Multiprofessional round with checklist: association with the improvement in patient safety in intensive care / Ronda multiprofesional con checklist: asociación con la mejora en la seguridad del paciente en cuidados intensivos / Round multiprofissional com checklist: associação com a melhoria na segurança do paciente em terapia intensiva

ABSTRACT Objective To verify the association between a multiprofessional round with the use of checklists and patient safety practices by health professionals in an intensive care unit. Method Mixed-method study, delineated by the sequential explanatory approach, conducted in a hospital in southern Brazil. Quantitative data were analyzed using Poisson regression, and qualitative data, using content analysis. The integrated analysis was performed through the explained/connected combination. Results In the post-implementation period of the rounds with systematic use of the checklist, there was a significant improvement in the prophylaxis of venous thromboembolism, light sedation, reduction in the days of use of mechanical ventilation, central venous catheter and indwelling urinary catheter. Conclusion The multiprofessional round with the systematic use of checklist, associated with the improvement in patient safety practices, was considered as a strategy that ensures better care in intensive care and favors job satisfaction.

RESUMEN Objetivo Verificar la asociación entre una ronda multiprofesional con el uso de listas de verificación y prácticas de seguridad del paciente por profesionales de la salud en una unidad de cuidados intensivos. Método Estudio de método mixto, delineado por el enfoque explicativo secuencial, realizado en un hospital del sur de Brasil. Los datos cuantitativos se analizaron mediante regresión de Poisson, y los datos cualitativos, mediante análisis de contenido. El análisis integrado se realizo através de la combinación explicada/conectada. Resultados En el período de post-implementación de las rondas con uso sistemático del checklist, hubo una mejora significativa en la profilaxis del tromboembolismo venoso, sedación leve, reducción de los días de uso de ventilación mecánica, catéter venoso central y catéter urinario permanente. Conclusión La ronda multiprofesional con el uso sistemático de la lista de verificación, asociada a la mejora en las prácticas de seguridad del paciente, fue considerada como una estrategia que asegura una mejor atención en cuidados intensivos y favorece la satisfacción laboral.

RESUMO Objetivo Verificar a associação entre round multiprofissional com uso de checklist e práticas de segurança do paciente por profissionais de saúde de uma unidade de terapia intensiva. Método Estudo de método misto, delineado pela abordagem sequencial explanatória, realizado em um hospital do sul do Brasil. Os dados quantitativos foram analisados por meio de regressão de Poisson e os dados qualitativos, pela análise de conteúdo. Fez-se a análise integrada por meio da combinação explicada/conectada. Resultados No período pós-implementação dos rounds com uso sistemático de checklist houve melhora significativa da profilaxia de tromboembolia venosa, sedação leve, redução dos dias de uso de ventilação mecânica, cateter venoso central e de sonda vesical de demora. Conclusão O round multiprofissional com uso sistemático de checklist, associado com a melhoria nas práticas de segurança do paciente, foi considerado como uma estratégia que assegura melhores cuidados em terapia intensiva e favorece a satisfação no trabalho.

Effects of multidisciplinary rounds and checklist in an Intensive Care Unit: a mixed methods study / Efectos de las rondas multidisciplinarias y la lista de verificación en la Unidad de Cuidados Intensivos: un estudio de método mixto / Efeitos de rounds multidisciplinares e checklist em Unidade de Terapia Intensiva: estudo de método misto

ABSTRACT Objectives: to analyze the implementation of multidisciplinary checklist-directed rounds before health indicators and multidisciplinary team perception of an Intensive Care Unit. Methods: a mixed methods study, with an explanatory sequential design, carried out at a hospital in southern Brazil, from September 2020 to August 2021. The integration of quantitative and qualitative data was combined by connection. Results: after the implementation of checklist-directed rounds, there was a significant reduction in hospital stay from ventilator-associated pneumonia, urinary tract infection and daily invasive device use. The investigated practice is essential for comprehensive care, harm reduction, effective work and critical patient safety. Conclusions: the multidisciplinary rounds with checklist use reduced data on health indicators of critically ill patients and was considered a vital practice in the intensive care setting.

RESUMEN Objetivos: analizar la implementación de rondas multidisciplinarias guiadas por checklist frente a indicadores de salud y la percepción del equipo multidisciplinario de una Unidad de Cuidados Intensivos. Métodos: estudio de método mixto, con diseño secuencial explicativo, realizado en un hospital del sur de Brasil, de septiembre de 2020 a agosto de 2021. La integración de datos cuantitativos y cualitativos se combinó por conexión. Resultados: después de la implementación de las rondas dirigidas por listas de verificación, hubo una reducción significativa en la estancia hospitalaria por neumonía asociada a ventilación mecánica, infección del tracto urinario y en los días de uso de dispositivos invasivos. La práctica investigada es fundamental para la atención integral, la reducción de daños, el trabajo eficaz y la seguridad del paciente crítico. Conclusiones: las rondas multidisciplinarias con el uso de listas de verificación redujeron los datos sobre los indicadores de salud de los pacientes críticos y se consideró una práctica vital en el entorno de cuidados intensivos.

RESUMO Objetivos: analisar a implementação de rounds multidisciplinares direcionados por checklist frente aos indicadores de saúde e a percepção da equipe multiprofissional de uma Unidade de Terapia Intensiva. Métodos: estudo de método misto, com desenho sequencial explanatório, realizado em um hospital do sul do Brasil, no período de setembro de 2020 a agosto de 2021. A integração dos dados quantitativos e qualitativos foi combinada por conexão. Resultados: após a implementação dos rounds direcionados por checklist, constatou-se redução significativa no tempo de internação por pneumonias associadas à ventilação mecânica, infecção do trato urinário e nos dias de uso de dispositivos invasivos. A prática investigada é essencial para o cuidado integral, a redução de danos, o trabalho eficaz e a segurança do paciente crítico. Conclusões: os rounds multidisciplinares com uso de checklist reduziram os dados dos indicadores de saúde de pacientes críticos e foi considerado como prática vital no cenário de cuidados intensivos.

Experiências de enfermeiros de unidades pediátricas de um hospital universitário em relação às visitas multiprofissionais / Multidisciplinary visits in the experience of nurses in pediatric units of a university hospital / Experiencias de enfermeros en unidades pediátricas de un hospital universitario en relación con las visitas multiprofesionales

Objetivo: descrever a experiência dos enfermeiros atuantes nas unidades pediátricas frente às visitas multidisciplinares, compreender a percepção dos enfermeiros a respeito da participação da família nas visitas multidisciplinares e descrever as percepções dos enfermeiros residentes sobre o impacto das visitas multidisciplinares em sua formação profissional e no cuidado ao paciente e à família. Método: estudo qualitativo, realizado com 18 enfermeiros de unidades pediátricas de um hospital universitário, a partir de entrevistas semi-estuturadas, com uso da análise de conteúdo. Resultados: a experiência foi compreendida pelas categorias: Formato da visita multidisciplinar; Participação do enfermeiro na visita multidisciplinar; Participação da família na visita multidisciplinar; Benefícios da visita para o enfermeiro, residente e família; e Recomendações para os enfermeiros, família e desenho das visitas. Conclusão: a experiência dos enfermeiros é representada essencialmente pelas relações humanas estabelecidas, com benefícios ou prejuízos à sua participação e participação da família. A visita multidisciplinar constitui uma prática benéfica e com potencial formativo.

Objective: to describe how nurses working in pediatric units experienced multidisciplinary visits, to understand their perceptions of the families' participation in such visits, and the residents' perceptions of the visits' impact on training and on care for patients and families. Method: this qualitative, descriptive study involving 18 male nurses from pediatric units of a university hospital, was conducted through semi-structured interviews, using content analysis. Results: the nurses' experience was understood by categories: the design of multidisciplinary visits; nurses' participation in multidisciplinary visits; families' participation in multidisciplinary visits; benefits from visits for nurses, residents and families; and recommendations for nurses and families, and for visit design. Conclusion: the nurses' experience was essentially represented by the human relationships established, and the related benefits or detriments to participation by themselves and the families. The visit was found to be a beneficial practice with training potential.

Objetivo: describir la experiencia de enfermeros que laboran en unidades de pediatría antes las visitas multidisciplinarias, comprender la percepción de los enfermeros sobre la participación familiar en las visitas multidisciplinarias y describir las percepciones de los enfermeros residentes sobre el impacto de las visitas multidisciplinarias en su formación profesional y en la atención al paciente y la familia. Método: estudio cualitativo, junto a 18 enfermeros de unidades de pediatría de un hospital universitario, realizado a partir de entrevistas semiestructuradas, mediante análisis de contenido. Resultados: la experiencia fue entendida por las categorías: Formato de la visita multidisciplinaria; Participación del enfermero en la visita multidisciplinaria; Participación de la familia en la visita multidisciplinaria; Beneficios de la visita para el enfermero, el residente y la familia; y Recomendaciones para enfermeros, familia y diseño de las visitas. Conclusión: la experiencia de los enfermeros está esencialmente representada por las relaciones humanas establecidas, con beneficios o perjuicios a su participación y la participación familiar. La visita multidisciplinaria es una práctica beneficiosa con potencial formativo.

Experiências de enfermeiros de unidades pediátricas de um hospital universitário em relação às visitas multiprofissionais / Experiencias de enfermeros en unidades pediátricas de un hospital universitario en relación con las visitas multiprofesionales / Multidisciplinary visits in the experience of nurses in pediatric units of a university hospital

RESUMO Objetivo descrever a experiência dos enfermeiros atuantes nas unidades pediátricas frente às visitas multidisciplinares, compreender a percepção dos enfermeiros a respeito da participação da família nas visitas multidisciplinares e descrever as percepções dos enfermeiros residentes sobre o impacto das visitas multidisciplinares em sua formação profissional e no cuidado ao paciente e à família. Método estudo qualitativo, realizado com 18 enfermeiros de unidades pediátricas de um hospital universitário, a partir de entrevistas semi-estuturadas, com uso da análise de conteúdo. Resultados a experiência foi compreendida pelas categorias: Formato da visita multidisciplinar; Participação do enfermeiro na visita multidisciplinar; Participação da família na visita multidisciplinar; Benefícios da visita para o enfermeiro, residente e família; e Recomendações para os enfermeiros, família e desenho das visitas. Conclusão: a experiência dos enfermeiros é representada essencialmente pelas relações humanas estabelecidas, com benefícios ou prejuízos à sua participação e participação da família. A visita multidisciplinar constitui uma prática benéfica e com potencial formativo.

RESUMEN Objetivo describir la experiencia de enfermeros que laboran en unidades de pediatría antes las visitas multidisciplinarias, comprender la percepción de los enfermeros sobre la participación familiar en las visitas multidisciplinarias y describir las percepciones de los enfermeros residentes sobre el impacto de las visitas multidisciplinarias en su formación profesional y en la atención al paciente y la familia. Método: estudio cualitativo, junto a 18 enfermeros de unidades de pediatría de un hospital universitario, realizado a partir de entrevistas semiestructuradas, mediante análisis de contenido. Resultados la experiencia fue entendida por las categorías: Formato de la visita multidisciplinaria; Participación del enfermero en la visita multidisciplinaria; Participación de la familia en la visita multidisciplinaria; Beneficios de la visita para el enfermero, el residente y la familia; y Recomendaciones para enfermeros, familia y diseño de las visitas. Conclusión la experiencia de los enfermeros está esencialmente representada por las relaciones humanas establecidas, con beneficios o perjuicios a su participación y la participación familiar. La visita multidisciplinaria es una práctica beneficiosa con potencial formativo.

ABSTRACT Objective to describe how nurses working in pediatric units experienced multidisciplinary visits, to understand their perceptions of the families' participation in such visits, and the residents' perceptions of the visits' impact on training and on care for patients and families. Method this qualitative, descriptive study involving 18 male nurses from pediatric units of a university hospital, was conducted through semi-structured interviews, using content analysis. Results the nurses' experience was understood by categories: the design of multidisciplinary visits; nurses' participation in multidisciplinary visits; families' participation in multidisciplinary visits; benefits from visits for nurses, residents and families; and recommendations for nurses and families, and for visit design. Conclusion: the nurses' experience was essentially represented by the human relationships established, and the related benefits or detriments to participation by themselves and the families. The visit was found to be a beneficial practice with training potential.

Percepción estudiantil sobre la guardia médica como forma de educación en el trabajo / Student perception on the doctor on duty system as a form of in- service training

RESUMEN Fundamento: la guardia médica en pregrado constituye un escenario formativo para la adquisición de habilidades y valores propios de la carrera de Medicina. Objetivo: valorar la guardia médica como forma de educación en el trabajo según la percepción de estudiantes de quinto año de Medicina. Método: se realizó una investigación descriptiva y transversal en la Universidad de Ciencias Médicas de Pinar del Río durante 2019-2020. Se aplicaron métodos teóricos: análisis-síntesis, inducción-deducción e histórico-lógico; empíricos: cuestionario a estudiantes mediante el cual se exploraron sus opiniones sobre la guardia médica. Los resultados obtenidos se llevaron a tablas para sus análisis, a los que se les aplicó el método porcentual. Resultados: los estudiantes consideraron la guardia médica como una forma de vincular la adquisición de conocimientos, habilidades y hábitos para la solución de los problemas de salud en la comunidad; las especialidades Cirugía, Ginecología y Otorrinolaringología fueron las más reconocidas por sus aportes a la profesión; señalaron como mayores habilidades obtenidas: interrogar al paciente, confeccionar historias clínicas y buscar factores de riesgo; la mayoría coincidieron en opinar sobre la efectividad del control y evaluación docentes, aunque persistieron algunas deficiencias metodológicas para lograr una mayor motivación en ellos. Conclusiones: los estudiantes percibieron la efectividad de la guardia médica como forma de educación en el trabajo en la carrera de Medicina, pues opinaron favorablemente sobre ella a partir de los aportes ofrecidos en cuanto a solidez del aprendizaje, y en la concepción y desarrollo de habilidades y valores profesionales.

ABSTRACT Background: the undergraduate medical student on duty system constitutes a formative scene for the acquisition of skills and values ​​of the Medicine degree. Objective: to assess the medical student on duty system as a form of in-service training according to the perception of fifth-year medical students. Method: a descriptive and cross-sectional research was carried out at Pinar del Río University of Medical Sciences from 2019 to 2020. Theoretical methods were applied: analysis-synthesis, induction-deduction and historical-logical; empirical ones: questionnaire to students through which their opinions about the medical student on duty system were explored. The results were illustrated through tables where the percentage method was applied for analysis. Results: the students considered the medical on call system as a way to link the acquisition of knowledge, skills and habits for the solution of health problems in the community; Surgery, Gynecology and Otorhinolaryngology specialties were the most recognized for their contributions to the profession; They pointed out as greater skills obtained: questioning the patient, making medical records and looking for risk factors; The majority agreed in their opinion on the effectiveness of teacher control and evaluation, although some methodological deficiencies persisted in order to achieve greater motivation in them. Conclusions: the students perceived the effectiveness of the medical on call system as a form of in-service training in the Medicine degree, since they gave a favorable opinion about it based on the contributions offered in terms of solidity of learning and in the conception and development of skills and professional values.

Metodología para realizar el pase de visita docente-asistencial en inglés en escenarios de atención médica / Methodology to carry out the teaching ward round in English in medical care institutions

RESUMEN Fundamento: el pase de visita docente-asistencial en inglés es una modalidad de la educación en el trabajo donde se consolidan la aplicación del método clínico y las habilidades de la profesión médica. Objetivo: diseñar una metodología sobre el pase de visita docente asistencial en idioma inglés en los escenarios de la atención médica para estudiantes de quinto año de la carrera de Medicina. Métodos: se realizó un estudio descriptivo-cualitativo en la Universidad de Ciencias Médicas de Holguín durante el período 2015-2019. Se siguió un enfoque dialéctico-materialista y se emplearon métodos del nivel teórico: análisis-síntesis, inducción-deducción e histórico-lógico; y empíricos: cuestionario a docentes, observación de pases de visita, análisis documental y el criterio de especialistas. Resultados: las principales dificultades estuvieron relacionadas fundamentalmente con el desconocimiento de los procederes organizativos y uso inadecuado del vocabulario técnico durante la actividad, por lo que se diseñó una metodología para solucionarlas, la cual contiene aspectos didácticos relacionados con la solidez en el aprendizaje del idioma y el desarrollo de habilidades de la profesión. Conclusiones: fue valorada por los especialistas como adecuada por su estructura y su factibilidad de implementación. Después de aplicada resultó efectiva para la consolidación del aprendizaje estudiantil demostrada en un mejor rendimiento académico.

ABSTRACT Background: the teaching ward round in English is a modality of in-service training where the application of the clinical method and the skills of the medical profession are consolidated. Objective: to design a methodology on the teaching ward round in English in medical care institutions for fifth-year medical students. Methods: a descriptive-qualitative study was carried out at Holguín University of Medical Sciences from 2015 to 2019. A dialectical-materialist approach was followed and theoretical level methods were used: analysis-synthesis, induction-deduction and historical-logical; and empirical ones: questionnaire to teachers, observation to teaching ward rounds, documentary analysis and the criteria of specialists. Results: the main difficulties were mainly related to ignorance of organizational procedures and inappropriate use of technical vocabulary during the activity, so a methodology was designed to solve these aspects, it contains didactic aspects related to soundness in language learning and the development of professional skills. Conclusions: it was valued by specialists as adequate due to its structure and its feasibility of implementation. Its application showed to be effective for the consolidation of students´ learning which was demonstrated by a better academic performance.

Matriciamento: uma experiência ambulatorial / Matrix practice: an outpatient experience / Apoyo matriz: una experiencia ambulatoria

OBJETIVO: compreender a construção do matriciamento em um serviço de atenção a dependentes. MÉTODO: trata-se de uma pesquisa-ação realizada nos últimos sete anos, considerando as experiências de uma terapeuta ocupacional durante suas atividades no serviço, abrangendo reuniões clínicas, supervisões, grupos de estudos e capacitações. Os materiais utilizados foram prontuários, registros de supervisão e reunião e anotações pessoais. RESULTADOS: as demandas de cada sujeito são abordadas para além das especificidades de cada área. Os saberes são transmitidos nos encontros de equipe, permitindo, a quem está lidando diretamente com o caso, uma ampliação em sua compreensão e a experimentação de instrumentos clínicos construídos junto dos colegas. O processo de construção de trabalho com cada sujeito, matriciado constantemente entre os profissionais, permite, àquele que oferece a atenção, maior apropriação da construção clínica. Tal fenômeno também ocorre durante capacitações oferecidas pelo serviço a outras equipes de saúde. CONCLUSÃO: os espaços coletivos consideram a compreensão do sujeito por diversas perspectivas, mesmo sem contato direto com o indivíduo, a partir das narrativas de um dos profissionais e de hipóteses dos demais membros da equipe, ampliando as possibilidades de cuidado. O trabalho em projetos terapêuticos propaga-se pela instituição e em capacitações de outras equipes, permitindo a circulação e integração do saber.

OBJECTIVE: to understand the construction of the dependent care service matrixing. METHOD: this is an action-research conducted over the past seven years, considering the experiences of an occupational therapist during her service activities, covering clinical meetings, supervision, study groups and training. The materials used were medical records, supervision and meeting records and personal notes. RESULTS: the demands of each subject are addressed beyond the specificities of each area. The knowledge is transmitted in the team meetings, allowing, to those who are dealing directly with the case, an expansion in their understanding and the experimentation of clinical instruments built with colleagues. The process of building work with each subject, constantly matrixed among the professionals, allows, to the one who offers the attention, greater appropriation of the clinical construction. This phenomenon also occurs during training offered by the service to other health care teams. CONCLUSION: the collective spaces consider the subject's understanding from different perspectives, even without direct contact with the individual, from the narratives of one of the professionals and from the hypotheses of the other team members, expanding the possibilities of care. The work in therapeutic projects is spread throughout the institution and in training of other teams, allowing the circulation and integration of knowledge.

OBJETIVO: comprender la construcción del apoyo matriz en un servicio de atención a dependientes. MÉTODO: se trata de una investigación de acción realizada en los últimos siete años, considerando las experiencias de una terapeuta ocupacional durante sus actividades en el servicio, abarcando reuniones clínicas, supervisiones, grupos de estudios y capacitaciones. Los materiales utilizados fueron prontuarios, registros de supervisión y reunión y anotaciones personales. RESULTADOS: las demandas de cada sujeto se abordan más allá de las especificidades de cada área. Los saberes se transmiten en los encuentros de equipo, permitiendo a quien está lidiando directamente con el caso, una ampliación en su comprensión, experimentación de instrumentos clínicos construidos junto a los colegas. El proceso de construcción de trabajo con cada sujeto, con apoyo matriz constantemente entre los profesionales, permite al que ofrece la atención, mayor apropiación de la construcción clínica. Tal fenómeno, también ocurre durante capacitaciones ofrecidas por el servicio a otros equipos de salud. CONCLUSIÓN: los espacios colectivos consideran la comprensión del sujeto por diversas perspectivas, incluso sin contacto directo con el individuo, a partir de las narrativas de uno de los profesionales y de hipótesis de los demás miembros del equipo, amplían posibilidades de cuidado. El trabajo en proyectos terapéuticos, se propaga por la institución y en capacitaciones de otros equipos, permitiendo la circulación e integración del saber.

Practice of PBL teaching rounds in standardized residency training of anesthesiology / 中华医学教育探索杂志

Teaching rounds are an important part of hospitals at all levels to carry out clinical teaching work and improve medical quality. Taken anesthesia-related knowledge as the center, based on the patient's pathophysiology and anesthesia physiological changes, our department asked the core questions such as the impact of the operation method and anesthesia plan, then students answered, and finally closed the loop after the case. This process is called problem-based learning (PBL) teaching rounds. It is found that the teaching rounds can help improve the ability of anesthesiologists to solve problems, learn independently, and learn throughout their lives, thereby improving the teaching quality of standardized residency training of anesthesiology.

Factors Influencing Intentional Rounding Performance of Tertiary General Hospital Nurses / 간호행정학회지

PURPOSE: The purpose of this study was to examine the effects of perceptions of patient rounding, self-leadership and nursing organization culture on intentional rounding performance.METHODS: The participants for this study were 210 nurses who had the experience of patient rounding care in general hospitals in B and Y cities. Data were collected from February 5th to 22nd, 2018. Collected data were analyzed using descriptive statistics, χ² test, and independent t-test. Logistic regression analysis was performed to identify factors influencing intentional rounding performance.RESULTS: It was found that intentional rounding performance was carried out by 20.0% of the day shift nurses, 18.1% of the evening shift nurses, and 19.5% of the night shift nurses. The significant factors influencing intentional rounding performance were the recommended rounding time interval in wards and the use of rounding protocol in the wards (p < .050).CONCLUSION: It is expected that nurses will be able to provide more advanced and efficient patient rounding by promising a systematic patient rounding time for intentional rounding and developing appropriate protocols for each ward.

Implementation of standardized teaching rounds in clinical probation sessions of Dermatology and Venereology centered on rash / 中华医学教育探索杂志

Taking the course's characteristics and advantages into account, this study explores the systematic implementation of standardized teaching rounds in the clinical probation sessions of the Dermatology and Venereology course , and evaluates its effect by analyzing the cases of 125 medical students from grade 2015 of Sun Yat-sen University . The results showed that the implementation of standardized teaching rounds has positive effect on the course.

The evaluation of application effect of heuristic teaching rounds in cardiovascular disease / 中华医学教育探索杂志

Objective The "heuristic" teaching rounds were applied to cardiovascular diseases and we observed the application effect . Methods From January to March 2017, 56 resident physicians at internal medicine base in the First Affiliated Hospital of Xinjiang Medical University were randomly divided into the experimental group and the control group, with 28 people of each group. The experimental group mainly adopted heuristic teaching rounds, and the control group adopted conventional teaching rounds. Interview method was used to interview the instructors , resident physicians , doctors and nurses in preparation for teaching rounds, the implementation process, the expected goals and effects. 56 resident physicians evaluated the preparation, guidance process, guidance methods and outcomes of ward rounds. SPSS 19.0 was used for statistical analysis, and rank sum test was used for evaluation results. Results As to the familiarity of the instructor on the condition (82.15％vs. 30.86％), guiding the training of humanistic care (92.86％ vs. 39.29％), physical examination (96.43％ vs. 28.57％), analysis of auxiliary examination (85.71％vs. 35.71％), writing medical records (85.72％ vs. 14.29％), summarizing the characteristics of cases (78.57％vs. 35.71％), diagnosis and differential diagnosis (85.71％vs. 21.43％), treatment plan making (85.71％vs. 25.00％), question formulation (89.29％vs. 30.72％), explanation of difficult problems and new progress ( 78 . 57％ vs . 17 . 86％) , content summary ( 92 . 85％ vs . 28 . 58％) the experimental group was significantly higher than the control group. In the experimental group, the teaching rounds of communication (96.43％vs. 46.43％), history acquisition techniques (85.72％vs. 21.43％), examination techniques (92.86％vs. 28.57％), clinical thinking (92.86％ vs. 28.57％), learning interests (96.43％ vs. 25.00％) and efficiency (85.71％ vs. 14.28％), the understanding and memory of knowledge (85.72％ vs. 28.57％), the problem solving ability (89.29％ vs. 21.43％), improvement of team collaboration (67.86％ vs. 28.57％) were significantly higher than those in the control group (P<0.05). Conclusion The "heuristic" teaching rounds attached great importance to preparation before and after class, focusing on resident physicians' active participation and teamwork, integrating humanistic care and communication skills, giving full play to the resident physicians motivation so as to ensure their efficient learning.

El pase de visita en las asignaturas propedéutica clínica y medicina interna: ¿iguales o diferentes? / Ward rounds in the subjects clinical propedeutics and internal medicine: similar or different?

En este artículo se plantea la conveniencia de combinar el pase de visita convencional con una actividad de trabajo grupal adicional e independiente con los estudiantes de tercer año de la carrera de Medicina; esto facilitaría el logro de los objetivos formativos relacionados con dichas habilidades, al menos durante las primeras semanas de la asignatura propedéutica clínica y semiología médica. Se realiza un análisis de algunas particularidades que hacen diferente a la actividad de pase de visita en las asignaturas propedéutica clínica y medicina interna; diferencias determinadas por el nivel de formación de habilidades sensoperceptuales con el cual inician los estudiantes en ambas asignaturas, y determinantes a su vez de adecuaciones en la actuación profesoral.

In this article it is stated the convenience of combining the conventional ward round with an additional and independent group  activity with third year students  of the Medical major; this would facilitate the achievement of formative objectives with these abilities, at least during the first weeks of the subject clinical propedeutics and medical semiology. An analysis of some particularities    is made which differentiates the ward round in the subjects clinical propedeutics and internal medicine.; differences determined by the level of training sense-perceptive abilities with which students start in both subjects and determinant  at the same time of adequacies in professional performance.

Application of classic Chinese medicine theory in acupuncture CBL teaching rounds / 中国针灸

Teaching rounds is an important part of clinical teaching. It bright the theory guide to clinical practice. The classical Chinese medicine theory plays an essential role in teaching and clinical practice. During the CBL (case-based learning) teaching rounds of acupuncture and moxibustion, by selecting typical cases, in combination with directional problem settings, the classical Chinese medicine theory is run through the whole process to motivate students' initiative, improve teaching quality and promote inheritance and development of TCM.

A supervisão acadênica no Projeto Mais Médicos para o Brasil: a experiência do grupo expecial de supervisão / Academic supervision in the Doctors Project for Brazil: the experience of the special supervisory group

A supervisão acadêmica é um dos eixos educacionais do Projeto Mais Médicos para o Brasil. É desenvolvida por instituições de ensino que firmaram termo de adesão junto ao Ministério da Educação (MEC) para acompanhar as atividades dos médicos do projeto nas unidades básicas de saúde. Iniciada em 2013, a supervisão foi implantada em todos os estados do país como sendo uma estratégia para fortalecimento da Educação Permanente, mediante a integração ensino serviço. Encontrou na região norte o maior desafio para realizar suas atividades em virtude da dificuldade de deslocamento. Em 2014 o MEC cria o Grupo Especial de supervisão (GES) para realizar o acompanhamento de médicos em regiões de difícil acesso no estado do Amazonas. O GES foi considerado pela equipe do MEC o grupo que conseguiu desenvolver a supervisão acadêmica o mais próximo do que foi preconizado pela legislação do Projeto Mais Médicos para o Brasil. Este trabalho, é um estudo de caso com abordagem qualitativa, que tem por objetivo analisar o processo de Supervisão Acadêmica realizada pelo Ministério da Educação aos médicos participantes do Projeto Mais Médicos para o Brasil acompanhados pelos supervisores do Grupo Especial de Supervisão (GES) que atuam no Estado do Amazonas. Verificou-se que o GES desenvolve todas as atividades preconizadas pela supervisão, o que tem facilitado a realização das mesmas tem sido o apoio logístico das forças armadas para o deslocamento na Floresta Amazônica, a formação em medicina de família e comunidade dos supervisores, a integração com os tutores e a organização do processo de trabalho para realizar tudo que é previsto para a atividade de visita in loco, em um curto intervalo de tempo devido à dificuldade de deslocamento para região. Discutir o processo de trabalho desta estratégia é uma estratégia de educação permanente para qualificação da supervisão como um todo.(AU)

Academic supervision is one of the educational axes of the More Doctors Project for Brazil. It is developed by educational institutions that have signed an adhesion agreement with the Ministry of Education (MEC) to follow the activities of the project doctors in the basic health units. Beginning in 2013, supervision was implemented in all states of the country as a strategy to strengthen Lifelong Learning through the integration of teaching service. He found in the north the greatest challenge to carry out his activities due to the difficulty of displacement. In 2014 the MEC creates the Special Supervision Group (GES) to carry out the monitoring of physicians in regions of difficult access in the state of Amazonas. The GES was considered by the team of the MEC the group that was able to develop the academic supervision that was closer to what was recommended by the legislation of the More Medical Project for Brazil. This study is a case study with a qualitative approach, which aims to analyze the process of Academic Supervision carried out by the Ministry of Education to the physicians participating in the Project More Doctors for Brazil accompanied by the Supervisors of the Special Group of Supervision (GES) In the State of Amazonas. It was verified that the GES develops all the activities advocated by the supervision, which has facilitated the accomplishment of these have been the logistical support of the armed forces for the displacement in the Amazon Forest, training in family medicine and community of supervisors, With the tutors and the organization of the work process to accomplish everything that is planned for the activity of on-site visit, in a short time due to the difficulty of moving to the region. Discussing the work process of this strategy is a strategy of continuing education to qualify supervision as a whole.(AU)

Como se Sentem Pacientes Quando Examinados por Estudantes de Medicina? Um Misto entre Ambiguidades e Satisfações Encontradas em Estudo Qualitativo / How do Patients Feel when Examined by Medical Students? A Cross Between Ambiguities and Satisfaction Found in a Qualitative Study

No contexto do ensino médico, pacientes são habitualmente convidados a colaborar se submetendo ao exame clínico para serem observados. Como pacientes se sentem nessa situação? Para discutir significados psicológicos atribuídos a esta experiência, usamos o método clínico-qualitativo, conduzido com amostra intencional de dez pacientes de um hospital público de ensino, com entrevistas semidirigidas de questões abertas em profundidade. Os resultados foram interpretados segundo conceitos tradicionais da Psicologia Médica. Pacientes manifestam uma relação um tanto ambígua com os alunos, às vezes fortalecendo a relação médico-paciente-equipe, outras vezes a desconstruindo. A presença dos alunos é importante devido ao vínculo gerado, mas pode originar dúvidas sobre como lidar com situações mobilizadoras. As construções sociais são diferentes em um hospital de ensino em comparação com outros hospitais, visto que naqueles os pacientes têm um papel de agentes educadores. Pacientes podem perceber essa dinâmica, ainda que com pouca sistematização, ou não ter qualquer consciência social.

As part of medical training, patients are often invited to cooperate by allowing student observation of their medical examination. How do patients feel in this situation? To discuss the psychological meanings assigned to this experience we used the clinical-qualitative study method on an intentional sample of 10 patients from a teaching hospital, using in-depth semi-directed interviews. The results were interpreted according to concepts of Medical Psychology. We found that patients have an ambiguous relationship regarding the students. For example, the presence of students sometimes strengthens the doctor-patient-team relationship, but sometimes might undermine it. Student presence is important due to the bond generated, but students may act indecisively when dealing with certain situations. The social constructions within a teaching hospital differ to those in other hospitals, since in the former the patients also act as an educational agents. Some patients are aware of this dynamic albeit without it being systemized, whereas others display no such social awareness.

Exploration of the Teaching Rounds Mode for Tumor Therapeutic Radiology / 昆明医科大学学报

Objective Through comparing the traditional teaching rounds model with innovation model, explore appropriate teaching rounds model for Radiotherapy. Methods From September 2009 to June 2010, 82 students of Kunming Medical University were randomly divided into two groups, 41 students in test group with innovation teaching rounds model, and 41 students in control group with traditional model. The results of the two groups were compared. Results The differences of survey and test scores were statistically significant ( <0.01) between the test and control groups. Conclusion Test group could effectively improve the clinical thinking,practice operating capacity and teaching quality, mobilize the initiative and enthusiasm for learning.The teaching rounds model needs further exploration,improvement and evaluation.

A qualitative study on student-based nursing teaching rounds experience of vocational college nursing students in Pediatric during the initial stage of clinical practice / 中国实用护理杂志

Objective To explore true thoughts and experience about student-based nursing teaching rounds among vocational college nursing students in Pediatric during the initial stage of clinical practice.Methods Interview was conducted on 27 nursing students of seven focus groups with semi-structured interview.The data was transcribed based on the tape and were analyzed by Giorgi analysis.Results Nursing students held positive attitude to this mode.Three themes were extracted:stimulating nursing students' learning potential,enhancing the comprehensive ability of nursing students; some students had difficulties in case selection,disease analysis and physical examination; suggesting that detailed rounds guideline should be issued to students first,and teaching rounds should be held every two weeks.Conclusions We should strengthen training of the ability of nursing assessment in pediatrics for nursing students,play the role of facilitator and advocate self-directed learning methods.

La visita quirúrgica ideal: elementos para su correcta implementación / The ideal surgical rounds: elements for the correct implementation

La tradición de la visita quirúrgica tiene cientos de años y hace parte de las actividades médicas cotidianas. No obstante, su metodología es variable y cada cirujano le imprime su visión, sus métodos, sus condiciones y características, asumiendo que se hace bien. En vista de la heterogeneidad propia de la actividad, se pretende ofrecer algunas recomendaciones basadas en la literatura científica que permitan darle una organización y estandarización mínimas, y que sirvan como base para una aplicación de los modelos que se esperan de una visita quirúrgica. La visita quirúrgica que cumple sus funciones requiere de una planeación y un ejercicio sistemático para que consiga sus objetivos. La manera más útil hasta ahora conocida para no olvidar los pasos, mientras se convierte en una rutina, es utilizar listas de chequeo. Es la oportunidad para evaluarnos y evaluar a los otros dentro de un contexto académico, y es una estrategia perfecta para un control de los costos hospitalarios y evaluación de las políticas de costo-efectividad de las instituciones.

Surgical round is a centennial and routine activity. Nonetheless, its methodology is heterogeneous and each surgeon put his vision, methods, requirements and characteristics on it. Due to this heterogeneity, the aim of this article is to offer some recommendations based on scientific literature in order to organize and standardize it. These suggestions could serve as a model to make more effective surgical rounds. Surgical round needs planning and a systematic development to get its objectives. The best way to remember the minimal steps and convert it in a routine, is to use a checklist. Surgical round is an opportunity to assess ourselves and other into an academic setting. It is also a very good strategy to control health costos and evalute cost-effective interventions in hospitals.

Application of evidence based concept mapping in teaching rounds in the department of cardi-ology / 中华医学教育探索杂志

Objective To explore the value of evidence-based medicine (EBM)induced con-cept mapping in the teaching rounds in the department of cardiology. Methods Totally 25 medical students were taught to use EBM based concept mapping in preparing the medical teaching rounds during their rotations in the department of cardiology. Training of ward round ability was conducted by familiarizing with the producing method of concept map,selecting cases,posing questions,looking for literatures and discussing the concept map. Then assessment of this method was investigated and compared with that of the traditional teaching rounds method in other departments. t test was used and P≤0.05 was considered statistically significant. Results Compared with traditional method,EBM based concept mapping method showed advantages in cultivating medical students' critical thinking ((4.58±0.89)vs. (4.01±1.02)),creativity ((4.38±0.92)vs. (2.45±0.88))and integrated clinical thinking ((4.08±0.67)vs. (3.59±0.49)),self-study ability ((4.81±0.88)vs. (3.01±1.18))and literature search ability(P<0.05). Conclusions EBM based concept mapping can be a useful teaching ward round tool,which could efficiently improve teaching round quality and assist medical students in overall clinical skills.

Application of hospital teaching rounds in clinical teaching practice in hospitals for infectious diseases / 中华医学教育探索杂志

Great difficulties were existed in clinical teaching in hospitals for infectious diseases. Therefore,a centralized hospital teaching rounds,a new clinical teaching practice was taken in a hospital for infectious diseases. During seven years' practice,a basic mode of centralized hospital teaching rounds was established,which contains many aspects such as organizational form,time arrangement,case se-lection and operation procedures. Its effectiveness was evaluated accoding to the following aspects:number of people attending hospital teaching rounds,composition of these people,satisfaction of these people, comparison of ward rounds data recorded nowadays and 7 years before and assembling all the rounds records into a book. Results indicated that this measure overcame the limitations of the specialized hospi-tals to some extent and played an important role in improving clinical teaching quality.