Dental students' empathy levels and opinions about attributes for "good dentist": a cohort study

Empathy is fundamental to the physician-patient relationship and influences the clinical outcomes. The aim of this study was to determine the dental students' empathy levels and to compare their opinions on attributes of a "good dentist". This cohort research was included 79 dental students volunteering to participate in the study at a public university. The data were collected by the Dökmen's Empathic Tendency Scale (ETS) and Empathic Skill Scale (ESS). In this study, from the orientation day to the end of the third-year, the dental students' ETS mean scores (respectively 69.59 and 68.34) and ESS mean scores (respectively 142.53 and 140.00) showed a decline. At the end of the third-year, starting clinical rotations and taking patient responsibility may lead to decrease the empathy levels of students. The findings of our study show that female students have higher empathy tendency and skill scores compared to male students (p<0.001). In the ranking of the attributes required to be a good dentist, empathy was ranked 4th by the first-year students, while final-years students placed empathy in second rank (p<0.05). According to these results, it is possible to claim that the dentist candidates realized that being empathetic is necessary to be a good dentist.

La empatía es fundamental para la relación médico-paciente e influye en los resultados clínicos. El objetivo de este estudio de cohorte -que incluyó a 79 estudiantes de odontología de una universidad pública que se ofrecieron como voluntarios- fue determinar los niveles de empatía de los estudiantes de odontología y comparar sus opiniones sobre los atributos de un "buen dentista". Los datos se recogieron mediante las Escalas de Tendencia Empática (ETE) y Habilidad Empática (EHE) de Dökmen. Desde el día de orientación hasta el final del tercer año, los puntajes medios ETE de los estudiantes de odontología (69.59 y 68.34, respectivamente) y los puntajes medios de EHE (142.53 y 140.00, respectivamente) mostraron una disminución. Según la literatura, al final del tercer grado, iniciar rotaciones clínicas y asumir la responsabilidad del paciente puede llevar a disminuir los niveles de empatía de los estudiantes. Los hallazgos de nuestro estudio muestran que las estudiantes tienen una mayor tendencia a la empatía y puntajes de habilidad en comparación con los estudiantes (p<0.001). En el ranking de los atributos requeridos para ser un buen dentista, la empatía ocupó el cuarto puesto en estudiantes de primer año, mientras que los de último año colocaron la empatía en segundo lugar (p<0.05). De acuerdo con estos resultados, es posible afirmar que los candidatos a dentistas se dieron cuenta de que ser empáticos es necesario para ser un buen dentista.

A empatia é fundamental na relação médico-paciente e influencia os resultados clínicos. O objetivo deste estudo foi determinar os níveis de empatia de estudantes de odontologia e comparar suas opiniões sobre os atributos de um "bom dentista". Esta pesquisa de coorte contou com 79 estudantes de odontologia voluntários para participar do estudo em uma universidade pública. Os dados foram coletados pela Escala de Tendência Empática (ETE) de Dökmen e Escala de Habilidades Empáticas (EHE). Neste estudo, desde o dia da orientação até o final do terceiro ano, os escores médios do ETE dos alunos de odontologia (respectivamente 69,59 e 68,34) e os escores médios do EHE (respectivamente 142,53 e 140,00) apresentaram declínio. No final da terceira série, iniciar os rodízios clínicos e assumir a responsabilidade do paciente pode levar à diminuição dos níveis de empatia dos alunos. Os achados do nosso estudo mostram que os alunos do sexo feminino apresentam maior tendência à empatia e pontuações de habilidades em comparação aos alunos do sexo masculino (p<0,001). No ranking dos atributos necessários para ser um bom dentista, a empatia foi classificada em 4º lugar pelos alunos do primeiro ano, enquanto os alunos do último año colocaram a empatia em segundo lugar (p<0,05). De acordo com esses resultados, é possível afirmar que os candidatos a dentista perceberam que ser empático é necessário para ser um bom dentista.

On Kidney and Bladder Diseases in Nuzhat al-adhhan fi islah al-abdan by Physician Dawud b. 'Umar al-Antaki.

OBJECTIVES: Dawud b. 'Umar al-Antaki, known as the Avicenna of his time, was an Ottoman physician and scholar who wrote medical texts in Arabic in the 16th century. He was taught by an Iranian medical scholar, Muhammad Sharif, in the fields of logic, physical sciences, Greek, and medicine. After leaving Antioch, he traveled to Lebanon and then to Damascus, where he began writing his work, Tadhkiratu uli l-albab wa l-jami' li l-'ajab al-'ujab. Dawud b. 'Umar al-Antaki settled in Egypt, where he taught at the Zahiriyya Madrasa and practiced medicine before dying in Mecca in 1599. Here, we examined al-Antaki's writings on kidney and bladder diseases in his work Nuzhat al-adhhan fi islah al-abdan. MATERIALS AND METHODS: We translated sections on kidney and bladder diseases into English and compared Ilter Uzel's copy of Nuzhat al-adhhan fi islah al-abdan with a printed copy. We compared the relevant sections of Nuzhat al-adhhan fi islah al-abdan with the relevant sections of other important works of al-Antaki, al-Nuzhat al-mubhija fi tashhidh al-adhhan wa ta'dil al-amzija, and Tadhkiratu uli l-albab wa l-jami' li l-'ajab al-'ujab. The similarities and differences between these works were revealed. RESULTS: Kidney and bladder diseases are briefly discussed in Nuzhat al-adhhan fi islah al-abdan under the headings "amrad al-kula wa l-mathana," "al-hisa," and "harqan al-bawl wa taqtiruhu." CONCLUSIONS: Issues concerning kidney and bladder diseases are addressed more briefly in Nuzhat al-adhhan fi islah al-abdan than in al-Nuzhat al-mubhija fi tashhidh al-adhhan wa ta'dil al-amzija. Tadhkiratu uli l-albab wa l-jami' li l-'ajab al-'ujab consists solely of kidney and bladder stones. When these works are combined, the information in them complements each other.

An Ethical Analysis of Performance-Based Supplementary Payment in Turkey's Healthcare System.

In 2003 Turkey introduced the Health Transition Program to develop easily accessible, high-quality, and effective healthcare services for the population. This program, like other health reforms, has three primary goals: to improve health status, to enhance financial protection, and to ensure patients' satisfaction. Although there is considerable literature on the anticipated positive results of such health reforms, little evidence exists on their current effectiveness. One of the main initiatives of this health reform is a performance-based supplementary payment system, an additional payment healthcare professionals receive each month in addition to their regular salaries. This system may cause some ethical problems. Physicians have an ethical duty to provide high-quality care to each patient; however, pay-for-performance and other programs that create strong incentives for high-quality care set up a potential conflict between this duty and the competing interest of complying with a performance measure.

Ethical problems in geriatrics: views of Turkish primary healthcare professionals.

AIM: Primary healthcare professionals frequently encounter ethical issues in the care of older adults. These issues might particularly appear in the context of "age discrimination", "respect for autonomy", "respect for privacy" and "decision-making competency". The aims of this study were to determine the frequency rates of various geriatric ethical problems and to evaluate the importance given to these problems in primary healthcare. METHODS: In order to evaluate the opinions, a questionnaire tool was formulated. The participants were asked to review the list of geriatric ethical issues, to state the frequency of encountering them and to identify the importance ratings for each issue. The sample consisted of 86 primary healthcare professionals (50 physicians and 36 nurses) aged between 24 and 50 years. RESULTS: Based on the results, the most frequently encountered ethical issues were on "decision-making competency" and these issues respectively were "decision-making with relatives instead of elder patients", "not informing elders due to the lack of tolerance" and "not informing elders due to the lack of comprehending". The most important geriatric ethical issues were "ignoring respect for privacy", "ignoring patient's complaints" and "rejecting detailed examination or treatment because of age". CONCLUSION: Overall, the results show that the nurses and physicians in primary healthcare frequently encounter geriatric ethical problems related to the decision-making process, which is a common issue for Turkey as a paternalistic society. The findings show that primary healthcare professionals are sensitive to geriatric ethical issues; however, this sensitivity does not prevent the emergence of these issues.