BACKGROUND: Regional disparities in the working conditions of medical doctors have not been fully assessed in Japan. We aimed to clarify these differences in hospital characteristics: doctors' workload, wages, and popularity among medical students by city population sizes. METHODS: We targeted 423 teaching hospitals certified by the Japanese Society of Internal Medicine and assessed the working conditions of physicians specializing in internal medicine. We calculated their workload (the annual number of discharged patients per physician) and retrieved data on junior residents' monthly wages from the Resinavi Book which is popular among medical students in Japan to know the teaching hospital's information and each hospital's website. Furthermore, we explored the interim matching rate of each hospital as its popularity among medical students. Next, we classified cities in which all hospitals were located into eight groups based on their population size and compared the characteristics of these hospitals using a one-way analysis of variance. RESULTS: The average workload was 110.3, while the average workload in hospitals located in most populated cities (≥ 2,000,000) was 88.4 (p < 0.05). The average monthly wage was 351,199 Japanese yen, while that in most populated cities was 305,635.1 Japanese yen. The average popularity (matching rate) was 101.9%, and the rate in most populated areas was 142.7%, which was significantly higher than in other areas. CONCLUSIONS Hospitals in most populated areas had significantly lower workloads and wages; however, they were more popular among medical students than those in other areas. This study was the first to quantify the regional disparities in physicians' working conditions in Japan, and such disparities need to be corrected.
Cities/statistics & numerical data* ; Geography ; Hospitals, Teaching/statistics & numerical data* ; Japan ; Physicians/statistics & numerical data* ; Population Density ; Salaries and Fringe Benefits/statistics & numerical data* ; Students, Medical/psychology* ; Workload/statistics & numerical data*

BACKGROUND: The objectives of this study are to investigate the incidence and reporting behavior of sharp injuries among healthcare workers (HCWs) and identify the risk factors associated with these injuries. METHODS: A cross-sectional survey was conducted in February 2017 in a provincial teaching hospital in China. Data were collected from 901 HCWs using a self-administered questionnaire which included demographic information, experience, and reporting behavior of sharp injuries. Stepwise logistical regression was used to analyze the risk factors. RESULTS: HCWs (248 [27.5%]) had sustained a sharp injury in the previous year. Factors including seniority, job category, title, education, department, and training programs were associated with the occurrence of sharp injuries. According to the stepwise logistical regression, seniority, and training programs were the risk factors associated with the occurrence of sharp injuries. Of 248 sharp injuries, 130 HCWs were exposed to blood. Only 44 (33.9%) HCWs reported their injuries to the concerned body. The main reasons for not reporting the sharp injuries were as follows: perception that the extent of the injury was light (30.2%), having antibodies (27.9%), and unaware of injury (16.3%). CONCLUSIONS Sharp injuries in the studied hospital were common and were likely to be underreported. Therefore, an effective reporting system and sufficient education on occupational safety should be implemented by the relevant institutions. Moreover, it is important to take effective measures to manage sharp injuries in HCWs and provide guidance for their prevention.
Adult ; China ; epidemiology ; Cross-Sectional Studies ; Female ; Health Personnel ; statistics & numerical data ; Hospitals, Teaching ; Humans ; Incidence ; Male ; Needlestick Injuries ; epidemiology ; etiology ; psychology ; Occupational Exposure ; statistics & numerical data ; Risk Factors

PURPOSE: This study identifies challenges to the first nurse training program for undergraduate nursing students at a nursing and midwifery school in Iran using a collaborative approach in order to improve the program. METHODS: Action research was used as a research strategy with qualitative content analysis and quantitative evaluation. The participants were 148 individuals from nursing academic and clinical settings, including administrators, faculty members, students, and staff nurses. We obtained approval from the research deputy and ethics committee of Shahid Beheshti University of Medical Sciences in Tehran, Iran for this study. RESULTS: Lack of coherence in the educational program and implementation of the program, inadequate communication between management inside and outside the organization, insufficient understanding of situations by students, and improper control of inhibitors and use of facilitators in teaching and in practice were among the major challenges in the first training process in the context of this study. After classification of problems, the educational decision-making authorities of the school developed an operational program with stakeholder cooperation to plan initial reforms, implementation of reforms, reflection about the actions, and evaluation. Comparison of student satisfaction with the collaborative learning process versus the traditional method showed that except for the atmosphere in the clinical learning environment (p > .05), the mean differences for all dimensions were statistically significant. CONCLUSIONS: The results confirm the overall success of the revised partnership program, but stressed the need for further modification of some details for its implementation in future rounds.
Attitude of Health Personnel ; Education, Nursing/*organization & administration ; Educational Measurement/methods ; Health Services Research/organization & administration ; Humans ; Iran ; Midwifery/*education ; Nurse's Role ; Nursing Education Research/organization & administration ; Personal Satisfaction ; Reproducibility of Results ; Students, Nursing/psychology ; Teaching ; Trust

PURPOSE: No study had been conducted to assess the hospitals' environment for learning purposes in multicenter sites in Saudi Arabia. It aims to evaluate the environment of hospitals for learning purposes of pediatric residents. METHODS: We applied Postgraduate Hospital Educational Environment Measure (PHEEM) to measure the learning environment at six teaching hospitals in the Eastern Region of Saudi Arabia from September to December 2013. RESULTS: The number of respondents was 104 (86.7%) out of 120 residents and 37 females and 67 male residents have responded. The residents' response scored 100 out of 160 maximum score in rating of PHEEM that showed overall learning environment is favorable for training. There were some items in the social support domain suggesting improvements. There was no significant difference between male and female residents. There was a difference among the participant teaching hospitals (p<0.05). CONCLUSION: The result pointed an overall positive rating. Individual item scores suggested that their social life during residency could be uninspiring. They have the low satisfactory level and they feel racism, and sexual discrimination. Therefore, there is still a room for improvement.
Surveys and Questionnaires ; Discrimination (Psychology) ; Female ; Hospitals, Teaching ; Humans ; Internship and Residency* ; Learning ; Male ; Pediatrics ; Racism ; Saudi Arabia*

PURPOSE: The purpose of this study was to evaluate the effects of a risk factoretailored small group education on anxiety and depressive symptoms, self-efficacy and self-care compliance in patients with first-time acute coronary syndrome (ACS) for 12-month follow-up. METHODS: A quasi-experimental pretest and post-test design was used. Patients were recruited from a national university hospital from 2010 to 2011 in Korea. The group education consisted of a 60-minute long video developed using multimedia contents including voice-recorded texts, flash animation, and video clips, with nurses' dialogue. The intervention group (n = 34) participated in group education using the multimedia video in a small group of patients with similar risk factors, and received periodic telephone counseling and text messages. The control group (n = 40) received usual care and counseling upon request. RESULTS: Depressive symptoms decreased, and self-efficacy and self-care compliance in the areas of medication, exercise, and healthy diet practice significantly increased in patients in the intervention group, compared with those in the control group. CONCLUSIONS: Risk factoretailored small group education and periodic text message were an effective strategy for decreasing depression, and increasing self-efficacy and long-term compliance with lifestyle changes in patients with first-time ACS. We suggested that risk factoretailored small group education need to be given for first-time ACS patients for psychological support and behavioral change in clinical practice. It is also comparable to individual approach to encourage psychological and behavioral change.
Acute Coronary Syndrome/*nursing/*psychology ; Adaptation, Psychological ; Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; *Multimedia ; *Patient Education as Topic ; Patient-Centered Care/methods ; Republic of Korea ; Risk Factors ; Self Care/*methods ; Self Efficacy ; Stress, Psychological/*nursing ; Teaching/*methods

No abstract available.
Faculty/*psychology ; Humans ; *Motivation ; Teaching/*psychology

In order to improve teaching lever and explore teaching approach, the feasibility study on the combination of the problembased learning method CPBL) and the lecture-based learning method (LBL) was conducted in the teaching of Acupuncture and Moxibustion. The 2010 undergraduates in the major of clinical integrated Chinese and western medicine of five years were randomized into a PBL and LBL group and a LEL group. In the first semester, according to the basic teaching requirement, LBL was used to accomplish the teaching of basic theory. In the internship teaching section, the different teaching method was applied. In the PBL and LEL group, PEL was used, and in the LBL group, LBL was given. At the end of semester, the examination results of the theory learning and medical cases learning were evaluated. The questionnaire was summarized in the teachers and students. The final examination result of theory learning was not different significantly between the two groups (P >0. 05), but the result of medical cases learning in the PEL and LEL group was better than that in LEL group (84. 47±10. 72 vs 76. 00±9. 97, P<0. 05). The questionnaire for the students and teachers indicated that the result of PEL and LEL combined method was higher than that of LEL method (86. 27±8. 36 vs 56. 00±14. 59, P< 0. 01; 45. 89±3. 68 vs 36. 61±6. 41, P<0. 0l), indicating that the combined method of PBL and LEL is feasible in teaching of Acupuncture and Moxibustion and the teaching outcome is superior to the simple LBL, which provides the new approach to the teaching reform.
Acupuncture ; education ; Acupuncture Therapy ; methods ; Adolescent ; Education, Medical ; Faculty ; Female ; Humans ; Male ; Moxibustion ; methods ; Problem-Based Learning ; Students, Medical ; psychology ; Surveys and Questionnaires ; Teaching ; methods ; Young Adult

The General Medical Council encourages the integration of complementary and alternative medicine (CAM) teaching into basic medical education. We wished to explore the attitudes of medical students to CAM and its inclusion in their undergraduate curriculum. Medical students were invited to complete the validated Integrative Medicine Attitude Questionnaire (IMAQ) and to state whether they considered it appropriate for them to learn about CAM in medical school. The questionnaire was completed by 308 students (65.8% response rate). CAM had been received by a majority of respondents and their families. Participants believed that doctors with knowledge of CAM provide better patient care and that it is desirable for physicians to exploit the placebo effect. Most students expressed the view that doctors should be able to answer patients' questions about herbal medicines. There was a belief that patients should be warned to avoid using supplements which have not undergone rigorous testing. Students who were current or previous users of CAM or whose family members used CAM had higher total IMAQ scores and openness subscale scores than those who did not report use of CAM. Two-hundred and nine (68%) students expressed a desire to study CAM as part of their medical curriculum. This study reveals a positive attitude towards a holistic approach to patient care which embraces CAM. Medical students believe that integrative medicine should be taught in medical school.
Attitude of Health Personnel ; Complementary Therapies ; education ; Female ; Humans ; Integrative Medicine ; education ; Male ; Students, Medical ; psychology ; Surveys and Questionnaires ; Teaching

We attempted to investigate the reason why the students got a worse grade in gross anatomy and the way how we can improve upon the teaching method since there were gaps between teaching and learning under recently changed integration curriculum. General characteristics of students and exploratory factors to testify the validity were compared between year 2011 and 2012. Students were asked to complete a short survey with a Likert scale. The results were as follows: although the percentage of acceptable items was similar between professors, professor C preferred questions with adequate item discrimination and inappropriate item difficulty whereas professor Y preferred adequate item discrimination and appropriate item difficulty with statistical significance (P<0.01). The survey revealed that 26.5% of total students gave up the exam on gross anatomy of professor Y irrespective of years. These results suggested that students were affected by the corrected item difficulty rather than item discrimination in order to obtain academic achievement. Therefore, professors in a team-teaching subject should reach a consensus on an item difficulty with proper teaching methods.
Consensus ; Curriculum ; Discrimination (Psychology) ; Humans ; Learning ; Schools, Medical* ; Self-Assessment* ; Teaching

Biomedical Research ; education ; Career Choice ; Clinical Medicine ; education ; Humans ; Physician's Role ; Physicians ; psychology ; standards ; Professional Competence ; Research Personnel ; psychology ; standards ; Teaching ; Translational Medical Research