Medical Ethics Education: A Survey of Opinion of Medical Students in a Nigerian University

In Nigeria, medical education remains focused on the traditional clinical and basic medical science components, leaving students to develop moral attitudes passively through observation and intuition. In order to ascertain the adequacy of this method of moral formations, we studied the opinions of medical students in a Nigerian university towards medical ethics training. Self administered semi-structured questionnaires were completed by final year medical students of the College of Medicine, University of Ibadan, Nigeria. There were 82 (64.1%) male and 44 (34.4%) female respondents. The median age was 26 years. Most students (80.5%) responded that they did not receive enough training in medical ethics. The ethics instructions they received did not sufficiently prepare them for the ethical challenges they came across as medical students. Though inadequate, the few hours of lecture and discussion on human values and professional etiquette which they received positively influenced their moral reasoning. They identified end-of-life issues, dealing with financial issues and handling socio-cultural beliefs of patients and relations as some challenges that medical doctors are ill-prepared for by their current training. Most, 85.9% believed that formal medical ethics education would be worthwhile as it would enhance the making of complete and better doctors. They recommended incorporating bioethics as a course in the medical school curriculum. Nigerian medical students encounter ethical challenges for which they have not been adequately trained to resolve. They recommended formal medical ethics training in their curriculum and a uniform bioethics programme in the country.     

Billing for Medical Genetics and Genetic Counseling Services: A National Survey

In January 2007 the American Medical Association added a new Current Procedural Terminology® (CPT) code, 96040, for “Medical Genetics and Genetic Counseling Services.” In order to identify the impact of having this new code and to identify issues with implementation of the code, the National Society of Genetic Counselors (NSGC) CPT® Working Group surveyed NSGC members using an internet-based survey tool. The majority of respondents (94%) reported being aware of the new code and over half of the respondents (69%) said they were billing for genetic counseling. Approximately 24% of those billing reported using 96040. Many facilities are not using this code and the reported success of billing using 96040 is highly varied. Continued education may be beneficial to encourage reimbursement for 96040 and follow up is needed to assess the ongoing implementation and impact of the new CPT® code.     

临床医师医学人文认知情况的问卷分析——大连医科大学、哈尔滨医科大学、南京医科大学、河北医科大学、重庆医科大学联合调查之一

调查5个城市24所附属或教学医院的1 836名在职医师对医学人文的认知情况,结果表明,从总体来看,医学人文的问题已经开始引起医师们的重视,医师对医学人文的诸多问题有相当清楚的认识,医生们认为医学人文的核心思想是关爱、敬畏、呵护生命;实现医疗人性化的目标,更为重要的是临床诊疗实践中的人性化;在医院管理中落实医疗人性化,最主要的是优化行政管理,为医师们减轻压力;医学人文教育存在的最主要问题是医学人文教育与临床实践脱节;等等.     

Sex Biases in Subject Selection: A Survey of Articles Published in American Medical Journals

This study discusses the results of a survey of 1,800 articles published in American medical journals from 1985--1996. The study finds 9% of these articles reported research that uses only male subjects to examine medical conditions that affect both sexes; the ratio of research on female to male conditions among these articles was greater than 5:1; but 76.5% of the articles reported research that includes both male and female subjects. The study also discusses evidence that sex biases against women (and men) are decreasing. This study also offers some possible psychological, institutional, medical, and economic explanations of the sex biases in medical research published in American journals, and discusses some policy implications of sex biases in medical research. The study concludes by urging others to conduct more empirical research on sex biases in medical research.     

The Burden of Dementia: A Medical and Research Perspective

Alzheimer's disease remains the most common form of dementia. Dementia symptoms vary depending on individual personality, life experience, and social and cultural influences. As dementia progresses, involvement of multi-disciplinary health care professionals is needed to manage the disease. Alzheimer research is progressing rapidly. While 5% of all Alzheimer's disease may be genetically determined, the majority is not. Susceptibility genes can reveal the risk of contracting Alzheimer's disease. Early life risk factors such as education, nutrition, and vascular disease may increase the likelihood of dementia in later life. In the United States, two acetylcholinesterase inhibitors have been approved as cognitive enhancers. Possible prevention and symptomatic treatment interventions have focused on estrogen replacement therapy, antioxidants, and anti-inflammatory medications. Research advances have improved the clinical management of dementia. Ethical implications to the patient, family, and society are multiple and remain challenging.     

八年制医学生人文素质教育的满意度及影响因素的调查

通过对四川大学八年制医学生的问卷调查发现,八年制医学生对人文素质的重要性认识较好,对人文素质教育满意度不高.医学院校应该重视八年制医学生的人文素质教育,总结并借鉴国内外先进的经验,探索更有效的人文素质教育模式和方法,加强教材建设和师资建设,大力拓展第二课堂,培养出能够适应新时代需要的医学人才.     

婚检医疗纠纷的法律问题探讨

发生在婚前医学检查过程中的医疗纠纷增加了人们对婚前医学检查的负面评价和不信任.通过对近年来发生的婚检医疗纠纷进行研究发现,婚检医疗纠纷主要包括漏诊医疗纠纷、误诊医疗纠纷、侵犯隐私权和知情权医疗纠纷以及人身损害医疗纠纷四类.就婚检医疗纠纷所涉及的漏诊误诊责任的判断、损害后果范围的确定和医疗机构在知情权与隐私权冲突时的选择等相关法律问题进行了探讨,提出应当通过立法明确婚检疾病的范围和规范婚检医师的资质、婚检医疗机构严格保护受检者隐私和身体来防范婚检医疗纠纷的发生.     

The Research Use of Projective Techniques: A Seventeen Year Survey

The past 17 volumes (from 1947 to 1064) of the Journal of Projective Techniques and Personality Assessment were surveyed with regard to the degree of research usage of the various projective techniques. The most commonly used techniques in research have remained quite unchanged over the past 17 years, i.e., the Rorschach, the thematic tests, human figure drawings, and sentence completions. An analysis and comparison of the first five years covered by the survey with the last five years suggests that the Szondi, the Mosaic, Finger Painting Analysis, and the Make-A-Picture show relative decline in research usage; the Blacky, the Holtzman Inkblots, and the Hand Test appear to be increasing. The correlation between the degree of clinical usage reported by Sundberg (1961) and the degree of research usage found in this study was .60, suggesting a high relationship between the two measures. However, it was suggested that an increase or decline in the research usage of an instrument may precede a corresponding increase or decline in its clinical usage.     

中西方社会距离的研究综述

社会距离是人与人之间或群体与群体之间的理解与亲密的程度和等级,可分为主观距离、行为距离等。造成距离的原因很多,除了制度很均衡因素以外,还有社会地位差异、文化差异、空间隔离、生物差异等因素。     

Marijuana: A Review of Medical Research With Implications for Adolescents

Recent medical evidence indicates that marijuana is more harmful than had previously been suspected. A review of recent research in the following areas is presented: tolerance and persistence, reproductive system, respiratory system, immune system, central nervous system, genetic and chromosomal effects, and behavioral effects. Implications for mental health professionals are discussed.     

医患冲突中患方责任的认知差异性调查分析

采取整群随机抽样,调查发现,患者对医疗特殊性的理解、患者对医疗的期望、患者对医生的信任程度、患者财力与生存希望间的矛盾、个别受害患者对医疗事故的过激反应、媒体的舆论导向、责任和后果等方面存在认知差异性.这种差异性会影响医患关系的发展.实施医患沟通是医患双方的需要,也是减少医患纠纷极好的方法之一.     

医学生对当前医患利益关系若干问题的认知——医学生对医师职业精神认知的调查

调查四川大学医学生对医师职业精神中“医患关系”、“医疗纠纷和医疗风险”、“医院管理和利益冲突”三方面的认知,并与患者认知比较,了解不同层次医学生的职业精神认知现状,以及与患者的差异.结果显示,医学生和患者在上述三方面总体认知相近.     

The 2003 Survey of Academic Medical Center Psychologists: Implications and Outlook

This paper offers commentaries on Pate and Kohout’s (2005) report of data from the 1997 and 2003 surveys of psychologists in medical school settings. The commentaries reflect upon the significance of the survey findings and implications for psychology’s role in medical school and academic health science settings. Though the response rate to the survey was disappointing, the data indicate that psychologists are moving up in academic rank, and have made substantial gains in salary. The data also indicate that among psychologists who are medical staff members, who constitute half the 2003 sample, an increasing proportion are functioning autonomously as reflected in gains in the percentage having admitting privileges, staff voting privileges, and authority to write orders. Research continues to be a major focus for psychologists in academic medical centers. Overall, the findings indicate that psychologists can have productive, satisfying careers in medical school/academic health center settings—though there is one troubling sign, a sizeable drop in the number of positions being created for younger, more recently trained psychologists. Methodological enhancements are described that could improve the quality, scope, and usefulness of data from future studies, both for understanding long-term trends and for conducting salary negotiations. High quality data provide a solid foundation for advocating for psychologists’ full participation in the life of medical schools and academic health centers.     

我国医科类高校医学(生命)伦理学课程现状调查

为了解我国部分医科类高校医学(生命)伦理学课程的开展现状,对国内48所高校中68名从事医学(生命)伦理学教学工作的教师进行问卷调查。结果显示,23所高校教师人数超过4人;女性教师中学历为硕士的人数最多;32.4%的教师第一专业具备临床或医药背景;学时为32学时~36学时的高校仅1所,学分为2学分的高校也只有1所,以必修课形式开设的高校只有2所;28所高校开设了医学(生命)伦理学相关的讲座,其中2所高校年均开设次数达到5次或以上。调查显示,高校整体师资力量较薄弱、女性教师学历水平有待提高、教师知识结构较单一、课程受重视程度低、医学人文环境较差。建议扩大、优化师资结构,重树学科定位,加强医学人文建设,营造医学人文氛围。     

National Ambulatory Medical Care Survey: Tobacco intervention practices in outpatient clinics

Tobacco use remains the leading cause of preventable death. The outpatient medical clinic represents an important venue for delivering evidence-based interventions to large numbers of tobacco users. Extensive evidence supports the effectiveness of brief interventions. In a retrospective database analysis of 11,827 adult patients captured in the 2005 National Ambulatory Medical Care Survey (of which 2,420 were tobacco users), we examined the degree to which a variety of patient demographic, clinical and physician-related variables predict the delivery of tobacco counseling during a routine outpatient visit in primary care settings. In 2005, 21.7% of identified tobacco users received a tobacco intervention during their visit. The probability of receiving an intervention differed by gender, geographic region and source of payment. Individuals presenting with tobacco-related health conditions were more likely to receive an intervention. Most physicians classified as specialists were less likely to intervene. The provision of tobacco intervention services appears to be increasing at a modest rate, but remains well below desirable levels. It is a priority that brief interventions be routinely implemented to reduce the societal burden of tobacco use. (PsycINFO Database Record (c) 2012 APA, all rights reserved).     

质的研究:医学教育研究的另一种范式

通过将质的研究与定量研究、定性研究进行各维度对比,充分显示了质的研究范式的独特个性.并使用文献分析法,分析了我国医学教育领域中,医学教育研究方法应用的现状.进而探讨了质的研究范式在医学教育研究领域应用的意义及其优势,以及该研究范式在医学教育研究中如何引入的问题.     

勇于面对现实提升伦理判断力——一项对300份医学伦理学案例写作的调查研究

通过对北京大学四所附属医院医学生300份医学伦理学案例写作的分析,了解医学生的伦理关怀和基本的价值趋向,并对当前医学伦理学教育存在的弊端进行反思.研究发现,医学生具有强烈的现实主义伦理关怀,具有批判思维的潜能,但同时又充满冲突和困境.然而,医学伦理学教育应该着重培养医学生道德能力,同时建构一个全面的支持性系统.     

Survey Research Methods

This article presents an overview of the important stages and inherent problems of survey research and defines survey-related terminology. Particularly emphasized are the characteristic elements of survey research: survey designs, sampling theory, questionnaire development, and data collection procedures.     

Computer-Based Assessment: A NATO Survey

The purpose of this paper is to provide a brief summary of developments in NATO nations in order to bring these developments to a wider audience. The basis of the survey provided is the information collated by NATO Research Study Group 15 Computer-Based Assessment of Military Personnel as given in its report to NATO Headquarters in 1993.