Objective To study the current situation of doctor-patient communication education for medical undergraduates, and meanwhile to analyze the students’ satisfactory degree to communication education and its influencing factors, so as to provide sound suggestions to promote the students’ clinical communication abilities. Methods Using simple sampling, 50% of the students who majored in clinical medicine in grade 2006-2009 in West China Medical School of Sichuan University were selected as respondents. The investigation was conducted by face to face talk with a self-designed questionnaire. The data were input using EpiData 3.0 software and the results were analyzed by SPSS 13.0 software. Results A total of 450 questionnaires were distributed, and 404 were validly retrieved (89.78%). Among the respondents, 74.3% of them were satisfied with the current situation of doctor-patient communication education; 75.7% of them begun to know doctor-patient communication education since the stage of learning basic knowledge; 49.8% of them were trained by means of problem-based-learning (PBL); and 65.5% of them were trained with auxiliary standardized patient (SP). “Grade”, “Gender”, “SP used” and “PBL used” were the main factors affecting the satisfactory degree to current doctor-patient communication education (P=0.029, 0.023, 0.012, and 0.029, respectively). Conclusion The medical undergraduates’ satisfactory degree to current doctor-patient communication education is generally high, but it is also affected by various factors. Although doctor-patient communication education has started early, the training system is still problematic and the teaching resources coverage is limited. So in order to make a further systematic, standardized, overall designed education for students’ cognition and communication skills, the medical colleges should open integrated doctor-patient communication curriculum that combines with both PBL and SP auxiliary teaching methods, and covers all the undergraduate learning stage.
Objective To get known the existing problems in rural primary physicians training in Gansu province, so as to explore an appropriate training mode for Gansu province. Methods This study conducted a comprehensive analysis by combining literature analysis, on-site survey and interview. Such databases as CNKI, VIP and CBM were searched to include literature published before November 2011, and the references of the included literature were also retrieved. The qualitative analysis was performed after assessing the methodological quality of the included literature according to self-designed criteria. Additionally, the rural primary hospitals in Gansu province were classified according to their geographical position and economic development level, total 10 township hospitals were randomly selected by cluster sampling, and the following stuffs participated various trainings in past 3 years were on-site-investigated: clinical doctors, nurses, medical technicians, and medical administrators, in aspects of training time, place, contents, modes, and effects. Results The existing problems in primary physicians training modes in Gansu were as follows: uneven training levels, lack of targeted contents, neglect of skill training and process management, and absence of quality assessment of training processes and effects. Conclusion The training modes require that: a) specific plans and schemes; b) unified organization to integrate educational resources effectively; c) reasonable arrangement of implementation process, and d) innovation of training methods and contents to fully play the role of general hospitals and universities; and well control and feedback to promote the integration and perfection of training modes.
Objective To investigate the patient’s psychological anticipation and occurrence of chemotherapy-induced nausea and vomiting (CINV), and to assess the influence of CINV on quality of life, so as to provide evidence for clinical doctors to recognize and pay attention to CINV. Methods The patients in the Tongji Hospital affiliated to Tongji Medical College of Huazhong University of Science and Technology who took either moderately emetogenic chemotherapy (MEC) or highly emetogenic chemotherapy (HEC) were randomly sampled with a questionnaire for two circles. Patients were asked to record the following indexes before chemotherapy, on the second day and the sixth day of chemotherapy: acute and delayed nausea and vomiting, independently taking antiemetics, and functional living index-emesis (FLIE). Then, descriptive analysis and multiple linear regression analysis were adopted for the outcomes of investigation. Results A total of 344 patients were investigated, of which 303 fulfilled the questionnaire finally. For the single-day chemotherapy, the acute nausea and vomiting, delayed nausea vomiting and overall complete remission in the MEC group were 86.1%, 76.6%, and 71.5%, respectively; while those of the HEC group were 84.1%, 71.0%, and 66.7%, respectively. For the multi-day chemotherapy, the acute nausea and vomiting, delayed nausea vomiting and overall complete remission were 93.8%, 64.9%, and 64.9%, respectively. Patients’ expectation of nausea and anticipatory anxiety was closely related to the delayed nausea in their prior circle of chemotherapy. Based on the FLIE assessment, about 30% of all patients reported reduced daily living function. Conclusion CINV remains a significant problem among patients in China, especially in controlling the reaction during delayed phase and nausea as well. It requires that more attention should be paid to CINV and more effective prophylaxis should be adopted in clinical practice.
Objective To investigate infertile inpatients hospitalized in Pingjin Hospital in Tianjin from 2008 to 2010, so as to provide baseline data for further research. Methods According to diagnosis criteria of WHO, we collected demographical characteristics, disease cause and cost constitution of infertility inpatients hospitalized in Pingjin Hospital in Tianjin from 2008 to 2010. The data of each patient were input into ACCESS database and SPSS 13.0 was used for statistical analysis. Results a) From 2008 to 2010, there were 1 452 infertile patients from 33 different areas of mainland China, 79.7% of which was from the north of China. b) The mean age was 31.2±4.3 years old. The percentage of patients aged 30 to 34 years accounted for the most (40.3%). Mental laborers (23.3%) were more than physical laborers (7.2%). 36.7% of patients received education from universities and 83.1% of patients had family income ranging from 20,000 yuan to 190,000 yuan. c) The mean age of the first sexual activity was 21.4±2.9 years old. 53.7% of patients had only one sexual partner and most couples had sexual activities twice every week. The mean age of husbands was 32.9±5.5 years old with the highest percentage of 30 to 35 years old (39.2%). The percent of intellectual work of husband was the highest (35.9%). 64.9% of patients had normal semen analysis results and 23.0% never took related examination. d) 29.9% of patients was primary infertility and 70.1% was secondary infertility, of which 57.6% had either induced or medical abortion. The mean duration of infertility was 5.2±3.5 years (range 1 to 21 year). e) 76.3% of infertile patients had pelvic adhesion and 88.6% suffered from tubal disease. Among the tubal infertile patients, 23.6% had uterine disease, 5.2% had ovarian disease, 5.0% had endometriosis, 6.7% had multiple problems, and 4.8% had unexplained infertility. In patients with tubal infertility, the incidence of distal fimbria atresia (45.8%) was higher than that of proximal block (32.9%). 24.7% of patients with fimbria atresia had hydrosalpinx and among of them, 21.1% had no hydrosalpinx. 15.2% had congenital tubal defects. f) The average hospital stay was 10.5 days and the cost was 14 253.3 yuan per person. The percentage of material cost was 29.1% and that of drugs was 18.2%. Conclusion a) The total number of infertile inpatients was 1 452 in gynecology department of Pingjin Hospital of Tianjin from 2008 to 2010. 79.7% of patient was from North China. Most of them were 30 to 34 years old and 44.3% had no job. The percentage of patients had university education and that of low-middle family income was the highest. Sexual activity was relatively traditional. Most husbands were 30 to 35 years old and intellectual workers, and 23.0% of them had never taken an examination of semen analysis. More patients were secondary infertile, and the duration of infertility was 1 to 21 years. b) 76.3% of patients had pelvic adhesion and 88.6% had tubal disease. The incidence of distal tubal fimbria atresia was higher than proximal tubal occlusion. c) The average hospital stay was 10.5 days and the cost was 14 253.3 yuan per person which was further lower than each cycle cost of assisted reproductive technology. The overall costs included materials and drugs (47.3%), which were mainly at patients’ own expense.
Objective To investigate the students’ satisfaction on teaching content, teaching staff, organizations etc. of the evidence-based medical postgraduate summer school, so as to provide references for further effective training. Methods A self-made questionnaire with cluster sampling was used to investigate the regular students who had participated in the whole course of the evidence-based medical postgraduate summer school, and the feedbacks were analyzed. Results The total number of the questionnaires was 112 and the number of the effective questionnaires was 101; the effective recovery rate was 90.2%. The students were from 32 universities and medical institutions involving 36 disciplines in 26 provinces. A total of 93.1% of the students were satisfied with the general training organization and management, but the satisfaction rates of the class environment and the time arrangement were only 51.5% and 58.4%, respectively. The satisfaction rates of the whole course setting and the teaching materials were 84.2% and 90.1%, respectively. The satisfaction rate of the teaching content of “the progress of the evidence-based medicine” was up to 93.0%. Over 93.1% of the students believed that the teachers were great in teaching skills, but only 73.3% of the students thought that the interaction between teachers and students was plenty. Conclusion This summer school has active students, a great effect and a high overall satisfaction rate. The summer school is beneficial to the cultivation of innovative postgraduates, construction of excellent teaching teams, development of evidence-based medicine discipline and building of The Network Center for Evidence-Based Medicine Education. The satisfaction rate of the summer school training can get promoted by increasing schooling investments, appropriately prolonging training time, setting different subjects in different semesters and enhancing the teaching interaction.
Objective To explore the effects of evidence-based medicine (EBM) course on improvement of information consciousness and information morality for medical students.Methods A total of 288 medical undergraduates and postgraduates, who took EBM as an elective course in Sichuan University, were surveyed with ‘information consciousness and information morality questionnaire’ before and after that course. Results After the EBM course, the number of students surfing the Internet increased by 5%, of which postgraduates increased by 24% with significant differences (Plt;0.05), while their purpose for specialized knowledge increased by 7%; the number of students making plans in advance increased by 7%, and the number of students learning intellectual property and copyright law increased by 7%; the number of postgraduates knowing how to cite articles increased by 12% with significant differences (Plt;0.05); and the number of students not knowing how to get legitimate information decreased by 12% with significant differences (Plt;0.05). Conclusion Evidence-based medicine course is positive for the information consciousness and information morality of medical students.
Objective To investigate the satisfaction of participants in Wenjiang District of Chengdu regarding the New-style Rural Cooperative Medical Care (NRCMC), and to analyse its factors in order to help the decision makers optimize and improve the scheme in the future.Methods Three towns of Wenjiang District were selected for study by computer simple random sampling. Five percent of NRCMC participants were randomly selected in Wenjiang for a face-to-face interview using a questionnaire. Data entry and statistical analysis were completed by Epidata 3.0 and SPSS 11.5 respectively. Results A total of 2500 questionnaires were conducted for face-to-face interviews, and 2438 questionnaires were returned (response rate 97.6%); 58% participants were satisfied with NRCMC, and the results of stepwise multiple logistic regression analysis indicated that their desire to participation (partial regression coefficient B=-3.54, P=0.014) and the satisfaction with the present compensation proportion (partial regression coefficient B=-4.62, P=0.018) were the most important factors that influenced the total satisfaction with NRCMC.Conclusion It is of great significance to strengthen the promotion of NRCMC; reasonably establish the compensation mode and proportion; encourge voluntary participation for the sake of their benefits to improve the quality and performance of NRCMC.
Objective To investigate the situation and problems of medical evidence-based medicine （EBM） teaching in China. Methods One hundred and four participants from different hospitals or universities of China in 2005 “Evidence-Based Medicine Teachers Advanced Training Workshop Ⅱ of Ministry of Education” were investigated. A selfcomplete questionnaire on EBM teaching was given at the registration. Results Seventy five questionaires from responders who came from 50 medical institutions of 18 provinces and 25 cities were available for analysis, representing a response rate of 72%. The average age of responders were 38 years old, and 61.3% were graduates. And 14 hospitals or universities have given EBM courses. Namely, for the postgraduates in 9 universities, undergraduates in 2 universities, physicians, nurses and medical managers in 2 hospitals. The lectures lasted from 8 to 36 hours in different units. Di~culties were：lack of EBM teachers, and better understanding the concept and approach of EBM, less paid attention by policy makers, and too busy in specialty. Conclusion EBM teaching is blooming in medical universities in China. It is needed for us to train high qualified EBM teachers.
Objective To investigate the current leadership status of public hospital pharmacies, and to provide evidence and suggestions for further improving the performance of public hospital pharmacies. Methods According to our conception of the key characteristics of leadership, we designed a questionnaire to investigate leadership practices among 306 managers and pharmacists working in 74 public hospital pharmacies. We used percentage and proportion for statistical description. Results (1) Over 70% of participants thought that public pharmacies lacked independent decisiveness; power was distributed; and elections were democratic. (2) Nearly 60% thought that public pharmacies lacked effective communication and awareness of service. (3) Nearly 70% thought that leader’s abilities were not exceptional. (4)There were not obvious advantages or disadvantages among the leaders. (5) Half trusted the leaders and thought there should be no change. Conclusion Public hospitals should grant more power to pharmacies to implement effective leadership.
Objective To learn and analyse the current clinicians’ knowledge and attitudes towards patient safety, and to provide relevant evidence for future medical education. Method We conducted a survey on clinicians mainly in West China Hospital of Sichuan University with group random sampling method. We analysed the data on the clinicians’ knowledge and attitudes with SPSS softerware. Result Totally 300 questionnaires were distributed, of which 258 were completed adequately. The results showed the clinicians’ knowledge on patient safety was poor, however, the respcnse from the clinicians in Outpatient Department were better than those in Inpatient Department. The majority of the clinicians (above 95.00%) were willing to learn the knowledge of patient safety. Conclusion As the clinicians are willing to learn the knowledge of patient safety positively, it is necessary to integrate patient safety education into the current medical education curriculum.