1
|
Zhou Y, Zhou Y, Xu D, Min J, Du Y, Duan Q, Bao W, Sun Y, Xi H, Wang C, Bischof E. Practice Standards in International Medical Departments of Public Academic Hospitals in China: Cross-Sectional Study. JMIR Form Res 2024; 8:e53898. [PMID: 38739428 PMCID: PMC11130770 DOI: 10.2196/53898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 03/07/2024] [Accepted: 03/14/2024] [Indexed: 05/14/2024] Open
Abstract
BACKGROUND Improving health care in cities with a diverse, international population is crucial for ensuring health equity, particularly for foreigners facing challenges due to cultural and language barriers. This situation is especially relevant in China, a major destination for expatriates and travelers, where optimizing health care services and incorporating international standards in the public sector are vital. Achieving this involves understanding the operational details, cultural and linguistic nuances, and advancing medical digitalization. A strategic approach focusing on cultural competence and awareness of health care systems is essential for effectively navigating health care for foreigners and expatriates in China. OBJECTIVE The aim of this study was to perform an in-depth analysis of the subjective and objective experiences of local and international patients in public hospitals in China to provide a basis for enhancing the medical experience of all patients. METHODS A structured questionnaire was provided to patients at an international outpatient service of a top-tier university hospital in China. Qualitative analysis of the survey responses was performed to methodically categorize and analyze medical treatment, focusing on patient demand and satisfaction across four main category elements ("high demand, high satisfaction"; "high demand, low satisfaction"; "low demand, high satisfaction"; and "low demand, low satisfaction"), enabling a detailed cross-sectional analysis to identify areas for improvement. RESULTS Elements falling under "high demand, high satisfaction" for both Chinese and international patients were primarily in the realms of medical quality and treatment processes. In contrast, elements identified as "high demand, low satisfaction" were significantly different between the two patient groups. CONCLUSIONS The findings highlight the importance of systematic, objective research in advancing the quality of international health care services within China's leading academic medical centers. Key to this improvement is rigorous quality control involving both patients and providers. This study highlights the necessity of certifying such centers and emphasizes the role of digital platforms in disseminating information about medical services. This strategy is expected to cater to diverse patient needs, enhancing the overall patient experience. Furthermore, by developing comprehensive diagnosis and treatment services and highlighting the superior quality and costs associated with international health care, these efforts aim to foster a sense of belonging among international patients and increase the attractiveness of China's medical services for this demographic.
Collapse
Affiliation(s)
- Yaxu Zhou
- Finance Department, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Ying Zhou
- Smart Hospital Development Department, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Di Xu
- International Medical Service, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Jie Min
- International Medical Service, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yu Du
- International Medical Service, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Qi Duan
- International Medical Service, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Wen Bao
- International Medical Service, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yingying Sun
- International Medical Service, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Huiqin Xi
- Nursing Department, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Chunming Wang
- Smart Hospital Development Department, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Evelyne Bischof
- Department of Oncology and Clinical Cancer Center, State Key Laboratory of Oncogenes and Related Genes, Shanghai Cancer Institute, Shanghai, China
- Department of Oncology, Reni Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| |
Collapse
|
2
|
Chen X, Gong MF, Wu S, He J. "LEARN", a novel teaching method for Chinese clinical clerkship: A cross-sectional study. Front Surg 2023; 10:1113267. [PMID: 36860941 PMCID: PMC9968847 DOI: 10.3389/fsurg.2023.1113267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 01/20/2023] [Indexed: 02/16/2023] Open
Abstract
Background Despite the clerkship being crucial in the training of a future doctor, no widely accepted education model has been proposed. This study devised a new model for clinical clerkship rotations, titled "LEARN" for Lecture, English-video, Advisor, Real-case and Notion, and evaluated whether the LEARN model is appropriate for medical education in China. Methods A cross-sectional study was performed among 101 fourth-year students from the Xiangya School of Medicine during an Orthopaedic Surgery clerkship rotation in the Third Xiangya Hospital. They were divided into seven groups and took clerkship based on the LEARN model. A questionnaire was collected at the conclusion to measure learning outcomes. Results The LEARN model was highly accepted with the acceptance of five sessions being 95.92% (94/98), 93.88% (92/98), 96.98% (97/98), 100% (98/98) and 96.94% (95/98). The outcomes of two genders were comparable, whereas a difference was observed in the test score among groups (group 3 scored 93.93 ± 5.20, higher than others). Quantitative analysis showed that positive correlations existed in participation in the Notion (Notion means students' case discussion) section with leadership (r = 0.84, 95% CI: 0.72-0.94, p < 0.001), participation in the Real-case section with leadership (r = 0.66, 95% CI: 0.50-0.80, p < 0.001), participation in the Real-case section with mastery of inquiring skills (r = 0.57, 95% CI: 0.40-0.71, p < 0.001) and participation in the Notion section with mastery of physical examination skills (r = 0.56, 95% CI: 0.40-0.69, p < 0.001). Further qualitative analysis demonstrated that high-level participation in the English-video section indicated better outcomes in mastery of inquiring (p < 0.01), physical examination (p < 0.001), film reading (p < 0.01) and clinical reasoning (p < 0.01) skills. Conclusion Our results support the LEARN model is a promising method for medical clerkship in China. Further research involving more participants and more meticulous design is planned to test its efficacy. For refinement, educators may try to promote students' participation in the English-video session.
Collapse
Affiliation(s)
- Xiangyu Chen
- Department of Orthopaedic Surgery, Central South University Third Xiangya Hospital, Changsha, China,Department of Critical Care Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Matthew F. Gong
- Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, United States
| | - Song Wu
- Department of Orthopaedic Surgery, Central South University Third Xiangya Hospital, Changsha, China
| | - Jinshen He
- Department of Orthopaedic Surgery, Central South University Third Xiangya Hospital, Changsha, China,Correspondence: Jinshen He
| |
Collapse
|
3
|
Zhang Z. Statistical modeling to unravel multiple predictors of the choice of chemotherapy for non-small cell lung cancer. J Thorac Dis 2016; 8:2672-2673. [PMID: 27867539 PMCID: PMC5107555 DOI: 10.21037/jtd.2016.09.57] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- Zhongheng Zhang
- Department of Emergency Medicine, Sir Run-Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China
| |
Collapse
|
4
|
Wáng YXJ, Li YT. AME survey-003 A2: on the attractiveness of an medicine career in current China with a survey of 7,508 medical professionals and 443 non-medical professionals. Quant Imaging Med Surg 2016; 6:84-102. [PMID: 26981459 DOI: 10.3978/j.issn.2223-4292.2016.02.05] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
This is a part of the study of AME survey-003, aiming to understand the motivation and attractiveness of a career in medicine in China. The surveys were conducted on DXY platform with 3,564 medical professionals during October 26 to November 20; on Sojump platform with 1,587 medical professionals during October 28 to December 14, and 443 non-medical professionals during November 15 to December, all in 2015. Similar to our previous result, the not regretted participants vs. regretted participants (N/Y) ratio was 1.1 (P<0.01), and there was no significant difference in N/Y ratio between male and female medical professionals. Medical professionals working in class-IIIA hospitals, small township hospitals, or primary care clinics had a relatively higher job satisfaction than those in hospitals of other classes, while lecturer-level attending doctors (zhuzhi yishi) had a relatively lower job satisfaction than doctors of other grades. A large portion of respondents who replied they regretted entered medical profession said they would still like to be in this profession if they could be in their preferred hospital class and specialty. Public health and basic science research staff, anesthesiologists, oncologists had a relatively higher job satisfaction, while accident and emergency physicians, nurses, and pediatricians had a relatively lower job satisfaction. Medical professionals in Yunnan and Gansu ranked consistently high in job satisfaction than other provinces; despite they were not in the economically advanced regions in China. Similar to our previous result, the majority of the participants favored China to open up medical market to qualified foreign medical organizations to take part in fair competition, as well as favor the government to support regulated private hospitals. Pooled data of 7,508 medical professionals with data from AME survey-003 A1 included showed medicine was the top career choice among medical professionals' children (104/508, 20.5%), followed by finance and economics (74/508, 14.4%), and then electronic engineering or computer science (67/508, 13.2%). Among the 443 non-medical professionals, 122 have children who are attending university or have graduated, 12 (9.8%, 12/122) of them are pursuing a career in medicine. For the 100 non-medical professional parents whose children did not study medicine and if a choice could be given to them to start again, 60 parents (54.5%) replied they would support their children to study medicine. Our results consistently show medicine remained an attractive profession in China.
Collapse
Affiliation(s)
- Yì Xiáng J Wáng
- Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong SAR, China
| | - Yáo T Li
- Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong SAR, China
| |
Collapse
|
5
|
Wáng YXJ, L YT. AME survey-003 A1-part1: in current China, do you regret you joined the medical profession. Quant Imaging Med Surg 2015; 5:765-73. [PMID: 26682145 DOI: 10.3978/j.issn.2223-4292.2015.10.07] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND The medical workforce constitutes the foundation of the provision of health services in all countries. The effectiveness of health systems and the quality of health services are directly related to the performance of health workers. Satisfaction level of the job affects the quality of care for patients. An anonymous on-line survey was conducted with the aim to obtain a better understanding of the current morale of Chinese medical professionals. METHODS An online cross-sectional questionnaire based survey was conducted during the period of Sep 10-23, 2015, via the platform provided by DXY (www.dxy.cn), which is the largest medical and paramedical related website in China. In addition to demographics of the participants, a particular question was asked to the participants, in current China do you regret you joined the medical profession? This initial report analyzed the relationship between the participants with 'No' or 'Yes' answers to their demographic characteristics. RESULTS In total 2,356 DXY users completed the survey, including 1,740 males (73.82%) and 617 females (26.18%), with a mean age of 31.96±7.03 yrs. There were more participants from relatively economically developed eastern coast areas. The N/Y (no regret participants vs. regretted participants ratio) ratio for all participants was 1.06 (P=0.181). The N/Y ratio of males and females was 1.04 and 1.11 respectively, and there was no significant difference in this ratio among them. There were 1,549 participants from IIIA hospitals (65.72%, N/Y ratio =1.15, P=0.008), followed by IIIB & IIA hospitals (25.46%, N/Y ratio =0.87, P=0.086), IIB & II C hospitals (3.7%, N/Y ratio =0.83, P=0.394), and lastly 1A & 1B clinics (2.6%, N/Y ratio =1.35, P=0.249). A total of 1,323 participants (56.13%) were trainee doctors with N/Y ratio of 1.19 (P=0.002), followed by lecturer-level attending specialists (27.79%, N/Y ratio =0.81, P=0.009), associate principle doctors (12.43%, N/Y ratio =1.01, P=0.953), and lastly principle doctors (3.73%, N/Y ratio =1.59, P=0.033). Specialties with less stressful workload such as radiology and traditional Chinese medicine have the highest job satisfaction, while doctors in accident and emergency cluster have the least job satisfaction. Medical professionals from Yunnan, Gansu and Shanxi have relatively higher positive response (higher N/Y ratio), despite the fact that these are not the economically advanced regions in China; while Jiangsu, an economically advanced province, had relatively higher negative response (lower N/Y ratio). CONCLUSIONS The morale of majority medical professional in China mainland is likely to be positive. Job satisfaction is inversely related to work related stress level, but may not related to the absolute income.
Collapse
Affiliation(s)
- Yì-Xiáng J Wáng
- Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong SAR, China
| | - Yáo T L
- Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong SAR, China
| |
Collapse
|
6
|
Wáng YXJ. Why China is currently underperforming in medical innovation and what China can do about it?-Part II. Quant Imaging Med Surg 2015; 5:335-9. [PMID: 26029635 PMCID: PMC4426112 DOI: 10.3978/j.issn.2223-4292.2015.04.03] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Accepted: 04/09/2015] [Indexed: 11/14/2022]
Affiliation(s)
- Yì-Xiáng J Wáng
- Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong SAR, China
| |
Collapse
|
7
|
Wáng YXJ. Why so many Chinese clinical doctors are competing for basic research grants? Quant Imaging Med Surg 2015; 5:489-90. [PMID: 26029657 DOI: 10.3978/j.issn.2223-4292.2015.03.08] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Accepted: 02/27/2015] [Indexed: 11/14/2022]
Affiliation(s)
- Yì-Xiáng J Wáng
- Department of Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| |
Collapse
|
8
|
Wáng YXJ, Li T. A long way ahead to improve the cost-effectiveness of biomedical research in China. J Thorac Dis 2015; 7:E62-4. [PMID: 25922755 DOI: 10.3978/j.issn.2072-1439.2015.02.17] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2015] [Accepted: 02/09/2015] [Indexed: 11/14/2022]
Affiliation(s)
- Yì-Xiáng J Wáng
- 1 Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong SAR, China ; 2 DXY Website, Guanlan Networks (Hangzhou) Co. Ltd., Hangzhou 310052, China
| | - Tiantian Li
- 1 Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong SAR, China ; 2 DXY Website, Guanlan Networks (Hangzhou) Co. Ltd., Hangzhou 310052, China
| |
Collapse
|
9
|
Leung PC. Comments to Dr. Yi-Xiang Wang's on training of young doctors under the current health care system in China. J Thorac Dis 2015; 7:E60-1. [PMID: 25922754 PMCID: PMC4387429 DOI: 10.3978/j.issn.2072-1439.2015.02.16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Accepted: 02/02/2015] [Indexed: 01/22/2023]
|
10
|
Wáng YXJ. On the training of young doctors in China. Quant Imaging Med Surg 2015; 5:182-5. [PMID: 25694969 PMCID: PMC4312294 DOI: 10.3978/j.issn.2223-4292.2014.12.01] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Accepted: 11/26/2014] [Indexed: 11/14/2022]
Affiliation(s)
- Yì-Xiáng J Wáng
- Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong SAR, China
| |
Collapse
|