A perspectiva dos estudantes pré-clínicos sobre o ensino da ética médica: um estudo de grupo focal na Turquia

Aim: We aimed to receive the opinions of the preclinical medical students on medical ethics education, and to present some suggestions for the education program. Methods: Focus group discussions were held with third-grade medical students. The analyses were implemented using Creswell’s six-step qualitative data analysis. Results: During the data analysis, themes with the following titles were identified: necessity of the education, content, education methods, assessment, participation, contribution of the education, moving to clinical training and suggestions. Discussion: The students stated that the discussions on movies/books/case-based scenarios are more useful than lectures. Although they believed that student assessment was necessary for the medical ethics education, they had negative attitudes towards Multiple Choice Questions. At the stage of moving to the clinical training, their feelings and thoughts about the learning outcomes they would gain from ethical education were contradictory. Conclusion: Each theme and code obtained from the students’ expressions may contribute to improving medical ethics education for all institutions. Besides student education, it is also necessary the faculty development programs on medical ethics education for clinical teachers. Additionally, further studies can be conducted on the actions that need to be taken to help students internalize the ethical issues and feel the need of learning more.Nuestro objetivo consistió en recibir las opiniones de estudiantes de medicina en pre-clínica sobre educación en ética médica y presentar algunas sugerencias para el programa de educación. Métodos: Se mantuvo discusiones de grupo focal con estudiantes de medicina de tercer grado. Se implementó el análisis cualitativo de datos de seis pasos de Creswell. Resultados: Mediante el análisis de datos, se identificaron los siguientes temas: necesidad de la educación, contenido, métodos de educación, evaluación, participación, contribución de la educación, el paso a formación clínica y sugerencias. Discusión: Los estudiantes consideraron que las discusiones sobre películas/libros/escenarios de casos eran más útiles que las clases dictadas. Aunque pensaban que la evaluación de los estudiantes era necesaria para la educación en ética médica, no valoraron positivamente las pruebas de preguntas con respuesta múltiple. En el paso a la formación clínica, sus sentimientos y pensamientos sobre los resultados del aprendizaje en educación ética eran contradictorios. Conclusión: Cada tema y código obtenido de las propuestas de los estudiantes puede contribuir a mejorar la educación en ética médica en las instituciones. Además de la educación, también es necesario desarrollar programas sobre educación ética médica para los profesores clínicos. Además, se pueden realizar más estudios sobre las acciones que se necesitan tomar para ayudar a los estudiantes a internalizar los temas éticos y sentir la necesidad de aprender más.Objetivo: tivemos como objetivo coletar as opiniões dos estudantes pré-clínicos de medicina no ensino da ética médica e apresentar algumas sugestões para o programa de ensino. Métodos: foram realizadas discussões em grupos focais com estudantes do 3º período de medicina. As análises foram implementadas usando o método qualitativo de seis etapas de Creswell. Resultados: Durante a análise de dados, os seguintes temas foram identificados: a necessidade da educação, conteúdo, métodos de ensino, avaliação, participação, contribuição da educação, transição para o treinamento clínico e sugestões. Discussão: Os alunos concluíram que as discussões sobre filmes/livros/estudos de caso são mais úteis que aulas expositivas. Embora eles acreditassem que a avaliação de alunos era necessária para o ensino da ética médica, eles tinham atitudes negativas em relação a questões de múltipla escolha. Na fase de transição para o treinamento clínico, seus sentimentos e pensamentos sobre os resultados da aprendizagem, que eles obteriam com o ensino da ética eram contraditórios. Conclusão: Cada tema e código obtidos das opiniões dos alunos podem contribuir para melhorar o ensino da ética médica para todas as instituições. Além do ensino dirigido ao aluno, é necessário que haja também programas de desenvolvimento do corpo docente acerca da educação de ética médica. Ademais, mais estudos podem ser realizados sobre as ações que precisam ser tomadas para ajudar os alunos a interiorizar as questões éticas e sentir a necessidade de aprender mais a respeito

Normative data and discriminative properties of short form 36 (SF-36) in Turkish urban population

BACKGROUND: SF-36 has been both translated into different languages and adapted to different cultures to obtain comparable data on health status internationally. However there have been only a limited number of studies focused on the discriminative ability of SF-36 regarding social and disease status in developing countries. The aim of this study was to obtain population norms of the short form 36 (SF-36) health survey and the association of SF-36 domains with demographic and socioeconomic variables in an urban population in Turkey. METHODS: A cross-sectional study. Face to face interviews were carried out with a sample of households. The sample was systematically selected from two urban Health Districts in Izmir, Turkey. The study group consisted of 1,279 people selected from a study population of 46,290 people aged 18 and over. RESULTS: Internal consistencies of the scales were high, with the exception of mental health and vitality. Physical health scales were associated with both age and gender. On the other hand, mental health scales were less strongly associated with age and gender. Women reported poorer health compared to men in general. Social risk factors (employment status, lower education and economic strain) were associated with worse health profiles. The SF-36 was found to be capable of discriminating disease status. CONCLUSION: Our findings, cautiously generalisable to urban population, suggest that the SF-36 can be a valuable tool for studies on health outcomes in Turkish population. SF-36 may also be a promising measure for research on health inequalities in Turkey and other developing countries

Globalization of the pharmaceutical industry and the growing dependency of developing countries: The case of Turkey

In developing countries, the effect of globalization on the pharmaceutical sector has resulted in a decrease in exportation and domestic production, accompanied by an increase in importation of pharmaceuticals and a rise in prices and expenditures. As an example of a developing country, Turkey has been facing the long-standing and increasing pressure of global regulations placed on its pharmaceutical sector. This has led to an increasing dependency on multinational companies and a gradual deterioration of an already weakened domestic pharmaceutical sector. This case study of Turkey offers points to consider in the world of increasing globalization, as it offers lessons on ways of examining the effects of globalization on the pharmaceutical industry of developing countries

Bioethics and Turkey: Crossroads and challenges

Despite extraordinary improvements in medicine, health care worldwide continues to exhibit indefensible contradictions and extreme inequalities. "Health-for-all" campaigns, and development programs targeting welfare and social security have addressed these problems with limited success, but bioethicists, who by this point in the globalization era might have been expected to be addressing these problems urgently and persistently, have had little to say. We ask if bioethics, stalled at a crossroads, is prepared to alter course. We review the bioethics experience in Turkey as a case study, considering especially globalization and Turkey's application to join the European Union

Attitudes and practices of primary healthcare center patients about drug use in Turkey

Objective: Noncompliance is considered as a widespread but often neglected problem all over the world. In order to promote compliance, it is essential to first know the current drug use situation. Therefore, this study aims to investigate the level of drug compliance in patients of a primary healthcare centre and identify factors which affect the patients' drug compliance in Turkey

Trends in diagnostic imaging utilization in a university hospital in Turkey.

Objectives: The aim of this study was to evaluate utilization trends of the diagnostic imaging examinations during the past decade in a university hospital in Turkey

Globalization and the trends of medical technology trade in Turkey.

Medical technology trade is one of the most affected health areas by global regulations in the developing countries. The aim of the study is to examine recent changes in medical technology import and export and their results in Turkey. Data show that the total medical technology imports (MTI) increased from $34.6 million to$ 3427.9 million between 1970 and 2003. While MTI constituted 3.6% of total imports in 1970 and 1.3% in 1980, this ratio raised up to 4.9% in 2003. The ratio of MTI in total health expenditures were also increased from 7.6% in 1970 to 31.5% in 2003. Medical technology exports (MTE) have been increased from $0.9 million in 1970 to$ 303.2 million in 2003. The ratio of MTE to MTI increased from 2.7% to 13.9% between 1970 and 1990 and decreased after 1990, to 8.8%. Our study implied that the medical technology trade in Turkey has been negatively affected and in some respects differs from some other important industries in the globalization era. Nevertheless, detailed comparative studies in different developing countries such as China, Brazil, Mexico and India, are needed to explore the real state of medical technology trade, use and the effects of globalization on these topics. (c) 2006 Elsevier Ireland Ltd. All rights reserved

Direct-to-consumer advertising of pharmaceuticals: developed countries experiences and Turkey

While several major problems concerning drugs occur in the world, the attempts to direct-to-consumer advertising (DTCA) has gained a considerable impetus lately in both developed and developing countries. DTCA has increasingly become an appealing advertising alternative for the pharmaceutical industry as drug companies have come to wrestle with such problems as the expansion of the drug market; the decline of the medical representatives' work efficiency; drug reimbursement restrictions; and the escalating role of the Internet in the consumer market. Some of the main disadvantages of the DTCA are: increasing drug expenditures, unnecessary drug consumption and adverse effect risks. Even though the influence of pharmaceuticals on health services and the economy hold the same importance in the developed and developing countries, its negative consequences have increased by encompassing developing countries in its grip. Therefore, in this review, using Turkey as an example, the situation of direct-to-consumer advertisements in developing countries is analysed in relation with developed countries