title: Using a questionnaire among patient, resident doctor and senior supervisor: Are their answers the same?
abstract: OBJECTIVE
  This study aims to contribute to the development of objective diagnostic standards in Traditional Chinese Medicine (TCM), in order to improve the training of physicians.
  
  
  METHODS
  We devised a questionnaire study to evaluate the accuracy of resident doctors' diagnostic skills by comparing their assessment of patients with those of their senior supervising physician and the patients themselves. We selected 39 patients with systemic lupus erythematosus (SLE) at Chang Gung Memorial Hospital, Taiwan, between November 1, 2008 and June 30, 2012, and had the resident doctors (R), their senior supervisor (S) and their patients (P) fill out questionnaires before treatment (V1), immediately after treatment (V5) and two months after treatment (V6), in order to record their assessments on the patients' condition. The R and S questionnaires covered subjective symptoms, tongue, and pulse, while the P questionnaires only included general symptoms. We then compared the assessment records to determine the level of agreement between them.
  
  
  RESULTS
  The agreements of inquiry during the study for P and S were 0.78 (V1) to 0.84 (V6) and 0.87 (V1) to 0.94 (V6) for R and S, respectively, the agreements between R and S for tongue diagnosis and pulse diagnosis were 0.87 (V1) to 0.90 (V6) and 0.91 (V1) to 0.95 (V6), respectively. All the above agreements improved with time from V1 to V6.
  
  
  CONCLUSIONS
  The results show that the patient input was feasible and effective and that the questionnaire method provided an objective assessment standard to determine how successfully the resident doctor was trained. Furthermore, it facilitated a training process that could help resident doctors improve their skills.
authors.affiliation: Graduate Institute of Clinical Medicine, and Graduate Institute of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan 33378, Taiwan. Electronic address: magicbjp@gmail.com.
authors.forename: Ching-Mao
authors.initials: CM
authors.lastname: Chang
authors.affiliation: Department of Healthcare Management, Yuanpei University, Hsinchu 30015, Taiwan. Electronic address: wenhsiang_wu@mail.ypu.edu.tw.
authors.forename: Wen-Hsiang
authors.initials: WH
authors.lastname: Wu
authors.affiliation: Institute of Clinical Medicine, National Yang-Ming University, Taipei 11221, Taiwan. Electronic address: itkuo@vghtpe.gov.tw.
authors.forename: Benjamin Ing-Tiau
authors.initials: BI
authors.lastname: Kuo
authors.affiliation: School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan 33378, Taiwan. Electronic address: joyamen@mail.cgu.edu.tw.
authors.forename: Tzung-Yan
authors.initials: TY
authors.lastname: Lee
authors.affiliation: Department of Chinese Medicine, Linsen Chinese Medicine Branch, Taipei City Hospital, Taipei 10453, Taiwan. Electronic address: bryanliu0421@gmail.com.
authors.forename: Chia-Yu
authors.initials: CY
authors.lastname: Liu
authors.affiliation: Graduate Institute of Clinical Medicine, and Graduate Institute of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan 33378, Taiwan; School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan 33378, Taiwan; Center for Traditional Chinese Medicine, Chang Gung Memorial Hospital, Taoyuan 33378, Taiwan. Electronic address: tcmchh@mail.cgu.edu.tw.
authors.forename: Hen-Hong
authors.initials: HH
authors.lastname: Chang
mesh_terms: D006282:Health Personnel / Q000706:statistics & numerical data*; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000175:diagnosis*; D008516:Medicine, Chinese Traditional / Q000592:standards*; D010361:Patients / Q000706:statistics & numerical data*; D010820:Physicians / Q000706:statistics & numerical data*; D011674:Pulse; D011795:Surveys and Questionnaires; D013624:Taiwan / Q000453:epidemiology; D014059:Tongue / Q000473:pathology
keywords: Agreement; Chinese Medicine diagnosis; Objective and standard assessments; Quality of medical practice; Questionnaire; Systemic lupus erythematosus; Training