Research on the evaluation index of medical practitioners' competency of county-level public hospitals / 中华医院管理杂志

Objective To build an evaluation index system of medical practitioners'competency for county-level public hospitals. Methods By means of the Iceberg Model based on competence and professionalism, and following two rounds of consultations of 47 experts, the evaluation indexes and weights of medical practitioners' competency were determined using SPSS frequency, mean, Kendall harmony coefficient and factor analysis. Three county-level public hospitals in Shaanxi province were selected for example verification of service competency. Results The evaluation index system of county-level public hospitals included 4 level-1 indexes and 16 level-2 indexes. The 4 level-1 indexes were diagnosis competency, treatment competency, communication competency and self-development competency. The weights of these indexes were 0.3,0.3,0.2 and 0.2 respectively. Conclusions Such hospitals should start with these competencies to strengthen the cultivation of medical practitioners' competency and constantly improve their comprehensive service level.

A Study of the Discussions on Psychiatry of Korea in the 1960s and 1970s: From Mental Hygiene to Modern Psychiatry / 의사학

This study is to review the emergence of new psychiatrists, scientific rationalization, and popular internalization to reorganize the formation process of modern psychological medicine system. Unlike eugenic psychiatry from the Japanese Colonial Era, the social conditions and contexts forming autonomous system of psychiatry of Korea in the 1960s and 1970s have been concentrated. The discussion approach has been tried to secure two perspectives-treatment and criticism-at the same time and to expand the time and scope of study through the extensive texts such as newspapers, magazines, books, advertisements, and others in the 1960s and 1970s. Through formation of subject, rationalization, and popularization, this study has surveyed the characteristics of psychiatry in the 1960s and 1970s to accentuate complicated conditions and kinetic steps to systemize psychiatry as scientific field to promote treatment of patients by deviating from mental hygiene approaching national mental health from cleanliness and removal. The characteristics are summarized as follows. First, as the ethical models of good doctors, medical paternalistic doctors, and non-authoritarian symmetric doctors have been proposed as good psychiatrists by new medical specialists with experience of globality, a new subject emerges. However, there has been illegalization process of unlicensed medical practitioner excluded by the regulatory authority called “clearness.” Second, the rationalization of psychiatry has been accelerated through the dispute of enactment of Mental Hygiene Law, segmentalization of concept of mental illness, and scientific characteristics. Especially, the disputes over enactment of Mental Hygiene Law focused on criminalization of mental patients brought a result to regulate the patients as the target of humanistic treatment and potential criminals at the same time. Third, popularization of psychiatry has embraced invisible mental illness into popular daily life through visual measure called medicine advertisement, and through the discussion about social neurosis, a new paradigm for diagnosis of Korean society has been proposed. Moreover, by focusing on autobiographical works with voices of patients, this article reveals a new doctor-patient relationship.

Discussion on the Training Mode of General Practice Education in Contemporary Medical Colleges and Universities / 中国医学伦理学

At present,the training mode of general practice education in medical colleges and universities in China has the characteristics of common and personality.Although there is a great change in the form of “classroom instruction”,it is still one of the main modes of training of general medical education in medical colleges and universities.In addition,many colleges and universities explore the mentor type,team type,humanistic type,practice type and other general medical education training mode.A variety of training mode has accumulated a lot of valuable experience and achievements,but there are many problems.Currently,the overall quality of general practitioners in our country has yet to be improved and the training mode of general medical education needs further exploration and innovation.

Practice and reflection on teaching of rehabilitation medicine in general practitioners' training / 中华医学教育探索杂志

The practice of general practice emphasizes that the general practitioner is the backbone, and the primary health institution is the main body, which solves the main health problems of the commu-nity and meets the basic health service needs of the residents. Rehabilitation medicine occupies a prominent position in the community health service, and its related knowledge and skills are the important part of the whole medical education. However, rehabilitation medicine has more teaching contents, less training time and out-of-date teaching model, which have made the effect of rehabilitation medicine teaching not good. In the rehabilitation medicine teaching for training general practitioners, by strengthening the concept of reha-bilitation, elaborating teaching content, optimizing teaching ward-round, and outstanding ability as well as reforming evaluation way, we try to exercise the students' clinical thinking and improve clinical skills, to cultivate outstanding qualified general medical practitioners for community rehabilitation ultimately.

3. Medical Education in Japan and National Medical Practitioner Examination / 医学教育

<p>　It has been suggested that bed-side learning in Japanese medical schools may be not sufficient in its term and content, compared to that in European and American medical schools, although medical knowledge of Japanese medical students is on a par with that of European and American medical students. AJMC (Association of Japanese Medical Colleges) is now trying to certify medical students as Student Doctors based on a uniform standard with the use of CBT and OSCE. The quality assurance of medical students before proceeding to bed-side learning can make satisfying participation in such training possible with the understanding of patients. The National Medical Practitioner Examination poses a considerable burden to medical students because of a large number of problems. It is desirable for the National Medical Practitioner Examination to become a test to evaluate students' ability on bed-side practice in the future. If post-clinical clerkship OSCE is conducted in all medical schools in Japan with fairness and objectivity, the burden on medical students due to the National Medical Practitioner Examination may be alleviated.</p>

Clinical teaching for non-special medical practitioner in the department of pediatric hematology / 中华医学教育探索杂志

The common problems for non-special pediatric medical practitioners in the depart-ment of hematology include short-time of rotation, weak foundation of pediatric hematology and low enthusiasm of learning. The entrance education was highlighted in order to make refreshers familiar-ize with the severity of illness and eliminate the medical error. Basic theoretical study was strength-ened aiming at improving clinical skill and enhancing the learning interesting. Method of doctor-patient communication was reformed to reduce medical disputes.

Empirical research on the efficacy of medical colleges assessment reform / 中华医学教育探索杂志

Course assessment is the important part of teaching and education.Double effects of improving the teaching and education quality can be achieved through emphasizing assessment methods,separating teaching and testing,building test bank and network exam,offering course of basic clinical skills as well as verified assessment methods,such as stage-based comprehensive exam,unified exam of the course,national entrance exam.The first pass rate of national medical practitioner qualification exam can be guaranteed through implementing these measures.

Financial state of primary care physicians under the Korean insurance system

Greater than its influence on the medical practitioner's individual ability is the National Health Insurance System's influence on the management of medical practitioners' offices in Korea. However, despite the important effect health insurance exerts on the income of medical clinics, recently, the financial difficulties of medical clinics have often become an issue, and financial difficulty has been aggravated as much as a solution has been sought. The current state of the overall management of medical clinics was investigated to understand the factors influencing the sales and expenses in their management. A questionnaire was completed by 1,009 physicians registered in the Korean Medical Association who were participating in a statistical extraction course. As a result of the study, the factors influencing the total revenue and total expenditures of medical clinics, such as increases in the total number of doctors, increasing numbers of outpatients, the size of the medical office, medical disputes, and clinical specialties (based on the first medical treatment) showed statistical significance. In conclusion, in order to improve medical clinic management, a health insurance medical fee should be more reasonably fixed, a medical transfer system should be reestablished, and a cooperative strategy should be created for medical clinics and general hospitals in order to attract patients. As a result, low cost and highly efficient medical services could be provided and the satisfaction of patients improved.

Estudio del conocimiento sobre los Trastornos Depresivos entre los médicos asistenciales en Argentina / A study of level of knowledge about Depressive Disorders among general practitioners in Argentina

Objetivos: determinar entre los médicos encuestados su especialidad, los años de ejercicio de la profesión, y averiguar el conocimiento que tengan sobre los trastornos depresivos incluyendo su tratamiento, comorbilidad y posibilidad del suicidio. Métodos: el estudio cualitativo se realizó con una entrevista semi-estructurada de doce preguntas, en forma voluntaria, administrada a médicos en actividad asistencial, efectuándose la entrega y recolección de la entrevista por personal entrenado previamente. Se analizaron los datos hallados en los 288 profesionales de distintas especialidades. Resultados: los hallazgos permiten decir que la mayoría de los médicos (97, 6 por ciento, n= 281) consideran que la depresión es una enfermedad, pero de ese total un 39,6 por ciento (n= 114) de ellos piensa que es por falta de voluntad o una debilidad, lo que crea una discordancia en el concepto de enfermedad. Estimaron cuáles son sus falencias frente a los Trastornos Depresivos, cómo y cuánto tiempo medican, su criterio respecto al origen de la misma, el suicidio y la comorbilidad. Conclusiones: los datos encontrados entre los médicos que respondieron el cuestionario permiten deducir que es necesaria la intensificación de los programas de actualización sobre Trastornos Depresivos.

Objectives: To determine the level of knowledge about depressive disorders including their treatment, comorbidities and suicide potential among a number of general practitioners who agreed to fill out a questionnaire and provided information about their professional activities. Method: Exploratory cross-sectional study among a number of general practitioners who answered voluntarily and anonymously to a questionnaire consisting of twelve questions. Data collected from 288 physicians were analyzed. Results: The majority of physicians (97.6 percent, n=281) considered that depression was a disease, but 39.6 percent (n=114) believed that it was caused by lack of will power or characterological weaknesses, which create a dissonance with the concept of disease. They also felt that they did not have enough knowledge .about Depressive Disorders such as their origins, type of medications and length of treatment, comorbidities and suicide potential. Conclusions: The results point to the need for continuous medical education about Depressive Disorders among general practitioners.

Discussion of the method of examination in clinical skills for medical practitioners in China / 中华医院管理杂志

The author focuses his explanation on the scope, principles and method of examination in clinical skills and puts forward some basic ideas on the conduction of examination in clinical skills for medical practioners. These include: ①focusing on basic clinical operations, with no differentiation of specialties so far as the scope of the examination is concerned; ②adopting the modified multi-station method of examination; ③giving priority to the examination in clinical skills in designing examination items; ④giving expression to such principles as practicality, objectivity and impartiality in designing the examination in clinical skills. At the same time, the author gives an account of the implementation and primary evaluation of the 2001 examination in clinical skills in China.