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.
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
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.
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.
Wojtal, Mariola; Kurpas, Donata; Bielska, Dorota; Steciwko, Andrzej
The promotion of health is a science and art of helping people to change their environment and lifestyle to a health friendly one, in order to strengthen and build up their wellbeing. Smoking cigarettes is a most disadvantageous element of a lifestyle. Important elements of promotion of non-smoking lifestyle, by our students, as future Health Service members, are: promoting of smoke-free environment, encouraging of non-smoking fashion, education of health consequences of smoking cigarettes, motivation to quit smoking, advisement in the field of smoking addiction treatment. Public health and health promotion, these are classes where smoking cigarettes' problem has been discussed mostly. Over 90% of students' respondents claim that were able to give a nonsmoking advice to any patient. Because of the awareness of health threats caused by smoking cigarettes and because of the role of education in prevention and addiction fighting, over 82.4% of students were convinced that every doctor should ask every patient, about his/her attitude towards smoking cigarettes.
Farnan, Jeanne M; Snyder Sulmasy, Lois; Worster, Brooke K; Chaudhry, Humayun J; Rhyne, Janelle A; Arora, Vineet M
User-created content and communications on Web-based applications, such as networking sites, media sharing sites, or blog platforms, have dramatically increased in popularity over the past several years, but there has been little policy or guidance on the best practices to inform standards for the professional conduct of physicians in the digital environment. Areas of specific concern include the use of such media for nonclinical purposes, implications for confidentiality, the use of social media in patient education, and how all of this affects the public's trust in physicians as patient-physician interactions extend into the digital environment. Opportunities afforded by online applications represent a new frontier in medicine as physicians and patients become more connected. This position paper from the American College of Physicians and the Federation of State Medical Boards examines and provides recommendations about the influence of social media on the patient-physician relationship, the role of these media in public perception of physician behaviors, and strategies for physician-physician communication that preserve confidentiality while best using these technologies.
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.
Zackova, H.; Horakova, I.
The attention is paid to the role of the National Radiation Protection Institute (NRPI) in the support of the education on the pregraduate and postgraduate level. On pregraduate level the NRPI is engaged in education of the students of the Faculty of Nuclear Sciences and Physical Engineering (FNSPE) in the field of radiation protection and radiological physics. On the postgraduate level there is an important role of NRPI in the postgraduate education of the health professionals. This education can take advantage of the more than the thirty years cooperation between NRPI and IPVZ (Institute for postgraduate medical education). In the presentation the important data and experience of the courses of radiation protection organized for health professionals will be ShOWll. In the presentation there are also presented activities of the division of medical exposures of the NRPI, which are pointing to the public information. Some typical questions, which have been addressed to NRPI are brought forward and discussed. (authors)
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.
McNulty, Cliodna A M; Cookson, Barry D; Lewis, Michael A O
In the winter of 2007-08 a new public-facing antimicrobial campaign was agreed by the Advisory Committee on Antimicrobial Resistance and Healthcare-Associated Infection (ARHAI) Education sub-Group (later divided into subgroups for professional and public education): it comprised posters with a positive message on how the public could help themselves when they had a cold. However, the poster campaign, used in isolation in England, did not improve antibiotic use; therefore, the Public Education sub-Group took forward educational approaches to change the behaviour of the public and health professionals. Professionals have been encouraged to give patients clear information about the likely duration of symptoms, self-care, and benefits and harms of antibiotics, reinforcing the public poster campaigns in surgeries, hospitals and pharmacies. Since 2008, campaigns have been launched in England to coincide with European Antibiotic Awareness Day (EAAD) on 18 November, using Department of Health and EAAD materials. Professional education has been facilitated by the 2008 National Institute for Health and Clinical Excellence respiratory tract infection delayed prescribing guidance for general practitioners. A toolkit of materials for medicines management teams, to facilitate good antimicrobial stewardship in primary care (ASPIC), is being taken forward by the Public Education sub-Group and professional societies. After advice from ARHAI, in 2009 the General Medical Council requested that all postgraduate deans and Royal Colleges ensure infection prevention and control and antimicrobial prescribing become standard practice implemented in all clinical settings, and that they are emphasized strongly in undergraduate and postgraduate medical training. ARHAI has also taken a keen interest in reviewing, advising and leading on a number of European Union initiatives dealing with professional education.
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
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.
Full Text Available The healthcare enterprises are very disconnected. This paper intends to propose a solution that will provide citizens, businesses and medical enterprises with improved access to medical virtual public services. Referred medical services are based on existing national medical Web services and which support medically required services provided by physicians and supplementary health care practitioners, laboratory services and diagnostic procedures, clinics and hospitalsÃ¢Â€Â™ services. Requirements and specific rules of these medical services are considered, and personalization of user preferences will to be supported. The architecture is based on adaptable process management technologies, allowing for virtual services which are dynamically combined from existing national medical services. In this way, a comprehensive workflow process is set up, allowing for service-level agreements, an audit trail and explanation of the process to the end user. The process engine operates on top of a virtual repository, providing a high-level semantic view of information retrieved from heterogeneous information sources, such as national sources of medical services. The system relies on a security framework to ensure all high-level security requirements are met. SystemÃ¢Â€Â™s architecture is business oriented: it focuses on Service Oriented Architecture - SOA concepts, asynchronously combining Web services, Business Process Management Ã¢Â€Â“ BPM rules and BPEL standards.
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.
The mission statement of Nigerian public administration anchors on providing a ..... to incorporate into the Revised Public Service Rules and Financial ... in Africa is intended to consolidate rules for professional work ethic so that the public.
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.
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:.
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.
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
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.
Many of today's water problems cannot be solved within the traditional boundaries of organizations, disciplines, sectors and routines. Innovative solutions come into being in interplay between a variety of public, private and civil society actors. These so-called governance processes produce new
L.G. Tummers (Lars)
textabstractNowadays, many public professionals face identification problems towards public policies they have to implement; that is, they experience policy alienation. We conceptualize policy alienation, starting from the sociological concept of alienation and showing how this can be used in the
Hart, Mark; Stetten, Nichole E; Islam, Sabrina; Pizarro, Katherine
The use of social networking sites is increasingly being adopted in public health, in part, because of the barriers to funding and reduced resources. Public health professionals are using social media platforms, specifically Twitter, as a way to facilitate professional development. The objective of this study was to identify public health professionals using Twitter and to analyze how they use this platform to enhance their formal and informal professional development within the context of public health. Keyword searches were conducted to identify and invite potential participants to complete a survey related to their use of Twitter for public health and professional experiences. Data regarding demographic attributes, Twitter usage, and qualitative information were obtained through an anonymous Web-based survey. Open-response survey questions were analyzed using the constant comparison method. "Using Twitter makes it easier to expand my networking opportunities" and "I find Twitter useful for professional development" scored highest, with a mean score of 4.57 (standard deviation [SD] 0.74) and 4.43 (SD 0.76) on a 5-point Likert scale. Analysis of the qualitative data shows the emergence of the following themes for why public health professionals mostly use Twitter: (1) geography, (2) continuing education, (3) professional gain, and (4) communication. For public health professionals in this study, Twitter is a platform best used for their networking and professional development. Furthermore, the use of Twitter allows public health professionals to overcome a series of barriers and enhances opportunities for growth. ©Mark Hart, Nichole E Stetten, Sabrina Islam, Katherine Pizarro. Originally published in JMIR Public Health and Surveillance (http://publichealth.jmir.org), 20.09.2017.
Full Text Available The subjects of this paper are ethics and professionalism, topics closely linked in contemporary theory, and especially in practice of public relations, whose significance is increasingly coming to the spotlight of experts from this area. Several definitions, classification, the historical development and principles of theories of ethics most frequently used in ethical decision-making within a business environment, have been presented in the first chapter in the endeavor to ascertain the concept of ethics. The next chapter concerns the duties a public relations expert must pay attention to while carrying out his or her activities. Those are: duty towards oneself, towards the organization, society and profession, within which, in the case of a conflict of interest, the duty towards society (so-called social responsibility, or professional duty, must prevail. The chapter that follows concerns ethical problems in the contemporary practice of public relations: the competence of practitioners, possible conflicts of interest and the very sensitive area of media relations. The chapter on models of ethical decision-making involves concrete experts' advice on decision making which are firmly based on ethical principles. Next section concerns professionalism and professional education in public relations. Recommendations concerning topics which should be included in the university education in this area are also presented. The focus is on the following: the absence of standards that would establish who can work in public relations and under which conditions; the lack of a specified educational minimum and expertise which a practitioner should possess; the need for practitioners to be the members of professional associations, as well as to adhere to a required ethical codex. Some of the most significant world public relations associations are mentioned and at the end, and a review of the state of public relations in Serbia is given.
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.
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...
Chappelow, Marsha A.
Describes National School Public Relations Association standards for school public relations and communications professionals and program. Includes reactions and comments about new Association standards from seven superintendents and four school public-relations professionals. (PKP)
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.
Roberts, Sherron Killingsworth
Why should educators and service professionals bother writing for professional publication? Experienced editor, Sherron Roberts says writing for professional publication allows educators to share their work and make their practice visible. Any educator is quite capable of writing for a professional publication. This article is intended to show…
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.
Compatibility between publicity and deontology is an old problem. Since a few months, TV shows, press interviews or newspapers have aroused interest. Some judgements from the European Court and the National Council of the medical Order and lawmakers were expressed. An "inventory of fixtures" seems to be now necessary.
Kadek Dwi Cahaya Putra
Full Text Available Abstract: This paper attempts to describe that there is a chance for non-Public Relations graduates to work as or at the Public Relations industry. Studies have shown that Public Relations practitioners are mostly from generalist background (not Public Relations and even come into the job by chance. A Public Relations is a very sociable person, possess a mix of functional, managerial and negotiating abilities as well as analytical and well-developed communication and understand people and human psychology. With working roles of Expert Prescriber, Communication Facilitator, Problem Solving Facilitator and Communication Technician, a Public Relations needs to be well prepared by learning foreign language, joining personality improvement course, developing networking and understanding computer and communication technology. Areas of where a Public relations works are in-house (organization/company, consultancy and freelance practitioner having various titles showing their main function in the organization such as public affairs, event manager, community relations manager, marketing communication executive, employee relations manager, corporate communications manager, media coordinator. As there is an increased challenge of Public Relationsâ€™s professionalism, a true practitioner is best prepared by educational institutions with lecturers having sound education and practice combined with extensive link-and -match research and industrial-practical placement for the graduates.
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.
Journalists and health professionals share a symbiotic relationship during a disease outbreak as both professions play an important role in informing the public's perceptions and the decisions of policy makers. Although critics in the United States have focused on US reporters and media outlets whose coverage has been sensationalist and alarmist, the discussion in this article is based on the ideal--gold standard--for US journalists. Journalists perform three primary functions during times of health crises: disseminating accurate information to the public, medical professionals, and policy makers; acting as the go-between for the public and decision makers and health and science experts; and monitoring the performance of institutions responsible for the public health response. A journalist's goal is to responsibly inform the public in order to optimize the public health goals of prevention while minimizing panic. The struggle to strike a balance between humanizing a story and protecting the dignity of patients while also capturing the severity of an epidemic is harder in the era of the 24-7 news cycle. Journalists grapple with dueling pressures: confirming that their information is correct while meeting the demand for rapid updates. Just as health care professionals triage patients, journalists triage information. The challenge going forward will be how to get ahead of the story from the onset, racing against the pace of digital dissemination of misinformation by continuing to refine the media-science relationship.
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.
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...
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
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.
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.
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.
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.
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.
Yam, Carrie Ho-Kwan; Wong, Eliza Lai-Yi; Griffiths, Sian M; Yeoh, Eng-Kiong
To assess public knowledge and expectations of the ways to assess doctors' competence to ensure patient safety. Telephone survey of a random sample of 1000 non-institutionalized Hong Kong residents. Only 5% of public were correct that doctors are not required to periodically be assessed, and 9% were correct that the doctors are not required to update knowledge and skills for renewing their license. These results echo international studies showing a low public knowledge of medical regulation. The public overwhelmingly felt a periodic assessment (92%) and requirements for continuous medical education (91%) were important processes for assuring doctors' competence. A high proportion of the public felt that lay representation in the Medical Council was insufficient. There is a significant gap between public expectations and understanding of the existing medical regulation and the actual policies and practices. Despite a lack of public knowledge, the public thought it important to have an ongoing structured monitoring and assessment mechanism to assure doctors' competence. The public also expects a greater involvement in the regulatory processes as members of the Medical Council. There is a need to review and enhance the current regulatory system to meet public expectation and ensure accountability for the privilege and trust granted by the State in professional self-regulation. In the context of our complex health system, a thorough understanding on the dynamic interactions between different institutions and their complementary roles in a meta-regulatory framework is required in assuring patient safety.
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
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.
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…
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.
Tyler, Ingrid V; Hau, Monica; Buxton, Jane A; Elliott, Lawrence J; Harvey, Bart J; Hockin, James C; Mowat, David L
To understand the perceptions and attitudes of Canadian medical students toward their undergraduate medical public health curriculum and to identify student suggestions and priorities for curriculum change. Five focus groups of 11 or 12 medical students from all years of medical school were recruited at McMaster University Faculty of Health Sciences, Université de Sherbrooke Faculty of Medicine and Health Sciences, University of Toronto Faculty of Medicine, University of Manitoba Faculty of Medicine, and University of British Columbia Faculty of Medicine between February and April 2006. A professional facilitator was hired to conduct the focus groups using a unique, computer-based facilitation system. Questions in both the focus group and an accompanying survey sought to determine medical students' understanding and exposure to public health and how this impacted their attitudes and choices toward careers in the public health medical specialty of community medicine. The transcripts were independently reviewed and analyzed by each of the authors to identify themes. Four major themes related to students' desired curriculum change were identified: (1) poor educational experiences in public health courses, (2) lack of positive role models, especially exposure to community medicine specialists, (3) emphasis on statistics and epidemiology, and (4) negative attitudes toward public health topics. Students are disillusioned, disengaged, and disappointed with the public health curriculum currently being provided at the Canadian medical schools studied. Many medical students would prefer a public health curriculum that is more challenging and has more applied field experience and exposure to public health physician role models.
Hao, Aimin; Yi, Tao; Li, Xia; Wei, Lei; Huang, Pei; Xu, Xinzhou; Yi, Lihua
Purpose: The quality of medical services provided by competing public hospitals is the primary consideration of the public in determining the selection of a specific hospital for treatment. The main objective of strategic planning is to improve the quality of public hospital medical services. This paper provides an introduction to the history, significance, principles and practices of public hospital medical service strategy, as well as advancing the opinion that public hospital service strategy must not merely aim to produce but actually result in the highest possible level of quality, convenience, efficiency and patient satisfaction.
Saunders, Martha Dunagin; Perrigo, Eileen
Shows that negotiation provides an effective model for teaching public relations professionalism. Describes how two professors in a public relations class used a negotiation model to teach students to simultaneously balance the two components of professionalism: ethical considerations and pragmatic, problem-solving measures. (SR)
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.
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.
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.
Cahaya Putra, Kadek Dwi
Abstract: This paper attempts to describe that there is a chance for non-Public Relations graduates to work as or at the Public Relations industry. Studies have shown that Public Relations practitioners are mostly from generalist background (not Public Relations) and even come into the job by chance. A Public Relations is a very sociable person, possess a mix of functional, managerial and negotiating abilities as well as analytical and well-developed communication and understand people and hu...
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.
Davó-Blanes, M Carmen; Vives-Cases, Carmen; Barrio-Fernández, José Luis; Porta, Miquel; Benavides, Fernando G; de Miguel, Ángel Gil
To reach a consensus among public health faculty from various Spanish universities about the core public health competencies that should be integrated into undergraduate medical degrees. The 2nd Forum of University Teachers was held at the Rey Juan Carlos University (Madrid, 11-12 December 2014). Twenty-four university professors and lecturers from 19 Spanish universities imparting medical degrees participated in the forum. They were distributed in three working groups during three working sessions. In the first session, they were asked to identify and classify core public health competencies for medical degrees. In the second, they were asked to propose public health contents for the identified competencies. In the third session, the participants organized these contents in thematic blocks. The results were discussed in distinct plenary sessions. The highest number of core competencies was identified in the activities related to the public health functions «Assessment of the population's health needs» and «Developing health policies». The final programme included basic contents organised into five units: Concept of health, public health and its determinants; Epidemiology and health research; Determinants and health problems; Strategies, interventions and policies; and health systems, clinical and healthcare management. The public health core competencies and contents identified in this Forum may be considered as a starting point to improve and update public health training programmes for future medical professionals. Copyright © 2015 SESPAS. Published by Elsevier Espana. All rights reserved.
Pharmaceutical companies integrate scientific publications into the communication strategies they employ to influence the practices of health professionals. In their"publication plan", pharmaceutical companies, or the communication agencies they hire, develop key messages to promote their drugs and then plan in advance how, when and where to disseminate them in medical journals or at conferences. Although their true intent is promotional, these messages must appear to be purely scientific, and are therefore disseminated as research articles, review articles, editorials, commentaries. Publication planning involves the use of "ghost" authors who work directly for pharmaceutical companies, but whose contribution is rarely acknowledged in the final published article. Key opinion leaders are recruited as the honorary authors of these articles, to which they have made little, if any, contribution. The criteria for authorship set by journals that publish primary research articles do not provide adequate protection against the practice of ghost and honorary authorship. Certain journals publishing primary research derive a large proportion of their revenue from selling reprints used by pharmaceutical companies to promote their drugs, especially by their sales representatives.
Fox, Charles J.
The role of the National Association of Schools of Public Affairs and Administration (NASPAA) in promoting professionalism in public administration is explored, and potential problems associated with that role are discussed. The recent movement toward accreditation in public administration education based on a Total Quality Management mission is…
Hansson, Sven Ove
In order to shorten queues to healthcare, the Swedish government has introduced a yearly "queue billion" that is paid out to the county councils in proportion to how successful they are in reducing queues. However, only the queues for first visits are covered. Evidence has accumulated that queues for return visits have become longer. This affects the chronically and severely ill. Swedish physicians, and the Swedish Medical Association, have strongly criticized the queue billion and have claimed that it conflicts with medical ethics. Instead they demand that their professional judgments on priority setting and medical urgency be respected. This discussion provides an interesting illustration of some of the limitations of new public management and also more generally of the complicated relationships between medical ethics and public policy.
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
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.
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.
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.
Full Text Available In this article the author addresses the issue of the development of professional and ethical competence of public workers in the context of public administration reform. The concept of competence is complex, being approached them different perspectives. There are two main approaches in researching this phenomenon: sociological and psychological. Each of the theories analyzed in this paper contribute to the understanding of a range of aspects of competence. A main objective of the government of the Republic of Moldova at this stage is the management of human resource because professional and management training of public workers is a condition the lack which would render public administration incapable to face current challenges. A major role in the education and professional formation of public workers is played by the Academy of Public Administration.
Sisson, Jamie Huff; Iverson, Susan V.
Educational reforms across the globe have had implications for the work of preschool teachers and thus their professional identities. This article draws on a feminist discourse lens to examine data collected from a recent narrative inquiry focused on understanding the professional identities of five public preschool teachers in the USA. This…
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.
Writing for journal publication is a worthwhile but challenging activity that requires clear motives, purpose, planning and execution. Continuing professional development (CPD) articles are designed to be informative and educative, with the aim of enhancing the reader's understanding of a particular subject. This article provides an overview of how to approach and plan the writing of a CPD article to enhance the success of its acceptance for publication in a professional journal.
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
Tracey L. Adams
Full Text Available The regulation of professional groups has often been justified as being in the public interest. In recent decades, policymakers in Anglo-American countries have questioned whether self-regulating professions have truly served the public interest, or whether they have merely acted in their own interests. This paper draws on legislative records and policy reports to explore meanings attached to professional self-regulation and the public interest in Canada by state actors over the past 150 years. The findings point to a shift in the definition of the public interest away from service quality and professional interests, towards efficiency, human rights, consumer choice, and in some contexts business interests. Changing views of the public interest contribute to regulatory change.
Rodríguez, Dolors; Berenguera, Anna; Pujol-Ribera, Enriqueta; Capella, Jordina; Peray, Josep Lluís de; Roma, Josep
To identify current and future competencies (managers and technicians) for public health professionals in Catalonia (Spain). Qualitative research with a phenomenological approach. Between November 2009 and February 2010, 31 semistructured interviews were completed with public health professionals working in Catalonia. We purposely used a theoretical sample to include the maximum multiplicity of discourses. We conducted a thematic content analysis. We obtained a wide range of current professional competencies, as well as those required for the future, classified according to professional profile. The participants highlighted transversal competencies, such as the importance of sharing a general theoretical framework of the discipline and the institution. Among the most frequently reported competencies were knowledge management, communication skills, teamwork, multidisciplinary and intersectoral orientation, legal knowledge, computer skills and languages, particularly English. It was also important for individual professionals to have specific skills in their areas of activity. In terms of differences between managers and technicians, the study showed that technicians prioritize management skills concerning human and material resources, while managers emphasize organizational and professional public health expertise. There is a need for transversal and specific competencies in distinct areas. Public health is a multidisciplinary field, which collaborates with a wide range of professionals and organizations. Copyright © 2012 SESPAS. Published by Elsevier Espana. All rights reserved.
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.
Andersen, Lotte Bøgh
The theories of professions, public service motivation, and economic incentives explain the behaviour of the producers of publicly financed services differently. They emphasize professional norms, sector, and economic incentives, respectively. The few existing attempts to integrate these theories...... have, however, indicated that these factors interact. Using interviews, surveys and registers, the paper investigated how professional norms, economic incentives and sector affected the behaviour of Danish dentists and physicians. It was found that when strong professional norms existed, economic...... incentives were unimportant for both public and private employees. In contrast, when no firm professional norm applied, economic incentives affected behaviour. Controlling for different economic incentives, sector does not seem to affect the behaviour much. The results imply that the economic...
Main sources of radiation exposure are radiography for the diagnosis of disease and radiation therapy to kill cancer cells, which are using X-ray generators or radioisotopes. The radiation of medical purpose irradiates intentionally to the patients. Another example of intentional exposure is occupational workers who are handling radiological equipment. The patients receive radiation more than the dose exposed to the occupational workers, but there is no doubt for the secondary radiation hazard. Although the epidemiologic studies represents that even low dose irradiation can cause epidemiologic studies represents that even low dose irradiation can cause cancer or congenital anomaly in human as a late effect, the risk is negligible, particularly when it is compared with the incidence of same disease in general population
García-Goñi, Manuel; Maroto, Andrés; Rubalcaba, Luis
Innovations in public health services promote increases in the health status of the population. Therefore, it is a major concern for health policy makers to understand the drivers of innovation processes. This paper focuses on the differences in behaviour of managers and front-line employees in the pro-innovative provision of public health services. We utilize a survey conducted on front-line employees and managers in public health institutions across six European countries. The survey covers topics related to satisfaction, or attitude towards innovation or their institution. We undertake principal components analysis and analysis of variance, and estimate a multinomial ordered probit model to analyse the existence of different behaviour in managers and front-line employees with respect to innovation. Perception of innovation is different for managers and front-line employees in public health institutions. While front-line employees' attitude depends mostly on the overall performance of the institution, managers feel more involved and motivated, and their behaviour depends more on individual and organisational innovative profiles. It becomes crucial to make both managers and front-line employees at public health institutions feel participative and motivated in order to maximise the benefits of technical or organisational innovative process in the health services provision.
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.
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.
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.
Newman, Kristine; Dobbins, Maureen; Yost, Jennifer; Ciliska, Donna
Given the many different types of professionals working in public health and their diverse roles, it is likely that their information needs, information-seeking behaviors, and problem-solving abilities differ. Although public health professionals often work in interdisciplinary teams, few studies have explored their information needs and behaviors within the context of teamwork. This study explored the relationship between Canadian public health professionals' perceptions of their problem-solving abilities and their information-seeking behaviors with a specific focus on the use of evidence in practice settings. It also explored their perceptions of collaborative information seeking and the work contexts in which they sought information. Key Canadian contacts at public health organizations helped recruit study participants through their list-servs. An electronic survey was used to gather data about (a) individual information-seeking behaviors, (b) collaborative information-seeking behaviors, (c) use of evidence in practice environments, (d) perceived problem-solving abilities, and (e) demographic characteristics. Fifty-eight public health professionals were recruited, with different roles and representing most Canadian provinces and one territory. A significant relationship was found between perceived problem-solving abilities and collaborative information-seeking behavior (r = -.44, p public health professionals take a shared, active approach to problem solving, maintain personal control, and have confidence, they are more likely collaborate with others in seeking information to complete a work task. Administrators of public health organizations should promote collaboration by implementing effective communication and information-seeking strategies, and by providing information resources and retrieval tools. Public health professionals' perceived problem-solving abilities can influence how they collaborate in seeking information. Educators in public health
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
Hogan, Daniel B.
Granting of licenses to practice has long been linked to academic credentials, but this system offers more protection to the professions than to the public. There is an immediate need to break the credentials monopoly by opening up alternative routes to obtaining credentials. (Author/MLW)
Escoffery, Cam; Leppke, Allison M.; Robinson, Kara B.; Mettler, Erik P.; Miner, Kathleen R.; Smith, Iris
Training of public health professionals through web-based technology is rapidly increasing. This article describes one school of public health's effort to establish an online Master's program that serves students nationally and internationally. It examines the critical components in the design and implementation of distance education, including…
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.
Berner, Eta S
Academic culture has a set of norms, expectations, and values that are sometimes tacit and sometimes very explicit. In medical school and other health professions educational settings, probably the most common norm includes placing a high value on peer-reviewed research publications, which are seen as the major evidence of scholarly productivity. Other features of academic culture include encouraging junior faculty and graduate students to share their research results at professional conferences and lecturing with slides as a major way to convey information. Major values that faculty share with journal editors include responsible conduct of research and proper attribution of others' words and ideas. Medical school faculty also value technology and are often quick to embrace technological advances that can assist them in their teaching and research. This article addresses the effects of technology on three aspects of academic culture: education, presentations at professional meetings, and research publications.The technologies discussed include online instruction, dissemination of conference proceedings on the Internet, plagiarism-detection software, and new technologies deployed by the National Center for Biotechnology Information, the home of PubMed. The author describes how the ease of deploying new technologies without faculty changing their norms and behavior in the areas of teaching and research can lead to conflicts of values among key stakeholders in the academic medical community, including faculty, journal editors, and professional associations. The implications of these conflicts and strategies for managing them are discussed.
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.
Kim, Minjeong; Lee, Youngmin
New members in the field of instructional systems design and technology (ISD&T), including new students in this field, can find lists of publications and organizations available for them to read and to join. However, they may also wish to know which of these publications and organizations are recommended by established professionals. The field of…
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
Benton, David C; González-Jurado, Máximo Antonio; Beneit-Montesinos, Juan Vicente
Nurse mobility, developments such as health tourism and the rapid expansion of health systems have increased the need for regulatory bodies to reach beyond their normal stakeholder groups so as to familiarize themselves with the legislation of other jurisdictions. A systematic examination of a cross-section of nursing legislation, to ascertain the degree of consistency in the number of definitions specified as well as their underlying structure, was conducted to identify opportunities to strengthen public protection and reduce barriers to freedom of movement. A purposeful sample of legislation, drawn to maximize differences, was subjected to documentary analysis to identify possible relationships between the variables of interest and the way terms and processes were defined in fourteen nurse practice acts. Potential relationships were identified between factors such as geographic region, legal tradition, administrative approach, regulatory model and economic status and the number and approaches used to specify definitions. A major weakness in the precision of definitions was discovered. Several international organizations have started to develop lexicons but all have weaknesses. By drawing upon these lexicons a more comprehensive and precise dictionary could be formulated to support the development of next-generation nurse practice acts. Current legislation lacks precision and, within the context of increased mobility of nurses, there is an urgent need to develop an authoritative source of definitions that can contribute to increasing public safety as well as reducing delays in the freedom of movement of nurses from one jurisdiction to another.
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 ...
Professional identity formation is important for new recruits to training programmes. The integration of the accumulation of knowledge and assessment is a key aspect in its acquisition. This study assessed this interaction in Public Health Training in one English region. Semi-structured interviews were held with 15 registrars from the West Midlands Public Health Training Programme. Pre-interview questionnaires gathered background information. A thematic content analysis approach was taken. There was a lack of integration between academic and workplace learning, the professional examination process and professional identity development. Registrars considered sitting the examination and their workplace learning as two parallel processes. Passing the examination was considered a key part in the early development of a professional identity but this was replaced by the opinions of others by the third year of training. Having a Masters' in Public Health was less important but played a different role in their perceived acceptance by the wider Public Health workforce. The lack of integration between assessment and learning seemed to have a detrimental effect on professional identity development. A review of how these two aspects might combine in a more positive manner is needed.
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...
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
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.
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.
Crigger, Nancy J; Courter, Laura; Hayes, Kristen; Shepherd, K
Trust in the nurse-patient relationship is maintained not by how professionals perceive their actions but rather by how the public perceives them. However, little is known about the public's view of nurses and other health care professionals who participate in pharmaceutical marketing. Our study describes public perceptions of health care providers' role in pharmaceutical marketing and compares their responses with those of a random sample of licensed family nurse practitioners. The family nurse practitioners perceived their participation in marketing activities as significantly more ethically appropriate than did the public responders. Further research is warranted before conclusions can be drawn, but these early findings suggest that nurse practitioners should consider a conservative approach to participating in pharmaceutical marketing.
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.
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
This study investigated public school principals' reports of professional development implementation at the school level while working in different state- and local-level contexts (state accountability level, geographic locations, socioeconomic status, demographics, and grade levels). I attempted to measure principals' reported changes in levels…
L.G. Tummers (Lars)
textabstractToday, many public professionals feel estranged from the policy programs they implement. That is, they experience ‘policy alienation’. This is of concern as, for satisfactory implementation, some identification with the policy is required. We develop a quantitative scale to measure
Thozamile Richard Mle
Full Text Available One of the basic values and principles governing public administration enshrined in the Constitution of the Republic of South Africa, 1996 (Chapter 10 is that “a high standard of professional ethics must be promoted and maintained. Ethics is a process by which we clarify right and wrong and act on what we take to be right, that is, a set or system of moral principles that are generally accepted. Ethics simply means what is right and wrong, what is acceptable or unacceptable and is intertwined with the value system of people. Ethics can also be seen as being relative, not absolute, as ethical behaviour is in the eyes of the beholder. Be that as it may, however, ethical conduct and behaviour normally refer to conforming with generally accepted social norms. Relative to ethics is professionalism, which entails a high standard of work and adherence to certain standards and principles pertaining to specific work to be done. Professionalism embodies skills, competence, efficiency and effectiveness. Public institutions exist for the public good and employ public servants to render services to ensure a better life for all. The public sector is characterised by unprofessional and unethical conduct. The article unearths these and suggests strategies/mechanisms to address this ‘ill’. Can an unethical, unprofessional public servant be trusted to deliver services? Can, for example, a debt-trapped public servant who survives on borrowing money from micro-lenders, who cannot manage personal finances, be trusted to efficiently manage public funds and thus enhance service delivery? Can an incompetent, corrupt, disloyal, unaccountable, shoddy public servant who flouts the principles of Batho Pele and the code of conduct be entrusted with the responsibilities of ensuring a better life for all? The answers to these questions constitute the core of this article.
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.
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.
Full Text Available This study compares the organizational climate differences within professional roles in private and public hospitals. We focused on how physicians, administrative, healthcare and non-healthcare staff either in the public or in the private perceived their work environment and each organizational climate dimension. Data came from organizational-climate questionnaires administered in 2010 and 2012 to 19616 and 1276 health employees in public and private hospitals in the Tuscany Region respectively. We applied exploratory factoranalysis to verify the validity and internal consistency between items in the questionnaire and t-test, one-way analysis of variance to compare mean perceptions regarding to the dimensions across different groups of respondents. We measured four dimensions: “training opportunities”, “managerial tools”, “organization” and “management & leadership style” and overall job satisfaction. Hospital status in the professional roles was found significant in the staff's perceptions (p≤0.05.
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.
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...
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
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
Krieger, William H
Medical apps have featured in popular websites and mainstream news media in recent months. However, there has been almost no mention of these tools in journals focusing on relevant ethical or social issues, including conflict of interest, the role of politics in science, and technological oversight. This essay examines the role that these philosophical issues might play in answering both public and academic questions about these pieces of emergent technology.
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.
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 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 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
Sismondo, Sergio; Doucet, Mathieu
It is by now no secret that some scientific articles are ghost authored - that is, written by someone other than the person whose name appears at the top of the article. Ghost authorship, however, is only one sort of ghosting. In this article, we present evidence that pharmaceutical companies engage in the ghost management of the scientific literature, by controlling or shaping several crucial steps in the research, writing, and publication of scientific articles. Ghost management allows the pharmaceutical industry to shape the literature in ways that serve its interests. This article aims to reinforce and expand publication ethics as an important area of concern for bioethics. Since ghost-managed research is primarily undertaken in the interests of marketing, large quantities of medical research violate not just publication norms but also research ethics. Much of this research involves human subjects, and yet is performed not primarily to increase knowledge for broad human benefit, but to disseminate results in the service of profits. Those who sponsor, manage, conduct, and publish such research therefore behave unethically, since they put patients at risk without justification. This leads us to a strong conclusion: if medical journals want to ensure that the research they publish is ethically sound, they should not publish articles that are commercially sponsored.
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.
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
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
Kumar, Ramesh; Ahmed, Jamil; Shaikh, Babar Tasneem; Hafeez, Rehan; Hafeez, Assad
Job satisfaction largely determines the productivity and efficiency of human resource for health. It literally depicts the extent to which professionals like or dislike their jobs. Job satisfaction is said to be linked with the employee's work environment, job responsibilities and powers and time pressure; the determinants which affect employee's organizational commitment and consequently the quality of services. The objective of the study was to determine the level of and factors influencing job satisfaction among public health professionals in the public sector. This was a cross sectional study conducted in Islamabad, Pakistan. Sample size was universal including 73 public health professionals, with postgraduate qualifications and working in government departments of Islamabad. A validated structured questionnaire was used to collect data from April to October 2011. Overall satisfaction rate was 41% only, while 45% were somewhat satisfied and 14% of professionals highly dissatisfied with their jobs. For those who were not satisfied, working environment, job description and time pressure were the major causes. Other factors influencing the level of satisfaction were low salaries, lack of training opportunities, improper supervision and inadequate financial rewards. Our study documented a relatively low level of overall satisfaction among workers in public sector health care organizations. Considering the factors responsible for this state of affairs, urgent and concrete strategies must be developed to address the concerns of public health professionals as they represent a highly sensitive domain of health system of Pakistan. Improving the overall work environment, review of job descriptions and better remuneration might bring about a positive change.
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
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
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.
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.
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.
Wagner, J-D; Bezuidenhout, M C; Roos, J H
This study aimed to establish and describe the level of communication satisfaction that professional nurses experience in selected public hospitals in the City of Johannesburg, South Africa. The success of any organisation depends on the effectiveness of its communication systems and the interaction between staff members. Data were collected by means of questionnaires, based on the Communication Satisfaction Questionnaire (CSQ), from a sample of 265 professional nurses from different categories, chosen using a disproportionate random stratified sampling method. The results indicated poor personal feedback between nurse managers (operational managers) and professional nurses, as well as dissatisfaction among nurse managers and professional nurses with regard to informal communication channels. A lack of information pertaining to policies, change, financial standing and achievements of hospitals was identified. Nurse managers should play a leadership role in bringing staff of different departments together by creating interactive communication forums for the sharing of ideas. The results emphasise the need for nurse managers to improve communication satisfaction at all levels of the hospital services in order to enhance staff satisfaction and create a positive working environment for staff members. © 2014 The Authors. Journal of Nursing Management Published by John wiley & Sons Ltd.
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.
Catering for sustainability is often presented as a legitimate perspective for caterers to promote more equitable economic development locally and across distances through food procurement, integrated with environmental protection and concern for the welfare of customers and staff. Caterers are thus seen as agents responsible for sustainable food systems within their reach. This paper explores how public caterers use their position and productive intelligence in promoting a sustainable food system within the power field of their contextual networks. This article crystallises this 'agency for sustainability' as professional identity for sustainability, the shaping of which is analysed in Finnish public catering. The paper identifies eased and positive, troubled and critical as well as delimited and distancing approaches for sustainability, with respective views and efforts for sustainable food systems. The shaping of professional identity for sustainability could serve as co-operative platform for future contextual developments towards more sustainable food systems. Such progress could result in better alignment with political guidelines for sustainability and caterers' satisfaction due to their heightened professional position reaching beyond 'kitchen walls' to construct everyday sustainability.
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.
Battisti, Wendy P; Wager, Elizabeth; Baltzer, Lise; Bridges, Dan; Cairns, Angela; Carswell, Christopher I; Citrome, Leslie; Gurr, James A; Mooney, LaVerne A; Moore, B Jane; Peña, Teresa; Sanes-Miller, Carol H; Veitch, Keith; Woolley, Karen L; Yarker, Yvonne E
This updated Good Publication Practice (GPP) guideline, known as GPP3, builds on earlier versions and provides recommendations for individuals and organizations that contribute to the publication of research results sponsored or supported by pharmaceutical, medical device, diagnostics, and biotechnology companies. The recommendations are designed to help individuals and organizations maintain ethical and transparent publication practices and comply with legal and regulatory requirements. These recommendations cover publications in peer-reviewed journals and presentations (oral or poster) at scientific congresses. The International Society for Medical Publication Professionals invited more than 3000 professionals worldwide to apply for a position on the steering committee, or as a reviewer, for this guideline. The GPP2 authors reviewed all applications (n = 241) and assembled an 18-member steering committee that represented 7 countries and a diversity of publication professions and institutions. From the 174 selected reviewers, 94 sent comments on the second draft, which steering committee members incorporated after discussion and consensus. The resulting guideline includes new sections (Principles of Good Publication Practice for Company-Sponsored Medical Research, Data Sharing, Studies That Should Be Published, and Plagiarism), expands guidance on the International Committee of Medical Journal Editors' authorship criteria and common authorship issues, improves clarity on appropriate author payment and reimbursement, and expands information on the role of medical writers. By following good publication practices (including GPP3), individuals and organizations will show integrity; accountability; and responsibility for accurate, complete, and transparent reporting in their publications and presentations.
Renato Ferreira Leitão Azevedo
Full Text Available The decline in both the number and quality of students choosing accounting programs has been a worldwide source of concern to scholars and practitioners. According to Albrecht and Sack (2000, that decline is a consequence of several factors, such as changes in business environment, decrease in salary levels and development of alternative careers perceived as more attractive by students and lack of information and/or misunderstanding related to accounting careers. For Carnegie and Napier (2010, comprehension of such external images related to accounting careers and accountants is important for assessing the roles of these professionals in a wider social context. The success of the accounting profession, according to Belski et al. (2004, largely depends on how it is viewed by the public, considering that the image of the accounting profession has been damaged in the recent past by the widely publicized accounting frauds, scandals and failures involving accounting firms and accountants. To support a better understanding of this phenomenon, the objective of this study is to identify and analyze whether the accounting profession is negatively stereotyped by public perception according to ethics. Based on an adapted photo-survey, with 1,034 randomly selected respondents, and tests of differences between means, the central hypothesis of this study was rejected: it is not possible to state that accounting professionals are negatively stereotyped for professional ethics. Also, there were no significant differences based on gender, academic background or education levels of the respondents, but on the other hand is possible to confirm a positive perception based on confidence interval analysis. Implications for practice and recommendations for future studies are both presented in the last section.
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.
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
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…
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.
Wong, Y L
There is no doubt that gender bias has been inherent in medical and public health education, research, and clinical practice. This paper discusses the central question for medical and public health educators viz. whether women's health concerns and needs could be best addressed by the conventional biomedical approach to medical and public health education, research, and practice. Gender inequalities in health and gender bias in medical and public health education are revealed. It is found that in most public health and prevention issues related to women's health, the core issue is male-female power relations, and not merely the lack of public health services, medical technology, or information. There is, thus, an urgent need to gender-sensitize public health and medical education. The paper proposes a gender analysis of health to distinguish between biological causes and social explanations for the health differentials between men and women. It also assessed some of the gender approaches to public health and medical education currently adopted in the Asia-Pacific region. It poses the pressing question of how medical and public health educators integrate the gender perspective into medical and public health education. The paper exhorts all medical and public health practitioners to explore new directions and identify innovative strategies to formulate a gender-sensitive curriculum towards the best practices in medicine and public health that will meet the health needs of women and men in the 21st century.
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.
Hilton, S; Hunt, K; Langan, M; Hamilton, V; Petticrew, M
Objective: To examine how journals and magazines disseminate research evidence and guidance on best practice to health professionals by aligning commentaries on measles, mumps, and rubella vaccine (MMR) evidence in journals with key events in the MMR controversy. Design: Content analysis. Data sources: Comment articles in six commonly read UK publications. Main outcome measures: Number of comment pieces by publication, year and article type; trends in the focus, tone and inclusion of recommendations on MMR. Results: 860 articles met the inclusion criteria (BMJ n = 104, Community Practitioner n = 45, Health Visitor n = 24, Practice Nurse n = 61, Nursing Standard n = 61 and Pulse n = 565). Of these 860 comment pieces, 264 made some reference to evidence endorsing the safety of MMR. Around one in 10 were rated as negative (10.9%, n = 29) or neutral (11.3%, n = 30) in relation to MMR safety, and nearly a quarter (22.7%, n = 60) were rated as mixed. Following the publication of Wakefield et al’s 1998 paper there was a period of neutrality. In 2000, despite growing public concerns and widespread media coverage, fewer than 20 comment pieces were published. Less than a quarter of comment pieces (n = 196, 22.7%) included recommendations. Conclusion: While a period of neutrality may reflect a professional response to uncertainty by holding back until consensus emerges, it may also represent a missed opportunity to promote evidence-based practice. PMID:19414434
Joeri K Tijdink
Full Text Available BACKGROUND: Publication of scientific research papers is important for professionals working in academic medical centres. Quantitative measures of scientific output determine status and prestige, and serve to rank universities as well as individuals. The pressure to generate maximum scientific output is high, and quantitative aspects may tend to dominate over qualitative ones. How this pressure influences professionals' perception of science and their personal well-being is unknown. METHODS AND FINDINGS: We performed an online survey inviting all medical professors (n = 1206 of the 8 academic medical centres in The Netherlands to participate. They were asked to fill out 2 questionnaires; a validated Publication Pressure Questionnaire and the Maslach Burnout Inventory. In total, 437 professors completed the questionnaires. among them, 54% judge that publication pressure 'has become excessive', 39% believe that publication pressure 'affects the credibility of medical research' and 26% judge that publication pressure has a 'sickening effect on medical science'. The burn out questionnaire indicates that 24% of medical professors have signs of burn out. The number of years of professorship was significantly related with experiencing less publication pressure. Significant and strong associations between burn out symptoms and the level of perceived publication pressure were found. The main limitation is the possibility of response bias. CONCLUSION: A substantial proportion of medical professors believe that publication pressure has become excessive, and have a cynical view on the validity of medical science. These perceptions are statistically correlated to burn out symptoms. Further research should address the effects of publication pressure in more detail and identify alternative ways to stimulate the quality of medical science.
Kresal, Friderika; Roblek, Vasja; Jerman, Andrej; Meško, Maja
Drivers in public transport are subjected to lower back pain. The reason for the pain is associated with the characteristics of the physical position imposed on the worker while performing the job. Lower back pain is the main cause of absenteeism among drivers. The present study includes 145 public transport drivers employed as professional drivers for an average of 14.14 years. Analysis of the data obtained in the study includes the basic descriptive statistics, χ(2) test and multiple regression analysis. Analysis of the incidence of lower back pain showed that the majority of our sample population suffered from pain in the lower back. We found that there are no statistically significant differences between the groups formed by the length of service as a professional driver and incidence of lower back pain; we were also interested in whether or not the risk factors of lower back pain affects the absenteeism of city bus drivers. Analysis of the data has shown that the risk factors of pain in the lower part of the spine do affect the absenteeism of city bus drivers.
Full Text Available Abstract Background Job satisfaction largely determines the productivity and efficiency of human resource for health. It literally depicts the extent to which professionals like or dislike their jobs. Job satisfaction is said to be linked with the employee’s work environment, job responsibilities and powers and time pressure; the determinants which affect employee’s organizational commitment and consequently the quality of services. The objective of the study was to determine the level of and factors influencing job satisfaction among public health professionals in the public sector. Methods This was a cross sectional study conducted in Islamabad, Pakistan. Sample size was universal including 73 public health professionals, with postgraduate qualifications and working in government departments of Islamabad. A validated structured questionnaire was used to collect data from April to October 2011. Results Overall satisfaction rate was 41% only, while 45% were somewhat satisfied and 14% of professionals highly dissatisfied with their jobs. For those who were not satisfied, working environment, job description and time pressure were the major causes. Other factors influencing the level of satisfaction were low salaries, lack of training opportunities, improper supervision and inadequate financial rewards. Conclusion Our study documented a relatively low level of overall satisfaction among workers in public sector health care organizations. Considering the factors responsible for this state of affairs, urgent and concrete strategies must be developed to address the concerns of public health professionals as they represent a highly sensitive domain of health system of Pakistan. Improving the overall work environment, review of job descriptions and better remuneration might bring about a positive change.
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.
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…
Henry C.H. Ko
Full Text Available There is a wealth of medical information now available to the public through various sources that are not necessarily controlled by medical or healthcare professionals. In Australia there has been a strong movement in the health consumer arena of consumer-led sharing and production of medical information and in healthcare decision-making. This has led to empowerment of the public as well as increased knowledge-sharing. There are some successful initiatives and strategies on consumer- and public-led sharing of medical information, including the formation of specialised consumer groups, independent medical information organisations, consumer peer tutoring, and email lists and consumer networking events. With well-organised public initiatives and networks, there tends to be fairly balanced information being shared. However, there needs to be caution about the use of publicly available scientific information to further the agenda of special-interest groups and lobbying groups to advance often biased and unproven opinions or for scaremongering. With the adoption of more accountability of medical research, and the increased public scrutiny of private and public research, the validity and quality of medical information reaching the public is achieving higher standards.
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.
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.
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.
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.
Ushang Desai; Paras Patel
Over the few years medical marijuana is growing in the United States. Because of the medical marijuana legislators able to legalized recreational marijuana in the two states in the US. Marijuana has several potential benefits that help in certain disease. The delivery of marijuana is also important because smoking marijuana has severe side effects. Physicians also play important role in medical marijuana, physicians also divided on the use of medical marijuana. Their attitude towards medical ...
Full Text Available Influenced by the growing popularity of smart phones and the rapid development of open science, remote sensing is being developed and applied more by general public than by trained professionals. This trend is mainly embodied in the democratized data collection, democratized data processing and democratized data usage. This paper discusses and analyzes the three aforementioned characteristics, introduces some recent representative work and progress. It also lists numerous international open data processing tools, including photogrammetry processing, laser scanning processing, machine learning, and spatial information management. In addition, the article makes a detailed description of the benefits of open data, and lists a number of global data programs and experimental data sets for scientific research. At the end of this paper, it is pointed out that the democratization of remote sensing will not only produce great economic benefits, but also bring about great social benefits, and finally change the landscape of industry and the life style of people.
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.
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.
For a long time considered as total and absolute, healthcare professional secrecy is today difficult to reconcile with care practices. Lots of paradoxes question its preservation in favour of general interest and public order against the protection of private interest within an individualistic normative society. Exploring this interrogation, the article's objective is to initiate an ethical discussion from a professional caregiver secrecy's historical and sociological evolution perspective. Thus, with the help of theoretical understandings, especially those by Michel Foucault, medical secrecy is considered a defense of rationality specific to populations' government. This conceptualization finds arguments through social collective norms attached to an alienating biopower at the expense of secrecy integrated as an individualistic and immanent social norm. However, beyond the well-known debate on the absolute necessity for change, evolution… the distance from the Socratic and Hippocratic principles engage people and society in real democratic decisions about Health. Also, health professionals, patients, usgers and society must consider the limits that would lead to medical confidentiality.
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.
We also used the same method to obtain data on the PubMed medical publications from Tunisia, Morocco and Yemen. Tunisia had the largest number of PubMed publications among the studied countries: 20.4 publications per million population per year and 7.2 publications per year per one billion US$ GDP. Libya had ...
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.
Rajasekaran, Rajkumar; Sriman Narayana Iyengar, Nallani Chackravatula
Objectives: Mobile technology helps to improve continuing medical education; this includes all aspects of public health care as well as keeping one?s knowledge up-to-date. The program of continuing medical and health education is intertwined with mobile health technology, which forms an imperative component of national strategies in health. Continuing mobile medical education (CMME) programs are designed to ensure that all medical and health-care professionals stay up-to-date with the knowled...
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....
Full Text Available BACKGROUND: Few data are available evaluating the associations of formal public health education with long-term career choice and professional outcomes among medical school graduates. The objective of this study was to determine if formal public health education via completion of a masters of public health (MPH degree among US medical school graduates was associated with early and long-term career choice, professional satisfaction, or research productivity. METHODS: We conducted a retrospective cohort study in 1108 physicians (17.1% completed a MPH degree who had 10-20 years of follow-up post medical school graduation. Multivariable logistic regression analyses were conducted. RESULTS: Compared to their counterparts with no MPH, medical school graduates with a MPH were more likely to have completed a generalist primary care residency only [relative risk (RR 1.79, 95% confidence interval (CI 1.35-2.29], obtain employment in an academic institution (RR 1.81; 95% CI 1.33-2.37 or government agency (RR 3.26; 95% CI 1.89-5.38, and practice public health (RR 39.84; 95% CI 12.13-107.38 or primary care (RR 1.59; 95% CI 1.18-2.05. Furthermore, medical school graduates with a MPH were more likely to conduct public health research (RR 8.79; 95% CI: 5.20-13.82, receive NIH or other federal funding (RR 3.11, 95% CI 1.74-5.33, have four or more peer-reviewed publications (RR 2.07; 95% CI 1.56-2.60, and have five or more scientific presentations (RR 2.31, 95% CI 1.70-2.98. CONCLUSION: Formal public health education via a MPH was associated with career choice and professional outcomes among physicians.
Tatyana V. Matveeva
Full Text Available Leading role in the process of development and improvement of modern Russian education plays an additional professional education, which, to the greatest extent, responds to the qualitative changes in the socio-economic relations in a rapidly changing world. The aim of this paper is to identify the organizational and legal problems of professional and public accreditation of additional professional education programs in Russia and the opportunities development of this institution in modern conditions. The scientific research problem was to justify the need for professional and public accreditation of additional professional education programs of modern universities on the basis of delegation of procedures for evaluating the quality of education by public authorities to the public expert organizations, which ensure the independence and objectivity of the decisions made by qualified experts using a standardized assessment tools and tech to meet the needs of all parties concerned for highly qualified professionals. Methods. Empirical and theoretical methods were applied in the process of solving the problems in the scientific work to achieve the objectives of the study and test the hypothesis of an integrated methodology. Theoretical research methods involve: analysis of different literary sources (including legislative and regulatory enactments of the Higher Authorities of the Russian Federation, regulatory enactments of the Ministry of General and Vocational Education of the Russian Federation, compilation, synthesis of empirical data, comparative analysis, and others. Empirical research methods include: observation, testing, interview, questionnaire, ranking, pedagogical experiment, analysis of the products of activity, method of expert evaluations, methods of mathematical statistics, and other. Results. The expediency of independent accreditation procedures is proved. The goals that need to be solved to enhance the competitiveness of
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
... fatigue-related research concerning bus and motorcoach drivers to identify relevant scientific and medical... ``medical standards for operators of commercial motor vehicles that will ensure that the physical condition... of the MRB is open to the public. Oral comments on the topic from the public will be heard during the...
La Rocco, A; Jones, B
This bibliography of nonserial publications consists of 610 annotations. It is intended as a guide to the development of a collection for librarians and for health professionals in research and education. References are mostly to publications from 1960. Titles are in English. Both primary and secondary sources are cited.
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.
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.
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.
Full Text Available Public sector accounting has emerged as an area of concern within the sphere of professional accounting education. The International Federation of Accountants (IFAC allows its member bodies to apply discretion in the application of public sector accounting education requirements. This study explored the nature and extent to which public sector accounting features in the education syllabi of the leading chartered accountant professional bodies that form part of the IFAC contingent. By following an explorative approach, the study identified international trends within the ambit of public sector accounting education and provides guidance for other professional bodies in assessing the nature and extent of their public sector accounting education requirements
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
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.
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.
Hayat, Matthew J; Powell, Amanda; Johnson, Tessa; Cadwell, Betsy L
Statistical literacy and knowledge is needed to read and understand the public health literature. The purpose of this study was to quantify basic and advanced statistical methods used in public health research. We randomly sampled 216 published articles from seven top tier general public health journals. Studies were reviewed by two readers and a standardized data collection form completed for each article. Data were analyzed with descriptive statistics and frequency distributions. Results were summarized for statistical methods used in the literature, including descriptive and inferential statistics, modeling, advanced statistical techniques, and statistical software used. Approximately 81.9% of articles reported an observational study design and 93.1% of articles were substantively focused. Descriptive statistics in table or graphical form were reported in more than 95% of the articles, and statistical inference reported in more than 76% of the studies reviewed. These results reveal the types of statistical methods currently used in the public health literature. Although this study did not obtain information on what should be taught, information on statistical methods being used is useful for curriculum development in graduate health sciences education, as well as making informed decisions about continuing education for public health professionals.
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.
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.
Smith, P M
Key public policies that have contributed to the rise of modern medical research in the 20th Century are reviewed, focusing especially on the United States and the post-World War II period. Drawing on this history, the question is posed: "Are these policies sufficient to insure vigorous medical research in the 21st Century?" Although radical policy changes are not needed, several proposals for policy and medical research portfolio redirection are offered, including a rebalancing of public supported research in all fields of science that contribute to medical advances. Medical research must also invest in a national and international information infrastructure that will allow the linking of researchers, clinical experimenters, practicing physicians, and the public in ways heretofore not imagined. Medical researchers must be leaders and advocates for the whole research enterprise in the 21st Century.
Publication of pharmaceutical company-sponsored research in medical journals, and its presentation at conferences and meetings, is mostly governed by 'publication plans' that extract the maximum amount of scientific and commercial value out of data and analyses through carefully constructed and placed papers. Clinical research is typically performed by contract research organizations, analyzed by company statisticians, written up by independent medical writers, approved and edited by academic researchers who then serve as authors, and the whole process organized and shepherded through to journal publication by publication planners. This paper reports on a conference of an international association of publication planners. It describes and analyzes their work in an ecological framework that relates it to marketing departments of pharmaceutical companies, medical journals and publishers, academic authors, and potential audiences. The medical research described here forms a new kind of corporate science, designed to look like traditional academic work, but performed largely to market products.
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
ten Hoeve, Yvonne; Jansen, Gerard; Roodbol, Petrie
Aim To discuss the actual public image of nurses and other factors that influence the development of nurses' self-concept and professional identity. Background Nurses have become healthcare professionals in their own right who possess a great deal of knowledge. However, the public does not always
ten Hoeve, Yvonne; Jansen, Gerard; Roodbol, Petrie
Aim To discuss the actual public image of nurses and other factors that influence the development of nurses' self-concept and professional identity. Background Nurses have become healthcare professionals in their own right who possess a great deal of knowledge. However, the public does not always
Penrose, John M.
Aspects of research and pedagogy from the public relations discipline can benefit the business and professional communication instructor seeking new dimensions for the business and professional communication classroom. Elements of public relations (PR) found in Association for Business Communication articles and journals may be incorporated in the…
Yvonne ten Hoeve; Prof. Dr. Petrie F. Roodbol; Gerard Jansen
Aim. To discuss the actual public image of nurses and other factors that influence the development of nurses’ self-concept and professional identity. Background. Nurses have become healthcare professionals in their own right who possess a great deal of knowledge. However, the public does not always
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.
Dennis, Carol Azumah
Locating post-16 professionalism explores the ways in which teachers in the UK and the USA engaged in digitally mediated communication incidentally narrate their professional selves during extended exchanges about the process of post-qualification registration. Drawing on a theoretical framework derived from participatory democracy, the study is…
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...
It is time to review the reasons for including public health in medical education. Undergraduate medical students are interested above all in the diagnosis and treatment of individual cases of disease; population-based health care means little to most students, and is seldom regarded as important. Should public health teachers concentrate their efforts in other areas, where students are more receptive? This paper presents arguments for and against the proposition that public health has no place in the undergraduate medical course. In favour of the proposition, it is argued that the clinical imperative is so firmly entrenched in the minds of students and in the cultures of medical schools that public health will always be diminished and elbowed to one side in medical curricula. Moreover, the major gains in the health of populations will be won in other arenas. Therefore public health should rupture the links with medical schools that were formed in another age and, in any event, are now weakening as public health strikes a new identity. The effort that currently goes into teaching unwilling medical students would have better returns if it was invested elsewhere. Against the proposition, it is argued that the health of populations will not be improved without participation of all groups with an interest in and an influence on health care. No group is more influential in the organization and delivery of health services than the medical profession, so it would be foolish for public health to withdraw from medical education. Moreover, effective medical practice requires an ability to think in terms of populations as well as individuals.(ABSTRACT TRUNCATED AT 250 WORDS)
Sugawara, Yuya; Tsuya, Atsushi; Tanaka, Atsushi; Fukao, Akira
Background Twitter is a free social networking and microblogging service on the Internet. Medical professionals and patients have started to use Twitter in medicine. Twitter use by medical institutions can interactively and efficiently provide public health information and education for laypeople. Objective This study examined Twitter usage by medical institutions. Methods We reviewed all Japanese user accounts in which the names of medical institutions were described in the user’s Twitter profile. We then classified medical institutions’ tweets by content. Results We extracted 168 accounts for medical institutions with ≥500 followers. The medical specialties of those accounts were dentistry and oral surgery (n=73), dermatology (n=12), cosmetic surgery (n=10), internal medicine (n=10), ophthalmology (n=6), obstetrics and gynecology (n=5), plastic surgery (n=2), and others (n=50). Of these, 21 accounts tweeted medical knowledge and 45 accounts tweeted guidance about medical practice and consultation hours, including advertisements. In the dentistry and oral surgery accounts, individual behavior or thinking was the most frequent (22/71, 31%) content. On the other hand, consultation including advertisements was the most frequent (14/23, 61%) in cosmetic surgery, plastic surgery, and dermatology. Conclusions Some medical specialties used Twitter for disseminating medical knowledge or guidance including advertisements. This indicates that Twitter potentially can be used for various purposes by different medical specialties. PMID:27227154
Sugawara, Yuya; Narimatsu, Hiroto; Tsuya, Atsushi; Tanaka, Atsushi; Fukao, Akira
Twitter is a free social networking and microblogging service on the Internet. Medical professionals and patients have started to use Twitter in medicine. Twitter use by medical institutions can interactively and efficiently provide public health information and education for laypeople. This study examined Twitter usage by medical institutions. We reviewed all Japanese user accounts in which the names of medical institutions were described in the user's Twitter profile. We then classified medical institutions' tweets by content. We extracted 168 accounts for medical institutions with ≥500 followers. The medical specialties of those accounts were dentistry and oral surgery (n=73), dermatology (n=12), cosmetic surgery (n=10), internal medicine (n=10), ophthalmology (n=6), obstetrics and gynecology (n=5), plastic surgery (n=2), and others (n=50). Of these, 21 accounts tweeted medical knowledge and 45 accounts tweeted guidance about medical practice and consultation hours, including advertisements. In the dentistry and oral surgery accounts, individual behavior or thinking was the most frequent (22/71, 31%) content. On the other hand, consultation including advertisements was the most frequent (14/23, 61%) in cosmetic surgery, plastic surgery, and dermatology. Some medical specialties used Twitter for disseminating medical knowledge or guidance including advertisements. This indicates that Twitter potentially can be used for various purposes by different medical specialties.
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.
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.
Ziegler, Alexander; Mietchen, Daniel; Faber, Cornelius; von Hausen, Wolfram; Schöbel, Christoph; Sellerer, Markus; Ziegler, Andreas
Until fairly recently, medical publications have been handicapped by being restricted to non-electronic formats, effectively preventing the dissemination of complex audiovisual and three-dimensional data. However, authors and readers could significantly profit from advances in electronic publishing that permit the inclusion of multimedia content directly into an article. For the first time, the de facto gold standard for scientific publishing, the portable document format (PDF), is used here as a platform to embed a video and an audio sequence of patient data into a publication. Fully interactive three-dimensional models of a face and a schematic representation of a human brain are also part of this publication. We discuss the potential of this approach and its impact on the communication of scientific medical data, particularly with regard to electronic and open access publications. Finally, we emphasise how medical teaching can benefit from this new tool and comment on the future of medical publishing.
Sexual Harassment in Public Medical Schools in Ghana. ... of power harasses a subordinate) and contra power sexual harassment, (where a subordinate is the ... Results: Women were 61% more likely to be sexually harassed than men 39%.
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.
Full Text Available In most parts of the world, public relations (PR is seeking recognition as a profession. The path to gaining professional status hinges on its adherence to professional ethical standards. This paper argues that it is inappropriate for public relations practitioners to represent the tobacco industry because it is against the PR ethics of upholding truth and public interest. The paper cites historical tobacco industry documents to reveal that the industry would not hesitate to use unethical means to maximise profits.
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
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.
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...
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…
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.
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.
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
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)
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 ...
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.
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.
Wenghofer, Elizabeth F; Campbell, Craig; Marlow, Bernard; Kam, Sophia M; Carter, Lorraine; McCauley, William
This study aimed to investigate the relationship between participation in different types of continuing professional development (CPD), and incidences and types of public complaint against physicians. Cases included physicians against whom complaints were made by members of the public to the medical regulatory body in Ontario, Canada, the College of Physicians and Surgeons of Ontario (CPSO), during 2008 and 2009. The control cohort included physicians against whom no complaints were documented during the same period. We focused on complaints related to physician communication, quality of care and professionalism. The CPD data included all Royal College of Physicians and Surgeons of Canada (RCPSC) and College of Family Physicians of Canada (CFPC) CPD programme activities reported by the case and control physicians. Multivariate logistic regression models were used to determine if the independent variable, reported participation in CPD, was associated with the dependent variable, the complaints-related status of the physician in the year following reported CPD activities. A total of 2792 physicians were included in the study. There was a significant relationship between participation in CPD, type of CPD and type of complaint received. Analysis indicated that physicians who reported overall participation in CPD activities were significantly less likely (odds ratio 0.604; p = 0.028) to receive quality of care-related complaints than those who did not report participating in CPD. Additionally, participation in group-based CPD was less likely (OR 0.681; p = 0.041) to result in quality of care-related complaints. The findings demonstrate a positive relationship between participation in the national CPD programmes of the CFPC and RCPSC, and lower numbers of public complaints received by the CPSO. As certification bodies and regulators alike are increasingly mandating CPD, they are encouraged to continually evaluate the effectiveness of their programmes to maximise
Lee, R H; Hadley, J
In this article we develop and estimate a model of physicians' pricing that explicitly incorporates the effects of Medicare and Medicaid demand subsidies. Our analysis is based on a multiperiod model in which physicians are monopolistic competitors supplying services to several markets. The implications of the model are tested using data derived from claims submitted by a cohort of 1,200 California physicians during the years 1972-1975. We conclude that the demand for physician's services is relatively elastic; that increases in the local supply of physicians reduce prices somewhat; that physicians respond strategically to attempts to control prices through the customary-prevailing-reasonable system; and that price controls limit the rate of increase in physicians' prices. The analysis identifies a family of policies that recognize the monopsony power of public programs and may change the cost-access trade-off. PMID:7021479
... 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...
Broom, Glen M.; And Others
A content analysis compared the professional and research agendas of "Public Relations Journal" and "Public Relations Review" for the years 1975-81. A sample of 121 articles from the former and 111 articles from the latter were analyzed, and the content of each was assigned to one of 10 categories related to the context,…
ten Hoeve, Yvonne; Jansen, Gerard; Roodbol, Petrie
To discuss the actual public image of nurses and other factors that influence the development of nurses' self-concept and professional identity. Nurses have become healthcare professionals in their own right who possess a great deal of knowledge. However, the public does not always value the skills and competences nurses have acquired through education and innovation. Discussion paper. We identified 1216 relevant studies by searching MEDLINE, CINAHL and PsycINFO databases in the period 1997-2010. Finally, 18 studies met our inclusion criteria. The included studies show that the actual public image of nursing is diverse and incongruous. This image is partly self-created by nurses due to their invisibility and their lack of public discourse. Nurses derive their self-concept and professional identity from their public image, work environment, work values, education and traditional social and cultural values. Nurses should work harder to communicate their professionalism to the public. Social media like the Internet and YouTube can be used to show the public what they really do. To improve their public image and to obtain a stronger position in healthcare organizations, nurses need to increase their visibility. This could be realized by ongoing education and a challenging work environment that encourages nurses to stand up for themselves. Furthermore, nurses should make better use of strategic positions, such as case manager, nurse educator or clinical nurse specialist and use their professionalism to show the public what their work really entails. © 2013 John Wiley & Sons Ltd.
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…
Aki, Ozlem Erden; Ak, Sertac; Sonmez, Yunus Emre; Demir, Basaran
Electroconvulsive therapy (ECT) is safe and effective for the treatment of various psychiatric disorders. Despite being a well-known treatment method among health care professionals, lay people generally have a negative opinion of ECT. The present study aimed to examine knowledge of and attitudes toward ECT among medical students, psychology students, and the general public. Psychology students were included because they are among the important groups in mental health care in Turkey. A Likert-type questionnaire was administered to fifth-year medical students (n = 28), master of science and doctor of philosophy clinical psychology students (n = 35), and a sample of the general public (n = 26). The questionnaire included questions about the general principles of and indications for ECT, and sources of knowledge of and attitudes toward ECT. The medical students were the most knowledgeable about ECT, as expected. The medical students also had a more positive attitude toward ECT than the other 2 groups. More psychology students had negative attitudes on some aspects than general public sample, despite being more knowledgeable. Medical school theoretical and practical training in ECT played an important role in increasing the level of knowledge of and decreasing the prevalence of negative attitudes toward ECT among the medical students; similar training for psychology students is required to achieve similar results.
Thousands of pregnant patients and radiation workers are exposed to ionising radiation each year. Lack of knowledge is responsible for great anxiety and probably unnecessary termination of pregnancies. For many patients, the exposure is appropriate, while for others the exposure may be inappropriate, placing the unborn child at increased risk. Prenatal doses from most properly done diagnostic procedures present no measurably increased risk of prenatal death, malformation, or impairment of mental development over the background incidence of these entities. Higher doses, such as those involved in therapeutic procedures, can result in significant fetal harm. The pregnant patient or worker has a right to know the magnitude and type of potential radiation effects that might result from in utero exposure. Almost always, if a diagnostic radiology examination is medically indicated, the risk to the mother of not doing the procedure is greater than is the risk of potential harm to the fetus. Most nuclear medicine procedures do not cause large fetal doses. However, some radiopharmaceuticals that are used in nuclear medicine can pose significant fetal risks. It is important to ascertain whether a female patient is pregnant prior to radiotherapy. In pregnant patients, cancers that are remote from the pelvis usually can be heated with radiotherapy. This however requires careful planning. Cancers in the pelvis cannot be adequately treated during pregnancy without severe or lethal consequences for the fetus. The basis for the control of the occupational exposure of women who are not pregnant is the same as that for men. However, if a woman is, or may be, pregnant, additional controls have to be considered to protect the unborn child. In many countries, radiation exposure of pregnant females in biomedical research is not specifically prohibited. However, their involvement in such research is very rare and should be discouraged. Termination of pregnancy is an individual decision
Thousands of pregnant patients and radiation workers are exposed to ionising radiation each year. Lack of knowledge is responsible for great anxiety and probably unnecessary termination of pregnancies. For many patients, the exposure is appropriate, while for others the exposure may be inappropriate, placing the unborn child at increased risk. Prenatal doses from most properly done diagnostic procedures present no measurably increased risk of prenatal death, malformation, or impairment of mental development over the background incidence of these entities. Higher doses, such as those involved in therapeutic procedures, can result in significant fetal harm. The pregnant patient or worker has a right to know the magnitude and type of potential radiation effects that might result from in utero exposure. Almost always, if a diagnostic radiology examination is medically indicated, the risk to the mother of not doing the procedure is greater than is the risk of potential harm to the fetus. Most nuclear medicine procedures do not cause large fetal doses. However, some radiopharmaceuticals that are used in nuclear medicine can pose significant fetal risks. It is important to ascertain whether a female patient is pregnant prior to radiotherapy. In pregnant patients, cancers that are remote from the pelvis usually can be heated with radiotherapy. This however requires careful planning. Cancers in the pelvis cannot be adequately treated during pregnancy without severe or lethal consequences for the fetus. The basis for the control of the occupational exposure of women who are not pregnant is the same as that for men. However, if a woman is, or may be, pregnant, additional controls have to be considered to protect the unborn child. In many countries, radiation exposure of pregnant females in biomedical research is not specifically prohibited. However, their involvement in such research is very rare and should be discouraged. Termination of pregnancy is an individual decision
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.
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
Pampuri, O.; Czabanowska, K.; Hysa, B.; Roshi, E.; Burazeri, G.
Pampuri O, Czabanowska K, Hysa B, Roshi E, Burazeri G. Public health leadership competency level among health professionals in a South Eastern European country (Original research). SEEJPH 2015, posted: 10 February 2015. DOI 10.12908/SEEJPH-2014-40
Purcărea, V L; Coculescu, B I; Coculescu, E C
During the transition period, the Romanian medical system, subject (like other areas) to a process of reform, had to go through a difficult path, not without obstacles (malpractice, underfunding, embezzlement scandals in the media etc.). Consequently, Romania has faced (and unfortunately still is still facing) the massive exodus of health professionals to countries where they can benefit from better working conditions and payment, and those who suffer from health care crisis are the patients. Reform means "the people in the system for the people", which requires a change of mindset within the medical staff, especially in the continuous professional development. However, to talk about the quality of the medical act requires that all those involved in the medical system should create appropriate conditions - i.e. advanced technical equipment and appropriate salaries. In addition, as underfunding is the main cause of failure in the health system, that management remains the only tool that can lead to the appropriate use of the existing resources and the quality of health services. Therefore, the idea of public-private partnership - which occurred as a challenge, especially after the EU accession - can be considered a solution designed to improve the quality and cost of health services. In other words, the cooperation of the private sector with the public authority means increasing the rigor of the medical equipment performance, fostering professional competition, and an increased attention to the patient, in a word: performance. Currently, more and more frequently, the management has studied to identify opportunities for innovation in health care services in an attempt to bring together patients and practitioners in the field by resorting to the identification of the ways they can receive health care services promptly, fairly and efficiently. Therefore, a clear and responsible design in the spirit of ethics and medical ethic will help the marketing manager solve many
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
Vorstenbosch, Marc; Bolhuis, Sanneke; van Kuppeveld, Sascha; Kooloos, Jan; Laan, Roland
Publications on anatomy in medical education appear to be largely anecdotal. To explore this, we investigated the literature on anatomy in medical education, aiming first to evaluate the contribution of the literature on anatomy in medical education to "best evidence medical education" (BEME) and second to evaluate the development of this literature toward more "best evidence" between 1985 and 2009. Four databases were searched for publications on anatomy in medical education published between 1985 and 2009, resulting in 525 references. Hundred publications were characterized by five variables (journal category, paper subject, paper category, author perspective, and paper perspective). Statements from these publications were characterized by two variables (category and foundation). The publications contained 797 statements that involved the words "anatomy," "anatomical," or "anatomist." Forty-five percent of the publications contained no explicit research question. Forty percent of the statements made were about "teaching methods" and 17% about "teaching content," 8% referred to "practical value," and 10% to "side effects" of anatomy education. Ten percent of the statements were "positional," five percent "traditional," four percent "self-evident," and two percent referred to "quality of care." Fifty-six percent of the statements had no foundation, 17% were founded on empirical data, and 27% by references. These results substantiated the critical comments about the anecdotal nature of the literature. However, it is encouraging to see that between 1985 and 2009 the number of publications is rising that these publications increasingly focus on teaching methods and that an academic writing style is developing. This suggests a growing body of empirical literature about anatomy education. Copyright © 2011 American Association of Anatomists.
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.
The European Federation of Organisations for Medical Physics, EFOMP, is an umbrella organisation for National Medical Physics Organisations. One of the main objectives of EFOMP is to harmonise and promote the best practice of Medical Physics within Europe. To accomplish this goal, EFOMP has presented various recommendations and guidelines in a number of Policy Statements, unanimously adopted by EFOMP Member Organisations. Policy Statement No 9, 'Radiation Protection of the Patient in Europe: The Training of the Medical Physics Expert in Radiation Physics or Radiation Technology', is the EFOMP response to the Medical Exposure Directive, 97/43/Euratom. Here EFOMP presents its recommendations on the role and the competence requirements of the Medical Physics Expert, defined in this Directive, together with recommendations on education, training and Continuing Professional Development. The previous Directive 96/29/Euratom, the Basic Safety Standards Directive, defines a 'Qualified Expert' in the radiation protection of workers and the general public. EFOMP has an ongoing discussion on the interpretation of the competence requirements of the Qualified Expert in medical practice. The EFOMP approach to achieve harmonisation in the qualification of the Medical Physicist is to encourage the establishment of education and training schemes according to EFOMP recommendations. (author)
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.
Truong, Hoai-An; Patterson, Brooke Y.
The United States is facing a public health workforce shortage and pharmacists have the opportunity and obligation to address this challenge in health care. There have been initiatives and supports from within and beyond the profession for the pharmacist's role in public health. This article identifies existing professional and educational initiatives for the pharmacist's expanded role in public health, as well as postgraduate and other advanced educational opportunities in public health. Rec...
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.
Upadhyay, Ushma D; Cartwright, Alice F; Johns, Nicole E
A proposed California law will require student health centers at public universities to provide medication abortion. To understand its potential impact, we sought to describe current travel time, costs, and wait times to access care at the nearest abortion facilities. We projected total medication abortion use based on campus enrollment figures and age- and state-adjusted abortion rates. We calculated distance and public transit time from campuses to the nearest abortion facility. We contacted existing abortion-providing facilities to determine costs, insurance acceptance, and wait times. We estimate 322 to 519 California public university students seek medication abortions each month. As many as 62% of students at these universities were more than 30 minutes from the closest abortion facility via public transportation. Average cost of medication abortion was $604, and average wait time to the first available appointment was one week. College students face cost, scheduling, and travel barriers to abortion care. Offering medication abortion on campus could reduce these barriers. Copyright © 2018 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.
the ethics of animal research, data management, authorship , collaboration, publication, and other topics. It also considers the implications of...race, creed, color, sex, national origin, sexual orientation, gender identity or handicap. In emergencies, a physician should make her/his services...impartially and without discrimination on the basis of age, disease or disability, creed, ethnic origin, gender , nationality, political affiliation, race
Balaban, Victor; Warnock, Eli; Ramana Dhara, V; Jean-Louis, Lee Ann; Sotir, Mark J; Kozarsky, Phyllis
Few data currently exist on health risks faced by public health professionals (PHP) during international travel. We conducted pre- and post-travel health surveys to assess knowledge, attitudes, and practices (KAP), and illnesses among PHP international travelers. Anonymous surveys were completed by PHP from a large American public health agency who sought a pre-travel medical consult from September 1, 2009, to September 30, 2010. Surveys were completed by 122 participants; travelers went to 163 countries. Of the 122 respondents, 97 (80%) reported at least one planned health risk activity (visiting rural areas, handling animals, contact with blood or body fluids, visiting malarious areas), and 50 (41%) reported exposure to unanticipated health risks. Of the 62 travelers who visited malarious areas, 14 (23%) reported inconsistent or no use of malaria prophylaxis. Illness during travel was reported by 33 (27%) respondents. Most of the PHP travelers in our study reported at least one planned health risk activity, and almost half reported exposure to unanticipated health risks, and one-quarter of travelers to malarious areas reported inconsistent or no use of malaria chemoprophylaxis. Our findings highlight that communication and education outreach for PHP to prevent travel-associated illnesses can be improved. Published by Elsevier Ltd.
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.
Full Text Available Background: There have been various consultations on the Millennium Development Goals (MDGs by different groups. However, even if it is clear that the health sector has led the development success of the MDGs, only a few MDG reports consider public health experts’ points of view and these are mainly government driven. Designs: The World Federation of Public Health Associations (WFPHA has executed a global survey to consult public health professionals worldwide concerning the implementation and achievements of the MDGs.The survey was conceived by WFPHA health professionals and promulgated online. Public health professionals and organisations dealing with MDGs responded to the survey. Content analysis was conducted to analyse the data. Results: Survey participants attributed the highest importance worldwide to MDGs dealing with women, poverty and hunger reduction, and disease prevention and management. Moreover, they underlined the role of education, referring both to school children and professionals. In high and upper-middle income countries, environmental challenges also received considerable attention.Notably, respondents underlined that weak governance and unstable political situations, as well as the gap between professionals and politicians, were among the main causes that detracted from MDG achievements. Conclusion: The public health workforce felt it would be imperative to be included from the outset in the design and implementation of further goals. This implies that those professionals have to take an active part in the political process leading to a new and accountable framework.
McMurtry, Angus; Wilson, Kumanan; Clarkin, Chantalle; Walji, Rishma; Kilian, Brendan C; Kilian, Carney C; Lohfeld, Lynne; Alolabi, Bashar; Hagino, Carol; Busse, Jason W
An important influence on parents' decisions about pediatric vaccination (children under 6 years of age) is the attitude of their health care providers, including complementary and alternative medicine (CAM) providers. Very limited qualitative research exists, however, on how attitudes towards vaccination develop among healthcare professionals in-training. We explored perspective development among three groups of students: medical, chiropractic, and naturopathic. We conducted focus group sessions with participants from each year of study at three different healthcare training programs in Ontario, Canada. Semi-structured and open-ended questions were used to elicit dynamic interaction among participants and explore how they constructed their attitudes toward vaccination at the beginning and part way through their professional training. Analyses of verbatim transcripts of audiotaped interviews were conducted both inductively and deductively using questions structured by existing literature on learning, professional socialization and interprofessional relations. We found five major themes and each theme was illustrated with representative quotes. Numerous unexpected insights emerged within these themes, including students' general open-mindedness towards pediatric vaccination at the beginning of their training; the powerful influence of both formal education and informal socialization; uncritical acceptance of the vaccination views of senior or respected professionals; students' preference for multiple perspectives rather than one-sided, didactic instruction; the absence of explicit socio-cultural tensions among professions; and how divergences among professional students' perspectives result from differing emphases with respect to lifestyle, individual choice, public health and epidemiological factors-rather than disagreement concerning the biomedical evidence. This last finding implies that their different perspectives on pediatric vaccination may be complementary
S. M. Serjogin
Full Text Available The article analyzes ethical aspects of the personality of a public servant. Such concepts as, «professional honor», «professional dignity», «professional justice», «professional responsibility» are disclosed. The role of these concepts in public servants’ professional activities is defermined. It is stated that professional dignity of the public servant is closely connected with his position in the team, his personal merit and honor public servant. The matter is that a public servant is a representative a particular team, and the entire public service. The attention is focused on the fact that the higher developed feeling of personal and official dignity of public servants, the more he values his professional honor, the more significant social value he has to society. As a result, professional honor and professional dignity, complement each other, help to maintain a certain, fairly high level of a public servant’s morality. It was found that such concepts as «professional honor», «professional dignity», «professional justice», «professional responsibility» were brought up before and are brought up now in a large stable structures and organizations of the world. In developed countries, such as France, Germany, Japan, England – the honor and responsibility of public servant are essential professional qualities, which largely determine style of activities and influence decision-making process. In our country, nowadays, the education of a public servant is missed, therefore we will not be able in the future to count on the loyalty of civil servants to their job. We will have to deal with the satisfaction of public servants’ personal needs, as it often happens now. Based on the analysis concluded that the professional ethics of a public servant is a rather complicated and weighty task of harmonizing professional and personal moral responsibility, principles, values and interests.
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...
Fernandez Gomez, Isis Maria
The cause of radiation sources, by exposure to the public, has excluded all those medical and occupational exposures and exposure to natural background radiation normal, in the area. The main sources of public exposure that have found are: practices, discharges or spills, food or merchandise contaminated, chronic exposure scenarios (radon, NORM), waste management (predisposal management, storage, disposal). Public exposure can occur in two forms. One has been by procedure: transport, storage, handling of sources, radioactive waste, radioactive patient. The second has been per incident: transportation accidents, loss of sources, spread of contamination, unchecked pollution. (author) [es
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.
This project, managed by the American University of Beirut, will survey public health academics and practitioners around the world about their attitudes and practices around funding from for-profit corporations, particularly those whose products are associated with non-communicable diseases. The project will also review ...
Buttery, Thomas J.
In the first edition of Writing for Publication: An Organizational Paradigm (Buttery, 2010), I recommend a model for organizing theoretical articles. The process includes seven components: title, introduction, outline/advanced organizer, headings, transitions, summary and references. This article will focus on the writing process. The strands of…
Zarzeczny, Amy; Clark, Marianne
The pursuit of unproven stem cell-based interventions ("stem cell tourism") is an emerging issue that raises various concerns. Physicians play different roles in this market, many of which engage their legal, ethical and professional obligations. In Canada, physicians are members of a self-regulated profession and their professional regulatory bodies are responsible for regulating the practice of medicine and protecting the public interest. They also provide policy guidance to their members and discipline members for unprofessional conduct. We conducted semi-structured telephone interviews with representatives from six different provincial Colleges of Physicians and Surgeons in Canada to discuss their experiences and perspectives regarding stem cell tourism. Our focus was on exploring how different types of physician involvement in this market would be viewed by physicians' professional regulatory bodies in Canada. When considering physicians' professional obligations, participants drew analogies between stem cell tourism and other areas of medical tourism as well as with some aspects of complementary alternative medicine where existing policies, codes of ethics and regulations provide some guidance. Canadian physicians are required to act in the best interests of their patients, respect patient autonomy, avoid conflicts of interest and pursue evidence-based practice in accordance with accepted standards of care. Physicians who provide unproven treatments falling outside the standard of care, not in the context of an approved research protocol, could be subject to professional discipline. Other types of problematic conduct include referrals involving financial conflict of interest and failure to provide urgent medically necessary care. Areas of ambiguity include physicians' obligations when asked for information and advice about seeking unproven medical treatments, in terms of providing non-urgent follow-up care, and when asked to support efforts to go abroad by
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".
E. V. Pesennikova
Full Text Available Purpose. To consider the relationship between the concepts of “medical service” and “medical care” in the work of public medical institutions, based on the analysis of normative legal documents of the modern period.Materials and methods. In the course of the research, more than 18 legal and regulatory documents that were published during the period from 1990 to 2017 were analyzed, an analysis of judicial practice and related literature sources (periodicals was carried out.Results. The analysis made it possible to distinguish the stages in the development of the organizational and legal framework for the provision of paid medical services in the Russian Federation and the dynamics of the relationship between the terms “medical care” and “medical service”. It was revealed that the concept of “medical services” appeared much later and was associated with the development of paid medical services and the need to establish legal aspects of health care. The provision of medical assistance is regulated mainly by public law, and the provision of medical services is governed by private law. The term “medical care” is broader than the “medical service” from the standpoint of the social aspect. At the same time, the concept of “medical service” can be considered more widely than medical care in cases when it is not only about measures aimed at treating the patient, but also about providing additional services to the patient in the process of receiving medical care.Conclusion. Thus, we concluded that the categories of medical care and medical services should not be identified, but also not completely different concepts, but rather enter into a partial intersection relationship. The need to distinguish between the concepts of “medical care” and “medical service” is dictated not only by the category relations or opinion of the population and the medical community, but also by the need for legal support for the process of
Luk, Andrew Leung; Yau, Adrian Fai To
Overseas studies suggest that 10-20% of doctors are depressed, 30-45% have burnout, and many report dissatisfaction with work-life balance. A local study on public doctors showed that 31.4% of the respondents satisfied the criteria for high burnout. Young, but moderately experienced doctors who need to work shifts appeared most vulnerable. This study aims to explore the experiences of those public doctors who have managed their work difficulties and maintained professional enthusiasm for references in medical education and continuing professional training. Ten public doctors with reputation were invited respectively from three acute general hospitals for an in-depth interview. Interviews were audio recorded and transcribed. Content analysis was carried out to identify major themes in relation to the research questions. Three themes emerging from difficulties encountered were (1) managing people, mostly are patients, followed by colleagues and then patients' relatives; (2) constraints at work, include time and resources; and (3) managing self with decision-making within a short time. Three themes generating from managing work difficulties included (1) self-adjustment with practicing problem solving and learning good communication appeared more frequently, followed by maintaining a professional attitude and accumulating clinical experiences; (2) seeking help from others; and (3) organizational support is also a theme though it is the least mentioned. Four themes emerging from maintaining work enthusiasm were (1) personal conviction and discipline: believing that they are helping the needy, having the sense of vocation and support from religion; disciplining oneself by continuing education, maintaining harmonious family relationship and volunteer work. (2) Challenging work: different challenging natures of their job. (3) Positive feedback from patients: positive encounters with patients keep a connectedness with their clients. (4) Organization support: working with
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 IUGS Task Group on Global Geoscience Professionalism - promoting professional skills professionalism in the teaching, research and application of geoscience for the protection and education of the public
Allington, Ruth; Fernandez-Fuentes, Isabel
A new IUGS Task Group entitled the Task Group on Global Geoscience Professionalism was formed in 2012 and launched at a symposium at the 341GC in Brisbane on strengthening communication between fundamental and applied geosciences and between geoscientists and public. The Task Group aims to ensure that the international geoscience community is engaged in a transformation of its profession so as to embed the need for a professional skills base alongside technical and scientific skills and expertise, within a sound ethical framework in all arenas of geoscience practice. This needs to be established during training and education and reinforced as CPD throughout a career in geoscience as part of ensuring public safety and effective communication of geoscience concepts to the public. The specific objective of the Task Group on Global Geoscience Professionalism that is relevant to this poster session is: • To facilitate a more 'joined up' geoscience community fostering better appreciation by academics and teachers of the professional skills that geoscientists need in the workplace, and facilitate better communication between academic and applied communities leading to more effective application of research findings and technology to applied practitioners and development of research programmes that truly address urgent issues. Other Task Group objectives are: • To provide a specific international forum for discussion of matters of common concern and interest among geoscientists and geoscientific organizations involved in professional affairs, at the local, national and international level; • To act as a resource to IUGS on professional affairs in the geosciences as they may influence and impact "Earth Science for the Global Community" in general - both now and in the future; • To offer and provide leadership and knowledge transfer services to countries and geoscientist communities around the world seeking to introduce systems of professional governance and self
Moorman, P W; Schuemie, M J; van der Lei, J
In this short review we provide an update of our earlier inventories of publications indexed in MedLine with the MeSH term 'Medical Records Systems, Computerized'. We retrieved and analyzed all references to English articles published before January 1, 2008, and indexed in PubMed with the MeSH term 'Medical Records Systems, Computerized'. We retrieved a total of 11,924 publications, of which 3937 (33%) appeared in a journal with an impact factor. Since 2002 the number of yearly publications, and the number of journals in which those publications appeared, increased. A cluster analysis revealed three clusters: an organizational issues cluster, a technically oriented cluster and a cluster about order-entry and research. Although our previous inventory in 2003 suggested a constant yearly production of publications on electronic medical records since 1998, the current inventory shows another rise in production since 2002. In addition, many new journals and countries have shown interest during the last five years. In the last 15 years, interest in organizational issues remained fairly constant, order entry and research with systems gained attention, while interest in technical issues relatively decreased.
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.
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.
Cascón-Pereira, Rosalía; Kirkpatrick, Ian; Exworthy, Mark
This article aims to assess if the status of the medical profession has been reinforced or weakened with the new public management. With this purpose, it collects the opinion of two international experts regarding situation in the United Kingdom, in order to apply some lessons to the Spanish case. Both agree that, far from losing status and power with the healthcare reform, the medical profession has protected its status and autonomy against other social agents such as managers, politicians and patients. However, the maintenance of the status quo has been at the expense of an intra-professional stratification that has caused status inequalities linked to social class within the medical profession. Copyright © 2016 SESPAS. All rights reserved.
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.
Connie J Evashwick
Full Text Available A well-educated workforce is essential to the infrastructure of a public health system. At the time when global focus on public health is increasing, a severe shortage of public health professionals is projected. A strong educational framework is imperative to ensure the capacity and capability of the worldwide public health workforce for the future. Frenk and Chen (2011 comment that academic public health has done far less than medicine or nursing to examine its pedagogy. The goal of this study is to examine the literature pertaining to the education of public health professionals in order to document the extent to which those preparing public health professionals think about what they teach, how they teach, and what the results of the instruction are. The specific objectives are to (1 identify relevant peer reviewed literature, (2 analyze that literature for content, (3 characterize the literature according to type of methodology, and (4 draw conclusions and implications to enhance future pedagogical efforts. The study searched three bibliographic sources for articles written in English between 2000-2012. The search of PubMed, Scopus, Education Full Text identified 576 unique articles. The articles were analyzed according to ten content themes and four format categories. The conclusions are that those teaching public health professionals devote considerable thought to what and how they teach, although original research and evaluation studies are fewer than descriptive reports of courses, programs and curricula. A journal devoted specifically to articles pertaining to education of public health professionals will encourage academicians to write articles sharing approaches to educating the public health workforce.
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
Maguy Saffouh El Hajj
Full Text Available Maguy Saffouh El Hajj1, Nadir Kheir1, Manal Zaidan2, Peter J Jewesson11College of Pharmacy, Qatar University, Doha, Qatar; 2Pharmacy Department, Al Amal Cancer Centre, Doha, QatarPurpose: To characterize the professional demographics, opinions about the medication use process, perceived public satisfaction with pharmacy services, and professional satisfaction of pharmacists practicing in the state of Qatar.Materials and methods: The study was designed as a hypothesis-generating, online, anonymous, opinion survey of practicing pharmacists in Qatar.Results: Two hundred and sixty-four survey accesses were recorded during the 6-week study period, and 250 surveys containing responses to one or more questions were included in the analysis. Eighty-four percent of respondents reported graduating at least 5 years prior to the survey, and 86% held a baccalaureate degree in pharmacy as their highest degree. The most common source of the highest degree was one of five countries (Egypt, Jordan, India, Sudan, or Pakistan. Forty-five percent of respondents were working in a hospital setting, and 33% were in a community pharmacy. The lowest incidence of agreement across the 10 drug procurement and distribution process statements was observed for the adequacy of medication supplies statements (33% of all respondents. The highest incidence of agreement across the eight medication use process statements was for the statement pertaining to infrequent dispensing errors (68%, and the lowest incidence of agreement was observed for the statement pertaining to the adequacy of patient monitoring (30%. The pharmacist was chosen as the best candidate to resolve perceived unmet medication needs for four of eight statements, whereas physicians were most frequently chosen for three of the four remaining statements. Respondents' perceptions regarding patient satisfaction with the different elements of the medication use process revealed that the lowest incidence of agreement
de Castro-Santos, L A
Since George Herbert Mead studied "the social self" and the interactionists went further in distinguishing "images of self", a lecture on the building up of a Brazilian medical identity should try to focus on the patterns of self-images, presented images, and aspired-to images among the Brazilian medical elites during the First Republic (1889-1930). In no other period of Brazilian history were those "images" of professional identity so close--in contrast, later periods of Brazilian history witnessed an almost permanent "collision" or the clashing of such images among public health specialists. Oswaldo Cruz, Carlos Chagas, Artur Neiva and Belisário Pena are perhaps the best examples of successful careers as "sanitarians" (to recall John Duffy's historical work on luminaries before and after the "New Public Health" in the United States), and as important political actors during Brazil's First Republic. In light of the prominent political, policy-oriented, and scientific roles public health professionals played in Brazil, it is interesting to suggest that in large part such prominence resulted from the symbolic impact of the ideologies of sanitary reform on the political agenda of that period of Brazilian history. Where many studies look for personal rivalries and disputes around Chagas and Neiva as public figures, we may also see the importance of finding identity-building processes among public health specialists as an integrated group (e.g., trying to appear as "significant others" for the new generations of medical graduates in the country), regardless of existing rivalries. Cruz and Chagas, especially, were names with great impact in the Brazilian press (pro and con), a circumstance made possible largely by their easy and direct access to the Brazilian presidents Rodrigues Alves and Epitácio Pessoa, and, most clearly, by public health being one of Brazil's political priorities to find a place among the "civilized nations" of the world. A task that further
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...
Wells, Rebecca; Cilenti, Dorothy; Issel, L Michele
Throughout the United States, public health leaders are experimenting with how best to integrate services for individuals with complex needs. To that end, North Carolina implemented a policy incorporating both local public health departments and other providers into medical homes for low income pregnant women and young children at risk of developmental delays. To understand how this transition occurred within local communities, a pre-post comparative case study was conducted. A total of 42 people in four local health departments across the state were interviewed immediately before the 2011 policy change and six months later: 32 professionals (24 twice) and 10 pregnant women receiving case management at the time of the policy implementation. We used constant comparative analysis of interview and supplemental data to identify three key consequences of the policy implementation. One, having medical homes increased the centrality of other providers relative to local health departments. Two, a shift from focusing on personal relationships toward medical efficiency diverged in some respects from both case managers' and mothers' goals. Three, health department staff re-interpreted state policies to fit their public health values. Using a political economy perspective, these changes are interpreted as reflecting shifts in public health's broader ideological environment. To a large extent, the state successfully induced more connection between health department-based case managers and external providers. However, limited provider engagement may constrain the implementation of the envisioned medical homes. The increased focus on medical risk may also undermine health departments' role in supporting health over time by attenuating staff relationships with mothers. This study helps clarify how state public health policy innovations unfold at local levels, and why front line practice may in some respects diverge from policy intent. Published by Elsevier Ltd.
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.
Gomes, Antonio Marcos Tosoli; Oliveira, Denize Cristina de
The object of this study is the professional image constructed by public health nurses and the objective is to describe and analyze the professional images present in the representations of nurses who deliver direct care to this clientele. The theoretical-methodological reference framework adopted was Social Representations Theory. A qualitative study was developed in Petrópolis-Rio de Janeiro/Brazil, through in-depth interviews with 30 nurses. Alceste 4.5 software was used for the lexical analysis. The results reveal the existence of a professional self-image with three groups of meanings: being a reference for the team, the non-specific image and the image of plaster; and a professional hetero-image with four groups of meanings: administrator, invisible, positive image and superposition. The study of the professional image reflects the construction of the nurse's identity in itself and emphasizes Social Representations Theory as a useful tool for nursing research development.
Cheng, Terence C; Joyce, Catherine M; Scott, Anthony
The combination of public and private medical practice is widespread in many health systems and has important consequences for health care cost and quality. However, its forms and prevalence vary widely and are poorly understood. This paper examines factors associated with public and private sector work by medical specialists using a nationally representative sample of Australian doctors. We find considerable variations in the practice patterns, remuneration contracts and professional arrangements across doctors in different work sectors. Both specialists in mixed practice and private practice differ from public sector specialists with regard to their annual earnings, sources of income, maternity and other leave taken and number of practice locations. Public sector specialists are likely to be younger, to be international medical graduates, devote a higher percentage of time to education and research, and are more likely to do after hours and on-call work compared with private sector specialists. Gender and total hours worked do not differ between doctors across the different practice types. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.
Benotmane, Ilies; Glatz, Nicolas; Bihan, Solenn; Legrand, Fanny; Gosset, Didier; Boulanger, Eric
The purpose of this study was to determine the future, in terms of scientific publication, of medical thesis (MT) defended in the Medical School of Lille 2 University (MSL2U) between January 1st, 2001 and December 31st, 2007. The collection of MT published as a corresponding scientific article was realized from PubMed(®). For every corresponding article, we determined the journal Impact Factor (IF), the language of publication and the rank of the student and his MT director in the author list. Analyses were also realized according to the group of speciality of the TM. In all, 11.3% of the 2150 MT defended in the MSL2U were followed up by a scientific publication. The average IF was 2.32 with a median at 1.75 and extreme values from 0 to 14.78. Seventy percent of the articles were published in English. The rank of the student was placed before his MT director (2.06 vs. 3.15). The MT defended by students in the field of medical specialities presented the highest rate of publication (25.1%). The general medicine was the second speciality the most productive in term of number of published articles (n=49) after medical specialities (n=103). The MT director and the PhD students must be more motivated to publish their results. The value of 11.3% could be considered as weak but, because of a huge lack of references, it is impossible to compare our results to those of other French medical schools. It remains important to reform the objectives and the modalities of the writing of a MT: should we not have to turn to thesis called "on article"? Copyright © 2012. Published by Elsevier Masson SAS.
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.
Christofides, Stelios; Isidoro, Jorge; Pesznyak, Csilla; Cremers, Florian; Figueira, Rita; van Swol, Christiaan; Evans, Stephen; Torresin, Alberto
Continuing Professional Development (CPD) is vital to the medical physics profession if it is to embrace the pace of change occurring in medical practice. As CPD is the planned acquisition of knowledge, experience and skills required for professional practice throughout one's working life it promotes excellence and protects the profession and public against incompetence. Furthermore, CPD is a recommended prerequisite of registration schemes (Caruana et al. 2014) and is implied in the Council Directive 2013/59/EURATOM (EU BSS) and the International Basic Safety Standards (BSS). It is to be noted that currently not all national registration schemes require CPD to maintain the registration status necessary to practise medical physics. Such schemes should consider adopting CPD as a prerequisite for renewing registration after a set period of time. This EFOMP Policy Statement, which is an amalgamation and an update of the EFOMP Policy Statements No. 8 and No. 10, presents guidelines for the establishment of national schemes for CPD and activities that should be considered for CPD. Copyright © 2016. Published by Elsevier Ltd.
Barnieh, Lianne; Klarenbach, Scott; Gill, John S; Caulfield, Tim; Manns, Braden
The acceptability of financial incentives for organ donation is contentious. This study sought to determine (1) the acceptability of expense reimbursement or financial incentives by the general public, health professionals involved with organ donation and transplantation, and those with or affected by kidney disease and (2) for the public, whether financial incentives would alter their willingness to consider donation. Web-based survey administered to members of the Canadian public, health professionals, and people with or affected by kidney disease asking questions regarding acceptability of strategies to increase living and deceased kidney donation and willingness to donate a kidney under various financial incentives. Responses were collected from 2004 members of the Canadian public October 11-18, 2011; responses from health professionals (n=339) and people with or affected by kidney disease (n=268) were collected during a 4-week period commencing October 11, 2011. Acceptability of one or more financial incentives to increase deceased and living donation was noted in >70% and 40% of all groups, respectively. Support for monetary payment for living donors was 45%, 14%, and 27% for the public, health professionals, and people with or affected by kidney disease, respectively. Overall, reimbursement of funeral expenses for deceased donors and a tax break for living donors were the most acceptable. The general public views regulated financial incentives for living and deceased donation to be acceptable. Future research needs to examine the impact of financial incentives on rates of deceased and living donors.
Pan, Wei; Coatrieux, Gouenou; Bouslimi, Dalel; Prigent, Nicolas
Cloud computing promises medical imaging services offering large storage and computing capabilities for limited costs. In this data outsourcing framework, one of the greatest issues to deal with is data security. To do so, we propose to secure a public cloud platform devoted to medical image sharing by defining and deploying a security policy so as to control various security mechanisms. This policy stands on a risk assessment we conducted so as to identify security objectives with a special interest for digital content protection. These objectives are addressed by means of different security mechanisms like access and usage control policy, partial-encryption and watermarking.
Timeus, Krista; Ricard, Lykke Margot
The paper addresses two questions; what do professionals working in the public administration understand by ‘risk’ in relation to their work on innovation?; and how do these professionals understand their own role in managing risks of innovation? The paper takes an inductive approach and focuses....... In the last five years, Copenhagen municipality has implemented programmes and partnerships for innovation, especially in social services, such as a new ‘innovation house’ to coordinate the municipality’s innovation strategy across all administrative departments. This context makes it a suitable case to study...... on individuals, namely, professionals in Copenhagen municipality working on public services innovation. Such innovation includes new services or new methods of service delivery. Although all types of innovation include some risk, in public services, risks are exacerbated by the vulnerability of many users...
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…
Verma, Pradhuman; Sachdeva, Suresh K; Verma, Kanika Gupta; Khosa, Rameen; Basavraju, Suman; Dutta, Sanjay
Due to competitiveness and academic benefits, most dental professionals feel an urgent need to increase their publications. Hence, we explored the attitude of students and faculty members toward scientific publications through a questionnaire. A questionnaire consisting of 13 questions was sent by e-mails and posting the printed copies to dental postgraduate (PG) students (second and third year) and faculty members (n = 500 each). The returned completed questionnaires were analyzed. About 37% of dental PG faculty and 35.6% PG students responded to the questionnaire, with overall response of 72.6%. Among the PG faculty, professors (P) had more scientific publications, followed by senior lecturers (SL) and readers (R). The publications as first or corresponding author were less among both faculty and PG students while co-authorship was more among PG students compared to faculty members. Awareness about the term "plagiarism" was overall high and relatively highest among R, followed by SL, P and PG students. The percentage of publications in fee charging journals was more among PG students than faculty members and self-funding for publication was observed in 86.4% of PG students and 94-100% among faculty members. About 72.6% of dental professionals were involved in publishing of their research work and the number of publications increased steadily with an increase in their academic experience. All the dental professionals concurred publications as the criteria for academic excellence.
Gattrell, William T; Hopewell, Sally; Young, Kate; Farrow, Paul; White, Richard; Wager, Elizabeth; Winchester, Christopher C
Authors may choose to work with professional medical writers when writing up their research for publication. We examined the relationship between medical writing support and the quality and timeliness of reporting of the results of randomised controlled trials (RCTs). Cross-sectional study. Primary reports of RCTs published in BioMed Central journals from 2000 to 16 July 2014, subdivided into those with medical writing support (n=110) and those without medical writing support (n=123). Proportion of items that were completely reported from a predefined subset of the Consolidated Standards of Reporting Trials (CONSORT) checklist (12 items known to be commonly poorly reported), overall acceptance time (from manuscript submission to editorial acceptance) and quality of written English as assessed by peer reviewers. The effect of funding source and publication year was examined. The number of articles that completely reported at least 50% of the CONSORT items assessed was higher for those with declared medical writing support (39.1% (43/110 articles); 95% CI 29.9% to 48.9%) than for those without (21.1% (26/123 articles); 95% CI 14.3% to 29.4%). Articles with declared medical writing support were more likely than articles without such support to have acceptable written English (81.1% (43/53 articles); 95% CI 67.6% to 90.1% vs 47.9% (23/48 articles); 95% CI 33.5% to 62.7%). The median time of overall acceptance was longer for articles with declared medical writing support than for those without (167 days (IQR 114.5-231 days) vs 136 days (IQR 77-193 days)). In this sample of open-access journals, declared professional medical writing support was associated with more complete reporting of clinical trial results and higher quality of written English. Medical writing support may play an important role in raising the quality of clinical trial reporting. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go
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
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.
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.
Whether you think of it as your image, your standing in the community, or your reputation, your medical practice is also a brand. While many organizations, companies, products, and services are known for specific attributes that make them stand out from competitors, most use a combination of marketing disciplines to communicate who and what they are to their customers, consumers, and patients. Public relations is often considered the most powerful, cost-effective, and efficacious of the marketing disciplines, surpassing advertising, promotion, and direct mail in molding and developing brands. Your practice can benefit from a well-crafted branding public relations program.
A recent decision by the High Court of Australia (Wong v Commonwealth; Selim v Professional Services Review Committee (2009) 236 CLR 573) (the PSR case) has not only clarified the scope of the Australian constitutional prohibition on "any form of civil conscription" in relation to federal legislation concerning medical or dental services (s 51xxiiiA), but has highlighted its importance as a great constitutional guarantee ensuring the mixed State-federal and public-private nature of medical service delivery in Australia. Previous decisions of the High Court have clarified that the prohibition does not prevent federal laws regulating the manner in which medical services are provided. The PSR case determined that the anti-overservicing provisions directed at bulk-billing general practitioners under Pt VAA of the Health Insurance Act 1973 (Cth) did not offend the prohibition. Importantly, the High Court also indicated that the s 51(xxiiiA) civil conscription guarantee should be construed widely and that it would invalidate federal laws requiring providers of medical and dental services (either expressly or by practical compulsion) to work for the federal government or any specified State, agency or private industrial employer. This decision is likely to restrict the capacity of any future federal government to restructure the Australian health care system, eg by implementing recommendations from the National Health and Hospitals Reform Commission for either federal government or private corporate control of presently State-run public hospitals.
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.
Bond, V.P.; Wielopolski, L.
Starting with the classical threshold-sigmoid Medical-Toxicological plot, reasons are advanced for why the coordinates of this function are not appropriate for the analysis of Public Health-Epidemiological data. Misunderstanding with respect to both the level of biological organization and the word ''dose'' are pointed out, which explain why Public Health-Epidemiological data, anomalously, yield linear functions on medical-toxicological coordinates. It is then shown why substantially different coordinates must be used to obtain a function that describes properly and completely the cancer data obtained from epidemiological studies on the atomic bomb survivors. Arguments are put forth that seriously weaken the current interpretation of the ''linear, no-threshold hypothesis''. Reasons are advanced for why, if the amount of radiation energy is expressed in the proper terms, the numerical value for the cancer ''risk coefficient'' becomes substantially smaller than it now is
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.
Studies show significant negative effects of smoking marijuana on physical and mental health as well as social and occupational functioning. At the same time, there are more considerations about its ability to treat a number of diseases. This review summarizes current data in scientific literature that examines the medical effects of marijuana on human health with particular emphasis on its potential in medicine. Marijuana has a range of adverse health effects, particularly relating to young people because of higher risk for psychosis, traffic accidents, and cognitive impairment. Marijuana may be helpful in relieving symptoms of nausea and vomiting, increasing appetite and pain relief for persons with cancer, AIDS and multiple sclerosis. Smoking marijuana can impose significant public health risks. If there is a medical role for using marijuana, it lies in the application of clearly defined medical protocols and chemically defined compounds, not with using the unprocessed cannabis plant.
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.
Davis, Jonathan M; Mendelson, Bruce; Berkes, Jay J; Suleta, Katie; Corsi, Karen F; Booth, Robert E
The public health consequences of the legalization of marijuana, whether for medical or recreational purposes, are little understood. Despite this, numerous states are considering medical or recreational legalization. In the context of abrupt changes in marijuana policy in 2009 in Colorado, the authors sought to investigate corresponding changes in marijuana-related public health indicators. This observational, ecologic study used an interrupted time-series analysis to identify changes in public health indicators potentially related to broad policy changes that occurred in 2009. This was records-based research from the state of Colorado and Denver metropolitan area. Data were collected to examine frequency and trends of marijuana-related outcomes in hospital discharges and poison center calls between time periods before and after 2009 and adjusted for population. Analyses were conducted in 2014. Hospital discharges coded as marijuana-dependent increased 1% per month (95% CI=0.8, 1.1, pcenter calls mentioning marijuana (pcenter calls increased 0.8% per month (95% CI=0.2, 1.4, pcenter calls also increased 56% (95% CI=49%, 63%, p<0.001) in the period following the policy change. Further, there was one hospital discharge coded as dependent for every 3,159 (95% CI=2465, 3853, p<0.001) medical marijuana registrant applications. The abrupt nature of these changes suggests public health effects related to broad policy changes associated with marijuana. This report may be used to assist in policy decisions regarding the short-term public health effects of marijuana legalization. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
Gebbie, Kristine M; Rosenstock, Linda; Hernandez, Lyla M
...? Who Will Keep the Public Healthy? provides an overview of the past, present, and future of public health education, assessing its readiness to provide the training and education needed to prepare men and women to face 21st century challenges...
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
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.
Chapman, R. L.; Cleaveland, F. N.
The educational programs for public administration were studied to develop guidelines for meeting the requirements of public service in the 1980's. The current state of education for public service is discussed along with a prospective view of the service over the next decade. Criteria for evaluating graduate programs are presented.
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
Ria Sandra Alimbudiono
Full Text Available This study aims to give an insight about environmental awareness from public accountant and the role of Indonesian accounting professional bodies in ensuring professional sustainability. A naturalistic method was applied to get deep understanding about the perspectives of the boards of professional bodies as a representation from the condition of public accountants in general. Data collection methods used in this study were interviews and focus group discussion. The findings highlight a variety of perspectives on knowledge of environment, interest in environmental accounting and moral responsibility on environmental damage. This variation shows different levels of awareness and it is mainly caused by the lack of law enforcement and no mandatory standards on environmental issues. This condition will threat legitimacy of accounting profession and finally, be able to endangered professional accounting sustainability. Limitations are about the scope and sample,which provide insights of the boards of public accountant professional bodies on environmental accounting issues. Future studies should be done on other accounting fields such as environmental audit, environmental accounting and reporting and environmental costing.
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.
Mereu, Alessandra; Sotgiu, Alessandra; Buja, Alessandra; Casuccio, Alessandra; Cecconi, Rosaria; Fabiani, Leila; Guberti, Emilia; Lorini, Chiara; Minelli, Liliana; Pocetta, Giancarlo; Contu, Paolo
According to the Nairobi Call to Action, the growth of practitioners' skills can be favoured by setting accreditation standards and by reorienting professional competencies of current and future health workers. This will make it possible to develop a critical mass of competent practitioners, foster training, and increase visibility of the professional field. Through a review of the literature, the authors offer an overview of competency-based strategies for professional development in health promotion. The main research questions discussed were as follows: Is there a shared definition of public health?; Is there a shared definition of health promotion?; Who are the main stakeholders for public health and health promotion in Europe?; What is the meaning of professional competencies in education and practice for public health and health promotion?; Is there a shared system of professional core competencies in public health and health promotion?;What is common and what is specific between the two systems of professional competencies?; Is it useful and feasible to create specific strategies of professional development for public health and health promotion? A transformative use of competencies makes it possible to inform students, professionals, employers, and political decision-makers about what is expected from a specific profession and its values.
Stark, James F
Although historians have shown that there has been a complex and multi-layered relationship between the body, medicine and the force of electricity, many avenues remain to be explored. One of the most prominent of these is the way in which electrotherapy technologies were marketed to a wide variety of different end users and intermediaries. This paper offers the first historical analysis of one such device - the Overbeck Rejuvenator - a 1920s electrotherapy machine designed for use by the general public. Its inventor, Otto Overbeck, was not a medical man and this enabled him to use aggressive strategies of newspaper advertising, using testimonials to market his product alongside appeals to his own scientific authority. He commissioned the prestigious Ediswan Company to manufacture the Rejuvenator on a large scale, and took out patents in eleven countries to persuade users of the efficacy of the device. In response to Overbeck's activities, the British Medical Association enlisted an electrical engineer to examine the Rejuvenator, contacted practitioners whose endorsements were being used in publicity material, and denied Overbeck permission to advertise in the British Medical Journal. Despite this, the Rejuvenator brought its inventor wealth and notoriety, and helped redefine the concept of 'rejuvenation', even if the professional reception of such a device was almost universally hostile. This paper shows how the marketing, patenting and publishing of Overbeck combined to persuade members of the laity to try the Rejuvenator as an alternative form of therapy, bypassing the medical profession in the process.
Ditterich, Rafael Gomes; Moysés, Simone Tetu; Moysés, Samuel Jorge
Results-based management is a cornerstone of reform in public administration, including the health field, and has become the basis for other innovations such as the institutionalization of management contracts and the use of professional incentives. This review article aims to introduce and discuss the use of such management contracts in the public health sector. Management by results has developed means and tools that highlight the importance of shared responsibility and mutual commitment between workers and management-level directors. Thus, preset goals are negotiated among all the stakeholders and are evaluated periodically in order to grant professional incentives. It is necessary to improve the mechanisms for control and observation, to more precisely determine the healthcare and management indicators and their patterns, to train stakeholders in designing the plan, and to improve the use of professional incentives in order to effectively increase accountability vis-à-vis the desired results.
The generation of a public-good, capabilities-based approach to professional education in South African universities is outlined and proposed as a contribution to wider social transformation. The relevance and importance of understanding what Amartya Sen describes as "capability failure" in the lives of people living in poverty is…
Tremblay, Marie-Claude; Richard, Lucie; Brousselle, Astrid; Chiocchio, François; Beaudet, Nicole
The health promotion laboratory (HPL-Canada) is a public health professional development program building on a collaborative learning approach in order to support long-term practice change in local health services teams. This study aims to analyse the collaborative learning processes of two teams involved in the program during the first year of…
Biklen, Douglas; Schein, Philip Lambert
This article discusses a court case of an adolescent labeled retarded who was sexually assaulted. It examines implications of being spoken about and of others speaking for the labeled person. It then considers how a disability rights/People First framework could shift public and professional understandings and responses to human abuse. (Contains…
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
The Public Notice has replaced the previous Public Notice of Nuclear Regulatory Authority of the Slovak Republic No. 187/1999 Coll. on Professional competence of employees of nuclear power facilities. The new experience acquired in area of Professional preparation of employees holders of permissions has been included into the Public Notice as well as acknowledged principles of verification of the Professional competence and specific Professional competence of employees holders of permissions. There are rights and duties of permission holders elaborated in the Public Notice where the employees have an influence to the nuclear safety (professionally competent employees of permission holders) or have the direct influence to the nuclear safety (selected employees of permission holders). The Public Notice has also modified the details about preparation of employees of the operator of specific facilities who carry out the professional preparation of the employees holders of permissions
Gaertner, Jan; Vent, Julia; Greinwald, Ralf; Rothschild, Markus A; Ostgathe, Christoph; Kessel, Rene; Voltz, Raymond
Especially when caring for patients approaching the end of life, physicians and nursing staff feel committed to fulfilling as many patient desires as possible. However, sometimes a patient's "final will" may threaten public safety. This can lead to severe conflicts, outweighing the physician's obligation and dedication to care for the patient and to respect his autonomy. Yet, public safety can be threatened if confidentiality is not broken. This article provides a concise summary of the medicolegal and ethical fundamentals concerning this difficult situation. If the patient's and others' health and safety are at risk, physicians may (and in some countries must) break medical confidentiality and disclose confidential patient information to the police and other authorities. Physicians should be able to professionally deal with such a conflict in all patients, not only in patients with advanced illness. Copyright © 2011 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.
Vadepally, Ashwant Kumar; Sinha, Ramen
To investigate the perception of Oral and maxillofacial surgery by healthcare professionals, students and general public. A questionnaire form was created that listed ten clinical situations, and given by hand to 1200 individuals, divided into six groups: group 1, medical professionals; group 2, Specialties of dentistry; group 3, general dentists; group 4, medical students; group 5, dental students; and group 6, general public, each comprising 200 individuals. Respondents were asked to indicate who they would expect to treat them if they had one of the specified conditions listed in the questionnaire. We present the results and current awareness levels of this simple questionnaire. The present study addresses the common issue raised by many authors, 'What surgical education the speciality offers?' especially to medical professionals, medical students and general public to enhance an appropriate referral. Most of the respondents in groups 2, 3 and 5 agreed that specific conditions listed in the questionnaire were within the domain of oral and maxillofacial surgery, but such response was not seen in groups 1, 4 and 6 ( p oral and maxillofacial surgery was found to be 50.2%. The onus of creating and improving the awareness and perception of our specialty lies on oral and maxillofacial surgeon. Unified efforts at individual as well as global level will help achieve this goal.
Arnold, Jeffrey L; Ortenwall, Per; Birnbaum, Marvin L; Sundnes, Knut Ole; Aggrawal, Anil; Anantharaman, V; Al Musleh, Abdul Wahab; Asai, Yasufumi; Burkle, Frederick M; Chung, Jae Myung; Cruz-Vega, Felipe; Debacker, Michel; Della Corte, Francesco; Delooz, Herman; Dickinson, Garth; Hodgetts, Timothy; Holliman, C James; MacFarlane, Campbell; Rodoplu, Ulkumen; Stok, Edita; Tsai, Ming-Che
The lack of a universally applicable definition of terrorism has confounded the understanding of terrorism since the term was first coined in 18th Century France. Although a myriad of definitions of terrorism have been advanced over the years, virtually all of these definitions have been crisis-centered, frequently reflecting the political perspectives of those who seek to define it. In this article, we deconstruct these previously used definitions of terrorism in order to reconstruct a definition of terrorism that is consequence-centered, medically relevant, and universally harmonized. A universal medical and public health definition of terrorism will facilitate clinical and scientific research, education, and communication about terrorism-related events or disasters. We propose the following universal medical and public definition of terrorism: The intentional use of violence--real or threatened--against one or more non-combatants and/or those services essential for or protective of their health, resulting in adverse health effects in those immediately affected and their community, ranging from a loss of well-being or security to injury, illness, or death.
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
I. B. Ardashkin
Full Text Available The aim of the research is to analyze and summarize the Russian best practices of using the publication activity as a criterion to assess the professional activity of the academic staff; to identify the role of motivational factors as a method to manage and control the publication activity of the academic staff.Methods. The authors address the methodology of comprehensive research based on the method of document analysis, comparative analysis, and method of secondary use of sociological and psychological data.Results and scientific novelty concludes in presenting Russian and international best practices generalized on using the publication activity to assess the engagement of HEI (Higher Educational Institution academic staff; the most appropriate formats of using the publication activity as a criterion to assess the research component of the academic staff engagement are defined. Degree of reliability of this criterion is shown – its strengths and shortcomings. The conclusion is drawn on need of the essential changes in management of publication activity affecting both professional and motivational spheres of scientific and pedagogical staff. The most acceptable options of measurement of staff work efficiency of this category are formulated.Practical significance. The research outcomes can be the corpus for designing the assessment method for the professional engagement of the academic staff.
Full Text Available Staff policy in public administration must be based on the principle of merit. In the Republic of Moldova, performance management is the less used concept and has been approached in the specialized literature, but there is an evolving evolution. The efficiency and effectiveness of public administration can only be achieved with a professional body of civil servants. The performance and effectiveness of public administration activity, both at central and local level, is approached by Moldovan authors in multiple analytical studies and scientific communications.
Sznitman, Sharon R.; Bretteville-Jensen, Anne Line
Background Debate about medical cannabis legalization are typically informed by three beliefs: (1) cannabis has medical effects, (2) medical cannabis is addictive and (3) medical cannabis legalization leads to increased used of cannabis for recreational purposes (spillover effects). We examined how strongly these beliefs are associated with public support for medical cannabis legalization and whether this association differs across divergent medical cannabis policy regimes. Methods Robust reg...
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.
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.
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 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 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.
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.
Morley, Christopher P; Rosas, Scott R; Mishori, Ranit; Jordan, William; Jarris, Yumi Shitama; Competencies Work Group, Family Medicine/Public Health; Prunuske, Jacob
Phenomenon: The integration of public health (PH) competency training into medical education, and further integration of PH and primary care, has been urged by the U.S. Institute of Medicine. However, PH competencies are numerous, and no consensus exists over which competencies are most important for adoption by current trainees. Our objective was to conduct a group concept mapping exercise with stakeholders identifying the most important and feasible PH skills to incorporate in medical and residency curricula. We utilized a group concept mapping technique via the Concept System Global Max ( http://www.conceptsystems.com ), where family medicine educators and PH professionals completed the phrase, "A key Public Health competency for physicians-in-training to learn is …" with 1-10 statements. The statement list was edited for duplication and other issues; stakeholders then sorted the statements and rated them for importance and feasibility of integration. Multidimensional scaling and cluster analysis were used to create a two-dimensional point map of domains of PH training, allowing visual comparison of groupings of related ideas and relative importance of these ideas. There were 116 nonduplicative statements (225 total) suggested by 120 participants. Three metacategories of competencies emerged: Clinic, Community & Culture, Health System Understanding, and Population Health Science & Data. Insights: We identified and organized a set of topics that serve as a foundation for the integration of family medicine and PH education. Incorporating these topics into medical education is viewed as important and feasible by family medicine educators and PH professions.
Jacque, Berri; Malanson, Katherine; Bateman, Kathleen; Akeson, Bob; Cail, Amanda; Doss, Chris; Dugan, Matt; Finegold, Brandon; Gauthier, Aimee; Galego, Mike; Roundtree, Eugene; Spezzano, Lawrence; Meiri, Karina F
Medical schools, although the gatekeepers of much biomedical education and research, rarely engage formally with K-12 educators to influence curriculum content or professional development. This segregation of content experts from teachers creates a knowledge gap that limits inclusion of current biomedical science into high school curricula, affecting both public health literacy and the biomedical pipeline. The authors describe how, in 2009, scientists from Tufts Medical School and Boston public school teachers established a partnership of formal scholarly dialogue to create 11th- to 12th-grade high school curricula about critical health-related concepts, with the goal of increasing scientific literacy and influencing health-related decisions. The curricula are based on the great diseases (infectious diseases, neurological disorders, metabolic disease, and cancer). Unlike most health science curricular interventions that provide circumscribed activities, the curricula are comprehensive, each filling one full term of in-class learning and providing extensive real-time support for the teacher. In this article, the authors describe how they developed and implemented the infectious disease curriculum, and its impacts. The high school teachers and students showed robust gains in content knowledge and critical thinking skills, whereas the Tufts scientists increased their pedagogical knowledge and appreciation for health-related science communication. The results show how formal interactions between medical schools and K-12 educators can be mutually beneficial.
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.
Andrew Leung Luk
Full Text Available BackgroundOverseas studies suggest that 10–20% of doctors are depressed, 30–45% have burnout, and many report dissatisfaction with work-life balance. A local study on public doctors showed that 31.4% of the respondents satisfied the criteria for high burnout. Young, but moderately experienced doctors who need to work shifts appeared most vulnerable. This study aims to explore the experiences of those public doctors who have managed their work difficulties and maintained professional enthusiasm for references in medical education and continuing professional training.MethodTen public doctors with reputation were invited respectively from three acute general hospitals for an in-depth interview. Interviews were audio recorded and transcribed. Content analysis was carried out to identify major themes in relation to the research questions.ResultsThree themes emerging from difficulties encountered were (1 managing people, mostly are patients, followed by colleagues and then patients’ relatives; (2 constraints at work, include time and resources; and (3 managing self with decision-making within a short time. Three themes generating from managing work difficulties included (1 self-adjustment with practicing problem solving and learning good communication appeared more frequently, followed by maintaining a professional attitude and accumulating clinical experiences; (2 seeking help from others; and (3 organizational support is also a theme though it is the least mentioned. Four themes emerging from maintaining work enthusiasm were (1 personal conviction and discipline: believing that they are helping the needy, having the sense of vocation and support from religion; disciplining oneself by continuing education, maintaining harmonious family relationship and volunteer work. (2 Challenging work: different challenging natures of their job. (3 Positive feedback from patients: positive encounters with patients keep a connectedness with their clients. (4
Ventura, Carla A A; Mendes, Isabel A C; Trevizan, Maria A; Rodrigues, Driéli P
Health is a basic human right, and drug use represents a severe influence on people's health. This qualitative study aimed to understand how health professionals in a public health-care team working with drug users in a city of the state of São Paulo, Brazil, perceive the human rights of these users and how these rights are being respected in health care. Data were collected through semistructured interviews with 10 health professionals at the service under analysis. A thematic analysis of the interviews reveals the professionals' difficulty to define the concept of human right and contextualize these rights in their work environment. A deeper understanding of the right to health, however, represents an important premise for a more humanized care practice in health services to drug users.
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.
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
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.
Kari Tove Elvbakken
Full Text Available This article explores the role of food control in the professionalization of veterinarians in Norway. Veterinarians became engaged in public health through food control and market inspection, which were the responsibility of Norway’s city boards of health from the 1860s. Food inspection served a double purpose: to ensure honest trade and to maintain the safety of food. I argue that food control, which was associated with cities’ efforts to secure public health and order, was important to the legitimacy of the veterinarian profession. This activity is not what one today sees as a core practice of veterinarians, which is the prevention and curing of animal sickness. Exploring boundary activities at the fringes of a profession, and especially activity connected to the city and the state, may shed light on the more general sources of professional influence and legitimacy in the Norwegian profession state.
Dai, Yue; Sun, Hong; Zhou, Li
Due to the quasi-public attributes of medical service, the supply mode and system could influence equity and fairness of general people's health. Based on the view of public economics, the purpose of this paper was to explain the economic nature of medical service supply. By analyzing the practice of public-private partnership (PPP) mode in medical care supply and the related public economic issues, we summarized the feasibility and risks of PPP model in Chinese medical care supply market. Finally, we discussed the innovative medical service system provided by government, public hospitals, and social capitals together. Therefore, to guarantee further development of this new medical service supply--PPP mode, we should pay attention to some practical problems, such as the share of cooperation cost and the balance between the benefit and risk among all partners.
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.
Dagne, Tesfaye; Beyene, Waju; Berhanu, Negalign
Motivation is an individual's degree of willingness to exert and maintain an effort towards organizational goals. This study assessed motivational status and factors affecting it among health professionals in public hospitals of West Shoa Zone, Oromia Region. Facility based cross-sectional survey was employed. All health professionals who served at least for 6 months in Ambo, Gedo and Gindeberet hospitals were included. Self-administered Likert scale type questionnaire was used. Data were analyzed using SPSS version 20. Mean motivation calculated as percentage of maximum scale score was used. Bivariate and multiple linear regression analyses were done to see the independent effects of explanatory variables. The overall motivation level of health professionals was 63.63%. Motivation level of health professionals varied among the hospitals. Gindeberet Hospital had lower motivation score as compared to Ambo Hospital (B = -0.54 and 95% CI; -0.08,-0.27). The mean motivation score of health professionals who got monthly financial benefit was significantly higher than those who did not (B = 0.71 and 95% CI; 0.32, 1.10). Environmental factors had higher impact on doctors' motivation compared to nurses' (B = 0.51 and 95% CI; 0.10, 0.92). Supervisor-related factors highly varied in motivation relative to other variables. Motivation of health professionals was affected by factors related to supervisor, financial benefits, job content and hospital location. Efforts should be made to provide financial benefits to health professionals as appropriate especially, to those who did not get any such benefits. Officially recognizing best performance is also suggested.
Lydia Mikhailovna Semenova
Full Text Available The article is devoted to the organization of research work on forming professional image of the future public relations specialist. The purposes of the work were to study components of students’ image, to test the concept of a professional image of the specialist, and also to process and evaluate the results. The author has presented three phases of experimental research: statement, formative and evaluative. As a result, a positive trend of forming a professional image was found. The conceptual model of forming a professional image of the future experts tested in the course of experiment has shown to be highly effective, while new methods of training (training, workshops, panel discussions, action games, etc. have substantially improved the level of development of a professional image. The results can be used in the training and retraining of specialists of higher education and people whose profession related to communications.DOI: http://dx.doi.org/10.12731/2218-7405-2013-7-48
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…
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.
Naylor, Carlie-Jane; Madden, D Lynne; Oong, Deborah J
We explored how six forms of communication technology (teleconferencing, web bulletin boards, web conferencing, videoconferencing, media streaming and satellite television) are currently being used in public health work in NSW. Twelve public health professionals working in the NSW health service were interviewed. Teleconferencing and videoconferencing were the most commonly used forms of communication technology. Factors that facilitated use included ease of access to facilities and assistance in organising and setting up the technique. Barriers to use included cost and the perception that the equipment was hard to set up and operate. Participants identified factors that assisted them to engage with these techniques.
Demers, Anne Roesler; Mamary, Edward
Because of the need for a well-trained public health workforce, professional competencies have been recently revised by the Institute of Medicine and the National Health Educator Competencies Update Project. This study compared the self-identified training needs of public health educators with the updated competencies and assessed employer support for continuing education. A convenience sample of public health educators was recruited from an e-mail list of San Jose State University master of public health alumni. Respondents completed a Web-based survey that elicited information on emerging trends in public health education, training needs, and employer support for continuing education. Concerns about funding cuts and privatization of resources emerged as a theme. Key trends reported were an increase in information technology, the need for policy advocacy skills, and the importance of a lifespan approach to health issues. Primary areas for training were organization development, evaluation, and management. Although most employers were reported to support continuing education, less than two-thirds of respondents were reimbursed for expenses. These findings have implications for both research and practice. Innovative technologies should be developed to address health education professionals' training needs, and emerging themes should be incorporated into curricula for students.
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
Adewale L Oyeyemi
Full Text Available Understanding patterns of physical activity and sedentary time is important to effective population-wide primary prevention and control of non-communicable diseases. This study examined the patterns of objectively assessed physical activity and sedentary time, and the prevalence of compliance with physical activity guidelines according to different public health recommendations in a sub-population of health professional students in Nigeria.A cross-sectional study was conducted among 102 health professional students (age = 19-34 years old, 43.1% women of the University of Maiduguri, Nigeria. Participants wore Actigraph accelerometers on their waist for minimum of 5 days/week to objectively measure intensity and duration of physical activity and sedentary time. Prevalence and demographic patterns of physical activity and sedentary time were examined using descriptive and inferential statistics.The students spent most time in sedentary activity (458.6 ± minutes/day, about 61% of daily time and the least in vigorous-intensity activity (2.1 ± 4.4 minutes/day, about 0.3% of daily time. Sedentary time was higher among older than younger students (P<0.038 and among medical laboratory science students than physiotherapy and nursing students (P = 0.046. Total physical activity was higher among nursing and medical students than medical laboratory science students (P = 0.041. Although, 85.3% of the students engaged in 150 minutes/week of moderate-to-vigorous physical activity, only 2.9% met the guideline of 75 minutes/week of vigorous intensity activity.Prevalence of sedentary time was high while that of vigorous-intensity activity was very low among health professional students in Nigeria. Compliance with physical activity guidelines was mainly through accumulation of moderate intensity activity. The results suggest that age and academic programme may influence physical activity level and sedentary behaviour of health professional students in Nigeria
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,
Coleman, C. Norman; Sullivan, Julie M.; Bader, Judith L.; Murrain-Hill, Paula; Koerner, John F.; Garrett, Andrew L.; Weinstock, David M.; Case, Cullen; Hrdina, Chad; Adams, Steven A.; Whitcomb, Robert C.; Graeden, Ellie; Shankman, Robert; Lant, Timothy; Maidment, Bert W.; Hatchett, Richard C.
Resilience and the ability to mitigate the consequences of a nuclear incident are enhanced by (1) effective planning, preparation and training; (2) ongoing interaction, formal exercises, and evaluation among the sectors involved; (3) effective and timely response and communication; and (4) continuous improvements based on new science, technology, experience and ideas. Public health and medical planning require a complex, multi-faceted systematic approach involving federal, state, local, tribal and territorial governments, private sector organizations, academia, industry, international partners, and individual experts and volunteers. The approach developed by the U.S. Department of Health and Human Services Nuclear Incident Medical Enterprise (NIME) is the result of efforts from government and nongovernment experts. It is a “bottom-up” systematic approach built on the available and emerging science that considers physical infrastructure damage, the spectrum of injuries, a scarce resources setting, the need for decision making in the face of a rapidly evolving situation with limited information early on, timely communication and the need for tools and just-in-time information for responders who will likely be unfamiliar with radiation medicine and uncertain and overwhelmed in the face of the large number of casualties and the presence of radioactivity. The components of NIME can be used to support planning for, response to, and recovery from the effects of a nuclear incident. Recognizing that it is a continuous work-in-progress, the current status of the public health and medical preparedness and response for a nuclear incident is provided. PMID:25551496
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.
Christopher E. McCoy
Full Text Available The 25th known outbreak of the Ebola Virus Disease (EVD is now a global public health emergency and the World Health Organization (WHO has declared the epidemic to be a Public Health Emergency of International Concern (PHEIC. Since the first cases of the West African epidemic were reported in March 2014, there has been an increase in infection rates of over 13,000% over a 6-month period. The Ebola virus has now arrived in the United States and public health professionals, doctors, hospitals, Emergency Medial Services Administrators, Medical Directors, and policy makers have been working with haste to develop strategies to prevent the disease from reaching epidemic proportions. Prehospital care providers (emergency medical technicians and paramedics and medical first responders (including but not limited to firefighters and law enforcement are the healthcare systems front lines when it comes to first medical contact with patients outside of the hospital setting. Risk of contracting Ebola can be particularly high in this population of first responders if the appropriate precautions are not implemented. This article provides a brief clinical overview of the Ebola Virus Disease and provides a comprehensive summary of the Center for Disease Control and Prevention’s Interim Guidance for Emergency Medical Services (EMS Systems and 9-1-1 Public Safety Answering Points (PSAPS for Management of Patients with Known of Suspected Ebola Virus Disease in the United States. [West J Emerg Med. 2014;15(7:-0.
Ausserer, J; Schwamberger, J; Preloznik, R; Klimek, M; Paal, P; Wenzel, V
Tragic accidents, e.g. involving celebrity patients or severe incidents in hospital occur suddenly without any advance warning, often produce substantial interest by the media and quickly overburden management personnel involved in both hospitals and emergency medical services. While doctors, hospitals and emergency medical services desire objective media reports, the media promote emotionalized and dramatized reports to ensure maximum attention and circulation. When briefing the media, the scales may quickly tilt from professional, well-deliberated information to unfortunate, often unintended disinformation. Such phenomena may result in continuing exaggerated reports in the tabloid press, which in the presence of aggressive lawyers and a competitive hospital environment can turn into image and legal problems. In this article, several aspects are discussed in order to achieve successful public relations.Interviews should be given only after consultation with the responsible press officer and the director of the respective department or hospital director. Requests for information by the media should always be answered as otherwise one-sided, unintentional publications can result that are extremely difficult to correct later. One should be available to be contacted easily by journalists, regular press conferences should be held and critics should be taken seriously and not be brushed off. Questions by journalists should be answered in a timely manner as journalists are continuously under time pressure and do not understand unnecessary delays. Information for the media should always be provided at the same time, no publication should be given preference and an absolutely current list of E-mail contacts is required. When facing big events a press conference is preferred as many questions can be answered at once. Always be well prepared for an interview or even for just a statement. Each interview should be regarded as an opportunity to put a story forward which you
Tsuji, Satsuki; Kanda, Reiko
We undertook a survey to determine the public acceptance of medical radiation exposure throughout Japan, and 1,357 responses (67.9% response rate) were obtained using a two-stage systematic stratified random sampling method. The acceptance of exposure of children was generally similar to that of adults. For each of the attributes, 45-60% of the participants were accepting of exposure for cancer treatment and diagnosis, but only 30% were accepting of exposure for X-ray diagnoses of bone fractures and dental caries. In general, the presence of a child did not markedly affect women's acceptance of exposure. Factor analyses identified 3 factors influencing the acceptance of child exposure: symptomatic diseases to determine treatment, the possibility of high-risk diseases (or major organ diseases), and the association with cancer. Cluster analysis showed 4 clusters: a positive group regarding children's exposure for the diagnosis of bone fractures and dental caries (12.9% of all participants), a positive group for major organ disease and cancer (15.5%), a negative group excluding cancer (55.2%), and a positive group for all cases (16.4%). The cluster distributions revealed that mothers with 10- to 18-year-old firstborn children showed a tendency to accept the medical radiation exposure of their children in all cases. (author)
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.
The world now faces the dreadful possibility of biological weapons attacks by terrorists. Healthcare systems would have to cope with such emergencies should all preemptive measures fail. Information gained from the Global Mercury exercise and the SARS outbreak has shown that containing an outbreak at the start is more effective than reacting to it once it has spread and that containment should be treated both nationally and internationally. On the national level this entails developing rapid and effective methods to detect and identify infected cases, and implementing isolation and control measures to lower the risk of further transmission of the disease while assuring the safety of medical teams and laboratory workers. Strategic contingency plans should incorporate well-defined procedures for hospitalization and isolation of patients, providing regional backup of medical personnel and equipment and maintaining close cooperation between the various bodies in the healthcare system. Quarantine is an effective containment measure, especially if voluntarily imposed. Modern communication systems can help by sending professional teams timely instructions and providing the public with information to reduce panic and stress during quarantine procedures. Informing the public poses a dilemma: finding a balance between giving advance warning of an imminent epidemic outbreak and ascertaining the likelihood of its occurrence. Containment of international bioterrorist attacks depends entirely on close international cooperation to implement national and international strategic contingency plans with free exchange of information and recognition of procedures.
Betty Castro Maldonado
Full Text Available Introduction: The undergraduate thesis rather than a requirement to graduate, are a way of doing research. Previous studies show a thesis published between 2.7% to 17.6% in indexed journals. Objective: Describe the characteristics of the undergraduate thesis of the Faculty of a medical school. Bibliometric study. 221 theses were reviewed, collecting: Year, number of authors, advisers, and references, study population, and national priorities for health research. A search was performed on Google Scholar to assess publication. Descriptive statistics were used. Results: Being lower production in the years 2008-2010 was observed. 91.6% had one advisor, 76% descriptive, 82.8% in hospital population, and 62.4% of adults. Theses displayed between 2010-2014 72.9% did not correspond to any national health research priority. Only 6.8% was based on literature of the last five years. Only 9 (4.1% were published in a scientific journal indexed. Conclusions: The undergraduate thesis were characterized as descriptive, hospital, adults, literature based on outdated and not in line with the national priorities for health research. The publication is low.
Ticse, Ray; Hospital Nacional Cayetano Heredia. Lima, Perú. Facultad de Medicina, Universidad Peruana Cayetano Heredia. Lima, Perú. Médico internista endocrinólogo; magíster en Epidemiología Clínica.; Ygreda, Patricia; Facultad de Medicina, Universidad Peruana Cayetano Heredia. Lima, Perú. Médico cirujano.; Samalvides, Frine; Hospital Nacional Cayetano Heredia. Lima, Perú. Facultad de Medicina, Universidad Peruana Cayetano Heredia. Lima, Perú. Médico infectólogo.
In order to determine the frequency of publication in a scientific journal of the research projects done for medical specialty certification, a search was conducted in Google Scholar, Pubmed, biomedical databases and Peruvian medical society journals. These publications were research projects carried out by medical residents graduated from the Faculty of Medicine at the Universidad Peruana Cayetano Heredia, to obtain the certification of medical specialist. Of 351 medical residents graduated ...
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.
Quinn, Sandra Crouse; Thomas, Tammy; Kumar, Supriya
During the 2001 anthrax attacks, public health agencies faced operational and communication decisions about the use of antibiotic prophylaxis and the anthrax vaccine with affected groups, including postal workers. This communication occurred within an evolving situation with incomplete and uncertain data. Guidelines for prophylactic antibiotics changed several times, contributing to confusion and mistrust. At the end of 60 days of taking antibiotics, people were offered an additional 40 days' supply of antibiotics, with or without the anthrax vaccine, the former constituting an investigational new drug protocol. Using data from interviews and focus groups with 65 postal workers in 3 sites and structured interviews with 16 public health professionals, this article examines the challenges for public health professionals who were responsible for communication with postal workers about the vaccine. Multiple factors affected the response, including a lack of trust, risk perception, disagreement about the recommendation, and the controversy over the military's use of the vaccine. Some postal workers reacted with suspicion to the vaccine offer, believing that they were the subjects of research, and some African American workers specifically drew an analogy to the Tuskegee syphilis study. The consent forms required for the protocol heightened mistrust. Postal workers also had complex and ambivalent responses to additional research on their health. The anthrax attacks present us with an opportunity to understand the challenges of communication in the context of uncertain science and suggest key strategies that may improve communications about vaccines and other drugs authorized for experimental use in future public health emergencies.
McLean, Monica; Walker, Melanie
The education of professionals oriented to poverty reduction and the public good is the focus of the article. Sen's "capability approach" is used to conceptualise university-based professional education as a process of developing public-good professional capabilities. The main output of a research project on professional education in…
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.
Hoot, James L.; Szente, Judit
This article provides practical strategies for beginning scholars to assist in writing for professional publications. Specific strategies include awareness/understanding of publication requirements of institutions, types of manuscripts, creating time and space for writing, knowing publication outlets in the field, ethics/plagiarism, the manuscript…
Kuburović, Nina B; Dedić, Velimir; Djuricić, Slavisa; Kuburović, Vladimir
The quality of health care significantly depends on the satisfaction of the employees. The objective of this study was to establish the level of professional satisfaction of healthcare professionals in state hospitals in Belgrade, Serbia, and to determine and to rank the factors which impact on their satisfaction or dissatisfaction. Professional satisfaction survey was designed and conducted as a cross-sectional study in 2008. Completed questionnaires were returned by 6,595 healthcare professionals from Belgrade's hospitals. Statistical analysis was performed using the Student's t-test, χ² test and ANOVA. Factor analysis was applied in order to define determinants of professional satisfaction, i.e. dissatisfaction. This study showed that the degree of professional satisfaction of Serbian healthcare professionals was low. The main causes of professionals'dissatisfaction were wages, equipment, the possibility of continuous medical education/training and the opportunities for professional development. Healthcare professionals with university education were more satisfied with all the individual aspects of job satisfaction than those with secondary school and college education. There were significantly more healthcare professionals satisfied with their job among males, older than 60 years, in the age group 50-59 years, with managerial function, and with 30 or more years of service. Development strategy of human resources in the Serbian health care system would significantly improve the professional satisfaction and quality of the provided health care.
Agyapong, Vincent Israel Opoku; McLoughlin, Declan
Objectives: Authors assessed the impact of a public-speaking competition on the level of interest in psychiatry of Ghanaian medical students. Method: An inter-medical school public-speaking competition was organized to promote psychiatry as a fulfilling career option for Ghanaian medical students. Feedback questionnaires were completed by the…
... after the public workshop on the Internet at http://www.fda.gov/MedicalDevices/NewsEvents/Workshops..., compact, and mobile, the number of battery-powered medical devices will continue to increase. While many...] Battery-Powered Medical Devices Workshop: Challenges and Opportunities; Public Workshop; Request for...
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.
Alvim, Luísa; Calixto, José António
This work presents the results and the analysis of the questionnaire conducted among 99 professionals of Portuguese public libraries with Facebook page/profile at the beginning of the year 2014. It is part of a wider research - case study, using other techniques for data collection on the impact of Web 2.0 on the social role of Portuguese public libraries on the Facebook platform. The main purposes of the survey are to analyze how professionals from libraries explore the Facebo...
Rogers, M. A.; Schranz, S.; Kriederman, L.
Large wildfires require significant resources to combat, including dedicated meteorological support to provide accurate and timely forecasts to assist incident commanders in making decisions for logistical and tactical firefighting operations. Smaller fires often require the same capabilities for understanding fire and the fire weather environment, but access to needed resources and tools is often limited due to technical, training, or education limitations. Providing fire weather information and training to incident commanders for smaller wildfires should prove to enhance firefighting capabilities and improve safety for both firefighters and for the public as well. One of the premier tools used to support fire weather forecasting for the largest wildfires is the FX-Net product, a thin-client version of the Advanced Weather Interactive Processing System used by NWS incident meteorologists (IMETs) deployed to large wildfires. We present results from an ongoing project to extend the sophisticated products available from FX-Net to more accessible and mobile software platforms, such as Google Earth. The project involves input from IMETs and fire commanders to identify the key parameters used in fighting wildfires, and involves a large training component for fire responders to utilize simplified products to improve understanding of fire weather in the context of firefighting operations.
Masoud, Ferdosi; Alireza, Jabbari; Mahmoud, Keyvanara; Zahra, Agharahimi
Medical tourism for any study area is complex. Using full articles from other databases, Institute for Scientific Information (ISI), Science Direct, Emerald, Oxford, Magiran, and Scientific Information Database (SID), to examine systematically published articles about medical tourism in the interval 2000-2011 paid. Articles were obtained using descriptive statistics and content analysis categories were analyzed. Among the 28 articles reviewed, 11 cases were a kind of research articles, three cases were case studies in Mexico, India, Hungary, Germany, and Iran, and 14 were case studies, review documents and data were passed. The main topics of study included the definition of medical tourism, medical tourists' motivation and development of medical tourism, ethical issues in medical tourism, and impact on health and medical tourism marketing. The findings indicate the definition of medical tourism in various articles, and medical tourists are motivated. However, most studies indicate the benefits of medical tourism in developing countries and more developed countries reflect the consequences of medical tourism.
Bushueva Irina Petrovna
The article considers the necessity and possibility of formation of personal and professional competencies of specialists in the sphere of Public and Municipal Administration (PMA) at the pre-service professional stage of development. Purpose: to justify the necessity and possibility of personal and professional skills formation of specialists-to-be in PMA sphere, as well as to determine the conditions of such activity. Methods and methodology of the research: analysis of educational standard...
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 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.
Tamez, S; Bodek, C; Eibenschutz, C
During the late 70's and early 80's in Mexico, as in the rest of Latin-America, sanitary policies were directed to support the growth of the private sector of health care at the expense of the public sector. This work analyzes the evolution of the health insurance market as a part of the privatization process of health care. The analysis based on economic data, provides the political profile behind the privatization process as well as the changes in the relations between the State and the health sector. The central hypothesis is that the State promotes and supports the growth of the private market of medical care via a series of legal, fiscal and market procedures. It also discusses the State roll in the legal changes related to the national insurance activity. A comparative analysis is made about the evolution of the insurance industry in Argentina, Brazil, Chile and Mexico during the period 1986-1992, with a particular enfasis in the last country. One of the principal results is that the Premium/GNP and Premium/per capita, display a general growth in the 4 countries. This growth is faster for Mexico for each one) because the privatization process occurred only during the most recent years. For the 1984-1991 period in Mexico the direct premium as percentage of the GNP raised from 0.86% to 1.32%. If one focussed only in the insurance for health and accidents branches the rice goes form 8.84% in 1984 to 19.08% in 1991. This indicates that the insurance industry is one of the main targets of the privatization process of the health care system in Mexico. This is also shown by the State support to fast expansion of the big medical industrial complex of the country. Considering this situation in the continuity of the neoliberal model of Mexico, this will profound the inequity and inequality.
Figee, Edward L.; Gosselt, Jordi F.; Linders, Paul C.J.; de Jong, Menno D.T.
Although the profession of public affairs (PA) is increasingly important for organizations, relatively little is known about the range of competences PA professionals need. This article presents a qualitative study among 41 experienced Dutch PA professionals and practitioners, who were interviewed
Deriba, Beyazin Kebede; Sinke, Shimele Ololo; Ereso, Berhane Megersa; Badacho, Abebe Sorsa
Human resources are vital for delivering health services, and health systems cannot function effectively without sufficient numbers of skilled, motivated, and well-supported health workers. Job satisfaction of health workers is important for motivation and efficiency, as higher job satisfaction improves both employee performance and patient satisfaction. Even though several studies have addressed job satisfaction among healthcare professionals in different part of the world, there are relatively few studies on healthcare professionals' job satisfaction in Ethiopia. A facility-based cross-sectional study was conducted among health professionals working in health centers in April 2015 using self-administered structured questionnaires. All 322 health professionals working in 23 randomly selected public health centers were included. Factor scores were computed for the identified items by varimax rotation to represent satisfaction. Multivariate linear regression analysis was performed, and the effect of independent variables on the regression factor score quantified. Three hundred eight respondents participated with a response rate of 95.56%. The overall level of job satisfaction was 41.46%. Compensation (benefits) (beta 0.448 [95% CI 0.341 to 0.554]), recognition by management (beta 0.132 [95% CI 0.035 to 0.228]), and opportunity for development (beta 0.123 [95% CI 0.020 to 0.226]) were associated with job satisfaction. A unit increase in salary and incentives and recognition by management scores resulted in 0.459 (95% CI 0.356 to 0.561) and 0.156 (95% CI 0.065 to 0.247) unit increases in job satisfaction scores, respectively. The overall level of job satisfaction in health professionals was low. Salary and incentives, recognition by management, developmental opportunities, and patient appreciation were strong predictors of job satisfaction.
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.
Haeny, Angela M
Previous literature has documented the general issues psychologists often face while balancing their personal and professional lives. The struggle stems from attempting to satisfy the need to maintain a life outside of work while having the professional obligation to follow the American Psychological Association's (APA's) Ethical Principles of Psychologists and Code of Conduct (Ethics Code) to prevent their personal lives from interfering with their professional roles and relationships. The present paper analyzes the subject of psychologists taking a public position on controversial public issues. Although the APA Ethics Code does not restrict how psychologists conduct themselves during their personal time, taking a public stance on a controversial issue could potentially strain professional relationships and inadvertently reflect negatively on the profession. The present paper examines ethical issues that a) should be taken into account before psychologists take a public position on a controversial issue, and b) are in conflict with APA's Ethics Code or current research.
Haeny, Angela M.
Previous literature has documented the general issues psychologists often face while balancing their personal and professional lives. The struggle stems from attempting to satisfy the need to maintain a life outside of work while having the professional obligation to follow the American Psychological Association’s (APA’s) Ethical Principles of Psychologists and Code of Conduct (Ethics Code) to prevent their personal lives from interfering with their professional roles and relationships. The present paper analyzes the subject of psychologists taking a public position on controversial public issues. Although the APA Ethics Code does not restrict how psychologists conduct themselves during their personal time, taking a public stance on a controversial issue could potentially strain professional relationships and inadvertently reflect negatively on the profession. The present paper examines ethical issues that a) should be taken into account before psychologists take a public position on a controversial issue, and b) are in conflict with APA’s Ethics Code or current research. PMID:25342876
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
Edmunds, Margo; Fulwood, Charles
In the spring of 2000, US Surgeon General Dr. David Satcher convened a meeting of national experts to recommend strategies to promote equity in children's oral health status and access to dental care. The meeting was planned by a diverse group of health professionals, researchers, educators, and national organizations and by several federal agencies, including the Centers for Disease Control and Prevention, the Center on Medicare and Medicaid Services, the Health Resources and Services Administration, and the National Institute of Dental and Craniofacial Research, National Institutes of Health. This paper was commissioned by the meeting planners to introduce basic principles of social marketing and strategic communications. Many participants were academic researchers, practicing pediatric dentists and pediatricians, dental educators, policy analysts, and industry representatives, and most had no previous experience with public education or communications campaigns. Other participants were communications professionals, journalists, and community organizers without previous experience in oral health care or financing issues. Thus, the paper also served to introduce and illustrate basic ideas about oral health and general health, racial and ethnic disparities in health, and access to care. Through their interactions, the participants developed a series of recommendations to increase public awareness, build public support, improve media coverage, improve care coordination, expand the workforce, and focus the attention of national, state, and local policymakers on legislative and financing initiatives to expand access to dental care. Future coalitions of health professionals working with the policy, research, advocacy, and business communities may find this paper useful in implementing the action steps identified by the Surgeon General's report, "Oral Health in America."
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 ...
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
Rajasekaran, Rajkumar; Iyengar, Nallani Chackravatula Sriman Narayana
Mobile technology helps to improve continuing medical education; this includes all aspects of public health care as well as keeping one's knowledge up-to-date. The program of continuing medical and health education is intertwined with mobile health technology, which forms an imperative component of national strategies in health. Continuing mobile medical education (CMME) programs are designed to ensure that all medical and health-care professionals stay up-to-date with the knowledge required through mobile JXTA to appraise modernized strategies so as to achieve national goals of health-care information distribution. In this study, a 20-item questionnaire was distributed to 280 health professionals practicing traditional training learning methodologies (180 nurses, 60 doctors, and 40 health inspectors) in 25 rural hospitals. Among the 83% respondents, 56% are eager to take new learning methodologies as part of their evaluation, which is considered for promotion to higher grades, increments, or as part of their work-related activities. The proposed model was executed in five public health centers in which nurses and health inspectors registered in the JXTA network were referred to the record peer group by administrators. A mobile training program on immunization was conducted through the ADVT, with the lectures delivered on their mobiles. Credits are given after taking the course and completing an evaluation test. The system is faster compared with traditional learning. Medical knowledge management and mobile-streaming application support the CMME system through JXTA. The mobile system includes online lectures and practice quizzes, as well as assignments and interactions with health professionals. Evaluation and assessments are done online and credits certificates are provided based on the score the student obtains. The acceptance of mobile JXTA peer-to-peer learning has created a drastic change in learning methods among rural health professionals. The professionals
Kuburović Nina B.
Full Text Available Introduction. The quality of health care significantly depends on the satisfaction of the employees. Objective. The objective of this study was to establish the level of professional satisfaction of healthcare professionals in state hospitals in Belgrade, Serbia, and to determine and to rank the factors which impact on their satisfaction or dissatisfaction. Method. Professional satisfaction survey was designed and conducted as a cross-sectional study in 2008. Completed questionnaires were returned by 6,595 healthcare professionals from Belgrade’s hospitals. Statistical analysis was performed using the Student’s t-test, χ2 test and ANOVA. Factor analysis was applied in order to define determinants of professional satisfaction, i.e. dissatisfaction. Results. This study showed that the degree of professional satisfaction of Serbian healthcare professionals was low. The main causes of professionals’ dissatisfaction were wages, equipment, the possibility of continuous medical education/training and the opportunities for professional development. Healthcare professionals with university education were more satisfied with all the individual aspects of job satisfaction than those with secondary school and college education. Conclusion. There were significantly more healthcare professionals satisfied with their job among males, older than 60 years, in the age group 50-59 years, with managerial function, and with 30 or more years of service. Development strategy of human resources in the Serbian health care system would significantly improve the professional satisfaction and quality of the provided health care.
Lee, Hai Yong; Kim, Jong Hyung; Kim, Hyeog Ju; Kim, Ji Soon; Oh, Hyeon Joo; Kim, Cheol Hyeon; Yang, Hyun Kyu [Korea Food and Drug Administraion, Seoul (Korea, Republic of); Park, Chan Il [Seoul National Univ., Seoul (Korea, Republic of)
A nationwide survey was conducted to give representative levels of effective doses to patient for 17 types of CT examination and also representative level of MGD (mean glandular dose) to standard breast for mammography X-ray equipment. The effective doses to patient from 16 CT scanners were estimated from measurement of CTDI (Computed Tomography Dose Index) in air by multiplying conversion coefficients which are specified by National Radiological Protection Board in United Kingdom. The lowest and hightest mean values of effective dose measured to patient from CT scanner were 0.05 mSv for IAM examination and 17.75 mSv for routine abdomen examination, respectively. The average values of 17 effective doses were lower than other results of foreign countrys' surveys. The mean glandular doses to a standard breast for 26 mammography units were estimated from measurement of the air kerma at the surface of a 40 mm plain Perspex phantom by applying conversion factors described in Report 59 of the Institute of Physical Sciences in Medicine of United Kingdom. The exposure factors for this measurement were those used clinically at each hospital. The average MGD to standard breast was 1.06 mGy in units with grid and 0.49 mGy in units without grid. These results are lower than guidance levels by IPSM and AAPM. These results will be used for risk estimation to the Korean public from the medical radiation.
Mohamed Azmi Hassali
Full Text Available Context: A better understanding of medication safety ensures better health state among healthcare consumers. Aim: The study aims to assess general public awareness toward issues related to medication safety. Settings and Design: A cross-sectional study was conducted among general public selected conveniently in the state of Penang, Malaysia. Materials and methods: A total of 500 respondents were approached and 476 consumers participated in the survey giving a response rate of 95.2%. Statistical analysis: Data were analyzed by using SPSS version 12.0 and descriptive statistics were reported where appropriate. Results: Majority of the respondents (n=292, 61.3% stated that they were well aware of the possible side effects of their current medications. A total of 196 respondents (41.17% believed that all medicines registered in Malaysia are safe to use as these medicines have no side effects. About 40.33% (n=192 of the respondents claimed that they share their unused medicines with family and friends who are having similar illness. Majority of respondents 57.7% (n=275 were satisfied with the drug information provided by the healthcare professionals. This study also found that more than 80% of the respondents (n=409 did report that they read the labels of their medication before using. Conclusions: In this study, it was revealed that there is a moderate level of public knowledge regarding medication safety. It is evident that public underestimates the risk of their medications. There is a general lack of awareness and understanding among the public especially toward side effects.
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).
María del Mar Molero Jurado
Full Text Available Introduction: The figure of the caregiver of dependent persons is today the subject of scientific research in various disciplines in the health and social sciences. However, the terminology used to refer to the caregiver is often confusing, especially when they are not health professionals. Purpose: To analyze the terminology used to refer to the figure of the unpaid caregiver without technical training in scientific publications in recent years. Methods: A two-stage analysis was conducted: (1 review of publications in national and international databases in 1996-2005 and 2006-2016, and (2 review 2006-2016 using specific Dialnet database filters. Results: Despite the more frequent use of "family caregivers" (in Spanish and English in the publication titles, differences were observed in the use of other terms depending on the year of publication, the subject matter, type of journal or quality of the publication. Conclusion: The lack of agreement on the use of an established terminology to refer to the caregiver profile shows the need for constant revision and updating of the terms.
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.
Individuals who work in the public sector see themselves confronted with conflicting values, contradictory demands, and the need to serve an at times difficult to define ‘public interest’. This book contributes to our understanding of what drives public service professionals’ decision-making in real-life dilemma situations by looking into the combined effect of public service motivation (PSM) and professionalism. Because there are persistent knowledge gaps about the meaning and behavioural co...
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.