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Doris Østergaard

Publications and source records attributed to Doris Østergaard.

7 recordsLinked to original sources
PubMed2007

[Are Danish medical students concerned about their future job? A questionnaire study].

INTRODUCTION: Knowledge about the thoughts of Danish medical students regarding their job future is limited. The aim of this study was to investigate whether medical students are concerned about their future work, and if so, to describe the types of concerns they have, to what degree they are concerned, possible reasons for and consequences of their concerns; furthermore, to evaluate if gender and semester influate on the concerns. METHOD: A questionnaire was developed based on focus group interviews with medical students. The questionnaire was sent to 596 medical students from 3rd, 8th, and 13th semester at Copenhagen University. RESULTS: The response rate was 69.9%. A substantial number of students (47-90%) were very concerned or concerned to a certain degree with regard to aspects of working life that related to the patient and working conditions. A positive relation was seen between being highly concerned or concerned to a certain degree and daily or often worrying. Possible causes of the concerns were related to their experience through their clinical stays, the curriculum, comments about the job made by medical doctors and others and their own personality. Every sixth student had considered leaving university or refraining from entering clinical training due to these concerns. CONCLUSION: Medical students from 3rd, 8th, and 13th semester are concerned about their future work, especially in relation to the patient, regarding, for example, the risk of committing an error or being incompetent in relation to practical skills, but also work-related concerns are mentioned.

Clinical Competence↗
PubMed2006

[The attitude of doctors and nurses towards reporting and handling errors and adverse events].

INTRODUCTION: Few studies have been published about the attitudes of doctors and nurses towards reporting and handling adverse events. However, knowledge about staff attitudes is relevant and may be essential to dealing with potential problems and barriers that staff might have, as well as to supporting cultural change in relation to reporting and learning. MATERIALS AND METHODS: From February to March 2002, a questionnaire comprising 133 questions was distributed to 4019 doctors and nurses in four counties in Denmark. This paper deals with only a subset of the results of the survey. RESULTS: Responses were obtained from 703 doctors and 881 nurses, yielding an overall response rate of 51%. Statistical analysis was performed with non-parametric tests (Mann-Whitney, Kruskal-Wallis). The survey shows large differences in attitudes among different staff groups towards reporting adverse events, and errors, in their reasons for not reporting and their degree of distress at the prospect of making mistakes. Doctors are more reluctant (34%) than nurses (21%) to bring up adverse events and errors, indicating as their main reasons: lack of tradition, fear of the press, and the risk of being reprimanded. In contrast to consultants, "non-consultants" (staff specialists and junior doctors), and especially the female members of this group, show a greater agreement with each of the proposed reasons. The thought that one may cause injury to a patient induces 35% of "non-consultants" to consider giving up their job "now and then/often". DISCUSSION: Efforts to improve patient safety culture can become more effective via knowledge about similarities and differences among staff groups that have been uncovered in this survey.

Attitude of Health Personnel↗
PubMed2006

Patient views of adverse events: comparisons of self-reported healthcare staff attitudes with disclosure of accident information.

In the present paper, we report results of surveys in 2003 in Japan and Denmark about patients' views about adverse events, focusing on the actions of healthcare staff involved in a medical accident. Results show that patients were more likely to indicate negative expectations to a doctor's reactions after a medical accident when asked in general terms than when asked in relation to concrete case stories. When asked in general terms, 66% (47%) of Japanese (Danish) respondents expected that doctors sometimes hold back on providing information to patients about a medical accident, while 37% (7%) did so when asked about a concrete, mild-outcome case. We examine some possible reasons for the relatively high level of distrust of Japanese patients, and we discuss whether the seemingly lower level of disclosure in Japan than in Denmark and the negative stories in the Japanese press may have an impact. We also suggest some implications for introducing a patient-centred or customer-centred approach to risk management in healthcare and other domains.

Attitude of Health Personnel↗
PubMed2005

Pharmacokinetics and pharmacodynamics of mivacurium in patients phenotypically homozygous for the atypical plasma cholinesterase variant: effect of injection of human cholinesterase.

BACKGROUND: In patients homozygous for atypical plasma cholinesterase, mivacurium causes a long-lasting neuromuscular block, but injection of human cholinesterase has been proven effective in antagonizing the block. The purpose of this study was to evaluate the pharmacodynamics and pharmacokinetics of mivacurium in such patients, as well as the effect of cholinesterase injected early or late after mivacurium. METHODS: Eleven patients phenotypically homozygous for the atypical variant received 0.075 mg/kg (1 patient) or 0.15 mg/kg (10 patients) mivacurium. The neuromuscular block was monitored using train-of-four nerve stimulation and mechanomyography. Cholinesterase, 2.8-10.0 mg/kg, was administered approximately 30 or 120 min after mivacurium. The times to different levels of neuromuscular recovery and the venous concentrations of the isomers of mivacurium were measured. RESULTS: Injection of cholinesterase increased plasma cholinesterase activity to normal and the clearances of the active isomers and the elimination rate constants by a factor of 10-15. The first response was seen in 13.5 min (3.7-44.2 min). Time to a train-of-four ratio of 0.8 ranged from 30 to 60 min (n = 6). Neostigmine injected after cholinesterase shortened recovery further, and a train-of-four ratio of 0.8 was reached in 10-30 min. CONCLUSION: As expected, the duration of action of mivacurium is markedly prolonged in homozygous atypical patients. Injection of cholinesterase significantly increases the metabolism of mivacurium, leading to a shorter duration of action. Injection of neostigmine after the administration of cholinesterase speeds up recovery.

Adolescent↗
PubMed2004

The effect of in-training assessment on clinical confidence in postgraduate education.

INTRODUCTION: The literature on how in-training assessment (ITA) works in practice and what educational outcomes can actually be achieved is limited. One of the aims of introducing ITA is to increase trainees' clinical confidence; this relies on the assumption that assessment drives learning through its content, format and programming. The aim of this study was to investigate the effect of introducing a structured ITA programme on junior doctors' clinical confidence. The programme was aimed at first year trainees in anaesthesiology. METHODS: The study involved a nationwide survey of junior doctors' self-confidence in clinical performance before (in 2001) and 2 years after (in 2003) the introduction of an ITA programme. Respondents indicated confidence on a 155-item questionnaire related to performance of clinical skills and tasks reflecting broad aspects of competence. A total of 23 of these items related to the ITA programme. RESULTS: The response rate was 377/531 (71%) in 2001 and 344/521 (66%) in 2003. There were no statistically significant differences in mean levels of confidence before and 2 years after the introduction of the ITA programme - neither in aspects that were related to the programme nor in those that were unrelated to the programme. DISCUSSION: This study demonstrates that the introduction of a structured ITA programme did not have any significant effect on trainees' mean level of confidence on a broad range of aspects of clinical competence. The importance of timeliness and rigorousness in the application of ITA is discussed.

Anesthesiology↗