RESUMO
BACKGROUND: Inter-professional collaboration between physicians and nurses, within and between cultures, can help contain cost and insure better patient outcomes. Attitude toward such collaboration is a function of the roles prescribed in the culture that guide professional behavior. OBJECTIVES: The purpose of the study was to test three research hypotheses concerning attitudes toward physician-nurse collaboration across genders, disciplines, and cultures. METHOD: The Jefferson Scale of Attitudes Toward Physician-Nurse Collaboration was administered to 639 physicians and nurses in the United States (n = 267) and Mexico (n = 372). Attitude scores were compared by gender (men, women), discipline (physicians, nurses), and culture (United States, Mexico) by using a three-way factorial analysis of variance design. RESULTS: Findings confirmed the first research hypothesis by demonstrating that both physicians and nurses in the United States would express more positive attitudes toward physician-nurse collaboration than their counterparts in Mexico. The second research hypothesis, positing that nurses as compared to physicians in both countries would express more positive attitudes toward physician-nurse collaboration, was also supported. The third research hypothesis that female physicians would express more positive attitudes toward physician-nurse collaboration than their male counterparts was not confirmed. CONCLUSIONS: Collaborative education for medical and nursing students, particularly in cultures with a hierarchical model of inter-professional relationship, is needed to promote positive attitudes toward complementary roles of physicians and nurses. Faculty preparation for collaboration is necessary in such cultures before implementing collaborative education.
Assuntos
Atitude do Pessoal de Saúde/etnologia , Comportamento Cooperativo , Enfermeiras e Enfermeiros/psicologia , Relações Médico-Enfermeiro , Médicos/psicologia , Análise de Variância , Comparação Transcultural , Análise Fatorial , Feminino , Identidade de Gênero , Humanos , Descrição de Cargo , Masculino , México , Enfermeiros/psicologia , Médicas/psicologia , Inquéritos e Questionários , Estados UnidosRESUMO
PURPOSE: To compare the academic performances of Asian-American medical students--before, during, and after medical school--with those of white students. METHOD: The 140 Asian-American graduates and 2,269 white graduates from the classes of 1981-1992 at Jefferson Medical College were studied prospectively: data on academic performance, indebtedness, and delayed graduation were analyzed and compared for all the graduates. F-tests, chi-square tests, and regression models were used. RESULTS: The Asian-Americans had statistically significantly higher scores on the SAT (Scholastic Aptitude Test) quantitative subtest and on the MCAT (Medical College Admission Test) chemistry, physics, and science problems subtests; the whites had significantly higher scores on the MCAT reading subtest; third-year grade-point averages for required clerkships; and scores on National Board of Medical Examiners Part I, II, and III examinations (NBME I, II, and III). No significant difference was found in the other performance measures, including ratings in the first year of residency. Regression analysis showed that the MCAT reading score was the major predictor of Asian-Americans' performances on the NBME I and II. CONCLUSION: Because the MCAT reading score is the major predictor of later performance for Asian-American students, schools should consider employing different criteria in predicting and monitoring these students' performances.
Assuntos
Logro , Asiático/estatística & dados numéricos , Avaliação Educacional , Estudantes de Medicina/estatística & dados numéricos , População Branca/estatística & dados numéricos , Adulto , Competência Clínica/estatística & dados numéricos , Educação de Graduação em Medicina , Educação Pré-Médica , Avaliação Educacional/métodos , Feminino , Humanos , Internato e Residência , Estudos Longitudinais , Masculino , Philadelphia , Estudos ProspectivosRESUMO
The Department of Family Medicine at Jefferson Medical College has used the modified essay question as the final examination format for its required third-year clerkship since 1976. To compare the family medicine modified essay question format with the multiple choice question format used in the other five required junior clerkships, examination scores from 2,174 Jefferson graduates (1976-1985) were correlated with scores on the examinations of the National Board of Medical Examiners (NBME), ratings of clinical performance in the required third-year clerkships, and ratings on four global areas of postgraduate competence. Grades on the multiple choice examination in internal medicine consistently yielded the highest correlations with NBME scores and with postgraduate ratings of medical knowledge. Performance on the modified essay examination in family medicine had the lowest correlations in these areas. The family medicine scores, however, consistently yielded the highest correlations with overall third-year clinical performance and with postgraduate performance in the areas of data-gathering skills, clinical judgment, and professional attitudes. These results indicate that the modified essay question format may provide a different and important parameter in the evaluation of medical trainees.