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[The quality of referral letters to the gynecologist compared with the standard of the Dutch Family Physicians Society].

The quality of referral letters to the gynaecologist compared with the standard of the Dutch Association of General Practitioners. OBJECTIVE. To assess the quality of referral letters of general practitioners (GP) used to refer new patients to a gynaecologic outpatient clinic. DESIGN. Prospective study. SETTING. Gynaecologic outpatients' clinic, Medical Centre Alkmaar, the Netherlands. METHOD. The actual quality of referral letters was compared with ideal quality, as defined by the Dutch Association of General Practitioners (NHG) in 1989. RESULTS. Fifty-three (14%) of the 373 new patients did not have a referral letter: 23 women (6%) consulted the gynaecologist without having consulted their GP first. Of the 320 referral letters 63% conformed to the NHG criteria and 27% contained a specific question to the specialist. One hundred and fifty-two letters (47%) were handwritten, of which 32 (10% of the total) were hardly legible. A good to excellent letter had a length of slightly more than 6 to 8 lines (A4 size). CONCLUSION. Of all 320 letters analysed 15% was qualified as 'excellent', 48% as 'reasonable/good', 25% as 'brief/just adequate' and 12% as 'inadequate/insufficient'.

Costs and Cost Analysis↗

[Belle époque?].

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Periodicals as Topic↗

Writing for publication: a workshop to prepare faculty as medical writers.

BACKGROUND AND OBJECTIVES: A 2 1/2-day Writing for Publication Workshop was presented to faculty and fellows for 5 successive years, 1991-1995. This paper describes the workshop curriculum and reports evaluation results. METHODS: A three-part evaluation plan incorporated both quantitative and qualitative methods. First, a nine-item questionnaire was administered to the 1992-1995 participants immediately prior to and after the workshop to identify perceived change in knowledge and skills. Second, a follow-up qualitative interview was administered to the 1991 and 1992 participants to identify their perceptions of the workshop's usefulness. Third, pre- and postworkshop publications of the 1991 and 1992 participants were analyzed to identify types of publications and significant differences in rates of publication. RESULTS: Eighty individuals participated in the five workshops given during the 1991-1995 period. Pre/post self-assessment data indicated significant increases in perceived knowledge and skill in all nine areas of assessment. The follow-up interview data showed that participants felt that the workshop motivated them to begin and sustain writing projects, gave them skills that made their writing more effective, and demystified the submission and publication processes. Analysis of the difference between pre- and postworkshop rates of publication showed a significant increase in the rate of publication. CONCLUSIONS: The evaluation findings indicate that the Writing for Publication Workshop met its educational objectives. Future curricula to prepare faculty as medical writers need to be tested using quasi-experimental designs to determine their impact on publication productivity and quality.

Analysis of Variance↗

Prevalence of plagiarism among medical students.

AIM: To determine the prevalence of plagiarism among medical students in writing essays. METHODS: During two academic years, 198 second year medical students attending Medical Informatics course wrote an essay on one of four offered articles. Two of the source articles were available in an electronic form and two in printed form. Two (one electronic and one paper article) were considered less complex and the other two more complex. The essays were examined using plagiarism detection software "WCopyfind," which counted the number of matching phrases with six or more words. Plagiarism rate, expressed as the percentage of the plagiarized text, was calculated as a ratio of the absolute number of matching words and the total number of words in the essay. RESULTS: Only 17 (9%) of students did not plagiarize at all and 68 (34%) plagiarized less than 10% of the text. The average plagiarism rate (% of plagiarized text) was 19% (5-95% percentile=0-88). Students who were strictly warned not to plagiarize had a higher total word count in their essays than students who were not warned (P=0.002) but there was no difference between them in the rate of plagiarism. Students with higher grades in Medical Informatics exam plagiarized less than those with lower grades (P=0.015). Gender, subject source, and complexity had no influence on the plagiarism rate. CONCLUSIONS: Plagiarism in writing essays is common among medical students. An explicit warning is not enough to deter students from plagiarism. Detection software can be used to trace and evaluate the rate of plagiarism in written student assays.

Adult↗

Writing a scientific paper as part of the medical curriculum.

The curriculum at the Medical School, University of Tromsø reserves 23 weeks for optional studies, including a period of 12 weeks at the end of the fifth year when the students carry out an independent study and write a short thesis. Of the first 417 doctors (graduation year 1979-89) from Tromsø 84.6% answered a postal questionnaire asking them to evaluate this part of the curriculum. These postgraduates report high levels of satisfaction with and benefit from this part of the curriculum. A total of 26.8% started working on their thesis before the final 12-week period, 32.6% had also published their study, half of these in international journals, and 75.6% found that the skills acquired during the final optional period had been useful in their subsequent work, irrespective of specialty. In conclusion, postgraduates consider their work in preparing a scientific paper as an important and integral part of medical studies.

Curriculum↗

[Electronic medical prescription at a university hospital: writing failures and users' opinions].

This study analyzed the writing failure of the computerized physician order entry system and its advantages and disadvantages according to users. At a university hospital 1,351 physician orders were analyzed and 84 nursing and medical professionals were interviewed. The results showed that 17.7% of the orders presented measures, medication had been suspended in 16.8%, in 28.2% there was dubious or misleading information and in 25% medication had been prescribed manually. The professionals indicated advantages such as: ease of data reading and the quickness with which the order is entered and released, among others. They also reported disadvantages such as the repetition of orders from previous days without a review and incorrectly typed information. Therefore, it is concluded that, despite representing an important strategy for error reduction, this system must be overhauled and professionals must be trained to use it.

Brazil↗

What is the patient really taking? Discrepancies between surgery and anesthesiology preoperative medication histories.

BACKGROUND: Surgical patients may be at risk for medication discrepancies that may lead to medication errors because both the anesthesiologist and the surgeon write separate preoperative medication histories. METHODS: A prospective observational study was conducted to examine the extent of medication and allergy discrepancies between surgical and anesthesia preoperative medication histories for patients admitted to two surgical intensive care units in an academic medical center. RESULTS: Of the 79 patient records reviewed, 58 (73%) contained at least one discrepancy, 23% had different allergy information, 56% had different preoperative medications, and 43% had different doses or dosing frequencies listed in the medication histories. Of the 988 allergies, medications, and doses or dosing frequencies documented in the two histories, 456 (46%) contained discrepancies. Of these discrepancies, 20 (5%) were due to different allergies, 293 (64%) to different medications, and 143 (31%) to different doses or dosing frequencies. CONCLUSIONS: Discrepancies in preoperative medication histories between surgical and anesthesia records occur in most patients and further work is required to help improve agreement of patient medication histories between services.

Anesthesiology↗

Being skeptical about the medical humanities.

In this paper the author challenges the prevailing view that contemporary writing in the medical humanities is serving the needs of the various health care disciplines. The current medical humanities literature assumes that physicians are the appropriate target group. This is most notably the case within health care ethics literature. There appears to be an unexamined assumption that physician-centric approaches to clinical ethical decision-making are the standard by which appropriate ethical practice is judged. The author challenges this assumption and addresses the problems that this approach engenders. The medical humanities literature appears to reinforce hierarchical, patriarchal arrangements which are themselves not morally neutral.

Bioethical Issues↗