Practice pointsGlobally, medical professionals are shortaged. Despite being the most dispersedly populated country, Mongolia has trained sufficient number of medical doctors with local medical educ...

Background: The relatively young and inexperienced healthcare professionals in Mongolia faced with an unprecedent service demand in response to the COVID-19 pandemic. Due to the small size of the healthcare workforce the Mongolian Health Ministry had no choice but to mandate continuous and long workhours from the healthcare workforce. Many of the healthcare professionals exhibited signs and symptoms of mental health disorders. This study aimed to discern the prevalence various mental health concerns, i.e., depression, anxiety and stress, insomnia, and to discern the factors that increased susceptibility to mental health disorders among frontline healthcare professionals providing healthcare services for COVID-19 patients in Mongolia.Methods: A Cross-sectional research design was implemented. We collected data from 965 healthcare professional, randomly selected from 18 government hospitals, in four regions of Mongolia. Data were collected using the Depression Anxiety Stress-21, the General Self-Efficacy Scale, and the Insomnia Severity Index instruments. We constructed the scale of Pandemic Response Symptoms (PaReSy) which captured stress, depression, and anxiety. Data were analyzed using descriptive statistics, Kruskal–Wallis statistical test and multinominal logistic regression analysis.Results: Prevalence of depression (52.3%, CI 95%: 49.1–55.5%), anxiety (70.2%, CI 95%: 67.2–73.0%), and stress (35.8%, CI 95%: 32.7–38.9%) was documented among Mongolian healthcare professionals. Perception of self-efficacy reduced susceptibility to PaReSy either at mild/moderate (OR = 0.948, 95% CI = 0.911–0.988, P = 0.011) or severe/extremely severe level (OR = 0.911, 95% CI = 0.861–0.963, P = 0.001). Within each stratum of insomnia, the risk of experiencing PaReSy increased almost linearly both in the category of mild/moderate PaReSy and in the category of severe/extremely severe PaReSy.Conclusion: Improving self-efficacy and sleeping quality can assist healthcare workers to manage depression, anxiety, and stress. Findings provide important evidence to implement measures and strategies to assist healthcare professionals in low- and middle-income countries to constructively address their mental health concerns and needs.

Purpose: Due to the shortage in the healthcare workforce, insufficient qualifications, a lack of infrastructure and limited resources in Mongolia, it is not always possible for healthcare workers in rural areas who wish to attend continuous training and retraining courses to do so. However, in order to provide high-quality care, the demand for distance learning and the upgrading of knowledge and practice of many medical topics (especially related to morbidity and mortality) are necessary for the rural population. This study aimed to assess the needs of e-learning medical education, of graduates in Mongolia.Methods: A cross-sectional research design was implemented. We collected data from 1,221 healthcare professionals (nursing professionals, physicians, midwives, and feldshers) who were randomly selected from 69 government hospitals in Mongolia. Data were collected using self-assessment questionnaires which captured the needs assessment in a survey for online continuous medical education in Mongolia. Data were analyzed using descriptive statistics and Kruskal-Wallis statistical test.Results: Ninety percent of the respondents reported that they plan on attending online continuous medical education with the most preferred specialty area being emergency medicine. Results using the Kruskal-Wallis statistical technique suggested the preferred specialty area, educational content, appropriate time schedule, available devices, and tools were statistically significant and were different between the nursing professionals, physicians, midwives, and feldshers (p<0.05).Conclusion: Findings provide important evidence for the implementation of measures and strategies which can assist healthcare professionals in low and middle-income areas/countries to constructively address their need for enhanced knowledge and practice through distance learning.

Objectives: To evaluate multiple-choice questions of the Medical Licensing Examination. Methods: The study design was a cross sectional descriptive and item analysis method was used. This study was conducted in Health Development Center of the Ministry of Health. An item analysis was done on 1500 multiple-choice questions for the internal medicine licensing exam and of 2077 subjects from 2014 to 2016. The item analysis involved identifying reliability coefficient, difficulty index, and discrimination index for each question in relation to the doctors’ exam performance. Microsoft Excel 2010, and SPSS were used for the statistical analyses. Results: Reliability coefficient (KR20) of Mongolia’s medical licensing examination in 2014-2016 ranged from 0.79 - 0.92. The frequency of multiple-choice questions with a negative or zero discrimination index was 11.6 percent and a high difficulty index was 21.9 percent. Conclusion: Even though reliability of Mongolia’s medical licensing examinations were good, one-third of the multiple-choice questions used in the exams fail to evaluate examinee’s knowledge.

This study evaluated a practical competency evaluation for nursing students in three Asian countries using tablet PC-based tests. The need to evaluate practical competencies in a non-face-to-face manner continues to pose challenges in nursing education. This study presents descriptive comparative research on a tablet PC-based evaluation of practical competencies in three countries. tablet PC-based clinical practice competency evaluation was conducted among nursing college students in Korea, Vietnam and Mongolia. In total, 124 students answered 65 questions for practical competency evaluation and items on its usefulness. Students from Korea had the highest score of nursing competencies (41.6 points; n = 59, SD 6.02), followed by those from Vietnam (26.3 points; n = 30, SD 4.97) and Mongolia (18.4 points; n = 35, SD 5.36). Scores for usability showed an inverse relationship with competency scores. Questions incorporating video showed the lowest proportion of low-discrimination items. This research recognized that using video which provides contextual elements can increase item discrimination. These findings suggest that incorporating video into evaluation items in tablet-PC-based tests is useful for international comparison.