High Self-assessment Research Articles

Intubation using the gum-elastic bougie while wearing personal protective equipment.

To determine whether application of a gum-elastic bougie (GEB), a visual stylet used to improve success rates of difficult intubations, reduces the time, and number of attempts to achieve successful intubation while wearing personal protective equipment (PPE). A randomized cross-over study comparing orotracheal intubations performed on an AirMan® Mannequin, using either a semirigid stylet or a GEB, while wearing an active hood with a charcoal impregnated suit and butyl rubber gloves. Simulation training field of the Israel Defense Force Medical Corps. 27 military physicians and 23 paramedics (PMs). Comparing intubation with and without using the GEB while wearing PPE. Airway (AW) control was considered successful if the "lungs" of the mannequin ex-panded during bag ventilation. Three unsuccessful attempts or a procedure exceeding 60 seconds were regarded as a failure. Correlations between parameters of self-assessment of skills and successful intubation were also determined. With the GEB, success rate was lower (82 percent versus 100 percent, p = 0.002), more attempts were needed (1.4 ± 0.7 versus 1.0 ± 0.2, p = 0.005) and time-to-achieve AW control was longer (43.6 ± 14.6 sec-onds versus 23.1 ± 10.5 seconds, P < 0.001) than without it. Participants with high self-assessment of GEB-assisted AW management skills needed less attempts to perform successful intubation with GEB than participants with low self-assessment (1.0 ± 0.0 versus 1.4 ± 0.8, p = 0.001), but not less time to achieve it. While donning PPE, the use of GEB (versus semirigid stylets) did not reduce the time or the number of attempts necessary to achieve successful intubation.

Ocena poziomu wiedzy żywieniowej za pomocą kwestionariusza komPAN pacjentów po ostrym zespole wieńcowym hospitalizowanych na oddziale kardiologii inwazyjnej. Doniesienie wstępne

Introduction. Cardiovascular diseases are the major cause of mortality in Poland. Thus, both primary and secondary prevention should include lifestyle modification, including proper nutrition. The aim of the study was to examine dietary habits and nutritional beliefs for the purpose of evaluating the nutrition knowledge of cardiac patients after an acute coronary syndrome [ACS; non-ST-segment myocardial infarction (NSTEMI) and ST-segment myocardial infarction (STEMI)] undergoing invasive treatment. Material and methods. The study included 100 patients, including 35 women and 65 men aged 53.43 ± 10.11 years [mean ± standard deviation (SD)], admitted urgently due to ACS to the 2nd Department of Cardiology. The study used part C of the questionnaire: “Nutrition Beliefs” that consisted of 25 statements assessing nutrition knowledge. For each correct answer (“True” or “False”), 1 point was assigned, and for an incorrect answer or “Hard to say”, 0 points were assigned. Then, the points were added up. Results. It was found that only 20.8% (N = 21) of subjects followed dietary recommendations as advised by a physician. The majority of respondents were diagnosed with an excessive body mass: obesity in 35.4% (N = 35) of subjects, and overweight in 38.4% (N = 38) of subjects. Nutritional self-assessment was reported to be at a good level in 71.3% of patients (N = 72). However, the actual nutrition knowledge was found to be at a good level in only 6.9% (N = 7) of subjects. Conclusion . Patient nutrition knowledge as assessed using the komPAN questionnaire was found to be mostly at a satisfactory level, despite high self-assessment res ults provided by the respondents. There is a great need for regular nutrition education.

Positive Health Behaviors and Their Determinants Among Men Active on the Labor Market in Poland.

This paper reports on results from research conducted on health behaviors undertaken of men. Health behavior is one of the determinants of our health. The way in which people care for their health affects not only their health, but also their well-being, quality of life, and work ability. The lifestyle and health behavior have a significant impact on health, whereas a lack of pro-health behavior may cause the risk of many diseases and mortality, especially among men. The aim of the study was to define the determinants of positive health behaviors among men aged 20–65, active on the labor market.To check the attitudes of men toward health and health behavior, a questionnaire-based research has been carried out among 600 men active on the labor market. Several tools were used: Positive Health Behaviour Scale (Woynarowska-Sołdan & Węziak-Białowolska, 2012), Work Ability Index (Tuomi et al., 1998), work–life balance—with the Copenhagen Psychosocial Questionnaire (subscale “Work-home conflict”) (Kristensen & Borg, 2005), Multidimensional Health Locus of Control (Wallston & Wallston, 1978, in polish adaptation Juczyński, 2001), Inventory for Psychological Sex Assessment (Kuczyńska, 2012) and Personal Values (Juczyński, 2001), and questionnaire “Work conditions” (developed in CIOPPIB).These studies have shown which factors determine their health behavior. The positive health behaviors of men were associated with good economic status, high self-assessment of care for health, positive opinions about life and work, and masculinity. They were also white-collar workers with good work ability.

CORRELATION BETWEEN EFL STUDENTS’ PERCEIVED LINGUISTIC PROFICIENCY AND THEIR LEVEL OF CONFIDENCE IN USING ENGLISH

The main aim of this study is to find out the correlation between EFL students’ perceived linguistic proficiency and their level of confidence in using English. To achieve that, sixty first year students at the faculty of English language and literature, Ajloun University in Jordan, were selected based on convenience sampling. The subjects were asked to self-assess their linguistic proficiency using five-point Likert scale and to respond to the survey questionnaire. To test the statistical associations between the two variables, ANOVA was used to confirm if there were any statistically significant differences in self- assessment scores among the groups of students having different levels of confidence. To confirm where the differences lie, Post Hoc tests (Turkey HSD and Homogeneous Subsets) were used. NOVA gives an F value of 44.131 with 2 and 57 degrees of freedom (p &lt; 0.01), showing that there are differences in self-assessment means among groups. The multiple comparisons among mean differences by the Post Hoc tests (Turkey HSD and Fisher’s LSD) show that the group of students who are 'hardly confident' are significantly different from the other two groups of students. The group of students who are 'a little confident' are significantly different from 'hardly confident' students and 'confident' students. Finally, the group of students who are 'confident' differ significantly from the two groups of students who are 'hardly confident' and ‘a little confident’. Therefore, all groups differ from one another. The results of the Kendall's tau-b and Spearman's rho indicate that there is a statistically significant correlation between the students' confidence level and the means of self-assessment scores. In conclusion, the subjects having high self-assessment scores are more likely to have high confidence in using English and vice versa.

Metacognitive knowledge of mathematics education students in analytical geometry of space

This research aims to describe metacognitive knowledge of mathematics education students in open start problem solving. This research was qualitative research. The research subject was mathematics education students of Universitas Muhammadiyah Surakarta in academic year 2018/2019. The selected students consisted of 6 students, i.e. two subjects of intrapersonal intelligence with category high, intermediate, and low. The research instruments were questionnaire, open start problem solving task, and interview guidelines. Data validity used time triangulation. Data analyses were done by collecting data, reducing data, presenting data, and drawing conclusion. Based on findings, subjects with high intrapersonal intelligence have positive dominant character, i.e. able to do planning step appropriately and had high self-confidence that they were able to solve the problem, so their answer is correctly. Subjects with intermediate intrapersonal intelligence had high self-assessment but they unable to carrying out the plan properly, so that it resulted inaccurate. Subjects with low intrapersonal intelligence absolutely sure that their answer was correct, but he can not explain for their problem solving steps because they not yet introspection and had not fix the shortcomings that are owned, so their task result inaccurate.

Characteristics of centenarians’ lifestyles and their contribution to life satisfaction: A case study conducted on Hainan Island

BackgroundCentenarians represent an intriguing model for healthy aging. They appear to have adapted well to their lives and are likely to be influenced by previous lifestyle habits, and their life satisfaction is influenced by mental and psychological health. ObjectiveThe aim of this study is to explore centenarians’ lifestyles by sex and their potential contribution to life satisfaction. MethodIn order to examine the common characteristics of centenarians in Hainan and the potential differences between men and women, a cross-sectional survey was conducted with 223 cognitively-intact Chinese centenarians. We also explored the association between life satisfaction and other physical factors using binary logistic regression and principal component analysis. ResultsThe results provided supplementary evidence indicating that women tended to live longer than men. However, the difference in life satisfaction observed between the sexes was not obvious (p = 0.659). The proportion of physical factors between each sex showed a similar trend in distribution. Most centenarians’ lifestyles were similar, in that they followed a light diet and did not smoke or drink alcohol. Centenarians in better physical condition and with higher self-assessment, as well as those with “alcohol and tobacco habits,” were more satisfied with their life. Of the factors examined in the binary logistic regression, sleep satisfaction was the only factor significantly positively correlated with life satisfaction (p < .01). ConclusionThe research findings elucidated physiological and psychological health in centenarians and provided a model of healthy aging strategies for reference purposes.

Breast self-examination among nurses in Poland and their reparation in this regard.

Working at night and in shifts, as well as an unhealthy lifestyle, may increase the risk of breast cancer in nurses who therefore should frequently perform breast self-examination (BSE). The aim of the study was to investigate the performance of BSE among Polish nurses, its accuracy, sources of knowledge and skills, self-assessment of own competences and preparation to educate women about BSE. A descriptive, cross-sectional study was conducted in a group of female nurses (N=1,242). An anonymous, self-administrated questionnaire was used for data collection. To properly assess the BSE a four-item scale was made of the type single best answer multiple choice question. Each item referred to one agreed principle of performing BSE. Regularly BSE was performed by 56.1% nurses, 67.3% pre-menopause nurses 2-3 days after cessation of menstruation and 30.4% post-menopause women on a chosen day of the month. About 98% examined visually and by palpation; 58.9% did so in two positions. In the accuracy scale of BSE, the average number of points was 2.8 out of 4. All (4 points) or almost all (3 points) recommendations of accurate BSE were met by 61.4% of the nurses. Self-assessment of knowledge and BSE practical skills were considered as good or very good by 93.5% and 88.8% nurses, respectively. The self-evaluation of nurses' knowledge and BSE skills was significantly correlated with the result on the accuracy scale or this BSE. Many deficiencies concerning frequency, times and BSE techniques were revealed among Polish nurses. There is a discrepancy between the high self-assessment of competences and the accurate practice of BSE. Nurses' preparation in Poland in BSE is insufficient and requires improvement.

Metacognitive experience of mathematics education students in open start problem solving based on intrapersonal intelligence

This research aims to describe metacognitive experience of mathematics education students with strong, average, and weak intrapersonal intelligence in open start problem solving. Type of this research was qualitative research. The research subject was mathematics education students in Muhammadiyah University of Surakarta in academic year 2017/2018. The selected students consisted of 6 students with details of two students in each intrapersonal intelligence category. The research instruments were questionnaire, open start problem solving task, and interview guidelines. Data validity used time triangulation. Data analyses were done through data collection, data reduction, data presentation, and drawing conclusion. Based on findings, subjects with strong intrapersonal intelligence had high self confidence that they were able to solve problem correctly, able to do planning steps and able to solve the problem appropriately. Subjects with average intrapersonal intelligence had high self-assessment that they were able to solve the problem, able to do planning steps appropriately but they had not maximized in carrying out the plan so that it resulted incorrectness answer. Subjects with weak intrapersonal intelligence had high self confidence in capability of solving math problem, lack of precision in taking plans so their task results incorrectness answer.

Knowledge and experience with cochrane and evidence based medicine among health professionals in Debreberhan Referral Hospital in Ethiopia: a cross-sectional survey.

IntroductionCochrane generates and disseminates high-quality systematic reviews through the cochrane library. We surveyed Ethiopian health professionals' knowledge and experience with cochrane, the cochrane library and Evidence Based Medicine (EBM).MethodsA cross-sectional survey was conducted using a convenient sample of health professionals in DebreBerhan Referral hospital in Ethiopia. Participants completed a pre-tested self-administered survey before EBM training. Data were analyzed using Fisher's exact or Chi-Squared test with Yates' correction. The strength of association between variables was quantified using odds ratios with 95% confidence intervals.ResultsThe response rate was 71.4% (35/49). Over half (54.3%) of the sample were males; 68.6% aged ≤ 30 years; 54.3% were physicians and 37.1% were nurses. Up to 65.7% had heard about Cochrane and only two knew cochrane South Africa as their reference centre. Nearly 48.6% were aware of the cochrane library, of whom 46% accessed it however; none used it for lacking awareness, search skills, access to internet and time constraints. Majority had a positive attitude towards EBM; 45.7% had heard of EBM; 74.3% rated their EBM knowledge as low; 74.3% lacked EBM training; and 88.6% were keen to attend EBM course. Adequate EBM knowledge was correlated with prior training (OR = 3.7, 95% CI 1.9-6.9, P<0.001], high self-assessment of EBM knowledge (OR = 0.27, 95% CI 0.14-0.51, P<0.001), male gender (P = 0.04), a positive attitude towards EBM (P = 0.001) and awareness of Cochrane (P = 0.004).ConclusionEthiopian health professionals have unmet training needs and want support through professional development workshops and an improved education system to provide high-quality evidence-based healthcare.

Self-assessment and aggression’s manifestation of Judo wrestlers in age and qualification aspects

Purpose: to determine self assessment and aggression’s manifestations of Judo wrestlers in age and qualification aspects. Material: in the research boys - Judo wrestlers from sport schools of Kaunas (Lithuania) participated (n=90, age - 16.9 ± 2.0 years). The athletes were divided into three groups. In qualification aspects were divided into two groups. The first group was composed as per sport achievements - the members of combined Lithuanian teams. The second group consisted athletes of different sport categories, which were not the members of combined teams. We used questionnaire as per scale of self assessment of M. Rosenberg and questionnaire of aggressiveness of Buss-Perry. Estimation of the received data was fulfilled with the help of U criterion of Manna-Whitney, H criterion of Kruskall-Wallis and χ2-criterion. Assessment of confidence of mean group data’s differences was fulfilled by Student’s t-test. Correlations of indicators were determined with the help of correlation coefficient of Spearmen. Results: with increasing of Judo wrestlers’ age we observed the tendency to increasing of their self-assessment. The older sportsmen become the higher is theirs aggressiveness. Depending on self-assessment level we did not find statistically confident differences in their aggression indicators. Large quantity of elite Judo wrestlers has high self-assessment. Self assessment and aggression indicators of sportsmen with sport categories statistically do not differ for elite Judo wrestlers’ indicators. Correlation between mean level of self assessment and aggression are present only in young Judo wrestlers. Conclusions: in all age groups of Judo wrester’s average level of self assessment prevails. Higher level is characteristic only for members of combined teams of the country. Judo wrestlers’ aggression depending on age differs only by one component (more adult wrestlers are more aggressive than juniors). In respect to the level of sportsmanship - differences are absent.

ПРОБЛЕМА РЕГУЛИРОВАНИЯ СОЦИАЛЬНЫХ КОНФЛИКТОВВ РЕГИОНЕ: ДИСПОЗИЦИЯ ИСТЕБЛИШМЕНТА

В статье на основании результатов социологического исследования, проведенного в Волгоградской области в 2014 году методом анкетного опроса по многоступенчатой, квотной выборке (500 респондентов) анализируется специфика восприятия представителями регионального истеблишмента проблемы регулирования социальных конфликтов.Обосновывается вывод о том, что, главные причины социальных конфликтов представители элиты связывают с низкой политической культурой населения, взаимным отчуждением власти и населения, коррупцией, социальным расслоением и дефицитом толерантности. При этом они оказываются недостаточно готовыми к их разрешению в технологическом отношении. Несмотря на субъективно высокую самооценку, представители истеблишмента, как правило, испытывают дефицит знаний и опыта.Анализ дает основание утверждать, что истеблишменту в регионах пока не удалось сформировать систему регулирования конфликтов. Решение данной задачи требует организационного оформления конфликтного медиаторинга в государственных и муниципальных органах; разработки и внедрения механизма привлечения к участию в конфликтном медиаторинге институтов гражданского общества, прежде всего, общественных палат регионов; организации подготовки специалистов-конфликтологов в вузах.

A Novel Approach to Assessing Professionalism in Preclinical Medical Students Using Multisource Feedback Through Paired Self- and Peer Evaluations

ABSTRACTPhenomenon: Professionalism is integral to the role of the physician. Most professionalism assessments in medical training are delayed until clinical rotations where multisource feedback is available. This leaves a gap in student assessment portfolios and potentially delays professional development. Approach: A total of 246 second-year medical students (2013–2015) completed self- and peer assessments of professional behaviors in 2 courses following a series of Team-Based Learning exercises. Correlation and regression analyses were used to examine the alignment or misalignment in the relationship between the 2 types of assessments. Four subgroups were formed based on observed patterns of initial self- and peer assessment alignment or misalignment, and subgroup membership stability over time was assessed. A missing data analysis examined differences between average peer assessment scores as a function of selective nonparticipation. Findings: Spearman correlation demonstrated moderate to strong correlation between self-assessments completed alone (no simultaneous peer assessment) and self-assessments completed at the time of peer assessments (ρ = .59, p < .0001) but weak correlation between the two self-assessments and peer assessments (alone: ρ = .13, p < .013; at time of peer: ρ = .21, p < .0001). Generalized estimating equation models revealed that self-assessments done alone (p < .0001) were a significant predictor of self-assessments done at the time of peer. Course was also a significant predictor (p = .01) of self-assessment scores done at the time of peer. Peer assessment score was not a significant predictor. Bhapkar's test revealed subgroup membership based on the relationship between self- and peer ratings was relatively stable across Time 1 and Time 2 assessments (χ2 = 0.83, p = .84) for all but one subgroup; members of the subgroup with initially high self-assessment and low peer assessment were significantly more likely to move to a new classification at the second measurement. A missing data analysis revealed that students who completed all self-assessments had significantly higher average peer assessment ratings compared to students who completed one or no self-assessments with a difference of –0.32, 95% confidence interval [–0.48, –0.15]. Insights: Multiple measurements of simultaneous self- and peer assessment identified a subgroup of students who consistently rated themselves higher on professionalism attributes relative to the low ratings given by their peers. This subgroup of preclinical students, along with those who elected to not complete self-assessments, may be at risk for professionalism concerns. Use of this multisource feedback tool to measure perceptual stability of professionalism behaviors is a new approach that may assist with early identification of at-risk students during preclinical years.

The influence factors of medical professionalism: A stratified-random sampling study based on the physicians and patients in ambulatory care clinics of Chengdu, China.

As the relationship between physicians and patients deteriorated in China recently, medical conflicts occurred more frequently now. Physicians, to a certain extent, also take some responsibilities. Awareness of medical professionalism and its influence factors can be helpful to take targeted measures and alleviate the contradiction. Through a combination of physicians' self-assessment and patients' assessment in ambulatory care clinics in Chengdu, this research aims to evaluate the importance of medical professionalism in hospitals and explore the influence factors, hoping to provide decision-making references to improve this grim situation. From February to March, 2013, a cross-sectional study was conducted in 2 tier 3 hospitals, 5 tier 2 hospitals, and 10 community hospitals through a stratified-random sampling method on physicians and patients, at a ratio of 1/5. Questionnaires are adopted from a pilot study. A total of 382 physicians and 1910 patients were matched and surveyed. Regarding the medical professionalism, the scores of the self-assessment for physicians were 85.18 ± 7.267 out of 100 and the scores of patient-assessment were 57.66 ± 7.043 out of 70. The influence factors of self-assessment were physicians' working years (P = 0.003) and patients' complaints (P = 0.006), whereas the influence factors of patient-assessment were patients' ages (P = 0.001) and their physicians' working years (P < 0.01) and satisfaction on the payment mode (P = 0.006). Higher self-assessment on the medical professionalism was in accordance with physicians of more working years and no complaint history. Higher patient-assessment was in line with elder patients, the physicians' more working years, and higher satisfaction on the payment mode. Elder patients, encountering with physicians who worked more years in health care services or with higher satisfaction on the payment mode, contribute to higher scores in patient assessment part. The government should strengthen the medical professionalism for young physicians and improve the payment mode.

Financial Advice Seeking, Financial Knowledge and Overconfidence. Evidence from the Italian Market

This paper investigates the relationship between the propensity to seek for professional advice, financial knowledge and overconfidence, as well as the determinants of financial knowledge and overconfidence for a representative sample of Italian financial decision makers. The demand for financial advice is found to be positively related to financial knowledge and negatively related to overconfidence as measured by the mismatch between perceived and actual capability. High self-assessment of one’s own competence turns out to be significantly and negatively associated with high levels of financial knowledge, which in turn is higher among male, wealthier and more risk averse individuals. These findings show that financial advice acts as a complement rather than as a substitute of financial capability, thus confirming the concerns about regulation of financial advice being not enough to protect less sophisticated investors needing it most. Moreover, behavioural traits such as self-confidence do play a role in financial choices and are related with the level of financial literacy. Therefore, investor education programmes may be beneficial not only directly, i.e. by raising financial competence, but also indirectly, i.e. by enhancing people awareness in their financial capability and by hindering overconfident behaviours and behavioural biases. The paper contributes to the regulatory debate on the development of financial advice as a tool of investor protection. It also delivers relevant policy insights for the Italian context, where the vast majority of individuals exhibit both a low degree of literacy and a high propensity towards informal rather than professional advice.

Study of personality’s temperament and self-assessment of higher educational establishments’ students

Purpose: analysis of temperament and self-assessment characteristics in higher educational establishment students. Material: in the research 1st and 2nd year students (n=30) participated. Questioning was used, with the help of which personality’s self assessment and temperament characteristics were estimated. Results: the study of students’ temperament structure showed low demand in mastering of objective world and strive for mental and physical labor. High indicator of social activity and interpersonal skills was registered. The following indicators of self-assessment were received: 15% of students had too low self-assessment, 50% of students have adequate self-assessment and 10% have excessively high self-assessment. Conclusions: quickness of psychic processes (tem and rhythm), impressiveness and emotional sensitivity are important features of temperament. Students demonstrated feeling of anxiety and worry in respect to their studying at university. Besides the have sensitivity to failures to non coincidence of the desired and the results. студентов. With it students have adequate self assessment.

Między mitem eksperta a nadmierną pewnością siebie – o decyzjach finansowych w warunkach naturalnego eksperymentu

In consequence of the 2014 reform of the Polish pension system, Poles were faced with a necessity of declaration regarding the way they wanted to continue saving for retirement. Although the conditions of this natural experiment were considered controversial, from the scientific point of view it was interesting to analyse how decisions were made. The article presents the results of an analysis of factors that influenced following expert’s opinions or self-reliance in that case. Based on the results of the survey provided in February 2014 among the employees of the Maria Curie-Sklodowska University it was proved that those who voluntarily saved for retirement were most likely to follow experts in making their choice but declared high self-assessment of one’s knowledge on financial market, calculation of one’s pension needs and declared positive vision of one’s retirement were more often connected with self-reliance of decision. These mechanisms seem to confirm overconfidence and the Duning-Kruger effect.

Moving on Up? The Gendered Ambitions of State-Level Appointed Officials

Many scholars have offered explanations as to why women are underrepresented at all levels of government. Conventional wisdom states that fewer women are in public office due to lower ambition, and that the presence of gendered perceptions among women considering elected office contributes to women’s disinterest in the political arena. Using original survey data, this article expands the theory of gendered perceptions to current state-level appointed officeholders to explain their levels of interest in pursuing higher public office. The results indicate that gendered perceptions affect the progressive ambitions of appointees; like studies of ambition in elected officials, this study of appointed officials finds that women are generally less ambitious, and unlike studies of ambition in elected officials, this study of appointed officials finds that women with higher self-assessments are less ambitious rather than more.

Screening of possibly incompetent agents

Accepting a contract with a high performance sensitivity is normally interpreted as a signal of high ability. However, a high self-assessment may be an incompetent forecast by an incompetent worker. In a model where optimistic agents have low ability, a low performance sensitivity screens out the incompetent agents. However, when agents are wealthy enough, the principal prefers to select the incompetent agent who covers the downside (as in a vanity press).

Survey on teaching status of general practitioners in community health centers of Shanghai

Objective To survey the current situation of teaching for general practitioners (GPs) in community health centers of Shanghai. Methods A questionnaire survey on the teaching situation was conducted among 742 GP mentors who attended a municipal training workshop during July to October 2012 in Shanghai. The items of the survey included general background, previous teaching experience and self-evaluation on teaching ability. Results Among 742 GP mentors receiving the survey, the average age was (37± 6) years old. 49.8% (366/734) of mentors expressed their willingness of teaching, and the main reason was that it may upgrade themselves, while learning from teaching (58.6%, 419/715). Heavy work load, lack of teaching time (31.8%, 378/1 187) and teaching experience (30.7%, 364/1 187) were the main obstacles for teaching. Among 106 GP mentors who had teaching experience in community health center previously, 79.2% (80/101) made teaching plans, but only 8.9% (9/102) often prepared syllabus. Teaching plans were made mainly according to the work needs in community health care (54.2%, 52/96), the situation and demands students (29.1%, 28/96) or requirement of syllabus (17.7%, 17/96). The problems included lack of teaching experience (50.5%, 50/99) and time (42.4%, 42/99), monotonous instructional modality (24.1%, 25/104), and weak operability of the syllabus (21.2%). The self-reported results showed that 14.4% were not able to develop a teaching program and to execute, 18.3% were not able to use a variety of teaching methods, 31.2% were not able to engage in teaching for 1.5 days per week. Logistic regression analysis showed that mentors with higher education background (OR=2.027, P<0.05), community teaching experience (OR=3.069, P<0.05), higher self assessment of general personal quality and communication ability (OR=2.488, P<0.05), higher teaching ability (OR=2.399, P<0.05) and strong training wishes (OR=11.382, P<0.05) were more willing to engage in the teaching work. Conclusions Heavy work load, insufficiency of teaching capacity and experience are main problems for GP mentors in Shanghai community health centers. Educational theory and methods should be focus on teacher training so as to improve teaching abilities. Key words: Education, medical; Questionnaire; General practitioners

High self-assessment of disability and the surgeon's recommendation against surgical intervention may negatively impact satisfaction scores in patients with spinal disorders.

OBJECT Patient satisfaction scores have become a common metric for health care quality. Because satisfaction scores are right-skewed, even small differences in mean scores can have a large impact. Little information, however, is available on the specific factors that play a role in satisfaction in patients with spinal disorders. The authors investigated whether disability severity and the surgeon's recommendation for or against surgical intervention were associated with patient satisfaction scores. METHODS The authors conducted a retrospective cohort study involving adult patients who were referred to a spine surgeon for an outpatient evaluation of back pain. Patients completed the Oswestry Disability Index (ODI) before their clinic appointment and a Press Ganey patient satisfaction survey after their visit. Patients were grouped by self-assessed disability severity: mild to moderate (ODI < 40%) and severe (≥ 40%). Satisfaction scores were graded from 0 (very poor) to 100 (very good). Nonparametric tests were used to evaluate the association between patient satisfaction and current disability self-assessment. The authors also investigated whether the surgeon's recommendation against surgery negatively affected patient satisfaction. RESULTS One hundred thirty patients completed the ODI questionnaire before and satisfaction surveys after seeing a spine surgeon for a new outpatient back pain consultation. Of these, 68 patients had severe disability, 62 had mild to moderate disability, 67 received a recommendation for surgery, and 63 received a recommendation against surgery. Composite satisfaction scores were lower among patients who had severe disability than among those with mild to moderate disability (median [interquartile range]: 91.7 [83.7-96.4] vs 95.8 [91.0-99.3], respectively; p = 0.0040). Patients who received a recommendation against surgery reported lower satisfaction scores than those who received a recommendation for surgery (91.7 [83.5-95.8] vs 95.8 [88.5-99.8]; p = 0.0059). CONCLUSIONS High self-assessment of disability and a surgeon's recommendation against surgical intervention are associated with lower satisfaction scores in patients with spinal disorders.