The Practice of Cross-Cultural Medical Services in the United States and Its Enlightenment to China / 中国医学伦理学

This paper collected and sorted out the cross-cultural medical practice in the top 20 US hospitals in 2019-2020 through web surveys, and summarized the concepts, featured projects and models of cross-cultural medical services in American hospitals. Generally, hospitals in the US advocate the service concept of "patient-centered", provide full-process services before, during and after the treatment, involving appointments, accommodation, transportation, language translation, medical process management, etc., and attach great importance to the role of culture factors in medical treatment and cross-cultural medical education and training for employees. On this basis, it is proposed that Chinese medical institutions should focus on the following aspects in the development of foreign-related medical services: conform to international medical service concepts and standards, improve the cross-cultural medical competence of medical staff and other groups, explore cross-cultural medical service models with localized characteristics, and build the international image of the hospital with the construction of international environment.

The Practice of Cross-Cultural Medical Services in the United States and Its Enlightenment to China / 中国医学伦理学

This paper collected and sorted out the cross-cultural medical practice in the top 20 US hospitals in 2019-2020 through web surveys, and summarized the concepts, featured projects and models of cross-cultural medical services in American hospitals. Generally, hospitals in the US advocate the service concept of "patient-centered", provide full-process services before, during and after the treatment, involving appointments, accommodation, transportation, language translation, medical process management, etc., and attach great importance to the role of culture factors in medical treatment and cross-cultural medical education and training for employees. On this basis, it is proposed that Chinese medical institutions should focus on the following aspects in the development of foreign-related medical services: conform to international medical service concepts and standards, improve the cross-cultural medical competence of medical staff and other groups, explore cross-cultural medical service models with localized characteristics, and build the international image of the hospital with the construction of international environment.

Desarrollo de la competencia médica para el ejercicio profesional en centros ambulatorios / Development of competence for the professional practice in ambulatory centres

El desarrollo de competencias, es una característica profesional que trasciende las aulas, y cuyo progreso se describe como un proceso continuo. En un grupo de médicos se planeó analizar el grado de identificación con aspectos de la competencia presentados "Modelo de tres circulos" y la opinión de los mismos sobre el contexto laboral donde se inician como profesionales, siguiendo un diseño cuantitativo-cualitativo. Participaron 296 médicos egresados de 8 universidades venezolanas (promedio de egreso: 9 meses desviación estándar: 5,41 meses). Laborando en abulatorios rurales. Se utilizó un modelo descriptivo de la competencia que agrupa las actitudes, habilidades y conocimientos en 12 dominios, para elaborar dos cuestionarios validados llamados "dominios clínicos" de 95 ítems, y "dominios no clínicos" de 75 ítems, con un escalamiento tipo Likert de cinco puntos, con una confiabilidad aceptable (Alfa>0,75). Con el objeto de explorar las posibles variaciones entre diferentes subgrupos de la muestra de médicos, se consideraron las variables procedencia y universidad de origen. Para este fin se compararon los promedios de cada subgrupo en los puntajes totales de cada cuestionario mediante análisis de varianza o Kruskal Wallis, usando el programa SPSS versión 12.0 y Excel 2003. Los datos cualitativos relativos a opiniones sobre su experiencia laboral, se recogieron en 146 médicos mediante un cuestionario de preguntas abiertas, y un diario de campo, triangulando con tres informantes claves. Esta información fue procesada usando el programa Atlas/ti versión 4.2. Se encontró que los médicos se identifican con los aspectos de la competencia explorados en un 79% y se observaron diferencias significativas en los puntajes promedio de los instrumentos según la universidad de origen. La exploración cualitativa mostró una opinión desfavorable, en los médicos participantes en el estudio, hacia el ejercicio en centros ambulatorios, relacionada con factores económicos...

The development of competition is a profesional characteristic which go beyond the lecture room and its progress is described as a continual process. In a medical group it was decided to analyze the identification level with competition included in the model of the three circles and their opinions on the labour context where they begin as professionals, following a qualitative-qualitative design. In the study participate 296 medical doctors from 8 venezuelan universities (avaerage time of graduation: 9 ± 5,4 months) and working in rural health clinics. A descriptive competition model was used which includes evaluation of attitudes, skills and knowledge on 12 scopes, in order to elaborate two validated questionnaires: clinical (95 items) and non clinical (75 items), in a Lickert scale of five points with acceptable confidence (Cronbach alpha > 0.75. In order to explore possible vartation among the different sub-group of the sample of medical doctors, origin and university were considered. Mean scores from each type of questionnaire were compared by analysis of variance or Kruskall Walls test using the Statistical Package for the Social Sciences, 12th version and Excel 2003. Opinions on labour experience were collected from 146 medical doctors by means of a set of open ended questions and a field work diary and triangulation with three key informants. This qualitative data was processed by means of the Atlas/ti program, version 4.2. According to the results the medical doctors identified themselves in a 79% with the competition explored aspects. The qualitative inquire show unfavourable opinions from the participants medical doctors on their practice in the raraul clinics in relation to economic factors, labour contest and few opportunities to professional bring up. to date

Exploración de un modelo de la competencia médica en alumnos de sexto año de la Escuela de Medicina Luis Razetti / Exploring a model of medical competence in sixth graders from the School of Medicine

Los paradigmas y modelos de la educación médica están siendo sometidos en la actualidad a un proceso de revisión y reorientación por parte de los organismos responsables a nivel mundial, con miras al logro del desarrollo integral de los conocimientos, habilidades y actitudes (competencia médica), que deben adquirir los futuros profesionales médicos. Se realizó un estudio de tipo exploratorio, no experimental, transversal y de carácter descriptivo, con el propósito de desarrollar y validar un instrumento de exploración de los aspectos de la Competencia Médica, tal y como son definidos en el "Modelo de Tres Círculos" (M3C). Una vez aplicado dicho instrumento, se analizó el grado de identificación, con lo definido en el M3C, de los estudiantes del sexto año de la Facultad de Medicina de la Universidad Central de Venezuela para el período 2004 - 2005. Los resultados indican que los alumnos expresaron un nivel de "identificación" mayor de 70 por ciento con conductas, opiniones o sentimientos que reflejan el perfil de competencia médica, tanto en los aspectos clínicos y no clínicos. Si bien los resultados obtenidos no pueden ser considerados como una evaluación de la competencia, los mismos podrían servir de orientación en un proceso de revisión racional del modelo educativo y currículo de las Escuelas de Medicina.

The paradigms and models for Medical Education are being revised and refocus by wide-world responsible organisations, in order to achieve the integral development of the cognitions, skills and attitudes (Medical Competence), to be acquired by future physicians. An exploratory, non experimental, transversal and descriptive study was designed in order to evaluate and develop an instrument to explore the aspects of Medical Competence, as it was defined in the "Three Circle Model" (3CM). Once the instrument was applied, the grade of identification was analysed, as defined by the 3CM, in the students of the last year medical school Universidad Central de Venezuela (2004 - 2005). The results indicate that students expressed more than 70 percent "identification" level with conducts, opinions or feelings that reflect the profile of medical competence, in the clinical and non clinical aspects. Even though the results can not be consider as a competence evaluation, it could serve as a rational review process of the education model and curriculum in Medical School.