BACKGROUND

Telemedicine offers a solution to healthcare access issues, especially during the COVID-19 pandemic when physical distancing limited in-person visits. It can also be used by the Doctors-to-the-Barrios (DTTBs), who are often newly licensed physicians who have not undergone residency training yet, to remotely consult specialists and assist them in providing better healthcare recommendations to their patients. Understanding the acceptance of telemedicine particularly among DTTBs is crucial to optimizing its implementation, as local studies on this topic are lacking.

The purpose of this study is to determine the factors affecting acceptance of telemedicine by the DTTBs.

This study employed a descriptive and analytical cross-sectional research design from 2021 to 2022. Ethical approval was obtained prior to study implementation. Informed consent form was sent to all enrolled master’s students in the DTTB program. The study adapted the questionnaire utilized by Zailani et al. using a five-point Likert scale to identify the determinants of acceptance of telemedicine based on the following constructs: government policy, external supplier’s capacity, project team’s capacity, top management support, perceived usefulness, attitude, self-efficacy, acceptance of telemedicine, and organizational culture. Linear regression was performed to identify significant constructs that determine acceptance of telemedicine. All data were reported at 95% confidence interval.

Total of 116/180 DTTBs participated in the study. Attitude (β = 0.5849, p < 0.01) and self-efficiency (β = 0.5327, p < 0.01) together with organizational culture had a significant positive impact on the acceptance of telemedicine.

This study shows the current state of acceptance of telemedicine by our DTTBs. It highlights their positive attitude and self-efficiency towards telemedicine and the lack of support they receive from the government in funding and implementing telemedicine efforts despite its potential to address healthcare access issues.

The first theme set on me is “Was there any necessity that a cooperative society had to take it upon itself to provide community medicine?” The second is “its present meaning.”About the first theme, I think we need to look into the historical factors behind the start of community medicine by the cooperative -- especially the free medical practitioner system and community movement. Regarding the second theme, we have to ponder over why community medicine must be provided by the cooperative at the present.In my opinion, what is of paramount importance is that every person, as a human being who lives an ordinary life as a citizen think about these issues. I prefer not to stand on the medical donor side but on the side of medical care recipients when considering these themes.It is we that decide on tomorrow. People who are members of the community living there have the right to determine their future as the independent persons. You would learn from the history of the cooperative movement that the “spirit of cooperation” protects your health and well-being.
Community ; cooperative ; Medicine ; Health Care ; Hospitals

BACKGROUND: The purpose of this study was to compare students' awareness of and satisfaction with clerkships in family medicine between a university hospital and a community hospital or clinic. METHODS: Thirty-eight 4th year medical students who were undergoing a clerkship in family medicine in the 1st semester of 2012 were surveyed via questionnaire. The questionnaire was administered both before and after the clerkship. RESULTS: External clerkships were completed in eight family medicine clinics and two regional hospitals. At preclerkship, participants showed strong expectation for understanding primary care and recognition of the need for community clerkship, mean scores of 4.3±0.5 and 4.1±0.7, respectively. At post-clerkship, participants showed a significant increase in recognition of the need for community clerkship (4.7±0.5, P<0.001). The pre-clerkship recognition of differences in patient characteristics between university hospitals and community hospitals or clinics was 4.1±0.7; at post-clerkship, it was 3.9±0.7. Students' confidence in their ability to see a first-visit patient and their expectation of improved interviewing skills both significantly increased at post-clerkship (P<0.01). Satisfaction with feedback from preceptors and overall satisfaction with the clerkship also significantly increased, but only for the university hospital clerkship (P<0.01). CONCLUSION: Students' post-clerkship satisfaction was uniformly high for both clerkships. At pre-clerkship, students were aware of the differences in patient characteristics between university hospitals and community hospitals or clinics, and this awareness did not change by the end of the clerkship.
Clinical Clerkship ; Community Medicine ; Hospitals, Community* ; Hospitals, University* ; Humans ; Primary Health Care ; Students, Medical

BACKGROUND: The purpose of this study was to compare students' awareness of and satisfaction with clerkships in family medicine between a university hospital and a community hospital or clinic. METHODS: Thirty-eight 4th year medical students who were undergoing a clerkship in family medicine in the 1st semester of 2012 were surveyed via questionnaire. The questionnaire was administered both before and after the clerkship. RESULTS: External clerkships were completed in eight family medicine clinics and two regional hospitals. At preclerkship, participants showed strong expectation for understanding primary care and recognition of the need for community clerkship, mean scores of 4.3±0.5 and 4.1±0.7, respectively. At post-clerkship, participants showed a significant increase in recognition of the need for community clerkship (4.7±0.5, P<0.001). The pre-clerkship recognition of differences in patient characteristics between university hospitals and community hospitals or clinics was 4.1±0.7; at post-clerkship, it was 3.9±0.7. Students' confidence in their ability to see a first-visit patient and their expectation of improved interviewing skills both significantly increased at post-clerkship (P<0.01). Satisfaction with feedback from preceptors and overall satisfaction with the clerkship also significantly increased, but only for the university hospital clerkship (P<0.01). CONCLUSION: Students' post-clerkship satisfaction was uniformly high for both clerkships. At pre-clerkship, students were aware of the differences in patient characteristics between university hospitals and community hospitals or clinics, and this awareness did not change by the end of the clerkship.
Clinical Clerkship ; Community Medicine ; Hospitals, Community* ; Hospitals, University* ; Humans ; Primary Health Care ; Students, Medical

The use of complementary medicine (CM) is on the rise worldwide. In Malaysia, CM is available as over-the-counter products in community pharmacies and consumers expect pharmacists to be knowledgeable about CM. However, little is known about Malaysian community pharmacists’ attitude and knowledge of CM. This cross-sectional study aimed to investigate the extent of integration of CM into practice, taking into account community pharmacists’ attitudes towards CM, their role in recommending CM, their knowledge of the evidence-base for commonly used CM, further education and training needs, and knowledge of information sources which can be used by pharmacists for CM information. Ethics approval was obtained and a pilot study was conducted to validate the questionnaire. After amendments were made, community pharmacists were invited to complete a 41-item paper-based or web-based questionnaire. Invitations to complete the survey were sent by either social media, email or face-to-face invitation. A response rate of 27% (453/1662) was achieved providing data from 453 community pharmacists. Most respondents were female (63%), aged 24-72 years. Only 42% of pharmacists always asked their customers presenting with a prescription about concomitant CM use. Forty-two percent (42%) of pharmacists personally recommended CM and slightly more than half (58%) had notified manufacturers of CM products of any suspected adverse drug reactions. On average, pharmacists achieved a score of 54% for knowledge on CM-drug interactions and 71% for knowledge of clinically proven benefits. Most pharmacists (75%) obtained their CM product training through self-directed learning. In addition, most pharmacists (66%) supported CM education at the undergraduate level and almost all (94%) recognised the need for additional CM education for pharmacists. Malaysian registered pharmacists do not routinely ask customers about CM use, or recommend CM products, but have a positive attitude towards their use and were interested in learning more about CM.
complementary medicine ; integrative medicine ; community pharmacists ; pharmacy practice ; quality use of medicines

PURPOSE: Entering a new century in the year 2001, Chungbuk National University Medical School (CNUMS) decided to adopt a fully integrative curriculum. This plan has been executed from 2002 to 2005. we are now at a point to assess this new curriculum and further improve it for the future. METHODS: We studied 'Curricula for Undergraduate' from Chungbuk National University and 'The Present Educational Status of Medical College' the Dean's Council of Korean Medical College published from 1987 to 2005. RESULTS: All lectures consisted of integrated lectures between the basic and clinical medical sciences. First and second year lectures focused on the horizontal integration of basic and clinical medical sciences, respectively. Also lectures between the first and second years formed longitudinal integration and purposeful repetition. Practical Classes were comprised of essential major clinical medicines and elective clinical medicines. Generally, lectures were reduced to introduce active learning subjects including problem-based learning (PBL), communicational skills, objective structured clinical examination (OSCE) /clinical performance examination (CPX), basic clinical skills, community medicine, and health and society. CONCLUSION: The curriculum of CNUMS was changed from the traditional department-centered lectures to integrated organ-centered integrated lectures and practical classes. However, further innovation is required on the inside of curriculum.
Chungcheongbuk-do* ; Clinical Competence ; Community Medicine ; Curriculum* ; Educational Status ; Lectures ; Problem-Based Learning ; Schools, Medical*

OBJECTIVES: This study evaluated knowledge structure and its effect factor by analysis of co-author and keyword networks in Korea's preventive medicine sector. METHODS: The data was extracted from 873 papers listed in the Journal of Preventive Medicine and Public Health, and was transformed into a co-author and keyword matrix where the existence of a 'link' was judged by impact factors calculated by the weight value of the role and rate of author participation. Research achievement was dependent upon the author's status and networking index, as analyzed by neighborhood degree, multidimensional scaling, correspondence analysis, and multiple regression. RESULTS: Co-author networks developed as randomness network in the center of a few high-productivity researchers. In particular, closeness centrality was more developed than degree centrality. Also, power law distribution was discovered in impact factor and research productivity by college affiliation. In multiple regression, the effect of the author's role was significant in both the impact factor calculated by the participatory rate and the number of listed articles. However, the number of listed articles varied by sex. CONCLSIONS: This study shows that the small world phenomenon exists in co-author and keyword networks in a journal, as in citation networks. However, the differentiation of knowledge structure in the field of preventive medicine was relatively restricted by specialization.
*Authorship ; Community Networks/*organization & administration ; Humans ; Korea/epidemiology ; *Periodicals as Topic ; *Preventive Medicine

PURPOSE: We did this study to find out the current teaching status of the medical humanities and social sciences curriculum in Korean medical schools. Further, we discuss the tasks at hand to improve the curriculum in medical education. METHODS: The curricula of 41 medical schools and the syllabi of 10 schools were examined. We analyzed the tables of course organization and contents of integrated medical humanities. After analysis of the contents, they were grouped into 6 categories of medical humanities and social sciences domain. RESULTS: Our results are as follow: 1) there are 3 types of medical humanities and social sciences subject forms: inter-disciplinary (integrated, for example, PDS), multi-disciplinary (separated subject form), and mixed (integrated+separated); 2) most schools offer medical humanities and social sciences in a required class; 3) medical humanities and social sciences are taught through all school years and all 8 graduate medical schools offer a medical humanities and social sciences course from year 1; and 4) the average academic credits for medical humanities are 10 or 11. With respect to the curriculum content, there is some commonality in 10 schools: disease prevention, health improvement, medical ethics, medical regulation, professionalism, and community medicine. Differences were seen in content selection and organization. CONCLUSION: After brief reviews of the medical humanities and social science curriculums, we discovered that all Korean medical schools meet the need of medical humanities and social sciences education. However, curriculum implementation differed in various ways. We suggest the following tasks: 1) clarification of educational goals in order to develop a core curriculum of medical humanities and social sciences in Korea; 2) sharing experiences of developing a well-designed curriculum with other medical schools for effective teaching of this subject area.
Community Medicine ; Curriculum ; Education, Medical ; Ethics, Medical ; Hand ; Humanities ; Humans ; Learning ; Schools, Medical ; Social Sciences

In the future, geriatric care needs much more financial cost because korea is changing to an aging society rapidly and most of old people have health problems. It is important to have a comprehensive blueprint of the medical care of old patients, linking this with a welfare of old people. The government has to bring up and draw guidelines how to handle old patients and how much to treat them, before starting a national nursing insurance for old handicapped patients. Without a blueprint of old people care, we are in danger to encounter a huge financial leakage due to inefficient care system for old patients. Presently, old patient medical care are being randomly performed according to doctor's decision on a individual base. The multi-organ injury chronic diseased case tend to be rejected by doctors and will be referred to the higher level of medical center. Since old wealthy patient with a good economic and physical condition is a good target of making a money, this kind of old people will be welcomed and many lucrative cares will be applied under the name of anti-aging therapy. This consumptive environment must be changed to an efficient and economic system. The key content of a desirable system is a self-community of old-age people, which the lesser sick help the more sick and the lesser old patients help the more elderlies. The all around plan-building by the government is absolutely needed to provide a efficient medical treatment system for old patients with organizing the elderly as well as improving the regulations. Now, the government is ready to implement a national nursing insurance to solve the problems of the aging society. However, without a well prepared master plan for the future matters, we will meet other obstacles which could see in a tardy growing society.
Aged ; Aging ; Community Medicine ; Disabled Persons ; Humans ; Insurance ; Korea ; Nursing ; Social Control, Formal

Continuing care in family and community medicine is a dynamic process that requires regular patient assessments and adjustments of treatment strategies as the patient goes through the wellness and disease process. Family and community physicians need to be aware of any changes in the patient's clinical condition and re-assess therapeutic interventions when such changes occur. The use of clinical pathways can optimize the management of patients with a given disorder in our setting. The overall goal of the project is to improve the quality of health care in Philippine family and community medicine practice.
Clinical pathway is defined as a "tool to guide family and community medicine practitioners to implement evidence- based care and holistic interventions to specific group of patients and populations within a specific timeframe adjusted for acceptable variations that may be due to patient and practice setting characteristics designed to achieve optimum health outcome for the patient and community and efficient use of health care resources." In this definition, holistic interventions refer to interventions directed to the individual patient within the context of the family and community. In this context the PAFP Clinical Pathways Project will be developed to promote and implement the clinical pathways in family and community medicine. The PAFP Clinical Pathways Project will be implemented by a group who will review published medical literature to identify, summarize and operationalize the clinical content of diagnostics, interventions and clinical indicators or outcomes to develop an evidence-based clinical pathway in family medicine practice. The group will also identify processes and indicators to measure the effect of implementation of clinical pathways. Linear time-related representations of patient care processes, in terms of assessments, pharmacologic and non-pharmacologic interventions as well as social and community strategies to prevent complications and maintain wellness will be developed. The clinical pathways will be disseminated to the general PAFP membership and other stakeholders for consensus development. We hope that with this process, family and community medicine practitioners will be dedicated to a common goal and overcome organizational, personal, and professional perspectives barriers to the implementation of the clinical pathway.
The implementation of the clinical pathways to be adopted by the PAFP will include a nation-wide dissemination, education, quality improvement initiatives and feedback. Dissemination will be in a form of publication in the Family Filipino Physician Journal, conference presentations and focused group discussions. Quality improvement activities will be in a form of patient record reviews, audit and feedback. Audit standards will be the assessment and intervention recommendations in the clinical pathway. Variations will be discussed in focused group meeting and feedback sessions. The clinical pathways recommendations may also be revised if the variations are justified. Quality improvement activities will also be used to identify barriers in the implementation of clinical pathway. An electronic medical information system may also be used to facilitate the implementation.
To monitor the implementation of clinical pathways the PAFP need to select, define and use outcomes and impact to monitor the success of implementation. Outcomes and impact will be at the practice level and the organizational level. Practice level can be a simple count of family and community medicine practice using and applying the clinical pathways. Patient outcomes will also be measured based on quality improvement reports. Organizational outcomes can be activities of the PAFP devoted to the promotion, development, dissemination and implementation of clinical pathways.