 362 MRS practitioners who returned the survey, 93.9% engaged in professional reading on a weekly basis. In contrast, only 28.9% of respondents reported that their workplace allocates time for professional reading to practitioners. MRS practitioners employed in universities engaged in higher levels of reading than their colleagues employed in clinical workplaces (p < 0.01) and more university workplaces allocated time for professional reading to their employees than clinical workplaces (p < 0.01). There were no significant differences for clinical practitioners in level of reading across geographic, organisational and professional demographic factors. Significant differences in workplace allocation of time for professional reading in clinical workplaces were evident for health sector (p < 0.01); work environment (p < 0.01); geographic location (p < 0.01) and area of specialisation (p < 0.01). Conclusion: The vast majority of respondent MRS practitioners engage in professional reading to update their professional knowledge. This demonstrates an ongoing commitment at the individual practitioner level for updating professional knowledge. Updating professional knowledge is an organisational as well as an individual practitioner issue. Whilst
Shanahan, Madeleine, E-mail: email@example.com [School of Medical Science, RMIT University, Bundoora, Victoria (Australia); Herrington, Anthony [Head, School of Regional, Remote and eLearning (RRE), Curtin University, Perth (Australia); Herrington, Jan [School of Education, Murdoch University, Perth (Australia)
Purpose: Updating professional knowledge is a central tenet of Continuing Professional Development (CPD) and professional reading is a common method health practitioners use to update their professional knowledge. This paper reports the level of professional reading by Medical Radiation Science (MRS) practitioners in Australia and examines organisational support for professional reading. Materials and Methods: Survey design was used to collect data from MRS practitioners. A questionnaire was sent to 1142 Australian practitioners, which allowed self-report data to be collected on the length of time practitioners engage in professional reading and the time workplaces allocate to practitioners for professional reading. Results: Of the 362 MRS practitioners who returned the survey, 93.9% engaged in professional reading on a weekly basis. In contrast, only 28.9% of respondents reported that their workplace allocates time for professional reading to practitioners. MRS practitioners employed in universities engaged in higher levels of reading than their colleagues employed in clinical workplaces (p < 0.01) and more university workplaces allocated time for professional reading to their employees than clinical workplaces (p < 0.01). There were no significant differences for clinical practitioners in level of reading across geographic, organisational and professional demographic factors. Significant differences in workplace allocation of time for professional reading in clinical workplaces were evident for health sector (p < 0.01); work environment (p < 0.01); geographic location (p < 0.01) and area of specialisation (p < 0.01). Conclusion: The vast majority of respondent MRS practitioners engage in professional reading to update their professional knowledge. This demonstrates an ongoing commitment at the individual practitioner level for updating professional knowledge. Updating professional knowledge is an organisational as well as an individual practitioner issue. Whilst
Salpykova, Indira M.; Politaeva, Tatyana I.
The relevance of the researched problem is caused by the fact, that in modern social circumstances the special attention is given to the formation of a modern highly qualified music teacher, who should be prepared to implement his professional activity in a multicultural society, be able to treat the representatives of various social groups, their…
Makopoulou, Kyriaki; Armour, Kathleen
Background: In the contemporary "knowledge-driven" European society, the quality and relevance of Continuing Professional Development (CPD) for teachers and Physical Education teachers (PE-CPD) has come under scrutiny. National contexts within Europe vary considerably, however, so there is a need to gain analytical insights into PE-CPD…
Margaret C. Hardy
Academic, medical, and research communities are struggling to quickly and effectively address unethical conduct within their professional ranks. Without a policy in place, individuals and institutes are subject to convoluted procedures and unnecessary consequences. In addition to policies geared to prevent harassment and assault, it is important to protect the ethical basis for research and provide a set of guidelines for how professionals treat each other, students, and trainees. Since draft...
Conclusion: Most laboratory technicians in our study reported favourable perceptions of CME programmes, feeling that they increased professional confidence and competency. We recommend that core competencies be integrated into credentialing using profession-specific CME in a workplace setting. In addition, MLTs should be involved in designing the programmes as well. Further studies in a multicentre institution are needed to analyse the difference in perception among those who have attended CME and those who have not.
Radiation protection covers many disciplines from science through philosophy to law, and interacts with many human activities and endeavors. Professional societies for radiation protection were established and evolved throughout the second half of the twentieth century in many countries, and presently represent more than twenty thousand professionals working in more than fifty countries. During the same period a number of international organizations were established, some devoted to radiation safety, others with a role to play in radiation safety; such organizations being either independent non-governmental organizations or intergovernmental organizations of both regional and international dimensions. The national, regional and international radiation protection societies and associations have become the vehicle to provide this conduit from the profession to the international organizations. This is achieved by IRPA having representation within the relevant committees of the various international bodies, such as the Radiation Safety Standards Committee (RASSC) of the IAEA. At a national level radiation protection professionals can gain access to all international developments in radiation protection through the national societies and their interactions with IRPA and also as individual members of IRPA. The possibility to provide consolidated comment and feedback to the international organizations through national societies provides excellent opportunities for societies to organize national workshops and discussion platforms on all important areas of radiation protection.
Klemenc-Ketiš, Zalika; Kersnik, Janko
Abstract Background Professionalism topics are usually not covered as a separate lesson within formal curriculum, but in subtler and less officially recognized educational activities, which makes them difficult to teach and assess. Interactive methods (e.g. movies) could be efficient teaching methods but are rarely studied. The aims of this study were: 1) to test the relevance and usefulness of movies in teaching professionalism to fourth year medical students and, 2) to assess the impact of ...
Full Text Available Abstract Background The professional organization of medical work no longer reflects the changing health needs caused by the growing number of complex and chronically ill patients. Key stakeholders enforce coordination and remove power from the medical professions in order allow for these changes. However, it may also be necessary to initiate basic changes to way in which the medical professionals work in order to adapt to the changing health needs. Discussion Medical leaders, supported by health policy makers, can consciously activate the self-regulatory capacity of medical professionalism in order to transform the medical profession and the related professional processes of care so that it can adapt to the changing health needs. In doing so, they would open up additional routes to the improvement of the health services system and to health improvement. This involves three consecutive steps: (1 defining and categorizing the health needs of the population; (2 reorganizing the specialty domains around the needs of population groups; (3 reorganizing the specialty domains by eliminating work that could be done by less educated personnel or by the patients themselves. We suggest seven strategies that are required in order to achieve this transformation. Summary Changing medical professionalism to fit the changing health needs will not be easy. It will need strong leadership. But, if the medical world does not embark on this endeavour, good doctoring will become merely a bureaucratic and/or marketing exercise that obscures the ultimate goal of medicine which is to optimize the health of both individuals and the entire population.
Shadymov, A B; Fominykh, S A; Dik, V P
This article reports the results of the analysis of the new tendencies and normatives of the working legislation in the field of additional professional education in the speciality of «forensic medical expertise» and the application of the competency-based approach to the training of specialists in the framework of professional requalification and advanced training programs. Special attention is given to the problems of organization of the educational process and the elaboration of additional training programs based on the competency approach to the training of specialists at the Department of Forensic Medicine and Law with the professor V.N. Kryukov Course of Advanced Professional Training and Professional Requalification of Specialists at the state budgetary educational Institution of higher professional education «Altai State Medical University», Russian Ministry of Health. The study revealed the problems pertaining to the development of professional competencies in the framework of educational programs for the professional requalification and advanced training in the speciality «forensic medical expertise». The authors propose the legally substantiated approaches to the solution of these problems.
McPhail, Steven; Schippers, Mandy
Physical inactivity is a modifiable risk factor for many chronic conditions and a leading cause of premature mortality. An increasing proportion of adults worldwide are not engaging in a level of physical activity sufficient to prevent or alleviate these adverse effects. Medical professionals have been identified as potentially powerful sources of influence for those who do not meet minimum physical activity guidelines. Health professionals are respected and expected sources of advice and they reach a large and relevant proportion of the population. Despite this potential, health professionals are not routinely practicing physical activity promotion. Medical professionals experience several known barriers to physical activity promotion including lack of time and lack of perceived efficacy in changing physical activity behaviour in patients. Furthermore, evidence for effective physical activity promotion by medical professionals is inconclusive. To address these problems, new approaches to physical activity promotion are being proposed. These include collaborating with community based physical activity behaviour change interventions, preparing patients for effective brief counselling during a consultation with the medical professional, and use of interactive behaviour change technology. It is important that we recognise the latent risk of physical inactivity among patients presenting in clinical settings. Preparation for improving patient physical activity behaviours should commence before the consultation and may include physical activity screening. Medical professionals should also identify suitable community interventions to which they can refer physically inactive patients. Outsourcing the majority of a comprehensive physical activity intervention to community based interventions will reduce the required clinical consultation time for addressing the issue with each patient. Priorities for future research include investigating ways to promote successful referrals
Mostaghimi, Arash; Olszewski, Aleksandra E; Bell, Sigall K; Roberts, David H; Crotty, Bradley H
The increased use of social media, cloud computing, and mobile devices has led to the emergence of guidelines and novel teaching efforts to guide students toward the appropriate use of technology. Despite this, violations of professional conduct are common. We sought to explore professional behaviors specific to appropriate use of technology by looking at changes in third-year medical students' attitudes and behaviors at the beginning and conclusion of their clinical clerkships. After formal teaching about digital professionalism, we administered a survey to medical students that described 35 technology-related behaviors and queried students about professionalism of the behavior (on a 5-point Likert scale), observation of others engaging in the behavior (yes or no), as well as personal participation in the behavior (yes or no). Students were resurveyed at the end of the academic year. Over the year, perceptions of what is considered acceptable behavior regarding privacy, data security, communications, and social media boundaries changed, despite formal teaching sessions to reinforce professional behavior. Furthermore, medical students who observed unprofessional behaviors were more likely to participate in such behaviors. Although technology is a useful tool to enhance teaching and learning, our results reflect an erosion of professionalism related to information security that occurred despite medical school and hospital-based teaching sessions to promote digital professionalism. True alteration of trainee behavior will require a cultural shift that includes continual education, better role models, and frequent reminders for faculty, house staff, students, and staff. ©Arash Mostaghimi, Aleksandra E Olszewski, Sigall K Bell, David H Roberts, Bradley H Crotty. Originally published in JMIR Medical Education (http://mededu.jmir.org), 03.05.2017.
Clough, S; Shehabi, Z; Morgan, C
Medical risk assessment is essential to safe patient management and the delivery of appropriate dental care. The American Society of Anesthesiologists Physical Status (ASA PS) Classification is widely used within medicine and dentistry, but has received significant criticism. This is the first UK survey to assess the consistency of medical risk assessment in dentistry. (i) To determine the use and consistency of the ASA PS among dentists and anaesthetists. (ii) To consider the appropriateness of the ASA PS in relation to dental treatment planning and delivery of care. A cross-sectional online questionnaire was distributed to anaesthetists and dental practitioners in general practice, community and hospital dental services. Questions focused on professional backgrounds, use of the ASA PS, alternative approaches to risk assessment in everyday practice and scoring of eight hypothetical patients using ASA PS. There were 101 responses, 82 were complete. Anaesthetists recorded ASA PS score more frequently than dental practitioners and found it more useful. Inconsistencies were evident in the assignment of ASA PS scores both between and within professional groups. Many dental practitioners did not use or find ASA PS helpful, with significant inconsistencies in its use. An awareness of alternative assessment scales may be useful across settings. Accepting its limitations, it would be helpful for all dentists to be educated in ASA PS and its use in medical risk assessment, particularly in relation to conscious sedation.
Klemenc-Ketis, Zalika; Kersnik, Janko
Professionalism topics are usually not covered as a separate lesson within formal curriculum, but in subtler and less officially recognized educational activities, which makes them difficult to teach and assess. Interactive methods (e.g. movies) could be efficient teaching methods but are rarely studied. The aims of this study were: 1) to test the relevance and usefulness of movies in teaching professionalism to fourth year medical students and, 2) to assess the impact of this teaching method on students' attitudes towards some professionalism topics. This was an education study with qualitative data analysis in a group of eleven fourth year medical students from the Medical School of University Maribor who attended an elective four month course on professionalism. There were 8 (66.7%) female students in the group. The mean age of the students was 21.9 ± 0.9 years. The authors used students' written reports and oral presentations as the basis for qualitative analysis using thematic codes. Students recognised the following dimensions in the movie: communication, empathy, doctors' personal interests and palliative care. It also made them think about their attitudes towards life, death and dying. The controlled environment of movies successfully enables students to explore their values, beliefs, and attitudes towards features of professionalism without feeling that their personal integrity had been threatened. Interactive teaching methods could become an indispensible aid in teaching professionalism to new generations.
Full Text Available Abstract Background Professionalism topics are usually not covered as a separate lesson within formal curriculum, but in subtler and less officially recognized educational activities, which makes them difficult to teach and assess. Interactive methods (e.g. movies could be efficient teaching methods but are rarely studied. The aims of this study were: 1 to test the relevance and usefulness of movies in teaching professionalism to fourth year medical students and, 2 to assess the impact of this teaching method on students' attitudes towards some professionalism topics. Method This was an education study with qualitative data analysis in a group of eleven fourth year medical students from the Medical School of University Maribor who attended an elective four month course on professionalism. There were 8 (66.7% female students in the group. The mean age of the students was 21.9 ± 0.9 years. The authors used students' written reports and oral presentations as the basis for qualitative analysis using thematic codes. Results Students recognised the following dimensions in the movie: communication, empathy, doctors' personal interests and palliative care. It also made them think about their attitudes towards life, death and dying. Conclusions The controlled environment of movies successfully enables students to explore their values, beliefs, and attitudes towards features of professionalism without feeling that their personal integrity had been threatened. Interactive teaching methods could become an indispensible aid in teaching professionalism to new generations.
Full Text Available Abstract Background Transformation of medical students to become medical professionals is a core competency required for physicians in the 21st century. Role modeling was traditionally the key method of transmitting this skill. Medical schools are developing medical curricula which are explicit in ensuring students develop the professional competency and understand the values and attributes of this role. The purpose of this study was to determine student perception of professionalism at the University of Ottawa and gain insights for improvement in promotion of professionalism in undergraduate medical education. Methods Survey on student perception of professionalism in general, the curriculum and learning environment at the University of Ottawa, and the perception of student behaviors, was developed by faculty and students and sent electronically to all University of Ottawa medical students. The survey included both quantitative items including an adapted Pritzker list and qualitative responses to eight open ended questions on professionalism at the Faculty of Medicine, University of Ottawa. All analyses were performed using SAS version 9.1 (SAS Institute Inc. Cary, NC, USA. Chi-square and Fischer’s exact test (for cell count less than 5 were used to derive p-values for categorical variables by level of student learning. Results The response rate was 45.6% (255 of 559 students for all four years of the curriculum. 63% of the responses were from students in years 1 and 2 (preclerkship. Students identified role modeling as the single most important aspect of professionalism. The strongest curricular recommendations included faculty-led case scenario sessions, enhancing interprofessional interactions and the creation of special awards to staff and students to “celebrate” professionalism. Current evaluation systems were considered least effective. The importance of role modeling and information on how to report lapses and breaches was
Vargas-Blasco, C; Arimany-Manso, J; Gómez-Durán, E L; Martin Fumadó, C; Piqueras-Bartolomé, M; Capdevila-Querol, S; Laborda-Rodriguez, A
The follow-up of patients postvasectomy is frequently limited to a seminogram at 3months if azoospermia is observed. This study evaluates a series of cases of complaints for postvasectomy pregnancy to establish follow-up recommendations that increase the clinical safety and reduce the risk of complaints. We reviewed the database of the Department of Professional Responsibility of the Council of the College of Physicians of Catalonia, finding 28 complaints for postvasectomy pregnancy between 1992 and 2011. We analysed the clinical and legal variables of the cases. A total of 13 extrajudicial complaints (46.43%), 13 civil lawsuits (46.43%) and 2 criminal lawsuits (7.14%) were recorded. Only 10 cases had a signed document of informed consent specific to vasectomy. In 26 cases, the data from the spermogram was available. A single spermogram was conducted in 20 cases (76.92%), 2 spermograms were conducted in 4 cases (15.38%) and none were performed in 2 cases (7.69%). For 9 of the cases (45%) where only a single spermogram was performed, the test was performed before 3months postvasectomy. In 17 cases (65.38%), the result of the last spermogram was azoospermia, and 3 cases had oligospermia (11.54%). There were 2 failures of interpretation of the spermogram (7.69%) and 2 of normospermia (7.69%). In 2 cases, a spermogram was not performed (7.69%). Pregnancy occurred between 4 and 50 months after the intervention. In 12 cases (42.86%), it was considered that the practitioner was responsible. It is recommended that physicians emphasise (during the patient information stage) the possibility of spontaneous recanalisation and to request 2 spermograms, whose result should be azoospermia. Performing the test in the 3months after vasectomy is risky, as is basing the waiting time on the number of ejaculations. Copyright © 2016 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.
Weaver, Roslyn; Wilson, Ian; Langendyk, Vicki
Previous research has pointed to the role television can play in informing health practices and beliefs. Within the academic setting in particular, some educators have raised concerns about the influence of medical dramas on students. Less research, however, draws on the perspectives of students, and this study therefore explores medical students' perceptions of medical practice and professionalism in popular medical television programmes. Qualitative data from surveys of Australian undergraduate medical students showed that students perceived professionalism in dichotomous ways, with three main themes: cure-care, where a doctor's skill is either technical or interpersonal; work-leisure, where a doctor is either dedicated to work or personal life; and clinical-administration, where work is either direct patient care or administration. There continue to be imagined divisions between curing and caring for students, who express concerns about balancing work and leisure, and expectations that doctors should have little administrative work. Given students were able to identify these important contemporary issues around professionalism on television, there is pedagogical value in using popular images of the medical world in medical education. © The Author(s) 2014.
Lewkonia Ray M
Full Text Available Abstract Mission statements and role documents of medical schools in the United Kingdom, United States, Canada and Australia have been examined on their Internet Web sites and categorised in purpose, content and presentation. The format and content are highly variable, but there is a common vision of three integral roles, namely, education, advancement of knowledge and service to society. Other frequent themes include tradition and historical perspective, service for designated communities, and benchmarking to accreditation standards. Differences in content reflect variable interpretation of the notion of "mission", and local or national characteristics such as institutional affiliations, the types, levels and organisation of medical education, relationships with health systems, and extent of multi-professional education. Outcomes data and measures of medical school performance referenced to the institution's stated missions are rarely encountered. Mission documents placed on the Internet are in the public domain. These Web sites and documents and linked information constitute a valuable new resource for international exchange of approaches and ideas in medical education and generally in academic medicine. Routine inclusion of outcome or performance data could help to demonstrate the community roles and social accountability of medical schools This paper proposes that partial standardisation of these Web documents could enhance their value both internally and for external readers. A generic descriptive statement template is offered.
Vijay Rajput, MD
Full Text Available There is a need to redefine physician excellence through promoting professionalism with humanism to meet the needs of a diverse generational and cultural society. My goal is to bring together and advance concepts that cultivate emotional and social intelligence to complement the clinical skills required for the effective practice of medicine in the complex milieu of the 21st century
Sattar, Kamran; Roff, Sue; Meo, Sultan Ayoub
Medical professionalism is an essential aspect of medical education and practice worldwide and it must be adopted according to different social and cultural contexts. We examined the current congruence and variance in the perception of professionalism in undergraduate medical students and faculty members in one medical school in Saudi Arabia. The target population was first year to final year medical students of College of Medicine, King Saud University. Out of a total of 1431 students at College of Medicine 750 students (52 %) participated in the study. Fifty faculty members from clinical and non-clinical departments of the College of Medicine were randomly selected for this study and all participated in the study. The respondents recorded their responses through the Bristol online survey system, using a bilingual (English and Arabic) version of the Dundee Polyprofessionalism Inventory I: Academic integrity, which has 34 items. There are 17 lapses (50 % of the total) in professional behaviour where none of the faculty recommend the ignore sanction while students recommended a variable ignore sanction in a range of 6-29 % for different behaviours. Students and faculty recommended similar sanctions for 5 lapses (14.7 % of the total) in professional behaviours. Furthermore, there is statistically significant two level difference between the sanctions approved by faculty and students in the recommended sanctions for 12 lapses (35 % of the total (p < 0.050). These results raised concerns in relation to the students' understanding of professionalism. It is therefore, important to enhance their learning around the attributes of medical professionalism.
Garcia, Edna; Ali, Asma M; Soles, Ryan M; Lewis, D Grace
To determine the extent and distribution of workforce shortages within the nation's medical laboratories. Historically, the results of this biennial survey have served as a basis for additional research on laboratory recruitment, retention, education, marketing, certification, and advocacy. The 2014 Vacancy Survey was conducted through collaboration between American Society for Clinical Pathology's Institute of Science, Technology, and Policy in Washington, DC, and the Evaluation, Measurement, and Assessment Department and Board of Certification in Chicago, Illinois. Data were collected via an Internet survey that was distributed to individuals who were able to report on staffing and certifications for their laboratories. Data reveal increased overall vacancy rates since 2012 for all departments surveyed except cytology and cytogenetics. Also, results show higher anticipated retirement rates for both staff and supervisors. Overall certification rates are highest among laboratory personnel in cytogenetics, hematology/coagulation, and flow cytometry departments and lowest among phlebotomy, specimen processing, and anatomic pathology. Factors such as retirement and the improving economy are driving the need for more laboratory professionals. Recruitment of qualified laboratory professionals in the workforce and students in laboratory programs will be the key in fulfilling the higher vacancies revealed from the survey results in 2014. Copyright© by the American Society for Clinical Pathology.
Garner, Jayne; O'Sullivan, Helen
The rapid growth and accessibility of social networking websites has fundamentally changed the way people manage information about their personal and professional lives. In particular, it has been suggested that interaction in virtual communities erodes elements of responsibility, accountability and social trust that build traditionally meaningful communities. The purpose of this study was to investigate how undergraduate medical students use the social network website Facebook, and to identify any unprofessional behaviour displayed online. A voluntary anonymous online survey was devised by the University of Liverpool, and emailed to students. Question topics included the use of Facebook, privacy settings, groups relating to the course and professional behaviours. Results were input to spss for analysis. The response rate was 31 per cent (n = 56). The majority of respondents did have a Facebook account and admitted there were photos they found embarrassing on the site. Over half of the respondents reported they had seen unprofessional behaviour by their colleagues on Facebook. Although students say that they are aware of the UK's General Medical Council (GMC) guidance, unprofessional behaviour is still demonstrated on the site. This research highlights the issue of social networking websites and professionalism amongst medical students. Further guidance from the GMC and medical schools should remind students that images and information placed on social networking sites is in the public domain, and could impact upon their professional reputation and identity. © Blackwell Publishing Ltd 2010.
Essential characteristics of student professionalism are commitment, honesty, discretion, co-operation, participation, diligence and temperance. Students need to know how to deal with unprofessional behaviour, whether their own or other students' or teachers'. Medical schools must have comprehensive programmes for ...
Trust in medical professionals is an important aspect of demand for health care in South Sudan, without which many patients may never attempt to access clinics and hospitals. This qualitative research study used in-depth biographical interviews to explore family health histories according to the experiences of South ...
Full Text Available This article is based on the content and outcome of the 5th Annual International Conference on Social Work & Social Work Education in Leeuwarden, The Netherlands on February 5, 2016. It shows how Social Work is embedded in society, and describes the pressure of contemporary (international problems on society, and the way in which authorities respond to it. The article continues with a discussion of the answers given by the 200 conference participants on the question how social workers and social work educators could cope with this pressure without denying their international professional principles and standards.
Financial relationships among the biomedical industries, physicians, and professional medical associations (PMAs) can be professional, ethical, mutually beneficial, and, most importantly, can lead to improved medical care. However, such relationships, by their very nature, present conflicts of interest (COIs). One of the greatest concerns regarding COI is continuing medical education (CME), especially because currently industry funds 40-60% of CME. COIs have the potential to bias physicians in practice, educators, and those in leadership positions of PMAs and well as the staff of a PMA. These conflicts lead to the potential to bias the content and type of CME presentations and thereby influence physicians' practice patterns and patient care. Physicians are generally aware of the potential for bias when industry contributes funding for CME, but they are most often unable to detect the bias. This may because it is very subtle and/or the educators themselves may not realize that they have been influenced by their relationships with industry. Following Accreditation Council for Continuing Medical Education guidelines and mandating disclosure that is transparent and complete have become the fallback positions to manage COIs, but such disclosure does not really mitigate the conflict. The eventual and best solutions to ensure evidence-based education are complete divestment by educators and leaders of PMAs, minimal and highly controlled industry funding of PMAs, blind pooling of any industry contributions to PMAs and CME, strict verification of disclosures, clear separation of marketing from education at CME events, and strict oversight of presentations for the presence of bias. Wiley Periodicals, Inc.
Albertsen, Andreas; Thaysen, Jens Damgaard
The exposure of doctors, nurses and other medical professionals to risks in the context of epidemics is significant. While traditional medical ethics offers the thought that these dangers may limit the extent to which a duty to care is applicable in such situations, it has less to say about what we......, cure and care for the vulnerable, luck egalitarianism seems to imply that their claim of justice to medical attention in case of infection is weak or non-existent. The article demonstrates how a recent interpretation of luck egalitarianism offers a solution to this problem. Redefining luck...
Abdulrahman, Mahera; Alsalehi, Shahd; Husain, Zahra S M; Nair, Satish C; Carrick, Frederick Robert
Moral competencies and ethical practices of medical professionals are among the desired outcomes of academic training. Unfortunately, academic dishonesty and misconduct are reported from medical colleges across the world. This study investigates the level of academic dishonesty/misconduct among multicultural medical students. The aim of this study is to investigate the level of academic dishonesty/misconduct among multicultural medical students. Validated and customized version of Dundee Polyprofessionalism Inventory-1 detailing lapses of professionalism in undergraduate health professions education was used to determine the perceived prevalence and self-reported lapses of academic integrity in this study. This study shows that the majority (458/554, 83%) of medical students have admitted to acts of academic dishonesty mentioned in the questionnaire. Approximately 42% (231/554) of the students have given proxy for attendance and 71% of them considered this as an offense. Similarly, 12% (66/554) have copied from the record books of others, and 86% (477/554) have considered it unethical. In addition, 5% (28/554) of the students revealed forging a teacher's signature in their record or logbooks, with 16% (91/554) of them reporting that they have seen others forge signatures. This is the first multi-center, multi-cultural and multi-ethnic study involving a large number of participants that addresses academic professionalism among medical students in the Middle East. Certainly, the paucity of data limits definitive conclusions about the best approach to prevent academic misconduct in the UAE medical schools. Yet, the results of our study are anticipated not only to benefit the UAE but also to find application in the Arab world, with similar medical school programs, values, culture and tradition.
A. A. Kirichek
Full Text Available The European Society for Medical Oncology (ESMO Congress in partnership with the European Association for Cancer Research took place between September 8th and 12th of 2017 in Madrid. In 42 years of its existence, the forum has grown from a regional educational meeting in Europe to the main international event in oncology. The key topic of this Congress was integration of molecular biology knowledge with clinical specialties. The ESMO 2017 Congress united almost 24,000 professionals of various fields from 131 countries who submitted 1736 abstracts. More than 50 scientific abstracts which were deemed worthy of special discussion and capable of changing current clinical practice, were separated into a category of late-breaking abstract (LBA. This review highlights some important topics of oncological urology that were discussed at the ESMO 2017 Congress.
Bosch, Josefin; Maaz, Asja; Hitzblech, Tanja; Holzhausen, Ylva; Peters, Harm
Sufficient preparedness is important for transitions to workplace participation and learning in clinical settings. This study aims to analyse medical students' preparedness for early clerkships using a three-dimensional, socio-cognitive, theory-based model of preparedness anchored in specific professional activities and their supervision level. Medical students from a competency-based undergraduate curriculum were surveyed about preparedness for 21 professional activities and level of perceived supervision during their early clerkships via an online questionnaire. Preparedness was operationalized by the three dimensions of confidence to carry out clerkship activities, being prepared through university teaching and coping with failure by seeking support. Factors influencing preparedness and perceived stress as outcomes were analysed through step-wise regression. Professional activities carried out by the students (n = 147; 19.0%) and their supervision levels varied. While most students reported high confidence to perform the tasks, the activity-specific analysis revealed important gaps in preparation through university teaching. Students regularly searched for support in case of difficulty. One quarter of the variance of each preparedness dimension was explained by self-efficacy, supervision quality, amount of prior clerkship experience and nature of professional activities. Preparedness contributed to predicting perceived stress. The applied three-dimensional concept of preparedness and the task-specific approach provided a detailed and meaningful view on medical students' workplace participation and experiences in early clerkships.
Ana Maria Liberal
Full Text Available A number of private societies and clubs flourished in Oporto in the 19th Century, whose aim was to encourage in their members "benevolence relationships and good society" offering them "an honest and civilized leisure times". Clearly elitist, these nineteenth century recreational clubs had strict membership admission policies, which generally belonged to the higher echelons of society, more specifically the bourgeois, since the titled aristocracy was scarce in Oporto. It is worth mentioning here in parenthesis that Oporto was an essentially bourgeois, commercial city, unlike the capital, Lisbon, where the court "drags with it the whole official and unofficial world which conceitedly flutters around it". Each association organised musical concerts, balls and soirées musicales – weekly, twice a week or once a month – which also offered members other amusements, like conversation, reading, playing cards or dancing. Events of a musical character were normally performed by the club members, usually amateurs – referred to as dilettanti – who would be joined by prestigious Portuguese or foreign professionals. The purpose of this article is to describe the musical activity of the five main venues for private socialising in Oporto in the 1800s, and their contribution to the development of the musical taste of the city's society, taking into account both amateur and professional practice and particularly the repertoire performed.
Giménez, N; Alcaraz, J; Gavagnach, M; Kazan, R; Arévalo, A; Rodríguez-Carballeira, M
To determine the perception of healthcare professionals (tutors, residents and teaching collaborators) involved in specialist medical training on the core values and skills to develop their tasks. A tailor-made questionnaire aimed at healthcare professionals in 9health care centres and a referral hospital. Questionnaire: 4 sections and 51 variables (scale 1-10). A total of 287 professionals participated, which included 97% tutors (n=59), 38% residents (n=61), and 56% others (97 teaching collaborators and 70 not associated with teaching). The alfa Cronbach coefficient was 0.945. Best rated values were work compliance (8.7 points), ethics in professional practice (8.6 points), and respect for their team (8.3 points). The best rated competence was communication with patients and families (8.1 points), followed by self-motivating leadership (7.9 points), and the practical application of medical and healthcare theoretical knowledge (7.8 points). The values received, on average, 0.7 points above competences (95% CI: 0.5-0.9). There were no differences between tutors and residents, although differences were found between doctors and nurses, and between males and females. Most of the professionals (tutors, residents, and teaching collaborators) share the same perception of the values and competencies that influence their professional development. This perception was influenced by the professional category and gender, but not age or working in a hospital or primary health care. Copyright © 2016 SECA. Publicado por Elsevier España, S.L.U. All rights reserved.
Daniel Gómez Asensio
Full Text Available The Musical Societies are the cultural agent that produces most musical events in Valencia, gathering around them the vast majorities of local amateur musicians, who are the main support that conforms them and at the same time leads its management. Its rise and proliferation has led to the growth and complexity of their structures, making it increasingly difficult operation with management based on volunteerism. In this study we analyzed each of the areas of Music Societies from the perspective of its managers in charge, aware of its management, and its musicians, who are aware of the real effects of it. Thus checking to what extent each structural framework needs an increasingly dedicated and expert figure, we also show to the Musical Societies some operating possibilities at their fingertips and finally we enable a self-analysis that objectively will assess the advantages of professionalism in management.
Phillips, Susan P; Dalgarno, Nancy
Formal and informal medical curricula convey expectations about professionalization, that is, the development of physician identity, and also about professionalism. This study examined whether, in general, junior residents experienced any dissonance between these roles and focused particularly on how they negotiated conflicts between compassion, self-care, duty and medical expertise. In 2015, purposive sampling was used to select 21 first-year residents at a Canadian medical school. Participants listened to a 5-min audio-recording narrated in either male or female voice. Facing compassion fatigue after three obstetrical disasters over less than 2 days the resident narrator asks to go home. Participants reacted in writing to questions about this request and relevant teaching/modelling. Responses were analyzed using a qualitative, exploratory, thematic research design. Four themes were identified: i) empathy, self-doubt and fear of weakness, ii) the need for support from and communication with physicians and others, iii) education received, and iv) professionalization outranks professionalism. Participants agreed that under the circumstances the narrator's care, compassion and request were appropriate. Never the less, many grappled with feeling that asking to be relieved of work demonstrated weakness and a shirking of responsibility. Respondents had received no formal teaching about balancing compassion for patients or self with professional duty. Preceptors' informal teaching and modeling valorized scientific disengagement above all else. What emerged was participants' drive to become detached clinicians who set aside emotional responses and interactions that could impede and be incompatible with professionalization. However, participants also recognized and lamented what was lost in such a transformation. In the transition from student to practitioner, trainees' views and the modeling they receive shift emotion and compassion, whether for self or patients, from
Full Text Available Abstract Background Physical inactivity is a modifiable risk factor for many chronic conditions and a leading cause of premature mortality. An increasing proportion of adults worldwide are not engaging in a level of physical activity sufficient to prevent or alleviate these adverse effects. Medical professionals have been identified as potentially powerful sources of influence for those who do not meet minimum physical activity guidelines. Health professionals are respected and expected sources of advice and they reach a large and relevant proportion of the population. Despite this potential, health professionals are not routinely practicing physical activity promotion. Discussion Medical professionals experience several known barriers to physical activity promotion including lack of time and lack of perceived efficacy in changing physical activity behaviour in patients. Furthermore, evidence for effective physical activity promotion by medical professionals is inconclusive. To address these problems, new approaches to physical activity promotion are being proposed. These include collaborating with community based physical activity behaviour change interventions, preparing patients for effective brief counselling during a consultation with the medical professional, and use of interactive behaviour change technology. Summary It is important that we recognise the latent risk of physical inactivity among patients presenting in clinical settings. Preparation for improving patient physical activity behaviours should commence before the consultation and may include physical activity screening. Medical professionals should also identify suitable community interventions to which they can refer physically inactive patients. Outsourcing the majority of a comprehensive physical activity intervention to community based interventions will reduce the required clinical consultation time for addressing the issue with each patient. Priorities for future research
Toroser, Dikran; DeTora, Lisa; Cairns, Angela; Juneja, Renu; Georgieva, Anna; Weigel, Al; Pepitone, Kim
To review guidance from professional medical associations to physicians on the Sunshine Act, with a focus on industry support for medical publications. Using 'Sunshine Act' as a search term, we searched PubMed (dates February 2013 to November 2014) and the 'grey literature' using Google and Google Scholar. Online information was extracted from websites of pre-identified professional medical associations. Some professional medical associations have published peer-reviewed recommendations, position statements or general advice on their websites and in journals around the Sunshine Act. Associations also provided broad online educational resources for physicians. There was universal agreement between peer-reviewed publications, including guidelines, for the need for full transparency and disclosure of industry support. Surveys by some professional associations showed variance in opinion on the forecasted impact of the Sunshine Act on physician-industry relationships. There was scarce information specifically related to reporting requirements for industry-supported medical publications. There is a shortage of information for physicians from professional associations regarding the Sunshine Act and support for medical publications. Due to the lack of clear guidance regarding support for publications, there are presently varying interpretations of the Sunshine Act. The literature debates the potential impact of the Sunshine Act and expresses some concerns that physician-enabled innovation in drug development may be hindered.
Acupuncture was first used in China, probable about 2000 years ago. When acupuncture first arrived in the West in the 17th century, the principles which the Chinese had used to explain its actions were at variance with current scientific knowledge of the body's structure and function. This led to the rejection of acupuncture by the medical profession in the UK, although individual practitioners adopted it with enthusiasm, usually needling the point of maximal tenderness to treat musculoskeletal pain. Acupuncture was more generally accepted in France and Germany, where the pioneering British physician Felix Mann encountered it in the 1950s. He then taught acupuncture to other medical practitioners and organised regular meetings in London, from which the British Medical Acupuncture Society, BMAS, emerged in 1980. The tradition of biannual scientific meetings has continued since then. The Society has many connections with prominent acupuncturists internationally and is a founder member of the International Council of Medical Acupuncture and Related Techniques (ICMART), and has hosted two world congresses. The Society was involved in standardisation of the meridian nomenclature published in 1990. The Society's scientific journal, Acupuncture in Medicine, was founded in 1981 and has gained international recognition, being indexed on several databases. The Society has established regular teaching courses at different levels, which lead to professional qualifications of Certificate and Diploma. The membership is now open to different health professionals, has grown steadily and now stands at nearly 2500. The Society is administered from offices in Cheshire and London. Many individual members have contributed to the Society's characteristic Western 'medical' approach to acupuncture in which needling is seen as a form of neuromuscular stimulation that owes little to traditional meridians or points. The Society has shown a particular interest in acupuncture for myofascial
Mosconi, P; Colombo, C; Guella, F; Pierotti, B; Vimercati, F
In the framework of PartecipaSalute--an Italian research project aimed to involve lay people, patients' associations and scientific-medical representatives on the health debate --we carried out a survey with the Italian Federation of Medical Societies. The aims of the survey were to know medical societies attitude vs. patients involvement in research activities and healthcare setting and to find out possible projects conducted in partnership with patients associations. A web-questionnaire with 17 closed questions, and three open questions has been prepared on the basis of some experiences published on the literature and through the collaboration of members of the Italian Federation of Medical Societies. A total of 205 medical societies has been contacted by e-mail with a cover letter explaining the aims of the survey. At the end 74 medical societies completed the survey. Medical societies participating to the survey varied widely in terms of years of activity, number of members, and geographical distribution. Remarkably, 36 medical societies respondent organized collaborative initiatives with patients/consumers associations during the last three years. Among these, the most frequent were the preparation of written material for patients, organization of conferences or workshops, and health awareness campaigns. Moreover, 6 medical societies published documents on patients' rights but patients or their associations were involved in only 2 of these initiatives. Advantages and disadvantages reported by medical societies answering are also presented and discussed. In conclusion, to our knowledge this is the first survey on the value of patients' involvement conducted together with medical societies in Italy, and the results point the way to stronger collaboration in future between patients' associations and medical societies.
Nie, Jing-Bao; Smith, Kirk L; Cong, Yali; Hu, Linying; Tucker, Joseph D
As in other societies, medical professionalism in the Peoples' Republic of China has been rapidly evolving. One of the major events in this process was the endorsement in 2005 of the document, "Medical Professionalism in the New Millennium: A Physician Charter," by the Chinese Medical Doctor Association (hereafter, the Charter)(1). More recently, a national survey, the first on such a large scale, was conducted on Chinese physicians' attitudes toward the fundamental principles and core commitments put forward in the Charter. Based on empirical findings from that study and comparing them to the published results of a similar American survey, the authors offer an in-depth interpretation of significant cross-cultural differences and important transcultural commonalities. The broader historical, socio-economic, and ethical issues relating to salient Chinese cultural practices such as family consent, familism (the custom of deferring decisions to family members), and the withholding of medical information, as well as controversial topics such as not respecting patients' autonomy, are examined. The Chinese Survey found that Chinese physicians supported the principles of the Charter in general. Here we argue that Chinese culture and traditional medical ethics are broadly compatible with the moral commitments demanded by modern medical professionalism. Methodologically and theoretically-recognizing the problems inherent in the hoary but still popular habit of dichotomizing cultures and in relativism-a transcultural approach is adopted that gives greater (due) weight to the internal moral diversity present within every culture, the common ground shared by different cultures, and the primacy of morality. Genuine cross-cultural dialogue, including a constructive Chinese-American dialogue in the area of medical professionalism, is not only possible, but necessary. Copyright 2015 The Journal of Clinical Ethics. All rights reserved.
Daniel R Terry
Full Text Available Background At the time of recruitment, migration, and placement, international medical graduates (IMGs encounter professional challenges. These challenges may include a loss of status and professional identity, professional isolation in rural practice, restrictions on medical practice, and social isolation. Understanding the nature of these challenges may facilitate the recruitment, placement, and success of international medical graduates within rural Tasmania. Aims The aim of this study was to investigate the experiences, challenges,and barriers that IMGs encounter as they work and live in rural Tasmania. Methods The study used a mixed-methods design where data were collected using a questionnaire and semi-structured interviews across the south, north, and northwest of Tasmania. IMGs were recruited through purposive snowball and convenience sampling. Results A total of 105 questionnaires were returned (response rate 30.0per cent and 23semi-structured interviews were conducted with IMGs across Tasmania. Questionnaire participants indicated that the majority of IMGs are satisfied in their current employment; however, interview participants indicated there were a number of barriers to practising medicine in Tasmania as well as factors that would influence ongoing employment in the state. Despite these challenges, professional support was recognised as a key contributor to professional satisfaction, particularly among IMGs who had just arrived. Conclusion The study contributes to the current knowledge and understanding of IMGs who live and work in rural areas. The study shows that there are high levels of satisfaction among IMGs with their current position; however, the research also provides insight into the complexities and factors that impact IMGs as they work and live within rural areas such as Tasmania. This study offers an understanding for policy to improve greater retention of IMGs across rural areas.
Silver, Julie K; Slocum, Chloe S; Bank, Anna M; Bhatnagar, Saurabha; Blauwet, Cheri A; Poorman, Julie A; Villablanca, Amparo; Parangi, Sareh
Membership in medical societies is associated with a number of benefits to members that may include professional education, opportunities to present research, scientific and/or leadership training, networking, and others. In this perspective article, the authors address the value that medical specialty society membership and inclusion have in the development of an academic physician's career and how underrepresentation of women may pose barriers to their career advancement. Because society membership itself is not likely sufficient to support the advancement of academic physicians, this report focuses on one key component of advancement that also can be used as a measure of inclusion in society activities-the representation of women physicians among recipients of recognition awards. Previous reports demonstrated underrepresentation of women physicians among recognition award recipients from 2 physical medicine and rehabilitation specialty organizations, including examples of zero or near-zero results. This report investigated whether zero or near-zero representation of women physicians among recognition award recipients from medical specialty societies extended beyond the field of physical medicine and rehabilitation. Examples of the underrepresentation of women physicians, as compared with their presence in the respective field, was found across a range of additional specialties, including dermatology, neurology, anesthesiology, orthopedic surgery, head and neck surgery, and plastic surgery. The authors propose a call for action across the entire spectrum of medical specialty societies to: (1) examine gender diversity and inclusion data through the lens of the organization's mission, values, and culture; (2) transparently report the results to members and other stakeholders including medical schools and academic medical centers; (3) investigate potential causes of less than proportionate representation of women; (4) implement strategies designed to improve
O. V. Toussova
Full Text Available The article describes personality features, self-regulation patterns and professional orientation of medical students. It represents the results of the study conducted among the fourth year students. The sample is characterized with high enough behavior regulation, extraversion, high learning potential, flexible thinking, following intuition and personal opinion in profession choice. High anxiety as personality feature and stress vulnerability is typical for female students; independence tendency is typical for male students.
Bachmann, Larissa; Cantoni, Lorenzo
ELearning provides healthcare professionals an interesting alternative of participating to Continuing Medical Education (CME) activities. It offers the possibility to attend courses at a distance, and it allows creating personal learning schedules without needing to leave the job or the family. Hospitals can choose to organize CME activities for their employees and therefore may also opt to offer eLearning activities. The research studies eLearning acceptance in the CME of healthcare p...
Shultz, S M
This is the biography of a deceased medical journal, the North American Medical and Surgical Journal, born in 1826 in Philadelphia. It was a publication of the Philadelphia Chapter of the Kappa Lambda Society. In the prospectus of the North American Medical and Surgical Journal the promoters observed that a well-conducted journal would achieve the object of elevating the medical profession to its legitimate rank which up to that time had been the recipient of low public opinion. The Journal hoped to inculcate 'a higher standard of excellence not merely in the professional or ministrative but also in the ethical relations and duties of physicians'. After several successful and productive years it passed into history in October 1831, the victim of financial difficulty.
Haque, Mainul; Zulkifli, Zainal; Haque, Seraj Zohurul; Kamal, Zubair M; Salam, Abdus; Bhagat, Vidya; Alattraqchi, Ahmed Ghazi; Rahman, Nor Iza A
Defining professionalism in this constantly evolving world is not easy. How do you measure degrees of benevolence and compassion? If it is so obvious to our profession, what professionalism is, then why is it so difficult to teach it to medical students and residents? Today's definition of medical professionalism is evolving - from autonomy to accountability, from expert opinion to evidence-based medicine, and from self-interest to teamwork and shared responsibility. However, medical professionalism is defined as the basis for the trust in the patient-physician relationship, caring and compassion, insight, openness, respect for patient dignity, confidentiality, autonomy, presence, altruism, and those qualities that lead to trust-competence, integrity, honesty, morality, and ethical conduct. The purpose of this study is to explore professionalism in terms of its fundamental elements among medical students of Universiti Sultan Zainal Abidin (UniSZA). This was a cross-sectional study carried out on medical students of UniSZA. The study population included preclinical and clinical medical students of UniSZA from Year I to Year V of academic session 2014/2015. The simple random sampling technique was used to select the sample. Data were collected using a validated instrument. The data were then compiled and analyzed using SPSS Version 21. Out of 165 questionnaires distributed randomly among Year I to Year V medical students of UniSZA, 144 returned, giving a response rate of 87%. Among the study participants, 38% (54) and 62% (90) were males and females, respectively. The grand total score was 170.92±19.08. A total of 166.98±20.15 and 173.49±18.09 were the total professionalism score of male and female study participants, respectively, with no statistically significant (P=0.61) differences. This study found almost similar levels of familiarity with all fundamental issues of professionalism with no statistically (P>0.05) significant differences. Medical faculty members
Sawaya, George F; Smith-McCune, Karen K; Gregorich, Steven E; Moghadassi, Michelle; Kuppermann, Miriam
The American College of Physicians strongly recommends against performing pelvic examinations in asymptomatic, nonpregnant women, citing evidence of harm (false-positive testing, unnecessary surgery) and no evidence of benefit. In contrast, the American Congress of Obstetricians and Gynecologists recommends pelvic examinations in asymptomatic women beginning at age 21 years, citing expert opinion. We sought to evaluate if providing women with professional societies' conflicting statements about pelvic examinations (recommendations and rationales) would influence their desire for a routine examination. We recruited 452 women ages 21-65 years from 2 women's clinics to participate in a 50-minute face-to-face interview about cervical cancer screening that included a 2-phase study related to pelvic examinations. In the first phase, 262 women were asked about their desire for the examination without being provided information about professional societies' recommendations. In the second phase, 190 women were randomized to review summaries of the American College of Physicians or American Congress of Obstetricians and Gynecologists statement followed by an interview. First-phase participants served as the referent: 79% (208/262) indicated they would want a routine examination if given a choice. In the second phase, a similar percentage of women randomized to the American Congress of Obstetricians and Gynecologists summary had this desire (82%: 80/97; adjusted odds ratio, 1.37; 95% confidence interval, 0.69-2.70). Women randomized to the American College of Physicians summary, however, were less likely to indicate they would opt for an examination (39%: 36/93; adjusted odds ratio, 0.12; 95% confidence interval, 0.06-0.21). Overall, 94% (179/190) believed the potential benefits and harms should be discussed prior to the examination. Providing women with a professional society's recommendation advising against routine pelvic examinations substantially reduced their desire to
This essay argues that the concept of professionalism as it appears in health law is undergoing transformation as the applicable common law doctrines are increasingly being superseded by statutes and regulations. The doctor-patient relationship is being subjected to new rules of conduct intended to affirm the rights not only of patients but also of society at large. The bilateral relationship between doctor and patient has in many respects been transformed into a triadic one in which the concerns of public, as consumer and payor, are increasingly taken into account. In many respects this change has been necessary and inevitable as medicine has become a more commercial enterprise; but the change has also put traditional notions of professionalism at risk. Where professionalism is adversely affected by the process of its codification, it is incumbent upon law and policy makers to be aware of the fact. To this end, this essay first undertakes to define medical professionalism as a legal construct, and then formulates an analytic method with which to determine when professionalism is implicated and whether it is adequately accommodated by the law. The definition of professionalism the author advances is informed by concepts established in the literature of sociology, which identifies four core attributes-functional specificity, trust, disinterestedness and self-regulation. Each of these attributes is examined in turn with reference to case law selected to identify the value in question and to illustrate the nature of the change resulting from its codification.
The Anatomische Gesellschaft (anatomical society, AG) was founded in Germany in 1886 as an international society and remains the main organizing body of German anatomists to this day. A previous study of the history of the AG during National Socialism (NS) was based on the published proceedings of the AG and drew the preliminary conclusion that the "AG did not follow the path of preemptive obedience toward the new rulers" in contrast to some other professional societies. However, it was noted that archival sources were needed to support this conclusion and to illustrate the decision process within the society. Such sources are now available in the estate papers of Alfred Benninghoff, a leading anatomist at the time. His correspondence supports the previous finding that the AG was able to maintain its international character, thereby enabling it to avoid the active exclusion of "non-Aryan" members. The papers also confirm that the AG did not defend its vulnerable members as valiantly as the official narrative suggests, a fact illustrated in a controversy surrounding Martin Heidenhain. The interactions and conflicts between the leaders of the AG can now be reconstructed, i.e. between the secretary of the AG Heinrich von Eggeling, Benninghoff and Hermann Stieve. The Benninghoff documents also refer to a meeting of a subsection of the AG in November 1942, at which a disturbing radicalization of some anatomists developed. Finally, the papers reflect the political realities for German professionals trying to re-establish their science in a country divided into four occupation zones. Copyright © 2013 Elsevier GmbH. All rights reserved.
Archer, Ray; Elder, William; Hustedde, Carol; Milam, Andrea; Joyce, Jennifer
Teaching and evaluating professionalism remain important issues in medical education. However, two factors hinder attempts to integrate curricular elements addressing professionalism into medical school training: there is no common definition of medical professionalism used across medical education, and there is no commonly accepted theoretical model upon which to integrate professionalism into the curriculum. This paper proposes a definition of professionalism, examines this definition in the context of some of the previous definitions of professionalism and connects this definition to the attitudinal roots of professionalism. The problems described above bring uncertainty about the best content and methods with which to teach professionalism in medical education. Although various aspects of professionalism have been incorporated into medical school curricula, content, teaching and evaluation remain controversial. We suggest that intervening variables, which may augment or interfere with medical students' implementation of professionalism knowledge, skills and, therefore, attitudes, may go unaddressed. We offer a model based on the theory of planned behaviour (TPB), which describes the relationships of attitudes, social norms and perceived behavioural control with behaviour. It has been used to predict a wide range of behaviours, including doctor professional behaviours. Therefore, we propose an educational model that expands the TPB as an organisational framework that can integrate professionalism training into medical education. We conclude with a discussion about the implications of using this model to transform medical school curricula to develop positive professionalism attitudes, alter the professionalism social norms of the medical school and increase students' perceived control over their behaviours.
Full Text Available Aim: To create sustained improvements in medical students’ critical thinking skills through short teaching interventions in pharmacology. Method: The ability to make professional decisions was assessed by providing year-4 medical students at a UK medical school with a novel medical scenario (antenatal pertussis vaccination. Forty-seven students in the 2012 cohort acted as a pretest group, answering a questionnaire on this novel scenario. To improve professional decision-making skills, 48 students from the 2013 cohort were introduced to three commonly used medications, through tutor-led 40-min teaching interventions, among six small groups using a structured presentation of evidence-based medicine and ethical considerations. Student members then volunteered to peer-teach on a further three medications. After a gap of 8 weeks, this cohort (post-test group was assessed for professional decision-making skills using the pretest questionnaire, and differences in the 2-year groups analysed. Results: Students enjoyed presenting on medications to their peers but had difficulty interpreting studies and discussing ethical dimensions; this was improved by contextualising information via patient scenarios. After 8 weeks, most students did not show enhanced clinical curiosity, a desire to understand evidence, or ethical questioning when presented with a novel medical scenario compared to the previous year group who had not had the intervention. Students expressed a high degree of trust in guidelines and expert tutors and felt that responsibility for their own actions lay with these bodies. Conclusion: Short teaching interventions in pharmacology did not lead to sustained improvements in their critical thinking skills in enhancing professional practice. It appears that students require earlier and more frequent exposure to these skills in their medical training.
Wilcock, Jane; Strivens, Janet
Aim To create sustained improvements in medical students’ critical thinking skills through short teaching interventions in pharmacology. Method The ability to make professional decisions was assessed by providing year-4 medical students at a UK medical school with a novel medical scenario (antenatal pertussis vaccination). Forty-seven students in the 2012 cohort acted as a pretest group, answering a questionnaire on this novel scenario. To improve professional decision-making skills, 48 students from the 2013 cohort were introduced to three commonly used medications, through tutor-led 40-min teaching interventions, among six small groups using a structured presentation of evidence-based medicine and ethical considerations. Student members then volunteered to peer-teach on a further three medications. After a gap of 8 weeks, this cohort (post-test group) was assessed for professional decision-making skills using the pretest questionnaire, and differences in the 2-year groups analysed. Results Students enjoyed presenting on medications to their peers but had difficulty interpreting studies and discussing ethical dimensions; this was improved by contextualising information via patient scenarios. After 8 weeks, most students did not show enhanced clinical curiosity, a desire to understand evidence, or ethical questioning when presented with a novel medical scenario compared to the previous year group who had not had the intervention. Students expressed a high degree of trust in guidelines and expert tutors and felt that responsibility for their own actions lay with these bodies. Conclusion Short teaching interventions in pharmacology did not lead to sustained improvements in their critical thinking skills in enhancing professional practice. It appears that students require earlier and more frequent exposure to these skills in their medical training. PMID:26051556
Full Text Available Mainul Haque,1 Zainal Zulkifli,2 Seraj Zohurul Haque,3 Zubair M Kamal,4 Abdus Salam,5 Vidya Bhagat,2 Ahmed Ghazi Alattraqchi,2 Nor Iza A Rahman2 1Unit of Pharmacology, Faculty of Medicine and Defense Health, National Defense University of Malaysia, Kem Sungai Besi, Kuala Lumpur, Malaysia; 2Faculty of Medicine, Universiti Sultan Zainal Abidin, Jalan Sultan Mahmud, Kuala Terengganu, Terengganu, Malaysia; 3School of Medicine, University of Dundee, Ninewells Hospital & Medical School, Dundee, UK; 4Sleep Research Unit, Toronto Western Hospital, University Health Network, Toronto, ON, Canada; 5Department of Medical Education, Universiti Kebangsaan Malaysia Medical Centre, Cheras, Kuala Lumpur, Malaysia Abstract: Defining professionalism in this constantly evolving world is not easy. How do you measure degrees of benevolence and compassion? If it is so obvious to our profession, what professionalism is, then why is it so difficult to teach it to medical students and residents? Today’s definition of medical professionalism is evolving – from autonomy to accountability, from expert opinion to evidence-based medicine, and from self-interest to teamwork and shared responsibility. However, medical professionalism is defined as the basis for the trust in the patient–physician relationship, caring and compassion, insight, openness, respect for patient dignity, confidentiality, autonomy, presence, altruism, and those qualities that lead to trust-competence, integrity, honesty, morality, and ethical conduct. The purpose of this study is to explore professionalism in terms of its fundamental elements among medical students of Universiti Sultan Zainal Abidin (UniSZA. This was a cross-sectional study carried out on medical students of UniSZA. The study population included preclinical and clinical medical students of UniSZA from Year I to Year V of academic session 2014/2015. The simple random sampling technique was used to select the sample. Data were
Loudon, R F; Anderson, P M; Gill, P S; Greenfield, S M
Recent attention has focused on whether government health service institutions, particularly in the United Kingdom, reflect cultural sensitivity and competence and whether medical students receive proper guidance in this area. To systematically identify educational programs for medical students on cultural diversity, in particular, racial and ethnic diversity. The following databases were searched: MEDLINE (1963-August 1998); Bath International Data Service (BIDS) Institute for Scientific Information science and social science citation indexes (1981-August 1998); BIDS International Bibliography for the Social Sciences (1981-August 1998); and the Educational Resources Information Centre (1981-August 1998). In addition, the following online data sets were searched: Kings Fund; Centre for Ethnic Relations, University of Warwick; Health Education Authority; European Research Centre on Migration and Ethnic Relations, University of Utrecht; International Centre for Intercultural Studies, University of London; the Refugee Studies Programme, University of Oxford. Medical education and academic medicine journals (1994-1998) were searched manually and experts in medical education were contacted. Studies included in the analysis were articles published in English before August 1998 that described specific programs for medical students on racial and ethnic diversity. Of 1456 studies identified by the literature search, 17 met the criteria. Two of the authors performed the study selection independently. The following data were extracted: publication year, program setting, student year, whether a program was required or optional, the teaching staff and involvement of minority racial and ethnic communities, program length, content and teaching methods, student assessment, and nature of program evaluation. Of the 17 selected programs, 13 were conducted in North America. Eleven programs were exclusively for students in years 1 or 2. Fewer than half (n = 7) the programs were part of
This publication gathers abstracts of oral contributions and papers presented during a conference. Oral contributions were presented in different sessions: Proton/hadron therapy, Adaptive radiotherapy, Imagery in radiotherapy (preprocessing, IGRT...), Research in medical physics, Equipment quality insurance, Treatment planning, Use of MRI in radiotherapy, Advanced techniques in radiotherapy, PET/MRI based nuclear medicine, Optimisation in nuclear medicine, Radiology/MRI/ultrasound. Posters addressed the following themes: Radiotherapy, Nuclear medicine, Radiology/MRI/Ultrasound
... 197This page intentionally left blank PrefacePreface I have been interested in the medicalization of society for a long time. My Ph.D. dissertation was a participant observation study of the medicalization of hyperactivity in children (Conrad, 1976). This was followed by a more historical account of the medicalization of deviance, coau...
Rees, Charlotte E
Introduction Several studies have begun to explore medical students’ understandings of professionalism generally and medical professionalism specifically. Despite espoused relationships between academic (AP) and medical professionalism (MP), previous research has not yet investigated students’ conceptualisations of AP and MP and the relationships between the two. Objectives The current study, based on innovative visual analysis of mind maps, therefore aims to contribute to the developing literature on how professionalism is understood. Methods We performed a multilayered analysis of 98 mind maps from 262 first-year medical students, including analysing textual and graphical elements of AP, MP and the relationships between AP and MP. Results The most common textual attributes of AP were learning, lifestyle and personality, while attributes of MP were knowledge, ethics and patient-doctor relations. Images of books, academic caps and teachers were used most often to represent AP, while images of the stethoscope, doctor and red cross were used to symbolise MP. While AP-MP relations were sometimes indicated through co-occurring text, visual connections and higher-order visual metaphors, many students struggled to articulate the relationships between AP and MP. Conclusions While the mind maps’ textual attributes shared similarities with those found in previous research, suggesting the universality of some professionalism attributes, our study provides new insights into students’ conceptualisations of AP, MP and AP-MP relationships. We encourage medical educators to help students develop their understandings of AP, MP and AP-MP relationships, plus consider the feasibility and value of mind maps as a source of visual data for medical education research. PMID:28821520
Kauffmann-Lacroix, C; Albouy-Llaty, M; Migeot, V; Contet-Audonneau, N
The objective of the survey was to describe the practices of clinical laboratories in terms of cultures in medical mycology. We have implemented this project within the members of the French Society for Medical Mycology (SFMM) to evaluate the analytical processes of the mycological examination in our laboratories. This preliminary study would help to suggest the future French guidelines. A questionnaire regarding the processing of mycology analysis was sent to the 227 members of the SFMM in 2009. The data involved 21 types of samples, direct microscopic examination with or without colouring and the reagents, the number of culture media, the types of media (Sabouraud, Sabouraud antibiotic, Sabouraud cycloheximide and chromogenic medium), temperature and duration of the incubation (days) and the existence of a first result before the end of the incubation period. The analytical processes were compared to an accredited laboratory according to EN ISO 15189. A great heterogeneity was observed in the 36 forms from 27 (75%) laboratories belonging to university hospitals among the 38 existing in France. As for deep samples, two microscopic exams were performed, only one was usually done. A more sensitive technique was preferred to the wet-mount for some samples. Routine samples are often inoculated on a chromogenic media. For deep samples two medium are inoculated (chromogenic media, Sabouraud and antibiotics). If the temperature of incubation is unique, 30°C was chosen. A temperature of 37°C was preferred for samples where Candida spp. is selected. When there are two temperatures of incubation, 27°C and 37°C were preferred. Each biologist can compare his proceedings to the other laboratories and to a laboratory already accredited. The question is to find the best strategies for each medical mycology specimen. They will aid the process of accreditation according to EN ISO 15189, which now applies in all laboratories in Europe. Copyright © 2011 Elsevier Masson SAS
Pevernagie, Dirk; Stanley, Neil; Berg, Sören; Krieger, Jean; Amici, Roberto; Bassetti, Claudio; Billiard, Michel; Cirignotta, Fabio; Garcia-Borreguero, Diego; Tobler, Irene; Fischer, Jürgen
In recent years, sleep medicine has evolved into a full-grown discipline, featuring a multidisciplinary approach to diagnosis and treatment of patients with sleep disorders. Sleep medicine cuts across the boundaries of different conventional disciplines and is therefore open to medical and non-medical professionals with different specialty backgrounds. The aim of the current paper is to introduce a qualification for those professionals whose main occupation is to practice sleep medicine in the setting of a sleep medicine centre. The drafting of guidelines dealing with requirements for such qualification was entrusted to a task force by the European Sleep Research Society. The guidelines are the result of a progressive consensus procedure in which standards were defined for education, training, and evaluation. The final step along this pathway is a theoretical and practical examination, providing proof of proficiency in the field of sleep medicine. This paper describes the object of specific competences, the scope of sleep medicine, and the qualification procedures that pertain to three professional categories: medical specialists, non-medical professionals with a university master degree (such as psychologists and biologists), and nurses and technologists. Indices of preceding practical experience and theoretical knowledge are presented in Appendices 1 and 2. These guidelines are a European standard. They may be adapted in the future according to new scientific insights. National certification programs that comply with these guidelines may be subject to homologation by the ESRS.
Vargas-Blasco, César; Gómez-Durán, Esperanza L; Arimany-Manso, Josep; Pera-Bajo, Francisco
Clinical safety and medical professional liability are international major concerns, especially in surgical specialties such as urology. This article analyzes the claims filed at the Council of Medical Colleges of Catalonia between 1990 and 2012, exploring urology procedures. The review of the 173 cases identified in the database highlighted the importance of surgical procedures (74%). Higher frequencies related to scrotal-testicular pathology (34%), especially testicular torsion (7.5%) and vasectomy (19.6%), and prostate pathology (26 %), more specifically the surgical treatment of benign prostatic hyperplasia (17.9%). Although urology is not among the specialties with the higher frequency of claims, there are special areas of litigation in which it is advisable to implement improvements in clinical safety. Copyright © 2014 Elsevier España, S.L. All rights reserved.
Helmich, Esther; Derksen, Els; Prevoo, Mathieu; Laan, Roland; Bolhuis, Sanneke; Koopmans, Raymond
The importance of early clinical experience for medical training is well documented. However, to our knowledge there are no studies that assess the influence of very early nursing attachments on the professional development and identity construction of medical students. Working as an assistant nurse while training to be a doctor may offer valuable learning experiences, but may also present the student with difficulties with respect to identity and identification issues. The aim of the present study was to describe first-year medical students' perceptions of nurses, doctors and their own future roles as doctors before and after a nursing attachment. A questionnaire containing open questions concerning students' perceptions of nurses, doctors and their own future roles as doctors was administered to all Year 1 medical students (n=347) before and directly after a 4-week nursing attachment in hospitals and nursing homes. We carried out two confirmatory focus group interviews. We analysed the data using qualitative and quantitative content analyses. The questionnaire was completed by 316 students (response rate 91%). Before starting the attachment students regarded nurses as empathic, communicative and responsible. After the attachment students reported nurses had more competencies and responsibilities than they had expected. Students' views of doctors were ambivalent. Before and after the attachment, doctors were seen as interested and reliable, but also as arrogant, detached and insensible. However, students maintained positive views of their own future roles as doctors. Students' perceptions were influenced by age, gender and place of attachment. An early nursing attachment engenders more respect for the nursing profession. The ambivalent view of doctors needs to be explored further in relation to students' professional development. It would seem relevant to attune supervision to the age and gender differences revealed in this study.
Rafael Felipe García Rodríguez
Full Text Available The current work is a glossary of technical terms in English language for Medical Health Professionals, has been prepared due to the lack of technical lexicon the students have during and after their university studies, that is, the students have a deficit of technical words which limits their professional competence and accountability. This shortage limits them and makes it a great laboring challenge if they have to work overseas in English-speaking countries. The glossary comprises the main and necessary words which are needed for this type of professional in their field of action. These graduates have a solid knowledge and comprehension of biological, biochemical and biophysical fundamentals in their mother tongue but they do not have the necessary elements in the target language to operate properly. It is a need that they can work appropriately in the spheres of prevention, promotion and health recovery to support a diagnosis, a treatment and a management not only in their mother tongue but in English for their future work.
Wu, Siying; Zhu, Wei; Li, Huangyuan; Lin, Shaowei; Chai, Wenli; Wang, Xiaorong
Workplace violence has attracted increasing public attention over the past few decades in China. This study was conducted to evaluate the frequency of workplace violence in healthcare settings by various job titles and hospital departments, and to explore the related risk factors among Chinese medical professionals. A total of 2,464 medical professionals in 12 hospitals of two provinces were surveyed by using a stratified cluster sampling method. The Chinese version of the Workplace Violence Scale was used to measure the frequencies of workplace violence, classified as physical assault, emotional abuse, threat of assault, verbal sexual harassment and sexual assault experienced by the subjects over the previous 12 months. A structured questionnaire was administered to collect information on potentially influencing factors for workplace violence. Multivariate analysis was applied to determine the risk factors for workplace violence. About 50% of study subjects reported at least one type of workplace violence. The rates of experiencing two episodes or more of physical assault, emotional abuse, threat of assault, verbal sexual harassment, and sexual assault were 11%, 26%, 12%, 3%, and 1%, respectively. Identified risk factors for workplace violence included working in the departments of psychiatry, emergency, pediatrics and surgery, male gender, divorce/widowed status, long working hours (≥10 hr/day), and night shift. The study suggested that workplace violence occurs commonly in Chinese healthcare settings. Effective intervention strategies targeting workplace violence should be formulated in terms of major risk factors. Copyright © 2012 Wiley Periodicals, Inc.
Day, Donald D; Hand, Mikel W; Jones, Ann R; Harrington, Nancy Kay; Best, Robyn; LeFebvre, Kristine B
Combining the recommendations of the Institute of Medicine's report on the future of nursing, an Oncology Nursing Society (ONS) leadership think tank, and current evidence, the ONS Leadership Competencies were developed to provide all nurses with a pathway to advance their leadership skills and abilities. Generated through a systematic approach of literature review, data synthesis, and peer and expert review, the ONS Leadership Competencies are divided into five domains: vision, knowledge, interpersonal effectiveness, systems thinking, and personal mastery. Each of the competencies can be measured at the individual, group, and governance levels. They serve as a means of self-assessment, growth, future planning, and professional development. This article describes the process used to develop the ONS Leadership Competencies and offers examples of how they may be used in practice.
Benjamin, Hannah K; Royer, Danielle F
Social media, with its capabilities of fast, global information sharing, provides a useful medium for professional development, connecting and collaborating with peers, and outreach. The goals of this study were to describe a new, sustainable model for Twitter use by professional societies, and analyze its impact on @AACAnatomy, the Twitter account of the American Association of Clinical Anatomists. Under supervision of an Association committee member, an anatomy graduate student developed a protocol for publishing daily tweets for @AACAnatomy. Five tweet categories were used: Research, Announcements, Replies, Engagement, and Community. Analytics from the 6-month pilot phase were used to assess the impact of the new model. @AACAnatomy had a steady average growth of 33 new followers per month, with less than 10% likely representing Association members. Research tweets, based on Clinical Anatomy articles with an abstract link, were the most shared, averaging 5,451 impressions, 31 link clicks, and nine #ClinAnat hashtag clicks per month. However, tweets from non-Research categories accounted for the highest impression and engagement metrics in four out of six months. For all tweet categories, monthly averages show consistent interaction of followers with the account. Daily tweet publication resulted in a 103% follower increase. An active Twitter account successfully facilitated regular engagement with @AACAnatomy followers and the promotion of clinical anatomy topics within a broad community. This Twitter model has the potential for implementation by other societies as a sustainable medium for outreach, networking, collaboration, and member engagement. Clin. Anat. 31:566-575, 2018. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.
Raee, Hojat; Amini, Mitra; Momen Nasab, Ameneh; Malek Pour, Abdolrasoul; Jafari, Mohammad Morad
Self and peer assessment provides important information about the individual's performance and behavior in all aspects of their professional environment work. The aim of this study is to evaluate the professional behavior and performance in medical students in the form of team based assessment. In a cross-sectional study, 100 medical students in the 7(th) year of education were randomly selected and enrolled; for each student five questionnaires were filled out, including one self-assessment, two peer assessments and two residents assessment. The scoring system of the questionnaires was based on seven point Likert scale. After filling out the questions in the questionnaire, numerical data and written comments provided to the students were collected, analyzed and discussed. Internal consistency (Cronbach's alpha) of the questionnaires was assessed. A p<0.05 was considered as significant level. Internal consistency was acceptable (Cronbach's alpha 0.83). Interviews revealed that the majority of students and assessors interviewed found the method acceptable. The range of scores was 1-6 (Mean±SD=4.39±0.57) for the residents' assessment, 2-6 (Mean±SD= 4.49±0.53) for peer assessment, and 3-7 (Mean±SD=5.04±0.32) for self-assessment. There was a significant difference between self assessment and other methods of assessment. This study demonstrates that a team-based assessment is an acceptable and feasible method for peer and self-assessment of medical students' learning in a clinical clerkship, and has some advantages over traditional assessment methods. Further studies are needed to focus on the strengths and weaknesses.
Full Text Available Introducrion: Self and peer assessment provides important information about the individual’s performance and behavior in all aspects of their professional environment work. The aim of this study is to evaluate the professional behavior and performance in medical students in the form of team based assessment. Methods: In a cross-sectional study, 100 medical students in the 7th year of education were randomly selected and enrolled; for each student five questionnaires were filled out, including one self-assessment, two peer assessments and two residents assessment. The scoring system of the questionnaires was based on seven point Likert scale. After filling out the questions in the questionnaire, numerical data and written comments provided to the students were collected, analyzed and discussed. Internal consistency (Cronbach’s alpha of the questionnaires was assessed. A p<0.05 was considered as significant. Results: Internal consistency was acceptable (Cronbach’s alpha 0.83. Interviews revealed that the majority of students and assessors interviewed found the method acceptable. The range of scores was 1-6 (Mean±SD=4.39±0.57 for the residents' assessment, 2-6 (Mean±SD=4.49±0.53 for peer assessment, and 3-7 (Mean±SD=5.04±0.32 for self-assessment. There was a significant difference between self assessment and other methods of assessment. Conclusions: This study demonstrates that a team-based assessment is an acceptable and feasible method for peer and self-assessment of medical students’ learning in a clinical clerkship, and has some advantages over traditional assessment methods. Further studies are needed to focus on the strengths and weaknesses.
Abadel, Fatima T; Hattab, Abdulla S
Professionalism and communication skills constitute important components of the integral formation of physicians which has repercussion on the quality of health care and medical education. The objective of this study was to assess medical graduates' professionalism and communication skills from the patients' perspective and to examine its association with patients' socio-demographic variables. This is a hospital based cross-sectional study. It involved 315 patients and 105 medical graduates selected by convenient sampling method. A modified and validated version of the American Board of Internal Medicine's (ABIM) Patient Assessment survey questionnaire was used for data collection through a face to face interview. Data processing and analysis were performed using the Statistical Package for Social Science (SPSS) 16.0. Mean, frequency distribution, and percentage of the variables were calculated. A non-parametric Kruskal Wallis test was applied to verify whether the patients' assessment was influenced by variables such as age, gender, education, at a level of significance, p ≤ 0.05. Female patients constituted 46% of the sample, whereas males constituted 54%. The mean age was 36 ± 16. Patients' scoring of the graduate's skills ranged from 3.29 to 3.83 with a mean of 3.64 on a five-point Likert scale. Items assessing the "patient involvement in decision-making" were assigned the minimum mean values, while items dealing with "establishing adequate communication with patient" assigned the maximum mean values. Patients, who were older than 45 years, gave higher scores than younger ones (p communication skills at a good level. Patients' age and educational level were significantly associated with the rating level.
Bangladesh Medical Physics Society (BMPS
Full Text Available Following abstracts proceedings are available in PDF:Challenges in brachytherapy dosimetryEssentials of periodic QA in radiation therapyInterventional radiotherapy or brachytherapy: new challenges for a successful techniqueExternal beam radiotherapy and high dose rate (HDR brachytherapy treatment for carcinoma cervix practice in BPKMCH, Bharatpur, NepalTransition from 2D to 3D-CRT (NICRH experienceConformal HDR brachytherapy for prostate cancer: comparison between boost and monotherapyImportance and procedures of quality control of diagnostic CT and CT simulator using for modern radiation therapyMedical physics and biomedical engineering education in Gono UniversityPlan verification in tomotherapy using 3D semiconductor detectorComparison of the miniaturized Co-60 and Ir-192 sources in HDR brachytherpy applicationsA Supine based cranio-spinal irradiation technique using moving field junctions radiotherapyStatistical variation and significance in the responses of thyroid follicular cells of two areas of Bangladesh due to radiotherapy into head and neck regionDetermining proper patient’s set-up parameters like IFD, gantry angles, and field width in Ca. breast to achieve precise treatment, in a center where TPS & simulators are not availableAccidental exposure of cancer patient and its preventionComparison of physical and enhanced dynamic wedges beam characteristics for 6 MV photon energy using pencil-beam convolution (PBC algorithmProcedure to set up a radiotherapy unit & low cost unit analysisPatient setup verification and quality control (QC of electronic portal imaging device (EPID
Yue, Juan-Juan; Chen, Gang; Wang, Zhen-Wei; Liu, Wei-Dong
Background and purpose: Teacher professional development potentially enhances teachers' professional morale, knowledge, skills and autonomy, which helps improve the quality of education. The military medical university is an important medical education institution in China; however, studies of teacher professional development within military…
K Ganasegeran; SAR Al-Dubai
Context: The practice of medicine requires good communication skills to foster excellent rapport in doctor patient relationship. Reports on communication skills learning attitude among medical professionals are key essentials toward improving patient safety and quality of care. Aims: We aimed to determine factors affecting communication skills learning attitudes among medical residents in Malaysia. Settings and Design: Cross-sectional survey, in a Malaysian public health hospital. Materials a...
Full Text Available In the context of medical professional liability, obstetrics is one of the most involved medical specialties because the unfavorable outcome of a pregnancy is difficult to accept for parents, who tend to reduce it to inappropriate care that occurred during pregnancy or birth. 32 cases of perinatal asphyxia were evaluated by the Institute of Forensic Medicine in Brescia during the period between 1999 and 2014 (13 in Civil Court and 19 in Penal Court. 9 out of the 32 pregnancies were twins, so the considerations were carried out on a total of 41 fetuses/newborns. Profiles of inadequacy were identified in 66% of cases (85% of the cases evaluated in Civil Court; 53% of the cases evaluated in Penal Court. The existence of a causal relationship between the medical conduct and the onset of asphyxia was recognized in 79% of civil cases and in 38% of penal cases. There is a “greater rigor” in the verification of causal relationship and malpractice profiles in penal cases compared to civil ones: this is in harmony with the most recent Italian Court decisions, characterized by compelling suspect’s protection in the presence of a reasonable doubt in criminal matters and by victim’s protection in civil ones.
Guest, G F
As society transitions deeper into the Information Age, Information Technology has become a critical tool that supports all facets of the global economy. The Internet, via the World-Wide Web (WWW), has become a major component of business operations for corporate and educational organizational entities. An estimated 10,000 or more health-related websites are providing information for both consumers and healthcare professionals. In addition to private and state-supported institutions being present on the Internet, the federal government has moved rapidly toward disseminating information electronically, with significant utilization of the WWW as the technological vehicle. All branches of the US Government and federal-related agencies are now represented on the Internet in an effort to deliver content to their end users, primarily the public. The intent of this article is to complement the previous publication, "Internet Resources for Dentistry: Utilization of the Internet to Support Professional Growth, Decision Making, and Patient Care," by presenting dental healthcare professionals with information on additional governmental and medical "Internet" sites. In addition, healthcare professionals must arm themselves with more than just access itself, but also the ability to critically judge the quality of information retrieved from the WWW.
Full Text Available Objective: To determine the overall perception and utilization of the pharmacist managed medication therapy management (MTM clinic services, by healthcare professionals in a large, urban, university medical care setting.Methods: This was a cross-sectional, anonymous survey sent to 195 healthcare professionals, including physicians, nurses, and pharmacists at The University of Illinois Outpatient Care Center to determine their perception and utilization of the MTM clinic. The survey consisted of 12 questions and was delivered through a secure online application. Results: Sixty-two healthcare professionals (32% completed the survey. 82% were familiar with the MTM clinic, and 63% had referred patients to the clinic. Medication adherence and disease state management was the most common reason for referral. Lack of knowledge on the appropriate referral procedure was the prominent reason for not referring patients to the MTM clinic. Of the providers that were aware of MTM services, 44% rated care as ‘excellent’, 44% as ‘good’, 5% as ‘fair’, and 0% stated ‘poor’. Strengths of MTM clinic identified by healthcare providers included in-depth education to patients, close follow-up, and detailed medication reconciliation provided by MTM clinic pharmacists. Of those familiar with MTM clinic, recommendations included; increase marketing efforts to raise awareness of the MTM clinic service, create collaborative practice agreements between MTM pharmacists and physicians, and ensure that progress notes are more concise.Conclusion: In a large, urban, academic institution MTM clinic is perceived as a valuable resource to optimize patient care by providing patients with in-depth education as it relates to their prescribed medications and disease states. These identified benefits of MTM clinic lead to frequent patient referrals specifically for aid with medication adherence and disease state management.
Ganasegeran, K; Al-Dubai, S A R
The practice of medicine requires good communication skills to foster excellent rapport in doctor patient relationship. Reports on communication skills learning attitude among medical professionals are key essentials toward improving patient safety and quality of care. We aimed to determine factors affecting communication skills learning attitudes among medical residents in Malaysia. Cross-sectional survey, in a Malaysian public health hospital. A total of 191 medical residents across medical and surgical based rotations were included. We assessed the validated communication skills attitude scale among medical residents from different rotations. Statistical Package of Social Sciences (SPSS®) (version 16.0, IBM, Armonk, NY) was used. Cronbach's alpha was used to test the internal consistency of the scale. Descriptive analysis was conducted for all variables. Bivariate analysis was employed across the socio-demographic variables. Majority of the residents believed that communication skills training should be made compulsory in Malaysia (78.5%). Medical residents agreed that acquiring good communication skills is essential to be a good doctor. However, the majority cited time pressures for not being able to learn communication skills. Significant differences in communication skills learning attitude scores were found between Malays and Chinese. The majority of medical residents had a positive attitude toward communication skills learning. Socio-demographic factors influenced communication skills learning attitude among medical residents. Incorporating communicative skills modules during hospital Continuous Medical Education for medical residents is essential to cultivate communicative skills attitudes for effective doctor-patient relationship during the routine medical encounters.
The article deals with outlining guidelines for improving professional training of junior medical staff based on European experience. Consequently, guidelines and recommendations on enhancing the efficiency of medical education in general and junior medical specialists' professional training, in particular, published by European Union of Medical…
Weaver, Roslyn; Peters, Kath; Koch, Jane; Wilson, Ian
Medical students must develop not only their professional identity but also inclusive social attitudes for effective medical practice in the future. This study explores the elements that contribute to medical students' sense of professional identity and investigates the concept of social exclusivity and how this might relate to students' development of their identity as medical professionals. The study is based on qualitative data gathered in telephone interviews with 13 medical students enrolled in Years 1 or 3 at an undergraduate medical school at a university in Australia. The questions were open-ended and asked students about their experiences in medical school, sense of identity and social connections. Two main components contributed to a strong sense of professional identity in medical students: professional inclusivity and social exclusivity. Students experienced professional inclusivity when they attended clinical placements and when they were treated as future medical professionals by lecturers, doctors and patients. Social exclusivity was demonstrated by participants' perceptions of themselves as socially separate from non-medical students and isolated from students in other disciplines. Students described a sense of peer unity and a shared sense of identity as medical students within the medical school. It is important to understand how students develop their sense of identity as medical professionals and the ways in which medical education and clinical placements can influence this professional identity. Although this study noted a very strong sense of social exclusivity in its findings, there were also high levels of intra-discipline inclusivity. These results suggest that there is a reciprocal and reinforcing relationship between student experiences of professional inclusivity and social exclusivity that creates a defined sense of professional identity. © Blackwell Publishing Ltd 2011.
Holmes, Mary Anne; McKenzie, Judith
Women are under-represented for science awards and fellow status in professional science societies (accounting for career stage) and are over-represented for teaching and service awards (Ball et al., 2015; Lincoln et al., 2012; Holmes et al., 2011). In addition, for the American Geophysical Union, non-U.S. members are under-represented among all awardees. Gender bias in evaluation processes are well-documented (e.g., Valian, 1999), and cultural differences are at play in the under-representation of non U.S. members. U.S. members are more likely to nominate their peers for awards, and to write effusive letters to support the nomination (Ball et al., 2015). There are effective mechanisms to reduce bias in both nomination and evaluation processes, a few of which are: 1) separate the nomination and evaluation processes by creating nomination committees of a diverse group of people who actively seek potential nominees and promote their nominations; this expands the pool of nominees; 2) educate nomination and evaluation committees on the research that demonstrates the impact of implicit bias on nomination and selection processes (e.g., http://www.enei.org.uk/pages/unconscious-bias.html; http://wiseli.engr.wisc.edu/bias.php); 3) minimize use of simple bibliometric indices, which are known to exhibit gender bias (men self-cite more than women; Maliniak et al., 2013) and nationality bias (papers in English language journals are more likely to be cited than non-English journals (Bornmann et al., 2012; González-Alcaide et al., 2012); 4) members of the selection committee should understand the effects of gender on the quality of letters written for women (Trix and Psenka, 2003); 5) establish and follow clear criteria for the award. Professional societies can promote fairness and inclusion by self-study: find and compile the data on the gender, race, ethnicity and nationality of members who are nominated for and win awards, as well as on who is doing the nominating. Compare
Yaghmaei, Minoo; Yazdani, Shahram; Ahmady, Soleiman
The aim of this study was to show the interaction between the society, applicants and medical schools in terms of medical student selection. In this study, the trends to implement social factors in the selection process were highlighted. These social factors were explored through functionalism and conflict theories, each focusing on different categories of social factors. While functionalist theorists pay attention to diversity in the selection process, conflict theorists highlight the importance of socio-economic class. Although both theories believe in sorting, their different views are reflected in their sorting strategies. Both theories emphasize the importance of the person-society relationship in motivation to enter university. Furthermore, the impacts of social goals on the selection policies are derived from both theories. Theories in the sociology of education offer an approach to student selection that acknowledges and supports complexity, plurality of approaches and innovative means of selection. Medical student selection does not solely focus on the individual assessment and qualification, but it focuses on a social and collective process, which includes all the influences and interactions between the medical schools and the society. Sociological perspective of medical student selection proposes a model that envelops the individual and the society. In this model, the selection methods should meet the criteria of merit at the individual level, while the selection policies should aim at the society goals at the institutional level.
The Serbian Medical Society was founded in Belgrade in 1872, 126 years ago. At that time, Serbia was liberated from the Ottoman domination, and was one of some thirty existing independent states gaining international recognition in 1878. In 1932 an old dream has been fulfilled--on the occasion of the 60th anniversary of the existence and activity of the Serbian Medical Society--the home of Serbian Medical Society was opened. A 30-year-long period in which the building of the Home was one of the main preoccupations and a "guiding light" of Serbian doctors thus ended. Money from charitable funds was used, which caused certain benefactors to be praised as noted personalities. Medical practice in those days was in the state of choice. There were no means for adequate treatment of certain ailments, and therapy without realistic scientific base was given, often covered by fictitious reasons. This was especially true for tuberculosis and cancer. Under the pretext of the introduction of "new therapeutical approaches" into medical practice and treatment, diverse pharmaceutical formulas were introduced without knowledge of their real effect--injections of milk, drug containing animal embrional cells and special attention was paid to transplantation of the sexual glands. The injection of "camphor oil" (5 cc) was thus "recommended, harmless but useless". The treatment of tuberculosis, which domineered the pathology of population, was very chaotic. The greatest number of drugs for "successful cure" were to be found here. Most commotion was caused by the so-called Friedman's cure for tuberculosis which was rejected only after vigorous debates. Our drug "Joannin" on the basis of "the old tuberculine" was also represented in this confusion (and Koch himself was forced to recant it). This medicament was also hailed as "successful cure". The origin of serious scientific efforts, however, are to be found around newly formed journal "Medicinski pregled", which attracted new and
Doukas, David J; Volpe, Rebecca L
Professionalism is essential for a successful physician-patient relationship and widely acknowledged as an intrinsic and important component of medical education for learners at all levels, from medical school to residency to continuing medical education. The problem is defining the educational endpoints for learners and then determining how to assess these outcomes. This Invited Commentary focuses on what medical educators can and should do to refine the vision of professionalism in medical education. The authors propose a multi-step process in which learners, educators, and the public are engaged in articulating clearly and definitively the endpoints of professionalism education.
Evaluates professionalism in contemporary context and suggests ways to enhance educational institutions' learning capability. The new professionalism stresses use of democratic collaboration to confront bureaucratic constraints and disciplinary power in an uncertain age. New professionals must self-consciously create and recreate collaborative…
Homelessness is a social phenomenon of increasing frequency in Germany and of high relevance for an inclusive society. Its expression is both caused psychosocially and moderated socioeconomically, often with negatively reinforcing feedback-loops. This overview describes health effects and strategies for improvement, using the example of the "Mainzer Modell". The comprehensive availability of adequate medical care are both an individual right and a social duty for an inclusive society. © Georg Thieme Verlag KG Stuttgart · New York.
In July 2007 physicians, biologists and physicists that have collaborated in previous meetings of the medical branch of the Mexican Physical Society constituted the Mexican Society of Bioelectromagnetism with the purpose of promote scientific study of the interaction of electromagnetic energy (at frequencies ranging from zero Hertz through those of visible light) and acoustic energy with biological systems. A second goal was to increase the contribution of medical and biological professionals in the meetings of the medical branch of the Mexican Physical Society. The following paragraphs summarize some objectives of the Mexican Society of Bioelectromagnetism for the next two years
Liao, Joshua M; Etchegaray, Jason M; Williams, S Tyler; Berger, David H; Bell, Sigall K; Thomas, Eric J
To develop and test the psychometric properties of a survey to measure students' perceptions about patient safety as observed on clinical rotations. In 2012, the authors surveyed 367 graduating fourth-year medical students at three U.S. MD-granting medical schools. They assessed the survey's reliability and construct and concurrent validity. They examined correlations between students' perceptions of organizational cultural factors, organizational patient safety measures, and students' intended safety behaviors. They also calculated percent positive scores for cultural factors. Two hundred twenty-eight students (62%) responded. Analyses identified five cultural factors (teamwork culture, safety culture, error disclosure culture, experiences with professionalism, and comfort expressing professional concerns) that had construct validity, concurrent validity, and good reliability (Cronbach alphas > 0.70). Across schools, percent positive scores for safety culture ranged from 28% (95% confidence interval [CI], 13%-43%) to 64% (30%-98%), while those for teamwork culture ranged from 47% (32%-62%) to 74% (66%-81%). They were low for error disclosure culture (range: 10% [0%-20%] to 27% [20%-35%]), experiences with professionalism (range: 7% [0%-15%] to 23% [16%-30%]), and comfort expressing professional concerns (range: 17% [5%-29%] to 38% [8%-69%]). Each cultural factor correlated positively with perceptions of overall patient safety as observed in clinical rotations (r = 0.37-0.69, P safety behavioral intent item. This study provided initial evidence for the survey's reliability and validity and illustrated its applicability for determining whether students' clinical experiences exemplify positive patient safety environments.
Full Text Available Context: The practice of medicine requires good communication skills to foster excellent rapport in doctor patient relationship. Reports on communication skills learning attitude among medical professionals are key essentials toward improving patient safety and quality of care. Aims: We aimed to determine factors affecting communication skills learning attitudes among medical residents in Malaysia. Settings and Design: Cross-sectional survey, in a Malaysian public health hospital. Materials and Methods: A total of 191 medical residents across medical and surgical based rotations were included. We assessed the validated communication skills attitude scale among medical residents from different rotations. Statistical Analysis: Statistical Package of Social Sciences (SPSS® (version 16.0, IBM, Armonk, NY was used. Cronbach′s alpha was used to test the internal consistency of the scale. Descriptive analysis was conducted for all variables. Bivariate analysis was employed across the socio-demographic variables. Results: Majority of the residents believed that communication skills training should be made compulsory in Malaysia (78.5%. Medical residents agreed that acquiring good communication skills is essential to be a good doctor. However, the majority cited time pressures for not being able to learn communication skills. Significant differences in communication skills learning attitude scores were found between Malays and Chinese. Conclusion: The majority of medical residents had a positive attitude toward communication skills learning. Socio-demographic factors influenced communication skills learning attitude among medical residents. Incorporating communicative skills modules during hospital Continuous Medical Education for medical residents is essential to cultivate communicative skills attitudes for effective doctor-patient relationship during the routine medical encounters.
Benicio Barros Brandão
Full Text Available Background: The white medical coats used by health professionals may serve as a source of infection in health services because it is a potential vehicle for transmission of microorganisms. There are several studies that warn of the inherent dangers in bacterial contamination in lab coats, but there are few reports of fungal contamination in this personal protection equipment. Aims: The study aims to identify fungi in dental lab coats. Method: Samples were collected from ten dentists from a dentistry-school clinic of a higher education institution of Teresina, Piauí, Brazil, using sterile swab, soaked in saline contained in a test tube. Each sample was inoculated on chloramphenicol-containing Saboroud Dextrose agar and incubated at room temperature for fungal growth. Phenotypic and biochemical methods were used to identify the colonies. Results: Fungal growth was observed in all samples of the lab coats, and 19 isolates were counted. The genera Cladosporium and Aspergillus were the most frequent in this study. The results emphasize the role of fungi as contaminants in lab coats; and, as an effective means of transmission of pathogens in the community. Conclusions: This study suggests a methodology for the proper washing and decontamination of the lab coat and advocates the need to implement more rigid norms in concern to the use of lab coats, as well as educational campaigns to guide dentists about the correct use of this Personal Protection Equipment (PPE. Keywords: Individual Protection Equipment. Fungi. Cross infection.
McCloskey, Cindy B; Domen, Ronald E; Conran, Richard M; Hoffman, Robert D; Post, Miriam D; Brissette, Mark D; Gratzinger, Dita A; Raciti, Patricia M; Cohen, David A; Roberts, Cory A; Rojiani, Amyn M; Kong, Christina S; Peterson, Jo Elle G; Johnson, Kristen; Plath, Sue; Powell, Suzanne Zein-Eldin
Competency-based medical education has evolved over the past decades to include the Accreditation Council for Graduate Medical Education Accreditation System of resident evaluation based on the Milestones project. Entrustable professional activities represent another means to determine learner proficiency and evaluate educational outcomes in the workplace and training environment. The objective of this project was to develop entrustable professional activities for pathology graduate medical education encompassing primary anatomic and clinical pathology residency training. The Graduate Medical Education Committee of the College of American Pathologists met over the course of 2 years to identify and define entrustable professional activities for pathology graduate medical education. Nineteen entrustable professional activities were developed, including 7 for anatomic pathology, 4 for clinical pathology, and 8 that apply to both disciplines with 5 of these concerning laboratory management. The content defined for each entrustable professional activity includes the entrustable professional activity title, a description of the knowledge and skills required for competent performance, mapping to relevant Accreditation Council for Graduate Medical Education Milestone subcompetencies, and general assessment methods. Many critical activities that define the practice of pathology fit well within the entrustable professional activity model. The entrustable professional activities outlined by the Graduate Medical Education Committee are meant to provide an initial framework for the development of entrustable professional activity-related assessment and curricular tools for pathology residency training.
Noordegraaf, Mirko; Schneider, Magriet; Boselie, Paul; van Rensen, E.L.J.
With the rise of clinical management, new skills of medical doctors stand out, including leadership skills. Medical doctors organize medical work and improve patient care. The training of frontline leadership skills, however, is weakly developed in residency programmes. Medical professional cultures
Full Text Available Introduction: The changing doctor-patient relationship and commercialization of modem medical practice has affected the practice of medicine. The fundamental values of medicine insist that the doctors should be aware about the various medico-legal issues which help in proper recording of medical management details. Aim: To evaluate the knowledge on Medico-legal Issues among Medical and Dental College Health Professionals of Meenakshi University (MAHER, Tamilnadu. Materials & Method: A cross-sectional survey was conducted among health professionals of Meenakshi University (MAHER, Tamilnadu. A total o f320 health professionals (163 medical and 157 dental participated in the study. A structured, closed ended, self-administered questionnaire was used for collection of data. Chi-square test was used to compare the awareness of medico-legal issues between medical and dental health professionals. Results: Among the 320 health professionals, 87.4% of medical and 76.1% of dental professionals were aware about the informed consent, 18.8% of medical and 5.7% of dental professionals had awareness about COPRA and only 14.3% of medical and 7.6% of dental professionals had awareness regarding the Medico-legal programs/courses. Conclusions: The results illustrated that the participants had little awareness on medico-legal issues. Hence there is an urgent need to update the understanding of these issues to be on a legally safer side.
De Lasson, Lydia; Just, Eva; Stegeager, Nikolaj W.M.
Background The transition from student to medical doctor is challenging and stressful to many junior doctors. To practice with confidence and professionalism the junior doctors have to develop a strong professional identity. Various suggestions on how to facilitate formation of professional ident...... and acting as a doctor), adoption to medical culture, career planning and managing a healthy work/life-balance. Further studies in different contexts are recommended as well as studies using other methods to test the results of this qualitative study....
Bosshard, G; Broeckaert, B; Clark, D; Materstvedt, L J; Gordijn, B; Müller-Busch, H C
To analyse legislation and medical professional positions concerning the doctor's role in assisted dying in western Europe, and to discuss their implications for doctors. This paper is based on country-specific reports by experts from European countries where assisted dying is legalised (Belgium, The Netherlands), or openly practiced (Switzerland), or where it is illegal (Germany, Norway, UK). Laws on assisted dying in The Netherlands and Belgium are restricted to doctors. In principle, assisted suicide (but not euthanasia) is not illegal in either Germany or Switzerland, but a doctor's participation in Germany would violate the code of professional medical conduct and might contravene of a doctor's legal duty to save life. The Assisted Dying for the Terminally Ill Bill proposed in the UK in 2005 focused on doctors, whereas the Proposal on Assisted Dying of the Norwegian Penal Code Commission minority in 2002 did not. Professional medical organisations in all these countries except The Netherlands maintain the position that medical assistance in dying conflicts with the basic role of doctors. However, in Belgium and Switzerland, and for a time in the UK, these organisations dropped their opposition to new legislation. Today, they regard the issue as primarily a matter for society and politics. This "neutral" stance differs from the official position of the Royal Dutch Medical Association which has played a key role in developing the Dutch practice of euthanasia as a "medical end-of-life decision" since the 1970s. A society moving towards an open approach to assisted dying should carefully identify tasks to assign exclusively to medical doctors, and distinguish those possibly better performed by other professions.
Park, So-Youn; Shon, Changwoo; Kwon, Oh Young; Yoon, Tai Young; Kwon, Ivo
Physicians in both Western and Eastern countries are being confronted by changes in health care delivery systems and medical professionalism values. The traditional concept of "In-Sul" (benevolent art) and the modern history of South Korea have led to cultural differences between South Korea and other countries in conceptualizing medical professionalism; thus, we studied medical students' perceptions of professionalism as described in essays written on this topic. In 2014, we asked 109 first-year medical students who were enrolled in a compulsory ethics course to anonymously write a description of an instance of medical professionalism that they had witnessed, as well as reflecting on their own professional context. We then processed 105 valid essays using thematic content analysis with computer-assisted qualitative data analysis software. Thematic analysis of the students' essays revealed two core aspects of professionalism in South Korea, one focused on respect for patients and the other on physicians' accountability. The most common theme regarding physician-patient relationships was trust. By contrast, distributive justice was thought to be a non-essential aspect of professionalism. In Western countries, physicians tend to promote justice in the health care system, including fair distribution of medical resources; however, we found that medical students in South Korea were more inclined to emphasize doctors' relationships with patients. Medical educators should develop curricular interventions regarding medical professionalism to meet the legitimate needs of patients in their own culture. Because professionalism is a dynamic construct of culture, medical educators should reaffirm cultural context-specific definitions of professionalism for development of associated curricula.
Fronteira, Inês; Rodrigues, Amabélia; Pereira, Camilo; Silva, Augusto P; Mercer, Hugo; Dussault, Guilles; Ferrinho, Paulo
In Guinea Bissau, the majority of university level professionals are still being trained abroad and most of them do not return to their country. This was a major incentive for creating Guinea Bissau's Medical School. An observational, cross-sectional, analytic study was conducted on the second trimester of 2007 to characterize the socio-demographic, familial and educational profile of medical students, their satisfaction levels, difficulties and expectations concerning the medicine course. A questionnaire was used and a response rate of 63% achieved (81 students). Data was analyzed using SPSS v.17 for descriptive statistics. Students are very committed to their education. They tend to decide to take the medicine course early in their lives and are influenced by their relatives. They choose to be medical doctors because they like it but also for altruistic reasons and the desire to save lives. Although many face financial and material difficulties, they tend to have success in their academic live. They live with their parents, do not have children and some have side jobs to provide for extra income to help with their education. They expect their education to make them good doctors in any part of the world and want to work simultaneously in the public (to serve their country and pay their debt to the State) and in the private sector (to enhance their income). The large majority wants to work in a hospital, in Bissau, and to be a pediatrician or obstetrician. They have unreasonably high expectations concerning their future income as medical doctors.
Full Text Available Abstract Background The Chinese Medical Doctors Association (CMDA adopted the Charter of Medical Professionalism in the New Millennium (Charter and published the Chinese Medical Doctor Declaration (Declaration. This is an important step to re-building medical professionalism in China at a time when the commercialization of health care has led to a decline in physician accountability and public trust in the profession. In response, authors have begun to examine and promote medical professionalism in China. This study aims to present the key research themes, identify research gaps and offer recommendations from reviewing the increasing pool of Chinese-language literature on medical professionalism. Methods A scoping review of Chinese language papers was conducted using the China National Knowledge Infrastructure (including China Academic Journals Full-text Database, China Doctoral Dissertations Full-text Database, Masters’ Theses Full-text Database, China Core Newspapers Full-text Database, and China Yearbooks Full-text Database (CNKI database. Results Four major research themes were identified in Chinese discourse: (1 teaching professionalism, (2 practicing professionalism, (3 conceptualizing professionalism and (4 assessing professionalism. Overall, authors were concerned with the cultivation of humanism in physicians and emphasized the importance of communication skills to improve the physician-patient relationship in China. They explored the role of traditional Chinese values, such as Confucian and Taoist values, as well as the Communist Party’s political values, in promoting professional behaviour. Conclusions Authors demonstrate increasing interest in medical professionalism in China. The literature is of variable quality and further empirical studies are required in order to evaluate teaching interventions and guide professionalism assessment. A common professionalism framework is absent and could be developed with consideration to
Duncan, Janine; Duncan, Daniel
As demographics in the United States shift, family and consumer sciences (FCS) professionals must be prepared to foster healthy communities that embrace multilingual families. Because hegemonic language ideologies challenge multilingual families, FCS professionals need to know how to inclusively reframe communities to honor multilingual families.…
Karunakaran, Ilavenil; Thirumalaikolundusubramanian, Ponniah; Nalinakumari, Sheela Das
Professionalism and ethics have gained widespread recognition as competencies to be fulfilled, taught, and assessed within medical education. The role of the anatomy course in developed nations has evolved over time and now encompasses multiple domains, including knowledge, skills, and the inculcation of professionalism and ethics. The Medical Council of India recently recommended the integration of professionalism teaching in undergraduate medical curricula. The authors investigated whether the initial orientation lectures and instructions given by faculty at the outset of undergraduate medical anatomy courses throughout India served a "hidden curriculum" regarding professionalism practices, and whether these orientation messages could serve as an early exposure to medical professionalism and ethics for medical students. An online survey was carried out among 102 anatomy faculty members across India requesting details about specific professionalism protocols and instructions regarding behavior in the dissection hall that are routinely given to preclinical students, as well as the importance that they placed on professional behavior. It was found that most faculty members regularly instruct students regarding expected behavior during the anatomy course, including dissection practices. These instructions stress attributes of professionalism like humanism, accountability, and honesty. However, there needs to be a more concentrated effort by educators to prohibit such unprofessional practices like dissection hall photography, and better information is required regarding biomedical waste disposal. Despite the absence of clear guidelines for professionalism teaching in medical education in India, the existing framework of anatomy education provides an opportunity to introduce the concept of professionalism to the first-year medical student. This opportunity may provide an early foundation for designing a professionalism-integrated curriculum. Anat Sci Educ 10: 433
Doukas, David J; McCullough, Laurence B; Wear, Stephen; Lehmann, Lisa S; Nixon, Lois LaCivita; Carrese, Joseph A; Shapiro, Johanna F; Green, Michael J; Kirch, Darrell G
Given recent emphasis on professionalism training in medical schools by accrediting organizations, medical ethics and humanities educators need to develop a comprehensive understanding of this emphasis. To achieve this, the Project to Rebalance and Integrate Medical Education (PRIME) II Workshop (May 2011) enlisted representatives of the three major accreditation organizations to join with a national expert panel of medical educators in ethics, history, literature, and the visual arts. PRIME II faculty engaged in a dialogue on the future of professionalism in medical education. The authors present three overarching themes that resulted from the PRIME II discussions: transformation, question everything, and unity of vision and purpose.The first theme highlights that education toward professionalism requires transformational change, whereby medical ethics and humanities educators would make explicit the centrality of professionalism to the formation of physicians. The second theme emphasizes that the flourishing of professionalism must be based on first addressing the dysfunctional aspects of the current system of health care delivery and financing that undermine the goals of medical education. The third theme focuses on how ethics and humanities educators must have unity of vision and purpose in order to collaborate and identify how their disciplines advance professionalism. These themes should help shape discussions of the future of medical ethics and humanities teaching.The authors argue that improvement of the ethics and humanities-based knowledge, skills, and conduct that fosters professionalism should enhance patient care and be evaluated for its distinctive contributions to educational processes aimed at producing this outcome.
Gaudio, Flavio G; Lemery, Jay; Johnson, David E
The Epinephrine Roundtable took place on July 27, 2008, during the 25th Annual Meeting of the Wilderness Medical Society (WMS) in Snowmass, CO. The WMS convened this roundtable to explore areas of consensus and uncertainty in the field treatment of anaphylaxis. Panelists were selected on the basis of their relevant academic or professional experience. There is a paucity of data that address the treatment of anaphylaxis in the wilderness. Anaphylaxis is a rare disease, with a sudden onset and drastic course that does not lend itself to study in randomized, controlled trials. Therefore, the panel endorsed the following position based on the limited available evidence and review of published articles, as well as expert consensus. The position represents the consensus of the panelists and is endorsed by the WMS. In 2014, the authors reviewed relevant articles published since the Epinephrine Roundtable. The following is an updated version of the original guidelines published in Wilderness & Environmental Medicine 2010;21(4):185-187. Copyright © 2014 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.
Shield, Renée R; Farrell, Timothy W; Campbell, Susan E; Nanda, Aman; Wetle, Terrie
Teaching professionalism is an important goal in American medical education. With the aging of the U.S. population, it is critical to understand how medical students develop professional behaviors when caring for older adults. Exposure to geriatrics and older patients can enhance students' professional development with patients of all ages and across different specialties. Medical students learn explicit and implicit messages during their education. In addition to helping to evaluate curricula, reflective journaling encourages individual development and helps in revealing how medical students become professionals. In this study, medical student volunteers described their responses to new geriatrics content in their curriculum, encounters with older patients in clinical settings, and their evolving physician identities. Multidisciplinary team analysis elicited 10 themes regarding: evaluation of geriatrics within the curriculum, recognition of geriatrics principles, and attitudes regarding aging and professional development over time. This article focuses on the impact of geriatrics exposure on students' professional development, revealing ways that students think about professionalism and older patients. Medical educators should consider journaling to help foster and gauge students' professional development.
Jones, Claire L
This article explores how medical practitioners read, used, and experienced medical trade catalogs in late-nineteenth- and early-twentieth-century Britain. Reader responses to the catalog, a book-like publication promoting medical tools, appliances, and pharmaceuticals, have been chronically understudied, as have professional reading practices within medicine more generally. Yet, evidence suggests that clinicians frequently used the catalog and did so in three main ways: to order medical products, to acquire new information about these products, and to display their own product endorsements and product designs. The seemingly widespread nature of these practices demonstrates an individual and collective professional desire to improve medical practice and highlights the importance of studying professional reading practices in the cultural history of medicine.
David, Dagmar M; Euteneier, Alexander; Fischer, Martin R; Hahn, Eckhart G; Johannink, Jonas; Kulike, Katharina; Lauch, Robert; Lindhorst, Elmar; Noll-Hussong, Michael; Pinilla, Severin; Weih, Markus; Wennekes, Vanessa
The German graduate medical education system is going through an important phase of changes. Besides the ongoing reform of the national guidelines for graduate medical education (Musterweiterbildungsordnung), other factors like societal and demographic changes, health and research policy reforms also play a central role for the future and competitiveness of graduate medical education. With this position paper, the committee on graduate medical education of the Society for Medical Education (GMA) would like to point out some central questions for this process and support the current discourse. As an interprofessional and interdisciplinary scientific society, the GMA has the resources to contribute in a meaningful way to an evidence-based and future-oriented graduate medical education strategy. In this position paper, we use four key questions with regards to educational goals, quality assurance, teaching competence and policy requirements to address the core issues for the future of graduate medical education in Germany. The GMA sees its task in contributing to the necessary reform processes as the only German speaking scientific society in the field of medical education.
Kaproncszay, Katalin; Magyar, László András; Putnam, Constance E
The 170-year history of the library of the Royal Society of Medicine in Budapest illustrates both that political and cultural context matter and that "medical" libraries, if they survive, in due course become primarily "medical history" libraries. Two of the authors are on the staff of the Semmelweis Medical History Library; the third is a US scholar who makes frequent use of the library. Together, they avail themselves of archival and published materials-and personal experience with the collection-to establish the context that produced the original library, trace its evolution, and describe its present-day incarnation. A tale of transformation emerges that reflects how collections are likely to change. The authors present events and individuals in the life of the Royal Society's library and paint a picture of the value of today's Semmelweis Medical History Library. Unique treasures in the collection are described. The story told here is of how a particular nineteenth-century library became a twenty-first-century institution. The authors establish its peculiarly Hungarian context and potential value to librarians and historians from outside Hungary. The overall message is that general medical libraries everywhere are perforce likely to become medical historical libraries over time.
Wilkinson, Tim J; Moore, Maryleigh; Flynn, Eleanor M
Professionalism is fundamental to good medical practice but is multifaceted so observing that a person is professional in some areas will not guarantee that person would be professional in others. Most definitions of professionalism include a commitment to self-monitor and to improve; some personal virtues; and effective relationships with colleagues, patients and people who are important to those patients. In addition, it is suggested that expectations of professionalism may alter depending on context, both of time and place. Societal expectations relating to professionalism are likely to change over time and our expectations of individuals may alter according to the stage of training. The environment (the workplace, one's colleagues, the work tasks) is also highly influential on the manifestation of professional behaviours. The medical profession's social contract in relation to professionalism will always need to be updated. The effect of time and place means that searching for innate or stable elements of professionalism, in order to predict subsequent behaviours, is therefore difficult. This has implications for the selection, education and assessment of medical students. The focus should be on how to build adaptability and resilience to contextual influences; to identify those elements of professionalism that can be learnt; and build systems of assessment that reflect professionalism's multifaceted and contextual aspects.
Doukas, David J; Kirch, Darrell G; Brigham, Timothy P; Barzansky, Barbara M; Wear, Stephen; Carrese, Joseph A; Fins, Joseph J; Lederer, Susan E
Effectively developing professionalism requires a programmatic view on how medical ethics and humanities should be incorporated into an educational continuum that begins in premedical studies, stretches across medical school and residency, and is sustained throughout one's practice. The Project to Rebalance and Integrate Medical Education National Conference on Medical Ethics and Humanities in Medical Education (May 2012) invited representatives from the three major medical education and accreditation organizations to engage with an expert panel of nationally known medical educators in ethics, history, literature, and the visual arts. This article, based on the views of these representatives and their respondents, offers a future-tense account of how professionalism can be incorporated into medical education.The themes that are emphasized herein include the need to respond to four issues. The first theme highlights how ethics and humanities can provide a response to the dissonance that occurs in current health care delivery. The second theme focuses on how to facilitate preprofessional readiness for applicants through reform of the medical school admission process. The third theme emphasizes the importance of integrating ethics and humanities into the medical school administrative structure. The fourth theme underscores how outcomes-based assessment should reflect developmental milestones for professional attributes and conduct. The participants emphasized that ethics and humanities-based knowledge, skills, and conduct that promote professionalism should be taught with accountability, flexibility, and the premise that all these traits are essential to the formation of a modern professional physician.
Abdel-Razig, Sawsan; Ibrahim, Halah; Alameri, Hatem; Hamdy, Hossam; Haleeqa, Khaled Abu; Qayed, Khalil I; Obaid, Laila O; Al Fahim, Maha; Ezimokhai, Mutairu; Sulaiman, Nabil D; Fares, Saleh; Al Darei, Maitha Mohammed; Shahin, Nhayan Qassim; Al Shamsi, Noora Abdulla Omran; Alnooryani, Rashed Arif; Al Falahi, Salama Zayed
Background Medical professionalism has received increased worldwide attention, yet there is limited information on the applicability and utility of established Western professionalism frameworks in non-Western nations. Objective We developed a locally derived consensus definition of medical professionalism for the United Arab Emirates (UAE), which reflects the cultural and social constructs of the UAE and the Middle East. Methods We used a purposive sample of 14 physicians working in the UAE as clinical and education leaders. This expert panel used qualitative methods, including the world café, nominal group technique, the Delphi method, and an interpretive thematic analysis to develop the consensus statement. Results The expert panel defined 9 attributes of medical professionalism. There was considerable overlap with accepted Western definitions, along with important differences in 3 aspects: (1) the primacy of social justice and societal rights; (2) the role of the physician's personal faith and spirituality in guiding professional practices; and (3) societal expectations for professional attributes of physicians that extend beyond the practice of medicine. Conclusions Professionalism is a social construct influenced by cultural and religious contexts. It is imperative that definitions of professionalism used in the education of physicians in training and in the assessment of practicing physicians be formulated locally and encompass specific competencies relevant to the local, social, and cultural context for medical practice. Our goal was to develop a secular consensus statement that encompasses culture and values relevant to professionalism for the UAE and the Arab region.
Abdel-Razig, Sawsan; Ibrahim, Halah; Alameri, Hatem; Hamdy, Hossam; Haleeqa, Khaled Abu; Qayed, Khalil I.; Obaid, Laila O.; Al Fahim, Maha; Ezimokhai, Mutairu; Sulaiman, Nabil D.; Fares, Saleh; Al Darei, Maitha Mohammed; Shahin, Nhayan Qassim; Al Shamsi, Noora Abdulla Omran; Alnooryani, Rashed Arif; Al Falahi, Salama Zayed
Background Medical professionalism has received increased worldwide attention, yet there is limited information on the applicability and utility of established Western professionalism frameworks in non-Western nations. Objective We developed a locally derived consensus definition of medical professionalism for the United Arab Emirates (UAE), which reflects the cultural and social constructs of the UAE and the Middle East. Methods We used a purposive sample of 14 physicians working in the UAE as clinical and education leaders. This expert panel used qualitative methods, including the world café, nominal group technique, the Delphi method, and an interpretive thematic analysis to develop the consensus statement. Results The expert panel defined 9 attributes of medical professionalism. There was considerable overlap with accepted Western definitions, along with important differences in 3 aspects: (1) the primacy of social justice and societal rights; (2) the role of the physician's personal faith and spirituality in guiding professional practices; and (3) societal expectations for professional attributes of physicians that extend beyond the practice of medicine. Conclusions Professionalism is a social construct influenced by cultural and religious contexts. It is imperative that definitions of professionalism used in the education of physicians in training and in the assessment of practicing physicians be formulated locally and encompass specific competencies relevant to the local, social, and cultural context for medical practice. Our goal was to develop a secular consensus statement that encompasses culture and values relevant to professionalism for the UAE and the Arab region. PMID:27168882
Harrison, Stephen; Mcdonald, Ruth
This paper argues that the means by which the profession of medicine has to legitimise itself in the context of state‐provided health services is changing in a way that may be summarised in Weberian terms as a shift from substantive to formal rationality. The traditional model for such legitimations, evident in the UK over the last 50 years, relied heavily on professional interpretation of emergent patient needs, on professional pragmatism as a means of coping with resource limitations, on un...
Hampson, Neil B; Bell, Jeneita; Clower, Jacquelyn H; Dunn, Susan L; Weaver, Lindell K
While accidental carbon monoxide (CO) poisoning is common, it is felt to be largely preventable through targeted public education. Development of effective education programs requires accurate epidemiologic information about the condition. Many acute, severe cases of CO poisoning are treated with hyperbaric oxygen (HBO2) at hospital-based facilities staffed by members of the Undersea and Hyperbaric Medical Society (UHMS). In 2008, the Centers for Disease Control and Prevention (CDC) began sponsoring a UHMS proposal to use online reporting by UHMS members of cases treated with HBO2. This report describes development and implementation of the internet-based surveillance system, as well as its first year of operation. From August 2008 to July 2009, a total of 740 cases were reported by the 82 hyperbaric facilities participating nationwide. Extensive epidemiologic information about CO poisoning in the United States has been collected, and the utility of partnering with a medical specialty society for disease-specific surveillance demonstrated.
Olapade-Olaopa, E O; Sewankambo, N; Iputo, J E; Rugarabamu, P; Amlak, A H; Mipando, M; Monekosso G L
BACKGROUND - Globally, human resources for health are being optimized to address the increasing health burden and concomitant increased demands on health professionals. These demands are even more exacting in Sub-SaharanAfrica considering the shortage of health care workers, especially physicians. The noteworthy efforts at deploying task-shifting to address this situation not-withstanding, the situation also signals the need to re-define the objectives of medical instruction to ensure effective and contemporary medical practice in a mostly physician-led health workforce across the sub-continent. In this regard, medical and dental graduates must be educated to perform certain minimum essential professional duties competently. Essential Professional Duties are locally relevant professional activities of international standard that represent identifiable outcomes against which the effectiveness of physicians in a specific community can be measured to ensure social accountability. PROCEDURE AND PRODUCT - The Association of Medical Schools of Africa has developed the 'Essential Professional Duties for sub-Saharan medical and dental graduates' to ensure these physicians provide safe and effective contemporary medical/dental practice on the sub-continent. The duties have been grouped into those required for basic patient care, basic administrative skills, basic emergency care, communication, inter-professional relationships, self-directed learning and social responsibilities. Their relevance and suitability have been evaluated prior to their adoption by the Association. CONCLUSION; These Essential Physician Duties have been developed to serve as targets for health professionals training instruments and thus give direction to health system strategies. It is hoped that they will be adopted by medical and dental schools across sub-,. Saharan Africa.
Moss, Marc; Good, Vicki S; Gozal, David; Kleinpell, Ruth; Sessler, Curtis N
Burnout syndrome (BOS) occurs in all types of health-care professionals and is especially common in individuals who care for critically ill patients. The development of BOS is related to an imbalance of personal characteristics of the employee and work-related issues or other organizational factors. BOS is associated with many deleterious consequences, including increased rates of job turnover, reduced patient satisfaction, and decreased quality of care. BOS also directly affects the mental health and physical well-being of the many critical care physicians, nurses, and other health-care professionals who practice worldwide. Until recently, BOS and other psychological disorders in critical care health-care professionals remained relatively unrecognized. To raise awareness of BOS, the Critical Care Societies Collaborative (CCSC) developed this call to action. The present article reviews the diagnostic criteria, prevalence, causative factors, and consequences of BOS. It also discusses potential interventions that may be used to prevent and treat BOS. Finally, we urge multiple stakeholders to help mitigate the development of BOS in critical care health-care professionals and diminish the harmful consequences of BOS, both for critical care health-care professionals and for patients.
The Japanese Society of Neuropsychopharmacology (NP) has established a Translational Medical Science Committee (TMSC), which is introduced in this article. In this century, the Japanese Government has made great effort to establish highly organized supporting systems for translational research (TR); however, clinical developments for psychotropic drugs in Japan are facing stagnation. TMSC will provide advisory activities from an academic point of view in this field, which will be result in the improvement of people's health.
Aciksoz, Salih Can
During the 2013 Gezi protests in Turkey, volunteering health professionals provided on-site medical assistance to protesters faced with police violence characterized by the extensive use of riot control agents. This led to a government crackdown on the medical community and the criminalization of "unauthorized" first aid amidst international criticisms over violations of medical neutrality. Drawing from ethnographic observations, in-depth interviews with health care professionals, and archival research, this article ethnographically analyzes the polarized encounter between the Turkish government and medical professionals aligned with social protest. I demonstrate how the context of "atmospheric violence"-the extensive use of riot control agents like tear gas-brings about new politico-ethical spaces and dilemmas for healthcare professionals. I then analyze how Turkish health professionals framed their provision of health services to protestors in the language of medical humanitarianism, and how the state dismissed their claims to humanitarian neutrality by criminalizing emergency care. Exploring the vexed role that health workers and medical organizations played in the Gezi protests and the consequent political contestations over doctors' ethical, professional, and political responsibilities, this article examines challenges to medical humanitarianism and neutrality at times of social protest in and beyond the Middle East.
Rothman, David J; McDonald, Walter J; Berkowitz, Carol D; Chimonas, Susan C; DeAngelis, Catherine D; Hale, Ralph W; Nissen, Steven E; Osborn, June E; Scully, James H; Thomson, Gerald E; Wofsy, David
Professional medical associations (PMAs) play an essential role in defining and advancing health care standards. Their conferences, continuing medical education courses, practice guidelines, definitions of ethical norms, and public advocacy positions carry great weight with physicians and the public. Because many PMAs receive extensive funding from pharmaceutical and device companies, it is crucial that their guidelines manage both real and perceived conflict of interests. Any threat to the integrity of PMAs must be thoroughly and effectively resolved. Current PMA policies, however, are not uniform and often lack stringency. To address this situation, the authors first identified and analyzed conflicts of interest that may affect the activities, leadership, and members of PMAs. The authors then went on to formulate guidelines, both short-term and long-term, to prevent the appearance or reality of undue industry influence. The recommendations are rigorous and would require many PMAs to transform their mode of operation and perhaps, to forgo valuable activities. To maintain integrity, sacrifice may be required. Nevertheless, these changes are in the best interest of the PMAs, the profession, their members, and the larger society.
Dukić, Lora; Kopčinović, Lara Milevoj; Dorotić, Adrijana; Baršić, Ivana
Blood gas analysis (BGA) is exposed to risks of errors caused by improper sampling, transport and storage conditions. The Clinical and Laboratory Standards Institute (CLSI) generated documents with recommendations for avoidance of potential errors caused by sample mishandling. Two main documents related to BGA issued by the CLSI are GP43-A4 (former H11-A4) Procedures for the collection of arterial blood specimens; approved standard - fourth edition, and C46-A2 Blood gas and pH analysis and related measurements; approved guideline - second edition. Practices related to processing of blood gas samples are not standardized in the Republic of Croatia. Each institution has its own protocol for ordering, collection and analysis of blood gases. Although many laboratories use state of the art analyzers, still many preanalytical procedures remain unchanged. The objective of the Croatian Society of Medical Biochemistry and Laboratory Medicine (CSMBLM) is to standardize the procedures for BGA based on CLSI recommendations. The Working Group for Blood Gas Testing as part of the Committee for the Scientific Professional Development of the CSMBLM prepared a set of recommended protocols for sampling, transport, storage and processing of blood gas samples based on relevant CLSI documents, relevant literature search and on the results of Croatian survey study on practices and policies in acid-base testing. Recommendations are intended for laboratory professionals and all healthcare workers involved in blood gas processing.
Battistella, B.; Howsley, R.; Johnson, D.
The challenges inherent in managing nuclear and radiological materials are complex and growing; ensuring that such materials remain secure requires competent management supported by ongoing training. The nuclear industry is increasingly becoming aware of the need for nuclear security: numerous dedicated training centres have been established worldwide and the IAEA holds approximately 60 international nuclear security training events annually. International training programmes have been conducted in various fields over decades but assessing their value and having the assurance that these training have had a sustainable impact remain difficult. In the field of nuclear security training, no assessment is being made of the degree to which the investment made is making a difference in building sustainable capacity and capability. This paper aims to discuss a methodology to assess the return on investment of nuclear security training. WINS has established a new professional society called the WINS Academy Alumni, for those individuals who have achieved certification through the WINS Academy. This platform proposes a structure, based on established competency frameworks, through which to measure the return on investment and performance improvement of nuclear security training. The objectives of the WINS Academy society are to stay engaged with certified Alumni, track their continued professional development progress, provide them with additional opportunities, and encourage their continued security competence through recertification. We envision that these certified practitioners will in turn promote certification and continual professional development among their peers to help build a network of security-trained professionals that will lead to meaningful and sustainable changes to security culture worldwide. In the long run (5–10 years), we envision that this group will be at the forefront of new professional requirements for nuclear security competence, with
Tisdell, Elizabeth J.; Wojnar, Margaret; Sinz, Elizabeth
This chapter focuses on how to negotiate power and interest among multiple stakeholders to develop continuing professional education programs as graduate study for those in the health and medical professions.
Kopera, Maciej; Suszek, Hubert; Bonar, Erin; Myszka, Maciej; Gmaj, Bart?omiej; Ilgen, Mark; Wojnar, Marcin
The study investigated explicit and implicit attitudes towards people with mental illness among medical students (non-professionals) with no previous contact with mentally ill patients and psychiatrists and psychotherapists (professionals) who had at least 2?years of professional contact with mentally ill patients. Explicit attitudes where assessed by self-report. Implicit attitudes were measured with the Go/No-Go Association Task, a variant of the Implicit Association Test that does not requ...
Krokstad, Steinar; Westin, Steinar
The objective of this study was to describe sociomedical determinants and developments for the medically based disability pension in Norway by linking individual based data from a county health survey to data on disability from the National Insurance Administration. Two cross-sectional total population health surveys with an approximate 10-year interval were conducted in Nord-Trøndelag county, HUNT I (1984-86) and HUNT II (1995-97), which allows for analyses of changes over time, supplied with official incidence data on disability pension. The large-scale variations and overall increasing incidence rates of disability pension in Norway during the last 20 years also applied to the county of Nord-Trøndelag. The prevalence of disability pension generally increased in the population from the mid-1980s to the mid-1990s. A striking finding was a consistent pattern of increasing prevalence of disability pension with decreasing socio-economic status and education. A geographic pattern for disability pension prevalence on a municipality level suggested that structural and cultural factors were important in determining the level of disability in society. Medical determinants alone cannot explain either the dramatic variations or the overall increased incidence rates of disability pension in the last two decades in Norway. The results demonstrate the importance of social, non-medical and contextual determinants for disability pension, how these determinants result in important prevalence differences by socio-economic status, and their impact on the level of disability in society.
Karunakaran, Ilavenil; Thirumalaikolundusubramanian, Ponniah; Nalinakumari, Sheela Das
Professionalism and ethics have gained widespread recognition as competencies to be fulfilled, taught, and assessed within medical education. The role of the anatomy course in developed nations has evolved over time and now encompasses multiple domains, including knowledge, skills, and the inculcation of professionalism and ethics. The Medical…
Ngo, Elizabeth; Patel, Nachiket; Chandrasekaran, Krishnaswamy; Tajik, A Jamil; Paterick, Timothy E
Comprehensive, detailed documentation in the medical record is critical to patient care and to a physician when allegations of negligence arise. Physicians, therefore, would be prudent to have a clear understanding of this documentation. It is important to understand who is responsible for documentation, what is important to document, when to document, and how to document. Additionally, it should be understood who owns the medical record, the significance of the transition to the electronic medical record, problems and pitfalls when using the electronic medical record, and how the Health Information Technology for Economic and Clinical Health Act affects healthcare providers and health information technology.
Garcia, Edna; Fisher, Patrick B
To inform the pathology and laboratory field of the most recent national wage data from the American Society for Clinical Pathology (ASCP). Historically, the results of this biennial survey have served as a basis for additional research on laboratory recruitment, retention, education, marketing, certification, and advocacy. The 2015 wage survey was conducted through collaboration between the ASCP's Institute of Science, Technology, and Policy in Washington, DC, and the ASCP Board of Certification in Chicago, Illinois. Electronic survey invitations were sent to individuals who are currently practicing in the field. Data reveal increased salaries since 2013 for all staff-level laboratory professionals surveyed except phlebotomists and pathologists' assistants. Laboratory assistants and phlebotomists, regardless of level, continue to have lower salaries while pathologists' assistants and administration personnel have higher salaries than the rest of the laboratory professions surveyed. Survey results put emphasis on strategic recruitment and retention by laboratory training programs and institutions that hire laboratory professionals. © American Society for Clinical Pathology, 2017. All rights reserved. For permissions, please e-mail: firstname.lastname@example.org
Carmen SANDU (TODERAȘCU
Full Text Available The option for a knowledge-based society requires investment in the development of human resources so as to encourage employees to acquire new skills and accept occupational mobility. At the same time, it is important to promote work quality during recruitment and develop learning strategies and continuing professional development ones for the benefit of the many. The work shows the most important results of the analysis conducted on the topic of continuing professional development – as a sine qua non condition for the development of organizations. By using a complex methodology that included various research instruments and by investigating multiple categories of actors, we aimed at a theoretical analysis of the policy framework, the means to implement them and the impact categories of continuing professional development in the context of a knowledge - based society. Our approach particularly focuses on the formation experience of employees (public and private institutions and will be further completed by the perspective of other types of beneficiaries. At the moment, the problem of human resources competitiveness is a main area of intervention on the short term against the background of Romania’s efforts to counteract the effects of the world crisis.
Gholami-Kordkheili, Fatemeh; Wild, Verina; Strech, Daniel
The rising impact of social media on the private and working lives of health care professionals has made researchers and health care institutions study and rethink the concept and content of medical professionalism in the digital age. In the last decade, several specific policies, original research studies, and comments have been published on the responsible use of social media by health care professionals. However, there is no systematic literature review that analyzes the full spectrum of (1) social media-related challenges imposed on medical professionalism and (2) social media-related opportunities to both undermine and improve medical professionalism. The aim of this systematic qualitative review is to present this full spectrum of social media-related challenges and opportunities. We performed a systematic literature search in PubMed (restricted to English and German literature published between 2002 and 2011) for papers that address social media-related challenges and opportunities for medical professionalism. To operationalize "medical professionalism", we refer to the 10 commitments presented in the physicians' charter "Medical professionalism in the new millennium" published by the ABIM Foundation. We applied qualitative text analysis to categorize the spectrum of social media-related challenges and opportunities for medical professionalism. The literature review retrieved 108 references, consisting of 46 original research studies and 62 commentaries, editorials, or opinion papers. All references together mentioned a spectrum of 23 broad and 12 further-specified, narrow categories for social media-related opportunities (n=10) and challenges (n=13) for medical professionalism, grouped under the 10 commitments of the physicians' charter. The accommodation of the traditional core values of medicine to the characteristics of social media presents opportunities as well as challenges for medical professionalism. As a profession that is entitled to self
Background. Training and re-training of healthcare workers is pivotal to improved service delivery. Objective. To determine the proportion of practising medical laboratory scientists with in-service training in Benin City, Nigeria and areas covered by these programmes. Methods. Medical laboratory scientists from Benin City ...
Lange, R.; Verhulst, S. J.; Roberts, N. K.; Dorsey, J. K.
The use of students' "consumer feedback" to assess faculty behavior and improve the process of medical education is a significant challenge. We used quantitative Rasch measurement to analyze pre-categorized student comments listed by 385 graduating medical students. We found that students differed little with respect to the number of…
Material and methods: The first year medical students at the Faculty of Medicine and Health Sciences, Omdurman Islamic University were taught the Human Rights declaration issued by the United Nations in Dec 1948, The Principals of Islamic Human Rights, basics of medical ethics and the Doctors Figh and University ...
Elbe, Stefan; Roemer-Mahler, Anne; Long, Christopher
How do governments contribute to the pharmaceuticalization of society? Whilst the pivotal role of industry is extensively documented, this article shows that governments too are accelerating, intensifying and opening up new trajectories of pharmaceuticalization in society. Governments are becoming more deeply invested in pharmaceuticals because their national security strategies now aspire to defend populations against health-based threats like bioterrorism and pandemics. To counter those threats, governments are acquiring and stockpiling a panoply of 'medical countermeasures' such as antivirals, next-generation vaccines, antibiotics and anti-toxins. More than that, governments are actively incentivizing the development of many new medical countermeasures--principally by marshaling the state's unique powers to introduce exceptional measures in the name of protecting national security. At least five extraordinary policy interventions have been introduced by governments with the aim of stimulating the commercial development of novel medical countermeasures: (1) allocating earmarked public funds, (2) granting comprehensive legal protections to pharmaceutical companies against injury compensation claims, (3) introducing bespoke pathways for regulatory approval, (4) instantiating extraordinary emergency use procedures allowing for the use of unapproved medicines, and (5) designing innovative logistical distribution systems for mass drug administration outside of clinical settings. Those combined efforts, the article argues, are spawning a new, government-led and quite exceptional medical countermeasure regime operating beyond the conventional boundaries of pharmaceutical development and regulation. In the first comprehensive analysis of the pharmaceuticalization dynamics at play in national security policy, this article unearths the detailed array of policy interventions through which governments too are becoming more deeply imbricated in the pharmaceuticalization of
Coleman, Michele; Dexter, Donn; Nankivil, Nancy
Physicians' dissatisfaction in their work is increasing, which is affecting the stability of health care in America. The Wisconsin Medical Society (Society) surveyed 1016 Wisconsin physicians to determine the source of their dissatisfaction. The survey results indicate Wisconsin physicians are satisfied when it comes to practice environment, work-life balance, and income. In addition, they are extremely satisfied when it comes to rating their ability to provide high quality care, and they have identified some benefits related to the adoption of electronic health records. However, they are feeling burned out, very unsatisfied with the amount of time spent in direct patient care compared to indirect patient care, and that they are spending too much time on administrative and data entry tasks. In terms of future workforce, many physicians are either unsure or would not recommend the profession to a prospective medical student. Electronic health records serve as both a satisfier and dissatisfier and as a potential driver for future physician satisfaction interventions. Changes at the institutional, organizational, and individual levels potentially could address the identified dissatisfiers and build upon the satisfiers. The Society identifies 12 strategies to improve upon the physician experience.
Herrmann-Lingen, Christoph; Brunner, Edgar; Hildenbrand, Sibylle; Loew, Thomas H; Raupach, Tobias; Spies, Claudia; Treede, Rolf-Detlef; Vahl, Christian-Friedrich; Wenz, Hans-Jürgen
The evaluation of medical research performance is a key prerequisite for the systematic advancement of medical faculties, research foci, academic departments, and individual scientists' careers. However, it is often based on vaguely defined aims and questionable methods and can thereby lead to unwanted regulatory effects. The current paper aims at defining the position of German academic medicine toward the aims, methods, and consequences of its evaluation. During the Berlin Forum of the Association of the Scientific Medical Societies in Germany (AWMF) held on 18 October 2013, international experts presented data on methods for evaluating medical research performance. Subsequent discussions among representatives of relevant scientific organizations and within three ad-hoc writing groups led to a first draft of this article. Further discussions within the AWMF Committee for Evaluation of Performance in Research and Teaching and the AWMF Executive Board resulted in the final consented version presented here. The AWMF recommends modifications to the current system of evaluating medical research performance. Evaluations should follow clearly defined and communicated aims and consist of both summative and formative components. Informed peer reviews are valuable but feasible in longer time intervals only. They can be complemented by objective indicators. However, the Journal Impact Factor is not an appropriate measure for evaluating individual publications or their authors. The scientific "impact" rather requires multidimensional evaluation. Indicators of potential relevance in this context may include, e.g., normalized citation rates of scientific publications, other forms of reception by the scientific community and the public, and activities in scientific organizations, research synthesis and science communication. In addition, differentiated recommendations are made for evaluating the acquisition of third-party funds and the promotion of junior scientists. With the
... have experience hosting healthcare forums and meetings combining modern medicine and traditional... care by promoting education in the medical disciplines, honoring traditional healing principles and... and/or biomedical research. Foster forums where modern medicine combines with traditional healing to...
McPhaden, Michael; Leinen, Margaret; McEntee, Christine; Townsend, Randy; Williams, Billy
The American Geophysical Union, a scientific society of 62,000 members worldwide, has established a set of scientific integrity and professional ethics guidelines for the actions of its members, for the governance of the union in its internal activities, and for the operations and participation in its publications and scientific meetings. This presentation will provide an overview of the Ethics program at AGU, highlighting the reasons for its establishment, the process of dealing ethical breaches, the number and types of cases considered, how AGU helps educate its members on Ethics issues, and the rapidly evolving efforts at AGU to address issues related to the emerging field of GeoEthics. The presentation will also cover the most recent AGU Ethics program focus on the role for AGU and other scientific societies in addressing sexual harassment, and AGU's work to provide additional program strength in this area.
Tannen, Deborah; Wallat, Cynthia
This study analyzes videotaped conversations between various family members of a child with cerebral palsy and medical professionals. The conversations are examined for information elaboration and condensation, information negotiation, as well as methodological benefits. The medical interviews elicited new information in various contexts and…
Carrese, Joseph A; Malek, Janet; Watson, Katie; Lehmann, Lisa Soleymani; Green, Michael J; McCullough, Laurence B; Geller, Gail; Braddock, Clarence H; Doukas, David J
This article-the Romanell Report-offers an analysis of the current state of medical ethics education in the United States, focusing in particular on its essential role in cultivating professionalism among medical learners. Education in ethics has become an integral part of medical education and training over the past three decades and has received particular attention in recent years because of the increasing emphasis placed on professional formation by accrediting bodies such as the Liaison Committee on Medical Education and the Accreditation Council for Graduate Medical Education. Yet, despite the development of standards, milestones, and competencies related to professionalism, there is no consensus about the specific goals of medical ethics education, the essential knowledge and skills expected of learners, the best pedagogical methods and processes for implementation, and optimal strategies for assessment. Moreover, the quality, extent, and focus of medical ethics instruction vary, particularly at the graduate medical education level. Although variation in methods of instruction and assessment may be appropriate, ultimately medical ethics education must address the overarching articulated expectations of the major accrediting organizations. With the aim of aiding medical ethics educators in meeting these expectations, the Romanell Report describes current practices in ethics education and offers guidance in several areas: educational goals and objectives, teaching methods, assessment strategies, and other challenges and opportunities (including course structure and faculty development). The report concludes by proposing an agenda for future research.
Jawaid, Masood; Khan, Muhammad Hassaan; Bhutto, Shahzadi Nisar
To find out the frequency and contents of online social networking (Facebook) among medical students of Dow University of Health Sciences. The sample of the study comprised of final year students of two medical colleges of Dow University of Health Sciences - Karachi. Systematic search for the face book profiles of the students was carried out with a new Facebook account. In the initial phase of search, it was determined whether each student had a Facebook account and the status of account as ''private'' ''intermediate'' or ''public'' was also sought. In the second phase of the study, objective information including gender, education, personal views, likes, tag pictures etc. were recorded for the publicly available accounts. An in depth qualitative content analysis of the public profiles of ten medical students, selected randomly with the help of random number generator technique was conducted. Social networking with Facebook is common among medical students with 66.9% having an account out of a total 535 students. One fifth of profiles 18.9% were publicly open, 36.6% profiles were private and 56.9% were identified to have an intermediate privacy setting, having customized settings for the profile information. In-depth analysis of some public profiles showed that potentially unprofessional material mostly related to violence and politics was posted by medical students. The usage of social network (Facebook) is very common among students of the university. Some unprofessional posts were also found on students' profiles mostly related to violence and politics.
Trey, Torsten; Caplan, Arthur L; Lavee, Jacob
In this text, we present and elaborate ethical challenges in transplant medicine related to organ procurement and organ distribution, together with measures to solve such challenges. Based on internationally acknowledged ethical standards, we looked at cases of organ procurement and distribution practices that deviated from such ethical standards. One form of organ procurement is known as commercial organ trafficking, while in China the organ procurement is mostly based on executing prisoners, including killing of detained Falun Gong practitioners for their organs. Efforts from within the medical community as well as from governments have contributed to provide solutions to uphold ethical standards in medicine. The medical profession has the responsibility to actively promote ethical guidelines in medicine to prevent a decay of ethical standards and to ensure best medical practices.
Trey, Torsten; Caplan, Arthur L.; Lavee, Jacob
In this text, we present and elaborate ethical challenges in transplant medicine related to organ procurement and organ distribution, together with measures to solve such challenges. Based on internationally acknowledged ethical standards, we looked at cases of organ procurement and distribution practices that deviated from such ethical standards. One form of organ procurement is known as commercial organ trafficking, while in China the organ procurement is mostly based on executing prisoners, including killing of detained Falun Gong practitioners for their organs. Efforts from within the medical community as well as from governments have contributed to provide solutions to uphold ethical standards in medicine. The medical profession has the responsibility to actively promote ethical guidelines in medicine to prevent a decay of ethical standards and to ensure best medical practices. PMID:23444249
Grammaticos, Philip C
In this paper we try to describe the importance of a dignified behavior of the physician to his students, colleagues, patients and the society. We come to the conclusion that even if the other party is not showing the best of behavior, the physician has not only the responsibility and the duty but it is very much for his own interest to show a dignified and useful behavior to others. This is the main route for having a good reputation which will help him better exercise his medical duties and offer him personal happiness. Jeremy Bentham, an English judge and philosopher formed the Greek word deontology to mean correct behavior stating that this behavior is morally useful and a source of pleasure. The codes of Hammurabi, of the Indian Ayr Veda, of the Egyptians, the teaching of Aristotle, Hippocrates and others also describe medical deontology.
Feminist scholarship has considered how pedagogical identities and emotions are implicated in the gender politics of belonging and othering in higher education. This paper examines how gendered and embodied pedagogy is mobilised in Greek medical schools to construct notions of the ideal academic and assert women's position women in Academic…
Ozturk, Naim; Armato, Samuel G.; Giger, Maryellen L.; Serago, Christopher F.; Ross, Lainie F.
Purpose: To assess current education, practices, attitudes, and perceptions pertaining to ethics and professionalism in medical physics. Methods: A link to a web-based survey was distributed to the American Association of Physicists in Medicine (AAPM) e-mail membership list, with a follow-up e-mail sent two weeks later. The survey included questions about ethics/professionalism education, direct personal knowledge of ethically questionable practices in clinical care, research, education (teaching and mentoring), and professionalism, respondents’ assessment of their ability to address ethical/professional dilemmas, and demographics. For analysis, reports of unethical or ethically questionable practices or behaviors by approximately 40% or more of respondents were classified as “frequent.” Results: Partial or complete responses were received from 18% (1394/7708) of AAPM members. Overall, 60% (827/1377) of the respondents stated that they had not received ethics/professionalism education during their medical physics training. Respondents currently in training were more likely to state that they received instruction in ethics/professionalism (80%, 127/159) versus respondents who were post-training (35%, 401/1159). Respondents’ preferred method of instruction in ethics/professionalism was structured periodic discussions involving both faculty and students/trainees. More than 90% (1271/1384) supported continuing education in ethics/professionalism and 75% (1043/1386) stated they would attend ethics/professionalism sessions at professional/scientific meetings. In the research setting, reports about ethically questionable authorship assignment were frequent (approximately 40%) whereas incidents of ethically questionable practices about human subjects protections were quite infrequent (5%). In the clinical setting, there was frequent recollection of incidents regarding lack of training, resources and skills, and error/incident reporting. In the educational setting
Lumlertgul, Nuttha; Kijpaisalratana, Naruchorn; Pityaratstian, Nuttorn; Wangsaturaka, Danai
Using movies has been accepted worldwide as a tool to help students learn medical professionalism. In the second year, a group of medical students conducted the "Cinemeducation" project to promote professionalism in the "Medical Ethics and Critical Thinking" course. Five movies with professionalism issues were screened with 20-30 students attending each session. After the show, participants then were asked to reflect on what they had learned in terms of professionalism. Two students led group discussion emphasizing questioning and argumentation for 60 min. Additional learning issues emerging from each session were also explored in more depth and arranged into a report. In the Cinemeducation Project, medical students have learned five main ethical issues in each film, which were the doctor-patient relationship, informed consent and clinical trials in patients, management of genetic disorders, patient management, and brain death and organ transplantation. In addition to issues of professionalism, they also developed critical thinking and moral reasoning skills. Using a case-based scenario in movies has proven to be an effective and entertaining method of facilitating students with learning on professionalism.
Chandratilake, Madawa; McAleer, Sean; Gibson, John
Over the last two decades, many medical educators have sought to define professionalism. Initial attempts to do so were focused on defining professionalism in a manner that allowed for universal agreement. This quest was later transformed into an effort to 'understand professionalism' as many researchers realised that professionalism is a social construct and is culture-sensitive. The determination of cultural differences in the understanding of professionalism, however, has been subject to very little research, possibly because of the practical difficulties of doing so. In this multi-region study, we illustrate the universal and culture-specific aspects of medical professionalism as it is perceived by medical practitioners. Forty-six professional attributes were identified by reviewing the literature. A total of 584 medical practitioners, representing the UK, Europe, North America and Asia, participated in a survey in which they indicated the importance of each of these attributes. We determined the 'essentialness' of each attribute in different geographic regions using the content validity index, supplemented with kappa statistics. With acceptable levels of consensus, all regional groups identified 29 attributes as 'essential', thereby indicating the universality of these professional attributes, and six attributes as non-essential. The essentialness of the rest varied by regional group. This study has helped to identify regional similarities and dissimilarities in understandings of professionalism, most of which can be explained by cultural differences in line with the theories of cultural dimensions and cultural value. However, certain dissonances among regions may well be attributable to socio-economic factors. Some of the responses appear to be counter-cultural and demonstrate practitioners' keenness to overcome cultural barriers in order to provide better patient care. © Blackwell Publishing Ltd 2012.
For more than two decades, international healthcare crises and ensuing political debates have led to increasing professional governance and regulatory policy reform. Governance and policy reforms, commonly representing a shift from embodied trust in professionals to state enforceable trust, have challenged professional power and self-regulatory privileges. However, controversy remains as to whether such policies do actually shift the balance of power and what the resulting effects of policy introduction would be. This paper explores the roll-out and operationalisation of revalidation as medical regulatory reform within a United Kingdom National Health Service hospital from 2012 to 2013, and its impact upon professional power. Revalidation policy was subject to the existing governance and management structures of the organisation, resulting in the formal policy process being shaped at the local level. This paper explores how the disorganised nature of the organisation hindered rather than facilitated robust processes of professional governance and regulation, fostering formalistic rather than genuine professional engagement with the policy process. Formalistic engagement seemingly assisted the medical profession in retaining self-regulatory privileges whilst maintaining professional power over the policy process. The paper concludes by challenging the concept of state enforceable trust and the theorisation that professional groups are effectively regulated and controlled by means of national and organisational objectives, such as revalidation. Copyright © 2018 Elsevier Ltd. All rights reserved.
Shariff, Afreen I; Fang, Xiangming; Desai, Tejas
Twitter is the fastest growing social media network. It offers participants the ability to network with other individuals. Medical societies are interested in helping individuals network to boost recruitment, encourage collaboration, and assist in job placement. We hypothesized that the American Society of Nephrology (ASN) successfully used Twitter to create a network between participants and itself to stay connected with its members. Tweets from 3 Twitter networking sessions during Kidney Week 2011 were analyzed for content. These messages were used to create a network between all participants of the networking sessions. The network was analyzed for strength and influence by calculating clustering coefficients (CC) and eigenvector centrality (EC) scores, respectively. Eight moderators and 9 trainees authored 376 Twitter messages. Most tweets by trainees (64%) and moderators (61%) discussed 1 of 3 themes: networking, education, or navigating Kidney Week 2011. A total of 25 online network connections were established during the 3 sessions; 20% were bidirectional. The CC for the network was 0.300. All moderators formed at least 1 connection, but 7 of the 9 trainees failed to make any connections. ASN made 5 unidirectional and 0 bidirectional connections with a low EC of 0.108. ASN was unable to form powerful connections with trainees through Twitter, but medical societies should not be discouraged by the results reported in this investigation. As societies become more familiar with Twitter and understand the mechanisms to develop connections, these societies will have a greater influence within increasingly stronger networks. Copyright © 2013 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.
Yamazaki, Kentaro; Taniguchi, Hiroya; Yoshino, Takayuki; Akagi, Kiwamu; Ishida, Hideyuki; Ebi, Hiromichi; Nakatani, Kaname; Muro, Kei; Yatabe, Yasushi; Yamaguchi, Kensei; Tsuchihara, Katsuya
The Japanese Society of Medical Oncology (JSMO) previously published 2 editions of the clinical guidelines: "Japanese guidelines for testing of KRAS gene mutation in colorectal cancer" in 2008 and "Japanese Society of Medical Oncology Clinical Guidelines: RAS (KRAS/NRAS) mutation testing in colorectal cancer patients" in 2014. These guidelines have contributed to the proper use of KRAS and RAS mutation testing, respectively. Recently, clinical utility, particularly for colorectal cancer (CRC) patients with BRAF V600E mutation or DNA mismatch-repair (MMR) deficiency, has been established. Therefore, the guideline members decided these genetic alterations should also be involved. The aim of this revision is to properly carry out testing for BRAF V600E mutation and MMR deficiency in addition to RAS mutation. The revised guidelines include the basic requirements for testing for these genetic alterations based on recent scientific evidence. Furthermore, because clinical utility of comprehensive genetic testing using next-generation sequencing and somatic gene testing of analyzing circulating tumor DNA has increasingly evolved with recent advancements in testing technology, we noted the current situation and prospects for these testing technologies and their clinical implementation in the revised guidelines. © 2018 The Authors. Cancer Science published by John Wiley & Sons Australia, Ltd on behalf of Japanese Cancer Association.
A high level of quality is an unequivocal prerequisite for obtaining the highest possible accuracy in symptomatic patients and for reproducing the results concerning mortality reduction, which were obtained in large screening trials. Present deficiencies in Germany are due to legal regulations, which have not been updated and which are thus below European standard. Furthermore, the quality assurance program has not proven sufficiently effective for mammography. In order to promote mammographic quality assurance, the German Roentgen Society proposes an accreditation program. The accreditation, which concerns (A.) mammographic technique and positioning and (B.) mammographic reporting is not obligatory, but will allow acquisition of special official certificates, which may support the patients to find doctors who perform and read mammograms with high quality and expertise. The accreditation shall be performed by personel and/or institutions who are specifically trained surveyed. (orig.) [de
Entwistle, Tom; Matthews, Elaine
Sociologists repeatedly appeal to notions of altruism, bureaucratisation and self interest in their efforts to explain the changing place of the professions in contemporary society. We treat these three readings as institutional logics that are key to understanding the way in which doctors respond to the appraisal system at the heart of the UK's approach to revalidation. Our analysis of a survey of 998 general practitioners (GPs) working in Wales finds an altruistic commitment to learning and improvement, bureaucratic demands for reporting information and self-regarding resentment of changes in the occupational package provided by general practice. But the data also demonstrate that the maintenance of the appraisal regime is dependent on the preparedness and capacity of individual GPs to do micro-level institutional work on all fronts. © 2015 Foundation for the Sociology of Health & Illness.
Chretien, Katherine C; Tuck, Matthew G; Simon, Michael; Singh, Lisa O; Kind, Terry
While researchers have studied negative professional consequences of medical trainee social media use, little is known about how medical students informally use social media for education and career development. This knowledge may help future and current physicians succeed in the digital age. We aimed to explore how and why medical students use Twitter for professional development. This was a digital ethnography. Medical student "superusers" of Twitter participated in the study The postings ("tweets") of 31 medical student superusers were observed for 8 months (May-December 2013), and structured field notes recorded. Through purposive sampling, individual key informant interviews were conducted to explore Twitter use and values until thematic saturation was reached (ten students). Three faculty key informant interviews were also conducted. Ego network and subnetwork analysis of student key informants was performed. Qualitative analysis included inductive coding of field notes and interviews, triangulation of data, and analytic memos in an iterative process. Twitter served as a professional tool that supplemented the traditional medical school experience. Superusers approached their use of Twitter with purpose and were mindful of online professionalism as well as of being good Twitter citizens. Their tweets reflected a mix of personal and professional content. Student key informants had a high number of followers. The subnetwork of key informants was well-connected, showing evidence of a social network versus information network. Twitter provided value in two major domains: access and voice. Students gained access to information, to experts, to a variety of perspectives including patient and public perspectives, and to communities of support. They also gained a platform for advocacy, control of their digital footprint, and a sense of equalization within the medical hierarchy. Twitter can serve as a professional tool that supplements traditional education. Students
Garvey, Katharine C; Kesselheim, Jennifer C; Herrick, Daniel B; Woolf, Alan D; Leichtner, Alan M
The deterioration of humanism and professionalism during graduate medical training is an acknowledged concern, and programs are required to provide professionalism education for pediatric fellows. We conducted a needs assessment survey in a national sample of 138 first- and second-year gastroenterology fellows (82% response rate). Most believed that present humanism and professionalism education met their needs, but this education was largely informal (eg, role modeling). Areas for formal education desired by >70% included competing demands of clinical practice versus research, difficult doctor-patient relationships, depression/burnout, angry parents, medical errors, work-life balance, and the patient illness experience. These results may guide curricula to formalize humanism and professionalism education in pediatric gastroenterology fellowships.
Brickman, J P
The late 1930s challenged laissez-faire medicine. Recognition of serious inadequacies in the distribution of medical services stirred activists who questioned fee-for-service delivery and posited a national health program, including health insurance. The AMA and its components--state and county medical societies--counterattacked, mobilizing money and their powerful political arsenal to fight government intrusion in private medicine. The Physicians Forum, initially under the leadership of Ernst P. Boas, emerged as a formidable element within the New York County Medical Society (the largest component of the AMA). The Forum provoked discussion of medical indigence and economics, upsetting the Society leadership with independent candidate slates and telling the public that doctors spoke with more than one voice. For 25 years, the Physicians Forum altered the dynamics of the Medical Society of the County of New York. While the Forum effort to institutionalize minority opinion in the councils of medicine failed, the interchange between County regulars and Forum insurgents broadened the medical reform agenda and moved the County Society in directions that historically it had avoided. Although medical economics formed an unbridgeable chasm between County regulars and rebels, Forum members demonstrated that medicine was not monolithic, that "majority opinion [was not] ... unanimous opinion," and that doctors must speak to issues of medical and social policy.
Full Text Available Introduction: Transactional analysis is a personality and communication theory established by psychiatrist Eric Berne, at the end of the fifties. Counter script is the way of life in accordance with parental imperative. The person with a counter-script has a compulsion to fulfill the required task in order to avoid the disaster of ban. There are five drivers that are considered essential, and these are: 'Be perfect!', 'Be strong!', 'Hurry up!', 'Please others!' and 'Work hard!' Objective: a Determination of the most dominant driver in this medical service. b Because of the specifics of this job which requires speed and humanity, the emphasis will be on doublet: 'Hurry up!' and 'Please others!' Method: The study was conducted on a group of subjects employed in a general service with medical emergency. The instrument used in the study was Julie Hay's questionnaire for diagnosing the working styles. Results: Statistical research was conducted on a sample of 30 subjects employed in the emergency medical service. Availability of all afore mentioned drivers was tested. The research hypotheses were formulated as follows: H0: The driver is not present among the employees in this service; H1: The driver is present among the employees in this service. Calculated value of the t-statistics for the driver 'Hurry up!' is 1.398; for the driver 'Be perfect!' 3.616; for the driver 'Please others!' 11.693; for the driver 'Work hard!' -0.673; and for the driver 'Be strong!' 3.880. Since the realizable value of the t-statistics for the drivers: 'Be perfect!' and 'Please others!' and 'Be strong!' is bigger than the critical value 1.699, and p<0.05 we reject the null hypothesis and we accept the alternative hypothesis on the significance level of 95%. For the drivers 'Hurry up!' and 'Work hard!' the values of t-statistics are lower than the critical value 1.699 for significance level of 95%, so the alternative hypothesis are not acceptable. Conclusion: The results of
Pfadenhauer, Michaela; Kirschner, Heiko
With the emergence and spread of digital media, more business models foster and empower client participation in medical professions. With services and products ranging from rating platforms to apps targeting self-diagnosis, these businesses transform the client–practitioner relationship yet risk...... undermining a central pillar of professions – autonomy. Practitioners have to take legal actions against these business models, making visible the frictional interplay among the involved actors. This development calls for an analytical understanding of how this technology-induced cultural change affects...
Nikolac, Nora; Supak-Smolcić, Vesna; Simundić, Ana-Maria; Celap, Ivana
Phlebotomy is one of the most complex medical procedures in the diagnosis, management and treatment of patients in healthcare. Since laboratory test results are the basis for a large proportion (60-80%) of medical decisions, any error in the phlebotomy process could have serious consequences. In order to minimize the possibility of errors, phlebotomy procedures should be standardised, well-documented and written instructions should be available at every workstation. Croatia is one of the few European countries that have national guidelines for phlebotomy, besides the universally used CLSI (Clinical Laboratory Standards Institute) H3-A6 Procedures for the Collection of Diagnostic Blood Specimens by Venipuncture; approved Standard-Sixth Edition (CLSI, 2007) and WHO (World Health Organization) guidelines on drawing blood: best practices in phlebotomy (WHO, 2010). However, the growing body of evidence in importance of preanalytical phase management resulted in a need for evidence based revision and expansion of existing recommendations. The Croatian Society for Medical Biochemistry and Laboratory Medicine, Working Group for the Preanalytical Phase issued this recommendation. This document is based on the CLSI guideline H3-A6, with significant differences and additional information.
Wager, Elizabeth; Woolley, Karen; Adshead, Viv; Cairns, Angela; Fullam, Josh; Gonzalez, John; Grant, Tom; Tortell, Stephanie
To gather information about current practices and implementation of publication guidelines among publication professionals working in or for the pharmaceutical industry. Web-based survey publicised via email and social media to members of the International Society for Medical Publication Professionals (ISMPP) and other organisations from November 2012 to February 2013. 469 individuals involved in publishing industry-sponsored research in peer-reviewed journals, mainly working in pharmaceutical or device companies ('industry', n=144), communication agencies ('agency', n=238), contract research organisations (CRO, n=15) or as freelancers (n=34). Most respondents (78%) had worked on medical publications for ≥5 years and 62% had a PhD/MD. Over 90% of industry, agency and CRO respondents routinely refer to Good Publication Practice (GPP2) and the International Committee of Medical Journal Editors' Uniform Requirements. Most respondents (78% industry, 79% agency) received mandatory training on ethical publication practices. Over 90% of respondents' companies had publication guidelines or policies and required medical writing support to be acknowledged in publications (96% industry, 99% agency). Many industry respondents used publication management tools to monitor compliance with company guidelines and about half (46%) stated that their company had formal publication audits. Fewer agencies audited adherence to guidelines but 20% of agency respondents reported audits of employees and 6% audits of freelancers. Of concern, 37% of agency respondents reported requests from authors or sponsors that they believed were unethical, although 93% of these requests were withdrawn after respondents explained the need for compliance with guidelines. Most respondents' departments (63% industry, 58% agency, 60% CRO) had been involved in publishing studies with negative or inconclusive results. Within this sample, most publication professionals working in or for industry were aware of
Wager, Elizabeth; Woolley, Karen; Adshead, Viv; Cairns, Angela; Fullam, Josh; Gonzalez, John; Grant, Tom; Tortell, Stephanie
Objective To gather information about current practices and implementation of publication guidelines among publication professionals working in or for the pharmaceutical industry. Design/setting Web-based survey publicised via email and social media to members of the International Society for Medical Publication Professionals (ISMPP) and other organisations from November 2012 to February 2013. Participants 469 individuals involved in publishing industry-sponsored research in peer-reviewed journals, mainly working in pharmaceutical or device companies (‘industry’, n=144), communication agencies (‘agency’, n=238), contract research organisations (CRO, n=15) or as freelancers (n=34). Most respondents (78%) had worked on medical publications for ≥5 years and 62% had a PhD/MD. Results Over 90% of industry, agency and CRO respondents routinely refer to Good Publication Practice (GPP2) and the International Committee of Medical Journal Editors’ Uniform Requirements. Most respondents (78% industry, 79% agency) received mandatory training on ethical publication practices. Over 90% of respondents’ companies had publication guidelines or policies and required medical writing support to be acknowledged in publications (96% industry, 99% agency). Many industry respondents used publication management tools to monitor compliance with company guidelines and about half (46%) stated that their company had formal publication audits. Fewer agencies audited adherence to guidelines but 20% of agency respondents reported audits of employees and 6% audits of freelancers. Of concern, 37% of agency respondents reported requests from authors or sponsors that they believed were unethical, although 93% of these requests were withdrawn after respondents explained the need for compliance with guidelines. Most respondents’ departments (63% industry, 58% agency, 60% CRO) had been involved in publishing studies with negative or inconclusive results. Conclusions Within this sample
Steingard, S A
The NBA basketball players are among the finest athletes in the world. That along with the increased popularity of the NBA has put a premium on the health of the players. The course of the season puts tremendous stress and strain on players. As medical illnesses occur, the physician may feel increased pressure to put the ill player back into the line-up. One cannot let the pressure for the player to return to activity interfere with good medical practice. At times, it is difficult to allow for the natural course of an illness, however, as discussed in this article, sometimes this is exactly what needs to be done. The temptation to overtreat is also seen in some team physicians. This too must be avoided. Along with proper treatment, there is the need for education of the athletes both in social interactions and in diet and life-style. Then we, as team physicians, can sit back and enjoy the performance on the court.
Schnoor, Joerg; Heyde, Christoph-Eckhard; Ghanem, Mohamed
Demographic changes increase the financing needs of all social services. This change also generates new and complex demands on the medical staff. Accordingly, medical professionals in middle management positions hold a characteristic sandwich position between top management and the operational core. This sandwich position often constitutes new challenges. In the industrial field, the growing importance of the middle management for the company's success has already been recognized. Accordingly, the growing demand on economy urges an analysis for the medical field. While there are nearly no differences in the nature of the tasks of medical middle manager in the areas of strategy, role function, performance pressure and qualifications compared to those tasks of the industrial sector, there are basic differences as well. Especially the character of "independence" of the medical profession and its ethical values justifies these differences. Consequently, qualification of medical professionals may not be solely based on medical academic career. It is also based on the personal ability or potential to lead and to manage. Above all, the character of "independence" of the medical profession and its ethical values justifies medical action that is based on the patient's well-being and not exclusively on economic outcomes. In the future, medical middle managers are supposed to achieve an optimized balance between a patient-centered medicine and economic measures. It will be a basic requirement that middle managers accept their position and the resultant tasks putting themselves in a more active position. Because of that, middle managers can become "value-added bridge-builders".
今井, 美樹; Miki, IMAI; 昭和女子大学初等教育学科
This study examines the magazine Hocho-Ambai(Wielding Your Kitchen Knives, all 37 issues published from 1886 to 1891)to explore the activities of societies of culinary education for food and cooking in the mid-Meiji era. The author, from the viewpoint of gender, reviewed, selected and analyzed articles describing the activities of the Society of Art of Cooking Research and the Society of Food Research organized by professional cooks and cookery lovers in the period. The following results were...
Full Text Available The article reflects the analysis of the existing approaches to interpretation of the notion of selfdevelopment in psychological and pedagogical literature. It has been determined, that professional and personal self-development is carried out with the help of mechanisms of self-knowledge, self-organization, self-education, self-esteem, self-control. The research also presents the clarified essence and structure of the readiness of medical college students for professional self-development. Value, motivational, cognitive, operating, and volitional components have been singled out. Factors and stages of intending medical employees’ selfdevelopment have been substantiated in the article.
The American Academy of Family Physicians (AAFP) has recently been criticized for accepting a large corporate donation from Coca-Cola to fund patient education on obesity prevention. Conflicts of interest, whether individual or organizational, occur when one enters into arrangements that reasonably tempt one to put aside one's primary obligations in favor of secondary interests, such as financial self-interest. Accepting funds from commercial sources that seek to influence physician organizational behavior in a direction that could run counter to the public health represents one of those circumstances and so constitutes a conflict of interest. Most of the defenses offered by AAFP are rationalizations rather than ethical counterarguments. Medical organizations, as the public face of medicine and as formulator of codes of ethics for their physician members, have special obligations to adhere to high ethical standards.
MacCourt, Duncan; Bernstein, Joseph
physicians cede their implicit "right to remain silent", even if some injured patients will receive less than they do today. Likewise, physicians will be happier with a system that avoids blame-even if this system placed strict requirements for high quality care and disclosure of error. We therefore conceive of de facto trade between patients and physicians, a Pareto improvement, taking form via the establishment of "Societies of Quality Medicine." Physicians working within these societies would consent to onerous processes for disclosing, rectifying and preventing medical error. Patients would in turn contractually agree to assert their claims in arbitration and with limits on recovery. The role of plaintiffs' lawyers would be unchanged, but due to increased disclosure, discovery costs would diminish and the likelihood of prevailing will more than triple. This article examines the legal and policy issues surrounding the establishment of Societies of Quality Medicine, particularly the issues of contracting over liability, and outlines a means of overcoming the theoretical and practical difficulties with enterprise liability, alternative dispute resolution and the imposition of limits on recovery for non-pecuniary damages. We aim to build a welfare enhancing system that rebuffs the culture of silence and promotes error reduction, a system that is at the same time legally sound, fiscally prudent and politically possible.
R. Ortiz de Lejarazu Leonardo
Full Text Available SUMMARYIn Spain a million and a half blood transfusions by year are carried out, that supposes between 2 and 10 cases of infection of VIH by year. The present state of science invites to do something more with tests to detect other virological and immunological markers, in order to identify seronegative carriers and thus avoid HIV transmission by them. We must consider the possibility to incur in professional responsibilities if we do not report adequate of this risk or if we do not provide patients all the cares that require, according to the state of the science so called lex artis.RESUMENEn España se realizan un millón y medio de transfusiones de sangre al año, lo que supone un riesgo de entre 2 y 10 casos de infección de VIH a través de las mismas. El estado actual de la ciencia invita a hacer algo más pudiéndose ampliar los estudios de marcadores víricos e inmunológicos, para identificar a portadores seronegativos y así tratar de evitar la transmisión del virus de inmunodeficiencia humana a través de ellos. Debemos considerar la posibilidad de incurrir en responsabilidades profesionales si no informamos adecuadamente de este riesgo o si no proporcionamos a los pacientes todos los cuidados que requieren, según el estado actual de la ciencia, lo que denominamos lex artis.
Wilton Silva dos Santos
Full Text Available ABSTRACT Introduction: Socioeconomic and demographic diversity in the educational environment and the development of professional attitudes enhance the quality of health care delivery. Despite the importance of diversity for equity and accessibility to health care, its repercussions for students’ attitudinal learning have not been adequately evaluated. Purpose: Evaluate the influence of academic sociodemographic diversity and curricular organization in the development of professional attitudes in different phases of the undergraduate medical curriculum. Method: In 2012, the attitudinal performance of 310 socioeconomically diverse medical students was evaluated by the administration of a five-point professional attitudes scale. The participants were at different points in their education at a Brazilian public school of medicine in Brasília, Federal District. The scale comprised 6 factors: communication, ethics, professional excellence, self-assessment, beliefs, social determinants; and a general factor called medical professionalism and was validated for the purpose of this research. The reliability coefficients (aCronbach ranged from 0.65 to 0.87, according to different scale dimensions. Student diversity was analyzed according to differences in gender, age, religious affiliation, system of student selection and socioeconomic background. Results: The authors observed a decline in the mean attitude scores during the clinical phase compared to the preclinical phase of the curriculum. Female students displayed more positive attitudes than male students, and the students who declared a religious affiliation recorded higher attitude scores compared to those who declared themselves atheist, agnostic or non-religious. There was no correlation between family income or the system of student selection and the students’ attitude scores. The students who had attended public schools expressed a greater interest in working in the public health system
Rabow, Michael W; Evans, Carrie N; Remen, Rachel N
During medical training, students gain professional competence but may lose elements of personal humanity. Little is known about what personal qualities or values students themselves experience to be at risk or surrendered during medical school. Medical students participating in the Healer's Art elective in the United States and internationally during 2008--2009 were asked to reflect, identify, and draw a part of themselves that they were wary about revealing, not comfortable showing, or felt may be diminished in medical school and label this part with a word. Using a team-based qualitative approach, these words were categorized into common themes and the themes analyzed using descriptive and chi-square statistics. Words from 673 students from 31 medical schools were analyzed. Most students were female (58.7%) and in their first year (86.3%). Eleven themes were identified: spirituality, emotional engagement, identity/self-expression, freedom/spontaneity, relationships, self-care, creativity, negative emotions, values, other, and joy/happiness. The most common individual words used were creativity, family, balance, freedom, love, peace, compassion, relationships, and reflection. There were only rare differences in distributions of themes across gender, year in school, school size, or school nationality. An international cadre of Healer's Art students identified core personal qualities and values that they may not reveal or feel may be diminished in medical school. Medical training involves not only professional formation but exposure to professional deformation as well. Educators must attend to both gains in professional competence and the personal qualities and values that are at risk in the course of professional development.
Issayev, T; Masalimova, A; Magzumova, R
In modern conditions, there is a tendency to replace the qualification approach of assessing economists in medical organizations - competence. The purpose of the study was to identify the professional and personal abilities of economists in medical organizations to actively participate in the management decisions of the medical organization in the transition from public administration to the right of economic management. The study was carried out in 3 stages. At the first stage, the degree of influence of the experience of the economist, the frequency of training and its burden on the profitability of the medical organization was analyzed. At the second stage - the personal evaluation of the respondents by psychodiagnostic methods (memory, attention, the level of the person's orientation, self-esteem, the level of personal claims). At the third stage, the data of professional behavior and personal evaluation were summarized in the table of SWOT-analysis factors, for determining the personnel strategy of development of economists in medical organizations. The sample size was 43 respondents, which amounted to 10.3% of the participation of medical organizations. The results of the SWOT analysis of the personal and professional qualities of medical economists in medical organizations showed the predominance of weaknesses in corporate competencies among medical economists over strong ones, while personal opportunities prevail over risks. In general, the professional-personal SWOT analysis showed the prevalence of the possibilities of medical economists (Ps=5,3) over threats (Ps = 4,9), strong (Ps = 4,4) and weak sides (Ps = 3,8). At the same time, the force of influence does not suffice: the length of work for profitability (r = -0.3, p economist to employees on the growth of the specific weight of paid services (r = 0.001, p economists on the profitability of the medical organization (r = 0.7, peconomists, the higher the profitability, showed our results in the studied
Fatemeh Donboli Miandoab
Full Text Available Background: Professionalism and adherence to ethics and professional standards are among the most important topics in medical ethics that can play a role in reducing medical errors. This paper examines and evaluates the effect of professional ethics on reducing medical errors from the viewpoint of faculty members in the medical school of the Tabriz University of Medical Sciences. Methods: in this cross-sectional descriptive study, faculty members of the Tabriz University of Medical Sciences were the statistical population from whom 105 participants were randomly selected through simple random sampling. A questionnaire was used, to examine and compare the self-assessed opinions of faculty members in the internal, surgical, pediatric, gynecological, and psychiatric departments. The questionnaires were completed by a self-assessment method and the collected data was analyzed using SPSS 21. Results: Based on physicians’ opinions, professional ethical considerations and its three domains and aspects have a significant role in reducing medical errors and crimes. The mean scores (standard deviations of the managerial, knowledge and communication skills and environmental variables were respectively 46.7 (5.64, 64.6 (8.14 and 16.2 (2.97 from the physicians’ viewpoints. The significant factors with highest scores on the reduction of medical errors and crimes in all three domains were as follows: in the managerial skills variable, trust, physician’s sense of responsibility against the patient and his/her respect for patients’ rights; in the knowledge and communication skills domain, general competence and eligibility as a physician and examination and diagnosis skills; and, last, in the environmental domain, the sufficiency of trainings in ethical issues during education and their satisfaction with basic needs. Conclusion: Based on the findings of this research, attention to the improvement of communication, management and environment skills should
Ament, Stephanie M C; de Groot, Jeanny J A; Maessen, José M C; Dirksen, Carmen D; van der Weijden, Trudy; Kleijnen, Jos
To evaluate (1) the state of the art in sustainability research and (2) the outcomes of professionals' adherence to guideline recommendations in medical practice. Systematic review. Searches were conducted until August 2015 in MEDLINE, CINAHL, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL) and the Guidelines International Network (GIN) library. A snowball strategy, in which reference sections of other reviews and of included papers were searched, was used to identify additional papers. Studies needed to be focused on sustainability and on professionals' adherence to clinical practice guidelines in medical care. Studies had to include at least 2 measurements: 1 before (PRE) or immediately after implementation (EARLY POST) and 1 measurement longer than 1 year after active implementation (LATE POST). The search retrieved 4219 items, of which 14 studies met the inclusion criteria, involving 18 sustainability evaluations. The mean timeframe between the end of active implementation and the sustainability evaluation was 2.6 years (minimum 1.5-maximum 7.0). The studies were heterogeneous with respect to their methodology. Sustainability was considered to be successful if performance in terms of professionals' adherence was fully maintained in the late postimplementation phase. Long-term sustainability of professionals' adherence was reported in 7 out of 18 evaluations, adherence was not sustained in 6 evaluations, 4 evaluations showed mixed sustainability results and in 1 evaluation it was unclear whether the professional adherence was sustained. (2) Professionals' adherence to a clinical practice guideline in medical care decreased after more than 1 year after implementation in about half of the cases. (1) Owing to the limited number of studies, the absence of a uniform definition, the high risk of bias, and the mixed results of studies, no firm conclusion about the sustainability of professionals' adherence to guidelines in medical practice can be drawn
James Kleshinski, MD
Full Text Available Purpose: The purpose of this study was to determine the impact of professionalism scenarios on the medical school admissions process from applicant and faculty perspectives. Specifically, do completing professionalism scenarios as part of the medical school interview process have an impact on both the interviewee’s and the faculty’s perception of the process and outcome?Method: Ninety-one faculty interviewed 199 applicants from January 2007 through April 2007 at The University of Toledo College of Medicine. All applicants were asked one standard professionalism scenario in each of their two interviews. A total of six scenarios were used for the entire interviewing season in rotation every two months. A survey was administered by an admissions office staff member to both the interviewed applicants as well as faculty who conducted interviews about how these scenarios impacted their interview experience.Results: Asking applicants to respond to professionalism scenarios during the interview was described as having a positive influence on their interview experience. This was also associated with leaving an impression on the applicant about what our institution values in its students and contributed an element of personal reflection about what will be expected of them in the medical profession. Applicants more often reported that asking questions about professionalism was an important aspect of the interview than did faculty. Overall, there was an association between the interviewer’s perception of the applicant’s response and the interviewer’s assessment of professionalism.Conclusions: Professionalism scenarios can be a worthwhile tool for use in the admissions process. The interview process should encourage participation from faculty who value this as an important component in the evaluation of an applicant. Determinants of faculty perception of the role of assessing professionalism in the interview process should be investigated in future
Bhargavan, Mythreyi; Sunshine, Jonathan H.; Schepps, Barbara
Purpose: To aid in understanding the employment market for radiation oncologists, we present annual data for 1991 to 2000 from the American College of Radiology's placement service, the Professional Bureau. This data series is twice as long as any previously available. Secondarily, we compare these data with other data on the employment market. Methods and Materials: The trends in job listings, job seekers, and listings per seeker in the Bureau are tabulated and graphed. We calculate correlations and graph relationships between the last of these and measures of the job market calculated from annual surveys. Results: Bureau data show listings per job seeker declined from 0.53 in 1991 to a nadir of 0.30 in 1995 and then recovered to 1.48 in 2000. Bureau listings and job seekers, each considered separately, show a similar pattern of job market decline and then eventual recovery to better than the 1991 situation. Bureau listings per job seeker correlate 0.895 with a survey-derived index of program directors' perceptions of the job market, but statistical significance is limited (p=0.04), because very few years of survey data are available. Conclusions: The employment market for radiation oncologists weakened in the first half of the 1990s, as had been widely reported; we present the first systematic data showing this. Data from a professional society placement service provide useful and inexpensive information on the employment market
García-Carbonero, R; Vilardell, F; Jiménez-Fonseca, P; González-Campora, R; González, E; Cuatrecasas, M; Capdevila, J; Aranda, I; Barriuso, J; Matías-Guiu, X
The annual incidence of neuroendocrine tumours in the Caucasian population ranges from 2.5 to 5 new cases per 100,000 inhabitants. Gastroenteropancreatic neuroendocrine tumours is a family of neoplasms widely variable in terms of anatomical location, hormone composition, clinical syndromes they cause and in their biological behaviour. This high complexity and clinical heterogeneity, together with the known difficulty of predicting their behaviour from their pathological features, are reflected in the many classifications that have been developed over the years in this field. This article reviews the main tissue and clinical biomarkers and makes recommendations for their use in medical practice. This document represents a consensus reached jointly by the Spanish Society of Medical Oncology (SEOM) and the Spanish Society of Pathology (SEAP).
In this paper, I make several proposals of what Japanese Neurological Society is able to do or should do in preparing future disaster in Japan. I mention several points separately.Patient education: Patients usually try to visit their hospital as soon as possible for the safety, especially in Japan. Is it true? The traffic jams actually blocked this action in March 11, 2011, which made more serious problems in some patients. We should ask them to prepare matters necessary for staying at home at least for a week when no medical emergency is present.Disaster prevention training: We should make a list of hospitals which accept emergent patients at disaster. We should have some methods of communication still active at disaster (internet, satellite phone) and make society network for communication and patient transportation. How to transfer required drugs to patients is another issue we should consider.Name tag: We sometimes treated unidentified patients in the disaster because the name tag or reference papers was gone or not specified to a certain patient. It is due to great mechanical power of injury or rains. For not detached from the patient and waterproofed, I recommend writing the patient's name on the chest with a permanent marker used in the triathlon when transferring the patients to other hospitals or other places.
Around the turn of the twenty-first century a new practice in international politics became established: representatives of political, economic and religious organisations apologised for the historical and political crimes of their own collectives, addressing the victims or the victims' descendants. At a public event in June 2001, a formal apology of this kind was made by the president of the Max Planck Society (MPS), who had previously launched an extensive programme of research into the National Socialist history of what was then the Kaiser Wilhelm Society. The majority of the eight invited survivors of human experimentation in Nazi concentration camps refused forgiveness. Instead, they called for the MPS not to content itself with historical research and analysis, but to ensure the continued remembrance of the victims and their suffering. Starting from this 2001 ritual of repentance, the paper examines the participants' diverse views of how to deal with the medical crimes of National Socialism, and asks about possibilities of going beyond historical retrospection to fulfil the imperative of remembrance.
Dwarswaard, J; Hilhorst, M; Trappenburg, M
Society in the 21st century is in many ways different from society in the 1950s, the 1960s or the 1970s. Two of the most important changes relate to the level of education in the population and the balance between work and private life. These days a large percentage of people are highly educated. Partly as a result of economic progress in the 1950s and the 1960s and partly due to the fact that many women entered the labour force, people started searching for ways to combine their career with family obligations and a private life (including hobbies, outings and holidays). Medical professional ethics, more specifically: professional attitudes towards patients and colleagues, is influenced by developments such as these, but how much and in what way? It was assumed that surgery ethics would be more robust, resistant to change and that general practitioner (GP) ethics would change more readily in response to a changing society, because surgeons perform technical work in operating theatres in hospitals whereas GPs have their offices in the midst of society. The journals of Dutch surgeons and GPs from the 1950s onwards were studied so as to detect traces of change in medical professional ethics in The Netherlands. GP ethics turned out to be malleable compared with surgery ethics. In fact, GP medicine proved to be an agent of change rather than merely responding to it, both with regard to the changing role of patients and with regard to the changing work life balance.
Al-Dubai, Sami Abdo Radman; Ganasegeran, Kurubaran; Perianayagam, Wilson; Rampal, Krishna Gopal
This study was the first to explore factors associated with emotional burnout (EB) among medical residents in Malaysia. A cross-sectional study was conducted in a universal sample of 205 medical residents in a Malaysian general hospital. The self-administered questionnaire used consisted of questions on sociodemographics and work characteristics, sources of job stress, professional fulfillment, engagement, and EB. EB was measured using the emotional exhaustion subscale, the Maslach Burnout In...
Morokhovets, Halyna Yu; Lysanets, Yuliia V
The main objectives of higher medical education is the continuous professional improvement of physicians to meet the needs dictated by the modern world both at undergraduate and postgraduate levels. In this respect, the system of higher medical education has undergone certain changes - from determining the range of professional competences to the adoption of new standards of education in medicine. The article aims to analyze the parameters of doctor's professionalism in the context of competence-based approach and to develop practical recommendations for the improvement of instruction techniques. The authors reviewed the psycho-pedagogical materials and summarized the acquired experience of teachers at higher medical institutions as to the development of instruction techniques in the modern educational process. The study is based on the results of testing via the technique developed by T.I. Ilyina. Analytical and biblio-semantic methods were used in the paper. It has been found that the training process at medical educational institution should be focused on the learning outcomes. The authors defined the quality parameters of doctors' training and suggested the model for developing the professional competence of medical students. This model explains the cause-and-effect relationships between the forms of instruction, teaching techniques and specific components of professional competence in future doctors. The paper provides practical recommendations on developing the core competencies which a qualified doctor should master. The analysis of existing interactive media in Ukraine and abroad has been performed. It has been found that teaching the core disciplines with the use of latest technologies and interactive means keeps abreast of the times, while teaching social studies and humanities to medical students still involves certain difficulties.
McLachlan John C
Full Text Available Abstract Background Measuring professionalism in undergraduate medical students is a difficult process, and no one method has currently emerged as the definitive means of assessment in this field. Student skills in reflection have been shown to be highly important in the development of professional behaviours. By studying student reflections on lapses in professional judgement, recorded as 'critical incidents', it is possible to explore themes which are significant for the development of professional behaviour in an undergraduate setting. Methods We examined critical incident reporting combined with optional written student reflection as a method for exploring professionalism in undergraduate medical students. 228 students split between Year 1 and 2 of one academic year of undergraduate medicine were studied retrospectively and a grounded theory approach to analysis was employed. Results This year generated 16 critical incident reports and corresponding student reflections, all of which were considered. In addition to identifying the nature of the critical incidents, 3 principal themes emerged. These were the impact and consequences of the report having been made, student reactions to the events (both positive and negative, and student responses regarding future actions. Conclusion This study indicates that unprofessional behaviour can be identified and challenged by both the faculty and the students involved, and suggests that positive behavioural changes might be made with the aim of preventing future occurrences. We provide a low cost approach of measuring and recording professional behaviour.
Full Text Available Purpose: to work out and experimentally prove model of professional-applied physical training of medical higher educational establishments’ students. Material: in the research 80 students participated. In questioning physical education instructors of medical higher education establishments (n=20 participated. Results: influence of students’ professionally important characteristics on general physical fitness indicators and functional state has been shown. Directions of students’ physical fitness parameters’ individual diagnostic and control over physical education effectiveness have been offered. Volumes of physical exercises in the structure of training have been found: special training (15-20% and competition exercises (20-30%. Conclusions: the need in raising the level of professionally important for students’ abilities has been noted: speed power, static power endurance, power endurance, coordination of arms’ movements, static balance.
Royal, Kenneth D.; Gonzalez, Liara M.
The purpose of this study was to evaluate the psychometric properties of a newly developed instrument intended to measure faculty competence as it pertains to their role as advisors, particularly in medical and professional programs. A total of 166 students completed the Faculty Advisor's Skills and Behaviors Inventory (FASBI). The psychometric…
Carlquist, Erin; Lee, Nathan E; Shalin, Sara C; Goodman, Michael; Gardner, Jerad M
- Use of social media in the medical profession is an increasingly prevalent and sometimes controversial practice. Many doctors believe social media is the future and embrace it as an educational and collaborative tool. Others maintain reservations concerning issues such as patient confidentiality, and legal and ethical risks. - To explore the utility of social media as an educational and collaborative tool in dermatopathology. - We constructed 2 identical surveys containing questions pertaining to the responders' demographics and opinions regarding the use of social media for dermatopathology. The surveys were available on Twitter and Facebook for a period of 10 days. - The survey was completed by 131 medical professionals from 29 different countries: the majority (81%, 106 of 131) were 25 to 45 years of age. Most replied that they access Facebook or Twitter several times a day (68%, 89 of 131) for both professional and social purposes (77%, 101 of 131). The majority agreed that social media provides useful and relevant information, but stated limitations they would like addressed. - Social media is a powerful tool with the ability to instantaneously share dermatopathology with medical professionals across the world. This study reveals the opinions and characteristics of the population of medical professionals currently using social media for education and collaboration in dermatopathology.
Ho, Ming-Jung; Gosselin, Katherine; Chandratilake, Madawa; Monrouxe, Lynn V.; Rees, Charlotte E.
In an era of globalization, cultural competence is necessary for the provision of quality healthcare. Although this topic has been well explored in non-Western cultures within Western contexts, the authors explore how Taiwanese medical students trained in Western medicine address intercultural professionalism dilemmas related to tensions between…
Kadriye O. Lewis
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.
Conclusions: Elderly patients are apt to assume that they “understand well”, therefore, in order to recognize and close the perception gap between elderly patients and medical professionals, it is necessary to provide them with more aggressive (frequent instructions on inhalation therapy.
Leffel, G. Michael; Mueller, Ross A. Oakes; Curlin, Farr A.; Yoon, John D.
Despite widespread pedagogical efforts to modify discrete behaviors in developing physicians, the professionalism movement has generally shied away from essential questions such as what virtues characterize the good physician, and how are those virtues formed? Although there is widespread adoption of medical ethics curricula, there is still no…
Widdifield, H; Ryan, C A; O'Sullivan, E
The Royal College of Physicians & Surgeons of Canada developed a competency framework to assist future specialists in responding to challenges as health care providers. The CANMEDs project described 7 essential roles of Specialist Physicians include Health Advocate, Manager, Scholar, Medical Expert, Professional, Communicator and Collaborator (HMSEPC(2)). The object of the current study was to investigate whether medical students and dental students in Ireland recognised these responsibilities as essential to a qualified doctor/dentist. Ninety-eight medical and forty-six dental students (year 1 and year 4) were asked to mind map the responsibilities of qualified doctors/dentists. The comments on the mind map were applied to one of the 7 CANMED roles. There were 484 comments from 128 students. Students had the greatest number of responses referring to the Medical and Dental Expert (257, 30.4%) and Professional (227, 26.9%) roles. This was followed by Communicator (130, 15.4%), Scholar (107, 12.7%) and Health Advocate (82, 9.7%) roles. There were relatively few responses relating to Manager (12, 1.4%) and Collaborator (i.e. teamwork) roles (30, 3.6%). There were no differences in responses between Dental Students and Medical Students and between 1 st year and 4th year students. Similarly there were no differences between the responses of Irish students (n =95; 68%) and International students (n =45; 32%) Students are aware of their responsibilities as Medical or Dental experts (diagnostic and therapeutic skills) for ethical and effective patient care (professional role). They are somewhat aware of the Communicator (therapeutic relationships and effective listening), Scholar (personal continuing education strategies) and Health Advocate (contribute to improved community health) roles. In general they have little concept of the importance of Management skills (utilising resources effectively), and of Collaboration (teamwork and consulting effectively with other
Full Text Available Abstract Background As socioeconomic health inequalities persist and widen, the health effects of adversity are a constant presence in the daily work of physicians. Gruen and colleagues suggest that, in responding to important population health issues such as this, defining those areas of professional obligation in contrast to professional aspiration should be on the basis of evidence and feasibility. Drawing this line between obligation and aspiration is a part of the work of professional medical colleges and associations, and in doing so they must respond to members as well as a range of other interest groups. Our aim was to explore the usefulness of Gruen's model of physician responsibility in defining how professional medical colleges and associations should lead the profession in responding to socioeconomic health inequalities. Methods We report a case study of how the Royal Australian College of General Practitioners is responding to the issue of health inequalities through its work. We undertook a consultation (80 interviews with stakeholders internal and external to the College and two focus groups with general practitioners and program and policy review of core programs of College interest and responsibility: general practitioner training and setting of practice standards, as well as its work in public advocacy. Results Some strategies within each of these College program areas were seen as legitimate professional obligations in responding to socioeconomic health inequality. However, other strategies, while potentially professional obligations within Gruen's model, were nevertheless contested. The key difference between these lay in different moral orientations. Actions where agreement existed were based on an ethos of care and compassion. Actions that were contested were based on an ethos of justice and human rights. Conclusion Colleges and professional medical associations have a role in explicitly leading a debate about values
Full Text Available Background: Concepts such as organizational commitment and employees’ and managers’ ethics provide decision-makers and policy makers with potentially useful information which can result in increasing organizational efficiency and effectiveness. This study aimed to explore the relationship between professional ethics and organizational commitment among the staff working in the education departments of Tabriz University of Medical Sciences. Methods: This cross-sectional study was conducted in 2015. The study population consisted of all staff working as educational experts in the education departments of Tabriz University of Medical Sciences (N = 65. Data collection instruments used in this study were two standard questionnaires on professional ethics and organizational commitment. SPSS software version 21 was used to analyze the data. Results: According to the results, mean scores obtained for professional ethics and organizational commitment were (91.57± 9.13 (95% CI, 89.23-93.91 and (64.89 ± 10.37 (95% CI, 62.2367.54, respectively. A significant relationship was observed between professional ethics and organizational commitment among the educational experts working in Tabriz University of Medical Sciences (correlation coefficient = 0.405 (P = 0.001 (at 95% confidence level. Furthermore, there was a significant relationship between professional ethics and work experience (P = 0.043. The highest level of professional ethics observed was associated with those participants having a work experience of ranging from 6 to 10 years. Individuals with fulltime employment scored the highest in organizational commitment. Conclusion: Educational experts possessed a high level of professional ethics. The finding provides the grounds for promoting organizational commitment, which will lead to higher levels of organizational effectiveness.
Hafferty, Frederic W; Levinson, Dana
Modern-day discourse on medical professionalism has largely been dominated by a "nostalgic" view, emphasizing individual motives and behaviors. Shaped by a defining conflict between commercialism and professionalism, this discourse has unfolded through a series of waves, the first four of which are discovery, definition, assessment, and institutionalization. They have unfolded in a series of highly interactive and overlapping sequences that extend into the present. The fifth wave-linking structure and agency-which is nascent, proposes to shift our focus on professionalism from changing individuals to modifying the underlying structural and environmental forces that shape social actors and actions. The sixth wave-complexity science-is more incubatory in nature and seeks to recast social actors, social structures, and environmental factors as interactive, adaptive, and interdependent. Moving towards such a framing is necessary if medicine is to effectively reestablish professionalism as a core principle.
Parandavar, Nehleh; Rahmanian, Afifeh; Jahromi, Zohreh Badiyepeymaie
Background: Commitment to ethics usually results in nurses’ better professional performance and advancement. Professional self-concept of nurses refers to their information and beliefs about their roles, values, and behaviors. The objective of this study is to analyze the relationship between nurses’ professional self-concept and professional ethics in hospitals affiliated to Jahrom University of Medical Sciences. Methods: This cross sectional-analytical study was conducted in 2014. The 270 participants were practicing nurses and head-nurses at the teaching hospitals of Peimanieh and Motahari in Jahrom University of Medical Science. Sampling was based on sencus method. Data was collected using Cowin's Nurses’ self-concept questionnaire (NSCQ) and the researcher-made questionnaire of professional ethics. Results: The average of the sample's professional self-concept score was 6.48±0.03 out of 8. The average of the sample's commitment to professional ethics score was 4.08±0.08 out of 5. Based on Pearson's correlation test, there is a significant relationship between professional ethics and professional self-concept (P=0.01, r=0.16). Conclusion: In view of the correlation between professional self-concept and professional ethics, it is recommended that nurses’ self-concept, which can boost their commitment to ethics, be given more consideration. PMID:26573035
Parandavar, Nehleh; Rahmanian, Afifeh; Badiyepeymaie Jahromi, Zohreh
Commitment to ethics usually results in nurses' better professional performance and advancement. Professional self-concept of nurses refers to their information and beliefs about their roles, values, and behaviors. The objective of this study is to analyze the relationship between nurses' professional self-concept and professional ethics in hospitals affiliated to Jahrom University of Medical Sciences. This cross sectional-analytical study was conducted in 2014. The 270 participants were practicing nurses and head-nurses at the teaching hospitals of Peimanieh and Motahari in Jahrom University of Medical Science. Sampling was based on sencus method. Data was collected using Cowin's Nurses' self-concept questionnaire (NSCQ) and the researcher-made questionnaire of professional ethics. The average of the sample's professional self-concept score was 6.48±0.03 out of 8. The average of the sample's commitment to professional ethics score was 4.08±0.08 out of 5. Based on Pearson's correlation test, there is a significant relationship between professional ethics and professional self-concept (P=0.01, r=0.16). In view of the correlation between professional self-concept and professional ethics, it is recommended that nurses' self-concept, which can boost their commitment to ethics, be given more consideration.
Keating, Edward G; Massey, Hugh G; Mele, Judith D; Mundell, Benjamin F
Since the advent of the all-volunteer force, one of the foremost personnel challenges of the U.S. Air Force has been recruiting and retaining an adequate number of medical and professional officers in the Air Force's seven medical and professional officer corps: the Biomedical Sciences Corps (BSC), the Chaplain Corps, the Dental Corps, the Judge Advocate General (JAG) Corps (attorneys), the Medical Corps (physicians), the Medical Service Corps (MSC), and the Nurse Corps. For each of these corps, there are highly similar jobs in the private sector, so attracting and retaining these corps' officers is a constant challenge. This article analyzes all seven Air Force medical and professional officer corps and their relative statuses with regard to end strengths, accession levels, promotion flow, and attrition since the late 1970s. The authors find that recent accession and retention trends have been most adverse in the Air Force's Nurse Corps, while the MSC and the JAG Corps appear to have the most stable populations.
Full Text Available Societies are facing medical resource scarcities, inter alia due to increased life expectancy and limited health budgets and also due to temporal or continuous physical shortages of resources like donor organs. This makes it challenging to meet the medical needs of all. Ethicists provide normative guidance for how to fairly allocate scarce medical resources, but legitimate decisions require additionally information regarding what the general public considers to be fair. The purpose of this study was to explore how lay people, general practitioners, medical students and other health professionals evaluate the fairness of ten allocation principles for scarce medical resources: 'sickest first', 'waiting list', 'prognosis', 'behaviour' (i.e., those who engage in risky behaviour should not be prioritized, 'instrumental value' (e.g., health care workers should be favoured during epidemics, 'combination of criteria' (i.e., a sequence of the 'youngest first', 'prognosis', and 'lottery' principles, 'reciprocity' (i.e., those who provided services to the society in the past should be rewarded, 'youngest first', 'lottery', and 'monetary contribution'.1,267 respondents to an online questionnaire were confronted with hypothetical situations of scarcity regarding (i donor organs, (ii hospital beds during an epidemic, and (iii joint replacements. Nine allocation principles were evaluated in terms of fairness for each type of scarcity along 7-point Likert scales. The relationship between demographic factors (gender, age, religiosity, political orientation, and health status and fairness evaluations was modelled with logistic regression.Medical background was a major predictor of fairness evaluations. While general practitioners showed different response patterns for all three allocation situations, the responses by lay people were very similar. Lay people rated 'sickest first' and 'waiting list' on top of all allocation principles-e.g., for donor organs 83
Krütli, Pius; Rosemann, Thomas; Törnblom, Kjell Y; Smieszek, Timo
Societies are facing medical resource scarcities, inter alia due to increased life expectancy and limited health budgets and also due to temporal or continuous physical shortages of resources like donor organs. This makes it challenging to meet the medical needs of all. Ethicists provide normative guidance for how to fairly allocate scarce medical resources, but legitimate decisions require additionally information regarding what the general public considers to be fair. The purpose of this study was to explore how lay people, general practitioners, medical students and other health professionals evaluate the fairness of ten allocation principles for scarce medical resources: 'sickest first', 'waiting list', 'prognosis', 'behaviour' (i.e., those who engage in risky behaviour should not be prioritized), 'instrumental value' (e.g., health care workers should be favoured during epidemics), 'combination of criteria' (i.e., a sequence of the 'youngest first', 'prognosis', and 'lottery' principles), 'reciprocity' (i.e., those who provided services to the society in the past should be rewarded), 'youngest first', 'lottery', and 'monetary contribution'. 1,267 respondents to an online questionnaire were confronted with hypothetical situations of scarcity regarding (i) donor organs, (ii) hospital beds during an epidemic, and (iii) joint replacements. Nine allocation principles were evaluated in terms of fairness for each type of scarcity along 7-point Likert scales. The relationship between demographic factors (gender, age, religiosity, political orientation, and health status) and fairness evaluations was modelled with logistic regression. Medical background was a major predictor of fairness evaluations. While general practitioners showed different response patterns for all three allocation situations, the responses by lay people were very similar. Lay people rated 'sickest first' and 'waiting list' on top of all allocation principles-e.g., for donor organs 83.8% (95% CI
Full Text Available Till date, the medical decision-making process in Korea has followed the paternalist model, relying on the instructions of physicians. However, in recent years, shared decision making at the end-of-life between physicians and nurses is now emphasized in Korea. The purpose of this study was conducted to explore how health care professionals’ characteristics, attitude toward dignified dying, and moral sensitivity affect their shared medical decision making. The design was descriptive survey. This study was undertaken in two university hospitals in two metropolitan cities, South Korea. The participants were 344 nurses and 80 physicians who work at university hospitals selected by convenience sampling method. Data were collected from January 10 through March 20, 2014 using the Dignified Dying Scale, Moral Sensitivity Scale, and Shared Medical Decision-Making Scale. Shared medical decision making, attitude toward dignified dying, moral sensitivity, age, and working experience had a significant correlation with each other. The factors affecting shared medical decision making of Korean health care professionals were moral sensitivity and attitude toward dignified dying. These variables explained 22.4% of the shared medical decision making. Moral sensitivity and a positive attitude toward dignified dying should be promoted among health care professionals as a part of an educational program for shared medical decision making.
van Ark, Allard E; Wijnen-Meijer, Marjo
The worlds of a physician and a jazz musician seem entirely different. Various studies, however, relating the concepts behind jazz music to medical practice and education, have been published. The aim of this essayistic review is to summarize previously described concepts behind jazz music and its required artistic skills that could be translated to medicine, encouraging doctors, medical students and medical educators to see their professional environment from a different perspective. A systematic search was conducted using PubMed, Embase, and ERIC databases, combining keywords with regard to jazz, medicine and medical education. Background information concerning jazz music and several jazz musicians was retrieved through an additional nonsystematic search using Google Scholar. Lessons with regard to improvisational skills, both in communication with patients and in a technical context, communication skills, leadership, interprofessional teamwork and coping with errors are presented. Doctors and medical students could learn various lessons from jazz music performance and jazz musicians. The potential and the possibilities of implementing jazz into the medical curriculum, in order to contribute to the development of professional skills and attitudes of medical students, could be explored further.
Holden, Mark D; Buck, Era; Luk, John; Ambriz, Frank; Boisaubin, Eugene V; Clark, Mark A; Mihalic, Angela P; Sadler, John Z; Sapire, Kenneth J; Spike, Jeffrey P; Vince, Alan; Dalrymple, John L
The University of Texas System established the Transformation in Medical Education (TIME) initiative to reconfigure and shorten medical education from college matriculation through medical school graduation. One of the key changes proposed as part of the TIME initiative was to begin emphasizing professional identity formation (PIF) at the premedical level. The TIME Steering Committee appointed an interdisciplinary task force to explore the fundamentals of PIF and to formulate strategies that would help students develop their professional identity as they transform into physicians. In this article, the authors describe the task force's process for defining PIF and developing a framework, which includes 10 key aspects, 6 domains, and 30 subdomains to characterize the complexity of physician identity. The task force mapped this framework onto three developmental phases of medical education typified by the undergraduate student, the clerkship-level medical student, and the graduating medical student. The task force provided strategies for the promotion and assessment of PIF for each subdomain at each of the three phases, in addition to references and resources. Assessments were suggested for student feedback, curriculum evaluation, and theoretical development. The authors emphasize the importance of longitudinal, formative assessment using a combination of existing assessment methods. Though not unique to the medical profession, PIF is critical to the practice of exemplary medicine and the well-being of patients and physicians.
Frankford, D M; Patterson, M A; Konrad, T R
Practice organizations will increasingly engage in activities that are the functional equivalents of continuing medical education. The authors maintain that if these activities are properly structured within practice organizations, they can become powerful engines of socialization to enhance physicians' lifelong learning and commitment to medical professionalism. They propose that this promise can be realized if new or reformed practice organizations combine education and service delivery and institutionalize processes of individual and collective reflection. The resulting "institutions of reflective practice" would be ones of collegial, experiential, reflective lifelong learning concerning the technical and normative aspects of medical work. They would extend recent methods of medical education such as problem-based learning into the practice setting and draw on extant methods used in complex organizations to maximize the advantages and minimize the disadvantages that practice organizations typically present for adult learning. As such, these institutions would balance the potentially conflicting organizational needs for, on the one hand, (1) self-direction, risk taking, and creativity; (2) specialization; and (3) collegiality; and, on the other hand, (4) organizational structure, (5) coordination of division of labor, and (6) hierarchy. Overall, this institutionalization of reflective practice would enrich practice with education and education with practice, and accomplish the ideals of what the authors call "responsive medical professionalism." The medical profession would both contribute and be responsive to social values, and medical work would be valued intrinsically and as central to practitioners' self-identity and as a contribution to the public good.
Shabila, Nazar P; Al-Tawil, Namir G; Tahir, Rebaz; Shwani, Falah H; Saleh, Abubakir M; Al-Hadithi, Tariq S
The views of medical professionals on efficiency of health system and needs for any changes are very critical and constitute a cornerstone for any health system improvement. This is particularly relevant to Iraqi Kurdistan case as the events of the last few decades have significantly devastated the national Iraqi health system while the necessity for adopting a new health care system is increasingly recognized since 2004. This study aims to examine the regional health system in Iraqi Kurdistan from medical professionals' perspectives and try to define its problems and priorities for improvement. A survey questionnaire was developed and administered to a convenience sample of 250 medical professionals in Erbil governorate. The questionnaire included four items; rating of the quality of services and availability of resources in the health institutions, view on different aspects of the health system, the perceived priority needs for health system improvement and gender and professional characteristics of the respondents. The response rate to the survey was 83.6%. A high proportion of respondents rated the different aspects of services and resources in the health institutions as weak or very weak including the availability of the required quantity and quality of medicines (68.7%), the availability of sufficient medical equipment and investigation tools (68.7%), and the quality of offered services (65.3%). Around 72% of respondents had a rather negative view on the overall health system. The weak role of medical research, the weak role of professional associations in controlling the system and the inefficient health education were identified as important problems in the current health system (87.9%, 87.1% and 84.9%, respectively). The priority needs of health system improvement included adoption of social insurance for medical care of the poor (82%), enhancing the role of family medicine (77.2%), adopting health insurance system (76.1%) and periodic scientific
Schuklenk, Udo; Smalling, Ricardo
We describe a number of conscientious objection cases in a liberal Western democracy. These cases strongly suggest that the typical conscientious objector does not object to unreasonable, controversial professional services-involving torture, for instance-but to the provision of professional services that are both uncontroversially legal and that patients are entitled to receive. We analyse the conflict between these patients' access rights and the conscientious objection accommodation demanded by monopoly providers of such healthcare services. It is implausible that professionals who voluntarily join a profession should be endowed with a legal claim not to provide services that are within the scope of the profession's practice and that society expects them to provide. We discuss common counterarguments to this view and reject all of them. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Giselle Crosara Gracindo
Full Text Available Objective: To identify the nature of infractions committed by doctors working within the field of psychiatry, between 2010 and 2016, from the scope of appeals within ethical-disciplinary cases judged at the Plenary Tribunal of the Federal Medical Council, based on the medical ethics code, and to list some elements that make it possible to outline the professional profile of those involved. Method: This was a document-based investigation in the form of a retrospective and descriptive study. Data were gathered using the Federal Medical Council (CFM database and from consultation of judgments issued by the Plenary Body of the Medical Ethics Tribunal (TSEM, of the CFM. The investigation used a sample consisting of 206 appeals and 19 referrals, totaling 224 appeals by doctors who underwent trials. We took into account cases judged between April 13, 2010 and August 3, 2016. Three databases were used in the investigation: cases (224; doctors facing charges (191 and cases/penalties (146. Based on the records of the 191 doctors charged, the ethical-disciplinary cases of seven doctors working in psychiatry were analyzed specifically for the present study, whether or not they had a specialist title. Characterization of infractions committed encompassed references to the articles of the medical ethics code most frequently infringed in the field of psychiatry, along with a survey of the motives for these infractions and some characteristics relating to these professionals’ profile. Results: Among the findings from this investigation, infractions of the articles of the medical ethics code can be highlighted, such as article 30 “[...] Use of the profession to corrupt customs and to commit or favor crime [...]” and article 40 “[...] Taking advantage of situations arising from the doctor-patient relationship to obtain physical, emotional, financial or any other advantage [...]”. The professional profile of those involved in these cases was also shown
Huddle, Thomas S
Contemporary accounts of medical ethics and professionalism emphasize the importance of social justice as an ideal for physicians. This ideal is often specified as a commitment to attaining the universal availability of some level of health care, if not of other elements of a "decent minimum" standard of living. I observe that physicians, in general, have not accepted the importance of social justice for professional ethics, and I further argue that social justice does not belong among professional norms. Social justice is a norm of civic rather than professional life; professional groups may demand that their members conform to the requirements of citizenship but ought not to require civic virtues such as social justice. Nor should any such requirements foreclose reasonable disagreement as to the content of civic norms, as requiring adherence to common specifications of social justice would do. Demands for any given form of social justice among physicians are unlikely to bear fruit as medical education is powerless to produce this virtue.
Wojtal, Mariola; Kurpas, Donata; Bielska, Dorota; Steciwko, Andrzej
Cigarette smoking has been main reason of the Polish society health hazard and one of the most widespread unhealthy element of the human life style. Aim of the study is to evaluate the attitude of the nursing students of Public Higher Medical Professional School in Opole towards the smoking problems in Poland. Most of respondents considered the nicotinism problem in Poland as very important--3 of them evaluate importance of problem on the scale of 0 - 10, estimated it from 8, 9 and 10 points. 74.3% of respondents support the opinion to put the total injunction from smoking at public areas into practice. According to respondents, the most effective forms to express a non-smoking lifestyle is to promote the idea of the total injunction from smoking at public areas and the promotion of the nonsmoking people at the mass media.
Khalil, Hanan; Bell, Brian; Chambers, Helen; Sheikh, Aziz; Avery, Anthony J
Medication-related adverse events in primary care represent an important cause of hospital admissions and mortality. Adverse events could result from people experiencing adverse drug reactions (not usually preventable) or could be due to medication errors (usually preventable). To determine the effectiveness of professional, organisational and structural interventions compared to standard care to reduce preventable medication errors by primary healthcare professionals that lead to hospital admissions, emergency department visits, and mortality in adults. We searched CENTRAL, MEDLINE, Embase, three other databases, and two trial registries on 4 October 2016, together with reference checking, citation searching and contact with study authors to identify additional studies. We also searched several sources of grey literature. We included randomised trials in which healthcare professionals provided community-based medical services. We also included interventions in outpatient clinics attached to a hospital where people are seen by healthcare professionals but are not admitted to hospital. We only included interventions that aimed to reduce medication errors leading to hospital admissions, emergency department visits, or mortality. We included all participants, irrespective of age, who were prescribed medication by a primary healthcare professional. Three review authors independently extracted data. Each of the outcomes (hospital admissions, emergency department visits, and mortality), are reported in natural units (i.e. number of participants with an event per total number of participants at follow-up). We presented all outcomes as risk ratios (RRs) with 95% confidence intervals (CIs). We used the GRADE tool to assess the certainty of evidence. We included 30 studies (169,969 participants) in the review addressing various interventions to prevent medication errors; four studies addressed professional interventions (8266 participants) and 26 studies described
Salinas Urbina, Addis Abeba; Jarillo Soto, Edgar Carlos
The subject of sexuality in academic and service institutions is perceived through predominantly biological conceptual perspectives, blurring the subjective component that is imbued in social and cultural processes. The meanings that medical staff construct around sexuality have implications in their professional development and practice. This work presents results from a qualitative study into the meaning of sexuality among medical interns from the Universidad Autónoma Metropolitana-Xochimilco. In-depth interviews were conducted with students during their community service. This group was selected because they had finished their studies and were performing an independent and autonomous professional practice. The results, which were analyzed based on Grounded Theory, revealed three dichotomies: biology vs. social construction, individual vs. professional and theoretical learning vs. experiences in the community. The most relevant aspect revealed was the antagonism found between a medical intern's biology-centered academic knowledge and the challenge posed by their patients' reproductive and sexual health needs. The interns recognize that they lack the necessary skills to face issues of sexuality in their professional practice.
Morgan, Susan; Plaisant, Odile; Lignier, Baptiste; Moxham, Bernard J
Previous studies suggest that, while both medical students and professional anatomists recognize the importance of gender issues and do not wish to associate with sexism, most are unaware of the possible negative aspects of sexism within anatomy (Morgan et al. , J. Anat. 224:352-365; , Clin. Anat. 29:892-910). To further investigate this issue, we provided second year medical students at Cardiff University (n = 293) and at the University of Paris Descartes, Sorbonne Paris Cité (n = 142) and professional anatomists (n = 208) with a questionnaire inviting them to address the possibility that gender factors within anatomical imagery (both historical and contemporary) hinder the dispassionate representation of anatomy. Ethical approval for the survey was obtained from the universities at both Cardiff and Paris. In the light of previous findings, the hypothesis tested was that medical students and professional anatomists do not perceive a gender bias when reflected in imagery that is based on anatomical iconography. Our survey results support this hypothesis and suggest that most students and anatomists are unaware of the possible negative aspects of sexism within the culture of anatomy. We consequently recommend that teachers of anatomy and authors of anatomical textbooks should be aware of the possibility of adverse effects on professional matters relating to equality and diversity issues when using imagery. Clin. Anat. 30:711-732, 2017. © 2017Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.
Bustamante, Eliseo; Sanabria, Álvaro
Professionalism is a subject of interest in medical schools around the world. The use of a questionnaire could be useful to assess professionalism in Colombia. To adapt The Penn State University College of Medicine Professionalism Questionnaire as a culturally valid instrument in the Spanish language. We followed recommendations from the IQOLA project and used forward and back translation with four independent translations, as well as a pilot evaluation and an evaluation of psychometric features with 250 students. We evaluated item-scale correlations and internal consistency with Chronbach's alpha test and conducted a principal components factor analysis. Global Cronbach's alpha was 0.86, the Kaiser-Meyer-Olkin measure of sampling adequacy was 0.83, and Bartlett's test of sphericity had a p >0.00001. We found six factors that explained 93% of the total variance and four new factors emerged in the factor analysis, while eight items had high uniqueness. The Penn State University College of Medicine Scale measures professionalism attitudes in medical students with good reliability. However, the structure of the scale demonstrated differences when used in the Latin American medical student population.
José Luis Jiménez-López
Full Text Available The current perception of a dehumanized medical attention and its low quality has questioned the empathic capacity and ethics of the health professionals. The research in this field reports variations in this attributes along the doctors’ education. Objective: to explore the global levels of empathy and professional ethics, as well as the levels of each component of both attributes in a sample of applicants to a medical graduate program. Methodology: 65 residents that applied for graduation studies in a very specialized medical unit were included. As part of the application process, they answered the Cognitive and Affective Empathy Test and the Professional Ethical Attitudes Scale. Results: The average scores of the sample got Average in empathy and Optimal in professional ethics. The comparison by gender, specialty and competences showed less affective and better ethical competence in women, more cognitive empathy in surgical specialties, and in general an absence of correlation between the two variables and specifically by competence. Conclusions: The importance of measuring the specific competences of each attribute is highlighted given that the variation in specific competences impact in different aspects the doctor’s education, as the specialty choice, the student selection, the development of academic programs and the adequate learning about the construction of an effective relation doctor-patient. © Revista Colombiana de Ciencias Sociales
Gomes, Alexandra W; Butera, Gisela; Chretien, Katherine C; Kind, Terry
Inappropriate social media behavior can have detrimental effects on students' future opportunities, but medical students are given little opportunity to reflect upon ways of integrating their social media identities with their newly forming professional identities. In 2012, a required educational session was developed for 1st-year medical students on social media and professional identity. Objectives include identifying professionalism issues and recognizing positive social media use. The 2-hour large-group session uses student-generated social media examples to stimulate discussion and concludes with an expert panel. Students complete a postsession reflection assignment. The required social media session occurs early in the 1st year and is part of the Professionalism curriculum in The George Washington University School of Medicine. Reflection papers are graded for completion. The study began in 2012 and ran through 2014; a total of 313/505 participants (62%) volunteered for the study. Assessment occurred through qualitative analysis of students' reflection assignments. Most students (65%, 203/313) reported considering changes in their social media presence due to the session. The analysis revealed themes relating to a broader understanding of online identity and opportunities to enhance careers. In a 6-month follow-up survey of 76 students in the 2014 cohort who completed the entire survey, 73 (94%) reported some increase in awareness, and 48 (64%) made changes to their social media behavior due to the session (response rate = 76/165; 46%), reflecting the longer term impact. Opportunities for discussion and reflection are essential for transformational learning to occur, enabling understanding of other perspectives. Incorporating student-submitted social media examples heightened student interest and engagement. The social media environment is continually changing, so curricular approaches should remain adaptable to ensure timeliness and relevance. Including
Pichiule-Castañeda, Myrian; Domínguez-Berjón, M Felicitas; Esteban-Vasallo, María D; García-Riolobos, Carmen; Álvarez-Castillo, M Carmen; Astray-Mochales, Jenaro
In the Community of Madrid there is 42.7% late HIV diagnosis. Primary care is the gateway to the health system and the frequency of serological tests requested by these professionals is unknown. The objectives were to establish the frequency of requests for HIV serology by medical and nursing primary care professionals in the Community of Madrid and the factors associated with these requests. An 'on-line' survey was conducted, asking professionals who participated in the evaluation study of strategies to promote early diagnosis of HIV in primary care in the Community of Madrid (ESTVIH) about the number of HIV-serology tests requested in the last 12 months. The association between HIV-serology requesting and the sociodemographic and clinical practice characteristics of the professionals was quantified using adjusted odds ratios (aOR) according to logistic regression. 264 surveys (59.5% physicians). Eighty-two point two percent of medical and 18.7% of nursing professionals reported requesting at least one HIV-serology in the last 12 months (median: 15 and 2 HIV-serology request, respectively). The doctors associated the request with: being male (aOR: 2.95; 95% CI: 0.82-10.56), being trained in pre-post HIV test counselling (aOR: 2.42; 95% CI: 0.84-6.93) and the nurses with: age (13 years; aOR: 3.02; 95% CI: 1.07-8.52). It is necessary to promote HIV testing and training in pre-post HIV test counselling for medical and nursing professionals in primary care centres. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.
Beck, Jimmy; Chretien, Katherine; Kind, Terry
To describe the experience of medical students volunteering at a camp for children with a variety of medical conditions. Rising second-year medical students who had served as counselors for 1 week at a medical specialty camp were invited to participate. We conducted a 2-part qualitative study using on-site focus groups and follow-up individual interviews. Nine medical students participated. Students described their experience as motivating and career reinforcing. It helped them "move beyond the textbook" and deepened their commitment to serving future patients with compassion. One theme that emerged was the idea that their camp experience fostered the development of their professional identities. A 1-week, immersive community service experience at a medical specialty camp played a role in influencing the early formative professional identities of rising second-year medical students. Medical schools could use camps as a promising community service-learning experiences to foster professional identity. © The Author(s) 2015.
Chen, Antonia F; Bi, Wenzhu; Singhabahu, Dilrukshika; Londino, Joanne; Hohl, Justin; Ward, Maeve; Ward, W Timothy
Prospective questionnaire administration study. To assess the ability to translate total and domain scores from Scoliosis Research Society (SRS)-24 to SRS-22r in a surgical-range, medical/interventional adolescent idiopathic scoliosis (AIS) patient population. Conversion of SRS-24 to SRS-22r is demonstrated in an operative cohort of patients with AIS, but not in a medical/interventional patient population. We simultaneously administered SRS-24 and SRS-22r questionnaires to 75 surgical-range, medical/interventional AIS patients and compared them. We performed analysis by regression modeling to produce conversion equations from SRS-24 to SRS-22r. The total SRS-24 score for these medical/interventional AIS patients was 92.5 ± 9.45 (mean, 3.9 ± 0.39), and the total SRS-22r score was 93.5 ± 9.63 (mean, 4.3 ± 0.44). The correlation between these 2 groups was fair (R 2 = 0.77) and improved to good when mental health or recall questions were removed. The correlation was also fair for total pain domains (R 2 = 0.73). However, there was poor correlation for general self-image (R 2 = 0.6) and unacceptable for post-treatment self-image (R 2 = 0.01), general function (R 2 = 0.52), activity function (R 2 = 0.56), and satisfaction (R 2 = 0.53). Compared with a published population of operative AIS patients, R 2 values for total SRS-24 scores, pain, general self-image, activity function, and satisfaction were similar (p > .05). The R 2 values for general function and combined general and activity function were significantly different between the operative and medical/interventional cohorts. Scoliosis Research Society-24 can be converted to SRS-22r scores with fair accuracy in the surgical-range, medical/interventional AIS patient population for total score, and total pain domains. The SRS-24 translates unacceptably to the SRS-22r in self-image, function, and satisfaction domains. The SRS-24 to SRS-22r conversion equations are similar to operative AIS patients, except for the
Min Hye Jang
Full Text Available Background: Since 2003, the Korean Society of Pathologists (KSP has been officially providing medical advisory services (MAS. We reviewed the cases submitted to the KSP between 2003 and 2014. Methods: In total, 1,950 cases were submitted, most by private health insurance companies. The main purposes of the consultations were to clarify the initial diagnoses and to assign a proper disease classification code. We comprehensively reviewed 1,803 consultation cases with detailed information. Results: In spite of some fluctuations, the number of submitted cases has been significantly increasing over the 12 study years. The colon and rectum (40.3%, urinary bladder (14.2%, and stomach (6.9% were the three most common tissues of origin. The most common diagnoses for each of the three tissues of origin were neuroendocrine tumor (50.7%, non-invasive papillary urothelial carcinoma (70.7%, and adenocarcinoma (36.2%. Regardless of the tissue of origin, neuroendocrine tumor of the digestive system was the most common diagnosis (419 of 1,803. Conclusions: In the current study, we found that pathologic consultations associated with private health insurance accounted for a large proportion of the MAS. Coding of the biologic behavior of diseases was the main issue of the consultations. In spite of the effort of the KSP to set proper guidelines for coding and classification of tumors, this review revealed that problems still exist and will continue to be an important issue.
Rosso, G L; Feola, M; Rubinetto, Maria Paola; Petti, N; Rubinetto, L
The use of psychoactive substances has been shown to be a risk factor for accidents in professional drivers. According to an approved Italian law, in order to detect dependency at the workplace the occupational health physician is called to assess the use of illicit drugs among professional drivers. The main purpose of this study was to investigate the use of psychoactive substances among professional drivers. From July to December 2008, rapid urine screening test was carried out on 198 professional drivers. All positive results from the screening stage were verified by specialized laboratories. We found 4 workers with a positive rapid urine screening test (7.1%), one of which was positive only for benzodiazepines and another positive test was not confirmed by specialized laboratory. By only considering illegal substances detected, 6.1% of the drivers tested positive. In this study, the high number of consumers among professional drivers ranged from 31 to 35 years old. Cannabis (THC) was the most frequently detected substance (seen in 10 over 12 cases,), after that was methadone (2/12 cases) and cocaine (1/12 case). We only had one case where more than one substance was found in the same subject (THC and cocaine). Five (41.7%) were former drug-addicts and public Pathological Addiction Services (Ser.T.) had previously followed them. Our results highlight the problem of drug consumption among professional drivers in Piedmont region. Health education and medical surveillance in workplace drug-testing may improve worker and third parties safety.
Using data from a survey of 923 medical interns in Mexico, this article analyzes preferences for type of medical activity (general or specialized practice), type of site (ambulatory or hospital), and type of medical care institution (public assistance, social security, or private). Four independent variables are examined: social origin, medical school, place of internship, and assimilation to the internship hospital. The great majority of the interns expressed a preference for specialty practice, hospitals, and social security institutions. The role of social origin was to selectively direct students into different medical schools. From then on, the structural attributes of the school itself and of the place of internship, as well as the socialization experiences that took place there, emerged as the most important determinants of career preferences. Such a process, however, tended to produce a "social specialization" of interns in terms of the role they expect to play in the medical field. It is argued that this kind of specialization has negative implications for the professional status of physicians, although it also poses a challenge to the development of innovative theories about the process of professionalization in medicine.
Malcolm, Dominic; Scott-Bell, Andrea; Waddington, Ivan
To compare the current methods of appointment, qualifications and occupational experience of club doctors and physiotherapists in English professional football with (i) those outlined in a study published in 1999, and (ii) Football Association (FA) medical regulations. Qualitative. Postal questionnaire survey of (head) doctors and physiotherapists at each of the clubs in the English Premiership, Championship and Football Leagues 1 and 2. Response rates of 35.8% and 45.6% respectively were obtained. The majority of football club doctors are GPs who have sports medicine qualifications and relevant occupational experience. Time commitments vary from full time to a few hours per week. Most are appointed through personal contacts rather than job advertisements and/or interview. Almost all football clubs have a chartered physiotherapist, many of whom have a postgraduate qualification. They work full time and long hours. Most are appointed through personal contacts rather than job advertisements. They are frequently interviewed but not always by someone qualified to judge their professional expertise. Football club medical provision has become more extensive and increasingly professional over the last 10-20years, with better qualified, more career-oriented and more formally contracted staff. It is likely that clinical autonomy has subsequently increased. However recruitment procedures still need to be improved, especially in relation to advertising vacancies, interviewing candidates, and including medical personnel on interview panels. In two aspects clubs appear not to be compliant with current FA medical regulations. Copyright © 2017 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.
The application of radiation in the field of medicine is the most active area. Due to the rapid and strong development of intervention radiology at present near 20 years, particularly, the medical workers become a popularize group which most rapid increasing and also receiving the must high of professional exposure dose. Because, inter alias, radiation protection management nag training have not fully follow up, the aware of radioactive protection and appropriate approach have tot fully meet the development and need, the professional exposure dose received by medical workers, especially those being engaged in intervention radiology, are more higher, as well as have not yet fully receiving the complete personal dose monitoring, the medical workers become the population group which should be paid the most attention to. The writer would advice in this paper that all medical workers who being received a professional radiation exposure should pay more attention to the safety and healthy they by is strengthening radiation protection and receiving complete personal dose monitoring. (authors)
Background This study investigated whether the introduction of professional development teaching in the first two years of a medical course improved students' observed communication skills with simulated patients. Students' observed communication skills were related to patient-centred attitudes, confidence in communicating with patients and performance in later clinical examinations. Methods Eighty-two medical students from two consecutive cohorts at a UK medical school completed two videoed consultations with a simulated patient: one at the beginning of year 1 and one at the end of year 2. Group 1 (n = 35) received a traditional pre-clinical curriculum. Group 2 (n = 47) received a curriculum that included communication skills training integrated into a 'professional development' vertical module. Videoed consultations were rated using the Evans Interview Rating Scale by communication skills tutors. A subset of 27% were double-coded. Inter-rater reliability is reported. Results Students who had received the professional development teaching achieved higher ratings for use of silence, not interrupting the patient, and keeping the discussion relevant compared to students receiving the traditional curriculum. Patient-centred attitudes were not related to observed communication. Students who were less nervous and felt they knew how to listen were rated as better communicators. Students receiving the traditional curriculum and who had been rated as better communicators when they entered medical school performed less well in the final year clinical examination. Conclusions Students receiving the professional development training showed significant improvements in certain communication skills, but students in both cohorts improved over time. The lack of a relationship between observed communication skills and patient-centred attitudes may be a reflection of students' inexperience in working with patients, resulting in 'patient-centredness' being an abstract concept
Kubacki Angela M
Full Text Available Abstract Background This study investigated whether the introduction of professional development teaching in the first two years of a medical course improved students' observed communication skills with simulated patients. Students' observed communication skills were related to patient-centred attitudes, confidence in communicating with patients and performance in later clinical examinations. Methods Eighty-two medical students from two consecutive cohorts at a UK medical school completed two videoed consultations with a simulated patient: one at the beginning of year 1 and one at the end of year 2. Group 1 (n = 35 received a traditional pre-clinical curriculum. Group 2 (n = 47 received a curriculum that included communication skills training integrated into a 'professional development' vertical module. Videoed consultations were rated using the Evans Interview Rating Scale by communication skills tutors. A subset of 27% were double-coded. Inter-rater reliability is reported. Results Students who had received the professional development teaching achieved higher ratings for use of silence, not interrupting the patient, and keeping the discussion relevant compared to students receiving the traditional curriculum. Patient-centred attitudes were not related to observed communication. Students who were less nervous and felt they knew how to listen were rated as better communicators. Students receiving the traditional curriculum and who had been rated as better communicators when they entered medical school performed less well in the final year clinical examination. Conclusions Students receiving the professional development training showed significant improvements in certain communication skills, but students in both cohorts improved over time. The lack of a relationship between observed communication skills and patient-centred attitudes may be a reflection of students' inexperience in working with patients, resulting in 'patient-centredness' being
Schmutz, Joel A.
Over 2,000 people are employed in wildlife biology in the United States federal government. The size of this constituency motivated me to examine the amount of formal education federal biologists have received and the extent of continuing education they undertake by reading journals or attending scientific meetings. Most federal biologists who are members of The Wildlife Society (TWS) have a graduate degree. However, one-third have only a Bachelor of Science degree, despite the current trend toward hiring people with graduate degrees. Most federal biologists are not research biologists. Numbers of journals subscribed to was positively related to educational level. Less than one-third of all wildlife biologists employed by the United States Fish and Wildlife Service are members of TWS or subscribe to any of its journals. In contrast, the majority of presenters at the TWS 2000 Annual Conference were research biologists and members of TWS. The failure of many federal wildlife biologists to read scientific literature or attend professional meetings indicates a failure to promote the importance of continuing education in the federal workplace. I identify 2 potential adverse impacts of this failing: an inability to recognize important and relevant scientific contributions and an ineffectiveness in carrying out adaptive management.
In June 2001, the then president of the Max Planck Society addressed a formal apology to survivors of Nazi medical crimes. Starting from this ritual of repentance, the paper examines the participants' diverse views of how to deal with the medical crimes of National Socialism. In comparison with the DGPPN, it asks about possibilities of going beyond historical retrospection to fulfil the imperative of remembrance.
Full Text Available Abstract Background The purpose of this paper is to describe and analyze the professional expectations of medical students during the 2007-2008 academic year at the public medical schools of Angola, Guinea-Bissau and Mozambique, and to identify their social and geographical origins, their professional expectations and difficulties relating to their education and professional future. Methods Data were collected through a standardised questionnaire applied to all medical students registered during the 2007-2008 academic year. Results Students decide to study medicine at an early age. Relatives and friends seem to have an especially important influence in encouraging, reinforcing and promoting the desire to be a doctor. The degree of feminization of the student population differs among the different countries. Although most medical students are from outside the capital cities, expectations of getting into medical school are already associated with migration from the periphery to the capital city, even before entering medical education. Academic performance is poor. This seems to be related to difficulties in accessing materials, finances and insufficient high school preparation. Medical students recognize the public sector demand but their expectations are to combine public sector practice with private work, in order to improve their earnings. Salary expectations of students vary between the three countries. Approximately 75% want to train as hospital specialists and to follow a hospital-based career. A significant proportion is unsure about their future area of specialization, which for many students is equated with migration to study abroad. Conclusions Medical education is an important national investment, but the returns obtained are not as efficient as expected. Investments in high-school preparation, tutoring, and infrastructure are likely to have a significant impact on the success rate of medical schools. Special attention should be given
Asgary, Ramin; Junck, Emily
Short-term humanitarian medical volunteerism has grown significantly among both clinicians and trainees over the past several years. Increasingly, both volunteers and their respective institutions have faced important challenges in regard to medical ethics and professional codes that should not be overlooked. We explore these potential concerns and their risk factors in three categories: ethical responsibilities in patient care, professional responsibility to communities and populations, and institutional responsibilities towards trainees. We discuss factors increasing the risk of harm to patients and communities, including inadequate preparation, the use of advanced technology and the translation of Western medicine, issues with clinical epidemiology and test utility, difficulties with the principles of justice and clinical justice, the lack of population-based medicine, sociopolitical effects of foreign aid, volunteer stress management, and need for sufficient trainee supervision. We review existing resources and offer suggestions for future skill-based training, organisational responsibilities, and ethical preparation.
Anderson, Misti Ault; Giordano, James
The importance of strong science, technology, engineering, and mathematics education continues to grow as society, medicine, and the economy become increasingly focused and dependent upon bioscientific and technological innovation. New advances in frontier sciences (e.g., genetics, neuroscience, bio-engineering, nanoscience, cyberscience) generate ethical issues and questions regarding the use of novel technologies in medicine and public life. In light of current emphasis upon science, technology, engineering, and mathematics education (at the pre-collegiate, undergraduate, graduate, and professional levels), the pace and extent of advancements in science and biotechnology, the increasingly technological orientation and capabilities of medicine, and the ways that medicine - as profession and practice - can engage such scientific and technological power upon the multi-cultural world-stage to affect the human predicament, human condition, and perhaps nature of the human being, we argue that it is critical that science, technology, engineering, and mathematics education go beyond technical understanding and directly address ethical, legal, social, and public policy implications of new innovations. Toward this end, we propose a paradigm of integrative science, technology, ethics, and policy studies that meets these needs through early and continued educational exposure that expands extant curricula of science, technology, engineering, and mathematics programs from the high school through collegiate, graduate, medical, and post-graduate medical education. We posit a synthetic approach that elucidates the historical, current, and potential interaction of scientific and biotechnological development in addition to the ethico-legal and social issues that are important to educate and sustain the next generation of medical and biomedical professionals who can appreciate, articulate, and address the realities of scientific and biotechnological progress given the shifting
Lai, Meng-Kuan; Aritejo, Bayu Aji; Tang, Jing-Shia; Chen, Chien-Liang; Chuang, Chia-Chang
Family presence during resuscitation is an emerging trend, yet it remains controversial, even in countries with relatively high acceptance of family presence during resuscitation among medical professionals. Family presence during resuscitation is not common in many countries, and medical professionals in these regions are unfamiliar with family presence during resuscitation. Therefore, this study predicted the medical professionals' intention to allow family presence during resuscitation by applying the theory of planned behaviour. A cross-sectional survey. A single medical centre in southern Taiwan. Medical staffs including physicians and nurses in a single medical centre (n=714). A questionnaire was constructed to measure the theory of planned behaviour constructs of attitudes, subjective norms, perceived behavioural control, and behavioural intentions as well as the awareness of family presence during resuscitation and demographics. In total, 950 questionnaires were distributed to doctors and nurses in a medical centre. Among the 714 valid questionnaires, only 11 participants were aware of any association in Taiwan that promotes family presence during resuscitation; 94.7% replied that they were unsure (30.4%) or that their unit did not have a family presence during resuscitation policy (74.8%). Regression analysis was performed to predict medical professionals' intention to allow family presence during resuscitation. The results indicated that only positive attitudes and subjective norms regarding family presence during resuscitation and clinical tenure could predict the intention to allow family presence during resuscitation. Because Family presence during resuscitation practice is not common in Taiwan and only 26.19% of the participants agreed to both items measuring the intention to allow family presence during resuscitation, we recommend the implementation of a family presence during resuscitation education program that will enhance the positive beliefs
Learn how to stay ahead of the game when budgets and staff are cut Medical Library Downsizing: Administrative, Professional, and Personal Strategies for Coping with Change explores corporate downsizing and other company-wide events as they relate to medical librarians in their organization. This training manual is designed to help librarians prepare for a new era where shrinking budgets, inflated journal costs, and the increasing demand for new and expensive services now put salaries and jobs at risk. While focused on health care issues, this book will appeal to a general library audience and
Yielder, Jill; Moir, Fiona
The introduction of a new domain of learning for Personal and Professional Skills in the medical program at the University of Auckland in New Zealand has involved the compilation of a portfolio for assessment. This departure from the traditional assessment methods predominantly used in the past has been challenging to design, introduce, and maintain as a relevant and authentic assessment method. We present the portfolio format along with the process for its introduction and appraise the challenges, strengths, and limitations of the approach within the context of the current literature. We then outline a cyclical model of evaluation used to monitor and fine-tune the portfolio tasks and implementation process, in response to student and assessor feedback. The portfolios have illustrated the level of insight, maturity, and synthesis of personal and professional qualities that students are capable of achieving. The Auckland medical program strives to foster these qualities in its students, and the portfolio provides an opportunity for students to demonstrate their reflective abilities. Moreover, the creation of a Personal and Professional Skills domain with the portfolio as its key assessment emphasizes the importance of reflective practice and personal and professional development and gives a clear message that these are fundamental longitudinal elements of the program.
Yielder, Jill; Moir, Fiona
The introduction of a new domain of learning for Personal and Professional Skills in the medical program at the University of Auckland in New Zealand has involved the compilation of a portfolio for assessment. This departure from the traditional assessment methods predominantly used in the past has been challenging to design, introduce, and maintain as a relevant and authentic assessment method. We present the portfolio format along with the process for its introduction and appraise the challenges, strengths, and limitations of the approach within the context of the current literature. We then outline a cyclical model of evaluation used to monitor and fine-tune the portfolio tasks and implementation process, in response to student and assessor feedback. The portfolios have illustrated the level of insight, maturity, and synthesis of personal and professional qualities that students are capable of achieving. The Auckland medical program strives to foster these qualities in its students, and the portfolio provides an opportunity for students to demonstrate their reflective abilities. Moreover, the creation of a Personal and Professional Skills domain with the portfolio as its key assessment emphasizes the importance of reflective practice and personal and professional development and gives a clear message that these are fundamental longitudinal elements of the program. PMID:29349315
Bernard, Aaron W; Malone, Matthew; Kman, Nicholas E; Caterino, Jeffrey M; Khandelwal, Sorabh
Professionalism development is influenced by the informal and hidden curriculum. The primary objective of this study was to better understand this experiential learning in the setting of the Emergency Department (ED). Secondarily, the study aimed to explore differences in the informal curriculum between Emergency Medicine (EM) and Internal Medicine (IM) clerkships. A thematic analysis was conducted on 377 professionalism narratives from medical students completing a required EM clerkship from July 2008 through May 2010. The narratives were analyzed using established thematic categories from prior research as well as basic descriptive characteristics. Chi-square analysis was used to compare the frequency of thematic categories to prior research in IM. Finally, emerging themes not fully appreciated in the established thematic categories were created using grounded theory. Observations involving interactions between attending physician and patient were most abundant. The narratives were coded as positive 198 times, negative 128 times, and hybrid 37 times. The two most abundant narrative themes involved manifesting respect (36.9%) and spending time (23.7%). Both of these themes were statistically more likely to be noted by students on EM clerkships compared to IM clerkships. Finally, one new theme regarding cynicism emerged during analysis. This analysis describes an informal curriculum that is diverse in themes. Student narratives suggest their clinical experiences to be influential on professionalism development. Medical students focus on different aspects of professionalism depending on clerkship specialty.
Full Text Available Abstract Background Clinical experience has traditionally been highly valued in medical education and clinical healthcare. On account of its multi-faceted nature, clinical experience is mostly difficult to articulate, and is mainly expressed in clinical situations as professional approaches. Due to retirement, hospitals in Scandinavia will soon face a substantial decrease in the number of senior specialist doctors, and it has been discussed whether healthcare will suffer an immense loss of experienced-based knowledge when this senior group leaves the organization. Both senior specialists and junior colleagues are often involved in clinical education, but the way in which these two groups vary in professional approaches and contributions to clinical education has not been so well described. Cognitive psychology has contributed to the understanding of how experience may influence professional approaches, but such studies have not included the effect of differences in position and responsibilities that junior and senior doctors hold in clinical healthcare. In the light of the discussion above, it is essential to describe the professional approaches of senior doctors in relation to those of their junior colleagues. This study therefore aims to describe and compare the professional approaches of junior and senior doctors when making clinical judgements. Methods Critical incident technique was used in interviews with nine senior doctors and nine junior doctors in internal medicine. The interviews were subjected to qualitative content analysis. Result Senior and junior doctors expressed a variety of professional approaches in clinical judgement as follows: use of theoretical knowledge, use of prior experience of cases and courses of events, use of ethical and moral values, meeting and communicating with the patient, focusing on available information, relying on their own ability, getting support and guidance from others and being directed by the
Erschens, Rebecca; Keifenheim, Katharina Eva; Herrmann-Werner, Anne; Loda, Teresa; Schwille-Kiuntke, Juliane; Bugaj, Till Johannes; Nikendei, Christoph; Huhn, Daniel; Zipfel, Stephan; Junne, Florian
This systematic review and meta-analysis aim to summarize the available evidence on the prevalence of professional burnout among medical students. The review was performed according to the PRISMA guidelines. Databases were systematically searched for peer-reviewed articles, reporting burnout among medical students published between 2000 and 2017. The meta-analysis was conducted on the available data on burnout rates in medical students measured with the Maslach Burnout Inventory (MBI-HSS). Fifty-eight out of 3006 studies were found eligible for inclusion. Twelve of these studies met the criteria for meta-analysis. Weighted mean values for the three sub-dimensions of the MBI-HSS were M = 22.93 (SD = 10.25) for Emotional Exhaustion, M = 8.88 (SD = 5.64) for Depersonalization, and M = 35.11 (SD = 8.03) for Personal Accomplishment. Prevalence rates for professional burnout ranged from 7.0% to 75.2%, depending on country-specific factors, applied instruments, cutoff-criteria for burnout symptomatology. This review underlines the burden of burnout among medical students. Future research should explicitly focus on specific context factors and student group under investigation. Such efforts are necessary to control for context-dependent confounders in research on medical students' mental health impairment to enable more meaningful comparisons and adequate prevention strategies.
Gupta, Setu; Singh, Satendra; Dhaliwal, Upreet
This study aimed to assess medical students' presence on Facebook and the extent of their visible activity, with particular reference to online professionalism. This was a cross-sectional study including all medical students enrolled in the University College of Medical Sciences, University of Delhi, India during the period of the study, which was conducted from 2011 to 2012. After approval by the Institutional Ethical Committee, the full names of all students were obtained from our institution. After creating a fictitious profile, Facebook was searched for students' profiles, and those found were examined for visible content and unprofessional behaviour. Of 611 students, 477 (78.1%) had detectable Facebook profiles. Out of 477 profiles, date of birth, address, email, phone number, religion, and political views were rarely shared; sexual orientation and relationship status were displayed on approximately one third of the profiles; and an identifiable profile picture (80.3%), field of study (51.6%), and institution (86.2%) were commonly shared . The visible content included friend lists (88.7%), photo albums (36.1%), and associations with diverse groups and pages (97.1%). Five profiles (1.05%) displayed unprofessional content, including one profile photograph depicting alcohol consumption, one association with groups relating to excessive alcohol consumption, two profiles containing sexually explicit language, and one association with a sexist page. Most of our students use Facebook's privacy settings to hide some content from others. Unprofessional content was rarely visible from a stranger's profile. However, even when hidden from strangers, unprofessional behaviour is still unprofessional behaviour. As Facebook is an integral part of life, it is important for medical educators and students to understand the implications and importance of e-professionalism. Professionalism curricula should address e-professionalism.
Essary, Alison C
The use of social media is the norm among the digital native generation, with 75% of the Millennial Generation connected through Facebook. For students in medical education who struggle to distinguish between personal and professional boundaries, social media provides yet another challenge. Incidents of unprofessional conduct and academic dismissal have been reported. Administration, faculty, and students would benefit from clear policies and procedures, case scenarios of social media violations, and suggestions for using social media wisely.
Purpose: This study aimed to assess medical students’ presence on Facebook and the extent of their visible activity, with particular reference to online professionalism. Methods: This was a cross-sectional study including all medical students enrolled in the University College of Medical Sciences, University of Delhi, India during the period of the study, which was conducted from 2011 to 2012. After approval by the Institutional Ethical Committee, the full names of all students were obtained from our institution. After creating a fictitious profile, Facebook was searched for students’ profiles, and those found were examined for visible content and unprofessional behaviour. Results: Of 611 students, 477 (78.1%) had detectable Facebook profiles. Out of 477 profiles, date of birth, address, email, phone number, religion, and political views were rarely shared; sexual orientation and relationship status were displayed on approximately one third of the profiles; and an identifiable profile picture (80.3%), field of study (51.6%), and institution (86.2%) were commonly shared . The visible content included friend lists (88.7%), photo albums (36.1%), and associations with diverse groups and pages (97.1%). Five profiles (1.05%) displayed unprofessional content, including one profile photograph depicting alcohol consumption, one association with groups relating to excessive alcohol consumption, two profiles containing sexually explicit language, and one association with a sexist page. Conclusion: Most of our students use Facebook’s privacy settings to hide some content from others. Unprofessional content was rarely visible from a stranger’s profile. However, even when hidden from strangers, unprofessional behaviour is still unprofessional behaviour. As Facebook is an integral part of life, it is important for medical educators and students to understand the implications and importance of e-professionalism. Professionalism curricula should address e-professionalism
Full Text Available Purpose: This study aimed to assess medical students’ presence on Facebook and the extent of their visible activity, with particular reference to online professionalism. Methods: This was a cross-sectional study including all medical students enrolled in the University College of Medical Sciences, University of Delhi, India during the period of the study, which was conducted from 2011 to 2012. After approval by the Institutional Ethical Committee, the full names of all students were obtained from our institution. After creating a fictitious profile, Facebook was searched for students’ profiles, and those found were examined for visible content and unprofessional behaviour. Results: Of 611 students, 477 (78.1% had detectable Facebook profiles. Out of 477 profiles, date of birth, address, email, phone number, religion, and political views were rarely shared; sexual orientation and relationship status were displayed on approximately one third of the profiles; and an identifiable profile picture (80.3%, field of study (51.6%, and institution (86.2% were commonly shared . The visible content included friend lists (88.7%, photo albums (36.1%, and associations with diverse groups and pages (97.1%. Five profiles (1.05% displayed unprofessional content, including one profile photograph depicting alcohol consumption, one association with groups relating to excessive alcohol consumption, two profiles containing sexually explicit language, and one association with a sexist page. Conclusion: Most of our students use Facebook’s privacy settings to hide some content from others. Unprofessional content was rarely visible from a stranger’s profile. However, even when hidden from strangers, unprofessional behaviour is still unprofessional behaviour. As Facebook is an integral part of life, it is important for medical educators and students to understand the implications and importance of e-professionalism. Professionalism curricula should address e-professionalism.
Rivera, F; Andres, R; Felip, E; Garcia-Campelo, R; Lianes, P; Llombart, A; Piera, J M; Puente, J; Rodriguez, C A; Vera, R; Virizuela, J A; Martin, M; Garrido, P
The SEOM Future Plan is aimed at identifying the main challenges, trends and needs of the medical oncology speciality over the next years, including potential oncologist workforce shortages, and proposing recommendations to overcome them. The estimations of the required medical oncologists workforce are based on an updated Medical Oncologist Register in Spain, Medical Oncology Departments activity data, dedication times and projected cancer incidence. Challenges, needs and future recommendations were drawn from an opinion survey and an advisory board. A shortage of 211 FTE medical oncologist specialists has been established. To maintain an optimal ratio of 158 new cases/FTE, medical oncology workforce should reach 1881 FTE by 2035. Main recommendations to face the growing demand and complexity of oncology services include a yearly growth of 2.5% of medical oncologist's workforce until 2035, and development and application of more accurate quality indicators for cancer care and health outcomes measure.
Ng, Angie T; Chang, Anne Lynn S; Cockburn, Myles; Peng, David H
(i) To assess the baseline knowledge of non-medical skin care professionals (estheticians, cosmetologists, massage therapists) on tanning bed use and its association with melanoma; and (ii) to provide preliminary evidence of the potential impact of a fast and simple educational intervention on tanning beds and melanoma on the awareness of non-medical skin care professionals towards skin cancer prevention. A pre-intervention survey was administered to non-medical skin care professional at salons or spas in Southern California to assess baseline knowledge on tanning and skin cancer. This was followed immediately by a 10-minute oral presentation on tanning bed use and its association with melanoma. One month later, a post-intervention survey was distributed to individuals who attended the initial oral presentation. Significant changes pre- and post-intervention were found in non-medical skin care professionals' answer responses to the following: (i) increased speaking to clients about cancer risk with tanning bed use 42-66% (OR 2.44; 95% CI 1.39, 4.30)]; (ii) decreased personal tanning bed use (23-15% [OR 0.61; 95% CI 0.37, 1.00]); and (iii) decreased belief that tanning beds are an excellent cosmetic tool (29-20% [OR 0.60; 95% CI 0.38, 0.96]). This study provides preliminary evidence that non-medical skin care professionals could be an important source of primary prevention information for reducing the burden of melanoma. © 2012 The International Society of Dermatology.
Lockyer, Jocelyn; Bursey, Ford; Richardson, Denyse; Frank, Jason R; Snell, Linda; Campbell, Craig
Competency-based medical education (CBME) is as important in continuing professional development (CPD) as at any other stage of a physician's career. Principles of CBME have the potential to revolutionize CPD. Transitioning to CBME-based CPD will require a cultural change to gain commitment from physicians, their employers and institutions, CPD providers, professional organizations, and medical regulators. It will require learning to be aligned with professional and workplace standards. Practitioners will need to develop the expertise to systematically examine their own clinical performance data, identify performance improvement opportunities and possibilities, and develop a plan to address areas of concern. Health care facilities and systems will need to produce data on a regular basis and to develop and train CPD educators who can work with physician groups. Stakeholders, such as medical regulatory authorities who are responsible for licensing physicians and other standard-setting bodies that credential and develop maintenance-of-certification systems, will need to change their paradigm of competency enhancement through CPD.
Full Text Available The Optic Neuritis Treatment Trial and subsequent studies have had a tremendous impact on the treatment and prognosis of optic neuritis and multiple sclerosis in adults. The results of these studies have been extrapolated to children; however, pediatric data are sparse. Using the method of prospective preference assessment, the willingness of parents and medical professionals to enroll children in a hypothetical Pediatric Optic Neuritis Treatment Trial was assessed using a mock consent form and questionnaire. A 3-arm trial was proposed: 1 intravenous corticosteroids, 2 high-dose oral corticosteroids, and 3 an oral placebo. The forms were completed by 198 parents and 49 physicians. After reviewing the hypothetical scenario, trial design, risks and benefits, and alternatives to the study, 21% of parents would enroll their children in the trial whereas 98% of medical professionals would enroll their patients. With medical professional recommendation, 43% of parents would enroll their children. The manner in which this hypothetical trial was presented to parents, specifically with respect to the recommendation of their child’s health care team, influenced a parent’s willingness to participate.
Dimaria-Ghalili, Rose Ann; Edwards, Marilyn; Friedman, Gerald; Jaferi, Azra; Kohlmeier, Martin; Kris-Etherton, Penny; Lenders, Carine; Palmer, Carole; Wylie-Rosett, Judith
The current nutrition education curricula for students in U.S. medical schools, and schools of other health professions, such as nursing and oral health, do not provide enough opportunity to gain knowledge of the interactions among micro- and macronutrients, their role in maintaining optimal body functions, factors that interfere with these interactions, or, importantly, how to integrate this knowledge into medical practice. There is a need to better prepare healthcare professionals for identifying nutrition risk and managing hospitalized patients, especially those with chronic conditions, using an interprofessional, team-based approach. A major goal of this report is to revisit current nutrition training programs for physicians and other healthcare professionals in order to explore opportunities for providing healthcare providers with the essential tools of preventative and therapeutic nutrition intervention strategies. The issues addressed include whether a consensus exists on how to integrate basic and applied nutrition into the general healthcare professional curriculum, and if so, at which stages of training and at what depth should these integrations occur; how nutrition education is dealt with and achieved throughout all the health professions; and whether current nutrition education models are sufficient. To help address these issues, the report will review current nutrition education practices-their strengths and weaknesses-as well as evaluate promising new initiatives, and offer proposals for new directions for nutrition education training of future generation of medical practitioners. © 2013 New York Academy of Sciences.
Recommendations for the follow-up care of female breast cancer survivors: a guideline of the Spanish Society of Medical Oncology (SEOM), Spanish Society of General Medicine (SEMERGEN), Spanish Society for Family and Community Medicine (SEMFYC), Spanish Society for General and Family Physicians (SEMG), Spanish Society of Obstetrics and Gynecology (SEGO), Spanish Society of Radiation Oncology (SEOR), Spanish Society of Senology and Breast Pathology (SESPM), and Spanish Society of Cardiology (SEC).
Barnadas, A; Algara, M; Cordoba, O; Casas, A; Gonzalez, M; Marzo, M; Montero, A; Muñoz, M; Ruiz, A; Santolaya, F; Fernandez, T
The increased incidence and decreased mortality of breast cancer have produced an increased number of breast cancer survivors. The type of sequelae and comorbidities that these patients present call for a collaborative follow-up by hospital-based specialized care and primary care. In this document, we present a guideline drafted and agreed among scientific societies whose members care for breast cancer survivors. The purpose of this guideline is to achieve the shared and coordinated follow-up of these patients by specialized care and primary care professionals. In it, we review the health issues derived from the treatments performed, with recommendations about the therapeutic approach to each of them, as well as a proposal for joint follow-up by primary and specialized care.
Rocha, Paulo Novis; de Castro, Naara Alethéa Azael
Unprofessional online behavior by medical students or physicians may damage individual careers, and the reputation of institutions and the medical profession. What is considered unprofessional online behavior, however, is not clearly defined and may vary in different cultures. To determine the frequency with which students from a Brazilian Medical School come across ten given examples of unprofessional online behavior by medical students or physicians, and gather the opinions of participants regarding the appropriateness of these behaviors. A cross-sectional survey of 350 students from the Medical School of Bahia, Brazil. Only those who had a profile in social media were included in the final analyses. 336/350 (96.0%) medical students kept a profile in social media. Only 13.5% reported having discussions about online professionalism during ethics classes. They reported witnessing the investigated examples of unprofessional online behavior with varying frequencies, ranging from 13.7% for "violation of patient's privacy" to 85.4% for "photos depicting consumption of alcoholic beverages". Most participants felt neutral about posting "pictures in bathing suits", whereas the vast majority rated "violation of patient's privacy" as totally inappropriate. When presented with a case vignette illustrating violation of patients' privacy (publication of pictures of hospitalized children or neonates in social media), however, most participants felt neutral about it. Participants considered all investigated examples of unprofessional online behavior more inappropriate if carried out by doctors rather than by students. Medical students are witnessing a high frequency of unprofessional online behavior by their peers and physicians. Most investigated behaviors were considered inappropriate, especially if carried out by physicians. Participants were not able to recognize the publication of pictures of hospitalized children or neonates in social media as cases of violation of
Craig, Sienna R; Scott, Rebekah; Blackwood, Kristy
Nascent medical students' first view into medical school orients them toward what is considered important in medicine. Based on ethnography conducted over 18 months at a New England medical school, this article explores themes which emerged during a first-year student orientation and examines how these scripts resurface across a four-year curriculum, revealing dynamics of enculturation into an institution and the broader profession. We analyze orientation activities as discursive and embodied fields which serve "practical" purposes of making new social geographies familiar, but which also frame institutional values surrounding "soft" aspects of medicine: professionalism; dynamics of hierarchy and vulnerability; and social difference. By examining orientation and connecting these insights to later, discerning educational moments, we argue that orientation reveals tensions between the overt and hidden curricula within medical education, including what being a good doctor means. Our findings are based on data from semi-structured interviews, focus groups, and participant-observation in didactic and clinical settings. This article answers calls within medical anthropology and medical education literature to recognize implicit values at play in producing physicians, unearthing ethnographically how these values are learned longitudinally via persisting gaps between formal and hidden curricula. Assumptions hidden in plain sight call for ongoing medical education reform.
Phronesis has become a buzzword in contemporary medical ethics. Yet, the use of this single term conceals a number of significant conceptual controversies based on divergent philosophical assumptions. This paper explores three of them: on phronesis as universalist or relativist, generalist or particularist, and natural/painless or painful/ambivalent. It also reveals tensions between Alasdair MacIntyre's take on phronesis, typically drawn upon in professional ethics discourses, and Aristotle's original concept. The paper offers these four binaries as a possible analytical framework for classifying and evaluating accounts of phronesis in the medical ethics literature. It argues that to make sense of phronesis as a putative ideal in professional medical ethics--for example, with the further aim of crafting interventions to cultivate phronesis in medical ethics education--the preliminary question of which conception of phronesis is most serviceable for the aim in question needs to be answered. The paper identifies considerable lack of clarity in the current discursive field on phronesis and suggests how that shortcoming can be ameliorated.
Full Text Available The aim of this paper is to present specificities of the English language teaching necessary for successful education and professional training of medical students. In contemporary globalized world the English language has become the basic language of communication in all scientific fields including the field of medical science. It is well established that Medical English teaching should primarily focus on stable linguistic competence in English that is created by means of content and context based curriculum, thus preparing students for active use of English upon graduation. In order to achieve this it is very important that English language teaching be based on specific real situations in which the language is to be used. In addition, students should be encouraged to adapt practical skills applicable in specific future professional setting. Medical English teaching represents constant challenge for teachers because they need to be flexible, open to new approaches and methods, make decisions and adapt themselves to constant changes. In addition, long-term learning is at the core of higher education, and being equal partners, both students and teachers should be aware that education is a two-way process.
Bham, G; Bhandari, J; Neupane, M R; Dawadi, R; Pradhan, P
Hospital environment is a reservoir of wide varieties of microorganisms which are frequently reported colonizing in medical equipment. Stethoscopes are essential tools and of universal use in the medical profession, which might be a source of spreading nosocomial infections. This research project was conducted with an aim to assess the presence of aerobic bacteria in the stethoscope of the medical doctors working at Patan Hospital and students of Patan Academy of Health Sciences. It is a cross sectional study based on structured questionnaire and sample assessment from the stethoscope of doctors and students of Patan Hospital and Patan Academy of Health Sciences. The stethescopes used by the doctors of five major departments of Patan Hospital and students of clinical years were included in this study. Total of 99 stethoscope owned by different level of professionals (positions) and different departments were examined for bacterial contamination. Out of them, 36 were found to be considerably contaminated. Single strain of bacteria was grown from a single stethoscope. Among them 34 were Gram positive and remaining were Gram negative. Out of 34 gram postive bacteria, 29 were identified as Staphylococcus aureus, six were identified as Coagulase Negative Staphylococcus and remaining were Gram positive bacilli. There is presence of aerobic bacteria in diaphragmatic portion of stethoscope of medical professional of which the gram positives were the commonest.
Leffel, G Michael; Oakes Mueller, Ross A; Curlin, Farr A; Yoon, John D
Despite widespread pedagogical efforts to modify discrete behaviors in developing physicians, the professionalism movement has generally shied away from essential questions such as what virtues characterize the good physician, and how are those virtues formed? Although there is widespread adoption of medical ethics curricula, there is still no consensus about the primary goals of ethics education. Two prevailing perspectives dominate the literature, constituting what is sometimes referred to as the "virtue/skill dichotomy". The first perspective argues that teaching ethics is a means of providing physicians with a skill set for analyzing and resolving ethical dilemmas. The second perspective suggests that teaching ethics is a means of creating virtuous physicians. The authors argue that this debate about medical ethics education mirrors the Rationalist-Intuitionist debate in contemporary moral psychology. In the following essay, the authors sketch the relevance of the Rationalist-Intuitionist debate to medical ethics and professionalism. They then outline a moral intuitionist model of virtuous caring that derives from but also extends the "social intuitionist model" of moral action and virtue. This moral intuitionist model suggests several practical implications specifically for medical character education but also for health science education in general. This approach proposes that character development is best accomplished by tuning-up (activating) moral intuitions, amplifying (intensifying) moral emotions related to intuitions, and strengthening (expanding) intuition-expressive, emotion-related moral virtues, more than by "learning" explicit ethical rules or principles.
This special issue is dedicated to Nowadays Applied Ethics in Society, and falls in the field of social sciences and humanities, being hosted both theoretical approaches and empirical research in various areas of applied ethics. Applied ethics analyzes of a series of morally concrete situations of social or professional practice in order to make / adopt decisions. In the field of applied ethics are integrated medical ethics, legal ethics, media ethics, professional ethics, environmental ethic...
Adler, Amy B; Adrian, Amanda L; Hemphill, Marla; Scaro, Nicole H; Sipos, Maurice L; Thomas, Jeffrey L
Studies of medical staff members have consistently documented high levels of burnout compared to those in other professions. Although there are studies of burnout in military medical staff, there are gaps in understanding the experience of medical staff while they are deployed and few occupationally-related factors associated with decreased burnout have been identified in this population. To assess work-related variables accounting for burnout over and above rank, post-traumatic stress disorder (PTSD) symptoms, and professional stressors in the deployed environment. U.S. military medical staff members were surveyed in Afghanistan. The survey assessed burnout (emotional exhaustion and depersonalization), PTSD symptoms, perception of professional stressors, self-care behaviors, taking care of team members (team care), general leadership, and health-promoting leadership. Participants provided informed consent under a protocol approved by the institutional review board at Walter Reed Army Institute of Research, and coordinated through the Washington Headquarters Service and the Joint Casualty Care Research Team located in Afghanistan. A total of 344 individuals provided their consent (83.3%) and completed the survey. Correlations found significant positive relationships between perception of professional stressors and levels of burnout. Significant negative correlations were found between burnout and self-care, team care, general leadership, and health-promoting leadership. Regression analyses found self-care and team care accounted for less burnout even after controlling for rank, PTSD symptoms, and professional stressors. Health-promoting leadership accounted for less burnout even after controlling for these same covariates and general leadership as well. Although a cross-sectional survey, results provide three specific directions for reducing burnout in deployed medical staff. By emphasizing self-care, team care, and health-promoting leadership, policy makers
Fonfrède, Michèle; Couaillac, Jean Paul; Augereau, Christine; Lepargneur, Jean Pierre; Watine, Joseph
Medical practice guidelines (GLs) being tools that are mainly designed to evaluate medical professionals, it sounds logical, and fair, that professionals should in turn evaluate GLs. Microbiology being a medical discipline, we used the AGREE instrument, i.e. an established evaluation tool for GLs, in order to evaluate the quality of two major microbiology guidelines, i.e. the SFM GLs and the ASM GLs). Both guidelines remain sub-optimal in their levels of quality, and obtain scores that are not very different from the average scores obtained by many other guidelines in various medical disciplines. We therefore believe that both guidelines need to be modified before they can be recommended without provisos. A higher degree of multi-disciplinary work, including a more formal implication of methodologists, as well as of infectious disease clinicians, and of economists, might perhaps enable future editions of these guidelines to reach higher levels of quality.
There are no special legal arrangements for the field of aesthetic medicine; rather, the general medico-legal regulations apply although they raise specific questions as far as aesthetic medicine is concerned. Legally, a contract exists between physician and patient which is also applicable to aesthetic medicine. This means that the physician owes the patient only the provision of a proper, non-defective service, but does not need to guarantee that it actually leads to the desired outcome. Before performing a medically non-indicated procedure the physician is obliged to provide the patient with particularly thorough information about this procedure. Various problems and issues are raised by the advertising limitations for medical professionals and the maintenance of the boundaries confining the special field of aesthetic medicine. Medically indicated procedures are suitable for statutory reimbursement if the patient suffers from "physical disfigurement" or somatic complaints that lead to considerable impairment and if there are no other, cheaper treatment options available.
Knox, Shane; Cullen, Walter; Dunne, Colum
As in other countries, the Irish Regulator for Pre-Hospital practitioners, the Pre-Hospital Emergency Care Council (PHECC), will introduce a Continuous Professional Competence (CPC) framework for all Emergency Medical Technicians (EMTs), Paramedics and Advanced Paramedics (APs). This framework involves EMTs participating in regular and structured training to maintain professional competence and enable continuous professional developments. To inform the development of this framework, this study aimed to identify what EMTs consider the optimum educational outcomes and activity and their attitude towards CPC. All EMTs registered in Ireland (n = 925) were invited via email to complete an anonymous online survey. Survey questions were designed based on Continuous Professional Development (CPD) questionnaires used by other healthcare professions. Quantitative and qualitative analyses were performed. Response rate was 43% (n = 399). 84% of participants had been registered in Ireland for less than 24 months, while 59% had been registered EMTs for more than one year. Outcomes were: evidence of CPC should be a condition for EMT registration in Ireland (95%), 78% believed that EMTs who do not maintain CPC should be denied the option to re-register. Although not required to do so at the time of survey, 69% maintained a professional portfolio and 24% had completed up to 20 hours of CPC activities in the prior 12 months. From a list of 22 proposed CPC activities, 97% stated that practical scenario-based exercises were most relevant to their role. E-learning curricula without practical components were considered irrelevant (32%), but the majority of participants (91%) welcomed access to e-learning when supplemented by related practical modules. EMTs are supportive of CPC as a key part of their professional development and registration. Blended learning, which involves clinical and practical skills and e-learning, is the optimum approach.
Navarro-Sandoval, Cleyber; Arones-Guevara, Shermany; Carrera-Palao, Rosa; Casana-Jara, Kelly; Colque-Jaliri, Tomasa
To determine the characteristics of the criminal complaints claining medical professional liability, based on the expert reports issued by the Forensic Examination Division of Lima, Peru. A cross-sectional study was carried out, which included all the expert reports issued between 2005 and 2010 at the Forensic Examination Division of Lima, Peru. A descriptive analysis of each of the variables was performed. 60.3% (495/821) of the criminal complaints for medical professional liability were valued as being in accordance with the lex artis while 16.8% (138/821) were not in accordance with the lex artis. In 13% (107/821) of the cases, conclusions could not be drawn;in 9.9% (81/821) of the cases, the conclusions in the expert report did not include an valuations of the medical act.The cases in which the injury was attributed to the process of the disease itself accounted for 80.9% (502/620), and those in which in the injury was considered a result of the health care received were 19.0% (118/620). The distribution of the cause of the injury based on accordance with the lex artis showed significant differences. In our country, the number of claims for claimed medical liability is increasing, predominantly in relation to surgical specialties, where a medical act is more likely to be considered not in accordance with the lex artis. In addition, in a significant percentage of cases, no conclusions are drawn about the medical act.
Richter Lagha, Regina Anne
Self-report is currently used as an indicator of professional practice in a variety of fields, including medicine and education. Important to consider, therefore, is the ability of self-report to accurately capture professional practice. This study investigated how well professionals' self-reports of behavior agreed with an expert observer's…
Makhni, Eric C; Buza, John A; Byram, Ian; Ahmad, Christopher S
The increased physical demands of professional athletes predispose this patient population to a unique set of injuries typically not seen in the general population. This systematic literature review investigates the nature of injury reporting (both orthopedic and nonorthopedic conditions) in the medical literature of professional athletes in the National Football League (NFL), Major League Baseball (MLB), the National Basketball Association (NBA), and the National Hockey League (NHL). Rigorous reporting of sports injuries helps clinicians better understand disease mechanisms relevant to specific sports. The nature of injury reporting will differ within each professional sport and reflect the anatomic emphasis of each sport. An electronic literature search of all publications addressing injuries and medical conditions among professional athletes in the NFL, MLB, NBA, and NHL was conducted using the Pubmed/Medline, Scopus, and Embase databases through January 2013. Retrieved publications were categorized by journal type, medical type, and area of focus. A total of 536 publications met all inclusion criteria. There were a higher number of articles regarding the NFL (n = 211) and MLB (n = 216) when compared with the NBA (n = 34) or NHL (n = 75). The NFL had significantly more articles addressing nonorthopedic injuries/medical issues than were found with the MLB, NBA, or NHL (109 vs 75, 14, 41, respectively). Both the NFL (33 of 109, 30%) and NHL (6 of 41, 15%) had a relatively high percentage of articles regarding concussions/neurology, and MLB had a relatively high percentage of articles dedicated to vascular medicine (13 of 65, 20%). The proportion of publications dedicated to the knee/lower leg were highest in the NFL (29 of 102, 28%) and NBA (9 of 20, 45%), those dedicated to the shoulder/elbow were highest in MLB (113 of 151, 75%), and those dedicated to the hip/pelvis were highest in the NHL (16 of 34, 47%). The number and type of publications vary among the 4
Fraas, M R; Coughlan, G F; Hart, E C; McCarthy, C
Self-reported concussion rates among U-20 and elite rugby union players in Ireland are 45-48%. Half of these injuries go unreported. Accurate knowledge of concussion signs and symptoms and appropriate management practices among coaches and medical staff is important to improve the welfare of players. Examine concussion knowledge among coaches, and management techniques among medical staff of professional Irish rugby teams. Surveys were administered to 11 coaches and 12 medical staff at the end of the 2010-2011 season. Coaches demonstrated an accurate knowledge of concussion with a good understanding of concussion-related symptoms. Medical staff reported using a variety of methods for assessing concussion and making return-to-play decisions. Reliance on subjective clinical methods was evident, with less reliance on objective postural stability performance. Overall, the coaches in this investigation have accurate knowledge of concussion and medical staff use effective techniques for managing this injury. On-going education is needed to assist coaches in identifying concussion signs and symptoms. It is recommended that medical staff increase their reliance on objective methods for assessment and return-to-play decision making.
Patricia de Oliveira Furukawa
Full Text Available ABSTRACT Objectives: to verify the correlation between the characteristics of professionals and the practice of sustainable actions in the medication processes in an ICU, and to determine if interventions such as training and awareness can promote sustainable practices performed by nursing staff in the hospital. Methods: before-and-after design study using Lean Six Sigma methodology, applied in an intensive care unit. Nursing staff were observed regarding the practice of ecologically sustainable actions during medication processes (n = 324 cases for each group (pre and post-intervention through a data collection instrument. The processes analyzed involved 99 professionals in the pre-intervention phase and 97 in the post-intervention phase. Data were analyzed quantitatively and the association of variables was accomplished by means of statistical inference, according to the nature of the related variables. Results: the education level was the only characteristic that showed to be relevant to an increase in sustainable practices, with a statistically significant difference (p = 0.002. When comparing before and after the intervention, there was an increase in environmentally friendly actions with statistically significant differences (p = 0.001. Conclusions: the results suggest that institutions should encourage and invest in formal education, as well as training of health professionals to promote sustainable practices in the hospital.
Dewhurst, David; Borgstein, Eric; Grant, Mary E; Begg, Michael
The development of online virtual patients has proved to be an effective vehicle for pedagogical and technological skills transfer and capacity building for medical and healthcare educators in Malawi. A project between the University of Edinburgh and the University of Malawi has delivered more than 20 collaboratively developed, virtual patients, contextualised for in-country medical and healthcare education and, more significantly, a cadre of healthcare professionals skilled in developing digital resources and integrating these into their emerging curricula. The process of engaging with new approaches to teaching and delivering personalised, context sensitive content via a game-informed, technology-supported process has contributed to the ability of healthcare educators in Malawi to drive pedagogical change, meet the substantial challenges of delivering new curricula, cope with increasing student numbers and promote teacher professional development. This initial phase of the project has laid the foundation for a broader second phase that focuses on promoting curriculum change, developing educational infrastructure and in-country capacity to create, and integrate digital resources into education and training across multi-professional groups and across educational levels.
Faunce, Thomas; McKenna, Michael; Rayner, Johanna; Hawes, Jazmin
In recent times, Australia's national security concerns have had controversial impacts on regulation of Australian medical practitioners in areas related to immigration detention. This column explores three recent case studies relevant to this issue. The first involves the enactment of the Australian Border Force Act 2015 (Cth), which has a significant impact on the regulation of medical professionals who work with people in immigration detention. The second involves the decision of the High Court of Australia in Plaintiff M68/2015 v Minister for Immigration and Border Protection  HCA 1 that an amendment to Australian federal legislation justified sending children back to immigration detention centres in Papua New Guinea and Nauru. This legislation was previously heavily criticised by the Australian Human Rights Commissioner. The third concerns the deregistration of Tareq Kamleh, an Australian doctor of German-Palestinian heritage who came to public attention on ANZAC Day 2015 with his appearance online in a propaganda video for the Islamic State terrorist organisation al-Dawla al-Islamyia fil Iraq wa'al Sham, also known as Islamic State of Iraq and Syria (ISIS) or Daesh. Australia's professional regulatory system should presumptively respect professional virtues, such as loyalty to the relief of individual patient suffering, when dealing with doctors (whether in Australia or ISIS-occupied Syria) working under regimes whose principles appear inconsistent with those of ethics and human rights.
Melo, Francisca A. de; Victor Filho, Edgard; Silva, Carla V. da; Santos, Tayline T. dos; Guerra, Decio C.
The objective of this study is to evaluate the medical exposure to ionizing radiation of X type in a interventional radiology service, of an university hospital, making a correlation with the importance of using dosimeters for monitoring the effective dose in individuals occupationally exposed (IOE). It was performed an analysis of radiation doses in two stages: the first there was not guidance on the need of using dosimeters; in the second time the professionals performed all procedures carrying the dosimeter. The result showed an average effective dose of professionals / year of 8.60 mSv at first moment, against a dose of 27.41 mSv in the second time after the routine of use the dosimeters, surpassing, in this second phase, the annual dose rate allowed by current radiation protection legislation, which calls for 20 mSv / year for professional. The comparison result in an increase of effective dose of professionals in nearly 300%. It is concluded that the implementation a continuing education project, including awareness of the importance in daily use dosimeter, shows up as a solution for optimizing the dose of these occupationally exposed individuals
Vossen, M.; Peerdeman, S.; Kleinveld, J.; Kusurkar, R.A.
Background: Training of doctors in The Netherlands seeks to develop clinical competences including professional behaviour. Behaving as a professional is not just a desirable trait but a clearly stated requirement for doctors and medical students. Results: We designed an educational theme,
Sami Abdo Radman Al-Dubai
Full Text Available This study was the first to explore factors associated with emotional burnout (EB among medical residents in Malaysia. A cross-sectional study was conducted in a universal sample of 205 medical residents in a Malaysian general hospital. The self-administered questionnaire used consisted of questions on sociodemographics and work characteristics, sources of job stress, professional fulfillment, engagement, and EB. EB was measured using the emotional exhaustion subscale, the Maslach Burnout Inventory (MBI. Mean (±SD age of the respondents was 26.5 (±1.6. The most common source of job stress was “fear of making mistakes.” Most of the participants were dissatisfied with the increase of residentship period from one year to two years. A high level of EB was reported by 36.6% of the respondents. In multivariate analysis, the most important correlates of EB were sources of job stress, professional fulfillment, and engagement. A high prevalence of EB was found among medical residents. Sociodemographic characteristics, performance pressure, and satisfaction with policies were significantly associated with EB. Although this study was limited by its cross-sectional design, its findings posit a sufficient foundation to relevant authorities to construct, amend, and amalgamate existing and future policies.
The Core Entrustable Professional Activities for Entering Residency (Core EPAs) have taken a strong hold on undergraduate medical education (UME). This Perspective questions their value added and considers the utility of the Core EPAs along two separate dimensions: (1) the ways they change the content and focus of the goals of UME; and (2) the extent to which entrustable professional activity (EPA)-based assessment conforms to basic principles of measurement theory as practiced in the social sciences. Concerning content and focus, the author asks whether the 13 Core EPAs frame UME too narrowly, putting competencies into the background and overlooking certain aspirational, but important and measurable, objectives of UME. The author also discusses the unevenness of EPAs in terms of their breadth and their developmental status as core activities. Regarding measurement and assessment, the author raises concerns that the EPA metric introduces layers of inference that may cause distortions and hinder accuracy and rater agreement. In addition, the use of weak anchors and multidimensional scales is also of concern. The author concludes with a proposal for reframing the Core EPAs and Accreditation Council for Graduate Medical Education competencies into broadly defined sets of behaviors, referred to as "Tasks of Medicine," and calls for the development of a systematic and longitudinal research agenda. The author asserts that "slowing down when you should" applies to medical education as well as patient care, and calls for a reevaluation of the Core EPAs before further commitment to them.
Full Text Available The study aimed at evaluating the personal and professional development (PPD module in the undergraduate medical curriculum in Melaka Manipal Medical College, India. PPD hours were incorporated in the curriculum. A team of faculty members and a faculty coordinator identified relevant topics and students were introduced to topics such as medical humanities, leadership skills, communication skills, ethics, professional behavior, and patient narratives. The module was evaluated using a prevalidated course feedback questionnaire which was administered to three consecutive batches of students from March 2011 to March 2013. To analyze faculty perspectives, one to one in-depth interviews and focus group discussions were conducted by the coordinators with faculty members who conducted the PPD classes. Analysis of the course feedback form revealed that majority (80% of students agreed that the module was well prepared and was "highly relevant" to the profession. Faculty found the topics new and interdisciplinary and there was a sense of sharing responsibility and workload by the faculty. PPD modules are necessary components of the curriculum and help to mould students while they are still acquiescent as they assume their roles as doctors of the future.
Patient access to health information and patient-provider communication is integral to medicine, and can be facilitated by mobile applications ("apps"). Traditionally, student training in mobile Health (mHealth) has focussed on health professionals as consumers of information, with negative impacts on the quality and value of medical apps. This study focuses on teaching medical students to develop their own medical apps. At Sultan Qaboos University, Oman, an app development environment, iBuildApp, was taught to medical students and used to develop their first apps. Students were surveyed on their perceptions of the project. Of the 166 students, 107 (64.5%) completed the survey. There was an increase in the perceived need for such learning, apps were aimed primarily at patients, and previous programming experience was the strongest influencer of a positive experience. A majority (77.6%) wanted more sophisticated development environments in spite of their apparent struggles. The impact of previous experience is similar to other studies; the perceived value and focus on patient apps is indicative of an awareness of patients' use of the devices not reflected in all literature. It is possible to teach medical students the fundamentals of app design so that they may contribute to app development in the future.
Lutz, Gabriele; Pankoke, Nina; Goldblatt, Hadass; Hofmann, Marzellus; Zupanic, Michaela
Professional competence is important in delivering high quality patient care, and it can be enhanced by reflection and reflective discourse e.g. in mentoring groups. However, students are often reluctant though to engage in this discourse. A group mentoring program involving all preclinical students as well as faculty members and co-mentoring clinical students was initiated at Witten-Herdecke University. This study explores both the attitudes of those students towards such a program and factors that might hinder or enhance how students engage in reflective discourse. A qualitative design was applied using semi-structured focus group interviews with preclinical students and semi-structured individual interviews with mentors and co-mentors. The interview data were analyzed using thematic content analysis. Students' attitudes towards reflective discourse on professional challenges were diverse. Some students valued the new program and named positive outcomes regarding several features of professional development. Enriching experiences were described. Others expressed aversive attitudes. Three reasons for these were given: unclear goals and benefits, interpersonal problems within the groups hindering development and intrapersonal issues such as insecurity and traditional views of medical education. Participants mentioned several program setup factors that could enhance how students engage in such groups: explaining the program thoroughly, setting expectations and integrating the reflective discourse in a meaningful way into the curriculum, obliging participation without coercion, developing a sense of security, trust and interest in each other within the groups, randomizing group composition and facilitating group moderators as positive peer and faculty role models and as learning group members. A well-designed and empathetic setup of group mentoring programs can help raise openness towards engaging in meaningful reflective discourse. Reflection on and communication of
Brunot, Alain; Thompson, Céline
A cross-sectional study was conducted with a sample of 278 health professionals (GPs and specialists, dentists, physical therapists and nurses) in a private medical practice in Paris to study the medical waste management practices related to the production and disposal of potentially hazardous health care waste. With the exception of physical therapists, most professionals produced medical waste (72% to 96,2% according to occupation), with a monthly median of 3 liters (inter-quartile range 1-15 liters). All sharp objects and needles were separated and 91% of them eliminated via a specific process for that sector. These percentages were respectively 84% and 69% concerning contaminated waste that was neither needles or used for cutting. 48% of the professionals reported the existence of documents that could track the disposal of their medical waste. To improve practice, professionals cited collection on-site at the office (74%) and reliability of the contracted service provider to collect the waste (59%). The study showed that health professionals need information on the regulations regarding potentially infectious medical waste, in particular on the traceability of its elimination. They also noted the lack of clarity and precision with regard to the definition of risk of infection: 31,7% of professionals only declare the production of sharp or cutting waste without having specified criteria for risk of infection.
Boyer, L; Renaud, M-H; Baumstarck-Barrau, K; Fieschi, M; Samuelian, J-C
The potential benefits of the application of an electronic medical record (EMR) in medical care are well recognized. However, if these benefits are to be accomplished, professionals must adopt and utilize EMR as a part of their practice. The aim of this study was to assess the evolution of the health care professionals' opinions of EMR and their use on a period of 1 year in a French Public Psychiatric Hospital. Our institution is a 204-bed psychiatric hospital, employing 328 professionals and comprising three sectors: six units of complete hospitalisation (102 beds), one unit of week hospitalisation (15 beds), one unit of emergency (seven beds) and one unit of night hospitalisation (15 beds). Three extrahospital structures include the day hospitalisation (65 places), the medicopsychological centres (CMP) and the part-time therapeutic reception centres (CATTP) of the three sectors. We conducted face-to-face, semi-structured interviews with health care professionals of a public psychiatric hospital on two occasions: 1 month after the establishment of the EMR (t0) and one year later (t1). All the solicited people agreed to participate in the investigation. The interviews were conducted until no new ideas emerged in the content analysis performed in real time, comprising 60 care professionals at t0 (10 psychiatrists, 42 nurses and eight paramedical professionals) and 55 at t1 (six psychiatrists, 42 nurses and seven paramedical professionals). Content analysis was performed by two members of the steering committee who were skilled in textual analysis. A descriptive analysis was also performed. The variables were described by proportions and means. The proportions were compared using the Chi-squared test or Fisher exact test where appropriate. A two-tailed p-value of greater than 0.05 was considered to indicate statistical significance. Statistical analyses were carried out using SPSS version. The proportion of EMR use remained stable and high (respectively 97% in 2007
[Work and Training Conditions of Young German Physicians in Internal Medicine - Results of a Second Nationwide Survey by Young Internists from the German Society of Internal Medicine and the German Professional Association of Internists.
Raspe, Matthias; Vogelgesang, Anja; Fendel, Johannes; Weiß, Cornelius; Schulte, Kevin; Rolling, Thierry
Medical specialty training is the basis for career development of young internists and it is vital for the delivery of high-quality medical care. In 2014 the young internists of two professional bodies in Germany conducted a survey among their young members and described major factors influencing training and working conditions. We present the results of a follow-up survey to describe changes of these factors over time. An additional focus is set on the difficulties of balancing medical career and family. In the end of 2016 we conducted an online-based survey of all members in training of the German Society of Internal Medicine (DGIM) and the Professional Association of German Internists (BDI). The questionnaire used in the 2014 survey was modified and items investigating the balance between career and family were added. A total of 1587 questionnaires were returned and analysed. Mayor findings did not change over time. Psychosocial strain remains very high among medical trainees in internal medicine. A structured training curriculum and meaningful feedback are associated with lower psychosocial strain and higher work satisfaction. Internists - and here especially women - with children experience the daily balance of medical career and family as extremely challenging. These results demonstrate that there is still a serious need for adjusting training and working conditions of young internists in Germany. Especially the role and increasing importance of female physicians has to be recognized by enabling a successful integration of medical career and family. © Georg Thieme Verlag KG Stuttgart · New York.
Shnier, Adrienne; Lexchin, Joel
Professional medical associations (PMAs) play a crucial role in providing accredited continuing medical education (CME) to physicians. Funding from the pharmaceutical industry may lead to biases in CME. This study examines publicly available policies on CME, adopted by Canadian PMAs as of December 2015. Policies were evaluated using an original scoring tool comprising 21 items, two questions about PMAs' general and CME funding from industry, and three enforcement measures. We assessed 236 policies adopted by Canadian PMAs (range, 0 to 32). Medical associations received summative scores that ranged from 0% to 49.2% of the total possible points (maximum score = 63). Twenty-seven associations received an overall score of 0%. The highest mean scores were achieved in the areas of industry involvement in planning CME activities (mean: 1.1/3), presence of a review process for topics of CME activities (mean: 1.1/3), content review for balanced information (mean: 1.1/3), and responsibility of distribution of funds (mean: 1.0/3). The lowest mean scores were achieved in the areas of awards (mean: 0.0/3), industry personnel, representatives, and employees (mean: 0.1/3), distribution of industry-funded educational materials at CME activities (mean: 0.1/3), and distinction between marketing and educational materials (mean: 0.1/3). These results suggest that Canadian PMAs' publicly available policies on industry involvement in CME are generally weak or non-existent; therefore, the accredited CME that is provided to Canadian physicians may be viewed as open to bias. We encourage all Canadian medical associations to strengthen their policies to avoid the potential for industry influence in CME.
Nie, Jing-Bao; Cheng, Yu; Zou, Xiang; Gong, Ni; Tucker, Joseph D; Wong, Bonnie; Kleinman, Arthur
To investigate the phenomenon of patient-physician mistrust in China, a qualitative study involving 107 physicians, nurses and health officials in Guangdong Province, southern China, was conducted through semi-structured interviews and focus groups. In this paper we report the key findings of the empirical study and argue for the essential role of medical professionalism in rebuilding patient-physician trust. Health professionals are trapped in a vicious circle of mistrust. Mistrust (particularly physicians' distrust of patients and their relatives) leads to increased levels of fear and self-protection by doctors which exacerbate difficulties in communication; in turn, this increases physician workloads, adding to a strong sense of injustice and victimization. These factors produce poorer healthcare outcomes and increasingly discontented and angry patients, escalate conflicts and disputes, and result in negative media coverage, all these ultimately contributing to even greater levels of mistrust. The vicious circle indicates not only the crisis of patient-physician relationship but the crisis of medicine as a profession and institution. Underlying the circle is the inherent conflict of interest in the healthcare system by which health professionals and hospitals have become profit-driven. This institutional conflict of interest seriously compromises the fundamental principle of medical professionalism-the primacy of patient welfare-as well as the traditional Chinese ideal of "medicine as the art of humanity". Patient trust can be restored through rectifying this institutional conflict of interest and promoting medical professionalism via a series of recommended practical measures. © 2017 John Wiley & Sons Ltd.
Anisa Ahmad, MSc
awareness related to culture, society, and politics. A positive outcome of the CFCS program was found to be its fostering of research skills, which is related to the use of epidemiology and research methods. Conclusion: The findings indicate that the CFCS program promotes PID among medical students. The current data highlight and provide insights into the importance of integrating CBE into medical curricula to prepare future doctors for their entry into the profession. الكلمات المفتاحية: المعتمد على المجتمع, الهوية المهنية, الوعي السياسي, طلاب الطب, النوعي, Keywords: Community-based education, Medical students, Political awareness, Professional identity, Qualitative study
The current discussions surrounding the German health care system are being determined and defined by the concepts of "profitability", "efficiency" and "saving". These concepts also determine the demands made on this system and have had an effect on the medical profession. The economy's growing influence on physicians' decision-making and the increasing necessity to look at and regulate services under economic aspects arising from the need to save costs are seen by the medical profession as a threat to its autonomous conduct and freedom to make decisions, in other words it sees it as a danger to its medical orientation. Conflicts between medical autonomy and economic orientation in physicians' conduct are therefore already foreseeable, as are conflicts between medicine and economy in regards to who has the power to define the terms of the public health system. This article will outline the area of conflict based on the available literature. It will discuss how the political and economic regulatory attempts affect the medical profession's autonomous conduct. It will also discuss which conflicts of conduct emerge for physicians, what types of solutions the medical profession tends to develop as a reaction, and whether or not this tension between medical and economic orientation can be resolved in an acceptable way. This article should first outline the changed economic and political basic conditions and the attempts to reform the German health care system, using this as a starting point. Following this, it will explore the significance professional autonomy acquires within the concept of profession from the point of view of the sociology of professions. With this in mind, the third part of this article will describe and analyze the effects of advanced economization on the medical profession's autonomous conduct, which has long been regarded as uncontested. This part of the article will also describe and analyze the medical profession's strategies it uses to defend
The current discussions surrounding the German health care system are being determined and defined by the concepts of "profitability", "efficiency" and "saving". These concepts also determine the demands made on this system and have had an effect on the medical profession. The economy's growing influence on physicians' decision-making and the increasing necessity to look at and regulate services under economic aspects arising from the need to save costs are seen by the medical profession as a threat to its autonomous conduct and freedom to make decisions, in other words it sees it as a danger to its medical orientation. Conflicts between medical autonomy and economic orientation in physicians' conduct are therefore already foreseeable, as are conflicts between medicine and economy in regards to who has the power to define the terms of the public health system. Objective: This article will outline the area of conflict based on the available literature. It will discuss how the political and economic regulatory attempts affect the medical profession's autonomous conduct. It will also discuss which conflicts of conduct emerge for physicians, what types of solutions the medical profession tends to develop as a reaction, and whether or not this tension between medical and economic orientation can be resolved in an acceptable way. Methodology: This article should first outline the changed economic and political basic conditions and the attempts to reform the German health care system, using this as a starting point. Following this, it will explore the significance professional autonomy acquires within the concept of profession from the point of view of the sociology of professions. With this in mind, the third part of this article will describe and analyze the effects of advanced economization on the medical profession's autonomous conduct, which has long been regarded as uncontested. This part of the article will also describe and analyze the medical profession
Harmon, Kimberly G; Drezner, Jonathan A; Gammons, Matthew; Guskiewicz, Kevin M; Halstead, Mark; Herring, Stanley A; Kutcher, Jeffrey S; Pana, Andrea; Putukian, Margot; Roberts, William O
PURPOSE OF THE STATEMENT: ▸ To provide an evidence-based, best practises summary to assist physicians with the evaluation and management of sports concussion. ▸ To establish the level of evidence, knowledge gaps and areas requiring additional research. ▸ Sports medicine physicians are frequently involved in the care of patients with sports concussion. ▸ Sports medicine physicians are specifically trained to provide care along the continuum of sports concussion from the acute injury to return-to-play (RTP) decisions. ▸ The care of athletes with sports concussion is ideally performed by healthcare professionals with specific training and experience in the assessment and management of concussion. Competence should be determined by training and experience, not dictated by specialty. ▸ While this statement is directed towards sports medicine physicians, it may also assist other physicians and healthcare professionals in the care of patients with sports concussion. ▸ Concussion is defined as a traumatically induced transient disturbance of brain function and involves a complex pathophysiological process. Concussion is a subset of mild traumatic brain injury (MTBI) which is generally self-limited and at the less-severe end of the brain injury spectrum. ▸ Animal and human studies support the concept of postconcussive vulnerability, showing that a second blow before the brain has recovered results in worsening metabolic changes within the cell. ▸ Experimental evidence suggests the concussed brain is less responsive to usual neural activation and when premature cognitive or physical activity occurs before complete recovery the brain may be vulnerable to prolonged dysfunction. ▸ It is estimated that as many as 3.8 million concussions occur in the USA per year during competitive sports and recreational activities; however, as many as 50% of the concussions may go unreported. ▸ Concussions occur in all sports with the highest incidence in football, hockey
Dyrbye, Liselotte N; Harper, William; Moutier, Christine; Durning, Steven J; Power, David V; Massie, F Stanford; Eacker, Anne; Thomas, Matthew R; Satele, Daniel; Sloan, Jeff A; Shanafelt, Tait D
Although burnout is associated with erosion of professionalism and serious personal consequences, whether positive mental health can enhance professionalism and how it shapes personal experience remain poorly understood. The study simultaneously explores the relationship between positive mental health and burnout with professionalism and personal experience. The authors surveyed 4,400 medical students at seven U.S. medical schools in 2009 to assess mental health (categorized as languishing, moderate, and flourishing) and burnout. Additional items explored professional behaviors, beliefs, suicidal ideation, and serious thoughts of dropping out. A total of 2,682/4,400 (61%) responded. Prevalence of suicidal ideation (55/114 [48.2%], 281/1,128 [24.9%], and 127/1,409 [9.1%]) and serious thoughts of dropping out (15/114 [13.2%], 30/1,128 [2.7%], and 14/1,409 [1.0%]) decreased as mental health improved from languishing, moderate, and flourishing, respectively (all P mental health persisted independent of burnout (all P mental health improved, the prevalence of unprofessional behaviors (i.e., cheating and dishonest behaviors) also declined, whereas students' altruistic beliefs regarding physicians' responsibility toward society improved. For example, 33/113 (29.2%), 426/1,120 (38.0%), and 718/1,391 (51.6%) of students with languishing, moderate, and flourishing mental health endorsed all five altruistic professional beliefs (P mental health persisted among students with burnout, whereas fewer relationships were found among students without burnout. Findings suggest that positive mental health attenuates some adverse consequences of burnout. Medical student wellness programs should aspire to prevent burnout and promote mental health.
Suess, Amets; Ruiz Pérez, Isabel; Ruiz Azarola, Ainhoa; March Cerdà, Joan Carles
The recent publication of the Royal Decree-Law 16/2012 (RDL 16/2012), which introduces structural changes in the Spanish Public Healthcare System, can be placed in the broader context of budgetary adjustments in response to the current economic crisis. An analysis of the interrelationships among economic crisis, healthcare policies, and health reveals that citizen participation is one of several potential strategies for reducing the impact of this situation on the population. This observation raises the interest to know the citizens' perspectives on the modifications introduced by the RDL 16/2012. Narrative review of documents related to the RDL 16/2012 published by civil society organizations and professional associations in the Spanish context. A broad citizen response can be observed to the introduction of RDL 16/2012. The documents reviewed include an analysis of changes in the healthcare model inherent to the RDL 16/2012, as well as predictions on its impact on access to healthcare, healthcare quality, and health. The civil society organizations and professional associations offer recommendations and proposals, as well as collaboration in elaborating alternative strategies to reduce costs. The response of civil society organizations and professional associations underscores the importance of strengthening citizen participation in the development of healthcare policies aimed at maintaining the universal character and sustainability of the Spanish Public Healthcare System in the current moment of economic and systemic crisis. Copyright © 2014 SESPAS. Published by Elsevier Espana. All rights reserved.
Bringedal, Berit; Isaksson Rø, Karin; Magelssen, Morten; Førde, Reidun; Aasland, Olaf Gjerløv
We present and discuss the results of a Norwegian survey of medical doctors' views on potential ethical dilemmas in professional practice. The study was conducted in 2015 as a postal questionnaire to a representative sample of 1612 doctors, among which 1261 responded (78%). We provided a list of 41 potential ethical dilemmas and asked whether each was considered a dilemma, and whether the doctor would perform the task, if in a position to do so. Conceptually, dilemmas arise because of tensions between two or more of four doctor roles: the patient's advocate, a steward of societal interests, a member of a profession and a private individual. 27 of the potential dilemmas were considered dilemmas by at least 50% of the respondents. For more than half of the dilemmas, the anticipated course of action varied substantially within the professional group, with at least 20% choosing a different course than their colleagues, indicating low consensus in the profession. Doctors experience a large range of ethical dilemmas, of which many have been given little attention by academic medical ethics. The less-discussed dilemmas are characterised by a low degree of consensus in the profession about how to handle them. There is a need for medical ethicists, medical education, postgraduate courses and clinical ethics support to address common dilemmas in clinical practice. Viewing dilemmas as role conflicts can be a fruitful approach to these discussions. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Waddington, I; Roderick, M
To examine the ways in which confidential matters are dealt with in the context of the relationship between the club doctor (or physiotherapist) and the player as patient in English professional football clubs. Semistructured tape recorded interviews with 12 club doctors, 10 club physiotherapists, and 27 current and former players. A questionnaire was also sent to 90 club doctors; 58 were returned. There is among club doctors and physiotherapists no commonly held code of ethics governing how much and what kind of information about players may properly be passed on to managers; associated with this, there is considerable variation from one club to another in terms of the amount and kind of information passed on to managers. In some clubs, medical staff attempt to operate more or less on the basis of the rules governing confidentiality that apply in general practice, but in other clubs, medical staff are more ready to pass on personal information about players. In some situations, this raises serious ethical questions. Guidelines dealing with confidentiality in practitioner-patient relationships in medical practice have long been available and have recently been restated, specifically in relation to the practice of sports medicine, by the British Olympic Association, the British Medical Association, and the Football Association. This is a welcome first step. However, if the guidelines are to have an impact on practice, detailed consideration needs to be given to ensuring their effective implementation; if this is to be achieved, consideration also needs to be given to identifying those aspects of the culture and organisation of professional football clubs that may hinder the full and effective implementation of those guidelines.
Witman, Yolande; van den Kerkhof, Peter C M; Braat, Didi D M
In the current system for guaranteeing quality of care, emphasis is placed firmly on external control of professionals. We looked for a way to appeal to the intrinsic motivation of medical professionals and to discover what they mean by 'good work'. This was achieved with the aid of reflective sessions using the toolkit 'Good Work': in four sessions three different groups of medical professionals (medical department chairs, residents and interns) from a Dutch university hospital reflected on the topics 'excellence', 'moral responsibility' and 'personal engagement'. The participants exchanged practice-based stories during the sessions. The most important theme was moral responsibility, with its accompanying dilemmas. The sessions gave rise to feelings of mutual acknowledgement, recognition, inspiration and motivation. Sharing meaningful practice-based stories can be considered as a 'moment of learning', strengthening professional identity and stimulating intrinsic motivation. More space for this form of reflection might restore the balance with external control systems.
Herdeiro, María T; Polonia, Jorge; Gestal-Otero, Juan J; Figueiras, Adolfo
The spontaneous reporting of adverse drug reactions (ADRs) through the yellow card and made concrete by the knowledge and attitudes of doctors, has been rousing a great deal of bibliographical interest in recent years. However, there does not seem to be any actual revision in the theme on which the theoretical models that explain the process of decision in reporting are proposed. In this work an explanatory model of the factors that condition reporting is proposed and a revision of the literature on the subject has also been carried out. The proposed model is centralized in the medical professional and it considers the habit of reporting as the result of the doctor's formation and his interaction with the environment. The combination of knowledge-attitudes-practices and the theory of the satisfaction of needs seemed very adequate for ADR systematization. The results also indicate that, to improve the participation of health professionals in surveillance systems through spontaneous reporting, it might be necessary to design combined strategies that modify both intrinsic (knowledge, attitudes) and extrinsic (relationship between health professionals and their patients, the national health system and pharmaceutical companies) factors.
The purpose of this qualitative study was to identify the complex issues facing Asian/Pacific Islander (API) women students at one Midwestern medical school as they subjectively experience their medical training. Of particular interest was how students navigated family influences, career planning, and ethnic and gender stereotypes. Sixty-five percent of the students reported that their parents exerted various degrees of encouragement or pressure to enter medicine. The remaining students said that the decision was entirely theirs (20%) or that the decision had been made for them (15%). Many reported the larger Asian "community" as a source of influence. A slight majority of students thought they were perceived by faculty as being "quiet," often too quiet. With only 1 exception, all of the students believed that their cultural identity influenced their specialty choice. Stressors reported by students centered on competition, achievement, and formation of intimate relationships (i.e., dating). Medical educators who provide personal and professional support for API women students should be keenly aware of the career, gender, and family issues that emerge at the intersection of API and Euro-American cultures. Faculty development should include an educational component on issues of concern to API students, men and women. Faculty also need to wrestle with the cultural values of "modesty, respect for authority, public self-consciousness, and other directness" as they intersect with assertion as a primary value found in Euro-American culture in general and in medical education in particular.
Full Text Available Abstract Introduction This paper compares the socioeconomic profile of medical students registered at the Faculty of Medicine of Universidade Eduardo Mondlane (FM-UEM, Maputo, for the years 1998/99 and 2007/08. Case study The objective is to describe the medical students' social and geographical origins, expectations and perceived difficulties regarding their education and professional future. Data were collected through questionnaires administered to all medical students. Discussion and evaluation The response rate in 1998/99 was 51% (227/441 and 50% in 2007/08 (484/968. The main results reflect a doubling of the number of students enrolled for medical studies at the FM-UEM, associated with improved student performance (as reflected by failure rates. Nevertheless, satisfaction with the training received remains low and, now as before, students still identify lack of access to books or learning technology and inadequate teacher preparedness as major problems. Conclusions There is a high level of commitment to public sector service. However, students, as future doctors, have very high salary expectations that will not be met by current public sector salary scales. This is reflected in an increasing degree of orientation to double sector employment after graduation.
Ferrinho, Paulo; Fronteira, Inês; Sidat, Mohsin; da Sousa, Fernando; Dussault, Gilles
This paper compares the socioeconomic profile of medical students registered at the Faculty of Medicine of Universidade Eduardo Mondlane (FM-UEM), Maputo, for the years 1998/99 and 2007/08. The objective is to describe the medical students' social and geographical origins, expectations and perceived difficulties regarding their education and professional future. Data were collected through questionnaires administered to all medical students. The response rate in 1998/99 was 51% (227/441) and 50% in 2007/08 (484/968).The main results reflect a doubling of the number of students enrolled for medical studies at the FM-UEM, associated with improved student performance (as reflected by failure rates). Nevertheless, satisfaction with the training received remains low and, now as before, students still identify lack of access to books or learning technology and inadequate teacher preparedness as major problems. There is a high level of commitment to public sector service. However, students, as future doctors, have very high salary expectations that will not be met by current public sector salary scales. This is reflected in an increasing degree of orientation to double sector employment after graduation.
The growing number of foreign applicants looking forward to getting education in Ukrainian medical universities makes us find the ways how to improve and make effective the pre-professional training system of foreign medical applicants for further education. The article deals with the issues of the history of formation and development of the…
Varekamp, Inge; Haafkens, Joke A.; Detaille, Sarah I.; Tak, Paul P.; van Dijk, Frank J. H.
OBJECTIVE: To compare the perspectives of employees with rheumatoid arthritis (RA) with those of medical professionals regarding what persons with RA need to prevent work disability. METHODS: Concept mapping was conducted in a group session with 21 employees and by mail with 17 medical
Kessler, Christian S; Michalsen, Andreas; Holler, Sophie; Murthy, Vijayendra S; Cramer, Holger
The aim of this survey was to examine differences in personality profiles among 198 vegan (n = 64; 32.3%), vegetarian (n = 78; 39.4%) and omnivore (n = 55; 27.8%) medical professionals. Outcomes were motives for the nutritional approaches, WHO QoL-BREF, Big Five SOEP Inventory, Portraits Value Questionnaire, and Empathizing Scale. Regarding motives for particular diets, omnivores rated influence of guardians (p vegans and vegetarians. Vegans and vegetarians consumed less coffee (p = 0.007) and alcohol compared to omnivores (p = 0.017). The duration of adhering to a specific diet was significantly shorter in vegans. Data suggest that vegan medical professionals do not differ from vegetarians or omnivores regarding empathy, values or personality traits. Differences to a related internet sample were observed for a number of outcomes. Given the small sample size and potential selection bias through the specific subpopulation attending a plant-based nutrition conference, further studies are warranted to confirm these results. Particularly, potential reciprocities between empathy and individual nutritional choices deserve further attention.
Sumerall, S W; Oehlert, M E; Trent, D D
Vertical integration in medical settings typically involves the merging of independent physicians, physician groups, and hospitals to render an organized health care network. Such systems are considered to be vertical, as they may allow for a seamless continuation of services throughout the range of needs a patient may require. Mergers often result in the redefining of professional services offered in the acquired facility or across the network. As such, mergers have the potential of adversely impacting psychological practices. Professional psychology needs to take a proactive stance in this changing health care landscape. Research regarding empirically validated treatments and effects of psychological interventions on overall health-care costs needs to be properly disseminated to health care administrators to assure their knowledge of the utility of psychological services in the medical setting. Training psychologists to assume leadership positions in health-care institutions, gaining representation on hospital staff boards, and linking psychologists and physicians through collaborative training, to provide improved care, may allow for psychology to influence health care delivery.
Brenner, Judith; Bird, Jeffrey; Ginzburg, Samara B; Kwiatkowski, Thomas; Papasodero, Vincent; Rennie, William; Schlegel, Elisabeth; Ten Cate, Olle; Willey, Joanne M
Two dominant themes face medical education: developing integrated curricula and improving the undergraduate medical education (UME) to graduate medical education (GME) transition. An innovative solution to both of these challenges at the Zucker School of Medicine has been the application of the cognitive apprenticeship framework in requiring emergency medical technician (EMT) certification during the first course in medical school as the core on which to build an integrated curriculum and provide entrustable clinical skills. Beginning with the Class of 2011, student feedback about the short-term impact of the experience was collected annually. In addition, perceptions of near graduates and alumni were surveyed in 2017 to explore the long-term impact of the experience. Theme analysis was conducted via inductive coding. Both first-year and more experienced learners report the value of the EMT curriculum as an integrated component of the first course of medical school. Reported positive long-term impacts included the first-hand observation of social determinants of health and interprofessionalism. Negative comments by early learners focused on course logistics, whereas older learners recalled the variability of clinical experiences during ambulance runs. The integration of the EMT curriculum as a core component of the first course serves multiple purposes: 1) it provides the foundation of a spiral learning approach; 2) it contextualizes the basic sciences within clinical practice; 3) it provides opportunities for students to engage in authentic clinical activities under the guidance of mentors; 4) it introduces students to the interdisciplinary nature of medicine; and 5) it serves as the first entrustable professional activity (EPA) for our students.
Robakowska, Marlena; Tyrańska-Fobke, Anna; Walkiewicz, Maciej; Tartas, Małgorzata
The goal of this paper is to verify the correlations between adaptive and maladaptive perfectionism and the selected demographic and job characteristics vs. professional burnout among medical laboratory scientists in Poland. The study group consisted of 166 laboratory scientists. The Polish Adaptive and Maladaptive Perfectionism Questionnaire (Szczucka) was used for testing perfectionism. The Oldenburg Burnout Inventory was used for examining burnout syndrome. Adaptive perfectionism was positively and maladaptive perfectionism was negatively correlated with both aspects of professional burnout: the disengagement from work and exhaustion. What is more, maladaptive perfectionism was correlated negatively with age and work experience. People in relationships have a higher level of disengagement and a higher level of exhaustion than single ones. The results of hierarchical regression analyses have revealed, after having controlled selected demographic and job factors, that a significant predictor of disengagement is the high level of adaptive perfectionism and low level of maladaptive perfectionism. In addition, a significant predictor of high level of exhaustion is the low level of maladaptive perfectionism. Professional burnout among medical laboratory scientists is of a specific nature. The "healthier" perfectionism they reveal, the higher level of burnout they present. In this profession, lower risk of burnout is represented by those who are characterized by the lack of confidence in the quality of their actions and a negative reaction to their own imperfections associated with imposed social obligation to be perfect. The individuals pursuing their internal high standards experience burnout faster. Med Pr 2018;69(3):253-260. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.
Zhu, Wei; Wang, Lijie; Yang, Chengshang
In the medical practice in China, giving and taking "red envelopes" (monetary gifts) is a common phenomenon although few openly admit it. This paper, based on our empirical study including data collected from interviews and questionnaires with medical professionals and patients, attempts to explore why "red envelopes" have become a serious problem in the physician-patient relationship and how the situation can be improved. Previous studies show that scholars tend to correlate the spread of "red envelopes" in health care sector to the commercialization trend, the general erosion of traditional values, and the lowering of the moral level in the medical field. However, in this paper, the authors argue that medical professionals' choice of taking "red envelopes" is actually more a way to compensate for their problematic self-image and marred dignity in real practice. Medical professionals in China as a whole are in an embarrassing situation where the work pressure and income, and the sense of pride that used to be part of their profession are not comparable to each other. Under this circumstance, we believe that the effective way to deal with the "red envelopes" issue does not lie solely in introducing more stringent regulations or granting medical professionals higher payments, but rather in protecting and enhancing the professional dignity of all those working in healthcare. And on top of that, there must also be effort to cultivate a more favorable moral environment. © 2017 John Wiley & Sons Ltd.
Systematic observations regarding techniques of medical career-socialization has hardly ever appeared in Hungarian technical literature yet. Focusing on the need for practical medical training the author elaborated a career-socialization program consisting of a three-level, three-branch training technique. This consisted of a Junior Bálint-group, an imaginative visualization technique, and an expressive, drama-pedagogical working method completed with a projective technique. This career-socialization program focuses on the physician's personality, capability-expansion in relationship management, and practicing a set of professional behavior-roles. During the empirical observations connected to the work the author examined medical students' patient-representation, their relation to the patients, and the development of the physician's professional character. Within the frames of this three-level, three-branch training technique program it enables us to observe which training technique is able to reveal all those psychological qualities that can contribute to the conformation of the representations, thus to the process of career-socialization in the most effective way. The content-analyses of the cases of Junior Bálint-groups (n = 60) revealed that the most frequent problems are fear of intimacy, of bodily contact, communication with patients in a chronic or terminal state, and the fear of medical practice. The content-analyses of imaginary patient-images (n = 62) with Rorschach-signs confirmed that the psychological burdens mentioned above are the most serious problems for medical students. The process-, and content-analyses of drama-games, the integrative healing contact training groups (n = 74) showed that group work primarily intensifies the relationship responsiveness, the ability to adopt the other's (the patient's) viewpoints, and enables an involuntary and distressless identification with the patient and the physician, both agents in the healing relationship
Rua, Melissa Jo
The present study examined the understandings held by 5th, 8th, and 11th-grade students, their teachers and medical professionals about germs. Specifically, this study describes the content and structure of students' and adults' conceptions in the areas of germ contraction, transmission, and treatment of infectious and non-infectious diseases caused by microorganisms. Naturalistic and empirical research methods were used to investigate participants' conceptions. Between and within group similarities were found using data from concept maps on the topic "flu," drawings of germs, a 20 word card sort related to germs and illness, and a semi-structured interview. Concept maps were coded according to techniques by Novak and Gowan (1984). Drawings of germs were coded into four main categories (bacteria, viruses, animal cell, other) and five subcategories (disease, caricature, insect, protozoa, unclassified). Cluster patterns for the card sorts of each group were found using multidimensional scaling techniques. Six coding categories emerged from the interview transcripts: (a) transmission, (b) treatment, (c) effect of weather on illness, (d) immune response, (e) location of germs, and (f) similarities and differences between bacteria and viruses. The findings showed students, teachers and medical professionals have different understandings about bacteria and viruses and the structures of those understandings vary. Gaps or holes in the participants knowledge were found in areas such as: (a) how germs are transmitted, (b) where germs are found, (c) how the body transports and uses medicine, (d) how the immune system functions, (e) the difference between vaccines and non-prescription medicines, (f) differences that exist between bacteria and viruses, and (g) bacterial resistance to medication. The youngest students relied heavily upon personal experiences with germs rather than formal instruction when explaining their conceptions. As a result, the influence of media was
should not be a goal but a point in time which. 2 marks the ... and medical, educational and psychological personnel are .... note the prescription given by St. Paul to the. Romans: “Be ... you have had the princely privilege of being brought up ...
Moss, Marc; Good, Vicki S; Gozal, David; Kleinpell, Ruth; Sessler, Curtis N
Burnout syndrome (BOS) occurs in all types of health-care professionals and is especially common in individuals who care for critically ill patients. The development of BOS is related to an imbalance of personal characteristics of the employee and work-related issues or other organizational factors. BOS is associated with many deleterious consequences, including increased rates of job turnover, reduced patient satisfaction, and decreased quality of care. BOS also directly affects the mental health and physical well-being of the many critical care physicians, nurses, and other health-care professionals who practice worldwide. Until recently, BOS and other psychological disorders in critical care health-care professionals remained relatively unrecognized. To raise awareness of BOS, the Critical Care Societies Collaborative (CCSC) developed this call to action. The present article reviews the diagnostic criteria, prevalence, causative factors, and consequences of BOS. It also discusses potential interventions that may be used to prevent and treat BOS. Finally, we urge multiple stakeholders to help mitigate the development of BOS in critical care health-care professionals and diminish the harmful consequences of BOS, both for critical care health-care professionals and for patients. Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.
Hall, Jill; Bond, Christine; Kinnear, Moira; McKinstry, Brian
To explore the perceived acceptability, advantages and disadvantages of electronic multicompartment medication devices. Qualitative study using 8 focus groups and 10 individual semistructured interviews. Recordings were transcribed and analysed thematically. Strategies were employed to ensure the findings were credible and trustworthy. Community pharmacists (n=11), general practitioners (n=9), community nurses (n=12) and social care managers (n=8) were recruited from the National Health Service (NHS) and local authority services. Patients (n=15) who were current conventional or electronic multicompartment medication device users or had medication adherence problems were recruited from community pharmacies. 3 informal carers participated. Electronic multicompartment medication devices which prompt the patient to take medication may be beneficial for selected individuals, particularly those with cognitive impairment, but who are not seriously impaired, provided they have a good level of dexterity. They may also assist individuals where it is important that medication is taken at fixed time intervals. These are likely to be people who are being supported to live alone. No single device suited everybody; smaller/lighter devices were preferred but their usefulness was limited by the small number/size of storage compartments. Removing medications was often challenging. Transportability was an important factor for patients and carers. A carer's alert if medication is not taken was problematic with multiple barriers to implementation and no consensus as to who should receive the alert. There was a lack of enthusiasm among professionals, particularly among pharmacists, due to concerns about responsibility and funding for devices as well as ensuring devices met regulatory standards for storage and labelling. This study provides indicators of which patients might benefit from an electronic multicompartment medication device as well as the kinds of features to consider when
Taylor, Catherine A; Fleckman, Julia M; Lee, Shawna J
Hitting children for disciplinary purposes (i.e., spanking or corporal punishment [CP]) is a strong risk factor for child physical abuse and is highly prevalent in the U.S. Yet, little is currently known about the relevant attitudes, beliefs, or training needs of key professionals who often advise parents regarding child discipline strategies. A survey of the American Professional Society on the Abuse of Children (APSAC) membership, comprised of mental health professionals, physicians, child welfare professionals, and other professionals in the child maltreatment field, was conducted to assess attitudes, beliefs, perceived norms, training needs, and motivations to change norms regarding CP (N=571, response rate=51%). Most respondents agreed that spanking is a bad disciplinary technique (82%), is harmful for children (74%), and leads to negative outcomes (M=3.0, SD=0.6) more frequently than positive outcomes (M=2.1, SD=0.6; t=20.8; p<0.0001) for children. Professionals reported perceiving that their colleagues' level of endorsement of CP (M=2.4, SD=1.0) was higher than their own (M=1.9, SD=1.0; t(568)=-10.7, p<0.0001) though still below the midpoint. Professionals reported high levels of preparedness to effectively advise parents on non-physical child discipline strategies, but reported perceiving lower levels of preparedness amongst their colleagues. They reported highly valuing giving such advice to parents and being very motivated to participate in activities designed to change social norms regarding CP. Most APSAC members are poised to change these norms and, in doing so, to help reduce rates of child physical abuse in the U.S. Copyright © 2017 Elsevier Ltd. All rights reserved.
Tan, Chay-Hoon; Macneill, Paul
This paper presents an analysis of the effect of globalisation and attendant economic factors on the global practice of medicine, medical education, medical ethics and medical professionalism. The authors discuss the implications of these trends, citing case scenarios in the healthcare insurance, medical tourism, pharmaceutical industries, and the educational systems as well as in clinical practice, to illustrate the impact of globalisation and economics on professionalism. Globalisation, on the one hand, offers benefits for the global practice of medicine and for medical education. On the other, globalisation can have negative effects, particularly when the main driver is to maximise profitability across national boundaries rather than concern for human well-being. Appraising the effect of globalisation on professionalism involves assessing its effects at the intrapersonal, interpersonal, and institutional levels, and its effect on society at large.
Al-Dubai, Sami Abdo Radman; Ganasegeran, Kurubaran; Perianayagam, Wilson; Rampal, Krishna Gopal
This study was the first to explore factors associated with emotional burnout (EB) among medical residents in Malaysia. A cross-sectional study was conducted in a universal sample of 205 medical residents in a Malaysian general hospital. The self-administered questionnaire used consisted of questions on sociodemographics and work characteristics, sources of job stress, professional fulfillment, engagement, and EB. EB was measured using the emotional exhaustion subscale, the Maslach Burnout Inventory (MBI). Mean (±SD) age of the respondents was 26.5 (±1.6). The most common source of job stress was "fear of making mistakes." Most of the participants were dissatisfied with the increase of residentship period from one year to two years. A high level of EB was reported by 36.6% of the respondents. In multivariate analysis, the most important correlates of EB were sources of job stress, professional fulfillment, and engagement. A high prevalence of EB was found among medical residents. Sociodemographic characteristics, performance pressure, and satisfaction with policies were significantly associated with EB. Although this study was limited by its cross-sectional design, its findings posit a sufficient foundation to relevant authorities to construct, amend, and amalgamate existing and future policies. Nothing will sustain you more potently than the power to recognize in your humdrum routine, as perhaps it may be thought, the true poetry of life-the poetry of the common place, of the common man, of the plain, toil-worn woman, with their loves and their joys, their sorrows and their grief.SirWilliam Osler, Aphorisms from the Student Life (Aequanimitas, 1952).
Ross, Shelley; Lai, Krista; Walton, Jennifer M; Kirwan, Paul; White, Jonathan S
Social media site use is ubiquitous, particularly Facebook. Postings on social media can have an impact on the perceived professionalism of students and practitioners. In this study, we explored the attitudes and understanding of undergraduate medical students towards professionalism, with a specific focus on online behaviour. A volunteer sample of students (n = 236) responded to an online survey about understanding of professionalism and perceptions of professionalism in online environments. Respondents were encouraged to provide free text examples and to elaborate on their responses through free text comments. Descriptive analyzes and emergent themes analysis were carried out. Respondents were nearly unanimous on most questions of professionalism in the workplace, while 43% felt that students should act professionally at all times (including free time). Sixty-four free text comments revealed three themes: "free time is private time";" professionalism is unrealistic as a way of life"; and "professionalism should be a way of life". Our findings indicate a disconnect between what students report of what they understand of professionalism, and what students feel is appropriate and inappropriate in both online and real life behaviour. Curriculum needs to target understanding of professionalism in online and real environments and communicate realistic expectations for students.
Graafland, Maurits; Ten Cate, Olle; van Seventer, Jan-Pieter; Schraagen, Jan Maarten C; Schijven, Marlies P
Serious games are potentially powerful tools for residency training and increasingly attract attention from medical educators. At present, serious games have little evidence-based relations with competency-based medical education, which may impede their incorporation into residency training programs. The aim of this study was to identify highly valued entrustable professional activities (EPAs) to support designers in the development of new, serious games built on a valid needs-assessment. All 149 licensed medical specialists from seven specialties in one academic hospital participated in seven different Delphi expert panels. They filled out a two-round Delphi survey, aimed at identifying the most valuable EPAs in their respective curricula. Specialists were asked to name the most highly valued EPA in their area in the first Delphi round. In the second round, the generated responses were presented and ranked according to priority by the medical specialists. Sixty-two EPAs were identified as valuable training subjects throughout five specialties. Eleven EPAs--"management of trauma patient," "chest tube placement," "laparoscopic cholecystectomy," "assessment of vital signs," "airway management," "induction of general anesthesia," "assessment of suicidal patient," "psychiatric assessment," "gastroscopy," "colonoscopy," and "resuscitation of emergency patients"--were consistently given a high score. The future medical specialist is an active learner, comfortable with digital techniques and learning strategies such as serious gaming. In order to maximize the impact and acceptance of new serious games, it is vital to select the most relevant training subjects. Although some serious games have already targeted top-priority EPAs, plenty of opportunities remain.
The problem of professional training of skilled human personnel in the industry of information communication technology, the urgency of which is recognized at the state level of Ukraine and the world, has been considered. It has been traced that constantly growing requirements of the labour market, swift scientific progress require the use of…
Lehmann, Bianca; Krémer, Brigitte; Werwick, Katrin; Herrmann, Markus
Aim: The evaluation of medical students' perceptions regarding an elective study course in Homeopathy in which small groups have participated annually for six years, at the Institute for General Practice and Family Medicine at the Otto Von Guericke University, Magdeburg. The course was assessed in terms of concept, delivery, and influence on students' professional development. Methodology: Since the autumn term of 2008/09, three group discussions have been conducted with thirty of the course participants (3 total electives). These discussions were semi-structured and guided by central topics; the analysis was qualitative and guided by content. Results: The overall concept and implementation of the course were very successful. The main learning themes, that is, an emphasis on a more holistic and individual view of patients and the importance of a cooperative partnership between doctor and patient, were positively rated, regardless of the students' attitudes towards homeopathy. Their assessment was based on their previous experience and a comparison with conventional medical education. Conclusion: Homeopathy as an elective subject is not only useful for acquiring specific knowledge in integrative medicine, but also important as a means of developing physicians' core skills that are often not well considered in conventional medical education. PMID:24575158
The Justice George Lewis Ruffin Society is an organization founded in 1984 to support minority professionals in the Massachusetts criminal justice system. The Society began the sponsorship of statewide Convocations in 1992. These events provide minority criminal justice professionals with the opportunity to focus on pertinent topics through expert presentations, panel discussions, and peer interactions. Because of its increasing importance in the criminal justice process at large, and growing significance to the minority community in particular, the committee determined that the 1994 Convocation would focus on DNA. A decision was made to concentrate both on the science and the ethical and moral considerations pertinent to its application. The committee determined that along with expert presentations, a large portion of each day`s program should be devoted to workshops, designed to provide participants with an opportunity to review, test and discuss the material in a small group environment. Overall objectives of the Convocation were to provide minority and non-minority criminal justice professionals with a basic foundation in the science of genetics as well as current developments in genetic diagnostic technology, to highlight the actual and potential application of DNA technology to the criminal justice system and elsewhere, and to underscore the implications of these developments for criminal justice policy and the law.
Pickersgill, Martyn; Hogle, Linda
For some time now, bioethicists have paid close attention to issues associated with 'enhancement'; specifically, the appropriate use and regulation of substances and artefacts understood by some to improve the functioning of human bodies beyond that associated with 'normal' function. Medical humanities scholars (aside from philosophers and lawyers) and social scientists have not been frequent participants in debates around enhancement, but could shine a bright light on the range of dilemmas and opportunities techniques of enhancement are purported to introduce. In this paper, we argue that empirical research into the notion and practice of enhancement is necessary and timely. Such work could fruitfully engage with-and further develop-existing conceptual repertoires within the medical humanities and social sciences in ways that would afford benefit to scholars in those disciplines. We maintain that empirical engagements could also provide important resources to bioethicists seeking to regulate new enhancements in ways that are sensitive to societal context and cultural difference. To this end, we outline an empirical agenda for the medical humanities and social sciences around enhancement, emphasising especially how science and technology studies could bring benefits to-and be benefitted by-research in this area. We also use the example of (pharmaceutical) cognitive enhancement to show how empirical studies of actual and likely enhancement practices can nuance resonant bioethical debates. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
Nomura, Kyoko; Yamazaki, Yuka; Gruppen, Larry D; Horie, Saki; Takeuchi, Masumi; Illing, Jan
Objectives To investigate the difficulties Japanese female doctors face in continuing professional practice. Design A qualitative study using the Kawakita Jiro method. Setting A survey conducted in 2011 of 13 private Japanese medical school alumni associations. Participants 359 female doctors. Primary outcome measures Barriers of balancing work and gender role. Results The female doctors reported that professional practice was a struggle with long working hours due to a current shortage of doctors in Japan. There was also a severe shortage of childcare facilities in the workplace. Some women appeared to have low confidence in balancing the physician's job and personal life, resulting in low levels of professional pursuit. There appeared to be two types of stereotypical gender roles, including one expected from society, stating that “child rearing is a woman's job”, and the other perceived by the women themselves, that some women had a very strong desire to raise their own children. Male doctors and some female doctors who were single or older were perceived to be less enthusiastic about supporting women who worked while raising children because these coworkers feared that they would have to perform additional work as a result of the women taking long periods of leave. Conclusions Important factors identified for promoting the continuation of professional practice among female doctors in Japan were the need to improve working conditions, including cutting back on long working hours, a solution to the shortage of nurseries, a need for the introduction of educational interventions to clarify professional responsibilities, and redefinition of the gender division of labour for male and female doctors. In addition, we identified a need to modernise current employment practices by introducing temporary posts to cover maternity leave and introducing flexible working hours during specialist training, thus supporting and encouraging more women to continue their medical
Nomura, Kyoko; Yamazaki, Yuka; Gruppen, Larry D; Horie, Saki; Takeuchi, Masumi; Illing, Jan
To investigate the difficulties Japanese female doctors face in continuing professional practice. A qualitative study using the Kawakita Jiro method. A survey conducted in 2011 of 13 private Japanese medical school alumni associations. 359 female doctors. Barriers of balancing work and gender role. The female doctors reported that professional practice was a struggle with long working hours due to a current shortage of doctors in Japan. There was also a severe shortage of childcare facilities in the workplace. Some women appeared to have low confidence in balancing the physician's job and personal life, resulting in low levels of professional pursuit. There appeared to be two types of stereotypical gender roles, including one expected from society, stating that "child rearing is a woman's job", and the other perceived by the women themselves, that some women had a very strong desire to raise their own children. Male doctors and some female doctors who were single or older were perceived to be less enthusiastic about supporting women who worked while raising children because these coworkers feared that they would have to perform additional work as a result of the women taking long periods of leave. Important factors identified for promoting the continuation of professional practice among female doctors in Japan were the need to improve working conditions, including cutting back on long working hours, a solution to the shortage of nurseries, a need for the introduction of educational interventions to clarify professional responsibilities, and redefinition of the gender division of labour for male and female doctors. In addition, we identified a need to modernise current employment practices by introducing temporary posts to cover maternity leave and introducing flexible working hours during specialist training, thus supporting and encouraging more women to continue their medical careers. Published by the BMJ Publishing Group Limited. For permission to use (where not
Symposium 'Methodology in Medical Education Research' organised by the Methodology in Medical Education Research Committee of the German Society of Medical Education May, 25th to 26th 2013 at Charité, Berlin.
Schüttpelz-Brauns, Katrin; Kiessling, Claudia; Ahlers, Olaf; Hautz, Wolf E
In 2013, the Methodology in Medical Education Research Committee ran a symposium on "Research in Medical Education" as part of its ongoing faculty development activities. The symposium aimed to introduce to participants educational research methods with a specific focus on research in medical education. Thirty-five participants were able to choose from workshops covering qualitative methods, quantitative methods and scientific writing throughout the one and a half days. The symposium's evaluation showed participant satisfaction with the format as well as suggestions for future improvement. Consequently, the committee will offer the symposium again in a modified form in proximity to the next annual Congress of the German Society of Medical Education.
Fiebich, Martin [Technische Hochschule Mittelhessen, Giessen (Germany). Inst. fuer Medizinische Physik und Strahlenschutz; Zink, Klemens (ed.) [Technische Hochschule Mittelhessen, Giessen (Germany). Inst. fuer Medizinische Physik und Strahlenschutz; Universitaetsklinikum Giessen-Marburg, Marburg (Germany). Klinik fuer Strahlentherapie und Radioonkologie
The abstracts volume of the 46th annual meeting of the German Society for Medical Physics includes abstracts on the following issues: audiology; particle therapy: dosimetric and biological aspects; functional and molecular imaging; computerized tomography; dosimetry: 2D dosimetry and clinical dosimetry; MR imaging: cardio and lungs imaging; quality assurance in radiation therapy; brachytherapy/IORT; irradiation planning; functional and molecular imaging: methodic principles; dosimetry: dosimetric base data and Monte Carlo; adaptive and guided radiation therapy; irradiation planning; laser accelerated protons; brachytherapy/IORT: dosimetry; particle therapy: irradiation planning and imaging; stereotaxis and radiosurgery; radiation protection; dosimetry: detectors and small photon fields; MRT and MRS - neuroimaging; particle therapy: in vivo verification.
Silva, Teogenes A. da; Pereira, Elton G.; Alonso, Thessa C.; Guedes, Elton C.; Goncalves, Elaine C.; Nogueira, Maria Angela A.
The role of the CDTN/CNEN as far as the radiological protection services in the medical and dental radiology has changed a lot due to the new Regulatory Directives. The CDTN/CNEN was recognized as the regional reference center for providing not only radiological survey services, but to coordinate an accreditation procedure for professional persons to be accepted by the State Regulatory Authorities to work at Minas Gerais. All the new activities were formalized in a Cooperation Agreement between the CDTN/CNEN and the Regulatory Authority. This paper describes the accreditation procedure for candidates, the adopted requirements, the intercomparison results among measuring instruments and the main achievements during the first year of the Agreement. (author)
Sir William Burnett (1779-1861) had an active career as a Royal Navy surgeon in the French Revolutionary and Napoleonic Wars, including service at the battles of St Vincent, the Nile and Trafalgar. From 1822 to 1855 he was professional head of the Royal Naval Medical Department, when he provided effective leadership in a time of great change. Although his official work earned him the reputation of a "hard-working, unimaginative, somewhat harsh man", his correspondence shows a very humane centre under the official carapace. His official performance and reputation were both eroded towards the end of his career by his determined promotion of zinc chloride, for which he held lucrative patents.
Full Text Available According to the WHO- “Health is a state of complete physical, mental and social well-being and not merely an absence of disease or infirmity”. The good health is the fundamental right of all the people on earth. The concept of ‘One Medicine’ coined by Calvin W. Schwabe evolves towards ’One Health’ which comprises collaborative efforts of multiple disciplines to achieve perfect health of people, animals, and our environment. ‘One Health’ deals with the challenges at the intersection of animal, human and environment health including the infectious diseases, the global food crises, and climate change due to global warming. The cordial and active association of various disciplines such as medicine, veterinary, public health, environment, wildlife, ecology, and food hygiene is highly emphasized in order to achieve the goal of ‘One Health’. This mini-review describes brief history of ‘one health’, the roles of veterinary, medical and environmental professionals, and developing collaboration with various concern professionals to achieve ‘one health’. In addition, the selected achievements of ‘one health’ in the past 10 years have been described along with the challenges ahead for the successful implementation of such concept.
Zahedul Karim Ahmad
Full Text Available This cross sectional study was conducted in different medical college hospitals of Dhaka city during the months of Jan-March 2009. The objective of this study was to find out the awareness level on organ transplantation amongst the teachers, doctors and nurses working in these medical college hospitals and 1st to 5th year students. A structured questionnaire was given to the respondents. The total number of respondents was 462 of which 103 (22.3% were doctors, 268 (58% were medical students and 91 (19.7% were nurses. Among the study group 31.4% knew that there was an organ transplantation law in Bangladesh and 16.5% said that there was no such law whereas 52.2% had no idea whatsoever about the law. Of the respondents 33.8% were willing to donate their organs after death, 41.6% did not want to donate and 24.2% were not sure. This study revealed that there was a lack of understanding regarding the religious views on organ transplantation. Only 37.1% of respondents thought that were was no religious objection to organ transplantation whereas 27.1% felt that there was religious objection while 35.7% were not sure. The study shows that there is significant lack of awareness regarding organ transplantation issues among the health care professionals and medical students in Bangladesh. The dictates of religion on this matter were also not clear to most of the respondents. Ibrahim Med. Coll. J. 2009; 3(2: 55-58
Sachin R. Jhawar, MD
Conclusion: ASTRO's use of Twitter lags behind ASCO and SSO. Although all 3 societies show increased Twitter use during their annual meetings, they should work toward more meaningful engagement throughout the year. The new metrics of tweet density and supporter ratio will serve as benchmarks for member engagement in future studies.
Li, Honghe; Liu, Yang; Wen, Deliang
Background Over the last three decades, various instruments were developed and employed to assess medical professionalism, but their measurement properties have yet to be fully evaluated. This study aimed to systematically evaluate these instruments’ measurement properties and the methodological quality of their related studies within a universally acceptable standardized framework and then provide corresponding recommendations. Methods A systematic search of the electronic databases PubMed, Web of Science, and PsycINFO was conducted to collect studies published from 1990–2015. After screening titles, abstracts, and full texts for eligibility, the articles included in this study were classified according to their respective instrument’s usage. A two-phase assessment was conducted: 1) methodological quality was assessed by following the COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN) checklist; and 2) the quality of measurement properties was assessed according to Terwee’s criteria. Results were integrated using best-evidence synthesis to look for recommendable instruments. Results After screening 2,959 records, 74 instruments from 80 existing studies were included. The overall methodological quality of these studies was unsatisfactory, with reasons including but not limited to unknown missing data, inadequate sample sizes, and vague hypotheses. Content validity, cross-cultural validity, and criterion validity were either unreported or negative ratings in most studies. Based on best-evidence synthesis, three instruments were recommended: Hisar’s instrument for nursing students, Nurse Practitioners’ Roles and Competencies Scale, and Perceived Faculty Competency Inventory. Conclusion Although instruments measuring medical professionalism are diverse, only a limited number of studies were methodologically sound. Future studies should give priority to systematically improving the performance of existing
Morgan, Susan; Plaisant, Odile; Lignier, Baptiste; Moxham, Bernard J
Two hundred and eight professional anatomists responded to a questionnaire inviting them to address the possibility that social/gender factors hinder the dispassionate representation of anatomy. Ethical approval for the study was obtained from Cardiff University. The results of the survey provided comparisons with the attitudes of medical students that have previously been reported (Morgan et al., 2014). Although a few differences were discerned between females and males in our surveys and between anatomists and medical students, overall our findings suggest that, while both professional anatomists and medical students recognize the importance of gender issues and do not wish to associate with sexism, most are unaware of the possible negative aspects of sexism within anatomy. We recommend that teachers of anatomy should become more aware of the possibility of adverse effects on professional matters relating to equality and diversity issues. Clin. Anat. 29:892-910, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.
Approved by the China Association for Science and Technology, Chinese Society for Rock Mechanics and Engineering newly established 'Professional Committee on Waste Underground Disposal'. The committee will organise the national and international academic exchange, and provide advice on discipline development, sustainable industrial development, environmental protection, etc.. This is the establishing conference of the professional committee, as well as the first academic seminar. The following topics on waste underground disposal are discussed: the theory, practice and exploration, project examples, new technologies and new methods. The contents include: waste disposal technology in the new century, the geological disposal of high level radioactive waste, LLW and ILW underground waste disposal, urban and industrial waste underground disposal, and etc.
Yasmin, Ephia; Balachandren, Neerujah; Davies, Melanie C; Jones, Georgina L; Lane, Sheila; Mathur, Raj; Webber, Lisa; Anderson, Richard A
Fertility preservation in the female poses several challenges due to the invasive nature of the techniques available to achieve it. The guideline aims to bring together the evidence available for the measures for fertility preservation and their outcome. The guideline addresses fertility preservation for medical reasons and includes both oncological and non-oncological causes. The techniques that the guideline considers are: (i) embryo and oocyte cryopreservation; (ii) ovarian tissue cryopreservation; (iii) GnRH agonist suppression and (iv) ovarian transposition. Although ovarian tissue cryopreservation is still considered experimental, the availability of this technique is gaining momentum as more live births from auto-transplanted tissue are reported. The guideline also highlights use of current treatment modalities for benign and malignant conditions that have a better fertility sparing profile. The guideline recommends a multidisciplinary approach in counselling women and girls about the risk to their fertility and available techniques. The role of psychological support in assisting women and girls with decision-making is highlighted. The guideline also highlights the risks associated with these techniques. Women need to be medically fit to undergo invasive procedures. Fertility preservation techniques are appropriate when treatment has curative intent. Fertility preservation is a subject of on-going research on outcomes of different techniques and at the time of publication, studies are still likely to emerge adding to the available literature.
Information and communication on risks related to medications and proper use of medications for healthcare professionals and the general public: precautionary principle, risk management, communication during and in the absence of crisis situations.
Molimard, Mathieu; Bernaud, Corine; Lechat, Philippe; Bejan-Angoulvant, Theodora; Benattia, Cherif; Benkritly, Amel; Braunstein, David; Cabut, Sandrine; David, Nadine; Fourrier-Réglat, Annie; Gallet, Benoit; Gersberg, Marta; Goni, Sylvia; Jolliet, Pascale; Lamarque-Garnier, Véronique; Le Jeunne, Claire; Leurs, Irina; Liard, François; Malbezin, Muriel; Micallef, Joelle; Nguon, Marina
Recent drug crises have highlighted the complexity, benefits and risks of medication communication. The difficulty of this communication is due to the diversity of the sources of information and the target audience, the credibility of spokespersons, the difficulty to communicate on scientific uncertainties and the precautionary principle, which is influenced by variable perceptions and tolerances of the risk. Globally, there is a lack of training in risk management with a tendency of modern society to refuse even the slightest risk. Communication on medications is subject to regulatory or legal requirements, often uses tools and messages that are not adapted to the target audience and is often based on a poor knowledge of communication techniques. In order to improve this situation, the available information must be coordinated by reinforcing the unique medication information website and by coordinating communication between authorities by means of a single spokesperson. A particular effort must be made in the field of training in the proper use and risk of medications for both the general population and patients but also for healthcare professionals, by setting up a unified academic on-line teaching platform for continuing medical education on medications and their proper use. © 2014 Société Française de Pharmacologie et de Thérapeutique.
Jackson, Angela; Baron, Robert B; Jaeger, Jeffrey; Liebow, Mark; Plews-Ogan, Margaret; Schwartz, Mark D
The Graduate Medical Education (GME) system in the United States (US) has garnered worldwide respect, graduating over 25,000 new physicians from over 8,000 residency and fellowship programs annually. GME is the portal of entry to medical practice and licensure in the US, and the pathway through which resident physicians develop the competence to practice independently and further develop their career plans. The number and specialty distribution of available GME positions shapes the overall composition of our national workforce; however, GME is failing to provide appropriate programs that support the delivery of our society's system of healthcare. This paper, prepared by the Health Policy Education Subcommittee of the Society of General Internal Medicine (SGIM) and unanimously endorsed by SGIM's Council, outlines a set of recommendations on how to reform the GME system to best prepare a physician workforce that can provide high quality, high value, population-based, and patient-centered health care, aligned with the dynamic needs of our nation's healthcare delivery system. These recommendations include: accurate workforce needs assessment, broadened GME funding sources, increased transparency of the use of GME dollars, and implementation of incentives to increase the accountability of GME-funded programs for the preparation and specialty selection of their program graduates.
Studnek, Jonathan R; Bentley, Melissa; Crawford, J Mac; Fernandez, Antonio R
Ensuring the health and productivity of emergency medical services (EMS) professionals is important. However, there has been no known national baseline assessment of the health and wellness of EMS professionals in the United States. According to Healthy People 2010, top indicators of personal health include physical activity, body mass index (BMI), and smoking prevalence. The objectives of this study included quantifying existing health conditions and describing key health indicators among EMS professionals. It was hypothesized that work-life characteristics were associated with existing health conditions and key health indicators. Data utilized for this analysis were obtained from a 2007 questionnaire included in biennial national recertification packets. This questionnaire utilized validated items from the Behavioral Risk Factor Surveillance System (BRFSS) and the Longitudinal EMT Attributes and Demographics Study (LEADS). Along with common demographic characteristics, items inquired about existing health conditions (diabetes, asthma, hypertension, myocardial infarction, angina, stroke, and/or high blood cholesterol level), general health, physical activity, and smoking status. Descriptive analyses were performed utilizing chi-square tests, and logistic regression was utilized to describe associations between existing health conditions and the key health indicators. There were 58,435 individuals who became recertified in 2007, with 30,560 (52%) returning questionnaires. Individuals with missing data were removed, leaving 19,960 individual records. There were 4,681 (23.5%) individuals who reported at least one existing health condition. The mean BMI for the study participants was 27.69 kg/m(2). There were 5,742 (28.8%) individuals classified as having normal weight and 5,146 (25.8%) who were obese. The overwhelming majority of individuals did not meet the Centers for Disease Control and Prevention (CDC) recommendations for physical activity (15,022, 75.3%). There
Raes, Patricia; Angstwurm, Matthias; Berberat, Pascal; Kadmon, Martina; Rotgans, Jerome; Streitlein-Böhme, Irmgard; Burckhardt, Gerhard; Fischer, Martin R
Amended in 2013, the current version of the German Medical Licensure Regulation contains structural specifications that are also required of non-university institutions involved in Practical Year clinical training. The criteria are worded in relatively general terms. Furthermore, not all of the structural specifications can be readily applied to every subject area. In order to ensure commensurability in Practical Year instruction in Germany, not least in light of recently introduced Practical Year mobility, it is necessary to define consistent quality criteria for Practical Year training. The authors therefore propose a catalogue of criteria for the quality management process in Practical Year instruction facilities. In January 2014, the board of directors of the German Society for Medical Education decided to establish a committee comprised of representatives from various German medical faculties. In a process similar to the Delphi methodology, the group developed criteria for structure, process and outcome quality in Practical Year training in Germany. The criteria developed for structure, process and outcome quality apply to Practical Year training in academic teaching hospitals and university medical centres. Furthermore, modalities for review are proposed. The present catalogue of criteria is intended to contribute to the formation of a basis for the most consistent quality standards possible for Practical Year instruction in Germany.
Full Text Available Background. Due to restrictions imposed on a clinical freedom, interest for professionalism in healthcare has been getting bigger not only in medicine literature and various mass media but also in teaching and organisation of healthcare. Professionalism stands not only for a medicine’s contract with society, recognition of a physician status, privilege and monopoly but also for a genuine physician’s commitment to professional responsibilities.Analysis. In 2002 European and American associations approved a document on medical professionalism in the new millenium, so-called Physician Charter. This document includes fundamental principles of professionalism such as altruism, patient autonomy and social justice. In particular, it analyses a physician’s professional competency, honesty with patients, patient confidentiality, appropriate relations with patients, improvements regarding a healthcare quality, healthcare access, just distribution of finite funds, commitment to scientific knowledge, trust maintenance by managing conflicts of interest and a professional responsibility.Conclusions. Physician’s professionalism means philosophycal and sociological analysis of his/her profession and its position in a society. It includes a concern for improvements of his/ her own scientific knowledge, skills, a genuine ethic interest for an individual patient bearing in mind principles of equality and justice in society. Whether performing an organisational and public work or participating in professional health organizations, physician’s interest for a patient must prevail.
Full Text Available Background: Empirical studies on healthcare personnel indicate that professionals’ experiences with dying and death become silenced and unutterable within the healthcare service. Aim: To explore and interpret silence about encounters with death and dying among healthcare professionals in Norway. Method: The method used was theoretical exploration, using a psychosocial approach. Findings: This analysis reveals complex interrelations and two-way dynamics between subject-worlds, sociocultural and societal worlds when it comes to dealing with death and dying at work. A performance culture saturates these worlds, and may be implicated in silencing death within the healthcare institutions of the Norwegian welfare state. Conclusions: This article suggests that silence about death and dying among healthcare professionals is indicative of crucial emerging and unresolved tensions in the neoliberal episteme, accompanied and reinforced by the ineluctable basic conditions of life and intrapsychic defence against threats towards the self. Implications for practice: Silence about death and dying presents a serious challenge for dying patients and next of kin. Healthcare professionals should be enabled to acknowledge their thoughts and emotions about death in order to be able to support and contain patients and next of kin Learning activities such as peer support and supervision can help the processing of difficult psychological content and allow for emotional aspects of professionals’ work to be acknowledged and thought about in a way that encourages reflective and sound practice Clinical managers should address whether performance pressures induce shameful feelings in staff, who may believe that by providing appropriate levels of care they are compromising productivity. Shame in turn, may undermine professionals’ emotional wellbeing and ability to continue to provide attuned and adequate care for dying patients Creative approaches to facilitate
Full Text Available Abstract Background Detecting cognitive impairment in medical inpatients is important due to its association with adverse outcomes. Our aim was to study recognition of cognitive impairment and its association with mortality. Methods 200 inpatients aged over 60 years were recruited at the Department of General Internal Medicine at University Hospital MAS in Malmö, Sweden. The MMSE (Mini-Mental State Examination and the CDT (Clock-Drawing Test were performed and related to recognition rates by patients, staff physicians, nurses and informants. The impact of abnormal cognitive test results on mortality was studied using a multivariable Cox proportional hazards regression. Results 55 patients (28% had no cognitive impairment while 68 patients (34% had 1 abnormal test result (on MMSE or CDT and 77 patients (39% had 2 abnormal test results. Recognition by healthcare professionals was 12% in the group with 1 abnormal test and 44-64% in the group with 2 abnormal test results. In our model, cognitive impairment predicted 12-month mortality with a hazard ratio (95% CI of 2.86 (1.28-6.39 for the group with 1 abnormal cognitive test and 3.39 (1.54-7.45 for the group with 2 abnormal test results. Conclusions Cognitive impairment is frequent in medical inpatients and associated with increased mortality. Recognition rates of cognitive impairment need to be improved in hospitals.
Hauer, Karen E; Boscardin, Christy; Fulton, Tracy B; Lucey, Catherine; Oza, Sandra; Teherani, Arianne
The new UCSF Bridges Curriculum aims to prepare students to succeed in today's health care system while simultaneously improving it. Curriculum redesign requires assessment strategies that ensure that graduates achieve competence in enduring and emerging skills for clinical practice. To design entrustable professional activities (EPAs) for assessment in a new curriculum and gather evidence of content validity. University of California, San Francisco, School of Medicine. Nineteen medical educators participated; 14 completed both rounds of a Delphi survey. Authors describe 5 steps for defining EPAs that encompass a curricular vision including refining the vision, defining draft EPAs, developing EPAs and assessment strategies, defining competencies and milestones, and mapping milestones to EPAs. A Q-sort activity and Delphi survey involving local medical educators created consensus and prioritization for milestones for each EPA. For 4 EPAs, most milestones had content validity indices (CVIs) of at least 78 %. For 2 EPAs, 2 to 4 milestones did not achieve CVIs of 78 %. We demonstrate a stepwise procedure for developing EPAs that capture essential physician work activities defined by a curricular vision. Structured procedures for soliciting faculty feedback and mapping milestones to EPAs provide content validity.
Kennedy, Tara J T; Regehr, Glenn; Baker, G Ross; Lingard, Lorelei
To develop a conceptual framework of the influences on medical trainees' decisions regarding requests for clinical support from a supervisor. Phase 1: members of teaching teams in internal and emergency medicine were observed during regular clinical activities (216 hours) and subsequently completed brief interviews. Phase 2: 36 in depth interviews were conducted using videotaped vignettes to probe tacit influences on decisions to request support. Data collection and analysis used grounded theory methods. Three teaching hospitals in an urban setting in Canada. 124 members of teaching teams on general internal medicine wards and in the emergency department, comprising 31 attending physicians, 57 junior and senior residents, 28 medical students, and eight nurses. Purposeful sampling to saturation was conducted. Trainees' decisions about whether or not to seek clinical support were influenced by three issues: the clinical question (clinical importance, scope of practice), supervisor factors (availability, approachability), and trainee factors (skill, desire for independence, evaluation). Trainees perceived that requesting frequent/inappropriate support threatened their credibility and used rhetorical strategies to preserve credibility. These strategies included building a case for the importance of requests, saving requests for opportune moments, making a plan before requesting support, and targeting requests to specific team members. Trainees consider not only clinical implications but also professional credibility when requesting support from clinical supervisors. Exposing the complexity of this process provides the opportunity to make changes to training programmes to promote timely supervision and provides a framework for further exploration of the impact of clinical training on quality of care of patients.
Alqubaisi, Mai; Tonna, Antonella; Strath, Alison; Stewart, Derek
Effective and efficient medication reporting processes are essential in promoting patient safety. Few qualitative studies have explored reporting of medication errors by health professionals, and none have made reference to behavioural theories. The objective was to describe and understand the behavioural determinants of health professional reporting of medication errors in the United Arab Emirates (UAE). This was a qualitative study comprising face-to-face, semi-structured interviews within three major medical/surgical hospitals of Abu Dhabi, the UAE. Health professionals were sampled purposively in strata of profession and years of experience. The semi-structured interview schedule focused on behavioural determinants around medication error reporting, facilitators, barriers and experiences. The Theoretical Domains Framework (TDF; a framework of theories of behaviour change) was used as a coding framework. Ethical approval was obtained from a UK university and all participating hospital ethics committees. Data saturation was achieved after interviewing ten nurses, ten pharmacists and nine physicians. Whilst it appeared that patient safety and organisational improvement goals and intentions were behavioural determinants which facilitated reporting, there were key determinants which deterred reporting. These included the beliefs of the consequences of reporting (lack of any feedback following reporting and impacting professional reputation, relationships and career progression), emotions (fear and worry) and issues related to the environmental context (time taken to report). These key behavioural determinants which negatively impact error reporting can facilitate the development of an intervention, centring on organisational safety and reporting culture, to enhance reporting effectiveness and efficiency.
Sundberg, Kristina; Josephson, Anna; Reeves, Scott; Nordquist, Jonas
The mission of undergraduate medical education leaders is to strive towards the enhancement of quality of medical education and health care. The aim of this qualitative study is, with the help of critical perspectives, to contribute to the research area of undergraduate medical education leaders and their identity formation; how can the identity of undergraduate medical education leaders be defined and further explored from a power perspective? In this explorative study, 14 educational leaders at a medical programme in Scandinavia were interviewed through semi-structured interviews. The data was analysed through Moustakas' structured, phenomenological analysis approach and then pattern matched with Gee's power-based identity model. Educational leaders identify themselves more as mediators than leaders and do not feel to any larger extent that their professional identity is authorised by the university. These factors potentially create difficulties when trying to communicate with medical teachers, often also with a weaker sense of professional identity, about medical education. The perceptions of the professional identity of undergraduate medical education leaders provide us with important notions on the complexities on executing their important mission to develop medical education: their perceptions of ambiguity towards the process of trying to lead teachers toward educational development and a perceived lack of authorisation of their work from the university level. These are important flaws to observe and correct when improving the context in which undergraduate medical education leaders are trying to develop and improve undergraduate medical programmes. A practical outcome of the results of this study is the facilitation of design of faculty development programmes for educational leaders in undergraduate medial education.
Kasvosve, Ishmael; Ledikwe, Jenny H; Phumaphi, Othilia; Mpofu, Mulamuli; Nyangah, Robert; Motswaledi, Modisa S; Martin, Robert; Semo, Bazghina-Werq
Laboratory professionals are expected to maintain their knowledge on the most recent advances in laboratory testing and continuing professional development (CPD) programs can address this expectation. In developing countries, accessing CPD programs is a major challenge for laboratory personnel, partly due to their limited availability. An assessment was conducted among clinical laboratory workforce in Botswana to identify and prioritize CPD training needs as well as preferred modes of CPD delivery. A self-administered questionnaire was disseminated to medical laboratory scientists and technicians registered with the Botswana Health Professions Council. Questions were organized into domains of competency related to (i) quality management systems, (ii) technical competence, (iii) laboratory management, leadership, and coaching, and (iv) pathophysiology, data interpretation, and research. Participants were asked to rank their self-perceived training needs using a 3-point scale in order of importance (most, moderate, and least). Furthermore, participants were asked to select any three preferences for delivery formats for the CPD. Out of 350 questionnaires that were distributed, 275 were completed and returned giving an overall response rate of 79%. The most frequently selected topics for training in rank order according to key themes were (mean, range) (i) quality management systems, most important (79%, 74-84%); (ii) pathophysiology, data interpretation, and research (68%, 52-78%); (iii) technical competence (65%, 44-73%); and (iv) laboratory management, leadership, and coaching (60%, 37-77%). The top three topics selected by the participants were (i) quality systems essentials for medical laboratory, (ii) implementing a quality management system, and (iii) techniques to identify and control sources of error in laboratory procedures. The top three preferred CPD delivery modes, in rank order, were training workshops, hands-on workshops, and internet-based learning
Catalogue of learning goals for pregraduate education in geriatric medicine. A recommendation of the German Geriatric Society (DGG), the German Society of Gerontology and Geriatrics (DGGG), the Austrian Society of Geriatrics and Gerontology (OGGG) and the Swiss Society of Geriatric Medicine (SFGG) on the basis of recommendations of the European Union of Medical Specialists Geriatric Medicine Section (UEMS-GMS) 2013
Singler, K.; Stuck, A. E.; Masud, T.
using a modified Delphi technique in order to encourage education in this field. This catalogue of learning objectives for geriatric medicine focuses on the minimum requirements with specific learning goals in knowledge, skills and attitudes that medical students should have acquired by the end...... at German-speaking medical faculties and universities of Austria, Germany and Switzerland. This article contains the final German translation of the curriculum. The Geriatric Medicine Societies of Germany, Austria, and Switzerland formally endorse the present curriculum and recommend that medical faculties...
The Serbian medical association was founded in Belgrade 125 years ago. At that time, Serbia was liberated from the Ottoman domination, and was one of some thirty existing independent states gaining international recognition in 1878. The physicians of the Serbian medical association have shared the fate of their people over the past 125 years. This is best illustrated by the fact that Serbia lost more than 1,000,000 people in World War I and that every third doctor in Serbia lost his life serving his people during the war. This was the highest expression of philanthropy, unsurpassed in the history of mankind. The period of time after the war, was the time of renewal and commemoration. In that time John Maynard Keynes, one of the most outstanding figures in the field of world economics, was on the Peace Conference in Paris, after the World War I, in charge of estimating war damages and the degree of destruction in the Allied countries, but without considering their losses in "human capital"-- the only exception he made for Serbia. In his book "The Economic Consequences of the Peace (published in 1920) he wrote: "The losses of Serbia, although from a human point of view her sufferings were the greatest of all, are not measured pecuniarily by great figures, on account of her low economic development." He quoted some extraordinary figures of the loss of life--"at above 1,000,000, or more than one-third of the population of Old Serbia." In the end he concludes: "Of all the Allies, Serbian sufferings and losses were proportionately the greatest, and after Serbian, the French. In these times, also, according to professor Hichmann (Geographical Statistical Atlas 1920) "it was found, when the nations counted their losses after the war, that Serb casualties amounted to 23% of her population as compared with 3.7% for Great Britain, 8.5% for France and 9.3% for Germany. No small nation can suffer a loss such as Serbia, drawn moreover entirely from its able-bodied manhood
What is a profession? According to Cruess, it is an occupation whose core element is work that is based on the mastery of a complex body of knowledge and skills. It is a vocation in which knowledge of some department of science or learning, or the practice of an art founded on it, is used in the service of others. Its members profess a commitment to competence, integrity, morality, altruism, and the promotion of the public good within their domain. These commitments form the basis of a social contract between a profession and society, which in return grants the profession autonomy in practice and the privilege of self-regulation. Although medical professionals share the role of healer, there are wide variations between individuals. Professionalism is the basis of medicine's contract with society. Public trust is essential to that contract, and public trust depends on the integrity of both individual professionals and the whole profession. The introduction to this important symposium includes definitions of professions and of medical professionalism. It also includes discussions of reciprocal altruism, conflicts of interest in medical societies, the theory of cognitive dissonance, and the moral foundations of professionalism.
Essential learning tools for continuing medical education for physicians, geneticists, nurses, allied health professionals, mental health professionals, business administration professionals, and reproductive endocrinology and infertility (REI) fellows: the Midwest Reproductive Symposium International.
Collins, Gretchen G; Jeelani, Roohi; Beltsos, Angeline; Kearns, William G
Essential learning tools for continuing medical education are a challenge in today's rapidly evolving field of reproductive medicine. The Midwest Reproductive Symposium International (MRSi) is a yearly conference held in Chicago, IL. The conference is targeted toward physicians, geneticists, nurses, allied health professionals, mental health professionals, business administration professionals, and reproductive endocrinology and infertility (REI) fellows engaged in the practice of reproductive medicine. In addition to the scientific conference agenda, there are specific sessions for nurses, mental health professionals, and REI fellows. Unique to the MRSi conference, there is also a separate "Business Minds" session to provide education on business acumen as it is an important element to running a department, division, or private clinic.
Mathee, Kalai; Silver, Lynn L; Tatke, Gorakh
In the last 70 years, we have seen a radical change in our perception and understanding of the microbial world. During this period, we learned from Woese and Fox there exists a third kingdom called 'Archea' based on the phylogenetic studies of the 16S rRNA that revolutionized microbiology (Woese & Fox, 1977; Woese et al., 1978). Furthermore, we were forced to reckon with the fact that Koch and Pasteur's way of growing cells in test-tubes or flasks planktonically does not necessarily translate to the real-life scenario of bacterial lifestyle, where they prefer to live and function as a closely knit microbial community called biofilm. Thanks are due to Costerton, who led the crusade on the concept of biofilms and expanded its scope of inquiry, which forced scientists and clinicians worldwide to rethink how we evaluate and apply the data. Then progressively, disbelief turned into belief, and now it is universally accepted that the micro-organisms hobnob with the members of their community to communicate and coordinate their behaviour, especially in regard to growth patterns and virulence traits via signalling molecules. Just when we thought that we were losing the battle against bacteria, antimicrobials were discovered. We then witnessed the rise and fall of antibiotics and the development of antibiotic resistance. Due to space and choice limitation, we will focus on the three areas that caused this major paradigm shift (i) antimicrobial resistance (AMR), (ii) biofilm and (iii) quorum sensing (QS), and how the Journal of Medical Microbiology played a major role in advancing the shift.
Krleza, Jasna Lenicek; Dorotic, Adrijana; Grzunov, Ana; Maradin, Miljenka
Capillary blood sampling is a medical procedure aimed at assisting in patient diagnosis, management and treatment, and is increasingly used worldwide, in part because of the increasing availability of point-of-care testing. It is also frequently used to obtain small blood volumes for laboratory testing because it minimizes pain. The capillary blood sampling procedure can influence the quality of the sample as well as the accuracy of test results, highlighting the need for immediate, widespread standardization. A recent nationwide survey of policies and practices related to capillary blood sampling in medical laboratories in Croatia has shown that capillary sampling procedures are not standardized and that only a small proportion of Croatian laboratories comply with guidelines from the Clinical Laboratory Standards Institute (CLSI) or the World Health Organization (WHO). The aim of this document is to provide recommendations for capillary blood sampling. This document has been produced by the Working Group for Capillary Blood Sampling within the Croatian Society of Medical Biochemistry and Laboratory Medicine. Our recommendations are based on existing available standards and recommendations (WHO Best Practices in Phlebotomy, CLSI GP42-A6 and CLSI C46-A2), which have been modified based on local logistical, cultural, legal and regulatory requirements. We hope that these recommendations will be a useful contribution to the standardization of capillary blood sampling in Croatia.
Morison, Sue; Boohan, Mairead; Moutray, Marianne; Jenkins, John
Teamwork and collaboration are regarded as important goals for health and social care education and inter-professional education (IPE) the vehicle to achieve this. However, there is debate concerning the best strategies for implementation, location and delivery of IPE. This exploratory study was undertaken to anticipate some of the problems of implementing a pre-qualification IPE programme for Children's Branch nursing students and medical students undertaking a Paediatrics module and to identify strategies to maximise success. A modified version of the readiness for inter-professional learning scale (RIPLS), including additional open-ended questions, was used with a convenient, purposeful sample of 20 medical and 10 nursing students. Both groups regarded learning team-working skills as important. Medical students regarded IPE as a means to learn about team-work and professional roles otherwise they indicated a preference for a discipline-based approach. Both groups were found to have acquired a strong sense of their own professional role. Both perceived IPE as disadvantageous if it impeded their own professional learning. Results also highlighted the importance of class size, stage of learning, appropriate skills and subject in IPE planning. We conclude that a small exploratory study can provide a useful guide for programme planning and additional qualitative data can enable a more comprehensive explanation of results.
Zink, Therese; Halaas, Gwen Wagstrom; Brooks, Kathleen D
Professionalism is now an explicit part of the medical school curricula. To examine the components that are part of developing professionalism during the Rural Physician Associate Program (RPAP) experience, a 9-month rotation in a rural community during the third year of medical school. Two researchers analysed 3 years of essays for themes. IRB approval was obtained. Themes were organized using Van de Camp's model of professionalism. Students described how patients taught them about illnesses, the affects on their lives and the lives of their families. Preceptors role-modelled how to relate to patients with compassion and respect (Professionalism Towards the Patient). As a member of the health care team, clinic and hospital staff taught students how to be a good team member (Towards Other Health Care Professionals). Shadowing preceptors in their roles as physicians and community members, students learned about their responsibilities to the community (Towards the Public). Multiple opportunities for self-evaluation and reflection taught students to know themselves and find balance between work responsibilities and their personal lives (Towards Oneself). The RPAP appears to create a supportive learning environment that incorporates psychological safety, appreciation of differences, openness to new ideas and time for reflection - an ideal environment for developing professionalism.
Visser, Cora L F; Wilschut, Janneke A; Isik, Ulviye; van der Burgt, Stéphanie M E; Croiset, Gerda; Kusurkar, Rashmi A
The Readiness for Interprofessional Learning Scale is among the first scales developed for measurement of attitude towards interprofessional learning (IPL). However, the conceptual framework of the RIPLS still lacks clarity. We investigated the association of the RIPLS with professional identity, empathy and motivation, with the intention of relating RIPLS to other well-known concepts in healthcare education, in an attempt to clarify the concept of readiness. Readiness for interprofessional learning, professional identity development, empathy and motivation of students for medical school, were measured in all 6 years of the medical curriculum. The association of professional identity development, empathy and motivation with readiness was analyzed using linear regression. Empathy and motivation significantly explained the variance in RIPLS subscale Teamwork & Collaboration. Gender and belonging to the first study year had a unique positive contribution in explaining the variance of the RIPLS subscales Positive and Negative Professional Identity, whereas motivation had no contribution. More compassionate care, as an affective component of empathy, seemed to diminish readiness for IPL. Professional Identity, measured as affirmation or denial of the identification with a professional group, had no contribution in the explanation of the variance in readiness. The RIPLS is a suboptimal instrument, which does not clarify the 'what' and 'how' of IPL in a curriculum. This study suggests that students' readiness for IPE may benefit from a combination with the cognitive component of empathy ('Perspective taking') and elements in the curriculum that promote autonomous motivation.
Steinauer, Jody E; Turk, Jema K; Preskill, Felisa; Devaskar, Sangita; Freedman, Lori; Landy, Uta
Obstetrics and gynecology residency programs are required to provide access to abortion training, but residents can opt out of participating for religious or moral reasons. Quantitative data suggest that most residents who opt out of doing abortions participate and gain skills in other aspects of the family planning training. However, little is known about their experience and perspective. Between June 2010 and June 2011, we conducted semistructured interviews with current and former residents who opted out of some or all of the family planning training at ob-gyn residency programs affiliated with the Kenneth J. Ryan Residency Training Program in Abortion and Family Planning. Residents were either self-identified or were identified by their Ryan Program directors as having opted out of some training. The interviews were transcribed and coded using modified grounded theory. Twenty-six physicians were interviewed by telephone. Interviewees were from geographically diverse programs (35% Midwest, 31% West, 19% South/Southeast and 15% North/Northeast). We identified four dominant themes about their experience: (a) skills valued in the family planning training, (b) improved patient-centered care, (c) changes in attitudes about abortion and (d) miscommunication as a source of negative feelings. Respondents valued the ability to partially participate in the family planning training and identified specific aspects of their training which will impact future patient care. Many of the effects described in the interviews address core competencies in medical knowledge, patient care, communication and professionalism. We recommend that programs offer a spectrum of partial participation in family planning training to all residents, including residents who choose to opt out of doing some or all abortions. Learners who morally object to abortion but participate in training in family planning and abortion, up to their level of comfort, gain clinical and professional skills. We
Zaghloul, Ashraf Ahmad; Elsergany, Moetaz; Mosallam, Rasha
There has been a growing awareness that patients are subject to injuries that can be prevented as a direct consequence of health care. Error disclosure is an effective technique to restore the lost trust with the health care system. The current study aimed to develop a valid and reliable scale to determine the factors facilitating the disclosure of health professionals in health organizations. This study had a cross-sectional design that consisted of 722 responses (response rate of 68.3%) from 1 private and 1 public hospital in Sharjah, United Arab Emirates. The data collection tool included 23 items rated on a Likert scale ranging from 5, strongly agree, to 1, strongly disagree.The internal consistency was established through calculating the split-half reliability for part 1 (12 items), which had a Cronbach coefficient of 0.65, and part 2 (11 items), which had a Cronbach coefficient of 0.62. Scale validity was assessed with the Kaiser-Meyer-Olkin measure of sampling adequacy, which had a value of 0.62, and the Bartlett test of sphericity (approximated χ = 13012.2, P = 0.0001) supported the factorability of the correlation matrix. The varimax rotation revealed 5 components that explained 77.8% of the total variance. The varimax rotation revealed 21 items loaded on the following 5 factors: fear of disclosure and provider image consequences (factor 1), apology (factor 2), organizational culture toward patient safety (factor 3), professional ethics and transparency (factor 4), as well as patient and provider education (factor 5). The disclosure of medical mistakes requires preliminary considerations to effectively and compassionately disclose these events to patients. The validity and reliability of the results support the use of this scale at hospitals as part of the health care providers' disclosure processes.
Basehore, Pamela M; Mortensen, Luke H; Katsaros, Emmanuel; Linsenmeyer, Machelle; McClain, Elizabeth K; Sexton, Patricia S; Wadsworth, Nicole
Entrustable professional activities (EPAs) are measurable units of observable professional practice that can be entrusted to an unsupervised trainee. They were first introduced as a method of operationalizing competency-based medical education in graduate medical education. The American Association of Medical Colleges subsequently used EPAs to establish the core skills that medical students must be able to perform before they enter residency training. A recently published guide provides descriptions, guidelines, and rationale for implementing and assessing the core EPAs from an osteopathic approach. These osteopathically informed EPAs can allow schools to more appropriately assess a learner's whole-person approach to a patient, in alignment with the philosophy of the profession. As the single accreditation system for graduate medical education moves forward, it will be critical to integrate EPAs into osteopathic medical education to demonstrate entrustment of medical school graduates. The authors describe the collaborative process used to establish the osteopathic considerations added to EPAs and explores the challenges and opportunities for undergraduate osteopathic medical education.
van Luijk, S.J.; Gorter, R.C.; van Mook, W.N.K.A.
Background: From 2002 onwards, a nationwide working group of representatives from all medical (8), dental (3) and veterinary medicine (1) schools collaborated in order to develop and implement recommendations for teaching and assessing professional behaviour. Aim: The aim of this article is to
Abu, Ozotu Rosemary
This mixed method research explores unprofessional behaviour experienced by clinical Medical students, during clinical training in Ireland; with a view to obtaining learning points that inform future design of modules on Professionalism. It also looks at the impact of these on students and the relationship between gender\\/ethnicity and students’ experiences of these behaviours.
[Catalogue of learning goals for pregraduate education in geriatric medicine. A recommendation of the German Geriatric Society (DGG), the German Society of Gerontology and Geriatrics (DGGG), the Austrian Society of Geriatrics and Gerontology (ÖGGG) and the Swiss Society of Geriatric Medicine (SFGG) on the basis of recommendations of the European Union of Medical Specialists Geriatric Medicine Section (UEMS-GMS) 2013].
Singler, K; Stuck, A E; Masud, T; Goeldlin, A; Roller, R E
Sound knowledge in the care and management of geriatric patients is essential for doctors in almost all medical subspecialties. Therefore, it is important that pregraduate medical education adequately covers the field of geriatric medicine. However, in most medical faculties in Europe today, learning objectives in geriatric medicine are often substandard or not even explicitly addressed. As a first step to encourage undergraduate teaching in geriatric medicine, the European Union of Medical Specialists -Geriatric Medicine Section (UEMS-GMS) recently developed a catalogue of learning goals using a modified Delphi technique in order to encourage education in this field. This catalogue of learning objectives for geriatric medicine focuses on the minimum requirements with specific learning goals in knowledge, skills and attitudes that medical students should have acquired by the end of their studies.In order to ease the implementation of this new, competence-based curriculum among the medical faculties in universities teaching in the German language, the authors translated the published English language curriculum into German and adapted it according to medical language and terms used at German-speaking medical faculties and universities of Austria, Germany and Switzerland. This article contains the final German translation of the curriculum. The Geriatric Medicine Societies of Germany, Austria, and Switzerland formally endorse the present curriculum and recommend that medical faculties adapt their curricula for undergraduate teaching based on this catalogue.
Ongolo-Zogo, P.; Nguehouo, M.B.; Yomi, J.; Nko'o Amven, S.
Medical use of ionizing radiation is now the most common radiation source of the population at the global level. The knowledge and practices of health professionals working with X-rays determine the level and quality of implementation of internationally and nationally recommended measures for radiation protection of patients and workers. The level of implementation and enforcement of international recommendations in African countries is an issue of concern due to weak laws and regulations and regulatory bodies. We report the results of a cross-sectional survey of health professionals working with ionizing radiation in Yaounde, the capital city of Cameroon. More than 50% of these professionals have a moderate level of knowledge of the norms and principles of radiation protection and more than 80% have never attended a continuing professional development workshop on radiation protection. (authors)
Mohammad Abdul Baseer
Conclusion: Oral health knowledge among the health professionals working in KFMC, Riyadh was lower than what would be expected of these groups, which had higher literacy levels in health care, but they showed a positive attitude toward professional dental care.
Grammaticos, Philip C
Unfortunately, today very few care about medical deontology-ethics that is about how to behave and respect others when we exercise our medical duties. Perhaps we do not show our real care and kind leadership to our students. We do not very much respect our medical colleagues. We are often tired to spend much time examining patients. We attend medical meetings for pleasure or because our expenses are covered by pharmaceutical firms. We write unimportant papers in order to have a rich curriculum. We consider the Impact Factor of a journal as awarded only to underline the importance of a letter to the Editor we publish in a prestigious journal. We refrain from useful research. We are not always truthful in publishing the results of our research. Many such examples are included in this paper. Overall, we go for a financial success disregarding the "old" Hippocratic ideas and oath. We are supposed to seak for life-happiness. Instead, we feel guilty, inconvenient as to our social behaviour and unhappy. "The Lancet" mentioned long ago (1969) a phrase by John Keats: "Truth is beauty...this only exists on Earth and this is what we need to know".
Myers, Kimberly R; George, Daniel R
The field of medical humanities has traditionally focused on medical students and, more recently, on premedical undergraduates. Comparatively little formal humanities pedagogy has been dedicated to midcareer health professionals. To address this lack, the Department of Humanities at the Pennsylvania State University College of Medicine and the Milton S. Hershey Medical Center designed eight annual humanities mini-courses for faculty and staff throughout the college and medical center.These mini-courses fell into four categories: reading, reflection, and discussion; creative expression; technology; and ethics. They were geared toward midcareer health professionals who were seeking new intellectual and creative stimulation and variety in daily routine. They also provided humanities faculty the opportunity to devote attention to topics that capitalize on their professional training and that interest them personally.Participants indicated a high degree of satisfaction with the mini-courses for four principal reasons: (1) learning the tools and methodologies of a new discipline or domain other than biomedicine, (2) using their minds and training in uncustomary ways, (3) forming new alliances with colleagues (which served to lessen the sense of professional isolation), and (4) enjoying a respite from the stressful flow of the workday. Humanities faculty facilitators provided more mixed responses but agreed that conducting the mini-courses had been a positive overall experience.Although this article provides a foundational framework for the development of a humanities mini-course series, the authors encourage others to replicate these curricula in other medical settings as an important step toward a robust pedagogy designed for midcareer health care professionals.
Li, David G; Wong, Gordon X; Martin, David T; Tybor, David J; Kim, Jennifer; Lasker, Jeffrey; Mitty, Roger; Salem, Deeb
To determine the attitudes of physicians and trainees in regard to the roles of both cost-effectiveness and equity in clinical decision making. In this cross-sectional study, electronic surveys containing a hypothetical decision-making scenario were sent to medical professionals to select between two colon cancer screening tests for a population. Three Greater Boston academic medical institutions: Tufts University School of Medicine, Tufts Medical Centre and Lahey Hospital and Medical Centre. 819 medical students, 497 residents-in-training and 671 practising physicians were contacted electronically using institutional and organisational directories. Stratified opinions of medical providers and trainee subgroups regarding cost-effectiveness and equity. A total of 881 respondents comprising 512 medical students, 133 medical residents-in-training and 236 practising physicians completed the survey (total response rate 44.3%). Thirty-six per cent of medical students, 44% of residents-in-training and 53% of practising physicians favoured the less effective and more equitable screening test. Residents-in-training (OR 1.49, CI 1.01 to 2.21; p=0.044) and practising physicians (OR 2.12, CI 1.54 to 2.92; pmedical students. Moreover, female responders across all three cohorts favoured the more equitable screening test to a greater degree than did male responders (OR 1.70, CI 1.29 to 2.24; pmedical professionals place on equity. Among medical professionals, practising physicians appear to be more egalitarian than residents-in-training, while medical students appear to be most utilitarian and cost-effective. Meanwhile, female respondents in all three cohorts favoured the more equitable option to a greater degree than their male counterparts. Healthcare policies that trade off equity in favour of cost-effectiveness may be unacceptable to many medical professionals, especially practising physicians and women. © Article author(s) (or their employer(s) unless otherwise stated
Roshana, Shrestha; Kh, Batajoo; Rm, Piryani; Mw, Sharma
Basic life support (BLS), a key component of the chain of survival decreases the arrest - cardiopulmonary resuscitation interval and increases the rate of hospital discharge. The study aimed to explore the knowledge of and attitude towards basic life support (BLS) among medical/paramedical professionals. An observational study was conducted by assessing response to self prepared questionnaire consisting of the demographic information of the medical/paramedical staff, their personnel experience/attitude and knowledge of BLS based on the 2005 BLS Guidelines of European Resuscitation Council. After excluding incomplete questionnaires, the data from 121 responders (27 clinical faculty members, 21 dental and basic sciences faculty members, 29 house officers and 44 nurses and health assistants) were analyzed. Only 9 (7.4%) of the 121 responders answered ≥11, 53 (43%) answered 7-10, and 58 (48%) answered basic sciences faculty members attained a least mean score of 4.52 ±2.13 (P<0.001). Those who had received cardiopulmonary resuscitation (CPR) training within 5 years obtained a highest mean score of 8.62±2.49, whereas those who had the training more than 5 years back or no training obtained a mean score of 5.54±2.38 and 6.1±2.29 respectively (P=0.001). Those who were involved in resuscitation frequently had a higher median score of 8 in comparison to those who were seldom involved or not involved at all (P<0.001). The average health personnel in our hospital lack adequate knowledge in CPR/BLS. Training and experience can enhance knowledge of CPR of these personnel. Thus standard of CPR/BLS training and assessment are recommended at our hospital.
Laurino, Mercy Y; Leppig, Kathleen A; Abad, Peter James; Cham, Breana; Chu, Yoyo Wing Yiu; Kejriwal, Saahil; Lee, Juliana M H; Sternen, Darci L; Thompson, Jennifer K; Burgess, Matthew J; Chien, Shu; Elackatt, Niby; Lim, Jiin Ying; Sura, Thanyachai; Faradz, Sultana; Padilla, Carmencita; Paz, Eva Cutiongco de-la; Nauphar, Donny; Nguyen, Khanh Ngoc; Zayts, Olya; Vu, Dung Chi; Thong, Meow-Keong
The Professional Society of Genetic Counselors in Asia (PSGCA) was recently established as a special interest group of the Asia Pacific Society of Human Genetics. Fostering partnerships across the globe, the PSGCA's vision is to be the lead organization that advances and mainstreams the genetic counseling profession in Asia and ensures individuals have access to genetic counseling services. Its mission is to promote quality genetic counseling services in the region by enhancing practice and curricular standards, research and continuing education. The PSGCA was formally launched during the Genetic Counseling Pre-Conference Workshop held at the 11th Asia-Pacific Conference on Human Genetics in Hanoi, Viet Nam, September 16, 2015. The pre-conference workshop provided an opportunity for medical geneticists and genetic counselors from across 10 Asia Pacific countries to learn about the varied genetic counseling practices and strategies for genetic counseling training. This paper provides an overview of the current status and challenges in these countries, and proposed course of unified actions for the future of the genetic counseling profession.
Crisford, Paul; Winzenberg, Tania; Venn, Alison; Schultz, Martin; Aitken, Dawn; Cleland, Verity
To identify factors associated with non-medical health professionals' engagement in physical activity (PA) promotion. Five electronic databases were searched for studies including practising health professionals (excluding medical doctors), a PA promotion practice measure, a test of association between potential influencing factors and PA promotion practice, and written in English. Two researchers independently screened studies and extracted data. Extracted data were synthesized in a tabular format with a narrative summary (thematic analysis). Thirty studies involving 7734 non-medical health professionals were included. Self-efficacy in PA promotion, positive beliefs in the benefits of PA, assessing patients' PA, and PA promotion training were the main factors associated with engaging in PA promotion. Lack of remuneration was not associated. Common study limitations included a lack of information on non-responders, data collection by survey only and limited reliability or validity testing of measurements. There are common factors influencing PA promotion, but the absence of studies from some health professions, limitations related to study measures, and the lack of randomised controlled intervention trials highlights the need for further research. The factors identified may prove useful for guiding the development of strategies to encourage greater engagement in PA promotion by health professionals. Copyright © 2018 Elsevier B.V. All rights reserved.
Mahlknecht, Angelika; Nestler, Nadja; Bauer, Ulrike; Schüßler, Nadine; Schuler, Jochen; Scharer, Sebastian; Becker, Ralf; Waltering, Isabel; Hempel, Georg; Schwalbe, Oliver; Flamm, Maria; Osterbrink, Jürgen
Pharmacotherapy in residents of nursing homes is critical due to the special vulnerability of this population. Medical care and interprofessional communication in nursing homes are often uncoordinated. As a consequence, polypharmacy and inappropriate medication use are common and may lead to hospitalizations and health hazards. The aim of this study is to optimize communication between the involved professional groups by specific training and by establishing a structured medication review process, and to improve medication appropriateness and patient-relevant health outcomes for residents of nursing homes. The trial is designed as single-arm study. It involves 300 nursing home residents aged ≥ 65 years and the members of the different professional groups practising in nursing home care (15-20 general practitioners, nurses, pharmacists). The intervention consists of interprofessional education on safe medication use in geriatric patients, and a systematic interprofessional therapy check (recording, reviewing and adapting the medication of the participating residents by means of a specific online platform). The intervention period is divided into two phases; total project period is 3 years. Primary outcome measure is the change in medication appropriateness according to the Medication Appropriateness Index. Secondary outcomes are cognitive performance, occurrence of delirium, agitation, tendency of falls, total number of drugs, number of potentially dangerous drug-drug interactions and appropriateness of recorded analgesic therapy regimens according to the Medication Appropriateness Index. Data are collected at t 0 (before the start of the intervention), t 1 (after the first intervention period) and t 2 (after the second intervention period). Cooperation and communication between the professional groups are investigated twice by qualitative interviews. The project aims to establish a structured system for monitoring of drug therapy in nursing home residents
S V Kirankumar
Full Text Available Aims: The aim of this study was to analyze medical professional, perception, attitude, knowledge, and experience about child abuse and neglect in Bagalkot district, north Karnataka, India. Materials and Methods: Two hundred medical professional, working in both public and private sectors in the province were interviewed by a single operator. Descriptive analyses were carried out by using the obtained data. Results: Medical professional′s perception about child abuse and neglect (CAN is low and these professionals have poor attitude and knowledge toward CAN in accordance with the code of conduct and law. The available information and education is also poor. Conclusions: The results obtained from the study showed that there is lack of knowledge and poor attitude and perception about CAN among medical professionals that prevents them from detecting and identifying suspected cases. Continuing medical education is required to enhance the ability of professionals to detect CAN cases.
Management of hemodynamically unstable pelvic trauma: results of the first Italian consensus conference (cooperative guidelines of the Italian Society of Surgery, the Italian Association of Hospital Surgeons, the Multi-specialist Italian Society of Young Surgeons, the Italian Society of Emergency Surgery and Trauma, the Italian Society of Anesthesia, Analgesia, Resuscitation and Intensive Care, the Italian Society of Orthopaedics and Traumatology, the Italian Society of Emergency Medicine, the Italian Society of Medical Radiology -Section of Vascular and Interventional Radiology- and the World Society of Emergency Surgery)
Hemodynamically Unstable Pelvic Trauma is a major problem in blunt traumatic injury. No cosensus has been reached in literature on the optimal treatment of this condition. We present the results of the First Italian Consensus Conference on Pelvic Trauma which took place in Bergamo on April 13 2013. An extensive review of the literature has been undertaken by the Organizing Committee (OC) and forwarded to the Scientific Committee (SC) and the Panel (JP). Members of them were appointed by surgery, critical care, radiology, emergency medicine and orthopedics Italian and International societies: the Italian Society of Surgery, the Italian Association of Hospital Surgeons, the Multi-specialist Italian Society of Young Surgeons, the Italian Society of Emergency Surgery and Trauma, the Italian Society of Anesthesia, Analgesia, Resuscitation and Intensive Care, the Italian Society of Orthopaedics and Traumatology, the Italian Society of Emergency Medicine, the Italian Society of Medical Radiology, Section of Vascular and Interventional Radiology and the World Society of Emergency Surgery. From November 2012 to January 2013 the SC undertook the critical revision and prepared the presentation to the audience and the Panel on the day of the Conference. Then 3 recommendations were presented according to the 3 submitted questions. The Panel voted the recommendations after discussion and amendments with the audience. Later on a email debate took place until December 2013 to reach a unanimous consent. We present results on the 3 following questions: which hemodynamically unstable patient needs an extraperitoneal pelvic packing? Which hemodynamically unstable patient needs an external fixation? Which hemodynamically unstable patient needs emergent angiography? No longer angiography is considered the first therapeutic maneuver in such a patient. Preperitoneal pelvic packing and external fixation, preceded by pelvic binder have a pivotal role in the management of these patients
Cendán, Juan C; Castiglioni, Analia; Johnson, Teresa R; Eakins, Mike; Verduin, Marcia L; Asmar, Abdo; Metcalf, David; Hernandez, Caridad
Capturing either lapses or excellence in behaviors related to medical professionalism is difficult. The authors report a mixed-methods analysis of a novel mobile platform for assessing medical professionalism in a training environment. A mobile Web-based platform to facilitate professionalism assessment in a situated clinical setting (Professional Mobile Monitoring of Behaviors [PROMOBES]) was developed. A professionalism framework consisting of six domains (reliability, adaptability, peer relationships, upholding principles, team relationships, and scholarship) encompassing 25 subelements underpins the reporting structure. This pilot study involved 26 faculty supervising 93 medical trainees at two sites from January 12 to August 8, 2016. Notable professionalism behaviors were linked to the framework domains and elements; narrative details about incidences were captured on mobile devices. Surveys gauged the technological functionality and impact of PROMOBES on faculty assessment of professionalism. Qualitative focus groups were employed to elucidate user experience. Although users anticipated PROMOBES's utility would be for reporting lapses in professionalism, 94.7% of reports were for commendation. Comfort assessing professionalism (P = .04) and recognition of the reporting procedures for professionalism-related concerns (P = .01) improved. PROMOBES attained high acceptance ratings. Focus group analysis revealed that the explicit connection to the professionalism framework was powerful; similarly, the near real-time reporting capability, multiple observer inputs, and positive feedback facilitation were strengths. Making the professionalism framework visible and accessible via a mobile platform significantly strengthens faculty knowledge and behaviors regarding assessment. The strong desire to capture positive behaviors was an unexpected finding.
Full Text Available There is a dire need to evaluate new strategies to bridge the wide kidney demand-supply gap. The current study examined the attitude of medical professionals regarding controversial issues pertaining to transplantation. A questionnaire, presenting controversial issues related to kidney transplantation, in an agree-disagree format with supporting reasons, was employed. The research was exploratory. Data were analyzed quantitatively and qualitatively. The sample comprised 140 doctors from Mumbai (mean = 38.1 years, standard deviation = 17.95; Males = 44.3%, Females = 55.7%. Whereas 47.1% of the participants felt that live donors should be given incentives for kidney donation, others (52.9% disagreed,