This paper attempts to utilise clinical scenarios where ethical issues are embedded and requires appropriate application of the steps of the framework mentioned. A step by step sequential approach is adopted to illustrate how the ‘ethical decision model ‘can be used to resolve ethical problems to arrive at a reasonable conclusion. The UNESCO ethical method of reasoning is used as the framework for decision making. Physicianeducators should be competent to use ethical decision models as well as best available scientific evidence to be able to arrive at the best decision for patient care as well as teach health professional trainees how reasonable treatment decisions can be made within the perimeter of medical law and social justice.
Obstetrics ; Education, Medical

*Education, Medical ; *Education, Medical, Graduate ; *Gynecology ; *Obstetrics

*Abortion, Legal ; *Contraceptives, Oral ; *Education, Medical ; *Gynecology ; *Obstetrics ; *Pregnancy

BACKGROUND: Red blood cell (RBC) transfusion is an essential practice during surgery to accommodate for bleeding. As such, there are efforts being made to allow for a safe and appropriate transfusion due to shortages of blood components and to minimize transfusion-related adverse reactions. However, a conventional transfusion decision with relatively high hemoglobin (Hb) threshold is still performed in clinical setting. In this study, we investigated the threshold of Hblevel and appropriateness of RBC transfusion in patients receiving perioperative RBC transfusion in surgical departments. METHODS: We investigated the pre-transfusion Hb level of 1,379 patients (2,170 episodes) receiving perioperative RBC transfusion in five surgical departments, including cardiothoracic surgery (CS), general surgery (GS), neurosurgery (NS), obstetrics and gynecology (OBGY), and orthopedics (OS), between June 2017 and March 2018. The appropriateness of transfusion was evaluated with two criteria: 1) pretransfusion Hb level ≤10 g/dL and 2) posttransfusion Hb level ≤10 g/dL. RESULTS: The median pretransfusion Hb level was 8.5 g/dL (interquartile range 7.7~9.4); that of each department was as follows: 8.6 g/dL (7.9~9.2) in CS, 7.9 g/dL (7.3~8.6) in GS, 9.1 g/dL (8.5~9.8) in NS, 8.5 g/dL (7.7~9.8) in OBGY, and 8.7 g/dL (7.9~9.7) in OS. With a criteria of pretransfusion of Hb level ≤10 g/dL, 85.4% of total episodes were appropriate. With criteria of post-transfusion of Hb level ≤10 g/dL, 44.7% were appropriate. CONCLUSION: This study presents a fundamental data observing the trend of RBC transfusion in a single institution. A significant proportion of inappropriate RBC transfusion are still being conducted in surgical setting. Continuous and effective education of clinicians and implementation of monitoring systems to assess the appropriateness of RBC transfusion may be necessary.
Education ; Erythrocyte Transfusion ; Erythrocytes ; Gynecology ; Hemorrhage ; Humans ; Neurosurgery ; Obstetrics ; Orthopedics

PURPOSE: This study aims to determine obstetrics nurses knowledge, attitude, and practice about breast cancer and breast self-examination (BSE), and to contribute to the early detection of breast cancer during breastfeeding periods. METHODS: For the survey, 163 individuals (obstetric nurses) were chosen by convenience sampling and agreed to participate in the study. Their knowledge, attitude, and practice about breast cancer and BSE. RESULTS: Knowledge and attitude averaged 70.45+/-10.90 (of 100) and 3.64+/-0.27 (of 5), respectively. While most nurses (99%) recognized the importance of BSE, only 58.9% experienced BSE. BSE practice level averaged 8.35+/-1.96 (of 12). Only 20.2% had recommended BSE to their clients. Practice level varied significantly for different marital status, breastfeeding experience, and education, while knowledge and attitude remained independent. Nurses who had experienced mammogram or breast ultrasonogram themselves scored higher in knowledge. Attitude was higher for nurses who received recommendation for BSE, performed BSE, received BSE education, or recommended BSE to clients. Practice level was higher for nurses who received BSE education or willing to perform BSE in future. Practice level had a positive correlation with attitude but no correlation to knowledge. CONCLUSION: Obstetric nurses need continuing education for practicing BSE. Practical BSE education can not only promote preventive behavior of nurses, but it can also improve the breast health management of obstetrical clients.
Breast ; Breast Feeding ; Breast Neoplasms ; Breast Self-Examination ; Education, Continuing ; Marital Status ; Obstetrics

There are four principles of medical ethics; Beneficence, Respect for autonomy, Non-maleficence, and Justice. It is not easy to apply to principles of medical ethics in the special circumstances of obstetrics and gynecology. Student doctors must learn to be familiar with principles of medical ethics tailored to the special circumstances while the obstetrics and gynecology practice.
Beneficence ; Education, Medical* ; Ethics* ; Ethics, Medical ; Gynecology* ; Humans ; Obstetrics* ; Social Justice

Clinical education is difficult for actual practice of medical students. In particular, the practice in the field of obstetrics is more difficult to many students. Moreover, the education of sub-fields of obstetrics such as birth or abortion needs many materials of women's reproductive organs. However, the ordinary paper-based textbooks have some limitations for clinical education of obstetrics. The electronic textbook system based on multimedia data enables that many student, doctor, and public user overcome these difficulties, as a computer assisted learning. We developed multimedia database system which is connected with web using ODBC(Open DataBase Connectivity)and ASP(Active Server Page)/IDC(Internet DataBase Connection). Many text and multimedia data are gathered in the database. This system serves various multimedia data using internet and intranet in the student's class or home. In conclusion, providing multimedia data of obstetrics using ODBC, ASP/IDC method reduce the limitation of clinical education. This model of the electronic textbook would be a reference to develop multimedia database on the network.
Computer Communication Networks ; Education ; Humans ; Internet ; Learning ; Multimedia* ; Obstetrics ; Parturition ; Students, Medical

COVID-19 ; Child ; Humans ; Internship and Residency ; Obstetrics/education* ; SARS-CoV-2 ; Singapore

INTRODUCTIONThis study aimed to develop a realistic and lifelike uterine model for the training of hysteroscopy skills.

MATERIALS AND METHODSA lifelike "uterine" model was constructed using female pig bladder. The pig bladder was enclosed within a malleable mould, with both ureters blocked by pins. Both rigid and flexible hysteroscopes were used in this study.

RESULTSBasic diagnostic hysteroscopy can be performed in the usual fashion using this lifelike model. The cost of each learning station is minimal. Pig bladder accurately simulates the human uterus with its realistic tactile feel, and conditions in the surgical environment, including obscuration of vision by debris, uterine "folds", realistic "ostia", incomplete shearing of tissue, "uterine" perforation, etc.

CONCLUSIONThis low-cost novel model provides realistic tissue resistance and yields an almost anatomically accurate hysteroscopic training tool, thereby allowing trainees to effectively acquire both diagnostic and therapeutic hysteroscopic skills.

Animals ; Education, Medical, Graduate ; methods ; Female ; Gynecology ; education ; Hysteroscopes ; Hysteroscopy ; education ; instrumentation ; Models, Anatomic ; Obstetrics ; education ; Singapore ; Swine ; Urinary Bladder ; Uterus

This study was attempted to identify the knowledge to breast-feeding and the performance of nursing activities for breast-feeding and to test "how does the degree of knowledge to breast-feeding influence the nursing activities for breast-feeding?" The subjects were 180 nurses working in delivery rooms, nursery, obstetrics & pediatrics wards or OPD of obstetrics & gynecology of 8 general hospitals in Pusan as of August 3 through 13, 1996. The results are abstracted as follows : 1) Subject nurses' age : 25-29 was 45.6%(the major), education levels ; graduates from junior college were 95.0%, unmarried status was 62.2%, 76.5% of married nurses had children, 39.7% in-service education for Breast-Feeding, 337% did nursing activities for breast-feeding actively, the reason for inadequate activities for breast-feeding was "too much other tasks." 2) The degree of knowledge to breast-feeding ; mean score was 13.54, the degree of performance of nursing activities for breast-feeding ; 92.38+/-20.93 points out of possible 145 points(3.19+/-.74 out of possible 5 points) meaned that it was a low level. 3) The hypothesis "the nurses who have higher degrees of knowledge to breast-feeding will show higher degrees of performance of nursing activities for breast-feeding than the nurses who have lowe degrees of knowledge to breast-feeding" was tested by t-test(t=-.01, P=.9888), but rejected because it turned out statistically not significant at the level of P<.05) Above results suggested the degrees of knowledge to breast-feeding and the degrees of performance of nursing activities for breast-feeding were generally low and the degree of knowledge didn't influence the nursing activities. Researchers believe that the education for breast-feeding by the nurses need to be performed systemically & practically and new-method of breast-feeding education program need to include hospital managers as well as nurses related mothers and their family. In addition, researchers propose the introduction of "lactation specialist system", for the specialist can change the attitude of feeding-mothers positively with their specialty and authority.
Busan ; Child ; Delivery Rooms ; Education ; Gynecology ; Hospitals, General ; Humans ; Mothers ; Nurseries ; Nursing* ; Obstetrics ; Pediatrics ; Single Person ; Specialization ; Child Health