Background: In recent years, healthcare organizations worldwide have shifted away from clinic- and medical professional-centered service delivery models toward more patient-centered approaches. These approaches emphasize personalized care, active patient engagement in medical decision-making, and support for patients in managing their chronic conditions. Aim: To study patient-centered care in outpatient services of public and private hospitals. Materials and Methods: A hospital-based analytical cross-sectional study design was employed using a quantitative survey method. A total of 575 patients who received outpatient care in public and private hospitals were included in the study. The Patient–Professional Interaction Questionnaire (PPIQ) was used to evaluate patient-centered outpatient care. The questionnaire consisted of 16 items grouped into four domains. The internal consistency of the instrument was high, with a Cronbach’s α=0.929. Data were analyzed using SPSS version 25.0. Statistical significance was set at p< 0.05. Result: The mean score for effective communication was higher in private hospitals 4.36 (SD=0.61) compared with public hospitals 3.90 (SD=0.66) with a mean difference of 0.46 points (p<0.001). The mean score for attention to the patient’s agenda was higher in private hospitals 3.93 (SD=0.80) than in public hospitals 3.36 (SD=0.88), showing a statistically significant difference of 0.57 points (p<0.001). Similarly, empathy scores were higher in private hospitals 3.94 (SD=0.76) than in public hospitals 3.51(SD=0.79), with a mean difference of 0.43 points (p<0.001). Patient involvement scores were also higher in private hospitals 4.11(SD=0.80) compared with public hospitals 3.56 (SD=0.87), indicating a statistically significant difference of 0.55 points (p<0.001). Conclusion This study compared patient-centered outpatient care between public and private hospitals and found that all indicators-including effective communication, interest patient’s agenda, empathy, and patient involvement in care -were statistically significantly higher in private hospitals (p<0.001).

Background: In recent years, medical education worldwide has undergone a paradigm shift from knowledge-centered training to a competency-based approach. Within the framework of this reform, it has become crucial to systematically evaluate the workplace performance and professional competencies of graduates rather than solely assessing theoretical knowledge. International standards now demand that medical practice be an integrated synthesis of communication, attitude, ethics, and leadership, extending beyond clinical knowledge. Aim: The study aims to evaluate the current state of comprehensive professional competencies by investigating graduate satisfaction regarding the learning outcomes of the “Medical Doctor” program. Materials and Methods: An analytical cross-sectional study was conducted between January 2024 and January 2026. The study involved 114 graduates (2020–2022) of the School of Medicine, MNUMS, currently working in primary healthcare. Data were collected using a 41-item questionnaire comprising demographic characteristics (10 items), CanMEDS competency indicators (29 items), and open-ended questions. Satisfaction was measured using a 5-point Likert scale. Statistical analysis was performed using IBM SPSS Statistics 26, utilizing Cronbach’s Alpha for internal consistency, t-tests and ANOVA for group comparisons, partial eta squared (ηp2) for effect size, and Factor Analysis for item clustering. Result: The participant pool consisted of 86.1% females and 13.9% males, with a mean age of 27.49±1.15. Regarding workplace distribution, 54.8% were employed in urban areas and 45.2% in rural areas. The questionnaire demonstrated high reliability with Cronbach’s α=0.962. The overall mean satisfaction level of graduates was 3.63±0.79. Among the CanMEDS roles, the “Professional” role received the highest rating (3.78±0.77), while the “Medical Expert” role received the lowest (3.49±0.67). However, the “Medical Expert” competency showed a statistically significant increase (p<0.026) from 2020 (3.24) to 2022 (3.68), indicating improved curricular continuity. Specifically, the graduation year had a medium effect size on sub-competencies ME9 (Prevention, p<0.031) and ME10 (Using evidence, p<0.025), with ηp2 values ranging from 0.061 to 0.064. Workplace location did not significantly influence competency assessment (p>0.05). Factor Analysis categorized the 29 items into five main factors, explaining 69.68% of the total variance. The primary factor, “Integrated Clinical and Management Competency,” alone accounted for 49.08% of the variance, reflecting the integrated nature of comprehensive professional competencies. Conclusion 1.Graduate satisfaction with comprehensive professional competencies is at an above-average level (3.63). 2.The high rating for the “Professional” role indicates strong ethical development and professional maturity, while the lower score for the “Medical Expert” role suggests a need for increased focus on refined clinical skills in training. The longitudinal improvement in “Medical Expert” scores reflects the positive impact of curriculum reforms. 3.These findings confirm that clinical and soft skills are inextricably integrated for primary healthcare physicians, providing evidence for future program development based on this holistic integration.

Background: Patient-centred care is one of the six dimensions of healthcare quality, alongside safety, timeliness, effectiveness, efficiency, and equity. Among these dimensions, patient centredness encompasses many of the characteristics of high-quality care and has been rapidly integrated into clinical practice worldwide. This growing emphasis on patient-centred care provides the rationale for the present study. Aim: To assess the attitudes of physicians and healthcare professionals in public and private hospitals toward patient-centered care and to investigate the factors influencing its implementation. Materials and Methods: A hospital-based analytical cross-sectional study was conducted using a quantitative research approach. A total of 218 physicians and healthcare professionals from public and private hospitals participated in the study. Patient-centred care was assessed using the Provider–Patient Relationship Questionnaire (PPRQ-16) developed by Gremigni et al. The questionnaire consists of 16 items grouped into four domains. The overall reliability of the instrument was excellent (Cronbach’s α = 0.944). Data were analyzed using SPSS version 25.0. A p-value of less than 0.05 was considered statistically significant. Results: Among the participants, 43.1% (n = 94) demonstrated a moderate level of knowledge regarding patient-centred care. The overall mean score for patient-centred care was 3.79 (SD = 0.64). Among the four domains, information exchange had the highest mean score (4.09 ± 0.70), while empathy had the lowest mean score (3.59 ± 0.71). No statistically significant differences were observed between public and private hospitals across any patient-centred care domains (p>0.05).
Pearson correlation analysis revealed significant positive correlations between patient centred care dimensions and several factors, including knowledge of patient-centred care (r = 0.184–0.233, p < 0.001), time available for patients (r = 0.142–0.243, p < 0.001), nurses’ cooperation (r = 0.249–0.323, p < 0.001), low patient health literacy (r = 0.137–0.253, p < 0.001), and job satisfaction (r = 0.176–0.249, p<0.01). Conclusion Healthcare professionals’ patient-centred care practices did not differ by hospital ownership (public versus private). These findings indicate that the implementation of patient-centred care is influenced not only by healthcare professionals’ knowledge and attitudes, but also by organizational and work-related factors, including organizational culture, workload, time allocated to patients, and effective collaboration among healthcare team members.

Background: Modern medical education increasingly integrates Outcome- Based Education (OBE) and Problem-Based Learning (PBL) approaches to improve training quality. The Mongolian National University of Medical Sciences (MNUMS) implemented an OBE curriculum in 2013, creating a need to examine student satisfaction as a measure of program effectiveness. Student satisfaction is recognized as a key indicator of educational quality and is linked to outcomes such as graduate retention and institutional reputation. Aim: To assess the level of student satisfaction in the medical doctor (MD) training program and identify factors influencing it, in order to provide a basis for improving training quality. Materials and Methods: A cross-sectional survey was conducted in 2023– 2024 among 1167 students (third- to sixth-year MD students) at MNUMS. Participants had a mean age of 22.2 ± 1.5 years, and 79.9% were female. A questionnaire with 23 questions (including 16 Likert-scale items on satisfaction) was administered; responses were given on a 5-point Likert scale. Data were analyzed using SPSS version 26. Descriptive statistics, independent t-tests, one-way ANOVA, Pearson correlation analysis, exploratory factor analysis, and multiple linear regression were performed. All statistical tests were twotailed, and significance was set at p<0.05. Results: The satisfaction survey demonstrated high internal consistency (Cronbach’s α = 0.927). Overall satisfaction with the training program was moderately high, with a mean score of 3.51 ± 0.84 out of 5. Fourth-year students reported the highest satisfaction with teaching methods (mean 3.97 ± 0.67), whereas third-year students gave the lowest rating for the sufficiency of learning materials (mean 2.98 ± 1.01); these differences were statistically significant (p<0.001). Additionally, satisfaction with clinical training declined by the final year of study, with a mean rating of 3.16 in the sixth year compared to 3.70 in the third year (p<0.001). No significant difference in overall satisfaction was observed between male and female students (p>0.05). Exploratory factor analysis (KMO = 0.950; Bartlett’s test p<0.001) identified two key underlying factors influencing perceived training quality, which together explained 55.83% of the total variance: (1) “Curriculum organization and teaching methodology,” and (2) “Material resources and learning environment.” Correlation and regression analyses further indicated that better course organization and active teacher engagement were associated with higher student satisfaction (p<0.01). Conclusion The study shows that enhancing teaching methods and improving curriculum coherence are needed to further improve the quality of the MD training program. Additionally, strengthening educational resources and updating instructional approaches are crucial for raising satisfaction levels, particularly for senior (sixth-year) students. These findings provide an evidence- based foundation for curriculum and policy improvements to boost student satisfaction and overall educational outcomes.

Background: Medical education has undergone significant changes over the past few decades, with a focus on studentcentered learning, problem-based learning, competency-based learning, and outcome-based education. Among these, internal medicine diagnostics plays a crucial role in preparing students for clinical practice. However, there is limited research on the factors influencing student satisfaction in this course. Studies by Harden et al. (1999) and Irby et al. (2010) have emphasized the importance of continuous evaluation and effective teaching methods in medical education. This study aims to assess student satisfaction with the internal medicine diagnostics course within the “Physician” program at the Mongolian National University of Medical Sciences (MNUMS), aligning with these global trends. Aim: The primary objective of this study is to evaluate student satisfaction with the internal medicine diagnostics course in the Physician program. Specific objectives include: Assessing satisfaction with the diagnostics course in the 2nd year of the basic medical education program, evaluating satisfaction with the internal medicine diagnostics course in the 3rd year, exploring the relationship between these two courses. Materials and Methods: This analytical study was conducted from June 2023 to June 2024, involving 1,167 students enrolled in the “Physician” program at MNUMS. Data were collected using a 34-item questionnaire, including:Demographic information (5 questions),General satisfaction (17 questions),Internal medicine diagnostics-specific satisfaction (12 questions). Satisfaction was measured using a 5-point Likert scale (1=strongly disagree, 5=strongly agree). Data were analyzed using SPSS Statistics 26, employing descriptive statistics, ANOVA, T-tests, and regression analysis. Effect sizes were calculated using Cohen’s d and Partial Eta Squared (η²), with statistical significance set at p<0.05. Results: Overall satisfaction: The average satisfaction score was 3.98±0.73. 2nd-year diagnostics course: Highest satisfaction (4.07±0.90), particularly with “course content” (4.07±0.90). 3rd-year internal medicine diagnostics course: Lowest satisfaction (3.97±0.78), especially with “learning environment” (3.90±0.90). Gender and Year Differences: No significant gender-based differences (p>0.05). Satisfaction with the internal medicine diagnostics course decreased as students progressed to higher years (B=-0.172, p=0.016). Course Relationship: A strong positive correlation was found between the two courses (r=0.818, p<0.001), but the effect size was minimal (η²=0.008). Conclusion The above-average student satisfaction reflects the quality of the curriculum content and the effectiveness of teaching methodologies. The decline in satisfaction with internal medicine courses as students progress may be due to course difficulty and resource limitations. The weak correlation between the two subjects suggests the need for further development of integrated learning.

Radon is a radioactive gas that has no smell, colour or taste. Radon is produced from the natural radioactive decay of uranium, which is found in all rocks and soils. Radon can also be found in water. Outdoors, radon quickly dilutes to very low concentrations and is generally not a problem. The average outdoor radon level varies from 5 Bq/m³ to 15 Bq/m³. However, radon concentrations are higher indoors and in areas with minimal ventilation, with highest levels found in places like mines, caves and water treatment facilities. In buildings such as homes, schools, offices, radon levels can vary substantially from 10 Bq/m³ to more than 10 000 Bq/m³.
The effects of residential radon on human health have been studied worldwide since the 1980s. In addition, studies conducted in Europe, North America, and China have proven that even radon levels in dwellings below the acceptable level can pose long-term risks to residents health and contribute to the development of lung cancer. Relying upon the average level of radon and the prevalence of cigarette smoking in the country, radon causes 3-14% of the total incidence of lung cancer. An increase of 100 Bq/m 3 in long time average radon concentration increases the risk of lung cancer by approximately 16%, which is considered that there is a linear relationship between radon concentration and lung cancer.

BACKGROUND: According to International osteoporosis foundation report, osteoporosis is a multifactorial condition associated with an increased risk of fracture and is caused by social, behavioral and physiological factors. Overall incidence is increasing in every country due to people’s life style changes, diet and increased life expectancy. OBJECTIVES: To evaluate the some hormonal effects in bone mineral density among Mongolian population. METHODS: Bone density was measured in the distal one third of radius using the Sunlight Omnisense (Sunlight Medical, Rehovot, Israel) and classified into 3 groups according to WHO osteoporosis criteria. Normal participants were selected into control group and osteoporotic participants were selected into control group. We have evaluated PTH, calcitonin, 25-hydroxy vitamin D in case-control group. RESULT: The prevalence of osteoporosis was 25.7% and 25.3% of participants were osteopenic. It was clear that PTH elevated group (>30.3pg/ml) had more risk of osteoporosis. CONCLUSION: The prevalence of osteoporosis was 25.7% and 25.3% of participants were osteopenic. PTH elevation is risk factor in men.

BACKGROUND Patient safety has become a matter of interest to healthcare professionals, governments and researchers worldwide. During the last decade, many studies have been conducted to assess the prevalence, severity and causes of a large variety of different types of adverse events in hospitals, as well as the effectiveness of various approaches to enhance safety. In Mongolia, it is also an arguable point, mistakes and errors associated with physicians, hospital staffs and healthcare organizations has been occurring frequently in recent years. Our main aim is to find difference between physicians and nurses’ attitude on patient safety culture. METHODS The study included 3 tertiary hospitals from Ulaanbaatar city, Mongolia with a total of 122 respondents; all hospital staff. The Hospital Survey on Patient Safety Culture (HSOPSC) Questionnaire from AHRQ (Agency for Healthcare Research and Quality) was used. AHRQ methods, Pearson’s Chi-squared test, pairwise proportion test (p≤ 0,05) were used for statistical analysis. RESULTS Patient safety in hospitals was evaluated as positive by 62.3% of healthcare workers. The highest scores were obtained in specific dimensions as teamwork within unit (77.3%), unit’s team learning from occurred adverse events (71%). Per our survey, health care workers considered non-punitive response to error (20.6%) and communication openness (27.7%) as being weak areas. In surveyed hospitals, physicians and nurses had a significantly different outlook at communication, adverse events reporting and management support. Physicians reported fewer errors than nurses. CONCLUSION Doctors rated safety culture less positively than nurses in some dimensions of patient safety culture- feedback and communication about error, transition and handoffs, management support for patient safety and teamwork across units. This result could indicate a need for more intensive interventions in certain areas of patient safety culture and is certainly an area for future research inquiry.

BACKGROUND The study was based on the facts that high patient satisfaction and good health indicators are common in countries where quality of nursing care and organization has reached high level and skill level of these professionals is the main factor for the improvement of health care service quality. OBJECTIVE Evaluate practical skill levels of nurses who are responsible for pre- and post-operative care in the National First Central Hospital (NFCH). METHOD Using cross-sectional design, we have conducted 120 questions questionnaire, which was developed by Canadian Nursing Association and Kwantlen Polytechnic University in 2008, to determine 4 levels of skill (never done – did independently) among 41 nurses who work in the Department of Surgery of NFCH. Data was analyzed using social studies statistics software SPSS 21. RESULT Average age and average work years of the 41 nurses who work in the Department of Surgery were 29.9±8.6 and 7.7±9.1, respectively. In terms of specialty, 4 were anesthesiology and intensive care nurse (9.8%) and 17 were surgical nurse (41.5%) while almost half of them (20, 48.8%) did not have specialty certification. During the evaluation of practical skill levels of participants in regards to pre- and post-operative care, for checking readiness of respiratory apparatus, there were 9 (22%) nurses who had never done it, 11 (27%) nurses who did it with assistance, 9 (22%) nurses who did it under guidance, and 12 (29%) nurses who did it independently, for checking neurologic function, there were 4 (11%) nurses who had never done it, 3 (7%) nurses who did it with assistance, 7 (17%) nurses who did it under guidance, and 27 (65%) nurses who did it independently, for operation wound care, there were 5 (12%) nurses who had never done it, 2 (5%) nurses who did it with assistance, 11 (27%) nurses who did it under guidance, and 23 (56%) nurses who did it independently, for using nasal and tracheal intubation, there were 10 (24%) nurses who had never done it, 4 (10%) nurses who did it with assistance, 10 (24%) nurses who did it under guidance, and 17 (42%) nurses who did it independently. There was correlation between average work years and skill level (p<0.001). CONCLUSION Varying skill levels (never done it 17.25%, with assistance 12.25%, under guidance 22.5%, and independently 48%) of surgical nurses who are responsible for pre- and post-operative care show that there is a need for improving practical skills of nurses in the Department of Surgery of NFCH.

Osteoporosis is a disease in which the density of bone is decreased with consequent increase in bone fragility and susceptibility to fracture risk. Vitamin D deficiency may cause secondary hyperparathyroidism and low bone mineral density. Our study was aimed to assess relation between vitamin D status and parathyroid hormone and bone density in adults. Relatively healthy 369 participants aged between 20-60 were randomly selected from Ulaanbaatar city. Specially designed questionnaire was used in the survey. Bone mass density was diagnosed according to the WHO criteria by the T-score. Respondents serum calcium and phosphorus levels were described by the fully automated analyzer (Cobas Integra 2800, Germany). Serum parathyroid hormone and 25-hydroxivitamin D levels were described by using ELISA kit (Eucardio Laboratory, Inc. USA) at the Molecular biology laboratory of MNUMS.The statistical result was analyzed by SPSS 21 program. The subjects mean age was 47.61±12.92, with a range of 20-83. The mean T-score was -0.60±2.17. Our study showed that negative correlation between bone mass density values at parathyroid hormone (r=-0.58, p<0.05), 25-hydroxyvitamin D (r=-0.48, p<0.05) and serum calcium (r=-0.21, p<0.05). Our study showed increased serum parathyroid hormone led the releasing calcium from bone and decreasing bone mass density.