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Yan H, Han Z, Nie H, Yang W, Nicholas S, Maitland E, Zhao W, Yang Y, Shi X. Continuing medical education in China: evidence from primary health workers' preferences for continuing traditional Chinese medicine education. BMC Health Serv Res 2023; 23:1200. [PMID: 37924090 PMCID: PMC10623727 DOI: 10.1186/s12913-023-10153-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 10/16/2023] [Indexed: 11/06/2023] Open
Abstract
BACKGROUND Continuing Medical Education (CME) is an important part of the training process for health workers worldwide. In China, training in Traditional Chinese Medicine (TCM) not only improves the expertise of medical workers, but also supports the Chinese Government's policy of promoting TCM as an equal treatment to western medicine. CME, including learning Traditional Chinese Medicine Technologies (TCMTs), perform poorly and research into the motivation of health workers to engage in CME is urgently required. Using a discrete choice experiment, this study assessed the CME learning preferences of primary health workers, using TCMT as a case study of CME programs. METHODS We conducted a discrete choice experiment among health workers in Shandong Province, Guizhou Province, and Henan provinces from July 1, 2021 to October 1, 2022 on the TCMT learning preferences of primary health workers. The mixed logit model and latent class analysis model were used to analyze primary health workers' TCMT learning preferences. RESULTS A total of 1,063 respondents participated in this study, of which 1,001 (94.2%) passed the consistency test and formed the final sample. Our key finding was that there were three distinct classes of TCMT learners. Overall, the relative importance of the seven attributes impacting the learning of TCMTs were: learning expenses, expected TCMT efficacy, TCMT learning difficulty, TCMT mode of learning, TCMT type, time required to learn, and expected frequency of TCMT use. However, these attributes differed significantly across the three distinct classes of TCMT learners. Infrequent users (class 1) were concerned with learning expenses and learning difficulty; workaholics (class 2) focused on the mode of learning; and pragmatists (class 3) paid more attention to the expected TCMT efficacy and the expected frequency of TCMT use. We recommend targeted strategies to motivate TCMT learning suited to the requirements of each class of TCMT learners. CONCLUSION Rather than a single TCMT medical education program for primary health workers, CME programs should be targeted at different classes of TCMT learners.
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Affiliation(s)
- Hao Yan
- School of Management, Beijing University of Chinese Medicine, Beijing, China
| | - Zhaoran Han
- School of Management, Beijing University of Chinese Medicine, Beijing, China
| | - Hanlin Nie
- School of Management, Beijing University of Chinese Medicine, Beijing, China
| | - Wanjin Yang
- School of Management, Beijing University of Chinese Medicine, Beijing, China
| | - Stephen Nicholas
- Australian National Institute of Management and Commerce, Sydney, NSW, Australia
- Guangdong Institute for International Strategies, Guangdong University of Foreign Studies, Guangzhou, China
- School of Economics and School of Management, Tianjin Normal University, Tianjin, China
- Newcastle Business School, University of Newcastle, Callaghan, NSW, Australia
| | - Elizabeth Maitland
- University of Liverpool Management School, University of Liverpool, Liverpool, UK
| | - Weihan Zhao
- School of Management, Beijing University of Chinese Medicine, Beijing, China
| | - Yong Yang
- Medical Device Regulatory Research and Evaluation Centre, West China Hospital, Sichuan University, Chengdu, China
| | - Xuefeng Shi
- School of Management, Beijing University of Chinese Medicine, Beijing, China.
- National Institute of Traditional Chinese Medicine Strategy and Development, Beijing University of Chinese Medicine, Beijing, China.
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Main PAE, Anderson S. Evidence for continuing professional development standards for regulated health practitioners in Australia: a systematic review. HUMAN RESOURCES FOR HEALTH 2023; 21:23. [PMID: 36941655 PMCID: PMC10026429 DOI: 10.1186/s12960-023-00803-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 02/15/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Health practitioner regulators throughout the world use continuing professional development (CPD) standards to ensure that registrants maintain, improve and broaden their knowledge, expertise and competence. As the CPD standard for most regulated health professions in Australia are currently under review, it is timely that an appraisal of the evidence be undertaken. METHODS A systematic review was conducted using major databases (including MEDLINE, EMBASE, PsycInfo, and CINAHL), search engines and grey literature for evidence published between 2015 and April 2022. Publications included in the review were assessed against the relevant CASP checklist for quantitative studies and the McMaster University checklist for qualitative studies. RESULTS The search yielded 87 abstracts of which 37 full-text articles met the inclusion criteria. The evidence showed that mandatory CPD requirements are a strong motivational factor for their completion and improves practitioners' knowledge and behaviour. CPD that is more interactive is most effective and e-learning is as effective as face-to-face CPD. There is no direct evidence to suggest the optimal quantity of CPD, although there was some evidence that complex or infrequently used skills deteriorate between 4 months to a year after training, depending on the task. CONCLUSIONS CPD is most effective when it is interactive, uses a variety of methods and is delivered in a sequence involving multiple exposures over a period of time that is focused on outcomes considered important by practitioners. Although there is no optimal quantity of CPD, there is evidence that complex skills may require more frequent CPD.
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Affiliation(s)
| | - Sarah Anderson
- Research and Evaluation Team, Australian Health Practitioner Regulation Agency, Melbourne, VIC, Australia.
- School of Allied Health, Human Services and Sport , La Trobe University, Bundoora, VIC, Australia.
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Norcini JJ, Weng W, Boulet J, McDonald F, Lipner RS. Associations between initial American Board of Internal Medicine certification and maintenance of certification status of attending physicians and in-hospital mortality of patients with acute myocardial infarction or congestive heart failure: a retrospective cohort study of hospitalisations in Pennsylvania, USA. BMJ Open 2022; 12:e055558. [PMID: 35470191 PMCID: PMC9058798 DOI: 10.1136/bmjopen-2021-055558] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To determine whether internists' initial specialty certification and the maintenance of that certification (MOC) is associated with lower in-hospital mortality for their patients with acute myocardial infarction (AMI) or congestive heart failure (CHF). DESIGN Retrospective cohort study of hospitalisations in Pennsylvania, USA, from 2012 to 2017. SETTING All hospitals in Pennsylvania. PARTICIPANTS All 184 115 hospitalisations for primary diagnoses of AMI or CHF where the attending physician was a self-designated internist. PRIMARY OUTCOME MEASURE In-hospital mortality. RESULTS Of the 2575 physicians, 2238 had initial certification and 820 were eligible for MOC. After controlling for patient demographics and clinical characteristics, hospital-level factors and physicians' demographic and medical school characteristics, both initial certification and MOC were associated with lower mortality. The adjusted OR for initial certification was 0.835 (95% CI 0.756 to 0.922; p<0.001). Patients cared for by physicians with initial certification had a 15.87% decrease in mortality compared with those cared for by non-certified physicians (mortality rate difference of 5.09 per 1000 patients; 95% CI 2.12 to 8.05; p<0.001). The adjusted OR for MOC was 0.804 (95% CI 0.697 to 0.926; p=0.003). Patients cared for by physicians who completed MOC had an 18.91% decrease in mortality compared with those cared for by MOC lapsed physicians (mortality rate difference of 6.22 per 1000 patients; 95% CI 2.0 to 10.4; p=0.004). CONCLUSIONS Initial certification was associated with lower mortality for AMI or CHF. Moreover, for patients whose physicians had initial certification, an additional advantage was associated with its maintenance.
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Affiliation(s)
| | - Weifeng Weng
- American Board of Internal Medicine, Philadelphia, Pennsylvania, USA
| | | | - Furman McDonald
- American Board of Internal Medicine, Philadelphia, Pennsylvania, USA
| | - Rebecca S Lipner
- American Board of Internal Medicine, Philadelphia, Pennsylvania, USA
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Nguyen TH, Thai TT, Pham PTT, Bui TNM, Bui HHT, Nguyen BH. Continuing Medical Education in Vietnam: A Weighted Analysis from Healthcare Professionals' Perception and Evaluation. ADVANCES IN MEDICAL EDUCATION AND PRACTICE 2021; 12:1477-1486. [PMID: 34938141 PMCID: PMC8687442 DOI: 10.2147/amep.s342251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 12/03/2021] [Indexed: 06/14/2023]
Abstract
PURPOSE Continuing medical education (CME) is a compulsory requirement for every health professional. However, to date, little is known about the effectiveness of CME in Vietnam. This study assessed CME programs based on attendees' perception and evaluation. METHODS A cross-sectional study was conducted during a five-month period in all 62 CME courses at a university hospital. A self-report, anonymous questionnaire was distributed to the participants during the course and was collected at the end of the course. The questionnaire included questions about demographic characteristics, experiences during the course and participants' perception and evaluation as measured by the 19-item Program Evaluation Instrument (PEI). A higher score on the PEI indicates a higher level of positive reaction toward CME programs. RESULTS Among 1312 participants in the analysis, the majority were females (58.1%) with a mean age of 34.5 (SD = 10.6) years. Almost all participants had good, positive perceptions toward CME. However, about 5% of participants reported CME a waste of time. Participants reported a high score on the PEI (95.0±8.9) and all four dimensions including program objectives (20.7±2.2), learner's objectives (18.8±2.3), teacher's behavior (25.7±2.7) and program satisfaction (29.7±3.4). While there was no association between demographic characteristics and PEI score, attendance rate during the courses and perceptions toward CME were positively associated with PEI score. CONCLUSION CME programs receive positive reaction and evaluation from healthcare professionals and are helpful in providing and updating knowledge, attitude and practice in Vietnam. However, further studies are needed in other settings and specialties to fully understand the effectiveness of CME in Vietnam.
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Affiliation(s)
- Thinh H Nguyen
- Training and Scientific Research Department, University Medical Center Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Truc T Thai
- Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Phuong T T Pham
- Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Tam N M Bui
- Training and Scientific Research Department, University Medical Center Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Han H T Bui
- Woolcock Institute of Medical Research, Ho Chi Minh City, Vietnam
| | - Bac Hoang Nguyen
- Training and Scientific Research Department, University Medical Center Ho Chi Minh City, Ho Chi Minh City, Vietnam
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Collins RT, Sanford R. The Importance of Formalized, Lifelong Physician Career Development: Making the Case for a Paradigm Shift. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2021; 96:1383-1388. [PMID: 34074898 DOI: 10.1097/acm.0000000000004191] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
The value of structured development processes has been recognized and implemented in formal physician training programs such as residencies and fellowships. Physicians are seemingly viewed as a "finished product" upon completing formal training. In recent years, a number of academic medical centers have implemented formalized early-career development programs for physicians, largely those who have a major research focus. However, beyond the early stage of physicians' careers, formalized and intentional physician career development programs are rare. The lack of a philosophy of intentional, career-long individual development at academic medical centers reflects a narrow understanding of the implicit contract between employers and employees. The resulting gap leads the vast majority of physicians to fall short of their potential, further leading to long-term loss for the academic medical centers, their physicians, and society as a whole. Based on the framework of analyze-design-develop-implement-evaluate, the authors propose a robust, iterative model for physician career development that goes beyond skills and knowledge maintenance toward leveraging a broad range of individual capabilities, needs, and contexts along the career lifespan. The model provides a means for harnessing physicians' strengths and passions in concert with the needs of their organization to create greater physician fulfillment and success, which in turn would benefit the patients they care for and the academic medical centers in which they work.
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Affiliation(s)
- R Thomas Collins
- R.T. Collins II is clinical associate professor, Departments of Pediatrics and Internal Medicine, Stanford University School of Medicine, Palo Alto, California; ORCID: http://orcid.org/0000-0002-3387-6629
| | - Rania Sanford
- R. Sanford is director, Faculty Professional Development, Stanford University School of Medicine, Palo Alto, California
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Aftab W, Khan M, Rego S, Chavan N, Rahman-Shepherd A, Sharma I, Wu S, Zeinali Z, Hasan R, Siddiqi S. Variations in regulations to control standards for training and licensing of physicians: a multi-country comparison. HUMAN RESOURCES FOR HEALTH 2021; 19:91. [PMID: 34301245 PMCID: PMC8299694 DOI: 10.1186/s12960-021-00629-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 07/08/2021] [Indexed: 05/06/2023]
Abstract
BACKGROUND To strengthen health systems, the shortage of physicians globally needs to be addressed. However, efforts to increase the numbers of physicians must be balanced with controls on medical education imparted and the professionalism of doctors licensed to practise medicine. METHODS We conducted a multi-country comparison of mandatory regulations and voluntary guidelines to control standards for medical education, clinical training, licensing and re-licensing of doctors. We purposively selected seven case-study countries with differing health systems and income levels: Canada, China, India, Iran, Pakistan, UK and USA. Using an analytical framework to assess regulations at four sequential stages of the medical education to relicensing pathway, we extracted information from: systematically collected scientific and grey literature and online news articles, websites of regulatory bodies in study countries, and standardised input from researchers and medical professionals familiar with rules in the study countries. RESULTS The strictest controls we identified to reduce variations in medical training, licensing and re-licensing of doctors between different medical colleges, and across different regions within a country, include: medical education delivery restricted to public sector institutions; uniform, national examinations for medical college admission and licensing; and standardised national requirements for relicensing linked to demonstration of competence. However, countries analysed used different combinations of controls, balancing the strictness of controls across the four stages. CONCLUSIONS While there is no gold standard model for medical education and practise regulation, examining the combinations of controls used in different countries enables identification of innovations and regulatory approaches to address specific contextual challenges, such as decentralisation of regulations to sub-national bodies or privatisation of medical education. Looking at the full continuum from medical education to licensing is valuable to understand how countries balance the strictness of controls at different stages. Further research is needed to understand how regulating authorities, policy-makers and medical associations can find the right balance of standardisation and context-based flexibility to produce well-rounded physicians.
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Affiliation(s)
| | - Mishal Khan
- Aga Khan University, Karachi, Pakistan.
- London School of Hygiene and Tropical Medicine, Keppel St, Bloomsbury, London, WC1E 7HT, United Kingdom.
| | - Sonia Rego
- London School of Hygiene and Tropical Medicine, Keppel St, Bloomsbury, London, WC1E 7HT, United Kingdom
| | | | - Afifah Rahman-Shepherd
- London School of Hygiene and Tropical Medicine, Keppel St, Bloomsbury, London, WC1E 7HT, United Kingdom
| | | | - Shishi Wu
- National University of Singapore, Singapore, Singapore
| | | | - Rumina Hasan
- Aga Khan University, Karachi, Pakistan
- London School of Hygiene and Tropical Medicine, Keppel St, Bloomsbury, London, WC1E 7HT, United Kingdom
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Gray BM, Vandergrift JL, Weng W, Lipner RS, Barnett ML. Clinical Knowledge and Trends in Physicians' Prescribing of Opioids for New Onset Back Pain, 2009-2017. JAMA Netw Open 2021; 4:e2115328. [PMID: 34196714 PMCID: PMC8251502 DOI: 10.1001/jamanetworkopen.2021.15328] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 04/29/2021] [Indexed: 12/28/2022] Open
Abstract
Importance Opioid musculoskeletal pain overprescribing was widespread in the mid-2000s. The degree to which prescribing changed as awareness of the danger grew among physicians with different levels of clinical knowledge remains unstudied. Objective To compare the association of clinical knowledge with opioid prescribing from 2009 to 2011 when prescribing peaked nationally with 2015 to 2017 when guidelines shifted away from opioid prescribing. Design, Setting, and Participants This cross-sectional study included 10 246 midcareer general internal medicine physicians in the United States who saw patients who were Medicare beneficiaries with Part D enrollment from 2009 to 2017. Main Outcomes and Measures Any opioid prescription and high dosage or long duration (HDLD) (>7 days or >50 daily morphine milligram equivalents) opioid prescriptions filled within 7 days of applicable visits for new low back pain concerns. Associations between opioid prescribing for new low back pain concerns during outpatient visits and clinical knowledge measured by prior year American Board of Internal Medicine (ABIM) Maintenance of Certification examination performance were estimated using serial cross-sectional logit regressions. Regression covariates included yearly examination quartile (ie, knowledge quartile) interacted with 3-year group dummies (ie, early: 2009-2011; middle: 2012-2014; late: 2015-2017), state and year dummies, physician, practice, patient characteristics, and state opioid regulations. Results Of the 55 387 low back pain visits included in this study, 37 185 (67.1%) were visits with female patients, 41 978 (75.8%) were with White patients, and the mean (SE) age of patients was 76.2 (<0.01) years. The rate of opioid prescribing was 21.6% (11 978) for any opioid prescription and 17.6% (9759) for HDLD prescriptions. From 2009 to 2011, visits with physicians in the highest and lowest knowledge quartiles had similar adjusted opioid prescribing rates with a 0.5 (95% CI, -1.9 to 3.0) percentage point difference. By 2015 to 2017, visits with physicians in the highest knowledge quartile prescribed opioids less frequently that physicians in the lowest knowledge quartile (4.6 percentage point difference; 95% CI, -7.5 to -1.8 percentage points). Visits in which HDLD opioids were prescribed showed no difference in the early period but showed a difference in the late period when comparing physicians in the highest and lowest knowledge quartiles (early period: difference -0.1; 95% CI, -2.4 to 2.2 percentage points; late period difference: 4.8; 95% CI, -7.4 to -2.1 percentage points). Conclusions and Relevance In this cross-sectional study, when the standard of care shifted away from routine opioid prescribing, physicians who performed well on an ABIM examination were less likely to prescribe opioids for back pain than physicians who performed less well on the examination.
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Affiliation(s)
- Bradley M. Gray
- American Board of Internal Medicine, Philadelphia, Pennsylvania
| | | | - Weifeng Weng
- American Board of Internal Medicine, Philadelphia, Pennsylvania
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The history of the American boards of surgery and colon and rectal surgery. SEMINARS IN COLON AND RECTAL SURGERY 2021. [DOI: 10.1016/j.scrs.2021.100812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Tong G, Geng Q, Xu T, Wang D, Liu T. Smartphone and web-based independent consultation and feedback for joint replacement surgeries: a randomized control trial protocol. BMC Med Inform Decis Mak 2021; 21:85. [PMID: 33663460 PMCID: PMC7934418 DOI: 10.1186/s12911-021-01457-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Accepted: 02/26/2021] [Indexed: 12/11/2022] Open
Abstract
Background Cost control and usage regulation of medical materials (MMs) are the practical issues that the government pays close attention to. Although it is well established that there is great potential to mobilize doctors and patients in participating MMs-related clinical decisions, few interventions adopt effective measures against specific behavioral deficiencies. This study aims at developing and validating an independent consultation and feedback system (ICFS) for optimizing clinical decisions on the use of MMs for inpatients needing joint replacement surgeries. Methods Development of the research protocol is based on a problem or deficiency list derived on a trans-theoretical framework which incorporates including mainly soft systems-thinking, information asymmetry, crisis-coping, dual delegation and planned behavior. The intervention consists of two main components targeting at patients and doctors respectively. Each of the intervention ingredients is designed to tackle the doctor and patient-side problems with MMs using in joint replacement surgeries. The intervention arm receives 18 months' ICFS intervention program on the basis of the routine medical services; while the control arm, only the routine medical services. Implementation of the intervention is supported by an online platform established and maintained by the Quality Assurance Center for Medical Care in Anhui Province, a smartphone-based application program (APP) and a web-based clinical support system. Discussion The implementation of this study is expected to significantly reduce the deficiencies and moral hazards in decision-making of MMs using through the output of economic, efficient, sustainable and easy-to-promote cooperative intervention programs, thus greatly reducing medical costs and standardizing medical behaviors. Trial registration number ISRCTN10152297.
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Affiliation(s)
- Guixian Tong
- School of Management, Hefei University of Technology, No.193 Tunxi Road, Hefei, People's Republic of China.,The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, No.17 Lujiang Road, Hefei, People's Republic of China
| | - Qingqing Geng
- The First Affiliated Hospital of Anhui University of Traditional Chinese Medicine, Anhui University of Traditional Chinese Medicine, No.177 Meishan Road, Hefei, People's Republic of China
| | - Tong Xu
- School of Data Science, University of Science and Technology of China, No. 443 Huangshan Road, Hefei, People's Republic of China
| | - Debin Wang
- School of Health Service Management, Anhui Medical University, No.81 Meishan Road, Hefei, People's Republic of China
| | - Tongzhu Liu
- The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, No.17 Lujiang Road, Hefei, People's Republic of China.
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Dubar M, Delatre V, Moutier C, Sy K, Agossa K. Awareness and practices of general practitioners towards the oral-systemic disease relationship: A regionwide survey in France. J Eval Clin Pract 2020; 26:1722-1730. [PMID: 31876066 DOI: 10.1111/jep.13343] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 12/10/2019] [Accepted: 12/11/2019] [Indexed: 12/12/2022]
Abstract
UNLABELLED RATIONALE, AIM, AND OBJECTIVE: "Periodontal medicine" is based on evidence of interactions between periodontal disease and overall health. The aim of the present study was to assess awareness of oral-systemic disease relationship among French general practitioners (GPs) and clarify how this influences their practices in a wider effort to better integrate oral health concerns into global health care delivery. METHOD GPs registered in the north of France were invited to complete an online self-administered questionnaire through local divisions of the French Medical Board. The questionnaire was divided into four sections: socio-demographic aspects, knowledge, practices, and an overview. RESULTS The questionnaire was completed by 253 GPs. Among these, 75% were aware of the association between periodontitis (PD) and diabetes, and 53% to 59% were aware of the impact of PD on cardiovascular diseases, inflammatory bowel diseases, and respiratory infections. Few GPs identified PD as a possible risk factor of rheumatoid arthritis and Alzheimer disease (35.18% and <15%, respectively); 74.31% of GPs reported never asking their patients about their periodontal health. However, a personal history of PD and professional experiences seem to influence the medical practices of GPs to include oral examination. GPs largely self-rated their knowledge of the oral-systemic disease connection as being insufficient and were favourable to completing an up-to-date training course (86.56%). CONCLUSION French GPs' knowledge about the association of PD with systemic diseases seems to be fair, but discrepancies in their daily clinical routine were found. Promisingly, a positive attitude was observed towards improving their knowledge of oral-systemic diseases link. These results indicate the importance to reinforce collaboration between medical doctors and oral health care specialists.
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Affiliation(s)
- Marie Dubar
- Department of Periodontology, School of Dentistry, Lille University Hospital, University of Lille, Lille, France
| | - Vincent Delatre
- Private Practice, School of Dentistry, University of Lille, Lille, France
| | - Cassandre Moutier
- Department of Public Health, School of Dentistry, Lille University Hospital, University of Lille, Lille, France
| | - Kadiatou Sy
- Department of Restorative Dentistry and Endodontics, School of Dentistry, Lille University Hospital, University of Lille, Lille, France
| | - Kevimy Agossa
- Department of Periodontology, School of Dentistry, Lille University Hospital, University of Lille, Lille, France
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Awareness, Practices, and Demands of Traditional Medicine Providers for Continuous Medical Education in District Hospitals of Vietnam. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2020; 2020:9852969. [PMID: 32714428 PMCID: PMC7341395 DOI: 10.1155/2020/9852969] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 05/19/2020] [Indexed: 11/17/2022]
Abstract
Expanding traditional medicine (TM) coverage in health care is a priority in Vietnam. Continuous medical education (CME) plays an important role in ensuring the quality of TM. However, evidence about TM CME in TM practitioners in Vietnam is insufficient. This paper aimed to evaluate the awareness, practice, and demands on TM CME among TM providers in district hospitals of Vietnam. This cross-sectional descriptive study was performed at the district level at TM hospitals and TM departments of general hospitals in Thanh Hoa Province. Demographic characteristics, awareness, practice, and demand for TM CME were collected via face-to-face interviews. Descriptive statistics and multivariable logistic regression models were applied to examine the factors associated with awareness, practice, and demand for TM CME. The majority of the respondents had ever heard of TM CME (87.5%). Only 60% received TM training in the last five years. Most respondents had a demand for CME (86.8%). The non-Kinh ethnic group (OR = 0.2, 95% CI: 0.1–0.8) and people who had a temporary contract (OR = 0.2, 95% CI: 0.1–0.7) were less likely to be ever heard about TM CME. Higher levels of education (college, OR = 14.1, 95% CI = 1.0–195.9; undergraduate, OR = 9.1, 95% CI = 1.9–44.6) are more likely to be ever heard of TM CME than the vocational training group. Those who regularly update their knowledge are more likely to have heard about TM CME (OR = 7.7, 95% CI = 2.8–21.7) and are more likely to have demands on TM CME (OR = 3.7, 95% CI = 1.2–11.5). Those who had heard about TM CME were more likely to take these courses in the last five years (OR = 6.9, 95% CI = 2.5–18.8). However, this result was the opposite for people with more years of experience (OR = 0.9, 95% CI: 0.8–0.9). There were limited awareness and participation in TM CME but was a high need for CME among TM providers at district hospitals in Vietnam. Promoting lifelong learning and providing promptly supports would be potential to increase the TM CME demands and participation among TM providers.
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Boulet JR, Durning SJ. What we measure … and what we should measure in medical education. MEDICAL EDUCATION 2019; 53:86-94. [PMID: 30216508 DOI: 10.1111/medu.13652] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2018] [Revised: 03/06/2018] [Accepted: 05/31/2018] [Indexed: 05/20/2023]
Abstract
CONTEXT As the practice of medicine evolves, the knowledge, skills and attitudes required to provide patient care will continue to change. These competency-based changes will necessitate the restructuring of assessment systems. High-quality assessment programmes are needed to fulfil health professions education's contract with society. OBJECTIVES We discuss several issues that are important to consider when developing assessments in health professions education. We organise the discussion along the continuum of medical education, outlining the tension between what has been deemed important to measure and what should be measured. We also attempt to alleviate some of the apprehension associated with measuring evolving competencies by discussing how emerging technologies, including simulation and artificial intelligence, can play a role. METHODS We focus our thoughts on the assessment of competencies that, at least historically, have been difficult to measure. We highlight several assessment challenges, discuss some of the important issues concerning the validity of assessment scores, and argue that medical educators must do a better job of justifying their use of specific assessment strategies. DISCUSSION As in most professions, there are clear tensions in medicine in relation to what should be assessed, who should be responsible for administering assessment content, and how much evidence should be gathered to support the evaluation process. Although there have been advances in assessment practices, there is still room for improvement. From the student's, resident's and practising physician's perspectives, assessments need to be relevant. Knowledge is certainly required, but there are other qualities and attributes that are important, and perhaps far more important. Research efforts spent now on delineating what makes a good physician, and on aligning new and upcoming assessment tools with the relevant competencies, will ensure that assessment practices, whether aimed at establishing competence or at fostering learning, are effective with respect to their primary goal: to produce qualified physicians.
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Affiliation(s)
- John R Boulet
- Foundation for Advancement of International Medical Education and Research (FAIMER), Philadelphia, Pennsylvania, USA
| | - Steven J Durning
- Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
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Gahagan J, Subirana-Malaret M. Improving pathways to primary health care among LGBTQ populations and health care providers: key findings from Nova Scotia, Canada. Int J Equity Health 2018; 17:76. [PMID: 29895297 PMCID: PMC5998559 DOI: 10.1186/s12939-018-0786-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Accepted: 05/29/2018] [Indexed: 11/20/2022] Open
Abstract
Background This study explores the perceived barriers to primary health care as identified among a sample of Lesbian, Gay, Bisexual, Transgender, and Queer (LGBTQ) identified individuals and health care providers in Nova Scotia, Canada. These findings, based on a province-wide anonymous online survey, suggest that additional efforts are needed to improve pathways to primary health among LGBTQ populations and in deepening our understanding of how to advance the unique primary health needs of these populations. Methods Data were collected from the LGBTQ community through an online, closed-ended anonymous survey. Inclusion criteria for participation were self-identifying as LGBTQ, offering primary health care to LGBTQ patients, being able to understand English, being 16 years of age or older, and having lived in Nova Scotia for at least one year. A total of 283 LGBTQ respondents completed the online survey which included sociodemographic questions, perceptions of respondents’ health status, and their primary health care experiences. In addition, a total of 109 health care providers completed the survey based on their experiences providing care in Nova Scotia, and in particular, their experiences and perceptions regarding LGBTQ access to primary health care and physician-patient interactions. Results Our results indicate that, in several key areas, the primary health care needs of LGBTQ populations in Nova Scotia are not being met and this may in turn contribute to their poor health outcomes across the life course. Conclusion A framework of intersectionality and health equity was used to interpret and analyze the survey data. The key findings indicate the need to continue improving pathways to primary health care among LGBTQ populations, specifically in relation to additional training and related supports for health care providers who work with these populations.
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Affiliation(s)
- Jacqueline Gahagan
- School of Health & Human Performance, Health Promotion, Gender & Health Promotion Studies Unit (GAHPS Unit), Healthy Populations Institute (HPI), Dalhousie University, 6230 South Street, Halifax, NS, B3H 3J5, Canada.
| | - Montse Subirana-Malaret
- School of Health & Human Performance, Health Promotion, Gender & Health Promotion Studies Unit (GAHPS Unit), Healthy Populations Institute (HPI), Dalhousie University, 6230 South Street, Halifax, NS, B3H 3J5, Canada.,Advanced Studies Group on Violence, Clinical Psychology and Psychobiology Unit, Universitat de Barcelona, Faculty of Psychology, Passeig de la Vall d'Hebron, 171, 08035, Barcelona, Spain
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Gray BM, Vandergrift JL, Lipner RS. Association between the American Board of Internal Medicine's General Internist's Maintenance of Certification Requirement and Mammography Screening for Medicare Beneficiaries. Womens Health Issues 2018; 28:35-41. [DOI: 10.1016/j.whi.2017.10.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Revised: 09/27/2017] [Accepted: 10/04/2017] [Indexed: 10/18/2022]
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