Erasmus School of Health Policy & Management (ESHPM), Erasmus University Rotterdam, Rotterdam, The Netherlands.
Villa 42, Raha Gardens, PO Box 965118, Abu Dhabi, United Arab Emirates.
BMC Med Educ. 2018 Dec 13;18(1):305. doi: 10.1186/s12909-018-1393-x.
Although healthcare regulation is commonplace, there is limited evidence of its impact. Making sure that healthcare professionals comply with the regulatory requirements is a prerequisite to achieving effective regulation. Therefore, investigating factors that influence compliance may provide better insights into how regulators can be more effective. This study aimed to find out if medical students' perceptions of regulation in the United Arab Emirates are associated with self-reported regulatory compliance.
In the cross-sectional study, we administered a structured questionnaire to students of medicine with different statements concerning their perceptions of healthcare regulation and self-reported compliance. The statements included statement regarding the legitimacy, fairness and regulatory performance, as well as the risk to getting caught and being punished. The association between perceptions and self-reported compliance was analyzed using multiple regression models.
One hundred and six Year 3 and 4 pre-clinical medicine students (56.4% response rate) completed the survey. Almost 40% of the students rated their level of awareness and understanding of regulation as Good or Very Good., despite their lack of direct contact with the regulatory authorities (less than 10% reported monthly or more frequent contact). Self-reported compliance was high with almost 85% of the students either agreeing or strongly agreeing with the four compliance statements (mean score 4.1 out of 5). The findings suggest that positive perceptions of the regulator's performance (β 0.27; 95% CI 0.13-0.41), fairness of the regulatory processes (β 0.25; 95% CI 0.11-0.38) and its legitimacy (β 0.23; 95% CI 0.05-0.41), are stronger associated with compliance than the perceived risks of getting caught and being punished (β 0.10; 95% CI -0.04 - 0.23).
To improve compliant behavior, healthcare regulators should pay more attention to their own perceived performance, as well as the perceived fairness and legitimacy of their regulatory processes rather than focusing on more traditional methods of deterrence, such as perceived risk of getting caught and being published.
尽管医疗保健监管很常见，但关于其影响的证据有限。确保医疗保健专业人员遵守监管要求是实现有效监管的前提。因此，研究影响合规性的因素可以更好地了解监管机构如何更有效地发挥作用。本研究旨在了解阿联酋医学生对监管的看法是否与自我报告的合规性相关。
在这项横断面研究中，我们向不同年级的医学生发放了一份关于他们对医疗保健监管看法和自我报告合规性的结构化问卷。这些陈述包括对监管合法性、公平性和监管绩效的看法，以及被发现和受到惩罚的风险。我们使用多元回归模型分析了看法与自我报告合规性之间的关联。
106 名三年级和四年级临床医学学生（56.4%的回复率）完成了调查。尽管他们与监管机构没有直接接触（不到 10%的学生报告每月或更频繁的接触），但近 40%的学生对自己对监管的认识和理解程度评价为良好或非常好。自我报告的合规性很高，几乎 85%的学生同意或强烈同意四项合规陈述（平均得分为 5 分制中的 4.1 分）。研究结果表明，对监管机构绩效（β0.27；95%置信区间 0.13-0.41）、监管程序公平性（β0.25；95%置信区间 0.11-0.38）和合法性（β0.23；95%置信区间 0.05-0.41）的积极看法与合规性的相关性强于被发现和受到惩罚的风险（β0.10；95%置信区间-0.04-0.23）。
为了提高合规行为，医疗保健监管机构应更加关注自身的绩效，以及监管程序的公平性和合法性，而不是专注于更传统的威慑手段，如被发现和被公布的风险。
