To obtain, in a survey-based study, detailed information on the faculty currently responsible for teaching radiation biology courses to radiation oncology residents in the United States and Canada.
In March-December 2007 a survey questionnaire was sent to faculty having primary responsibility for teaching radiation biology to residents in 93 radiation oncology residency programs in the United States and Canada.
The responses to this survey document the aging of the faculty who have primary responsibility for teaching radiation biology to radiation oncology residents. The survey found a dramatic decline with time in the percentage of educators whose graduate training was in radiation biology. A significant number of the educators responsible for teaching radiation biology were not fully acquainted with the radiation sciences, either through training or practical application. In addition, many were unfamiliar with some of the organizations setting policies and requirements for resident education. Freely available tools, such as the American Society for Radiation Oncology (ASTRO) Radiation and Cancer Biology Practice Examination and Study Guides, were widely used by residents and educators. Consolidation of resident courses or use of a national radiation biology review course was viewed as unlikely by most programs.
A high priority should be given to the development of comprehensive teaching tools to assist those individuals who have responsibility for teaching radiation biology courses but who do not have an extensive background in critical areas of radiobiology related to radiation oncology. These findings also suggest a need for new graduate programs in radiobiology.
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A recurrent theme in medical sociology has been the juxtaposition of emotion with scientific rationality in the delivery of health care services. However, apart from addressing this juxtaposition very little is said about the complex intertwinement of "emotional" and "rational" practices which makes up professionals' own day-to-day work experiences - and how these experiences are influenced by present ways of organising health care. This paper aims to explore the ways that hospital doctors relate emotions to their understanding of professional medical work and how they respond to recent organisational changes within the field.
Drawing upon a small series of semi-structured interviews (n = 14) with doctors from a public teaching hospital in Denmark, the paper adopts a constructivist framework to analyse personal biographies of health professionals' working lives.
The doctors represented rich accounts of professional medical work, which includes an understanding of what a doctor should feel and how he/she should make him/herself emotionally available to others. However, the impetus for making this appearance was not left unaffected by recent new public management reforms and attempts to accelerate the delivery of services.
The organisation of cancer services into a work system, which consists of a set of tasks broken down into narrow jobs, underestimates the emotional components of patient-doctor encounters. This makes the creation and maintenance of a genuine patient-doctor relationship difficult and the result is feelings of a failed encounter on behalf of the doctor.
The paper suggests that recent rearrangements of cancer services complicate doctors' ability to incorporate emotion into a stream of medical care in a "rational" way. This is shown to challenge their professional ethos and the forms emotional engagement takes in medical practice.
As part of a broader descriptive study of nurse educators' well-being at work in Finland, the quality of working life was assessed by the nurse educators themselves and by their spouses (or another adult living with them). Data were analysed from 477 (68% of 706) educators from 25 institutes throughout Finland and from 409 (58% of 706) spouses. Nurse educators evaluated their working life as being good. Background factors that improved one or several features of working life were: young age, being married, permanent employment in a small institute in the countryside, and highschool education. Lack of freedom to choose the teaching field and tasks at work reduced the quality of working life. Nurse educators estimated that they did an average of 9.6 hours overtime a week; according to their spouses the figure was 12.7 hours. More than moderate amounts of negative stress, derived mainly from work, were reported. Interactions with people at work and the support obtained for their work were generally judged to be good. Participants reported that they were not very satisfied with relationships with college directors, while they were, generally, satisfied with relationships with students. The spouses estimated nurse educators' working life more negatively than did the educators themselves, with the exception of the balance between work and leisure time, which both groups estimated similarly.
This study examined whether providing information to rehabilitation professionals, on the compensation status of patients, would influence their rating of nonverbal expressions of pain. In an experimental design two groups of physiotherapists and occupational therapists were asked to view videotapes of 10 patients with shoulder pain undergoing a total of 88 pain induction tests. They were asked to rate the amount of pain the patients were experiencing based solely on the facial expression of pain. Bias was instilled in one group (n = 18) by informing them that the patients originated from a workers' compensation facility. Sixteen therapists served as a control group. Results indicate that the therapists rated the nonverbal expression of pain similarly regardless of their perceived compensation status. These findings suggest that the mistrust that is commonly experienced by patients on workers' compensation does not come from rehabilitation professionals but from other sources within the system. Alternative explanations for the findings and directions for future research are explored.
This article aimed to examine changes in general health and time with back pain and neck pain and to identify predictors of any such changes. Hospital workers were studied longitudinally with surveys in 1995, 1996, and 1997 (N = 712). Back and neck pain were reported only at the 2nd and 3rd surveys. There was a significant decline in general health and significant increases in time with neck pain and back pain. Predictors of changes in these outcomes were mainly work-related variables (initial or change values), such as job interference with family, job influence, work psychological demands, and hours worked.
Health staff and elementary school teachers are key persons in prophylactic activity which is based on personal contact between the advisor and recipient. It is conceivable that their own habits play a part in how prophylactic information is distributed. This investigation describes how groups such as these consume alcohol and tobacco during pregnancy. As part of a local community experiment in which pregnant women in Odense participated in an information campaign from April 1985 to April 1987, information was collected concerning the habits of pregnant women until the 36th week of pregnancy. This information was collected in self-completed questionnaires which were sent anonymously to the Department of Social Medicine in Odense University. 87% out of the 13,815 pregnant women who attended midwives' clinics from April 1984 to April 1987 in Odense and Aalborg were included in the investigation. The following groups were selected for further analysis: nurses (627 women), nursing aides (492 women), doctors (85 women) and school teachers (468 women) and the group of office workers (1,136 women) was employed for comparison. The investigation revealed that school teachers, doctors and nurses had higher average consumption of alcohol during pregnancy than office workers. On the other hand, these groups has fewer episodes with consumption of eight or more drinks on a single occasion. Similarly, elementary school teachers, and the health groups (with the exception of nursing aides) smoked less. This investigation provided no evidence that these selected groups altered their habits on account of the informative campaigns which were directed to all pregnant women in the Odense region.
This article explores the extent to which hospital workers at a large teaching hospital at different managerial/supervisory levels (designated and non-designated supervisors, and non-supervisory staff), experienced job stress and job satisfaction prior to the re-engineering of hospital services. For all groups, increased levels of job demands were associated with higher levels of stress. Lower levels of decision latitude were associated with increased job stress for designated supervisors. Increasing levels of decision latitude were associated with both job stress and satisfaction for the other two groups. Co-worker support and teamwork contributed to increased job satisfaction for all groups.
Volunteers can support the delivery and sustainability of programs promoting chronic disease awareness to improve health at the community level. This paper describes the development of the peer education component of the Cardiovascular Health Awareness Program (CHAP) and assessment of the volunteer peer educator role in a community-wide demonstration project in two mid-sized Ontario communities. A case study approach was used incorporating process learning, a volunteer survey and debriefing discussions with volunteers. A post-program questionnaire was administered to 48 volunteers. Five debriefing discussions were conducted with 27 volunteers using a semi-structured interview guide. Discussions were audio-recorded and transcribed. Analysis used an editing approach to identify themes, taking into account the community-specific context. Volunteers reported an overall positive experience and identified rewarding aspects of their involvement. They felt well prepared but appreciated ongoing training and support and requested more refresher training. Understanding of program objectives increased volunteer satisfaction. Volunteers continued to develop their role during the program; however, organizational and logistical factors sometimes limited skill acquisition and contributions. The prospect of greater involvement in providing tailored health education resources addressing modifiable risk factors was acceptable to most volunteers. Continued refinement of strategies to recruit, train, retain and support volunteers strengthened the peer education component of CHAP. The experience and contributions of volunteers were influenced by the wider context of program delivery. Process evaluation allowed program planners to anticipate challenges, strengthen support for volunteer activities, and expand the peer educator role. This learning can inform similar peer-led health promotion initiatives.