Patient satisfaction with the information in received after molecular oncology examination of bladder cancer

A questionnaire was mailed to participants in a scientific project on the molecular oncology of bladder cancer to evaluate the participants' satisfaction with the information procedure as required by the Helsinki Deklaration and the Danish Law on a Scientific Ethical Committee System. Of the 584 questionnaires sent 73% were returned. Ninety percent of the respondents were satisfied with the written and 85% with the oral information given before entering the study. Seventy-six percent were satisfied with the timing of the information, and 83% (bladder cancer group) or 73% (control group, BPH' patients) were satisfied with the length of time, given for consideration on entering the study. Very few patients had felt any pressure to participate in the scientific project. Most patients were willing to participate in other scientific studies, and the majority of patients favoured the creation of tissue banks.     

Ten-year follow-up of vocational interest scores of 1950 medical college seniors.

Using the Strong Vocational lnterest Blank (SVIB) and the Medical Specialists Preference Blank, interest scales for surgeon, internists, pathologists, and psychiatrists were administered to 783 seniors in 15 medical schools in 1950. 87% of this group returned questionnaires regarding then professional activities in 1960. 75% of the group were in specialized practice compared to less than 25% of all physicians in 1950. The specialist interest scales did not predict the specialty entered. A scale based on all the specialists did differentiate specialists from general practitioners. The SVIB Physician Scale did not differentiate among specialties or type of practice. Younger physicians appear to resemble psychiatrists in their interests. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Analysis of knowledge about the anesthesiology specialty among a population of medical students

OBJECTIVES: To analyze the knowledge of anesthesiology possessed by a group of medical students representative of medically trained individuals who have not yet worked in a hospital. MATERIAL AND METHOD: Students in their fifth year of medical studies at the University of Valencia were invited to voluntarily and anonymously answer a questionnaire with dichotomous and multiple choice responses covering general and specific aspects of anesthesiology. The survey also collected personal and epidemiological data. One hundred eighty-five questionnaires were returned. RESULTS: The results obtained were analyzed for correlations with epidemiological and personal data (sex, information received, prior anesthesia); no significant correlations were found between these data and correct response. It was believed by 78.4% that the anesthesiologist's function during surgery does not go beyond warning the surgeon of changes in vital signs. Nevertheless, 76.2% asserted that the anesthesiologist's function is to protect the patient during the perioperative period. CONCLUSION: In comparison with the general population, medical students' training has left them with inadequate understanding of anesthesiology.     

Present status of psychological research and training in hypnosis.

Anonymous questionnaires on training and research in hypnosis were returned by 54 of 55 psychology department chairmen with approved clinical psychology training programs and 39 of 85 American Medical Association approved medical schools. 8 psychology departments and 2 medical schools have courses in hypnosis. Unless the "psychological profession is more active in protecting its rights to research and clinical use of a methodology which is basically psychological, it may find itself legally excluded from the field." (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Career preferences of medical students: influence of a new four-week attachment in general practice

BACKGROUND: It is not clear why medical students choose one specialty over another. Experiences at medical school are extremely strong determinants of attitudes to the medical specialties, and attitude is the most important factor in determining choice. AIM: This study sought to describe the factors influencing career choices of final year medical students, the effect of a new four-week attachment in general practice on career choices, and changes in career choices towards or away from general practice between the final year and the end of the preregistration house officer year. METHOD: Career preferences, and influences on them, were assessed by questionnaires administered to 206 medical students undergoing their final clinical attachment at the University of Glasgow immediately before and immediately after a four-week attachment in general practice. These were followed up by a postal questionnaire at the end of the preregistration house officer year. RESULTS: One hundred and thirty-one students returned all three questionnaires. Before the attachment, students born outside the UK, and those who had a previous or intercalated degree were significantly less likely to put general practice as a career preference; female students were more likely to put it as their first career choice. After the attachment, the number stating that it was 'likely' or 'very likely' that they would choose general practice as a career increased from 60 to 72--mainly through male students changing their preference--but after the preregistration house officer year it had fallen back to 56. Seventeen of the preregistration house officers were planning to complete posts which would qualify for GP training. Reasons for changing preference towards general practice were mainly to do with a dislike of and disillusionment with hospital medicine and with the perceived lifestyle advantages of general practice. Reasons for changing preference away from general practice were mainly to do with positive feelings about hospital medicine and a dislike of the management aspects of general practice. CONCLUSION: The general practice attachment influenced students, especially males, towards a career in general practice, but this effect was transient. This cohort of doctors should be followed up in order to discover their ultimate career choices.     

PIAP psychotherapy questionnaire.

PIAP (Psychologists Interested in the Advancement of Psychotherapy) in July 1962 sent questionnaires to all American Psychological Association Directory listed psychologists expressing interest in psychotherapy (N = 4494); 38% were returned. Results of the 12 item questionnaire are summarized. 17% of the respondents (N = 286) provided comments or offered suggestions which are discussed under the headings of Training, Private Practice, Organizational Issues, Problems of Subdoctoral Therapists, Research and New Directions, and Journal on Psychotherapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Treatment of depression by obstetrician-gynecologists: a survey study

OBJECTIVE: We performed an exploratory survey of depression diagnosis, treatment, and patient referral patterns by Fellows of ACOG. We also examined obstetrician-gynecologists' professional training in the management of clinical depression. METHODS: We sent a questionnaire to a total of 1370 ACOG Fellows. Sixty percent of the surveys were returned. RESULTS: As a group, obstetrician-gynecologists reported diagnosing an average of four new cases of depression per month. Within the overall sample, the number of new diagnoses of depression made each month was significantly greater for those defining themselves as primary care physicians than for those defining themselves as specialists. When treating depression pharmacologically, obstetrician-gynecologists reported that they overwhelmingly (74% of the time) chose selective serotonin reuptake inhibitor antidepressants. Ninety-five percent of obstetrician-gynecologists reported that they referred severely depressed patients to a mental health professional. A majority of respondents neither received residency training (80%) nor completed a continuing medical education course (60%) on the treatment of clinical depression in women. CONCLUSION: Obstetrician-gynecologists who describe themselves as primary care physicians make significantly more diagnoses of depression than those considering themselves specialists. Studies further to assess obstetrician-gynecologists' management of depression and better to define needs for professional education are warranted.     

Attitudes and practices of pharmacy managers regarding needle sales to injection drug users

Neurologic disease, already common in the United States, will become even more common in the future. But presently, neurology education at the undergraduate level and in primary care residencies is declining and does not adequately train physicians to manage neurologic illness. The authors maintain that this serious problem can be partially addressed by improving the neurology education of all primary care physicians and by allowing students access to neurology specialists. The education of medical students in the basic and clinical neurosciences must be integrated into a seamless curriculum over the four years of medical education. This education experience must be taught through a team approach and must be led by both a clinician and a basic scientist. All medical students must acquire the knowledge, skills, and attitudes necessary to perform an initial evaluation of the patient with a neurologic complaint. Finally, students must understand the role and recognize the importance of the neurologist and know when consultation is needed. This continuum of neurology education must be financially supported by the institution, and course leaders who show excellence in education must be rewarded with compensation and promotion.     

The undergraduate medical education in neurology and the active learning in small groups

In the undergraduate medical education of neurology, the lack of training for the application of acquired knowledge and the smaller chances for the practice of skills and the attitudinal education might lead medical students to be unconcerned about neurology. The measures for these problems introduced in Saitama Medical School were reviewed, which include the practical training for local diagnosis, the introduction to clinical medicine and the problem based learning in a manner of small group learning, respectively. Active, self-directed learning in small groups would help to improve the difficulties in current undergraduate medical education.     

On the importance and validity of medical accreditation standards

In late 1997, the authors conducted a national survey of communities of interest about the importance and clarity of 44 accreditation standards applied to teaching, learning, and evaluation in medical schools by the Liaison Committee on Medical Education (LCME). Questionnaires were mailed to deans and educational administrators at U.S. medical schools; current LCME members and surveyors and those who had served during the preceding five years; a random selection of residency program directors drawn from both general practice and speciality disciplines; sample groups of medical students and residents; and a cohort of practicing physicians not affiliated with academic medical institutions. Altogether 1,659 questionnaires were mailed, and 701 responses were received (42%). The recipients were asked to use a five-point Likert scale to rate each of the 44 standards both for its perceived importance as an indicator of the quality of undergraduate medical education and for the clarity with which the standard's intent was conveyed. Although the mean ratings of importance all fell in the "moderately important" and "highly important" areas across the respondent groups, the ratings divided into three groups, semantically and statistically. At the high end for importance are standards dealing with fundamental qualities of students, instruction, and the structuring of resources. At the low end of the importance scale are standards dealing largely with matters of process. The ratings for clarity were systematically lower than the ratings for importance, and in some cases the rating for clarity were even more widely discrepant with the ratings for importance. Individual comments by respondents about certain standards were critical of their complicated construction and of confusion about their meaning and measures of compliance. One or more of these hallmarks--being rated of lower importance or clarity, and being the target of criticism by survey respondents--distinguished most of the standards that earlier study had shown are often neglected by surveyors. The predictive validity of each of a number of standards was examined by testing the association between the standard (or its derivative) and outcomes expressed in annual student and school questionnaires and compiled in databases of the Association of American Medical Colleges and the American Medical Association. The result was a mixed bag, confounded by the absence of specific dimensions of many accreditation standards (independent variables) and the lack of discriminating measures of outcome (dependent variables). Nevertheless, the LCME's accreditation standards are believed to be important by those most affected by them. And beyond validating that medical accreditation is guided by relevant standards for teaching, learning, and evaluation, the results of this study point to ways by which the process can be made more precise and useful.     

Panic disorder. The pattern of somatic contacts in patients

The epidemiology, phenomenology and treatment of panic disorder have been thoroughly studied in recent years. The symptomatology of panic attacks may mimic cardiopulmonary, neurological and gastrointestinal disease. Forty Danish panic patients with panic disorder of ten years' duration had had contact with several medical specialists, hospital emergency and outpatient services. Thus, 28% had visited neurologists, 8% cardiologists and 20% an emergency service. One third had been admitted to hospital departments. Almost all patients had consulted psychiatrists or psychologists. Ninety had been treated with a benzodiazepine, 35% with tricyclic antidepressants and 57% with neuroleptics. To prevent costly medical testings and delay in accurate diagnosis in psychiatric and somatic settings, the phenomenology of panic disorders should be recognized by all medical specialists and general practitioners.     

Chronopharmacology

Chronopharmacology studies the influence of time of administration of drugs. Numerous studies have report on the influence of time of administration on acute toxicity of drugs. Qualitative and quantitative responses of the organism to drugs have been described in different areas such as anaesthesiology, cardiology, oncology, endocrinology, gastroenterology, obstetrics, neurology, pneumology, psychiatry, rheumatology... in animals and in men. Underlying mechanisms of such variations involve temporal variations of the mode of action of the drug i.e. at the receptor level or temporal modifications of the kinetics of the drug. Absorption, distribution and drug protein binding, metabolism and elimination vary according to the moment of administration of the drug. Chronotherapy consists on the choice of the moment of administration of a drug in order to minimise its side effects and/or to emphasize its therapeutic effects.     

School nurses' perceptions of parental involvement in school health. Results of a statewide study

The purpose of this study was to determine how school nurses attempt to involve parents of seventh graders in school health programs, identify nurses' perceptions of barriers to parental involvement, and identify related staff development needs. A questionnaire was sent to the school nurse in each school in Indiana that had a seventh grade (n = 447); 279 questionnaires were returned, a response rate of 63%. Most respondents worked in situations without written policies for parental involvement. A minority of school nurses reported receiving input from parents through advisory committees or parent surveys. The most common involvement activities were related to providing parents with information about the school health program. Less than half of the respondents reported offering health education through activities such as parent health education classes, health fairs, health education resource centers, or health newsletters. Lack of time was identified as the major barrier faced by school nurses. Several staff development needs were identified.     

Professional conditions and satisfaction in general practice in 1993. Practice profile of Norwegian primary physicians

European study of General Practice (GP) task profiles was carried out in 30 European countries in 1993. We analyzed the Norwegian results. 164 primary care physicians, 51% of a random sample, answered a questionnaire. 147 kept a diary on their practice for one week. Compared with results from two earlier studies performed 15 years ago, the proportion of female GPs had doubled to 25%, there were more group practices, more time was spent on vocational training and continuous education, and night service was less frequent than in 1978. 45% were specialists in general practice and 7% in community medicine. Job satisfaction was high, and highest for women, fee-for-service GPs on contract, and GPs who cooperated with other health professionals.     

Concomitant rotavirus serotypes 1 and 4 infections in a diarrhoeic child from Belém, Brazil

With the discussion of the quality of medical education in Germany the importance of evaluating the curriculum has grown. A working group of representatives of the German scientific societies for general medicine and the so-called "psychosocial" disciplines in medical education had adapted a questionnaire from Harvard Medical School and tested this version for the first time in summer 1995. 56 teachers and 1250 students took part in this pilot study. The instrument proved to be sufficiently valid to evaluate the quality of different types of teaching lessons. The disciplines (Medical Sociology, Medical Psychology, Social Medicine, General Medicine, Psychotherapy/Psychosomatics) were valued equally with concern to their relevance for medical education. They got significantly better values for quality of teaching and teaching engagement of the professors. It is recommended to notice these results in the actual debate on the reform of the medical curriculum and to include other disciplines in further evaluative investigations.     

How valid are medical records and patient questionnaires for physician profiling and health services research? A comparison with direct observation of patients visits

OBJECTIVES: This study was designed to determine the optimal nonobservational method of measuring the delivery of outpatient medical services. METHODS: As part of a multimethod study of the content of primary care practice, research nurses directly observed consecutive patient visits to 138 practicing family physicians. Data on services delivered were collected using a direct observation checklist, medical record review, and patient exit questionnaires. For each medical service, the sensitivity, specificity, and Kappa statistic were calculated for medical record review and patient exit questionnaires compared with direct observation. Interrater reliability among eight research nurses was calculated using the Kappa statistic for a separate sample of videotaped visits and medical records. RESULTS: Visits by 4,454 patients were observed. Exit questionnaires were returned by 74% of patients. Research nurse interrater reliabilities were generally high. The specificity of both the medical record and the patient exit questionnaire was high for most services. The sensitivity of the medical record was low for measuring health habit counseling and moderate for physical examination, laboratory testing, and immunization. The patient exit questionnaire showed moderate to high sensitivity for health habit counseling and immunization and variable sensitivity for physical examination and laboratory services. CONCLUSIONS: The validity of the medical record and patient questionnaire for measuring delivery of different health services varied with the service. This report can be used to choose the optimal nonobservational method of measuring the delivery of specific ambulatory medical services for research and physician profiling and to interpret existing health services research studies using these common measures.     

Unnecessary medical interventions. A questionnaire study among physicians and laymen

The aim of the study was to survey attitudes among medical doctors and lay people to unsolicited medical intervention. The design of the study was an anonymous questionnaire study including three scenarios implying ethical considerations. A total of 445 medical doctors working within different areas received the questionnaire, as did 75 medical students and 600 lay people. The results showed a response rate of 67%, highest among medical doctors and students. The lay people had significantly higher expectations concerning the medical intervention in two out of three scenarios compared to medical doctors and students. The participants were offered the opportunity to comment on the questionnaire. The conclusion of the Danish survey is that there is a significantly different approach to unsolicited medical intervention among lay people compared to medical doctors and students. Medical doctors are less disposed to perform unsolicited intervention compared with the wishes/expectations of the lay people. More open attitudes and information as well as better communication is recommended.