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.

Although all the pharmacy programs (1 public and 2 private) in Mongolia comply with the national standard for pharmacy higher education D 723400 (MNS 5323-126: 2012), competence based learning has not been introduced yet. Also, pharmaceutical public health service needs have not been assessed in community pharmacies of Mongolia. Our goal was to assess the learning needs of pharmacists’ public health competencies and link pharmacy education with the health needs of populations.This cross-sectional, in-pharmacy survey was conducted in a simple random sample of community pharmacies in 6 districts of Ulaanbaatar city central region, which provide price discount on selected drugs through national health insurance. The survey was developed with evidence for reliability and validity and focused on two main needs assessment: pharmaceutical public health (PPH) serviceprovision and PPH competencies learning. Open ended and 3 point scale (1=great benefit; 2=some benefit; 3=no benefit) questions were used to obtain: general information, public health service knowledge, and needs of learning PPH competencies. Descriptive statistics and comparisons using STATA 13 were performed.A total of 248 surveys were obtained (pharmacists n=82; customers n=166). Pharmacist knowledge/skills greatly impacted the public’s decision to use expanded services. The customers reported high levels (75.3%) of needs with pharmacists providing advice on health promotion and healthy life style. 47.6% of the pharmacists replied having knowledge on health promotion and disease prevention is a great benefit to their practice.Our findings indicate that the public is very interested in pharmaceutical public health services and believe they will benefit. Also pharmacists need to be trained ecessary competencies.

State that the private sector partnership is a general concept that encompasses formal legal relationships between government entities and the private sector to use private sector resources and expertise to ensure delivery of public services and property. This is because public services to improve the capacity for sustainable use of private sector skills and modernization of technology andfinancial resources, capacity building and increased capacity necessary to wait for the budget cost ofthe current economic situation of our country. Public-private partnership noted that the assessment made by international organizations to take place very effectively in our country. Therefore, the evaluation of the current public-private partnership in the health sector in order toimprove these conditions and to improve the quality and accessibility of care and identify ways of involvement in the implementation of a basis for the work of the study. The purpose of the study is to assess the state of public-private partnership conditions in the Mongolian health sector.We conducted overall 20 focus group interviews with 180 participants, including doctors and health care professionals. 17 out of 20 were from Ulaanbaatar and 3 were out of 20. From them, six interviews in the Aimag’s and district’s Complex Hospital represented for the secondary health care organizations, 8 interviews in the Family Clinic represented for primary health care organizations.3 interviews in the third health care organizations. Also 3 interviews in the private health care organizations.Is not known the advantages of public and private medical practitioners and medical specialists partners and do not have experience in working partner. But running has partnered with medical doctors, specialists increased support service types currently provided as a partnership between the hospital and doctor finds that your experience is improving and increasing the quality of service.For flip side is that partners can expand partnership working poor accountability. Future doctors and medical experts believe is necessary to strengthen the increasing awareness of the Partnership through the provision of secondary education, advocacy and policy.Doctors and medical experts believe that public-private partnerships Mongolian international health industry groups have developed expanding significantly. It believes that the lack of knowledge about the partnership, due to be implemented in a realistic policy document.

Regardless the possession of any graduation and qualifications anywhere in order to train the doctors and medical professionals with the capabilities to work in any places there are the needs of the knowledgeable mentors to teach their knowledge, abilities and trends to the students in national, regional and international levels. This survey was started to determine the needs of the skills development of the mentors of the Mongolian National University of Medical Sciences under the mission to make it as one of the best 100 medical universities in the Asia-Pacific region and in order to create the favorable environment to accelerate the development of the university and creating a team consists from qualified mentors and researchers by improving the trainings, researches and clinical favorable environment including the quality improvement of the activities.The total of 333 mentors from the 5 structures and 3 branches of the Mongolian National University of Medical Sciences were surveyed to be developed by the University of Michigan including the use of the widely used questionnaires in the universities consisting from 7 groups and 81 questions to determine the needs of the mentors.The working range of the best medical mentors including their needs of the skills was studied. The 55.7% (50.4-61.0%) of the mentors included in the survey were told that the facilitation of the learning needed, 82.4% (78.3-86.5%) as the role models needed, 79.9% (75.6-84.2%) as the provision of the information is needed, 76.3% (71.7-80.9%) as 82.8% (78.8-86.9%) as the planning needed and 81.0% (76.8-85.2%) as the assessment of the training is needed.There is a need to develop the skills related to the 6 frameworks as the learning facilitation for the mentors, role model providers, information providers, resource developers, planners and assessors.