PubMed · 10600973
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H Ferguson. Body piercing.. https://doi.org/10.1136/bmj.319.7225.1627
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OBJECTIVE: To assess the potential effect of educational intervention on episiotomy practice. STUDY DESIGN: A survey of the attitude of obstetrical caregivers toward episiotomy was conducted among obstetricians and midwives in the three public hospitals in Haifa. Data regarding episiotomy rates was collected for the years 2001-2003. At the beginning of 2002, lectures on the risks and benefits of episiotomy were given in two hospitals. Episiotomy rates before and after the lecture were compared. RESULTS: A significant and lasting reduction in episiotomy rates was observed in the two hospitals where lectures were given. There were no clinically significant and consistent changes in the episiotomy practices in the third hospital. CONCLUSION: Education may play an important role in changing common medical practices, as in episiotomy. It was clearly shown that our beliefs are not always up to date. We call for periodic reassessment of all medical procedures, as common and accepted as they are.
RATIONALE: The goal of this study was to examine oncologists' attitudes towards recommending exercise to patients with cancer during treatment. PATIENTS AND METHODS: Using a national survey, all 659 practicing medical and radiation oncologists in Canada were sent a brief questionnaire. RESULTS: The response rate was 46% (281/610). The majority of oncologists agreed that exercise was beneficial (62.0%), important (55.8%) and safe (63.1%) for patients with cancer during treatment. Forty-three percent of oncologists reported that they tried to recommend exercise to their patients when appropriate. Moreover, oncologists actually reported recommending exercise to 28% of their patients during the past month. Analyses also indicated significant differences between oncologists, with younger, female, and medical oncologists generally having more favorable attitudes towards exercise for patients with cancer than their older, male, and radiation oncology counterparts. CONCLUSIONS: Oncologists have a favorable attitude toward recommending exercise to patients with cancer although several important barriers may prevent oncologists from providing exercise advice to their patients. Further research is required evaluating the effectiveness of interventions and strategies designed to improve oncologists' confidence and ability to advise their patients on exercise during oncology consultations.
BACKGROUND: Work hour guidelines and core competencies were introduced to improve surgical education and are changing the landscape of surgical training. We sought to examine perceptions and attitudes regarding the impetus and impact associated with these changes. MATERIALS AND METHODS: Anonymous surveys were distributed to faculty and surgeons-in-training in an Accreditation Council for Graduate Medical Education, university-based, training program. RESULTS: Faculty (F, n = 30) and trainees (T, n = 30) agree that lifestyle expectations and long work hours are the principal issues facing surgical education (F = 80%, T = 56%; P = 0.03). Implementation of ACGME guidelines is perceived as NOT improving patient care or clinical experience (F = 100%, T = 90%; P = 0.03) while reducing operative experience (F = 50%, T = 70%). More faculty (>80%) than trainees (33%) are concerned that ACGME guidelines will diminish patient care experiences. Although most (F = 77%, T = 83%; P = NS) agree that hiring additional providers will improve guideline compliance, many oppose ACGME guideline implementation fearing a loss of professionalism. Although both (F = 50%, T = 47%) admonish deficient interpersonal and communication skills as the major impediment to implementing ACGME guidelines, opinions regarding implementation differ. Most faculty (67%) believe ACGME-imposed deadlines are the most influential reason; however, trainees (57%) believe guidelines should be promptly implemented to address long-awaited changes in work environment and surgical graduate medical education. CONCLUSIONS: Although faculty and trainees' perception of the issues surrounding ACGME guidelines converge, perception of changes following implementation is quite divergent. For successful implementation, leadership must address prevailing attitudes and set realistic expectations. These trends have important implications for planning the future of surgical education, unifying multi-generational colleagues, and improving systems-based practice.