Different perceptions of narrative medicine between Western and Chinese medicine students.

BACKGROUND: Western medicine is an evidence-based science, whereas Chinese medicine is more of a healing art. To date, there has been no research that has examined whether students of Western and Chinese medicine differentially engage in, or benefit from, educational activities for narrative medicine. This study fills a gap in current literature with the aim of evaluating and comparing Western and Chinese Medicine students' perceptions of narrative medicine as an approach to learning empathy and professionalism. METHODS: An initial 10-item questionnaire with a 5-point Likert scale was developed to assess fifth-year Western medical (MS) and traditional Chinese medical (TCMS) students' perceptions of a 4-activity narrative medicine program during a 13-week internal medicine clerkship. Exploratory factor analysis was undertaken. RESULTS: The response rate was 88.6% (412/465), including 270 (65.5%) MSs and 142 (34.5%) TCMSs, with a large reliability (Cronbach alpha = 0.934). Three factors were extracted from 9 items: personal attitude, self-development/reflection, and emotional benefit, more favorable in terms of enhancement of self-development/reflection. The perceptions of narrative medicine by scores between the two groups were significantly higher in TCMSs than MSs in all 9-item questionnaire and 3 extracted factors. CONCLUSIONS: Given the different learning cultures of medical education in which these student groups engage, this suggests that undertaking a course in Chinese medicine might enhance one's acceptance to, and benefit from, a medical humanities course. Alternatively, Chinese medicine programmes might attract more humanities-focused students.

The effects of ciprofloxacin on chest radiographic regression in patients with drug intolerance or resistant tuberculosis.

BACKGROUND: The aim of this study was to identify the clinical efficacy of ciprofloxacin as a second-line anti-tuberculosis agent in pulmonary tuberculosis patients with drug intolerance or resistance. METHODS: There were 20 patients with drug related adverse effects or drug resistance enrolled in the ciprofloxacin treatment group (CG). There were also 32 patients enrolled in the non-ciprofloxacin treatment group (NCG) that maintained conventional drug regimens or the addition of other drugs like streptomycin. The radiographic presentation was evaluated using score grading. The speed and outcome of regression in the chest radiographic presentations were also evaluated. RESULTS: Data showed the CG had significantly more rapid regression than the NCG in drug-resistant patients (p < 0.01). For the adversely effected patients in the CG, the mean scores of pre- and post-treatment were 3.1+/-0.2 and 2.2+/-0.3 (p < 0.001), respectively. For the adversely effected patients in the NCG, the mean score of pre-treatment was 3.7+/-0.4 and post-treatment mean score was 3.0+/-0.4 (p < 0.05). For the drug-resistant patients in the CG, the mean scores of pre- and post-treatment were 4.3+/-0.4 and 3.4+/-0.5 (p < 0.05), respectively. For the drug-resistant patients in the NCG, the mean score of pre-treatment was 3.7+/-0.3 and post-treatment mean score was 3.2+/-0.3 (no significant difference). Obviously, the CG had the same effects compared with the NCG in adverse-effect group. On the other hand, the CG had the tendency of more rapid radiographic regression and better radiographic outcomes than the NCG in drug-resistant patients. CONCLUSIONS: Ciprofloxacin provides a better option for second-line drug treatment for pulmonary tuberculosis when patients cannot use conventional anti-tuberculosis agents.