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首页> 外文期刊>The Journal of Graduate Medical Education >Medical Schools' Industry Interaction Policies Not Associated With Trainees' Self-Reported Behavior as Residents: Results of a National Survey
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Medical Schools' Industry Interaction Policies Not Associated With Trainees' Self-Reported Behavior as Residents: Results of a National Survey

机译：医学院的行业互动政策与学员的自我报告的行为无关：国家调查结果

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Background? Medical students attending schools with policies limiting industry/student interactions report fewer relationships with pharmaceutical representatives.;Objective? To investigate whether associations between students' medical school policies and their more limited industry interaction behaviors persist into residency.;Methods? We randomly sampled 1800 third-year residents who graduated from 120 allopathic US-based medical schools, using the American Medical Association Physician Masterfile. We surveyed them in 2011 to determine self-reported behavior and preferences for brand-name prescriptions, and we calculated the strength of their medical schools' industry interaction policies using the 2008 American Medical Student Association and Institute on Medicine as a Profession databases. We used logistic regression to estimate the association between strength of school policies and residents' behaviors with adjustments for class size, postresidency career plan, and concern about medical school debt.;Results? We achieved a 44% survey response rate (n = 739). Residents who graduated from schools with restrictive policies were no more or less likely to accept industry gifts or industry-sponsored meals, speak with marketing representative about drug products, attend industry-sponsored lectures, or prefer brand-name medications than residents who graduated from schools with less restrictive policies. Residents who correctly answered evidence-based prescription questions were about 30% less likely to have attended industry-sponsored lectures (OR = 0.72, 95% CI 0.56–0.98).;Conclusions? Any effect that medical school industry interaction policies had on insulating students from pharmaceutical marketing did not persist in the behavior of residents in our sample. This suggests that residency training environments are important in influencing behavior.;What was known and gap Meals, gifts, and other inducements from pharmaceutical industry representatives may affect physician prescribing decisions.;What is new Restrictive policies at the medical school level did not affect residents' likelihood of pharmaceutical industry interaction or prescribing practices.;Limitations A response rate of 44% and potential respondent bias; responses to scenarios may not reflect real-life decision making.;Bottom line Strong, consistent industry interaction policies are needed across the medical education continuum to influence learner understanding of industry practices and their possible biasing effects.;Editor's Note: The online version of this article contains the survey questions and clinical scenarios used in the study.;Introduction Many physicians and trainees report receiving free meals, gifts, or other inducements from the pharmaceutical industry.1,2 To varying degrees, these interactions may create a sense of obligation to use promoted products, reducing evidence-based prescribing, with physicians not always aware of the influence of biased information.3–11 Previous studies12–16 have suggested varying effects on prescribing behavior and attitudes toward the pharmaceutical industry among medical students and residents. Many medical schools have implemented policies for faculty to disclose industry relationships and have banned certain types of interactions (eg, speakers' bureaus). Organizations, such as the Institute on Medicine as a Profession (IMAP) and the American Medical Student Association (AMSA), have conducted systematic evaluations of the strength of academic institutions' industry interaction policies in an effort to improve the regulation of industry interactions, with a particular focus on the effect on medical trainees. Previous studies1,17 have demonstrated that students at medical schools with more restrictive policies were less likely to accept gifts and interact with the pharmaceutical sales representatives than those at schools with less restrictive policies. Since medical schools are the starting points of physicians' prof
机译：背景？学生参加学校的政策限制行业/学生互动报告与制药代表的关系较少。客观？调查学生医学院政策和更多有限产业互动行为之间的协会是否持续到居住。;方法？我们使用美国医疗协会医师大师使用，随机抽出了1800名三年居民，这些居民毕业于120次疗法的美国医学院。我们在2011年调查了他们，以确定名牌处方的自我报告的行为和偏好，并使用2008年美国医学学生协会和医学研究所作为职业数据库，计算了他们的医学院行业互动政策的实力。我们使用Logistic回归来估计学校政策和居民行为之间的关联，调整班级规模，Postresidency Career计划和对医学院债务的关注。;结果？我们达到了44％的调查响应率（n = 739）。居民毕业于具有限制性政策的学校，不再或多或少地接受行业礼物或行业赞助的膳食，与营销代表有关药品，参加行业赞助的讲座，或者更喜欢毕业于学校的居民的品牌药物限制性较少的政策。正确回答基于证据的处方问题的居民减少了大约30％，可能会出席行业赞助的讲座（或= 0.72,95％CI 0.56-0.98）。结论？医学校业互动政策对来自制药营销的绝缘学生的任何影响都不会持续存在我们样本中居民的行为。这表明居住培训环境在影响行为方面都很重要。;药物行业代表的众所周知和差距膳食，礼物和其他诱导可能会影响医生处方决策。;医学院水平的新限制性政策是什么？ “制药行业互动或处方实践的可能性。限制响应率为44％和潜在的受访者偏见;对情景的响应可能不会反映现实生活决策。在医学教育中，底线强大，一致的行业互动政策是影响学习者对行业实践的理解及其可能的偏见效应。;编者的注意：这个的在线版本文章包含该研究中使用的调查问题和临床情景。;引言许多医生和学员报告收到免费餐，礼品或其他诱导的药业.1,2互动，这些互动可能会产生一种义务感使用升级的产品，减少了基于证据的处方，医生并不总是意识到偏见信息的影响.3-11之前的研究12-16对医学生和居民的制药行业的态度提出了不同的影响。许多医学院已经为教师实施了披露行业关系的政策，并禁止了某些类型的互动（例如，发言人的管辖）。作为专业（IMAP）和美国医学学生协会（AMSA）的组织，对学术机构行业互动政策的实力进行了系统的评价，以改善行业互动的监管，特别关注对医疗学员的影响。以前的研究1,17已经证明，具有更多限制性政策的医学院的学生不太可能接受礼品，并与制药销售代表相互作用，而不是学校在学校的限制性政策。由于医学院是医生教授的起点

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