How to avoid medical errors, how to respond and relate to them: a review of the scientific monograph «Defects in the provision of medical care»

Currently, the number of judicial proceedings on real and alleged offenses and disputes in area of provision of medical care has been exponentially increased. Some of such proceedings become publicly disclosed, but many more of them remain unnoted in mass media and civilian society as a whole. Increasing number of medical doctors has been accused of criminal offenses, being more often sentenced to real terms of imprisonment, showing a clear tendency to increase gravity of responsibility applied to medical doctors. This publication represents a peer-reviewed response of paramount importance to the book by A.A. Ponkina and I.V. Ponkin «Defects in the provision of medical care» raising ontological, value and technical issues for negative outcome of medical care – by the fault or in the absence of the fault of the doctor. The book puts the scientific basis beneath changes so much awaited by the Russian public health in relation to medical doctors, their social importance, objective limitlessness of their opportunities and capabilities in curing sick people and saving their lives.

An Assessment of the Knowledge and Practice of Telemedicine Among Medical Doctors in University of Nigeria Teaching Hospital (UNTH), Ituku-ozalla, Enugu State, Nigeria.

Background: The outbreak of the novel SARS-COV-2 virus, created a paradigm shift in the practice of medicine, a speciality well known for its integration of clinical expertise and manual dexterity in the management of its patients. Telemedicine, a previously less conventional approach in developing countries, has now come to the forefront of patient care. This study assessed the knowledge and practice of telemedicine among doctors in the University of Nigeria Teaching Hospital, Ituku-Ozalla in Enugu state.Methodology: A questionnaire-based survey was used to obtain relevant information among 149 doctors in the University of Nigeria Teaching Hospital (UNTH), including their knowledge and awareness of telemedicine, its relevance and impact on the clinical outcomes of patients as well as factors limiting its use. Data was analyzed and presented in tables, graphs and pie charts.Results: There were 149 doctors, who were mostly aged 15 – 30 years (63%). Most 146 (98%) have heard about telemedicine but only 100 (67.3%) have consulted using telemedicine. Doctors were more likely to employ telemedical consultation for follow-up and emergency scenarios but least likely to use telemedicine for first-time visits and the management of chronic diseases.Conclusion: There is a good knowledge of telemedicine among medical doctors in UNTH but ICT illiteracy, inadequate patient-doctor interaction, patients’ preference, lack of internet access, high cost of set-up and maintenance and ethical issues were some of the factors limiting its practice.

How Can Dogs and Cats Help to Cure Human Cancers?

Like their owners, dogs and cats can be affected by several types of cancer, and some types are very similar to those seen in people. Unfortunately, there is still no cure for several types of cancer. How can humans’ best friends help? If a new therapy to fight cancer works well in pets, it is likely to also be effective in people with the same type of cancer. Scientists, medical doctors, and animal doctors are working together to develop new therapies that destroy cancer cells and save patients. Since the characteristics of certain types of cancer are very similar between humans and pets, new medicines that work in pet dogs or cats may also benefit human patients. Studying these “human-like” cancers in pets may speed up the development of effective anti-cancer drugs and will help to cure not only more dogs and cats, but also people with cancer.

Measuring online self-regulated learning among early-career medical doctors in a Massive Open Online Course on COVID-19

Introduction: As significant autonomy is given in a Massive Open Online Course (MOOC), online self-regulated learning (SRL) ability is crucial in such courses. We aim to measure the online SRL abilities of early-career medical doctors enrolled in a MOOC. Methods: We performed a cross-sectional study using the Self-Regulated Online Learning Questionnaire-revised version (SOL-Qr). We conducted a three-stage cross-cultural validation of the SOL-Qr, followed by Confirmatory Factor Analysis (CFA). The online SRL ability of 5,432 medical doctors enrolled in a MOOC was measured using the validated SOL-Qr. Results: The CFA of the cross-translated SOL-Qr confirmed its comparability to the original version, with excellent validity & reliability. Participants showed high levels of online SRL during their early careers. Despite high online SRL scores, MOOC completion rate was low. Male participants showed slightly better time management ability than female participants. Participants working in the primary epicentrum for COVID-19 in the country showed lower online SRL scores, while participants who graduated from higher accreditation levels showed better time management ability. Conclusion: The SOL-Qr and its subscales are suitable and valid for measuring the online SRL abilities of medical doctors in a MOOC during their early-career period. Time management ability was associated with previous experience during the medical education period, while other online SRL subscales were mostly associated with workload. However, as the scores did not correlate with the time spent for learning in MOOC, the corresponding learning effort or time spent may be beyond just the commitment to the described MOOC.

Measuring online self-regulated learning among early-career medical doctors in a Massive Open Online Course on COVID-19

Introduction: As significant autonomy is given in a Massive Open Online Course (MOOC), online self-regulated learning (SRL) ability is crucial in such courses. We aim to measure the online SRL abilities of early-career medical doctors enrolled in a MOOC. Methods: We performed a cross-sectional study using the Self-Regulated Online Learning Questionnaire-revised version (SOL-Qr). We conducted a three-stage cross-cultural validation of the SOL-Qr, followed by Confirmatory Factor Analysis (CFA). The online SRL ability of 5,432 medical doctors enrolled in a MOOC was measured using the validated SOL-Qr. Results: The CFA of the cross-translated SOL-Qr confirmed its comparability to the original version, with excellent validity & reliability. Participants showed high levels of online SRL during their early careers. Despite high online SRL scores, MOOC completion rate was low. Male participants showed slightly better time management ability than female participants. Participants working in the primary epicentrum for COVID-19 in the country showed lower online SRL scores, while participants who graduated from higher accreditation levels showed better time management ability. Conclusion: The SOL-Qr and its subscales are suitable and valid for measuring the online SRL abilities of medical doctors in a MOOC during their early-career period. Time management ability was associated with previous experience during the medical education period, while other online SRL subscales were mostly associated with workload. However, as the scores did not correlate with the time spent for learning in MOOC, the corresponding learning effort or time spent may be beyond just the commitment to the described MOOC.

Dental Awareness and Barriers in Reducing the Risk of Medication-related Osteonecrosis of the Jaw (MRONJ) Among Non-head and Neck Cancer Patients

Objectives. The objectives of this study are to assess the dental awareness in reducing the risk of Medication-Related Osteonecrosis of the Jaw (MRONJ) among non-head and neck cancer patients and their barriers of attending pre-medication dental evaluation (PMDE). Methodology: This study was conducted in the Department of Oncology of the University of Malaya Medical Centre. Non-head and neck cancer patients who are currently or will be undergoing anti-resorptive and/or anti-angiogenic therapy were interviewed using a questionnaire that consist of questions on patient’s awareness, attitude, and barriers of receiving PMDE. Ethics approval was obtained. Results. In total, 17 patients were interviewed. Only 6 patients were informed by the medical doctors about the risk of MRONJ. Nine patients were advised by the medical doctors to have the PMDE prior to the therapy, and most of them in this group follow the instruction and already had their PMDE done prior to the therapy. The other 8 patients, who did not attend a PMDE, thought it was not important because their medical doctors neither inform them about MRONJ, nor refer them for PMDE. Conclusion. Patients’ awareness of MRONJ risks and preventive strategies are poor. The main barrier for PMDE is the lack of referral and information on MRONJ from the medical doctors. Patients’ attitudes were positive towards PMDE if they were referred by the medical doctors.

Knowledge, Awareness and Practice with Antimicrobial Stewardship Programmes among Healthcare Providers in a Ghanaian Tertiary Hospital

Antimicrobial resistance (AMR) is a significant problem in global health today, particularly in low- and middle-income countries (LMICs) where antimicrobial stewardship programmes are yet to be successfully implemented. We established a partnership between AMR pharmacists from a UK NHS hospital and in Ho Teaching Hospital with the aim of enhancing antimicrobial stewardship knowledge and practice among healthcare providers through an educational intervention. We employed a mixed-method approach that included an initial survey on knowledge and awareness before and after training, followed by qualitative interviews with healthcare providers conducted six months after delivery of training. This study was carried out in two phases in Ho Teaching Hospital with healthcare professionals, including pharmacists, medical doctors, nurses and medical laboratory scientists. Ethical approval was obtained prior to data collection. In the first phase, we surveyed 50 healthcare providers, including nurses (33%), pharmacists (29%) and biomedical scientists (23%). Of these, 58% of participants had engaged in continuous professional development on AMR/AMS, and above 95% demonstrated good knowledge on the general use of antibiotics. A total of 18 participants, which included four medical doctors, five pharmacists, four nurses, two midwives and three biomedical scientists, were interviewed in the second phase and demonstrated greater awareness of AMS practices, particularly the role of education for patients, as well as healthcare professionals. We found that knowledge and practice with AMS was markedly improved six months after the training session. There is limited practice of AMS in LMICs; however, through AMR-focused training, we demonstrated improved AMS skills and practice among healthcare providers in Ho Teaching Hospital. There is a need for continuous AMR training sessions for healthcare professionals in resource-limited settings.