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Han X, Jiang F, Shen L, Liu Y, Liu T, Liu H, Wang P, Yang Z, Tang YL, Zhu J. Workplace Violence, Workforce Stability, and Well-being in China's Psychiatric Hospitals. Am J Prev Med 2022; 62:e265-e273. [PMID: 34865934 DOI: 10.1016/j.amepre.2021.09.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 09/10/2021] [Accepted: 09/17/2021] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Workplace violence against psychiatric professionals is a growing problem, yet nationally representative data in China are lacking. This study examines workplace violence against psychiatrists and psychiatric nurses in China as well as its association with workforce stability and well-being . METHODS Data came from a 2019 national survey of 14,264 participants (including 4,520 psychiatrists and 9,744 nurses) from 41 psychiatric hospitals across China. The occurrence of physical and verbal assaults among psychiatrists and psychiatric nurses was reported. Logistic regression models were constructed to examine the participants' characteristics associated with encountering workplace violence and the association of encountering violence with self-reported quality of life, health status, turnover intention, and career satisfaction. Analyses were performed during 2020. RESULTS In 2019, among 14,264 psychiatrists and psychiatric nurses in China, 81% reported encountering workplace violence during the past year. Psychiatrists were 0.68 (95% CI=0.55, 0.83) times less likely to report an encounter of violence than nurses. Male and younger nurses were 2.20 (95% CI=1.72, 2.81) and 1.21 (95% CI=1.01, 1.45) times more likely to report violence. Psychiatrists who had a higher educational degree or a higher professional rank were more vulnerable to violence. Encountering violence was significantly associated with poor quality of life, less satisfaction with health status, greater intention to leave the current job, and career dissatisfaction. CONCLUSIONS Workplace violence against psychiatrists and psychiatric nurses are common in China, indicating that China's psychiatric professionals are facing a significant threat to occupational safety. To maintain psychiatric workforce stability, actions are needed to reduce the prevalence of workplace violence at the system, institutional, and individual levels.
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Affiliation(s)
- Xinxin Han
- Vanke School of Public Health, Tsinghua University, Beijing, China; School of Medicine, Tsinghua University, Beijing, China
| | - Feng Jiang
- School of International and Public Affairs, Shanghai Jiao Tong University, Shanghai, China; Institute of Healthy Yangtze River Delta, Shanghai Jiao Tong University, Shanghai, China
| | - Lijun Shen
- Vanke School of Public Health, Tsinghua University, Beijing, China; School of Medicine, Tsinghua University, Beijing, China
| | - Yuanli Liu
- School of Health Policy and Management, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Tingfang Liu
- Institute for Hospital Management, Tsinghua University, Beijing, China
| | - Huanzhong Liu
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China; Department of Psychiatry, Anhui Psychiatric Center, Anhui Medical University, Hefei, China
| | - Peicheng Wang
- School of Medicine, Tsinghua University, Beijing, China; Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Zimo Yang
- School of Medicine, Tsinghua University, Beijing, China
| | - Yi-Lang Tang
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, Georgia; Mental Health Service Line, Atlanta, Georgia
| | - Jiming Zhu
- Vanke School of Public Health, Tsinghua University, Beijing, China.
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Li T, Wang W, Li Z, Wang H, Liu X. Problem-based or lecture-based learning, old topic in the new field: a meta-analysis on the effects of PBL teaching method in Chinese standardized residency training. BMC MEDICAL EDUCATION 2022; 22:221. [PMID: 35361207 PMCID: PMC8974027 DOI: 10.1186/s12909-022-03254-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 03/11/2022] [Indexed: 05/13/2023]
Abstract
BACKGROUND Standardized residency training (SRT) is crucial for graduate medical education and the training of high-quality doctors. Nevertheless, China started SRT nationwide only in the recent decade. During these years, researchers have been searching for suitable teaching methods to improve the abilities of residents. Although the problem-based learning (PBL) teaching mode has been applied in undergraduate teaching for many years, the teaching effect of PBL has not been unified in Chinese SRT according to the core competences of the residents. METHODS Studies that compared the teaching effect of PBL and lecture-based learning (LBL) on SRT in China from January 2010 to April 2020 in the Chinese databases, such as China National Knowledge Infrastructure (CNKI), WanFang, WeiPu, Chinese BioMedical Literature (CBM), and English-language online databases, such as PubMed, Embase, and Cochrane Library were systematically reviewed. Data were analyzed using the Stata version 12.0 software. RESULTS A total of 75 articles (76 studies) were included in this meta-analysis. Compared with LBL group, PBL-based methods are more effective in the mastery of medical theory knowledge (WMD = 7.14, 95% CI: 5.93-8.34), operational skills (WMD = 6.54, 95% CI: 4.55-8.53), analysis and diagnosis of cases (WMD = 8.52, 95% CI: 7.50-9.53), and overall capacity (WMD = 8.70, 95% CI: 6.87-10.53), but showed no advantage on operational skills in diagnostic imaging (WMD = 1.30, 95% CI: -0.11-2.71). The questionnaire surveys analyzed in this meta-analysis indicated the positive effects of PBL on the mastery of theoretical knowledge, clinical diagnostic thinking, teamwork ability, ability to analyze and solve problems, ability to consult documents, learning interest and learning efficiency, but that there were no advantages in improving self-directed learning ability, communication ability and hands-on ability. The questionnaire result analyzed in this meta-analysis also showed the residents' satisfaction with PBL-based strategies. CONCLUSIONS Taken together, the current meta-analysis provides a systematic and comprehensive analysis on PBL teaching mode in Chinese SRT and outlines a path for further research on the detailed design of suitable teaching methods for different specialties and abilities.
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Affiliation(s)
- Tingting Li
- Department of Nephrology, The First Affiliated Hospital of China Medical University, 155 North Nanjing Street, Shenyang, Liaoning 110001 P.R. China
| | - Weidong Wang
- Department of Nephrology, The First Affiliated Hospital of China Medical University, 155 North Nanjing Street, Shenyang, Liaoning 110001 P.R. China
| | - Zhijie Li
- Department of Nephrology, The First Affiliated Hospital of China Medical University, 155 North Nanjing Street, Shenyang, Liaoning 110001 P.R. China
| | - Hongmiao Wang
- Department of Nephrology, The First Affiliated Hospital of China Medical University, 155 North Nanjing Street, Shenyang, Liaoning 110001 P.R. China
| | - Xiaodan Liu
- Department of Nephrology, The First Affiliated Hospital of China Medical University, 155 North Nanjing Street, Shenyang, Liaoning 110001 P.R. China
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Deng G, Cai W, Yang M, Lio J, Feng C, Ma X, Liang L. Linking doctor-patient relationship to medical residents' work engagement: The influences of role overload and conflict avoidance. BMC FAMILY PRACTICE 2021; 22:191. [PMID: 34560844 PMCID: PMC8464118 DOI: 10.1186/s12875-021-01541-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 09/03/2021] [Indexed: 11/16/2022]
Abstract
Background Chinese residents’ practical work experiences are different from those described in Western studies. To explore potential mechanisms underlying the effects of doctor-patient relationships on medical residents’ work engagement, verifying a posited mediating effect of role overload, and moderating effect of conflict avoidance, in the Chinese context. Methods Based on the conservation of resources theory, a composite model was constructed. This study’s data were collected from four different Chinese tertiary hospitals; 195 residents undergoing regularization training took this survey. Hierarchical moderated and mediated regression analyses were utilized. Results Doctor-patient relationship were found to be positively related to residents’ work engagement (β=0.31, p≤0.001). Role overload partially mediated the effect of these relationships on work engagement, and the moderating role of conflict avoidance in the relationship between doctor-patient relationship and conflict avoidance was negative. Conclusion Maintaining good doctor-patient relationship can prompt residents to increase their engagement in work in order to meet their patients’ needs. Furthermore, role overload has a particular influence in early career stages. Not only is it necessary for residents to gain a sense of recognition and support while they carry out their job responsibilities, especially while dealing with complex doctor-patient relationship, but it is also important to create work environments that can help residents shape their professional competency.
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Affiliation(s)
- Guangwei Deng
- School of Management, Hefei University of Technology, Hefei, Anhui Province, 230009, P.R. China
| | - Wenjun Cai
- School of Management, University of Science and Technology of China, Hefei, P.R. China
| | - Monica Yang
- Robert B. Willumstad School of Business, Adelphi University, Garden City, USA
| | - Jonathan Lio
- Department of Medicine, University of Chicago, Chicago, USA
| | - Chenpeng Feng
- School of Management, Hefei University of Technology, Hefei, Anhui Province, 230009, P.R. China.
| | - Xiaopeng Ma
- Department of General Surgery, the First Affiliated Hospital of University of Science and Technology of China, Hefei, P.R. China
| | - Liang Liang
- School of Management, Hefei University of Technology, Hefei, Anhui Province, 230009, P.R. China
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Zhang J, Han X, Yang Z, Wang Z, Zheng J, Yang Z, Zhu J. Radiology residency training in China: results from the first retrospective nationwide survey. Insights Imaging 2021; 12:25. [PMID: 33595737 PMCID: PMC7889775 DOI: 10.1186/s13244-021-00970-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 01/19/2021] [Indexed: 12/30/2022] Open
Abstract
Objectives This was the first study to systematically landscape and examine China’s nationwide standardized residency training in radiology. Methods In this retrospective cross-sectional study, we used data from the 2019 national survey of the first two cohorts of 3679 radiology residents who completed training in 2017 and 2018 across all 31 provinces in China. A total of 1163 (32%) residents participated in the survey. Multivariable logistic regression was used to examine the implementation frequency of 24 identified training tasks (categorized into six competencies) by region, demographics, and other residency information. Results Among the 1163 respondents, 592 (51%) were trained in the more developed eastern region. Of the 24 identified training tasks, 15 were implemented significantly differently across regions, while the frequency of the most frequently conducted tasks (e.g., CT, MR, and radiograph interpretation and reporting) was consistent. The top 10 tasks all fell into the patient care and medical knowledge competency domains, while other competencies tended to be neglected. We found region and marital status were the most influential factors of training task implementation frequencies. Respondents trained in the northeast and the west were more likely to report, for instance, radiological examination recommendation (OR = 1.91, 95%CI = 1.27–2.88), as “very frequent.” Married respondents were more likely to report first-line night shift as “very frequent” (OR = 1.71, 95%CI = 1.29–2.26). Conclusions Despite the fast-win achievements of developing a national radiology residency training program, there is a gap to train quality and homogeneous radiologists across regions. Future improvement should be more tailored to residents’ personal characteristics and emphasize some “soft” competencies (e.g., communication skills).
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Affiliation(s)
- Jingfeng Zhang
- Department of Radiology, Hwa Mei Hospital, University of Chinese Academy of Sciences, Ningbo, China
| | - Xinxin Han
- School of Medicine, Tsinghua University, Beijing, China
| | - Zhenghan Yang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Zhenchang Wang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Jianjun Zheng
- Department of Radiology, Hwa Mei Hospital, University of Chinese Academy of Sciences, Ningbo, China
| | - Zimo Yang
- Vanke School of Public Health, Tsinghua University, Haidian District, Beijing, 100084, China
| | - Jiming Zhu
- Vanke School of Public Health, Tsinghua University, Haidian District, Beijing, 100084, China.
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Deng G, Zhao D, Lio J, Chen X, Ma X, Liang L, Feng C. Strategic elements of residency training in China: transactional leadership, self-efficacy, and employee-orientation culture. BMC MEDICAL EDUCATION 2019; 19:355. [PMID: 31521148 PMCID: PMC6744663 DOI: 10.1186/s12909-019-1792-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Accepted: 09/05/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND The standardized training of resident physicians in China is significant and robust. During the training, clinical teachers act as leaders. The training taking place in public hospitals requires a transactional leadership style (TLS), but existing research studies seldom analyze how to promote residents' performance from this perspective. METHODS Two hundred and ninety six new residents undertaking standardized training were recruited from five tertiary hospitals in two provinces of China. Hierarchical moderated and mediated regression analyses were used to test the hypotheses. The hypotheses include that TLS is positively related to the training performance; mediating effect of self-efficacy and moderating effect of employee-orientation organizational culture (EOC) are significant. RESULTS (1) Two kinds of teachers' TLS, punishment and reward, have significant positive influence on residents' performance. (2) Self-efficacy of residents partly mediates the positive relationship. (3) EOC moderates the relationship between the punitive behavior of clinical teachers with TLS and the self-efficacy of the residents. CONCLUSIONS Empirical evidence has shown the positive relationship between teachers' TLS and residents' performance outcomes in China. Teachers can enhance training performance by promoting self-efficacy of residents. This study also advances our understanding of EOC by examining the demonstrated moderating effects of cultural background in the relationship between teachers' TLS and the self-efficacy of residents.
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Affiliation(s)
- Guangwei Deng
- School of Management, Hefei University of Technology, Hefei, 230009 Anhui China
| | - Di Zhao
- School of Management, University of Science and Technology of China, Hefei, 230026 Anhui China
| | - Jonathan Lio
- Department of Medicine, University of Chicago, Chicago, IL 60637 USA
| | - Xinyu Chen
- National Health Commission of the People’s Republic of China, Beijing, 100044 China
| | - Xiaopeng Ma
- Division of Life Sciences and Medicine, The First Affiliated Hospital of USTC, University of Science and Technology of China, Hefei, 230001 Anhui China
| | - Liang Liang
- School of Management, Hefei University of Technology, Hefei, 230009 Anhui China
| | - Chenpeng Feng
- School of Management, Hefei University of Technology, Hefei, 230009 Anhui China
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Chen Y, Zhao ZN, Liu LK. Important doctor-patient communication ability for chinese medical students. Asian Pac J Cancer Prev 2015; 16:4143. [PMID: 25987101 DOI: 10.7314/apjcp.2015.16.9.4143] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Yang Chen
- Department of Biotechnology, Dalian Medical University, Dalian, China E-mail :
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