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University hospitals as drivers of career success: an empirical study of the duration of promotion and promotion success of hospital physicians.

ABSTRACT: BACKGROUND: German hospitals have a well-defined career structure for clinicians. In this hierarchical career system university hospital are stepping stones for career advancement. This longitudinal study investigates the impact of working in university hospitals on the career success of junior physicians and senior physicians. METHODS: Consideration of the career trajectories of 324 hospital physicians. Discrete-time event history analysis is used to study the influence of working in university hospitals on the chance of promotion from junior physician to senior physician and senior physician to chief physician. A comparison of medians provides information about the impact of working in university hospitals on the duration of promotion to senior and chief physician positions. RESULTS: Working in university hospitals has a negative impact for advancement to a senior physician position in terms of promotion duration (p = 0.005) and also in terms of promotion success, where a short time span of just 1-2 years in university hospitals has a negative effect (OR = 0.38, p < 0.01), while working there for a medium or long term has no significant effect. However, working in universities has a positive effect on the duration of promotion to a chief physician position (p = 0.079), and working in university hospitals for 3-4 years increases the chance of promotion to a chief physician position (OR = 4.02, p < 0.05), while working there >?=7 years decreases this chance (OR = 0.27, p < 0.05). In addition, physicians have a higher chance of promotion to a chief physician position through career mobility when they come to the position from a university hospital. CONCLUSION: Working at university hospitals has a career-enhancing effect for a senior physician with ambitions to become a chief physician. For junior physicians on the trajectory to a senior physician position, however, university hospitals are not drivers of career success.

SUBMITTER: Degen C

PROVIDER: S-EPMC4021192 | biostudies-other | 2014

REPOSITORIES: biostudies-other

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University hospitals as drivers of career success: an empirical study of the duration of promotion and promotion success of hospital physicians.

Degen Christiane C Kuntz Ludwig L

BMC medical education 20140423

<h4>Background</h4>German hospitals have a well-defined career structure for clinicians. In this hierarchical career system university hospital are stepping stones for career advancement. This longitudinal study investigates the impact of working in university hospitals on the career success of junior physicians and senior physicians.<h4>Methods</h4>Consideration of the career trajectories of 324 hospital physicians. Discrete-time event history analysis is used to study the influence of working ...[more]

PMID: 24755299

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Project description:BACKGROUND: International clinical trials are now rapidly expanding into Asia. However, the proportion of global trials is higher in South Korea compared to Japan despite implementation of similar governmental support in both countries. The difference in clinical trial environment might influence the respective physicians' attitudes and experience towards clinical trials. Therefore, we designed a questionnaire to explore how physicians conceive the issues surrounding clinical trials in both countries. METHODS: A questionnaire survey was conducted at Kyoto University Hospital (KUHP) and Seoul National University Hospital (SNUH) in 2008. The questionnaire consisted of 15 questions and 2 open-ended questions on broad key issues relating to clinical trials. RESULTS: The number of responders was 301 at KUHP and 398 at SNUH. Doctors with trial experience were 196 at KUHP and 150 at SNUH. Among them, 12% (24/196) at KUHP and 41% (61/150) at SUNH had global trial experience. Most respondents at both institutions viewed clinical trials favorably and thought that conducting clinical trials contributed to medical advances, which would ultimately lead to new and better treatments. The main reason raised as a hindrance to conducting clinical trials was the lack of personnel support and time. Doctors at both university hospitals thought that more clinical research coordinators were required to conduct clinical trials more efficiently. KUHP doctors were driven mainly by pure academic interest or for their desire to find new treatments, while obtaining credits for board certification and co-authorship on manuscripts also served as motivation factors for doctors at SNUH. CONCLUSIONS: Our results revealed that there might be two different approaches to increase clinical trial activity. One is a social level approach to establish clinical trial infrastructure providing sufficient clinical research professionals. The other is an individual level approach that would provide incentives to encourage doctors to participate in and conduct clinical trials.

Project description:BackgroundThe use of mobile devices in hospital care constantly increases. However, smartphones and tablets have not yet widely become official working equipment in medical care. Meanwhile, the parallel use of private and official devices in hospitals is common. Medical staff use smartphones and tablets in a growing number of ways. This mixture of devices and how they can be used is a challenge to persons in charge of defining strategies and rules for the usage of mobile devices in hospital care.ObjectiveTherefore, we aimed to examine the status quo of physicians' mobile device usage and concrete requirements and their future expectations of how mobile devices can be used.MethodsWe performed a web-based survey among physicians in 8 German university hospitals from June to October 2019. The online survey was forwarded by hospital management personnel to physicians from all departments involved in patient care at the local sites.ResultsA total of 303 physicians from almost all medical fields and work experience levels completed the web-based survey. The majority regarded a tablet (211/303, 69.6%) and a smartphone (177/303, 58.4%) as the ideal devices for their operational area. In practice, physicians are still predominantly using desktop computers during their worktime (mean percentage of worktime spent on a desktop computer: 56.8%; smartphone: 12.8%; tablet: 3.6%). Today, physicians use mobile devices for basic tasks such as oral (171/303, 56.4%) and written (118/303, 38.9%) communication and to look up dosages, diagnoses, and guidelines (194/303, 64.0%). Respondents are also willing to use mobile devices for more advanced applications such as an early warning system (224/303, 73.9%) and mobile electronic health records (211/303, 69.6%). We found a significant association between the technical affinity and the preference of device in medical care (χs2=53.84, P<.001) showing that with increasing self-reported technical affinity, the preference for smartphones and tablets increases compared to desktop computers.ConclusionsPhysicians in German university hospitals have a high technical affinity and positive attitude toward the widespread implementation of mobile devices in clinical care. They are willing to use official mobile devices in clinical practice for basic and advanced mobile health uses. Thus, the reason for the low usage is not a lack of willingness of the potential users. Challenges that hinder the wider adoption of mobile devices might be regulatory, financial and organizational issues, and missing interoperability standards of clinical information systems, but also a shortage of areas of application in which workflows are adapted for (small) mobile devices.

Project description:BackgroundEstablishment and improvement of patients' trust in healthcare organizations like hospitals necessitate delivery of high-quality services by nurses, as the largest group of healthcare providers. The present study aimed to compare hospital service quality based on the HEALTHQUAL model and trusting nurses at university and non-university hospitals in Iran.MethodsThis comparative cross-sectional study was conducted on 990 patients admitted to university and non-university hospitals located in Bushehr Province, southern Iran, who were selected using the stratified random sampling method. The data were collected through the HEALTHQUAL questionnaire and the Trust in Nurses Scale, and then analyzed via the SPSS Statistics software (version 22) as well as the General Linear Model (GLM) univariate procedure and the Chi-square test with a significance level of 0.05.ResultsThe study findings revealed that the mean values of real quality (perceptions) and ideal quality (expectations) were 3.89 ± 0.69 and 4.55 ± 0.47, respectively. The gap between the real and ideal quality (- 0.64) was also larger at non-university hospitals from the patients' viewpoints. Comparing various dimensions of service quality, the largest gap at university and non-university hospitals was associated with "environment" (- 0.13) and "empathy" (- 0.18), respectively. Additionally, the mean scores of the patient trust in nurses at university and non-university hospitals were 10.34 ± 5.81 and 8.71 ± 4.05, respectively, being a statistically significant difference (p < 0.001).ConclusionThe study results demonstrated that hospital service quality and trusting in nurses were at higher levels at the university hospital than the non-university one; however, hospital service quality was at a lower level than what the patients had expected. Accordingly, hospital managers and policy-makers were suggested to focus on patients to reduce gaps in service quality, to promote service quality, and to provide better healthcare services to patients.

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University hospitals as drivers of career success: an empirical study of the duration of promotion and promotion success of hospital physicians.

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University hospitals as drivers of career success: an empirical study of the duration of promotion and promotion success of hospital physicians.

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