Longitudinal evaluation of the Ophthalmology residents in Brazil: an observational prospective study

ABSTRACT BACKGROUND: The longitudinal evaluation of students seems to be a better way to assess their knowledge compared with that of the traditional methods of evaluation, such as modular and final tests. Currently, progress testing is the most consolidated type of longitudinal testing method. However, despite being well consolidated as an assessment tool in medical education, the use of this type of test in residency programs is scarce. OBJECTIVES: This study aimed to investigate residents' knowledge growth regarding residency training and to describe the implementation of a longitudinal evaluation test in ophthalmological residency training across several medical schools in Brazil. Finally, the study aimed to check whether performance in the tests can be used as a predictor of the results of the specialist title test. DESIGN AND SETTING: This was a prospective observational study. This study was conducted using an online platform. METHODS: Online tests were developed following the same pattern as the Brazilian Ophthalmology Council specialist tests. All the residents performed the test simultaneously. The tests were conducted once a year at the end of the school year. RESULTS: A progress test was conducted across 13 services with 259 residents. Our results demonstrated that resident scores improved over the years (P < 0.0001) and had a moderate correlation with the Brazilian Opthalmology Council specialist test (P = 0.0156). CONCLUSION: The progress test can be considered a valuable tool to assess knowledge, meaning their knowledge increased over residency training. In addition, it can be used as a predictor of the result in the specialist title test.

Time of clerkship rotations' interruption during COVID-19 and differences on Progress Test's scores

SUMMARY OBJECTIVES: The transition from face-to-face to remote teaching is yet to be fully understood. In clinical training, traditional teaching must prevail because it is essential for the acquisition of skills and professionalism. However, the responses of each school to the pandemic and the decision on when to resume clerkship rotations were mixed. In this study, we aimed to analyze whether the time to resume clerkship rotations was associated with the performance of the students by using a multi-institutional Progress Test. METHODS: This is a cross-sectional study conducted at nine different Brazilian medical schools that administer the same annual Progress Test for all students. We included information from 1,470 clerkship medical students and analyzed the time of clinical training interruption as the independent variable and the student's scores as the dependent variable. RESULTS: The comparisons of the students' scores between the schools showed that there are differences; however, they cannot be attributed to the time the clerkship rotations were paused. The correlation between the schools' average scores and the time to resume clerkship rotations was not significant for the fifth year (r= -0.298, p=0.436) and for the sixth year (r= -0.440, p=0.240). By using a cubic regression model, the time to resume clerkship rotations could explain 3.4% of the 5-year students' scores (p<0.001) and 0.9% of the 6-year students, without statistical difference (p=0.085). CONCLUSIONS: The differences between the students' scores cannot be attributed to the time when the schools paused the clerkship rotations.

Assessment of knowledge regarding tracheostomy care and management of early complications among healthcare professionals / Avaliação do conhecimento sobre cuidados com a traqueostomia e manejo de complicações precoces entre profissionais de saúde

Abstract Introduction: Tracheostomy is commonly performed surgical procedure in ENT practice. Postoperative care is the most important aspect for achieving good patient outcomes. Unavailability of standard guidelines on tracheostomy management and inadequate training can make this basic practice complex. The nursing staff and doctors play a very important role in bedside management, both in the ward and in the intensive care unit (ICU) setup. Therefore, it is crucial that all healthcare providers directly involved in providing postoperative care to such patients can do this efficiently. Objectives: The objective of this study is to assess the knowledge regarding identification and management of tracheostomy-related emergencies and early complications among healthcare professionals so as to improve practice and further standardization. Methods: Cross-sectional observational study included two hundred and fifty-four doctors and nurses from four large tertiary care hospitals. The questions used were simple and straightforward regarding tracheostomy suctioning, cuff care, cuff management, tube blockage, and feeding management in patients with tracheostomy. Results: Based on evidence from our study, knowledge level regarding tracheostomy care ranges from 48% to 52% with knowledge scores above 50% being considered satisfactory. Significant gaps in knowledge exist in various aspects of tracheostomy care and management among healthcare professionals. Conclusion: Our findings demonstrated an adequate knowledge level among health care professionals ranging from 48% to 52% with knowledge scores above 50% being considered satisfactory and revealed that gaps in knowledge still exist in various aspects of tracheostomy care and management.

HIGHLIGHTS Healthcare workers should be well versed in identifying tracheostomy management, its complications and responding accordingly. Doctors and nurses (131 =52%) possessed good knowledge about various aspects of tracheostomy care and management. The poorest scores were regarding cuff pressure (38.9%), suction pressure (39.4%) and first response in tube blockade (31.1%). Higher scores were found in age group 26 to 30 years (54.2%) and those having 1-3 years of clinical experience (41.2%). No statistically significant assoiation of knowledge regarding tracheostomy care was apparent with age, gender or years of practice.

Resumo Introdução: A traqueostomia é um procedimento cirúrgico comumente feito na prática otorrinolaringológica. O cuidado pós-operatório é o aspecto mais importante para alcançar bons resultados para o paciente. A indisponibilidade de diretrizes padrão para o manejo da traqueostomia e o treinamento inadequado podem tornar complexa essa prática básica. A equipe de enfermagem e os médicos desempenham um papel muito importante no manejo à beira do leito, tanto na enfermaria quanto na unidade de terapia intensiva (UTI). Portanto, é crucial que todos os profissionais de saúde diretamente envolvidos na prestação de cuidados pós-operatórios a esses pacientes possam fazer isso de forma eficiente. Objetivo: Avaliar o conhecimento sobre a identificação e manejo de emergências relacionadas à traqueostomia e complicações precoces entre os profissionais de saúde, a fim de melhorar a prática e sua padronização. Método: Estudo observacional transversal que incluiu 254 médicos e enfermeiras de quatro grandes hospitais terciários. As perguntas foram simples e diretas em relação à aspiração da traqueostomia, cuidados com o cuff, manejo do cuff, obstrução da cânula e manejo da alimentação em pacientes traqueostomizados. Resultado: Com base nas evidências de nosso estudo, o nível de conhecimento sobre os cuidados com a traqueostomia varia de 48% a 52%, com escores de conhecimento acima de 50% considerados satisfatórios. Existem lacunas significativas no conhecimento em vários aspectos dos cuidados e manejo da traqueostomia entre os profissionais de saúde. Conclusão: Nossos achados demonstraram um nível de conhecimento adequado entre os profissionais de saúde, variação de 48% a 52%, com escores de conhecimento acima de 50% considerados satisfatórios e revelaram que ainda existem lacunas no conhecimento em vários aspectos do tratamento e manejo do paciente traqueostomizado.

DESTAQUES Profissionais de saúde devem estar bem familiarizados com a identificac¸ão do manejo da traqueostomia, suas complicac¸ões e como agir de acordo com a necessidade. Médicos e enfermeiras (131 = 52%) possuíam bons conhecimentos sobre vários aspectos dos cuidados e manejo da traqueostomia. Os piores escores foram em relac¸ão à pressão adequada do cuff (38,9%), à pressão de aspirac¸ão adequada (39,4%) e primeiros socorros em caso de obstruc¸ão da cânula (31,1%). Os melhores escores foram encontrados no grupo 26 a 30 anos (54,2%) e aqueles com experiência clínica de 1-3 anos (41,2%). Não houve associac¸ão estatisticamente significante entre o conhecimento sobre os cuidados com a traqueostomia, idade e gênero e os anos de prática de médicos e enfermeiras.

A study to assess the knowledge and skills of Accredited Social Health Activists and its retention after training in community-based primary eye care

Purpose: Community volunteers like Accredited Social Health Activists (ASHAs) could be utilized for linking community and eye care services. Research is needed to effectively utilize them. This study was to assess whether ASHAs could imbibe new knowledge in eye care and conduct vision screening. Methods: Settings and Design: A pre?post?intervention study in South Delhi Integrated Vision Centres. It was conducted from January 2016 to March 2017. One day of conceptual training followed by hands?on training in vision screening was imparted to ASHAs. The knowledge was assessed thrice: before, immediately after, and following 1 year after training. The vision screening skill was assessed twice. Descriptive analysis using percentages, mean and standard deviations. Paired t?test was used for assessing the change in scores. Results: A total of 102 ASHAs were recruited. A significant increase in the knowledge score of ASHAs before (14.96) and after training (25.38) (P < 0.001) was noted. The knowledge score was sustained at 1 year (21.75). The satisfactory skill of vision screening was seen in 88 (86.3%) ASHAs after training, while 79 (77.5%) ASHAs still retained it after 1 year. Conclusion: The potential to involve ASHAs in community?based frontline eye care activities: awareness generation of eye diseases, identification of referrable conditions, and facilitating individuals to seek eye care facilities. This study informs about the duration, frequency, and content of the training. It also provides evidence on the improvement and sustainability of eye care knowledge and skills by ASHAs after conceptual and hands?on training

Self-Medication Practice among Amman’s Householders: Prevalence and Factors

Aims:This study is set out to explore the prevalence and the influencing factors of self-medication practice, besides, to assess the knowledge levels of Amman’s householders.Methods:A community-based cross-sectional study was conducted using pre-tested questionnaires. The householders (n=601) were randomly selected from two disparate regions in Amman (West and East), which reflect different segments of the society.Results:Self-medication was practised by more than half (53.1%) of Amman’s Householders. The East of Amman householders shows a relatively lower rate (49.7%) of self-medication than the West of Amman ones (56.5%), which can be attributed to the higher ability to pay for medicines and a higher level of knowledge among West residents that might allow them to go directly to the pharmacies without consulting a physician. The relatively severe illness (e.g. respiratory diseases and eye complaints) showed the lowest influence for self-medication, which indicates a good level of awareness about the importance of consulting the health care professionals. Furthermore, the two main reasons for self-medication were experiencing a good result from previous self-medication (87.8%) and saving time (84.6%). The self-medication practice was associated with the education level and the knowledge level; the knowledge level of West of Amman residents was correlated positively with the self-medication practice prevalence; nevertheless, East ones presented a less notable pattern.Conclusion:There is a knowledge gap regarding the proper SM practice, the health professionals must effectively educate the patients regarding the responsible self-medication practice and thus limit the adverse outcomes

Knowledge about HIV infection, transmission, diagnostic methods and its treatment among the students of a nursing and a Physiotherapy Colleges in Ujjain, Madhya Pradesh, India

Background: Human Immunodeficiency Virus (HIV) impairs the host's immune system until it reaches the terminal stage; Acquired Immune Deficiency Syndrome (AIDS). India has the third largest HIV epidemic in the world. Although healthcare workers (HCWs) can play a crucial role in prevention and control of HIV/AIDS, least attention is given to assess their knowledge and attitude on the topic.Methods: A prospective, cross sectional study was conducted (January 2014 and April 2015) to assess the knowledge of HIV/AIDS among students of a nursing and a physiotherapy college in Ujjain district of central India. All enrolled students were invited to participate, of those 98% participated voluntarily (nursing-120/120 and physiotherapy-56/60).Results: More than half of the participants were not aware that HIV is an infection causing virus and AIDS is a spectrum of conditions or a syndrome. The majority of the participants had poor knowledge about the available diagnostic tests and curative treatment of the infection. The study also reflected the participant’s belief in common myths and misconceptions. Physical contacts with intact skin during patient care and social interaction with a person living with HIV were considered as risk factors for infection transmission. More than 60% participants admitted for their inadequate knowledge and majority (>90%) were willing to participate in a training workshop on the topic.Conclusions: Extremely poor knowledge about the infection’s epidemiology, mode of transmission, diagnostics among the future HCWs might be a rick for discrimination. Discrimination-free healthcare, a prerequisite to end the epidemic, could be achieved by addressing the myths and misconceptions among the future and present HCWs

Assessment of knowledge regarding new-born care among mothers in Kancheepuram district, Tamil Nadu.

Background: Educating mothers to create awareness about essential obstetric and neonatal care are the key steps in achieving the goals of reproductive and child health programme. In this study, we aimed to assess the level of knowledge regarding essential new born care among the mothers. Methods: This community based cross sectional study was done in Kancheepuram district, using a sample size of 100 mothers arrived based on the expected number of pregnancies in the area. The participants were selected by simple random sampling and data collected regarding the knowledge on new-born care among the mothers, using a structured interview schedule. Results: The study result showed that mean age of mothers was 25 years and mean weight of babies was about 3 kg. Regarding the education status, 67% studied up to 10th standard and 18% studied up to plus two levels. Majority of them got information on new born care from health workers (44%) and family members (36%). The level of adequate knowledge regarding new-born care was present only in 15%, feeding practices in 39%, various components of immunization in 8%, growth and development in 42% and about new-born illness in 33% of the mothers. The knowledge regarding new born care was found to have a significant association with the educational status of the mothers. Conclusions: This study outcome shows the need for a better revamped awareness and education program coupled with effective health care delivery system to improve the level of knowledge among mothers on new born care, in achieving better health indicators as far as RCH services are concerned.

Evaluation of pre test and post test knowledge after intensive ICTC team training among health care workers in Bhavnagar District.

Background & Objectives: HIV counselling and testing services are a key entry point to prevention of HIV infection, and to treatment and care of people who are infected with HIV. In Gujarat at present 308 ICTC are functioning out of them 19 are functioning in Bhavnagar District. ICTC team training produce skilled personnel who can identify their client problems, are well informed and can provide high quality HIV related services so the objective of this study is to study knowledge regarding HIV/AIDS & Counselling amongst staff of ICTC running in Bhavnagar District. Methods: This was a cross sectional study conducted among participant of ICTC team Training during April 2011-May 2011. Results: The knowledge of participant regarding HIV/AIDS and Counselling aspects improved significantly after intervention. Interpretation & Conclusion: The informative & educable intervention definitely has a positive effect on awareness levels which would eventually encourage expansion of knowledge & help in improve the skill of counselling and positive attitude towards the client coming at different ICTC centre and increase the service utilization by client so this type of inductive training for newly appointed health care workers and refresher training for health workers, who employed longer than one year should be organized on regular basis for effectively utilization of ICTC.

Evaluación del nivel de conocimientos en áreas básicas en un posgrado de Cardiología / Evaluation of the Level of Knowledge in Basic Areas in Postgraduate Cardiology Education

Background In our country, training in cardiology is achieved by participating in residency programs, attending a hospital cardiology unit or taking university courses. On the basis of comments from teachers giving classes in the SAC Biennial Course about certain kind of deficit in basic areas of the specialty among cardiology residents attending the course, we decided to investigate their knowledge in cardiovascular anatomy, physiology, physical diagnosis, pharmacology and clinical cardiology after 1 or 2 years of training in Internal Medicine or Cardiology residency programs, respectively. Objective To evaluate the knowledge in basic areas in cardiology among residents attending the UBA Biennial Cardiology Course given by the Argentine Society of Cardiology. Material and Methods We conducted an observational, cross-sectional study. A questionnaire was designed with 50 multiple choice questions, divided in three subjects: Subject A, 17 questions about cardiovascular anatomy, physiology, pathophysiology and pharmacology; Subject B, 15 questions about clinical cardiology, physical diagnosis and electrocardiography; and Subject C, 17 questions regarding medical practice and cardiological clinical syndromes. The questionnaire was answered by residents either initiating the course (Group 1) or who were attending the second year (Group 2). Results In the general exam, Group 1 (n=63) had a median of 29/50 right answers (58%) and Group 2 (n=57) 30/50 (60%). There were no significant differences between both groups (p=0.21). The performance in Subject A was significantly lower compared to Subjects B and C in both groups. Conclusion The level of knowledge in basic areas of cardiology among residents is considered insufficient, with greatest deficits in cardiovascular anatomy, physiology, pathophysiology and pharmacology. It is necessary to revise the program of the Biennial Course and to analyze the opportunities of learning and reflection offered by the residency program.