Need for enforcement of ethicolegal education - an analysis of the survey of postgraduate clinical trainees.

"Disclosure of medical records and law case education As a first step, principal component analysis was performed as for the intern doctors' answers (multiple choice) to the question "Why do you think disclosure of medical records is required?" The characteristics of the three components extracted from the answers were elicited in reference to question items. Component 1 was one of the top two components (with a cumulative variance of 49%) and was considered to reflect "eagerness to heal" because the two most frequent choices were "reflect self-helping efforts" and "to summarize medical records". Component 2 may reflect "distrust of physicians" because the frequencies of "distrust physicians" and "considering lawsuits" were high (see Figure 1). Figure 1Principle component analysis of the awareness of the reasons for disclosure of medical records. Principal component analysis was performed as for the intern doctors' answers (multiple choice) to the question "Why do you think disclosure of medical records is required?" To evaluate the relationship between components 1 and 2, they were placed in a 2 × 2 matrix, with attention paid to each component's strengths and weaknesses, and classified into (A), (B), (C) and (D). In addition, to evaluate the relationship between components 1 and 2, they were placed in a 2 × 2 matrix, with attention paid to each component's strengths and weaknesses, and classified into (A), (B), (C) and (D) (see Figure 2). (A) indicated that "the disclosure was required since patients themselves had willingness to be cured or patients had distrust for doctors"; (B) indicated that "the disclosure was required only for patient's willingness to be cured"; (C) indicated that "the disclosure was required due to simple interests"; and (D) indicated that "the disclosure was required since patients had distrust for doctors". Figure 2Law cases of medical malpractice and results of principle component analysis of disclosure of medical records. A particularly strong trend could be observed in relation to answers (A), (B), (C) and (D) with respect to the answers to the question "Have you read literature concerning medical malpractice precedents?" Answers were: (A) in 22 subjects, (B) in 21, (C) in 24, and (D) in 35. In (A) to (D), the percentages of answers to the above question were expressed as pie graphs. The following analysis was performed by combining the above results for (A), (B), (C) and (D) with answers to other questions. As a result, a particularly strong trend could be observed in relation to answers (A), (B), (C) and (D) with respect to the answers to the question "Have you read literature concerning medical malpractice precedents?" Answers were: (A) in 22 subjects, (B) in 21, (C) in 24, and (D) in 35. In (A) to (D), the percentages of answers to the above question were expressed as pie graphs. As a result, the interesting fact emerged that doctors who selected (D) (followed by (C), (B) and (A)) had more experience of reading legal precedents. This indicated that there was some relation between interns' reading legal precedents and their reason given for "Why do patients require the disclosure of medical records?" An arrow directed from "patients" to "doctors" in Figure 1 shows how doctors perceive patients' evaluations of doctors. Competing interests The author(s) declare that they have no competing interests."