Background In 2013, Taiwan launched a curriculum reform—the 7-year undergraduate medical education program was shortened to 6 years. This study explored the evaluation results from students regarding the curriculum reform and investigated graduates’ perceptions regarding the curriculum organization of the two academic training programs affected by this curricular reform. Methods A cross-sectional survey was conducted from May 14 to June 12, 2019. The 315 graduates from both the 7-year and 6-year curriculum programs in the same medical school in Taipei were invited to participate in this study. In total, 197 completed questionnaires were received, representing a response rate of 62.5%. The results of the principal component analysis confirmed the validity of the constructs employed in this self-administered questionnaire. Results The t-test results yielded two main findings. First, the graduates from the 6-year program had significantly lower scores for preparedness for the upcoming postgraduate-year residency training than did their 7-year program counterparts. Additionally, the male graduates had significantly higher scores in terms of perceptions regarding curriculum organization and preparedness for postgraduate-year residency training than the female graduates. The results of stepwise regression also indicated that the sex difference was significantly correlated with graduates’ readiness for their postgraduate-year residency training. Conclusion To avoid sex disparities in career development, a further investigation of female medical students’ learning environment and conditions is necessary. In addition to the cross-sectional study of students’ perceptions, further repeated measurements of the objective academic or clinical performance of graduates in clinical settings are desirable.
ObjectivesThis study applied the theory of planned behavior (TPB) in shared decision making (SDM) to understand behavioral intention in patients with type 2 diabetes with regard to injection therapy for blood sugar control.MethodsA cross sectional study was conducted. Two hundred and fifty-four patients with type 2 diabetes participated this study and were interviewed by pharmacists in different clinics. A patient decision aid (PDA) entitled “Should I receive injection therapy regarding my type 2 diabetes condition?” was developed for this study and served as interview agenda which comprised 18 items to inquire their willingness to use injection therapy and related considerations during the SDM process.ResultsThe questionnaires were revised using item analysis, exploratory factor analysis, and a criteria of Cronbach's α > 0.7. This resulted in three constructs for all questionnaires that fit the TPB model. Attitude (β = 0.432; P < 0.001) and PBC (β = 0.258; P < 0.001) were directly correlated with intention. TPB explained 35.2% of the variance in intention toward the use of injection therapy.ConclusionsAttitude and PBC toward injection therapy positively and significantly influence the patients' intention to use injection therapy.Practical implicationsThese findings identify a key association for understanding behavioral intention in patients with type 2 diabetes with regard to blood sugar control during SDM.
Background: Blood shortage is a persistent problem affecting Taiwan’s health-care system. The theory of planned behavior (TPB) has been commonly used in studies of health advocacy. The purpose of this study was to develop a questionnaire measuring clinicians’ intention to prescribe transfusion based on the TPB. Method: A questionnaire comprising 15 items for assessing clinicians’ intention to prescribe blood transfusion was developed, and it collected demographic characteristics tested patient blood management (PBM) and perceived knowledge of PBM. Furthermore, it contained four subscales related to the TPB. A total of 129 clinicians participated in this pilot study between July and December, 2020. Item analysis and exploratory factor analysis were conducted to examine the validity and reliability of this measurement instrument. Results: The results indicated no statistically significant correlations between the demographic characteristics and test scores. Regarding perceived knowledge, the results of a one-way analysis of variance revealed that the effect of age, hierarchy of doctors, and education level was significant. In terms of subjective norms, a significant effect for education level was noted [t (129) = 2.28, p < 0.05], with graduate school graduates receiving higher scores than college graduates. An analysis of variance demonstrated the effect of hierarchy, education level, and medical specialty on perceived behavioral control. The results of the regression analyses revealed that perceived knowledge (β = 0.32, p < 0.01) and subjective norms (β = 0.22, p < 0.05) were significantly related to clinicians’ behavioral intention. Conclusions: This study revealed that factors affecting clinicians’ blood transfusion management can be explained using the TPB-based questionnaire. This study demonstrated that physicians’ perception of whether most people approve of PBM and their self-assessment of their PBM knowledge affect their intention to proceed with PBM. According to this finding, a support system among physicians must be established and maintained to increase physician’s confidence in promoting PBM.
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