Introduction: Medical practice involves routinely making critical decisions regarding patient care and management. Many factors influence the decision-making process, and self-confidence has been found to be an important factor in effective decision-making. With the proper transfer of knowledge during their undergraduate studies, selfconfidence levels can be improved. The purpose of this study was to evaluate the use of High Fidelity Simulation as a component of medical education to improve the confidence levels of medical undergraduates during emergencies. Methodology: Study participants included a total of 60 final year medical undergraduates during their rotation in Medical Senior Posting. They participated in a simulation exercise using a high fidelity simulator, and their confidence level measured using a self-administered questionnaire. Results: The results found that the confidence levels of ‘Assessment of an Emergency Patient’, ‘Diagnosing Arrhythmias’, ‘Emergency Airway Management’, ‘Performing Cardio-pulmonary Resuscitation’, ‘Using the Defibrillator’ and ‘Using Emergency Drugs’ showed a statistically significant increase in confidence levels after the simulation exercise. The mean confidence levels also rose from 2.85 to 3.83 (p<0.05). Conclusion: We recommend further use of High Fidelity Simulation in medical education to improve the confidence levels of medical undergraduates.
Students, Medical ; Practice Management, Medical

Through analysis and synthesis, through induction and deduction methods, the discussion with students and post graduate students at Hanoi faculty of Medicine, author realized that dialeclical materialism played an important role in the methodology of understanding and practicing the medicine. It forms a basis for building up a theory and interpreting the achievements of scientific studies. It can solve the philosophic problems rainsing in the processus of research. It is a right science for reasoning theoretically the problems and bringing them into practice of the physicians.
Medicine ; Practice Management, Medical ; methods

The committee of admitted doctors developed a questionnaire regarding medical dispute and distributed it to 1,600 members of Korean Academy of Orthodontics. The questionnaire consisted of three categories and 56 items covering basic information about the doctors and patients who had experienced medical disputes, the cause and workaround of medical accidents, and methods for taking precautions. The present survey showed a similar proportion of responders who had experienced a medical accident compared to the study in 1997. The primary reason for medical disputes was dissatisfaction with appearance. Many doctors felt that they would likely experience a medical dispute at some point. Most disputes were settled by doctors themselves, usually for an amount of less than 5 million Korean won. For some doctors, medical accidents lead to ongoing psychological problems. Responders felt that continuing education for medical dispute is very necessary. These results reveal a need for the association of orthodontists to lead advancements in education and countermeasures for preventing and managing medical accidents and disputes.
Dissent and Disputes* ; Education ; Education, Continuing ; Ethics ; Humans ; Korea* ; Medical Errors ; Methods ; Orthodontics ; Practice Management ; Surveys and Questionnaires ; Risk Management ; Socioeconomic Factors

Ideas and information to improve current medical practice come from many sources including the results of formal research studies, quality improvement projects and the clinical experiences and ideas of individual health professionals. Quality assurance is a method of continuously examining processes and making them more effective. It has been developed in an attempt to accelerate and support the change toward evidence-based practice.

OBJECTIVE: To determine the awareness of CLDH family physicians regarding quality assurance and its related activities.

MATERIALS AND METODS: A survey questionnaire was distributed to all the members of the Department of Family Medicine in CLDH from March 2007 to June 2007.

RESULTS: Almost all of the respondents have an acceptable attitude towards QA and believed that their colleagues have an acceptable attitude as well. The major perceived barriers for practicing QA were time constraint and lack of advocacy. Other perceived barriers were lack of budget to hold QA activities on a regular basis and the absence of a formal invitation. Similarly, the most perceived barrier on attending QA activities given by the PAFP was time constraint. In addition were fear of being evaluated, lack of incentive, inapplicability in practice, lack of motivation and support from the officers and limited lectures on QA. Thus, to improve interest in attending QA activities, they recommended that there should be regular activities on QA; encouragement of team work group discussion; incentives support structures, system for feedback and evaluation. Holding of quality assurance activities on a regular basis in the local chapters is the most recommended way to improve the dissemination and implementation of QA practices in localities. Similarly, dissemination through the media and email, making it a pre-requisite for residency training program and providing practice guidelines after completing modules were recommended.

CONCLUSION: The respondents have a high level of awareness but low application of QA in their practice. Almost all of them viewed QA positively and agreed that its practice improves patient care. The major perceived barriers for practicing QA were time constraint and lack of advocacy. Conducting regular activities on QA was the suggested way to improve the dissemination and implementation of QA practices in localities and to encourage physicians to attend QA activities.

Human ; Male ; Female ; EVIDENCE-BASED MEDICINE ; PRACTICE MANAGEMENT, MEDICAL ; Quality Improvement

Purpose: We analyzed the outcome of medical management for children with vesicoureteral reflux (VUR) and we determined the factors affecting the outcome. Materials and Methods: We retrospectively reviewed the records of 37 patients (56 kidneys) who were diagnosed with VUR between 1995 and 2004. All the patients were maintained on prophylactic antibiotics and had regular follow up. The subjects were stratified according to the grade of reflux at the time of diagnosis into the low grade group (grade III or below) or the high grade group (grade IV or above), based upon the International Classification System. The effects of the reflux grade, the presence or absence of renal scar, the age at diagnosis, laterality of disease and gender on the improvement/resolution rate of VUR were analyzed. Results: The mean duration until resolution was 35 months. Improvement occurred in 48 kidneys, including resolution in 27 kidneys. The resolution rate was higher in the kidneys with low grade reflux than that in the kidneys with high grade reflux. The resolution rate was higher in kidneys without scar than that in the kidneys with scar. A significantly higher improvement rate was observed for the children diagnosed before 1 year of age than that for the children diagnosed after 1 year of age. Conclusions: The most significant factor determining the outcome of medical management for children with VUR is the reflux grade at diagnosis. Medical management is appropriate in the management of low grade VUR. It may also be a viable treatment option for high grade VUR in selected cases.
Anti-Bacterial Agents ; Child ; Cicatrix ; Classification ; Diagnosis ; Follow-Up Studies ; Humans ; Kidney ; Practice Management, Medical ; Retrospective Studies ; Treatment Outcome ; Vesico-Ureteral Reflux*

The standardized management of acupuncture-moxibustion in Singapore General Hospital is introduced. With gradual improvement of outpatient infrastructure, re-training of medical staff, strict disinfection of manipulation, periodical inspection of medical instruments, unified management of writing, saving and processing in medical records and public education of TCM knowledge, a standardized management system in accordance with modernized hospital is gradually established. As a result, efficiency and quality of clinical treatment is continuously increasing. From April of 1998 to December of 2012, a total of 74 654 times of treatment were performed, and treatment amount per day is gradually increased. The unusual condition of acupuncture is avoided. Periodical strict inspection of joint committee authenticated by domestic and overseas medical health organization is repeatedly passed and accepted. Additionally, three clinical researches funded by Singapore Health-care Company are still in progress in acupuncture-moxibustion department.
Acupuncture Therapy ; standards ; Hospitals, General ; manpower ; organization & administration ; standards ; Humans ; Moxibustion ; standards ; Practice Management, Medical ; organization & administration ; standards ; Reference Standards ; Singapore