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Communication breakdowns are the major reasons of many cases of medical malpractice, this study intended to launch a 3-year project which focused on attending physician as intervention targets. Using an evidence-based approach, this intervention training program was designed to be tailored to individual record of malpractice history for physicians who participated. Many findings 1, 4 demonstrate that successful reduction of communication breakdowns can substantially improve patient safety and reduce errors. Therefore, the content in the teaching curriculum for this communication training will focus on communications among health professionals, and communications between patients and physicians, using the cases of medical malpractice claims in our hospitals. Methods: Totally 109 attending physicians agreed to attend this educational intervention. The teaching materials for educational intervention have been developed into five courses: (1) an overview for malpractice suits in the sampled hospital, (2) how to avoid getting sued? (3) Communications between patients and physicians in handling malpractice negotiation (4) simulation of medical court. Results and conclusions: Fifty-seven physicians attending segmental session and 52 physicians attended consecutive session. Both comparison of pretest and posttest indicates that physicians attending consecutive session obtained significantly higher scores than those physicians attending segmental session (p < .001). Also, for consecutive sessions, both physicians and nurses all had significantly scores of pretests than those of their pretest scores. First, this study employed evidence-based approach to offer a communication training which tailors to individual physician who had involved in malpractice claims or patient complaints. Learners could enrich their knowledge of malpractice and employ these communication skills in clinical practice. Second, this training can empowered physicians themselves to better manage the relationships with patients and enhanced their recovery ability from the stress generated from malpractice claim. Third, the curriculum design of consecutive session was proved to be beneficial to the facilitators and learners in medical education. [ABSTRACT FROM AUTHOR]

Background: Although hepatitis is one of the major presentations of acute Q fever, the possible influence of viral hepatitis in Q fever has, to our knowledge, never been investigated. It is an important issue in regions where Q fever hepatitis and viral hepatitis are prevalent, such as Taiwan. We conducted a study to investigate the possible influence of viral hepatitis in cases of acute Q fever hepatitis., Methods: Cases of acute Q fever confirmed by serologic examination were included in the study. All patients who were found to be positive for Q fever were tested for hepatitis B surface antigen and antibody to hepatitis C virus, and those with positive results had their viral loads determined. Demographic data, clinical manifestations, results of laboratory and imaging examinations, and responses to treatment were recorded retrospectively from charts., Results: A total of 58 patients with acute Q fever hepatitis were studied, of whom 16 (27.6%) had viral hepatitis (hepatitis B virus infection in 12 and hepatitis C virus infection in 4). Patients with and patients without viral hepatitis did not differ with regard to clinical manifestations and responses to treatment, except that chills (100% vs. 73.8%; P=.02) and nausea and/or vomiting (18.8% vs. 2.4%; P=.03) were significantly more common among patients with viral hepatitis. The change in hepatitis B and C virus loads between the acute and convalescent phase was <1.0 log(10)., Conclusions: The clinical manifestations of acute Q fever hepatitis differ little in patients with and patients without underlying viral hepatitis, and replication of hepatitis virus is not influenced by acute Q fever hepatitis.