scholarly journals Primary care workforce and continuous medical education in China: lessons to learn from a nationwide cross-sectional survey

BMJ Open ◽  
2017 ◽  
Vol 7 (7) ◽  
pp. e015145 ◽  
Author(s):  
William C W Wong ◽  
ShanZhu Zhu ◽  
Jason J Ong ◽  
MingHui Peng ◽  
Cindy L K Lam ◽  
...  
Keyword(s):  
Primary Care ◽  
Medical Education ◽  
Continuous Medical Education ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Primary Care Workforce ◽  
Education In China

What do Tunisian General Practitioners Know About Insomnia?

2017 ◽  
Vol 41 (S1) ◽  
pp. S289-S289
Author(s):  
K. Yaich ◽  
M. Maalej Bouali ◽  
N. Charfi ◽  
W. Sellami ◽  
N. Zouari ◽  
...  
Keyword(s):  
Medical Education ◽  
General Practitioners ◽  
Demographic Data ◽  
Continuous Medical Education ◽  
Economic Consequences ◽  
Theoretical Knowledge ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Competing Interest ◽  
Individual Training

IntroductionInsomnia is the most prevalent sleep disorders and affects 10% of adults worldwide. It has major social and economic consequences. The aim of our study was to evaluate the knowledge of Tunisian general practitioners (GPs) about insomnia.MethodsA cross-sectional survey was carried out during the month of May 2016. Among the 193 GPs randomly selected from different areas of Sfax, in Tunisia, 127 participated to the study. The latter filled a questionnaire including items related to socio-demographic data and clinical features of insomnia.ResultsAmong our participants, 58.3% (n = 74) were men and 41.7% (n = 53) women. The average age was 47.91 ± 10.1 years. They have been working for 17.36 ± 10.7 years on average. Seventy-six of GPs had an individual training and a training by attending conferences or by continuous medical education. Most participants (80.3%) thought that they had some lacuna in the management of insomnia. Specific recommendations for the management and treatment of insomnia were known by 7.2% of the GPs. As for theoretical knowledge about insomnia, 74.8% of participants (n = 95) had a high score of correct answers. The latter was correlated to age (P = 0.013) and to the male gender (P = 0.008). However, it was neither correlated to the seniority of the GPs (P = 0.051) nor to the knowledge of specific recommendations for the management of insomnia (P = 0.11).ConclusionOur results showed that the GPs had a rather good theoretical knowledge about insomnia. Yet, an improvement of the continuous medical education and a better knowledge of specific recommendations for the management of insomnia are needed.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Prepared and highly committed despite the risk of COVID-19 infection: a cross-sectional survey of primary care physicians’ concerns and coping strategies in Singapore

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Jerrald Lau ◽  
David Hsien-Yung Tan ◽  
Gretel Jianlin Wong ◽  
Yii-Jen Lew ◽  
Ying-Xian Chua ◽  
...  
Keyword(s):  
Primary Care ◽  
Coping Strategies ◽  
Stress Management ◽  
Primary Care Physicians ◽  
Well Being ◽  
Pandemic Preparedness ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Accessible Information ◽  
And Coping

Abstract Background Primary care physicians (PCPs) are first points-of-contact between suspected cases and the healthcare system in the current COVID-19 pandemic. This study examines PCPs’ concerns, impact on personal lives and work, and level of pandemic preparedness in the context of COVID-19 in Singapore. We also examine factors and coping strategies that PCPs have used to manage stress during the outbreak. Methods Two hundred and sixteen PCPs actively practicing in either a public or private clinic were cluster sampled via email invitation from three primary care organizations in Singapore from 6th to 29th March 2020. Participants completed a cross-sectional online questionnaire consisting of items on work- and non-work-related concerns, impact on personal and work life, perceived pandemic preparedness, stress-reduction factors, and personal coping strategies related to COVID-19. Results A total of 158 questionnaires were usable for analyses. PCPs perceived themselves to be at high risk of COVID-19 infection (89.9%), and a source of risk (74.7%) and concern (71.5%) to loved ones. PCPs reported acceptance of these risks (91.1%) and the need to care for COVID-19 patients (85.4%). Overall perceived pandemic preparedness was extremely high (75.9 to 89.9%). PCPs prioritized availability of personal protective equipment, strict infection prevention guidelines, accessible information about COVID-19, and well-being of their colleagues and family as the most effective stress management factors. Conclusions PCPs continue to serve willingly on the frontlines of this pandemic despite the high perception of risk to themselves and loved ones. Healthcare organizations should continue to support PCPs by managing both their psychosocial (e.g. stress management) and professional (e.g. pandemic preparedness) needs.

Current Models for Inpatient and Emergency Room Ophthalmology Consultation in U.S. Residency Programs

2020 ◽  
Vol 12 (02) ◽  
pp. e171-e174
Author(s):  
Donna H. Kim ◽  
Dongseok Choi ◽  
Thomas S. Hwang
Keyword(s):  
Emergency Department ◽  
Medical Education ◽  
Emergency Room ◽  
Program Directors ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Direct Supervision ◽  
Residency Programs ◽  
Residency Program Directors ◽  
Competency Assessments

Abstract Objective This article examines models of patient care and supervision for hospital-based ophthalmology consultation in teaching institutions. Design This is a cross-sectional survey. Methods An anonymous survey was distributed to residency program directors at 119 Accreditation Council for Graduated Medical Education accredited U.S. ophthalmology programs in the spring of 2018. Survey questions covered consult volume, rotational schedules of staffing providers, methods of supervision (direct vs. indirect), and utilization of consult-dedicated didactics and resident competency assessments. Results Of the 119 program directors, 48 (41%) completed the survey. Programs most frequently reported receiving 4 to 6 consults per day from the emergency department (27, 55.1%) and 4 to 6 consults per day from inpatient services (26, 53.1%). Forty-seven percent of programs reported that postgraduate year one (PGY-1) or PGY-2 residents on a dedicated consult rotation initially evaluate patients. Supervising faculty backgrounds included neuro-ophthalmology, cornea, comprehensive, or a designated chief of service. Staffing responsibility is typically shared by multiple faculty on a daily or weekly rotation. Direct supervision was provided for fewer of emergency room consults (1–30%) than for inpatient consults (71–99%). The majority of programs reported no dedicated didactics for consultation activities (27, 55.1%) or formal assessment for proficiency (33, 67.4%) prior to the initiation of call-related activities without direct supervision. Billing submission for consults was inconsistent and many consults may go financially uncompensated (18, 36.7%). Conclusion The majority of hospital-based ophthalmic consultation at academic centers is provided by a rotating pool of physicians supervising a lower level resident. Few programs validate increased levels of graduated independence using specific assessments.

scholarly journals Impact of conflict on medical education: a cross-sectional survey of students and institutions in Iraq

BMJ Open ◽  
2016 ◽  
Vol 6 (2) ◽  
pp. e010460 ◽  
Author(s):  
Ashton Barnett-Vanes ◽  
Sondus Hassounah ◽  
Marwan Shawki ◽  
Omar Abdulkadir Ismail ◽  
Chi Fung ◽  
...  
Keyword(s):  
Medical Education ◽  
Cross Sectional Survey ◽  
Cross Sectional

scholarly journals Exploring the global impact of the COVID-19 pandemic on medical education: an international cross-sectional study of medical learners

2021 ◽  
Author(s):  
Allison Brown ◽  
Aliya Kassam ◽  
Mike Paget ◽  
Kenneth Blades ◽  
Megan Mercia ◽  
...  
Keyword(s):  
Medical Education ◽  
Medical Training ◽  
Well Being ◽  
World Health ◽  
Future Research ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
The World ◽  
Geographic Regions ◽  
The Impact

Background: The evidence surrounding the impact of COVID-19 on medical learners remains anecdotal and highly speculative despite the anticipated impact and potential consequences of the current pandemic on medical training. The purpose of this study was to explore the extent that COVID-19 initially impacted medical learners around the world and examine global trends and patterns across geographic regions and levels of training. Methods: A cross-sectional survey of medical learners was conducted between March 25–June 14, 2020, shortly after the World Health Organization declared COVID-19 a pandemic. Results: 6492 learners completed the survey from 140 countries. Most medical schools removed learners from the clinical environment and adopted online learning, but students reported concerns about the quality of their learning, training progression, and milestone fulfillment. Residents reported they could be better utilized and expressed concerns about their career timeline. Trainees generally felt under-utilized and wanted to be engaged clinically in meaningful ways; however, some felt that contributing to healthcare during a pandemic was beyond the scope of a learner. Significant differences were detected between levels of training and geographic regions for satisfaction with organizational responses as well as the impact of COVID-19 learner wellness and state-trait anxiety. Conclusions: The disruption to the status quo of medical education is perceived by learners across all levels and geographic regions to have negatively affected their training and well-being, particularly amongst postgraduate trainees. These results provide initial empirical insights into the areas that warrant future research as well as consideration for current and future policy planning.

scholarly journals Task shifting from general practitioners to practice assistants and nurses in primary care: a cross-sectional survey in 34 countries

2021 ◽  
Vol 22 ◽  
Author(s):  
Peter P. Groenewegen ◽  
Wienke G. W. Boerma ◽  
Peter Spreeuwenberg ◽  
Bohumil Seifert ◽  
Willemijn Schäfer ◽  
...  
Keyword(s):  
Primary Care ◽  
General Practitioners ◽  
Professional Training ◽  
Institutional Development ◽  
Task Shifting ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Independent Variables ◽  
Nurse Prescribing ◽  
Number Of Patients

Abstract Aim: To describe variation in task shifting from general practitioners (GPs) to practice assistants/nurses in 34 countries, and to explain differences by analysing associations with characteristics of the GPs, their practices and features of the health care systems. Background: Redistribution of tasks and responsibilities in primary care are driven by changes in demand for care, such as the growing number of patients with chronic conditions, and workforce developments, including staff shortage. The need to manage an expanding range of services has led to adaptations in the skill mix of primary care teams. However, these developments are hampered by barriers between professional domains, which can be rigid as a result of strict regulation, traditional attitudes and lack of trust. Methods: Data were collected between 2011 and 2013 through a cross-sectional survey among approximately 7200 GPs in 34 countries. The dependent variable ‘task shifting’ is measured through a composite score of GPs’ self-reported shifting of tasks. Independent variables at GP and practice level are: innovativeness; part-time working; availability of staff; location and population of the practice. Country-level independent variables are: institutional development of primary care; demand for and supply of care; nurse prescribing as an indicator for professional boundaries; professionalisation of practice assistants/nurses (indicated by professional training, professional associations and journals). Multilevel analysis is used to account for the clustering of GPs in countries. Findings: Countries vary in the degree of task shifting by GPs. Regarding GP and practice characteristics, use of electronic health record applications (as an indicator for innovativeness) and age of the GPs are significantly related to task shifting. These variables explain only little variance at the level of GPs. Two country variables are positively related to task shifting: nurse prescribing and professionalisation of primary care nursing. Professionalisation has the strongest relationship, explaining 21% of the country variation.

scholarly journals Assessing a national policy on strengthening chronic care in primary care settings of a middle-income country using patients’ perspectives.

2020 ◽  
Author(s):  
Wichai Aekplakorn ◽  
Paibul Suriyawongpaisal ◽  
Samrit Srithamrongsaw ◽  
Phanuwich kaewkamjonchai
Keyword(s):  
Primary Care ◽  
Structural Equation ◽  
Health Care Services ◽  
Chronic Care ◽  
Care Quality ◽  
Equation Modeling ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Mixed Effect ◽  
Validated Questionnaire

Abstract Background To improve care for patients with chronic diseases, a recent policy initiative in Thailand focuses on strengthening primary care including training of the team to deliver healthcare based on the concept of Chronic Care Model (CCM). This study aimed to assess the perception of patients on the health care services after the implementation. Methods We conducted a cross-sectional survey of 4,071 patients with hypertension and/or diabetes registered to 27 primary care units and 11 hospital Non-communicable diseases (NCDs) clinics in 11 provinces.The patients were interviewed at home using a validated questionnaire of the Patient Assessment of Chronic Illness Care (PACIC+). It contains 20 items from the original PACIC, which measure different parts of the CCM, and an additional 6 items assess the 5A Model including assess, advise, agree, assist, and arrange subscales. Upgraded primary care unit (PCUs) were ordinary PCUs with the multi-professional team including a physician. Trained upgraded PCUs were upgraded PCUs with the training input. Structural equation modeling was used to create subscale scores for CCM and 5 A model characteristics. Mixed effect models were employed to compare subscale of patient perception of the care quality between trained upgraded PCUs, upgraded PCUs, ordinary PCUs and NCD clinics.Results There was an independent association between every PACIC subscale (as a measure of CCM) and facility type with the maximum likelihood for patients of ordinary PCU reporting high to highest scores (ORs: 1.46-1.85; p<0.05) compared to hospital NCD clinics. This is also the case for patients: seeing the same doctor on repeated visits (ORs: 1.82-2.17; p<0.05) or having phone contacts of the providers (ORs:1.53-1.99; p<0.05). Similarly, across all of the 5A model subscales, ORs for patients attending ordinary PCU responded with high to highest scores were 1.48-2.10 times compared to those for patients attending hospital NCD clinics (p<0.05). Conclusions The training and allocation of family physician approach in PCU may not satisfy the patients’ perception on quality of chronic care. Further studies might focus on other factors such as mismatch between health workforce and workload as a key factor influencing the success of the policy implementation.

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