The strongest theme was that of career development. This must be addressed by the Government of Nepal if there is to be any hope of improving retention of GPs in rural areas. GPs need to have a clear career ladder, with recognition of the value of service in rural areas. There is, however, no one single answer to the complex interacting factors that impact on GP retention in rural Nepal. A multifaceted, holistic response is necessary. From the level of community awareness, a career structure and financial remuneration to adequately set up hospitals, functional teams, family support, continuing professional development and a secure working environment - each area must be addressed for the whole to function.
This study explores the extent to which a one-week nursing rotation for medical students changed the interprofessional attitudes of the participating nurses and students. Third-year medical students worked with nurses before starting clinical rotations. Pre- and post-experience surveys assessing perceptions of mutual respect, nurse-doctor roles, and interprofessional communication and teamwork were given to 55 nurses and 57 students. The surveys consisted of qualitative questions and a Likert scale questionnaire that was analyzed using qualitative and quantitative content analyses. The response rate was 51/57 (89%) students and 44/55 (80%) nurse preceptors. Nurses reported that students met nurses’ expectations by displaying responsibility, respect, effective communication, and an understanding of nursing roles. Medical students’ narratives demonstrated two significant changes. First, their views of nurses changed from that of physician helpers to that of collaborative patient-centred professionals. Second, they began defining nursing not by its tasks, but as a caring- and communication-centred profession. Responses to Likert-scaled questions showed significant differences corresponding to changes described in the narrative. A one-week immersive clinical nursing rotation for medical students was a transformative way of learning interprofessional competencies. Learning in an authentic workplace during a clinical rotation engendered mutual respect between nurses and future doctors. Students’ view of the role of nurses changed from nurses working for doctors with patients, to working with doctors for patients.
Introduction: Postgraduate specialization is perceived as essential for success with high competition for enrolment. The reasons how medical students choose their postgraduate specialty are complex. Understanding the factors that influence career choice helps in workforce planning. So, we tried to identify the specialty preferred by postgraduate students and the factors that influenced these choices in a post graduate institution.Methods: A cross-sectional observational study was conducted in National Academy of Medical Sciences. All the postgraduate students of batch 2011 AD were enrolled for the study. The responses were rated on a five point Likert scale.Results: Significant gender preference was observed in specialties. General Surgery, Internal Medicine and Orthopedics were chosen by male students (P-Values, respectively, 0.001, 0.033 and 0.000) while Obstetrics and Gynecology and Ophthalmology being chosen by female students (P-Values, respectively, 0.000 and 0.006). Significant difference was observed between male and female student responses to the factor – scope in future (P – value 0.042), between married and unmarried students to the factor – workload flexibility (P – value 0.011), students who tried to go abroad versus who didn’t, for the factor – Illness of self/family/friend (P – value 0.016), and between those who worked in rural area versus those who didn’t, to the factor – Influence of friends/ seniors (P – value 0.038).Conclusions: Various factors affect the choices for preferred specialty. Policy makers should look at the needs of the nation, and ensure that specialty postgraduate education programs reflect those needs. Keywords: career choices; likert scale; medical education; postgraduate specialty. | PubMed
Introduction: This is a qualitative study, to generate a framework for a core curriculum in General Practice in the undergraduate setting, designed specifically for Nepal.
Methods:
A Delphi process was used to involve representatives from the GP faculty in Institute of Medicine, BP Koirala institute BPKIHS, Patan Hospital/National Academy Medical Sciences and Tansen mission hospital. The Delphi involves getting input from an identified group of experts and progressively feeding back the results from each round of enquiry so that subsequent views are influenced until a point of convergence is reached. In effect the Delphi not only analyses problems and identifies solutions, but can begin the process of commitment to change.
Results:
A prioritized list of the key outcomes for an undergraduate GP curriculum was developed and a broad list of knowledge, skills and attitudes were defined. A balance was observed between the need to train doctors who are skilled in communication, who have compassion for their patients, who are also required to be excellent rational clinicians able to respond to emergency situations. There was also the need for doctors to be competent not just in individual clinical care, but in the care of communities.
Conclusions:
General Practice, as a core component of primary care, should be an obligatory part of every undergraduate medical curriculum. This Delphi process has produced an important framework for a national undergraduate curriculum in General Practice, designed specifically for Nepal.
Keywords: curriculum; delphi technique; education medical undergraduate; family practice; needs assessment
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