Comparing the utility of a novel neonatal resuscitation cart with a generic code cart using simulation: a randomised, controlled, crossover trial.

OBJECTIVE: To compare a novel neonatal resuscitation cart (NRC) to a generic code cart (GCC). STUDY DESIGN: A prospective, randomised, controlled, crossover trial was performed to compare the utility of the NRC with the GCC during simulated deliveries of extremely low birthweight infants and infants with gastroschisis. Fifteen subjects participated. Mean times and accuracy of equipment and supply retrieval were compared for each scenario using the Wilcoxon test. RESULTS: Mean acquisition times for the NRC were always faster (by 58% to 74%) regardless of scenario (p<0.01). Accuracy of equipment selection did not differ. Ease of use was judged using a Likert scale (1=easiest to use; 5=most difficult), with mean score for NRC 1.1 and GCC 3.7 (p<0.0001). All subjects rated the NRC as easier to use. CONCLUSIONS: The NRC was superior to the GCC in acquisition speed, supply selection and ease of use.

[Motivation perception measurement of intermediate directors in three complex hospitals of the Region of the Maule, Chile]. / Percepción de la motivación de los directivos intermedios en tres hospitales de la Región del Maule, Chile.

OBJECTIVE: In this work, a questionnaire was designed and perceptions of motivation and demotivation of middle managers in three hospitals in the Region del Maule, Chile were measured. MATERIAL AND METHODS: The fieldwork was carried out between September and October, 2006. A questionnaire that included 57 statements to measure attitude was administered and qualified according to a five-point Likert-type scale. The population studied included l25 professionals that supervise roughly 3 800 employees. RESULTS: Ten variables were identified, 5 motivational and 5 demotivational. Notable among the motivational variables are vocation and service-oriented spirit; among the demotivational variables are lack of recognition and commitment. DISCUSSION: It is affirmed that both motivational variables as well as demotivational variables are essentially qualitative and that economic and salary variables are less relevant and less hierarchical.

Percepción de la motivación de los directivos intermedios en tres hospitales de la Región del Maule, Chile / Motivation perception measurement of intermediate directors in three complex hospitals of the Region of the Maule, Chile

OBJETIVO: En este trabajo se diseña un cuestionario y se cuantifican las percepciones de motivación-desmotivación de los jefes intermedios de tres hospitales de la Región del Maule, Chile. MATERIAL Y MÉTODOS: El trabajo de campo se realizó entre septiembre y octubre de 2006, se aplicó un cuestionario con 57 afirmaciones de medición de actitudes que se calificó de acuerdo con una escala tipo Likert de cinco puntos. La población objeto de la investigación fue de 125 profesionales bajo cuya supervisión se encuentran alrededor de 3 800 funcionarios. RESULTADOS: Se identificaron 10 variables, cinco motivacionales y cinco desmotivacionales. Entre las primeras destacan vocación y espíritu de servicio; entre las segundas falta de reconocimiento y falta de compromiso. DISCUSIÓN: Se confirma que tanto las variables motivacionales como las desmotivacionales son esencialmente cualitativas y que las variables económica y de sueldos son menos relevantes y de inferior jerarquía.

OBJECTIVE: In this work, a questionnaire was designed and perceptions of motivation and demotivation of middle managers in three hospitals in the Region del Maule, Chile were measured. MATERIAL AND METHODS: The fieldwork was carried out between September and October, 2006. A questionnaire that included 57 statements to measure attitude was administered and qualified according to a five-point Likert-type scale. The population studied included l25 professionals that supervise roughly 3 800 employees. RESULTS: Ten variables were identified, 5 motivational and 5 demotivational. Notable among the motivational variables are vocation and service-oriented spirit; among the demotivational variables are lack of recognition and commitment. DISCUSSION: It is affirmed that both motivational variables as well as demotivational variables are essentially qualitative and that economic and salary variables are less relevant and less hierarchical.

Experiences and reflections of former pediatric chief residents.

OBJECTIVE: To compare actual and ideal time commitments of pediatric chief residents between 1972 and 1992 and to determine if actual time commitments have changed. DESIGN: Descriptive, cross-sectional survey. PARTICIPANTS: One thousand two hundred eighty-four former pediatric chief residents. RESULTS: Chief residents between 1972 and 1982 spent a greater percentage of time teaching and providing patient care than chief residents between 1983 and 1992. Chief residents between 1983 and 1992 spent a greater percentage of time scheduling and performing other administrative tasks. In general, chief residents desired more time to teach, to conduct research, and to provide outpatient care and desired less time for scheduling and for performing other administrative duties. CONCLUSIONS: Although chief residents desire to spend more time teaching and less time performing administrative tasks, administrative duties have increased at the expense of teaching and patient care responsibilities over the past 20 years.

Intern candidates who withdraw from contracts: incidence and internal medicine program directors' attitudes.

OBJECTIVE: To study the prevalence of intern candidates accepted through the National Resident Matching Program (NRMP) or after the match who subsequently withdraw and the attitudes of program directors regarding this issue. DESIGN: Mailed survey. SETTING: Four hundred fifty-four internal medicine program directors. MEASUREMENTS: Questionnaires assessing program directors' attitudes toward interns who contract for positions after having verbal or written agreements elsewhere (and the program directors who accept them), the importance of this problem, and the incidence of this problem. MAIN RESULTS: Fifty-five programs (of the 221 responding) experienced intern withdrawals. Programs with larger numbers of open positions after the match had more intern withdrawals (p = 0.03). Eleven of the program directors knew of the prior commitment of the intern, and in all cases the other program director was called for permission to accept the intern. Program directors had negative feelings about both the interns who withdrew and the program directors who accepted them. Community, municipal, and Veterans Affairs hospital program directors were significantly less negative than those in university and university-affiliated hospitals toward interns who withdrew from written commitments (p = 0.001) and the program directors who accepted them (p < 0.05). CONCLUSION: Problems with intern candidate withdrawals from offered/matched programs affect a significant proportion of programs, especially those with larger numbers of unmatched positions. Program directors are generally disapproving.