SWOT analysis and strategy suggestions on the application of remote teaching consultation in the continuing medical education for general practitioners / 中华全科医师杂志

Remote teaching consultation is an online continuing medical education mode which combines medical practice with teaching and superimposes teaching functions on the basis of remote consultation. Based on the pilot experiences of collaboration between Zhongshan Hospital and Xidu Community Health Service Center, this article analyzes the strengths, weaknesses, opportunities and threats (SWOT)of the remote teaching consultation for general practitioners, and discusses strategies to improve the further implementation plan. The analysis showed that as a novel educational method, the remote teaching consultation should take the advantages of online education, make good use of the remote consultation platform, improve its teaching connotation, and form standardized implementation norms to meet the diversified needs of general practitioners for continuing medical education.

Application of MDT with laparoscopy model in hepatoma surgery teaching for general practice residency training / 中华全科医师杂志

A retrospective analysis was made on the effectiveness of with laparoscopy model in hepatoma surgery teaching for general practice residency training. One hundred and forty general practice residents undertook rotation in Department of Hepatobiliary Surgery of Fifth Affiliated Hospital of Zhengzhou University from January to December 2020. Seventy residents received multi-disciplinary team (MDT) with laparoscopy mode in hematoma surgery teaching (study group) and another 70 residents received conventional teaching mode (control group). After completing the study, the teaching effectiveness was compared between two groups. The questionnaire survey showed that the satisfaction score in study group was higher than that in control group (21.10±0.31 vs.17.48±0.35, P<0.05). The scores of clinical skill, graduation examination and case analysis in study group were all higher than those in control group(91.80±4.82 vs. 85.20±4.34, 87.5±4.1 vs. 85.1±3.6, 77.25±3.38 vs. 73.65±3.06, all P<0.05). The study indicates that laparoscopic combined with MDT teaching model can significantly improve the effectiveness of hepatoma surgery study for general practice residents, and is worthy of popularization and application in general surgery teaching.

The status quo of continuing education and training needs amomg general practitioners in Pudong New Area of Shanghai / 中华全科医师杂志

Objective:To investigate the status quo of continuing education and training needs among general practitioners in Pudong New Area of Shanghai.Methods:An online questionnaire survey was conducted among general practitioners registered in the community health service center of Shanghai Pudong New Area in September 2019. The questionnaire included items of general information, the status quo of continuing education, the training needs and demands, and the knowledge and skills to be improved.Results:There were total 1 824 general practitioner in Pudong New Areal, 861 participated in the survey with a participant rate of 47.2%. A total of 861 valid questionnaires retrieved with a response rate of 100.0%. Among all participants, 79 (9.18%) thought that continuing education was very useful for improving or developing their professional ability, 564 (65.51%) thought it was useful, and 41 people (4.76%) thought it was almost useless. There were significant different in views on the roles of continuing education among participants with different ages, types of registration, and working years (χ2=15.544, 15.382, 21.979; P<0.05). There are 112 participants (13.01%) who spend less than 1 day in continuing education each month, and 224 (26.02%) who spent more than 3 days a month in continuing education, the times of attending continuing education was related to the taking administrative duty for general practitioners (χ2=9.551, P<0.05). When general practitioners choose continuing education programs, the first consideration was the practicability of the contents [772 (31.94%)], followed by the form of teaching [541 (22.38%)]. The three most recognized forms of continuing education courses were online learning (28.22%), training and off-line teaching (25.58%) and special lectures (24.69%) The three most required knowledge and skills to be improved through continuing education were the endocrine system, respiratory system, and blood circulation system. Conclusions:The survey shows the current status and traing needs of continuing education among general practitioners in Shanghai Pudong New Area, which indicates that it is necessary to take the job competence as the core and carry out various activities of continuing education for general practitioners in community health service centers.

Experiencia de educación continua en línea en gastroenterología para médicos no especialistas / Experience of continuing online education in gastroenterology for non specialist medical doctors

Background: Continuing education is essential for health professions and online courses can be a good way for professional development. Aim: To describe the experience with online courses for continuing education in hepatology and gastroenterology and to analyze their educational impact. Material and Methods: A three years' experience in courses on liver diseases and digestive tract is described. Their curricular design, methodology, and the educational impact was analyzed using the four levels of the Kirkpatrick's model. Results: On average, there were 321 students per course (2015-2017). 94% were Chilean and 6% from abroad (20 countries). In the educational impact analysis, in level 1 "reaction": 93% said that the course fulfilled their expectations and 92% would recommend it. In level 2 "learning": 42% approved the courses. Level 3 "behavior" was not evaluated and level 4 "organizational change" highlighted that the traditional face-to-face continuing education model of Chilean Gastroenterology Society (SChG) changed to full distance model in these three courses, with 1284 students from South America, Asia and Europe, in a 3-years-period. Additionally, these programs were included in the Medical Society of Santiago (SMS) continuing education agenda. Conclusions: The alliance between the SMS and the SChG generated on line courses that meet the educational needs of physicians and medical students, with excellent results and student perception.

The use of mobile computing devices in microsurgery

Mobile computing devices (MCDs), such as smartphones and tablets, are revolutionizing medical practice. These devices are almost universally available and offer a multitude of capabilities, including online features, streaming capabilities, high-quality cameras, and numerous applications. Within the surgical field, MCDs are increasingly being used for simulations. Microsurgery is an expanding field of surgery that presents unique challenges to both trainees and trainers. Simulation-based training and assessment in microsurgery currently play an integral role in the preparation of trainee surgeons in a safe and informative environment. MCDs address these challenges in a novel way by providing valuable adjuncts to microsurgical training, assessment, and clinical practice through low-cost, effective, and widely accessible solutions. Herein, we present a review of the capabilities, accessibility, and relevance of MCDs for technical skills acquisition, training, and clinical microsurgery practice, and consider the possibility of their wider use in the future of microsurgical training and education.

Percepción del gastroenterólogo sobre las necesidades de educación médica continua en el Perú / Perception of the gastroenterologist about the needs of continuing medical education in Peru

Objetivo: Determinar la percepción del gastroenterólogo sobre las necesidades de educación médica continua (EMC) en el Perú. Material y métodos: Estudio transversal y descriptivo. La muestra fue no probabilística. Se aplicó una encuesta a los gastroenterólogos miembros de la Sociedad de Gastroenterología del Perú. El cuestionario se elaboró en base al "Canadian Association of Gastroenterology Educational Needs Assessment Report" con una escala tipo Likert de 5 puntos (1= no necesario y 5= indispensable). Se determinó el promedio de los puntajes obtenidos en cada uno de los 33 ítems de las áreas clínica, endoscópica y métodos de aprendizaje. Resultados: Hubo 75 participantes y la edad promedio fue 43,40 años (DE ± 10,22 años). El lugar de trabajo principalmente fue Lima (68%) y la mayoría (50,67%) tuvo un tiempo de servicio menor de 5 años. La percepción de necesidades educativas en el área clínica fue mayor para el cáncer gástrico (4,37 ± 0,87) y el cáncer de colon (4,37 ± 0,83); en el área endoscópica fueron la polipectomía (4,15 ± 0,95) y las técnicas de emergencia (4,13 ± 0,99). Los principales métodos de aprendizaje para los gastroenterólogos fueron la asistencia a congresos (4,29 ± 0,83) y los talleres endoscópicos (4,19 ± 1,06). Conclusiones: La percepción del gastroenterólogo encuestado sobre las necesidades de EMC fue principalmente sobre temas de cáncer gástrico y de colon. La mayoría de ellos consideró la asistencia a congresos como el principal método de aprendizaje.

Objective: To determine the perception of the gastroenterologist about the needs of continuing medical education (CME) in Peru. Material and methods: Cross-sectional and descriptive study. The sample was not probabilistic. A survey was applied to the gastroenterologists members of the Society of Gastroenterology of Peru. The questionnaire was developed based on the "Canadian Association of Gastroenterology Educational Needs Assessment Report" with a Likert scale of 5 points (1 = not necessary and 5 = indispensable). The average of the scores obtained in each of the 33 items of the clinical, endoscopic and learning methods areas was determined. Results: There were 75 participants and the average age was 43.40 years (SD ± 10.22 years). The place of work was mainly Lima (68%) and the majority (50.67%) had a service time of less than 5 years. The perception of educational needs in the clinical area was higher for gastric cancer (4.37 ± 0.87) and colon cancer (4.37 ± 0.83); in the endoscopic area were polypectomy (4.15 ± 0.95) and emergency techniques (4.13 ± 0.99). The main learning methods for gastroenterologists were attendance at congresses (4.29 ± 0.83) and endoscopic workshops (4.19 ± 1.06). Conclusions: The perception of the gastroenterologist surveyed on the needs of CME was mainly on gastric and colon cancer issues. Most of them considered congress attendance as the main learning method.

Pedagogical Preparation for Physicians and their Performance in the Medical Course / Preparação Pedagógica para Médicos e Sua Atuação no Curso de Medicina

ABSTRACT Qualifying the medical profile to meet the population's main health needs is a challenge for contemporary medical schools. In this process, the medical professor has a prominent place, since medical teaching practice is based on the production of models considered valid, previously learned, and the experience of medical practice. One questions, thus, the physician's pedagogical aptitude to teach, since the professor-academic relationship occurs differently from the physician-patient relationship, starting from the need to understand which ways professors seek to acquire the teaching-specific skills. Objective To carry out an integrative review on the pedagogical training of physicians in the teaching context. Methods This is a non-observational, descriptive integrative review of the literature. Initially, we searched the databases at the Scientific Electronic Library Online (SciELO), Latin American and Caribbean Literature in Health Sciences (Lilacs), the US National Library of Medicine and the National Institutes of Health (PubMed) and the Cochrane Library with the help of the Boolean operator and the following descriptors: Health Human Resource Training; Faculty, Medical and Education, Medical, Continuing. The inclusion criteria were free, complete articles, published from 2012 to 2016, in Portuguese, Spanish and English. Results The search resulted in 24 articles those discuss the research theme. After exhaustive reading of the articles found, only five converged and answered the guiding question raised in the initial reflection. Teaching strategies and methodologies, as well as the evaluation of clinical supervision processes to construct the students' technical knowledge appear as important topics on learning and teaching. In addition, these discussions raise professors' need for continuing education programs, as well as the construction of evaluation tools for professors, tutors and preceptors. Conclusions This study highlights the continuous improvement in the professors' pedagogical training and the development of permanent education programs and improvement of the faculty by the school.

RESUMO A formação de um perfil médico resolutivo das principais necessidades de saúde da população é um desafio para as escolas médicas contemporâneas. Nesse processo, o docente médico destaca-se, visto que a prática docente na formação médica se baseia na reprodução de modelos considerados válidos, aprendidos anteriormente, e na experiência prática. Questiona-se, então, a aptidão pedagógica do médico ao exercício docente, uma vez que a relação professor-acadêmico se dá em esferas diferentes da relação médico-paciente, partindo da necessidade de entender quais caminhos os docentes buscam para adquirir habilidades específicas à docência. Objetivo Realizar uma revisão integrativa acerca da formação pedagógica dos médicos no contexto da docência. Métodos Revisão integrativa da literatura, não observacional, descritiva. Inicialmente, buscaram-se estudos nas bases de dados Scientific Electronic Library Online (SciELO), Literatura Latino-Americana e do Caribe em Ciências da Saúde (Lilacs), US National Library of Medicine e National Institutes of Health (PubMed) e na Cochrane Library com auxílio do operador booleano e dos seguintes descritores: Health Human Resource Training; Faculty, Medical e Education, Medical, Continuing. Os critérios de inclusão foram: artigos gratuitos, completos, publicados entre 2012 e 2016, em português, espanhol e inglês. Resultados Nas quatro bases de dados, encontraram-se 24 artigos relacionados ao tema da pesquisa. Após leitura exaustiva dos artigos encontrados, apenas cinco convergiam e respondiam à questão norteadora levantada na reflexão inicial. As estratégias e metodologias de ensino e a avaliação dos processos de supervisão clínica na construção do saber técnico dos estudantes aparecem como tópicos importantes no aprender e exercer a docência. Além disso, emerge, nessas discussões, a necessidade de programas de educação continuada na formação docente, bem como a construção de instrumentos avaliativos dos professores, tutores e preceptores. Conclusões Nesse modo, ressalta-se o aprimoramento contínuo na formação pedagógica dos docentes e no desenvolvimento de programas de educação permanente e o aprimoramento do corpo docente pela escola.

Facebook as a tool to promote radiology education: expanding from a local community of medical students to all of South America / Facebook como uma ferramenta para impulsionar a educação em radiologia: expandindo-se de uma comunidade local de estudantes de medicina para a América do Sul

Abstract Objective: To assess the feasibility of Facebook to promote a radiology education project and to expand it from our university community of medical students to a wider audience. Materials and Methods: A group of 12 medical students created a Facebook page in June 2015, to contribute to radiology education in our university. From August 2015, clinical cases, including a brief explanation of clinical findings, along with different imaging modalities, were posted weekly and subscribers were encouraged to choose the most appropriate diagnosis. All cases were followed by the appropriate answer and an explanation to highlight imaging findings and diagnosis. Aiming to reach a larger audience, we also shared cases to a public Latin-American Facebook group, comprising a collective total of 28,182 physicians and medical students. Using the Facebook Insights tracking tool, we prospectively analyzed subscriber interaction with our page for 14 months. Results: During the period analyzed, 35 cases were posted. The most common imaging modalities were X-ray (n = 15) and computed tomography (n = 13). Before we began posting the weekly cases, our page had 286 likes. By October 2016, that number had grown to 4244, corresponding to an increase of 1484% and eight times the size of the medical student community at our institution (n = 530). Medical students made up most (76%) of the subscribers, followed by radiology residents (6%). An excellent or moderate contribution to personal image interpretation skills was reported by 65.3% and 33.1% of the users, respectively. Conclusion: Creating a Facebook page and posting weekly clinical cases proved to be an effective method of promoting radiology education.

Resumo Objetivo: Avaliar a viabilidade do Facebook em promover um projeto de educação em radiologia da nossa comunidade universitária de estudantes para um público ampliado. Materiais e Métodos: Um grupo de 12 estudantes de medicina criou uma página no Facebook em junho de 2015, como forma de contribuir para a educação em radiologia na nossa universidade. A partir de agosto de 2015, casos clínicos semanais foram postados, incluindo uma breve explicação dos achados clínicos, além de diversas modalidades de imagem, e os assinantes eram encorajados a escolher o diagnóstico mais apropriado. Todos os casos apresentavam uma resposta apropriada e uma explicação para destacar os achados de imagem e o diagnóstico. Com o objetivo de alcançar um público maior, os casos eram também compartilhados em um grupo latino-americano no Facebook, composto de 28.182 médicos e estudantes de medicina. Prospectivamente, analisamos a interação dos assinantes com nossa página durante 14 meses por meio da ferramenta Facebook Insights. Resultados: No período, 35 casos foram postados. Radiografia (n = 15) e tomografia computadorizada (n = 13) foram as modalidades mais comuns. Antes dos casos clínicos semanais, nossa página tinha 286 curtidas. Em outubro de 2016, esse número foi 4244, representando um aumento de 1484%, oito vezes maior do que nossa comunidade estudantil (n = 530). A maioria dos seguidores eram estudantes medicina (76%), seguidos de residentes de radiologia (6%). Os usuários reportaram que o projeto teve grande (65.3%) ou moderada (33.1%) contribuição para as habilidades pessoais de interpretação de imagens. Conclusão: A criação de uma página no Facebook com casos clínicos semanais foi efetiva no auxílio à promoção da educação em radiologia.

La educación del personal de salud: clave para la eliminación de la sífilis congénita en Colombia / Educating health workers is key in congenital syphilis elimination in Colombia

Resumen Introducción. Para la prevención de la transmisión materno-infantil de la sífilis en Colombia, se promueve el diagnóstico y el tratamiento en una sola consulta mediante el uso de pruebas de diagnóstico rápido, así como programas de eliminación conjunta de la transmisión materno-infantil de la sífilis y el HIV. Objetivo. Detectar los vacíos de capacitación del personal de salud en torno a la prevención de la transmisión materno-infantil de la sífilis y el HIV, y hacer recomendaciones para mejorar los programas. Materiales y métodos. Se hizo un estudio descriptivo mediante 306 encuestas hechas al personal de salud de 39 instituciones de Cali. Se indagó sobre la planeación, la gestión y la ejecución de los servicios ofrecidos a las mujeres gestantes, los conocimientos clínicos sobre la sífilis, el HIV y las pruebas rápidas, así como sobre las capacitaciones recibidas. Resultados. Se encontraron deficiencias en el conocimiento del manejo de la sífilis gestacional entre el personal de salud, incluidos los médicos. Las pruebas de diagnóstico rápido para sífilis se utilizan en los laboratorios de la ciudad, pero se detectaron fallas en su uso adecuado, especialmente en el control de calidad. La capacitación en temas de prevención de la transmisión materno-infantil de la sífilis y el HIV había sido escasa en los dos años anteriores. El personal de salud expresó su interés por diagnosticar y tratar la sífilis gestacional en una sola consulta, usar las pruebas de diagnóstico rápido y asistir a actividades de capacitación. Conclusiones. Se requiere la capacitación intensiva del personal de salud, de quienes toman las decisiones y de los grupos académicos, para lograr una adecuada implementación de las nuevas estrategias de prevención de la transmisión materno-infantil de la sífilisy el HIV.

Abstract Introduction: Colombia promotes the diagnosis and treatment of gestational syphilis in a single visit using rapid diagnostic tests to prevent mother-to-child transmission. Additionally, integrated health programs pursue the coordinated prevention of mother-to-child transmission of syphilis/HIV. Objective: To identify knowledge gaps among health workers in the prevention of mother-to-child transmission of syphilis/HIV and to provide recommendations to support these programs. Materials and methods: We conducted a descriptive study based on 306 surveys of health workers in 39 health institutions in the city of Cali. Surveys inquired about planning, management and implementation of services for pregnant women, clinical knowledge of HIV/syphilis rapid diagnostic tests, and prior training. Results: Knowledge deficits in the management of gestational syphilis were detected among the surveyed health workers, including physicians. Rapid tests for syphilis are currently used in clinical laboratories in Cali, however, procedural deficiencies were observed in their use, including quality control assurance. During the two years prior to the survey, training of health workers in the prevention of mother-to-child transmission of syphilis/HIV had been limited. Health workers are interested in identifying and treating gestational syphilis in a single event, in using rapid diagnostic tests and in receiving training. Conclusions: Intensive training targeting health workers, policy/decision makers and academic groups is needed to ensure adequate implementation of new strategies for the prevention of mother-to-child transmission of syphilis/HIV.

Educación continuada en Radiología: Perspectivas hacia un modelo basado en competencias / Continuing Education Radiology: Perspectives towards a Model Based On Competences

La educación médica continuada hace referencia a la planeación, organización, desarrollo y ejecución de diversas actividades académicas, con el fin de actualizar los conocimientos y desarrollar competencias a lo largo de la vida profesional de los posgraduados. En la especialidad de radiología e imágenes diagnósticas, la renovación del conocimiento va de la mano de los adelantos tecnológicos y la mejor evidencia científica, lo que implica un alto dinamismo en la validez de los mismos. En el presente artículo se revisa cuál es el propósito y justificación de un programa de recertificación en radiología con miras al mejoramiento de la calidad y el desempeño profesional, se discuten diferentes modelos internacionales de formación continuada, así como las metodologías más eficientes para la adquisición de competencias, ajustado a las necesidades y perspectivas de aprendizaje del radiólogo en nuestro país

The continuing medical education (CME) refers to the planning, organization, development and implementation of various academic activities, in order to update knowledge and develop skills throughout the professional life of postgraduates. In the specialty of Radiology and Diagnostic Imaging, renewal of knowledge goes hand in hand with technological advances and the best scientific evidence, which implies a high dynamism in the validity thereof. In this article we review what the purpose and justification of a recertification program in radiology with a view to improving the quality and professional performance, different international models of continuing education are discussed as well as the most efficient methodologies for the acquisition of competencies, tailored to the learning needs and perspectives of the radiologist in our country

Initial results of a doctorate in medical sciences program at a regional university / Resultados iniciales de un programa de doctorado en ciencias médicas de una universidad

The number of doctoral programs in the biomedical field has risen in recent decades, but with a concentration in Santiago and little expansion into the provinces. The aim of this article is to describe the initial results obtained by the Doctorate in Medical Sciences program of the Universidad de La Frontera, Chile. Observational study, conducted in the Department of Surgery at the Universidad de La Frontera, Chile. All cohorts in the program from 2008 to 2015 were included. The outcome variables were: Graduation rate and scientific productivity of the graduates (WoS and SciELO publications). Other variables of interest were: academic faculty productivity (WoS and SciELO publications), and characteristics of students who entered the program (age, sex, origin, profession, previous graduate training and number of years of formal university education). Descriptive statistics were applied. During the evaluation period, of a total of 17 qualified, 8 doctorates have been granted (1.6 per year), a graduation rate of 47.1 %. The research productivity for 2010-2015 was 14.1 publications per graduate (8.4 WoS and 5.7 SciELO) and 43.8 publications per academic (41.2 WoS and 2.6 SciELO). In the period, 55 professionals applied and 27 were accepted (49.1 % rate acceptance). Initial results of the Doctorate in Medical Sciences program of the Universidad de La Frontera, Chile are presented.

El número de programas de doctorado en el área biomédica ha crecido en las últimas décadas, aunque la mayoría se concentra en Santiago, con un escaso desarrollo en regiones. El objetivo de este artículo es describir los resultados iniciales obtenidos por el programa de Doctorado en Ciencias Médicas de la Universidad de La Frontera. Estudio observacional, descriptivo; realizado en el Departamento de Cirugía de la Universidad de La Frontera. Se incluyeron la totalidad de las cohortes que han ingresado al programa, desde 2008 a 2015. Las variables de los resultados fueron: Tasa de graduación y productividad de los graduados (publicaciones WoS y SciELO). Otras variables de interés fueron: productividad del Claustro (publicaciones WoS y SciELO); y características de los alumnos que ingresaron al programa (edad, sexo, origen, profesión, formación de postgrado previa y número de años de formación universitaria formal). Se aplicó estadística descriptiva. Durante el período evaluado, de un total de 17 habilitados, se graduaron 8 doctores (1,6 por año), tasa de graduación de 47,1 %. La productividad para el período 2010-2015 fue de 14,1 publicaciones por graduado (8,4 WoS y 5,7 SciELO); y 43,8 publicaciones por miembro del Claustro (41,2 WoS y 2,6 SciELO). En el período analizado postularon 55 profesionales, siendo aceptados un total de 27 (49,1 % de aceptación). Se presentan los resultados iniciales del programa de Doctorado en Ciencias Médicas de la Universidad de La Frontera.

Modelo de evaluación integral para la educación en el trabajo del internado de Estomatología / Model of comprehensive assessment for the in-service training in the odontoloy internship

Fundamento: la evaluación sistemática de estudiantes durante la educación en el trabajo es imprescindible para valorar el cumplimiento de las habilidades alcanzadas. Objetivo: valorar el efecto de un modelo de evaluación integral diseñado para el internado de Estomatología a través de criterios de especialistas y la calidad de resultados académicos. Métodos: se realizó una investigación cualitativa, de tipo experimental, en la Facultad de Estomatología de Villa Clara, en el curso escolar 2013-2014. El universo lo constituyeron 180 estudiantes de quinto año, con los cuales se trabajó en su totalidad; se utilizaron métodos teóricos y entre los empíricos: revisión documental, la encuesta y la técnica de grupo nominal. Resultados: en la revisión documental realizada se constató la necesidad de un modelo de evaluación integral para el control y evaluación sistemático en la educación en el trabajo del interno de Estomatología, el cual fue diseñado incluyendo en él, todas las acciones que responden a objetivos instructivos y formativos de los programas. Conclusiones: el instrumento fue valorado como pertinente por resultar necesario, útil, factible, económico y de fácil manipulación, estimuló la creatividad metodológica del colectivo de año y contribuyó al perfeccionamiento del proceso docente educativo al exhibir resultados de calidad luego de su implementación.

Background: the systematic evaluation of students during the in-service training is indispensable to value the abilities acquisition. Objective: to value the effect of the comprehensive assessment model designed for the Odontoloy internship through the specialists' criteria and the quality of academic results. Methods: it was carried out a qualitative investigation, of experimental type, in Villa Clara Odontoloy faculty, in the academic year 2013-2014. The universe comprised 180 fifth year students, the sample matches the universe; theoretical methods were used and among the empiric ones: documental revision, the survey and the technique of nominal group. Results: the documental revision showed the necessity of a comprehensive assessment model for the control and systematic evaluation in the in-service training of the Odontoloy internship, which was designed including in it all the actions that respond to instructive and formative objectives of the programs. Conclusions: the assessment instrument was valued as pertinent for it was necessary, useful, feasible, economic and of easy manipulation, it stimulated the methodological creativity of the year teaching staff and it contributed to the improvement of the teaching-learning process because it showed good quality results after it had been implemented.

Association between participation and compliance with Continuing Medical Education and care production by physicians: a cross-sectional study / Associação entre participação e cumprimento de um programa de Educação Médica Continuada e produção assistencial dos médicos: estudo transversal

Objective Physician participation in Continuing Medical Education programs may be influenced by a number of factors. To evaluate the factors associated with compliance with the Continuing Medical Education requirements at a private hospital, we investigated whether physicians’ activity, measured by volumes of admissions and procedures, was associated with obtaining 40 Continuing Medical Education credits (40 hours of activities) in a 12-month cycle. Methods In an exclusive and non-mandatory Continuing Medical Education program, we collected physicians’ numbers of hospital admissions and numbers of surgical procedures performed. We also analyzed data on physicians’ time since graduation, age, and gender. Results A total of 3,809 credentialed, free-standing, private practice physicians were evaluated. Univariate analysis showed that the Continuing Medical Education requirements were more likely to be achieved by male physicians (odds ratio 1.251; p=0.009) and who had a higher number of hospital admissions (odds ratio 1.022; p<0.001). Multivariate analysis showed that age and number of hospital admissions were associated with achievement of the Continuing Medical Education requirements. Each hospital admission increased the chance of achieving the requirements by 0.4%. Among physicians who performed surgical procedures, multivariate analysis showed that male physicians were 1.3 time more likely to achieve the Continuing Medical Education requirements than female physicians. Each surgical procedure performed increased the chance of achieving the requirements by 1.4%. Conclusion The numbers of admissions and number of surgical procedures performed by physicians at our hospital were associated with the likelihood of meeting the Continuing Medical Education requirements. These findings help to shed new light on our Continuing Medical Education program. .

Objetivo A participação de médicos em programas de Educação Médica Continuada pode ser influenciada por inúmeros fatores. Para avaliar os fatores associados ao cumprimento dos requisitos para Educação Médica Continuada em um hospital privado, investigamos se a atividade médica, medida por volume de internações e procedimentos, esteve relacionada à obtenção de 40 créditos (40 horas-aula) em um ciclo do programa de 12 meses. Métodos Em um programa exclusivo e não obrigatório de Educação Médica Continuada, coletamos o número de admissões e de procedimentos realizados por médico. Analisamos dados como tempo de formado, idade e sexo. Resultados Foram analisados dados de 3.809 médicos credenciados e autônomos. A análise univariada mostrou que os requisitos de Educação Médica Continuada eram mais preenchidos por médicos do sexo masculino (odds ratio de 1,251; p=0,009) e que eles apresentavam números de internações mais significativos (odds ratio de 1,022; p<0,001). A análise multivariada mostrou que idade e número de admissões estiveram associados ao cumprimento das metas estabelecidas. Cada admissão aumentou a chance de atingir a meta em 0,4%. Entre os que realizaram procedimentos cirúrgicos, a análise multivariada mostrou que médicos do sexo masculino eram 1,3 vez mais propensos a atingir a meta estabelecida que seus pares do sexo feminino. Cada procedimento cirúrgico realizado elevou a chance de atingir a meta em 1,4%. Conclusão O número de admissões e de procedimentos cirúrgicos realizados por médicos em nosso hospital foi associado à probabilidade de alcançar a meta de Educação Médica Continuada. Estes achados lançaram uma nova luz sobre o nosso programa de Educação Médica Continuada. .

Situation and demands analysis of hospital health professional personnel′s participation in continuing medical education in Nanning City / 重庆医学

Objective To investigate the situation ,influencing factors and demands of hospital health professional personnel′s participation in continuing medical education (CME) in Nanning city and provide a scientific basis for further development of CME . Methods A total of 936 health professional personnel from 18 hospitals were selected .Self designed questionnaires were adopted to investigate the situation ,influencing factors and demands of hospital health professional personnel′s participation in CME .Results Among all the health professional personnel ,14 .85% had not taken part in CME in 2011 .The content of CME activities was still carried out with the basic theory and basic skills mainly .The form of CME activities was still face‐to‐face teaching mainly ,and the utilization rate of resources in distance medical education was lower .Furthermore ,the fees of CME activities were still mostly self‐supported .Time (30 .04% ) and fees (21 .33% ) were the leading factors influencing the participation of CME activities .Clinical set‐ting and education level were significantly related to the participation rate of CME (P<0 .05) .The percent of choosing face to face teachingas CME form was 35 .22% .The percent of choosing acquire new knowledge and skillsas CME content was 36 .60% . Health professional personnel considered the ratio of the fees of CME activities paid by individual should be without payments (52 .78% ) ,or below 20 .00% (40 .06% ) .Conclusion Governments and CM E administrators at all levels should take individual characters of health professional personnel into consideration and various measures should been adopted to assure the sustained and healthy development of CM E .

Estresse em docentes universitários da saúde: situações geradoras, sintomas e estratégias de enfrentamento / Stress among university health teachers: generating situations, symptoms and coping strategies

O estresse relacionado ao trabalho é compreendido como uma resposta às situações em que a pessoa percebe seu ambiente de trabalho como ameaçador às necessidades de realização pessoal e profissional e/ou a sua saúde física/ mental, prejudicando a interação com o trabalho e com o ambiente. Este estudo teve como objetivos analisar as situações geradoras do estresse ocupacional, os sintomas e as estratégias de enfrentamento em docentes universitários da área da saúde, em uma instituição de Ensino Superior. Foram entrevistados, entre outubro enovembro de 2009, 18 professores, sendo 12 do sexo feminino e seis do masculino, com idade variando de 36 a 66 anos. Para levantar as situações geradoras de estresse e as estratégias de enfrentamento, foi aplicada uma entrevista semiestruturada. Os sintomas de estresse foram obtidos por questionário. As entrevistas foram analisadas por meio da análise de conteúdo temático e os sintomas de estresse, em frequência simples, foram relacionados aos demais achados. Com os resultados, percebeu-se que as situações geradoras de estresse foram lidar com alunos despreparados; sobrecarga de trabalho; contexto da universidade; preocupação do docente com a aprendizagem do aluno e prazos institucionais. As estratégias de enfrentamento mais utilizadas foram: autocontrole; suporte social; resolução de problemas e reavaliação positiva. Dentre os principais sintomas de estresse encontrados destacam-se a tensão muscular, problemas com a memória, insônia, cefaleia, perda do senso de humor, sensação de desgaste físico, irritabilidade, sensibilidade emotiva excessiva e ansiedade.

Work-related stress is understood as a response to situations where the person perceives his labor environment as a menace to the needs of personal and professional success and/or to the physical and mental health that damages the interaction with the work and the environment. This study aimed at analyzing the situations that generate occupational stress, the symptoms and coping strategies among university teachers from the health field in an Institution of University Education. Between October and November 2009, an interview was carried out with 18 teachers, 12 out of them were of feminine sex and 06, masculine, of age between 36 and 66 years old. A semi-structured interview raised the issues regarding stress-generating situations and coping strategies. Stress symptoms were obtained through a questionnaire. The interviews were analyzed by means of thematic content analysis and the stress symptoms, in simple frequency, were related to the remaining findings. From the results, one perceived that the stress-generating situations were handling with nonprepared pupils, work overload, university context, the teacher´s concern with the pupil´s learning process, and institutional terms. The most utilized coping strategies were: self-control, social support solution of problems and positive re-evaluation. Among the main stress symptoms found, the following stand out: muscular tension, memory problems, insomnia, migraine, loss of humor sense, sensation of physical weariness, irritability, excessive emotive sensitivity and anxiety.

Violência doméstica contra crianças e adolescentes: Formação e conhecimento dos médicos / Domestic violence against children and adolescents: Education and knowledge of physicians

A violência contra crianças e adolescentes sempre esteve presente na história da humanidade e é atualmente considerada um grave problema de saúde pública no Brasil, constituindo aprincipal causa de morte a partir dos 5 anos de idade. Trabalhar com casos de violência doméstica contra crianças e adolescentes (VDCA) não é uma tarefa fácil, uma vez que o médico pode se defrontar com situações complicadas, notadamente no Programa de Saúde da Família (PSF), que mantém estreito vínculo com comunidades inseridas em cenários propícios a esse fenômeno e expostas a risco social. Esta pesquisa exploratória, com análise qualitativa, foi desenvolvida com o objetivo de identificar a percepção de médicos atuantes no PSF sobre o processode atendimento às vítimas de VDCA no município de São Paulo (SP). O estudo confirmou a falta ou do pouco conhecimento sobre as imbricações e impactos da VDCA ― consequênciada não abordagem do tema nos cursos de graduação e da carência de educação continuada. Além disso, revelou que os médicos dedicados a programas de atenção básica se confrontam com dilemas éticos e sentimentos que desembocam na percepção de impotência diante das vítimas de maus-tratos, associada ao medo de represálias por parte dos agressores e ao descréditonas instituições que têm atribuição legal de dar encaminhamento aos casos. Os resultados obtidos nesta pesquisa indicam que esses fatores associados resultam em deficiências no sistema de notificação que acabam por ampliar as lacunas das estatísticas das ocorrênciasde violência doméstica no Brasil.

Violence against children and adolescents has always been present in the history of mankind, and is currently considered a severe public health problem in Brazil, where it is the major cause of death after the age of five. Working with cases of domestic violence against children and adolescents (DVCA) is a difficult task, as the doctor may have to deal with complicated situations, notably in the Family Health Program (PSF) which maintains close relationships with communities in scenarios where this phenomenon and the exposure to social risks are higher. This exploratory research, with qualitative analysis, aimed to identify the perceptions of doctors working in PSF on the process of healthcare for victims of DVCA in the municipal district of São Paulo (SP). The study confirmed a lack of or insufficient knowledge of the related issues and impacts of DVCA ― as a consequence of the failure of graduate courses to address the theme, and the lack of continuing education. In addition, this study reveals that doctors dedicated to basic healthcare programs face ethical dilemmas and feelings that are manifested as a sense of powerlessness to deal with victims of abuse, associated with a fear of reprisals by the aggressors and a lack of trust in the institutions that have legal attributions to refer cases. The results of this research indicate that all these factors, taken together, result in shortfalls in the reporting system that end up widening the gaps in the statistics on domestic violence in Brazil.

Training needs of continuing medical education for gereral practitioners in urban and suburban of Shanghai / 中华全科医师杂志

Objective To assess the continuing medical education (CME) and training needs for gereral practitioners (GPs) in urban and suburb of Shanghai.Methods Gereral practitioners in urban (n =710) and suburb (n =843) of Shanghai attending two municipal training programs were interviewed with self-designed questionnaire during July 2011 to May 2012.Results Urban group included 710 GPs whose mean age were (36.7 ± 6.8) y and 33.0％ were male.Suburban group had 843 GPs whose mean age were (36.6 ± 5.1) y and 33.2％ were male.The survey showed that 84.6％ of urban group and 85.6％ of suburban group had attended CME before.There was no statistical difference in the overall satisfaction of CME between two groups (Z =-0.895,P =0.371).The propotion of satisfied and very satisfied was 45.1％ and 13.8％ in urban groupt,while it was 49.5％ and 9.1％ in suburb group.The overall satisfaction rates of enhancing basic theories (Z =-2.296,P =0.022) and skills (Z =-2.013,P =0.044) and CME textbooks (Z =-2.819,P =0.005) were higher in suburban group than those in urban group.Both of them agreed that the contents of CME were divorced from reality of practice (60.3％ vs.65.2％,x2 =3.213,P =0.082).The percentages of complain of insufficient training time (19.7％ vs.11.0％,x2 =18.045,P ＜ 0.05) and contents (7.5％ vs.4.3％,x2 =5.747,P =0.019),and weak leadership commitment (14.3％ vs.6.5％,x2 =19.95,P ＜ 0.05) were higher in suburban group than those in urban group.On the contrary,the delivery of repeated contents (24.8％ vs.34.8％,x2 =15.327,P ＜0.05) and long training time (16.4％ vs.28.2％,x2 =26.055,P ＜ 0.05) were lower in suburban group than those in urban group.Using case study in the teaching was the common choice of both groups (73.3％ vs.78.0％,x2 =0.635,P =0.426).Compared to urban group,suburban group was more likely to choose lecture of theory (63.6％ vs.50.8％,x2 =6.712,P =0.010) rather than problem based learning (43.1％ vs.51.9％,x2 =4.273,P=0.010).Conclusions Both urban and suburban GPs in Shanghai are generally satisfied with the CME programs.There are some discrepancies in training needs of CME between urban and suburben area in Shanghai,indicating that the CMB programs need to be designed according to the needs of trainees in urban or suburb areas.

Success attitudes of young ophthalmologists in the first decade of their career / Atitudes de sucesso de jovens oftalmologistas na primeira década da carreira

PURPOSE: To describe the main success attitudes of young ophthalmologists in the first decade of their career. METHODS: This descriptive study comprised subjects selected from a sample of ophthalmologists who were participating in a congress, using a semi-structured questionnaire. The inclusion criteria were as follows: ophthalmologists under the age of 40 years, within 5-10 years from ophthalmology residency conclusion. The subjects were asked about the three main success attitudes in their personal experience during the first years of ophthalmology practice. After the initial results, the 10 most frequently mentioned attitudes were listed and volunteers were again interviewed to choose, within the latter list, the three main attitudes. RESULTS: Forty-eight ophthalmologists were interviewed, 24 (50%) were male; the mean age was 37 years (SD: 2 years, range: 33-40 years) and the mean time from ophthalmology residency conclusion was 8 years (SD: 1 year, range: 5-10 years). The frequency of such mentioned success attitudes were as follows: to invest in professional updating (22.9%), to have a good relationship with patients and professional partners (18.8%), to prioritize individual and family happiness (12.5%), initially to work in an established group (11.1%), to work in public service (9.7%), to have their own business with a homogeneous group (7.6%), to save money (7.6%), to be ready to resume work (4.2%), to get business administration skills (4.2%), and to have professional insurance (0.7%). CONCLUSIONS: The three main success attitudes consisted in investing in professional updating (22.9%), maintaining a good relationship with patients and professional partners (18.8%), and prioritizing individual and family happiness (12.5%). Although these results should not be generalized, they are helpful not only for those ophthalmologists at the beginning of a career but also those who want to reflect on what to prioritize in their professional practice.

OBJETIVOS: Descrever as principais atitudes de sucesso de jovens oftalmologistas na primeira década de exercício da profissão. MÉTODOS: Tratou-se de um estudo descritivo. Os sujeitos da pesquisa foram selecionados a partir de amostra de participantes de congresso de oftalmologia, utilizando-se questionário semi-estruturado. Os critérios de inclusão foram: médico oftalmologista com menos de 40 anos e que tivesse entre 5 e 10 anos de conclusão da residência médica. Questionou-se sobre quais foram as três principais atitudes de sucesso na experiência pessoal durante esses primeiros anos do exercício da medicina. Após os resultados iniciais, foram relacionadas as dez atitudes mais citadas e os voluntários foram mais uma vez entrevistados para que escolhessem, dentro desta última listagem, as três principais atitudes. RESULTADOS: Foram entrevistados 48 oftalmologistas, destes 24 (50%) eram do gênero masculino, a média da idade foi 37 anos (DP 2 anos, intervalo de 33 a 40 anos) e a média do tempo de conclusão do curso de 8 anos (DP 1 ano, intervalo de 5 a 10 anos). A frequência de citação das atitudes de sucesso foi: investir continuadamente na formação profissional (22,9%), manter bom relacionamento com pacientes e colegas de profissão (18,8%), priorizar a felicidade individual e familiar (12,5%), inicialmente prestar serviço para grupo estabelecido (11,1%), ingressar no serviço público (9,7%), montar consultório próprio junto a grupo homogêneo (7,6%), hábito de poupança (7,6%), estar pronto para o recomeço profissional (4,2%), investir na formação complementar em administração (4,2%), e contratação de seguro profissional (0,7%). CONCLUSÕES: As três principais atitudes foram: investir continuadamente na formação profissional, manter bom relacionamento com pacientes e colegas de profissão, e priorizar a felicidade individual e familiar. Embora estes resultados não devam ser universalmente generalizados, eles ajudam não apenas aos ingressantes na profissão, mas todo oftalmologista que deseja refletir sobre o que priorizar em seu exercício profissional.

Consultando o Artigo / Consulting the article / Consultando el artículo

O conceito de clube de leitura é conhecido entre os médicos desde os anos de Licenciatura, particularmente pelas apresentações de journal club em reuniões de serviço durante diferentes estágios clínicos. Um paralelismo pode ser estabelecido entre a prática clínica do médico da família e comunidade e o clube de leitura. De fato, do mesmo modo que uma consulta ao seu paciente, um journal club implica ler (ou mesmo ouvir) o artigo, questionar determinados aspectos perante dados que vai obtendo, aguardar uma resposta orientadora, estar atento a detalhes e captar o essencial (subjetivo). Como um exame objetivo, pressupõe-se inspecionar o seu desenho, palpar as suas limitações e percutir os resultados sobre a sua comunidade (objetivo). Após a leitura completa, o médico da família e comunidade vai avaliá-lo (avaliação) e planejar (plano) uma alteração na sua prática. Este processo decorre com a fluidez natural de uma consulta normal, cujo paciente seria, neste caso, o próprio artigo.

The concept of journal club is known among physicians since the undergraduate years, particularly from the presentations of published studies in scientific reunions during different clinical stages. A parallelism can be drawn between the clinical activity of the general practitioner and a journal club. In fact, just as a consultation with the patient, a journal club implies to read (or hear) the article, to question certain aspects in order to obtain certain data, to wait for a guiding answer, to be attentive to details, and to get the essential (subjective). As a physical examination, it implies to inspect the study design, to palpate the limitations, and to strike the results in the community (objective). After a complete reading, the general practitioner will evaluate it (evaluation) and plan (plan) a change in his/her practice. This process takes place with the natural flow of a normal consultation, where the patient would be, in this case, the article itself.

El concepto de club de lectura es conocido entre los médicos desde los años de estudiante, en particular por las presentaciones de journal club en las reuniones científicas durante las diferentes etapas clínicas. Un paralelismo se puede trazar entre la práctica clínica del médico de familia e un club de lectura. De hecho, como una consulta con su paciente, un club de lectura implica leer (o escuchar) el artículo, cuestionar algunos aspectos para obtener datos, esperar una respuesta, estar atento a los detalles y obtener la esencia (subjetivo). Como en un examen físico, implica inspeccionar su diseño, requiere palpar sus limitaciones y ejecutar la percusión de los resultados en su comunidad (objetivo). Después de una lectura completa, el médico de familia evaluará el artículo (evaluación) e creará un plan (plan) de cambio en su práctica. Este proceso se lleva a cabo con el flujo natural de una consulta normal, donde el paciente es, en este caso, el propio artículo.

Evaluación del primer "Entrenamiento en Metodología de Investigación Clínica en Chile" / Evaluation of the first training on clinical research methodology in Chile

Este trabajo describe la evaluación del primer "Entrenamiento en Metodología de Investigación Clínica en Chile (EMIC-Chile) tras 12 meses de haber finalizado. Se aplicó una encuesta online para alumnos y el método Delphi para el equipo docente. Entre los estudiantes, la mayoría informó que el programa apoyó su desarrollo profesional y que transmitieron los conocimientos en su lugar de trabajo. El 41 por ciento presentó un proyecto a fondos concursables de investigación una vez finalizado el curso. Entre los profesores, las áreas de mayor interés fueron la estrategia comunicacional, la metodología educativa, las características del equipo docente y las posibles estrategias de permanencia de EMIC-Chile a futuro. Esta experincia podría servir a futuras iniciativas de formación en investigación para profesionales de la salud. Se reconocen como desafíos la incorporación de profesiones no médicas en la investigación clínica, complejidades asociadas a la metodología semi-presencial y permanencia duradera de iniciativas de esta envergadura a nivel nacional y regional.

This paper describes the evaluation of the first training on clinical research methodology in Chile (EMIC-Chile) 12 months after its completion. An online survey was conducted for students and the Delphi method was used for the teaching team. Among the students, the majority reported that the program had contributed to their professional development and that they had shared some of the knowledge acquired with colleagues in their workplace. Forty-one percent submitted a project to obtain research funding through a competitive grants process once they had completed the course. Among the teachers, the areas of greatest interest were the communication strategy, teaching methods, the characteristics of the teaching team, and potential strategies for making the EMIC-Chile permanent in the future. This experience could contribute to future research training initiatives for health professionals. Recognized challenges are the involvement of nonmedical professions in clinical research, the complexities associated with the distance learning methodology, and the continued presence of initiatives of this importance at the national and regional level.