International Journal of Environmental Research and Public Health

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11 pages, 303 KiB

Open AccessArticle

Continuous Work Support Checklist for Female Healthcare Workers: Scale Development and Validation

by Mariko Ono, Toru Nagasawa, Takayoshi Ohkubo, Akiko Tsuchiya, Haruko Hiraike, Hiroko Okinaga and Kyoko Nomura

Int. J. Environ. Res. Public Health 2020, 17(16), 5875; https://doi.org/10.3390/ijerph17165875 - 13 Aug 2020

Cited by 2 | Viewed by 2251

Abstract

Healthcare jobs are very popular among women, however in Japan, women readily quit working because of gender-role responsibilities. This study aimed to develop a workplace support checklist for women to continue to work. In 2017, we investigated 780 (female 74.8%) faculty members and [...] Read more.

Healthcare jobs are very popular among women, however in Japan, women readily quit working because of gender-role responsibilities. This study aimed to develop a workplace support checklist for women to continue to work. In 2017, we investigated 780 (female 74.8%) faculty members and healthcare professionals of one medical university in Japan. We asked them to score the extent to which they considered 35 items identified by a task team, to be related to continuous work support for female workers in healthcare. We carried out an exploratory factor analysis and extracted four domains with 16 items in all: “Support for child rearing and home care” (five items), “Information dissemination” (five items), “Active promotion of women workers to higher positions” (three items), and “Consulting and counseling service” (three items), with Cronbach’s alpha values ranging from 0.88 to 0.92. We found that the first three factors were generally associated with reasonably relevant characteristics of being female, in their 30s, married, and members of faculty. We also found that women with “Intention to leave” the workplace underscored the importance of “Support for child rearing and home care” and “Consulting and counseling service”. These results suggest that the checklist is reliable and valid. Full article

(This article belongs to the Special Issue Medical and Health Professions Education: Are We Stepping Forward?)

22 pages, 371 KiB

Open AccessArticle

Compassionate Engagement and Action in the Education for Health Care Professions: A Cross-Sectional Study at an Ecuadorian University

by Viviana Davalos-Batallas, Ana-Magdalena Vargas-Martínez, Patricia Bonilla-Sierra, Fatima Leon-Larios, Maria-de-las-Mercedes Lomas-Campos, Silvia-Libertad Vaca-Gallegos and Rocio de Diego-Cordero

Int. J. Environ. Res. Public Health 2020, 17(15), 5425; https://doi.org/10.3390/ijerph17155425 - 28 Jul 2020

Cited by 8 | Viewed by 3221

Abstract

Objective: This study aimed at exploring the compassion attitudes and needs for awareness and training related to a compassionate approach for Medicine, Nursing, and Psychology students, as well as for the academic and administration personnel from the Universidad Técnica Particular de Loja (UTPL, [...] Read more.

Objective: This study aimed at exploring the compassion attitudes and needs for awareness and training related to a compassionate approach for Medicine, Nursing, and Psychology students, as well as for the academic and administration personnel from the Universidad Técnica Particular de Loja (UTPL, Ecuador) Health Sciences area. Methods: A cross-sectional observational study, based on a self-administered questionnaire through a sample of 788 UPTL students. STROBE guidelines were followed and applied. Results: A positive correlation was found between life engagement and compassion for others, from others, and self-compassion. The Nursing students were those who reported having previous experiences of contact with people with an advanced disease or in an end-of-life situation and having received some type of training compared to Medicine and Psychology students and lecturers (faculty members). Differences were found on the “self-compassion” and “compassion for others” subscales, noting a higher level of compassion among Psychology students. Conclusions: To implement the philosophy of compassionate universities it is necessary to design trainings that include the students, the faculty members, and the administrative staff, centered on sensitization and training about assistance, care, and accompaniment at the end of life, as well as cultivating compassion in the workplace. Full article

(This article belongs to the Special Issue Medical and Health Professions Education: Are We Stepping Forward?)

14 pages, 651 KiB

Open AccessArticle

Organizational Support in Healthcare Redesign Education: A Mixed-Methods Exploratory Study of Expert Coach and Executive Sponsor Experiences

by Pieter J. Van Dam, Phoebe Griffin, Gregory M. Peterson, Nicole S. Reeves, Lea Kirkwood and Sarah J. Prior

Int. J. Environ. Res. Public Health 2020, 17(15), 5308; https://doi.org/10.3390/ijerph17155308 - 23 Jul 2020

Cited by 4 | Viewed by 3740

Abstract

Healthcare organizations must continue to improve services to meet the rising demand and patient expectations. For this to occur, the health workforce needs to have knowledge and skills to design, implement, and evaluate service improvement interventions. Studies have shown that effective training in [...] Read more.

Healthcare organizations must continue to improve services to meet the rising demand and patient expectations. For this to occur, the health workforce needs to have knowledge and skills to design, implement, and evaluate service improvement interventions. Studies have shown that effective training in health service improvement and redesign combines didactic education with experiential project-based learning and on-the-ground coaching. Project-based learning requires organizational support and oversight, generally through executive sponsorship. A mixed-methods approach, comprising online surveys and semi-structured interviews, was used to explore the experiences of expert coaches and executive sponsors as key facilitators of workplace-based projects undertaken during an Australian postgraduate healthcare redesign course. Fifteen (54%) expert coaches and 37 (20%) executive sponsors completed the online survey. Ten expert coaches and six executive sponsors participated in interviews. The survey data revealed overall positive experiences for coaches and mixed experiences for sponsors. Interview participants expressed a sense of fulfillment that came from working with project teams to deliver a successful project and educational outcomes. However, concerns were raised about adequate resourcing, organizational recognition, competing priorities, and the skills required to effectively coach and sponsor. Expert coaches and executive sponsors sometimes felt under-valued and may benefit from cohort-tailored and evidence-based professional development. Full article

(This article belongs to the Special Issue Medical and Health Professions Education: Are We Stepping Forward?)

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7 pages, 297 KiB

Open AccessArticle

Affective Temperament Traits and Age-Predicted Recreational Cannabis Use in Medical Students: A Cross-Sectional Study

by Carmenrita Infortuna, Steven Silvestro, Keith Crenshaw, Maria Rosaria Anna Muscatello, Antonio Bruno, Rocco Antonio Zoccali, Eileen Chusid, Jordan Intrator, Zhiyong Han and Fortunato Battaglia

Int. J. Environ. Res. Public Health 2020, 17(13), 4836; https://doi.org/10.3390/ijerph17134836 - 5 Jul 2020

Cited by 20 | Viewed by 2654

Abstract

The use of cannabis among college students is increasing. Cannabis abuse has been proposed to be associated with personality dimensions. However, there are currently no known studies on the relationship of temperament traits and recreational cannabis use among college students. This is a [...] Read more.

The use of cannabis among college students is increasing. Cannabis abuse has been proposed to be associated with personality dimensions. However, there are currently no known studies on the relationship of temperament traits and recreational cannabis use among college students. This is a cross-sectional study that investigated 328 students at a Podiatric Medical College. We evaluated the association between temperament and recreational cannabis use by the students. Temperament was investigated using the Memphis, Pisa, Paris and San Diego Auto- Questionnaire (TEMPS-A (short version)). Additionally, we assessed demographics variables and perceived stress in the context of cannabis use, and analyzed the findings using logistic regression. The prevalence of recreational cannabis use was 8.45%. Recreational cannabis use among these students was highly associated with irritable and cyclothymic temperament traits. There was no association between recreational cannabis use and perceived stress, and demographic variables or other substance use. Furthermore, logistic regression analysis indicated that higher scores in cyclothymic or irritable temperament traits are significant predictors for recreational cannabis use. Our study has identified key temperament traits, with a strong association with recreational use of cannabis of the studied student population. Our findings are useful in designing screening and educational strategies directed towards increasing the wellbeing of medical students. Full article

(This article belongs to the Special Issue Medical and Health Professions Education: Are We Stepping Forward?)

9 pages, 569 KiB

Open AccessArticle

Evaluating Physician Adherence to Antithrombotic Recommendations in Patients with Atrial Fibrillation: A Pathway to Better Medical Education

by Ştefan Cristian Vesa, Sonia Irina Vlaicu, Octavia Sabin, Vitalie Văcăraș, Sorin Crișan, Sabina Istratoaie, Fatuma Samantar, Daciana Elena Popa, Antonia Eugenia Macarie and Anca Dana Buzoianu

Int. J. Environ. Res. Public Health 2020, 17(11), 4008; https://doi.org/10.3390/ijerph17114008 - 4 Jun 2020

Cited by 3 | Viewed by 2700

Abstract

Background: Atrial fibrillation is a major health problem due to the stroke risk associated with it. To reduce stroke risk, oral anticoagulants (OAC) are prescribed using the CHA₂DS₂-VASc (Congestive heart failure; Hypertension; Age ≥75 years; Diabetes Mellitus; Stroke; Vascular [...] Read more.

Background: Atrial fibrillation is a major health problem due to the stroke risk associated with it. To reduce stroke risk, oral anticoagulants (OAC) are prescribed using the CHA₂DS₂-VASc (Congestive heart failure; Hypertension; Age ≥75 years; Diabetes Mellitus; Stroke; Vascular disease; Age 65–74 years; Sex category) risk score, a clinical probability assessment that includes a combination of risk factors predicting the probability of a stroke. Not all patients with high risk are receiving this treatment. The aim of this study was to assess physician adherence to clinical guidelines concerning the OAC treatment and to identify the factors that were associated with the decision to prescribe it. Methods: Registry data from 784 patients with non-valvular atrial fibrillation were evaluated in this retrospective cross-sectional study. Demographic data, subtype of AF, comorbidities associated with higher stroke and bleeding risk, and antithrombotic treatment received were recorded. We compared stroke and bleeding risk in patients with and without OAC treatment to determine if the clinicians followed guidelines: prescribed when necessary and abstained when not needed. Results: OAC treatment was administered in 617 (78.7%) patients. Of the 167 patients who did not receive OAC, 161 (96.4%) were undertreated according to their risk score, as opposed to those who received OAC in which the percentage of overtreated was 3.2%. Most undertreated patients (60.5%, p < 0.001) were with paroxysmal atrial fibrillation subtype. Conclusions: The decision to use anticoagulants for stroke prevention was based on the type of atrial fibrillation, rather than on the risk of stroke as quantified by CHA2DS2-VASc as per the recommended guidelines. Full article

(This article belongs to the Special Issue Medical and Health Professions Education: Are We Stepping Forward?)

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14 pages, 2380 KiB

Open AccessArticle

Breastfeeding in Hospitals: Factors Influencing Maternal Choice in Italy

by Rosalia Ragusa, Gabriele Giorgianni, Marina Marranzano, Salvatore Cacciola, Valentina Lucia La Rosa, Alessandra Giarratana, Valentina Altadonna and Vincenzo Guardabasso

Int. J. Environ. Res. Public Health 2020, 17(10), 3575; https://doi.org/10.3390/ijerph17103575 - 20 May 2020

Cited by 13 | Viewed by 3452

Abstract

Monitoring the prevalence of breastfeeding is one of the actions provided for in Italian National Health System. This study aims to observe the prevalence of breastfeeding in a representative set of birthing hospitals in the province of Catania, in Sicily, Italy, to assess [...] Read more.

Monitoring the prevalence of breastfeeding is one of the actions provided for in Italian National Health System. This study aims to observe the prevalence of breastfeeding in a representative set of birthing hospitals in the province of Catania, in Sicily, Italy, to assess the factors influencing women in their decisions to breastfeed during hospitalization after delivery. We conducted an observational study on 3813 questionnaires administered to mothers of newborns during their hospital stay from the years 2016 to 2018 in eight hospitals of various types. The average maternal age was 31.3 years ± 5.8. Sixty-nine percent of women did not attend a prenatal course. From childbirth to discharge, the percentage of women who breastfed was 88%, of whom 45% did exclusive breastfeeding. Only 35% of women who had a caesarean section adopted exclusive breastfeeding. In our experience, rooming-in was not associated with an increase in breastfeeding. We observed that both attendance to prenatal courses and the mother’s education level played a minor role in influencing the mother’s decision in breastfeeding A fairly high percentage of exclusive breastfeeding, 75%, was attained just in one hospital, where dedicated staff was deployed to encourage breastfeeding. The lowest percentage (12%) of exclusive breastfeeding was observed in a large private accredited health facility. Hospital presence of professionals trained in human lactation is a smart investment for society. Full article

(This article belongs to the Special Issue Medical and Health Professions Education: Are We Stepping Forward?)

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14 pages, 1472 KiB

Open AccessArticle

Low-Value Clinical Practices: Knowledge and Beliefs of Spanish Surgeons and Anesthetists

by Jesús María Aranaz Andrés, José Lorenzo Valencia-Martín, Jorge Vicente-Guijarro, Cristina Díaz-Agero Pérez, Nieves López-Fresneña, Irene Carrillo, José Joaquín Mira Solves and SOBRINA Working Group

Int. J. Environ. Res. Public Health 2020, 17(10), 3556; https://doi.org/10.3390/ijerph17103556 - 19 May 2020

Cited by 9 | Viewed by 2843

Abstract

OBJECTIVES: To know the frequency and causes of low value surgical practices, according to the opinion of surgeons and anesthetists, and to determine their degree of knowledge about the Spanish “Choosing wisely” initiative. METHODS: Cross-sectional observational study, based on a self-administered [...] Read more.

OBJECTIVES: To know the frequency and causes of low value surgical practices, according to the opinion of surgeons and anesthetists, and to determine their degree of knowledge about the Spanish “Choosing wisely” initiative. METHODS: Cross-sectional observational study, based on a self-administered online questionnaire through an opportunistic sample of 370 surgeons and anesthetists from three Spanish regions, contacted through Scientific Societies. The survey took part between July and December 2017. RESULTS: A patient profile requesting unnecessary practices was identified (female, 51−65 years old and unaffiliated disease). The frequency of requests was weekly or daily for 50.0% of the professionals, of whom 15.1% acknowledged succumbing to these pressures. To dissuade the patient, clinical reasons (47%) were considered the most effective. To increase control and safety in the case was the main reason to indicate them. The greatest responsibility for overuse was attributed to physicians, defensive medicine and mass media. Assessing professionals’ knowledge on unnecessary practices, an average of 5 correct answers out of 7 was obtained. Some 64.1% of the respondents were unaware of the Spanish “Choosing wisely” initiative. CONCLUSIONS: Low value surgical practices are perceived as a frequent problem, which requires an approach entailing intervention with patients and the media as well as professionals. Increase awareness on unnecessary surgical practices, and how to avoid them remain essential. Full article

(This article belongs to the Special Issue Medical and Health Professions Education: Are We Stepping Forward?)

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15 pages, 391 KiB

Open AccessArticle

Attitudes and Values of Physical Education Professionals and Undergraduate Students about Their Role in Health Promotion

by Júlio César Nasário, Victor Zaia, Camila Martins Trevisan, Simone Garzon, Antonio Simone Laganà and Erik Montagna

Int. J. Environ. Res. Public Health 2020, 17(7), 2288; https://doi.org/10.3390/ijerph17072288 - 28 Mar 2020

Cited by 6 | Viewed by 4062

Abstract

Physical education (PE) is identified with health, with PE teachers and school PE regarded as legitimate instruments for health promotion. The PE teacher’s conceptions, attitudes, and values regarding the role of PE are inseparable from their performance. Thus, the objective of the present [...] Read more.

Physical education (PE) is identified with health, with PE teachers and school PE regarded as legitimate instruments for health promotion. The PE teacher’s conceptions, attitudes, and values regarding the role of PE are inseparable from their performance. Thus, the objective of the present work is to verify concepts and attitudes of PE professionals and undergraduate students, in order to verify how they value their role in health promotion. This was a cross-sectional study that used surveys to assess attitudes and values of PE professionals and undergraduate students about their concepts of the role of PE in health promotion. A total of 942 PE professionals and undergraduate students regards themselves as players in health promotion (86.9%) despite no clear definition about the concept of health or the curriculum to attain such a goal, mainly based on academic training only. Also, they attribute the responsibility for childhood obesity and lack of motivation for the practice of physical activity to external factors, such as media (72.6%), family (84.7%), and technologies (83.1%). Despite participants regarding themselves as players in health promotion, there is a loose definition on how to promote health, and how to provide curriculum and strategies to meet the needs of public health. Full article

(This article belongs to the Special Issue Medical and Health Professions Education: Are We Stepping Forward?)

15 pages, 695 KiB

Open AccessArticle

Fostering Empathy, Implicit Bias Mitigation, and Compassionate Behavior in a Medical Humanities Course

by Brian D. Schwartz, Alexis Horst, Jenifer A. Fisher, Nicole Michels and Lon J. Van Winkle

Int. J. Environ. Res. Public Health 2020, 17(7), 2169; https://doi.org/10.3390/ijerph17072169 - 25 Mar 2020

Cited by 24 | Viewed by 5569

Abstract

Increases in compassionate behavior improve patient outcomes and reduce burnout among healthcare professionals. We predicted that selecting and performing service-learning projects by teams of prospective medical students in a Medical Humanities course would foster students’ compassion by raising their reflective capacity, empathy, and [...] Read more.

Increases in compassionate behavior improve patient outcomes and reduce burnout among healthcare professionals. We predicted that selecting and performing service-learning projects by teams of prospective medical students in a Medical Humanities course would foster students’ compassion by raising their reflective capacity, empathy, and unconscious bias mitigation. In class, we discussed difficulties in communication and implicit bias. In this observational study, teams wrote individual and team critical reflections on these class discussions and their service-learning experiences, and we analyzed these reflections for dissonance, self-examination, bias mitigation, dissonance reconciliation, and compassionate behavior. Thirty-two students (53% female) completed the Reflective Practice Questionnaire and the Jefferson Scale of Empathy before the course in August 2019 and after it in December 2019. In December, students were surveyed concerning their attitudes toward team service-learning projects and unconscious bias. The students reported changes in their behavior to mitigate biases and become more compassionate, and their reflective capacity and empathy grew in association with discussions and team service-learning experiences in the course. Virtually all students agreed with the statement “Unconscious bias might affect some of my clinical decisions or behaviors as a healthcare professional,” and they worked to control such biases in interactions with the people they were serving. Full article

(This article belongs to the Special Issue Medical and Health Professions Education: Are We Stepping Forward?)

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10 pages, 316 KiB

Open AccessArticle

Relationship between Executive Functions, Mindfulness, Stress, and Performance in Pediatric Emergency Simulations

by Kacper Łoś, Jacek Chmielewski and Włodzimierz Łuczyński

Int. J. Environ. Res. Public Health 2020, 17(6), 2040; https://doi.org/10.3390/ijerph17062040 - 19 Mar 2020

Cited by 11 | Viewed by 3777

Abstract

Over the past decade, high-fidelity medical simulation has become an accepted and widely used teaching method in pediatrics. Both simulation and work in the real conditions of emergency departments are accompanied by stress that affects the executive functions of participants. One of the [...] Read more.

Over the past decade, high-fidelity medical simulation has become an accepted and widely used teaching method in pediatrics. Both simulation and work in the real conditions of emergency departments are accompanied by stress that affects the executive functions of participants. One of the methods for reducing stress among medical students and healthcare professionals is the practice of mindfulness. The aim of this study was to examine whether executive functions, mindfulness, and stress are related to the technical and non-technical skills of medical students participating in medical simulations in pediatrics. The study included 153 final-year medical students. A total of 306 high-fidelity simulations of life-threatening situations involving children were conducted. Results: Stress and the coping mechanism of the participants were correlated to their skills during pediatric simulations. Some components of mindfulness, such as non-judgment and conscious action, were positively related to the skills of medical team leaders. Executive functions correlated with the non-technical skills and mindfulness of the medical students. Conclusions: Stress, mindfulness, and executive functions modeled the behavior and skills of medical students during pediatric simulations of life-threatening events. Further research in this area may prove whether mindfulness training will improve learning outcomes in pediatric emergency medicine. Full article

(This article belongs to the Special Issue Medical and Health Professions Education: Are We Stepping Forward?)

16 pages, 749 KiB

Open AccessArticle

Storytelling in Medical Education: Narrative Medicine as a Resource for Interdisciplinary Collaboration

by Hung-Chang Liao and Ya-huei Wang

Int. J. Environ. Res. Public Health 2020, 17(4), 1135; https://doi.org/10.3390/ijerph17041135 - 11 Feb 2020

Cited by 35 | Viewed by 6855

Abstract

Objective: The study intended to use narrative medicine study for interdisciplinary collaboration to let medical and healthcare students have a chance to interact with one another and listen to patients’ stories to enhance students’ reflective thinking, communication, empathy, and narrative medicine writing skills. [...] Read more.

Objective: The study intended to use narrative medicine study for interdisciplinary collaboration to let medical and healthcare students have a chance to interact with one another and listen to patients’ stories to enhance students’ reflective thinking, communication, empathy, and narrative medicine writing skills. Methods: A fifteen-week quasi-experimental design was used to examine the learning outcomes of the intervention. Two groups of students were randomly assigned as the experimental group (33 students) and the control group (32 students). Before and after the intervention, both groups had to fill in a Reflective Thinking Scale for Healthcare Students and Providers (RTS-HSP), Patient–Healthcare Provider Communication Scale (P-HCS), Empathy Scale in Patient Care (ES-PC), and Analytic Narrative Medicine Writing Scoring Rubric (ANMWSR). Results: The findings showed that on the reflective thinking scale, experimental group students had significantly higher reflective thinking posttest scores in “reflective skepticism,” “empathetic reflection,” and “critical open-mindedness,” but not in “self-examination.” As for patient–healthcare provider communication, they had significantly higher posttest scores in all “perception of trust and receptivity,” “patient-centered information giving,” “rapport building,” and “facilitation of patient involvement” factors. As for empathy, they had significant higher posttest scores in “behavioral empathy” and “affective empathy,” but not in “intelligent empathy.” In narrative medical writing skills, they had significant higher posttest scores in the “attention → representation → affiliation,” “depth of reflection,” “focus and context structure,” and “ideas and elaboration” sections, but not in the “language and conventions” section. Conclusion: The findings suggest that narrative medicine is worth recommending for interdisciplinary collaboration for healthcare education. Full article

(This article belongs to the Special Issue Medical and Health Professions Education: Are We Stepping Forward?)

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12 pages, 2603 KiB

Open AccessArticle

Development and Validation of a Homemade, Low-Cost Laparoscopic Simulator for Resident Surgeons (LABOT)

by Domenico Soriero, Giulia Atzori, Fabio Barra, Davide Pertile, Andrea Massobrio, Luigi Conti, Dario Gusmini, Lorenzo Epis, Maurizio Gallo, Filippo Banchini, Patrizio Capelli, Veronica Penza and Stefano Scabini

Int. J. Environ. Res. Public Health 2020, 17(1), 323; https://doi.org/10.3390/ijerph17010323 - 2 Jan 2020

Cited by 18 | Viewed by 4369

Abstract

Several studies have demonstrated that training with a laparoscopic simulator improves laparoscopic technical skills. We describe how to build a homemade, low-cost laparoscopic training simulator (LABOT) and its validation as a training instrument. First, sixty surgeons filled out a survey characterized by 12 [...] Read more.

Several studies have demonstrated that training with a laparoscopic simulator improves laparoscopic technical skills. We describe how to build a homemade, low-cost laparoscopic training simulator (LABOT) and its validation as a training instrument. First, sixty surgeons filled out a survey characterized by 12 closed-answer questions about realism, ergonomics, and usefulness for surgical training (global scores ranged from 1—very insufficient to 5—very good). The results of the questionnaires showed a mean (±SD) rating score of 4.18 ± 0.65 for all users. Then, 15 students (group S) and 15 residents (group R) completed 3 different tasks (T1, T2, T3), which were repeated twice to evaluate the execution time and the number of users’ procedural errors. For T1, the R group had a lower mean execution time and a lower rate of procedural errors than the S group; for T2, the R and S groups had a similar mean execution time, but the R group had a lower rate of errors; and for T3, the R and S groups had a similar mean execution time and rate of errors. On a second attempt, all the participants tended to improve their results in doing these surgical tasks; nevertheless, after subgroup analysis of the T1 results, the S group had a better improvement of both parameters. Our laparoscopic simulator is simple to build, low-cost, easy to use, and seems to be a suitable resource for improving laparoscopic skills. In the future, further studies should evaluate the potential of this laparoscopic box on long-term surgical training with more complex tasks and simulation attempts. Full article

(This article belongs to the Special Issue Medical and Health Professions Education: Are We Stepping Forward?)

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13 pages, 334 KiB

Open AccessArticle

An Exploration of Medical Education in Central and Southern China: Measuring the Professional Competence of Clinical Undergraduates

by Xueyan Cheng and Jing Chen

Int. J. Environ. Res. Public Health 2019, 16(21), 4119; https://doi.org/10.3390/ijerph16214119 - 25 Oct 2019

Cited by 4 | Viewed by 2346

Abstract

Background: The cultivation and assessment of the professional competence of clinical undergraduates is essential to medical education. This study aimed to construct a scale to evaluate the professional competence of clinical undergraduates as well as its determinants. Methods: The competence scale was developed [...] Read more.

Background: The cultivation and assessment of the professional competence of clinical undergraduates is essential to medical education. This study aimed to construct a scale to evaluate the professional competence of clinical undergraduates as well as its determinants. Methods: The competence scale was developed on the basis of four medical education standards, the literature, and expert interviews. A total of 288 undergraduates from two types of medical colleges in central and southeastern China were selected by a multistage sampling strategy. Factor analysis, correlation analysis, and internal consistency reliability were used to verify the validity and reliability of the scale. Results: A scale consisting of eight factors with 51 items was determined for factor analysis. Cronbach’α coefficients among the eight dimensions were over 0.800, with mean scores of 1.76, 1.38, 1.92, 1.54, 1.77, 1.25, 1.60, and 2.34. Clinical undergraduates with above average academic grades achieved a higher score in essential clinical knowledge (p < 0.05) and better professionalism was reported among females (p < 0.05). Conclusion: The competence scale showed excellent reliability and validity. Respondents in this study showed a moderate level of professional competence. This study could be a reference for medical educators and policy makers in order to improve medical education standards for clinical undergraduates in China and other countries with similar settings. Full article

(This article belongs to the Special Issue Medical and Health Professions Education: Are We Stepping Forward?)

18 pages, 910 KiB

Open AccessArticle

Selecting and Performing Service-Learning in a Team-Based Learning Format Fosters Dissonance, Reflective Capacity, Self-Examination, Bias Mitigation, and Compassionate Behavior in Prospective Medical Students

by Alexis Horst, Brian D. Schwartz, Jenifer A. Fisher, Nicole Michels and Lon J. Van Winkle

Int. J. Environ. Res. Public Health 2019, 16(20), 3926; https://doi.org/10.3390/ijerph16203926 - 16 Oct 2019

Cited by 18 | Viewed by 3511

Abstract

More compassionate behavior should make both patients and their providers happier and healthier. Consequently, work to increase this behavior ought to be a major component of premedical and medical education. Interactions between doctors and patients are often less than fully compassionate owing to [...] Read more.

More compassionate behavior should make both patients and their providers happier and healthier. Consequently, work to increase this behavior ought to be a major component of premedical and medical education. Interactions between doctors and patients are often less than fully compassionate owing to implicit biases against patients. Such biases adversely affect treatment, adherence, and health outcomes. For these reasons, we studied whether selecting and performing service-learning projects by teams of prospective medical students prompts them to write reflections exhibiting dissonance, self-examination, bias mitigation, dissonance reconciliation, and compassionate behavior. Not only did these students report changes in their behavior to become more compassionate, but their reflective capacity also grew in association with selecting and performing team service-learning projects. Components of reflective capacity, such as reflection-on-action and self-appraisal, correlated strongly with cognitive empathy (a component of compassion) in these students. Our results are, however, difficult to generalize to other universities and other preprofessional and professional healthcare programs. Hence, we encourage others to test further our hypothesis that provocative experiences foster frequent self-examination and more compassionate behavior by preprofessional and professional healthcare students, especially when teams of students are free to make their own meaning of, and build trust and psychological safety in, shared experiences. Full article

(This article belongs to the Special Issue Medical and Health Professions Education: Are We Stepping Forward?)

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10 pages, 297 KiB

Open AccessArticle

Clinical Physicians’ Attitudes towards Evidence-Based Medicine (EBM) and Their Evidence-Based Practice (EBP) in Wuhan, China

by Jianan Hong and Jing Chen

Int. J. Environ. Res. Public Health 2019, 16(19), 3758; https://doi.org/10.3390/ijerph16193758 - 7 Oct 2019

Cited by 25 | Viewed by 4500

Abstract

Objective: Numerous studies have proved the importance of Evidence-Based Medicine (EBM) in daily clinical practice, however, clinicians’ attitudes play an important role in determining its implementation. The objective of this study was to investigate Chinese clinical physicians’ perception of and attitude towards EBM [...] Read more.

Objective: Numerous studies have proved the importance of Evidence-Based Medicine (EBM) in daily clinical practice, however, clinicians’ attitudes play an important role in determining its implementation. The objective of this study was to investigate Chinese clinical physicians’ perception of and attitude towards EBM and their Evidence-Based Practice (EBP) as well as the barriers towards EBP. Methods: Using a cross-sectional design, self-response questionnaires were distributed to clinical physicians (internal medicine and surgery departments) across three tertiary hospitals in Wuhan, China. Results: In total, 131 out of 195 (67.2%) physicians completed and returned the questionnaire. A total of 64.9% of the physicians either knew moderately or a lot about EBM. The mean score of physicians’ attitude toward EBM was 2.35 ± 0.35, and that of their EBP skill/ competency was 1.51 ± 0.56 (on 0–3 Likert scale). In total, 76.0% of physicians often or sometimes applied EBM in routine daily practice. The largest barrier preventing implementation was the varying individual differences in diseases (61.0%), followed by a lack of investment from the hospital/department (39.8%), and a lack of patient cooperation (37.4%). Chinese physicians in tertiary hospitals possessed expressed positive attitudes towards EBM; however, they only retained a moderate level of clinical evidence competency. Both an individual factor (personal interest) and organizational factors (workload, hospital requirement) had an effect on physicians’ attitudes and their EBP skills. Management and organizational efforts, in addition to time dedicated for EBP projects could help reduce barriers that prevent EBP. Full article

(This article belongs to the Special Issue Medical and Health Professions Education: Are We Stepping Forward?)

Review

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11 pages, 328 KiB

Open AccessFeature PaperReview

Medical and Health Care Professionals’ Sexuality Education: State of the Art and Recommendations

by Valeria Verrastro, Valeria Saladino, Filippo Petruccelli and Stefano Eleuteri

Int. J. Environ. Res. Public Health 2020, 17(7), 2186; https://doi.org/10.3390/ijerph17072186 - 25 Mar 2020

Cited by 31 | Viewed by 6949

Abstract

Sexuality is considered an important aspect of holistic care, but research has shown that it is often not considered, as it should be, in health services. Addressing clients’ sexuality requires a multidisciplinary approach and is not the responsibility of a single professional. The [...] Read more.

Sexuality is considered an important aspect of holistic care, but research has shown that it is often not considered, as it should be, in health services. Addressing clients’ sexuality requires a multidisciplinary approach and is not the responsibility of a single professional. The literature underlines that university students or those working in hospitals and other health care facilities are not adequately prepared to meet patients’ needs regarding sexuality. The objective of this study was, therefore, to review the scientific literature addressing training courses for health professionals in sexuality between 2000 and 2020. Several studies have shown enhancement in health care professionals’ ability to deal with patients’ sexuality issues after participating in sexuality education programs, regardless of the course load and modality, even if the long-term effects have still to be proved. Health care professionals therefore require education in the area of sexuality, regardless of their discipline. According to the articles reviewed, in order to improve the performance and comfort level of health care professionals to deal with patients’ sexuality, investments in training are necessary. Further evaluations of interdisciplinary sexuality education programmes should use larger samples and explore the differences across disciplines. Full article

(This article belongs to the Special Issue Medical and Health Professions Education: Are We Stepping Forward?)

14 pages, 337 KiB

Open AccessReview

Occupational Burnout Syndrome in Polish Physicians: A Systematic Review

by Magdalena Zgliczyńska, Stanisław Zgliczyński, Michał Ciebiera and Katarzyna Kosińska-Kaczyńska

Int. J. Environ. Res. Public Health 2019, 16(24), 5026; https://doi.org/10.3390/ijerph16245026 - 10 Dec 2019

Cited by 19 | Viewed by 3797

Abstract

Due to the nature of their work, physicians are exposed to chronic stress. This may potentially lead to the widespread occurrence of occupational burnout syndrome (BS). The aim of this systematic review study was to summarize available published data concerning the prevalence of [...] Read more.

Due to the nature of their work, physicians are exposed to chronic stress. This may potentially lead to the widespread occurrence of occupational burnout syndrome (BS). The aim of this systematic review study was to summarize available published data concerning the prevalence of BS in Polish doctors. The literature search was performed using the following databases: PubMed/MEDLINE, Scopus, Cochrane Central Register of Controlled Trials (CENTRAL) and Google Scholar. The last search was performed on September 27th, 2019. Only articles in English or Polish on graduated doctors practicing in Poland were taken into account. All types of original research were considered eligible. However, review articles, book chapters, case reports, case series, conference papers, study protocols and articles in languages other than English and Polish were excluded. There were no restrictions on age, seniority or specialty of study participants. The literature search revealed a total of 21 studies that met the inclusion criteria. The results of individual studies were very diverse, which makes it difficult to draw specific conclusions. However, the problem of burnout among Polish doctors is valid and worth special attention from society, health policy leaders, and doctors themselves. High-quality research is essential to for a better understanding of this topic. Full article

(This article belongs to the Special Issue Medical and Health Professions Education: Are We Stepping Forward?)

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