The most influence factor of the medical competence achievement regarding patient management ability on medical school graduates.

PURPOSE: A doctor's professional behavior and clinical competency reflect a range of personal and interpersonal qualities, attributes, commitments, and values. This study aimed to identify the most influential factor of medical competence regarding patient management ability. METHODS: We used an analytic observational design with a cross-sectional approach, and gathered the perceptions of medical school graduates of Bandung Islamic University via an online questionnaire scored on a Likert scale. Two hundred and six medical graduates who graduated at least 3 years prior to survey were included in the study. The factors evaluated included humanism, cognitive competence, clinical skill competence, professional behavior, patient management ability, and interpersonal skill. IBM AMOS ver. 26.0 (IBM Corp., Armonk, USA) was used for structural equation modelling of the six variables latent and 35 indicator variables. RESULTS: We found that graduates have highly positive perceptions of the humanism (95.67%). Followed by interpersonal skills (91.26%), patient management (89.53%), professional behavior (88.47%), and cognitive competence (87.12%). They rated clinical skill competence the lowest (81.7%). Regarding factors that contribute to patient management ability, the aspects of humanism, interpersonal skill, and professional behavior were found to significantly affect patient management ability (p-value=0.035, 0.00, and 0.00, respectively) with a critical rate of 2.11, 4.31, and 4.26 consecutively. CONCLUSION: Humanism and interpersonal skill are two important factors that medical graduates assessed very positively. According to surveyed medical graduates, their expectations of the institution were met regarding humanism. However, there is a need to strengthen medical students' clinical skills and improve their cognitive abilities through educational programs.

FRAX Calculated without BMD Resulting in a Higher Fracture Risk Than That Calculated with BMD in Women with Early Breast Cancer.

BACKGROUND AND PURPOSE: The aim of this study was to investigate the importance of including the measurement of bone mineral density (BMD) in reliable fracture risk assessment for women diagnosed with early nonmetastatic breast cancer (EBC) before AI treatment if zoledronic acid is not an option. MATERIAL AND METHODS: One hundred and sixteen women with EBC were included in the study before initiating AI treatment. Most participants were osteopenic. The 10-year probability of hip fracture and major osteoporotic fracture was calculated with and without BMD based on clinical information collected at baseline using the fracture risk assessment (FRAX) tool. To compare data, the nonparametric tests were used. RESULTS: There was a significant difference (p<0.001) in the number of high-risk and low-risk FRAX score of hip fracture between before and after including BMD values. The high-risk category decreased by 50.9%, while the low-risk category increased by 42.9%. In FRAX score of major osteoporotic the findings were similar (p<0.001): The high-risk and moderate-risk category decreased by 70.4% and 4.9%, respectively, while the low-risk category increased by 43.8% when including BMD value. When stratified by age, patients aged 65 years or older were at a significantly (p<0.001) higher risk of suffering a hip or major osteoporotic fracture, highlighting the importance of including BMD measurements in this age group. CONCLUSIONS: Our data support that DXA scanning of women with EBC should be performed to avoid overestimation of osteoporosis before AI treatment. It is particularly important in patients older than 65 years of age and when zoledronic acid is not an option.