Módulo Programas Médicos para el Sistema de Información Hospitalaria XAVIA HIS / Module Medical Programs for the XAVIA HIS Hospital Information System

La prestación personalizada de los servicios de salud resulta cada vez más atractiva y eficiente. El empleo de las herramientas informáticas para facilitar este propósito es una necesidad de las instituciones de salud. El Sistema de Información Hospitalaria XAVIA HIS es un ejemplo de la relación entre las necesidades de las instituciones de salud y la evolución funcional del mismo. Sin embargo, en el sistema no se ha concebido la posibilidad de planificar un protocolo que especifique los cuidados y procedimientos que deben realizarse en función del estado de salud del paciente. El trabajo presenta el desarrollo del módulo Programas Médicos para el sistema XAVIA HIS, que permite mejorar la gestión de la información generada durante el procesamiento de los programas médicos en las instituciones hospitalarias. Se realizó el análisis de los procesos de negocio asociados a la gestión de los programas médicos, se empleó como metodología de desarrollo AUP-UCI, JBoss Developer Studio, Java, JBoss como servidor de aplicaciones, PostgreSQL como sistema gestor de bases de datos y Visual Paradigm como herramienta CASE. Como resultado se obtuvo el módulo Programas médicos para el sistema XAVIA HIS, que permite la configuración de un programa médico a un paciente con una determinada enfermedad agrupando varios servicios, procedimientos, investigaciones clínicas por cada área del hospital(AU).

The health services personalized provision is becoming increasingly attractive and efficient. The computer tools used to facilitate this purpose is a necessity for health institutions. The Hospital Information System XAVIA HIS is an example of the relationship between the health institutions needs and its functional evolution. However, the system has not conceived the possibility of planning a protocol that specifies the care and procedures that must be performed depending on patient health condition. The paper presents the development of the Medical Programs module for the XAVIA HIS system, which allows to improve the management of information generated during the medical programs processing in hospital institutions. For this work development, an analysis of the business processes associated with the medical programs management was carried out; AUP-UCI was used as development methodology, JBoss Developer Studio, Java, JBoss as an application server, PostgreSQL as database management system and Visual Paradigm as a CASE tool. As a result, the Medical Programs module for the XAVIA HIS system was obtained, which allows the medical program configuration for a patient who has a certain disease, grouping several services, procedures, clinical investigations for each hospital area(AU)

Extensionist experience of undergraduate students in medicine as part of the Mais Médicos para o Brasil [more doctors for Brazil] program / Experiência extensionista de estudantes de graduação em medicina inseridos no programa Mais Médicos para o Brasil / Experiencia extensionista de estudiantes de graduación en medicina como parte del programa Mais Médicos para o Brasil

Problema: Las nuevas Directrices Curriculares Nacionales para Medicina de Pregrado en Brasil proponen que los académicos tengan contacto con el sistema de salud y sus usuarios en una etapa temprana. Sin embargo, las actividades prácticas en los cursos de pregrado resultaron ser insuficientes para el desarrollo adecuado de esta nueva perspectiva. En consecuencia, las experiencias en extensión universitaria tienen el propósito de llenar este vacío. Método: Este artículo tuvo como objetivo informar las experiencias vividas por los académicos del Proyecto de Extensión en Medicina Familiar y Comunitaria - ProMFC (Programa Mais Médicos para o Brasil) en el ámbito del Programa Más Médicos para Brasil - PMMB (Programa Mais Médicos para o Brasil). Este es un estudio cualitativo, del tipo informe de experiencia, con análisis de léxico y contenido utilizando el software IRaMutTeQ, versión 0.7 alpha 2, para establecer asociación entre los términos utilizados en el discurso de los becarios del ProMFC. Resultados: Se destacó la oportunidad de inmersión en entornos en los que los estudiantes pueden saber sobre los problemas y compartir la vida diaria de la comunidad asistida. El intercambio de conocimientos y experiencias entre estudiantes, médicos que trabajan en la Atención Primaria de Salud (becarios del PMMB, supervisor y tutores) y gerentes locales también fue relevante, así como la posibilidad de que los estudiantes desarrollen/capaciten habilidades, como trabajar en equipo, comunicación asertiva y planificación de la salud. Conclusión: El PMMB, tutorizado e integrado en un proyecto de extensión, el ProFMC, demostró ser una alternativa que, aunque embrionaria, tiene numerosos potenciales, ya que brinda a los extensionistas la oportunidad de inserción temprana en Atención Primaria de Salud.

Problema: As novas Diretrizes Curriculares Nacionais de Graduação em Medicina no Brasil propõem que os acadêmicos tenham contato com o sistema de saúde e seus usuários de forma precoce. No entanto, as atividades práticas na graduação mostraram-se insuficientes para o desenvolvimento adequado dessa nova perspectiva. Por conseguinte, as experiências de extensão universitária têm a proposta de preencher essa lacuna. Método: Este artigo objetivou relatar as experiências vivenciadas pelos bolsistas do Projeto de Extensão em Medicina de Família e Comunidade (ProMFC) no âmbito do Programa Mais Médicos para o Brasil (PMMB). Trata-se de estudo qualitativo, do tipo relato de experiência, com análise léxica e de conteúdo a partir do software IRaMutTeQ, versão 0.7 alpha 2, para estabelecer associação entre termos usados no discurso dos bolsistas do ProMFC. Resultados: Destacou-se a oportunidade de imersão em ambientes nos quais os estudantes podem conhecer as problemáticas e compartilhar o cotidiano da comunidade assistida. A troca de saberes e experiências entre estudantes, médicos atuantes na Atenção Primária à Saúde (bolsistas do PMMB, supervisores e tutores), e gestores locais também foi relevante, assim como a possibilidade de os alunos desenvolverem/treinarem habilidades, como trabalho em equipe, comunicação assertiva e planejamento em saúde. Conclusão: O PMMB, tutorado e integrado a um projeto de extensão, o Projeto de Extensão em Medicina de Família e Comunidade, mostrou-se como alternativa que, embora embrionária, tem inúmeras potencialidades, à medida que oportuniza aos extensionistas a inserção precoce na Atenção Primária à Saúde.

Problem: The new National Curriculum Guidelines of Undergraduate Medicine in Brazil propose that academics have contact with the health system and its users at an early stage. However, practical activities in undergraduate courses proved to be insufficient for the adequate development of this new perspective. Consequently, the experiences of university extension have the proposal to fill in this gap. Method: This article aimed to report the experiences of the scholarship holders of the Extension Project in Family and Community Medicine - ProMFC (Projeto de Extensão em Medicina de Família e Comunidade) under the More Doctors for Brazil Program ­ PMMB (Programa Mais Médicos para o Brasil). This is a qualitative, experience-type study with lexical and content analysis from the software IRaMutTeQ, version 0.7 alpha 2, to establish an association between the terms used in the discourse of the ProMFC. Results: The opportunity to immerse in environments in which students can learn about the problems and share the daily life of the assisted community was highlighted. The exchange of knowledge and experiences among students, physicians working in Primary Health Care (fellows of the PMMB, supervisors and tutors) and local managers was also relevant, as well as the students' ability to develop/train skills, such as teamwork, assertive communication, and health planning. Conclusion: The PMMB, tutored and integrated into an extension project, the ProMFC, is an alternative that, although embryonic, has many potentialities, as it allows the extensionists to be early inserted into the Attention Primary Health Care.

Exploration of PBL and mini-CEX in the clinical probation teaching for medical students of eight-year program in hematology department / 中华医学教育探索杂志

Objective The study explored the feasibility of PBL teaching approach and mini-CEX scores evaluation method in hematology probation teaching practice. Methods 54 medical students of eight-year program were selected in the study and they were in hematology department of Sun Yat-sen Memorial Hospital for clinical probation. The study compared PBL teaching approach with traditional training method, and used mini-CEX to evaluate the students' clinical competence. Results The performance of PBL teaching group is better than traditional teaching group in the aspect of inquiry skill, clinical diagnosis, therapy plan and humanistic care (P<0.05). There is no significant difference of basic knowledge, physical examination skill and clinical operational skills between these two groups. More than 85％of the students in PBL group are satisfied with the teacher in the aspect of participation, feedback, guidance, correction and assistance. Conclusion Through this teaching practice, the study provides new methods for improving the teaching of pre-internal clinical practice in hematology department.

Perfil de (morbilidad de pacientes hipertensos de una ese del área metropolitana de medellín, colombia 2013

Introducción. La hipertensión arterial es una enfermedad crónica degenerativa, considerada como un problema de salud pública a nivel mundial. Objetivo. Describir el perfil de comorbilidad de pacientes del programa de HTA de una ESE en el área metropolitana de Medellín, 2013. Materiales y métodos. Estudio descriptivo de 4827 personas pertenecientes a un programa de control de la HTA. Se calcularon las prevalencias globales de las enfermedades diagnósticas según la Clasificación Internacional de Enfermedades. Resultados. El 71,2 % fueron mujeres; la edad promedio fue 64 años con rango intercuartil entre 55 y 74 años. Se identificaron 153 comorbilidades, entre las cuales las más frecuentes fueron las metabólicas (17 %), las infecciosas (15,7 %), neurológicas (15 %), cardiovasculares (12 %) y degenerativas (2,6 %). Conclusiones. Este estudio constituye un antecedente importante para que la atención, prevención y promoción en salud incorpore acciones específicas para los grupos de mayor riesgo identificados en cada patología.

Introduction. Hypertension is a chronic degenerative disease considered as a public health problem worldwide magnitude. Objective. To describe the comorbidity profile of patients with HBP of an Institution Services Health of the metropolitan area of Medellin, 2013. Materials and Methods. Descriptive studied of 4,827 persons belonging to a program for control of hypertension. Global prevalence was calculated for each disease of the International Classification of Diseases. Results. 71.2 % were female; the average age was 64 years with interquartile range between 55 and 74 years. 153 pathologies were identified among which the most prevalent were metabolic with 17 %, followed by infectious 15.7 %, neurological 15 %, cardiovascular 12 % and degenerative 2.6 %. Conclusions. This study is an important issue for care, prevention and promotion health that incorporate specific actions for the highest risk groups identified in each pathology.

Introdução. A hipertensão arterial é uma enfermidade crônica degenerativa considerada como um problema de saúde pública em nível mundial. Objetivo. Descrever o perfil de comorbilidade de pacientes do programa de HTA de uma ESE na área metropolitana de Medellín, 2013. Materiais e métodos. Estudo descritivo de 4827 pessoas pertencentes a um programa de controle da HTA. Foram calculadas as prevalências globais das enfermidades diagnósticas segundo a Classificação Internacional de Enfermidades. Resultados. 71,2 % eram mulheres; a idade média foi de 64 anos com amplitude interquartil entre 55 e 74 anos. Foram identificados 153 comorbilidades, entre as quais as mais frequentes foram as metabólicas (17 %), as infecciosas (15,7 %), as neurológicas (15 %), as cardiovasculares (12 %) e as degenerativas (2,6 %). Conclusões. Eeste estudo constitui um antecedente importante para que a atenção, a prevenção e a promoção da saúde incorporem ações específicas para os grupos de maior risco identificados em cada patologia.

Learning anatomy through dissection: perceptions of a diverse medical student cohort / Aprendizaje de la anatomía a través de disección: percepción de una amplia cohorte de estudiantes de medicina

The debate on how best to teach anatomy and the central role of cadaveric dissections in medical training remains topical even today. Despite the use of a variety of teaching methodologies e.g. prosected specimens, plastinated specimens, cadaveric dissection and computer-assisted learning, the amount of time dedicated to a full body human dissection programme, its clinical relevance and whether it promotes deeper learning has become a bone of contention in problem- based learning context. The implementation of student centred, PBL curricula means that students' learning is autonomous, and studies suggest the link between students' approaches to learning with their perceptions of their learning environment. Therefore, this study explored the perceptions of an educationally diverse medical student cohort in a 5 year problem-based learning programme who learned anatomy through the dissection method, elaborating on the value of this subject to their medical studies. Quantitative and qualitative data was collected and thematically analysed. One hundred students of the MBChB2 cohort (44%) completed the questionnaire. The majority of the respondents (70%) reported a positive experience during anatomical dissection in terms of visual and clinical application whilst gaining anatomy understanding and skill. Students with prior educational qualifications (mature) and first time school leavers voiced similar complaints. Student responses differed qualitatively on how they benefitted from the dissection. This study confirms that dissection remains an effective method for basic anatomy teaching even in PBL contexts. It concludes with strategies to enhance the learning experiences of educationally diverse students.

El debate sobre la mejor manera de enseñar la anatomía y la relevancia de las disecciones de cadáveres en la formación médica sigue siendo un tema de actualidad. A pesar del uso de una variedad de metodologías de enseñanza, por ejemplo especímenes plastinados, la disección de cadáveres y el aprendizaje asistido por computador, el tiempo dedicado a un programa de disección de cuerpo completo, su relevancia clínica y el promover un aprendizaje más profundo se ha convertido en un tema de discordia en el contexto del aprendizaje de los estudiantes y sus percepciones del ambiente de aprendizaje. Este estudio investigó las percepciones desde un punto de vista educativo en un grupo de estudiantes de medicina en un programa de aprendizaje basado un estudio observacional, en un programa de 5 años basado en problemas a través del método de disección, evaluando el valor de este tema para sus estudios de medicina. Los datos cuantitativos y cualitativos fueron recolectados y analizados temáticamente. Un centenar de estudiantes de la cohorte MBChB2 (44%) completaron el cuestionario. La mayoría de los encuestados (70%) reportó una experiencia positiva durante la disección anatómica en términos de aplicación visual y clínica, mientras van adquiriendo comprensión de la anatomía y habilidad. Los estudiantes con títulos de estudios previos (maduros) y los recién egresados de la escuela secundaria expresaron quejas similares. Las respuestas de los estudiantes difieren cualitativamente en la forma en que se beneficiaron de la disección. Este estudio confirma que la disección sigue siendo un método eficaz para la enseñanza de anatomía básica incluso en contextos de ABP. El estudio concluye con estrategias para mejorar las experiencias de aprendizaje de los estudiantes basado en diversos problemas.

Analysis of the assessment of clinical students' doctor-patient communication skills and recom-mendations for improvement / 中华医学教育探索杂志

Objective To investigate the mastery of clinical students' doctor-patient communi-cation skills and to assess the teaching effectiveness about the doctor-patient communication, and then propose some improvement ideas. Methods We conducted a study in students of clinical medicine of Nanjing Medical University in Grade 2009, using Objective Structured Clinical Examination (OSCE) after internship, which included graduation assessment of doctor-patient communication skills. Then we analyzed the doctor-patient communication skills and related scores of students trained in different clinical medical programs. Results The average score of doctor-patient communication skills of 549 students was (82.72±4.23), of which, the average score of 329 five-year students of clinical medicine was (81.88±4.23) and the average score of seven-year students was (83.96±3.91) in. The average score of seven-year students of clinical medicine was significantly higher than five-year students (P=0.000). Moreover, there was a significant positive correlation between the total score of OSCE and the score of doctor-patient communication skills in both five-year and seven-year students of clinical medicine (five year program students' score correlation coefficient was 0.520, P=0.000;seven year pro-gram students' score correlation coefficient 0.416, P=0.000). Conclusion The teaching effectiveness of doctor-patient communication has proved to be quite effective, and it is definitely of great significance in improving clinical students' doctor-patient communication skills. The score of the assessment of the doctor-patient communication reflects not only the training effectiveness of the communication skills, but also the comprehensive capacity.

Investigation and analysis of the feedback of seven-year students of clinical medicine about the PBL teaching method / 中华医学教育探索杂志

Objective To understand the feedback of seven-year students of clinical medicine about the application of PBL teaching method and investigate its related factors.Methods Four classes of seven-year students of clinical medicine of Nanjing Medical University which had received PBL teaching method were randomly selected in grade 2009 and 2010 (243 students)and 233 valid questionnaires were analyzed statistically.The questionnaire has four main parts and they are about basic situation,factors that may affect the PBL Teaching,students' subjective attitude,their effect evaluation and suggestion for improvements.SPSS 11.0 was used to analyze the first part of the resuhs withx2 analysis(P＜0.05).Results 233valid questionnaires were recovered and 79.0％(184/233) of students held a favorable position toward PBL application in their course.It is irrelevant to no other related factors but the accessibility of information(P=0.000).More than half of the students think it is suitable for PBL on the clinical medical students(57.5％,134/233),PBL teaching is more free and easy(51.9％,121/233)and can improve their awareness of participation(72.5％,169/233).However more students (193) are in favor of more traditional teaching combined with PBL,with the former dominated.Conclusion PBL teaching method in seven-year clinical medical program has been proved to be quite effective.Though with certain drawbacks,it is a good supplement to the traditional teaching methods in many aspects,and it is definitely of great significance in improving the quality of teaching.

Reflection on compilation of text book Physiology for long-term medical program from students' perspective / 中华医学教育探索杂志

Investigators selected students who had finished physiology course using the second edition of textbook for long-term medical program.A questionnaire about its content organizations as well as overall compiling condition was designed.Investigators collected the feedback information from the 94 available questionnaires.Meanwhile,some contributive suggestions were provided for the compiling of the whole series of long-term medical program textbooks.

Input-output analysis of 17 research institutions with data envelope analysis / 中华医学科研管理杂志

As more attention is given to people's life and health,China continues to increase investment in scientific research to improve the level of medical research. However,the efficiency of the investment is unknown.In this study,we used the method of data envelopment analysis (DEA) to investigate the input-output relative efficiency of the projects funded by National Natural Science Foundation of China and completed in 2009 at 17 research institutes.We found 11 institutes to be DEA efficient,and 6 to be inefficient.It also showed that adjustment of research structure and setting performance objectives may improve the level of research management and increase the efficency of the investment.

Influence of scores of CET6 and biochemistry exams on scores of toxicology exam with all-English questions / 中华医学教育探索杂志

Objective To explore whether and how the medical students' performance in English and biochemistry studies on their exam scores in toxicology basics (in short:toxicology) with allEnglish questions.Methods The correlations between scores of toxicology exam with all-English questions and scores in college English test band 6 (CET6) and biochemistry test of 187 students in the eight-year medical program were analyzed.Results Score of toxicology exam was positively correlated with scores of CET6 and biochemistry tests to some degree ( the correlation coefficients were 0.359 and 0.413 respectively,P ＜ 0.01 ) ; the students who passed CET6 had higher score in toxicology exam than those who did not pass CET6 (P ＜ 0.01,by t-test).Conclusion Passing CET6 and having a good command of related subjects may be essential for adapting to all-English exam questions.

Research on the teaching reform of physiology experiment to enhance the research capacity of the eight-year program medical students / 中华医学教育探索杂志

Eight-year medical education is to train medical personnel with high research abi lity and innovative ability, while the experimental teaching, as an important part of physiology teaching, plays an important role in training students in observation, problem-solving skills and practical ability. This article mainly discusses our exploration and practice of teaching in physiology experiment for eight-year program medical students from teaching contents and organization of class teaching, in order to fully increase the studying enthusiasms and meet the scientific mind of these students.

Comparison of Career Choice Motivation and Moral Reasoning Ability between Students in Baccalaureate and Graduate-entry Programs / 한국의학교육

PURPOSE: This study was performed to investigate the differences in career choice motives and moral reasoning ability between students in baccalaureate and graduate-entry medical programs. METHODS: Forty-five students from a baccalaureate program and thirty-eight students from a graduate-entry program participated in this study. The students were required to fill out both the Career Choice Motivation Inventory and Defining Issues Test(DIT). The Career Choice Motivation Inventory is a 20-item questionnaire, which investigates five dimensions: effect of others, job security, interest in science, service and working with people, and working condition. Independent t-test was performed to compare the two groups. Pearson correlation coefficients were calculated to investigate the relationship among variables. RESULTS: There were significant differences in career choice motivations between the two groups. Students in the graduate-entry program were more likely to be motivated by scientific interest and opportunities to care for people. Status and job security were stronger factors in the baccalaureate students. For the students in this program, there were positive associations among their motives- interest in medical science, serving people, and working condition. There was no significant difference in moral reasoning ability between the two groups. CONCLUSION: Students in the graduate-entry medical program seem to have more professional and altruistic motivations for entering medicine. Although there is nostatistical significance, graduate students have numerically higher moral reasoning abilities compared to their counterparts. These results validate that a graduate-entry program provides an important alternative for student selection.

Innovating Model in Experiment Subject and Improving Creativity in Seven-Year Medical Students / 中华医学教育探索杂志

According to the project of personnel cultivation in 21st century,we have increased interdisciplinary comprehensive experimental courses to intensify the practical education,optimize operating model and teaching method of experimental courses.Experimental education must be strengthened in order to culture students' creativity.

The approach of the general surgery clinical practice for the eight-year program of military medical students / 中华医学教育探索杂志

Eight-year program of clinical medicine is an important way to develop high-talented students for medical education. According to the educational characteristics of general surgery,and based on the teaching achievement both in domestic and overseas schools,this article probes into the general surgery clinical practice for the military eight-year medical students.

Practice on the early training of basic scientific research skills for seven-year medical program students in preclinical medical teaching stage / 中华医学教育探索杂志

The training of basic scientific research skills is very important for seven-year medical program students. Through various kinds of scientific research training in preclinical medical teaching stage, the students’ abilities of scientific thinking, performing experiments, and writing scientific papers have been improved.

The Study on Developing Seven-year Medical Program Students'Ability in Basic Scientific Research Skills / 中华医学教育探索杂志

The early training of scientific research for seven-year medical program students is an important step to foster inventive advanced medicine professionals.According to our department research project,we give the students the medical research lecture and establishing the tutorial system in which the tutors are responsible for guiding students to become a study group,leading them to develop their primary scientific research.The result shows it has good effect on establishing scientific thinking,improving their scientific research ability and raising their awareness of scientific research.

Research on and Practice of Eight-year Medical Education / 中华医学教育探索杂志

Eight-year program of clinical medicine is the necessary trend of economic rapid development.Based on the introduction of research on and practice of eight-year medical education in The Third Military Medical University,the article makes a consideration on pre-school medical education,bilingual teaching,dual-tutorial system and the requirement of thesis.In addition,it puts forward some problems needing further study.