Postgraduate medical education in Colombia. Proposals to improve it

After 70 years of the formalization of medical specialties in Colombia, very little progress has been made in the educational models for the acquisition of clinical competencies in these postgraduate programs. Furthermore, although there is already a law on human resources in health, the Colombian medical education system lacks specific regulations on the training of health professionals (physicians) in the different medical specialty programs offered in the country. Likewise, at present, factors such as the financial crisis of public hospitals, the limited number of accredited hospitals and the growing number of medical schools and specialization programs, affect the comprehensive and equal development of medical competencies of professionals who are trained as specialists in the different postgraduate medical programs offered in Colombia. In view of the above, the purpose of this article is to present a proposal for postgraduate medical education that prioritizes the adequate acquisition of competencies over compliance with the time required to complete the curricula of the different medical specialties. However, this involves several prerequisites: a regulatory body in charge of overseeing and monitoring the training of medical residents or specialists in the country; strong training in university teaching for professors practicing in medical schools and university hospitals; the standardization of the graduates profile; adequate financing of university hospitals, as well as appropriate support in the process of accreditation as such, and the self-evaluation and continuous improvement of postgraduate medical programs.

Después de 70 años de la formalización de las especialidades médicas en Colombia, ha habido muy pocos avances en los modelos educativos para la adquisición de competencias clínicas en estos programas de posgrado. Además, a pesar de que ya hay una ley sobre el talento humano en salud, en el sistema educativo médico colombiano no hay regulaciones específicas sobre la formación de profesionales de la salud (médicos) en los diferentes programas de especialidades médicas ofrecidos en el país. Igualmente, en la actualidad factores como la crisis financiera de los hospitales públicos, el escaso número de hospitales acreditados y el creciente número de facultades de medicina y de programas de especialización afectan la adquisición integral e igualitaria de competencias médicas de los profesionales que se forman como especialistas en los diferentes programas de posgrado médico ofrecidos en Colombia. Teniendo en cuenta lo anterior, el propósito de este artículo es presentar una propuesta de educación médica de posgrado que priorice la adecuada adquisición de competencias por encima del cumplimiento del tiempo fijado para completar los planes de estudios de las diferentes especialidades médicas. Sin embargo, para esto se requieren varios aspectos: un ente regulatorio encargado de vigilar y monitorear la formación de los residentes o especialistas médicos en el país; una fuerte capacitación en docencia universitaria a los profesores que ejercen en las facultades de medicina y hospitales universitarios; la homogenización del perfil de los egresados; una adecuada financiación de los hospitales universitarios, así como un apropiado acompañamiento en su proceso de acreditación como tal, y la autoevaluación y mejoramiento continuo de los posgrados médicos.

Diplomado para la formación co-doctoral del residente de las ciencias médicas / A diploma program for the co-doctoral formation of medical sciences residents

Introducción: Como formas de posgrado se encuentran la especialidad y el doctorado, donde se desarrollan habilidades investigativas que no se enfocan siempre en dar continuidad al proceso. En la actualidad se precisa de propuestas que permitan alcanzar ambas categorías de forma paralela. Objetivo: Presentar una propuesta para la formación co-doctoral del profesional de las ciencias médicas. Posicionamiento de los autores: La propuesta se sustenta en un diplomado contentivo de 12 cursos, que tienen el taller como forma fundamental de organización de la enseñanza. Incluye cursos relacionados directamente con la gestión de la información científica, la redacción académica de textos científicos, la metodología de la información, entre otras temáticas para desarrollar habilidades docente investigativas en función del grado científico. El desarrollo de este se realizará de forma paralela a la especialización, por lo que requiere de la coordinación directa con los diferentes comités académicos de las especialidades. Conclusiones: Esta actividad de superación profesional, llevada a cabo junto con las contenidas en la especialidad, permitirá desarrollar habilidades docente-investigativas en el residente, para lograr un impacto significativo en sostenibilidad del claustro de la Universidad de Ciencias Médicas de Santiago de Cuba (AU)

Introduction: Specialty and doctoral programs are forms of postgraduate studies, in which research skills are developed but not always focused on providing continuity to the process. At present, proposals are needed to achieve both categories in parallel. Objective: To present a proposal for the co-doctoral training of medical sciences professionals. Authors' position: The proposal is based on a diploma program containing twelve courses, with the workshop as the fundamental form of teaching organization. It includes courses directly related to scientific information management, academic writing of scientific texts, information methodology, among other topics for developing teaching and research skills according to the scientific degree. This program will be developed in parallel with the specialization; therefore; it requires direct coordination with the different academic boards of the specialties. Conclusions: This professional upgrading activity, carried out together with those already part of the specialty, will allow the development of teaching-research skills in the resident, thus achieving a significant impact on the sustainability of the faculty of Universidad de Ciencias Médicas de Santiago de Cuba (AU)

Pharmacists' Educational Training and Professional Activities at the Municipal Level of the Brazilian National Health System

Abstract Brazilian pharmacists' education and training aims to prepare them for the various activities they will undertake during professional practice, especially in the national health system (SUS). By using an exploratory transversal study based on a validated questionnaire, we have characterized the educational and training background of pharmacists working in SUS municipal units in Ribeirão Preto, State of São Paulo (SP), Brazil, and the frequency with which these professionals carry out several activities. Pharmacists working in these municipal outpatient units (N=44) graduated between 1981 and 2014 (56.8% of them graduated from public state or federal institutions), are predominantly female (84%), and are aged 25-57 years; 34% of these pharmacists have a "Generalist" degree, and 90.9% attended postgraduate programs, mostly specialization (75%). All the pharmacists pointed out the need for continuing education. The frequency with which they carry out activities varies, but those involving direct contact with patients predominate. Consultations, therapeutic follow-up, case discussions, and health promotion activities take place only occasionally. We concluded that pharmacists who work in the municipality of Ribeirão Preto, SP, are very much involved with dispensing, but not with health education or pharmacotherapeutic follow-up, so investing in education and training in these areas is necessary.

Mastering your fellowship: Part 3, 2022

The series, 'Mastering your Fellowship', provides examples of the question formats encountered in the written and clinical examinations, Part A of the Fellowship of the College of Family Physicians of South Africa (FCFP SA) examination. The series is aimed at helping family medicine registrars (and their supervisors) prepare for this examination.Keywords: family physicians; FCFP (SA) examination; family medicine registrars; postgraduate training; national exit examination; infectious diseases.

Mastering Your Fellowship: Part 4, 2022

The 'Mastering Your Fellowship' series provides examples of the question format encountered in the written and clinical examinations, Part A of the Fellowship of the College of Family Physicians of South Africa examination. The series is aimed at helping family medicine registrars prepare for this examination.

Application of Delphi method in constructing the cultivation system of professional postgraduate medical students / 中华医学教育探索杂志

Objective:To construct a training system of the professional postgraduate degree of general practice using the Delphi method.Methods:On the basis of consulting relevant policies and literature, and drawing lessons from foreign general practice training systems, the index system of training professional postgraduate medical students of general practice was preliminarily developed. After two rounds of Delphi expert consultation, using the threshold method to select evaluation indexes, the training system was finally established. Excel 2010 and SPSS 19.0 were used to make data entry and statistical analysis.Results:The active coefficients of experts in the two rounds of Delphi consultation were 75.0% (12/16) and 91.7% (11/12) respectively, both the two rounds of the degree of specialist authority were 0.87, and the final coordination coefficient of the specialists' opinion was 0.452. The index system was composed of 5 first-level indexes including training objectives, theoretical curriculum setting, clinical practice setting, teaching staff and graduation requirements and 31 second-level indexes.Conclusion:The experts have great initiative and authority on research subjects. The opinions of all experts tend to be uniform after two rounds of consultation, and the results are reliable. A relatively complete and credible training index system of professional postgraduate degree of general medicine has been built.

Monitoreo del impacto en la formación de especialistas en Medicina Intensiva y Emergencias en Matanzas / Monitoring the impact in the formation of specialist in intensive medicine and emergencies, Matanzas

Introducción: la evaluación y acreditación de la calidad en la formación de las especialidades médicas en Cuba, conceptualiza el monitoreo del impacto como el proceso dirigido a evaluar la correspondencia entre los objetivos del programa y los resultados alcanzados por sus participantes en el entorno social donde se desarrollan profesionalmente. Objetivo: aplicar la metodología diseñada para el monitoreo del impacto en la formación de las especialidades médicas en el Programa de Medicina Intensiva y Emergencias. Materiales y métodos: se realizó un estudio de corte pedagógico donde se aplicó la metodología diseñada en la Universidad de Ciencias Médicas de Matanzas, para monitorear el impacto en la formación de la especialidad de Medicina Intensiva y Emergencias, desarrollado en el Hospital Universitario Comandante Faustino Pérez Hernández. Participaron 6 egresados, 11 profesores, 8 tutores y 4 directivos de la última edición concluida (octubre de 2016 a noviembre de 2019). Resultados: se observó un alto impacto en la institución y mediano en el individuo, con contraste entre el diagnóstico inicial y durante la formación: de excelencia en el 100 % de los residentes, pero un diagnóstico final con 33,3 % excelente y 66,6 % bien. No se evaluó la etapa de transferencia o impacto en la sociedad, por el corto de tiempo de experiencia laboral de los egresados. Conclusiones:la metodología aplicada permitió conocer un mediano impacto en la formación de los egresados de Medicina Intensiva y Emergencias, por contrastación entre el diagnóstico inicial y durante la formación, de excelente con un diagnóstico final de bien (AU).

Introduction: the evaluation of the quality in the formation of the medical specialties in Cuba, conceptualize the monitored of the impact like the process directed to evaluate the correspondence among the objectives of the program and the results reached by their participants in the social environment where they are developed professionally, guaranteeing the relevancy of the program. Objective: to apply the methodology designed for the monitored of the impact in the formation of the medical specialties in the program of intensive Medicine and emergencies. Materials and methods: carried out a study of pedagogic court where the methodology was applied designed in the Medical University of Matanzas, for the monitored of the impact in the formation of the specialty of intensive Medicine and emergencies, developed in the university hospital "Faustino Pérez Hernández." They participated six graduate, four directives, 11 professors and tutors of the last concluded edition, from October of the 2016 to November of the one 2019. Results: a high impact was observed in the institution and medium in the individual, with a contrast among the initial diagnosis and during for formation of excellence in 100% of the residents, with a final diagnosis of 33,3% excellent and 66,6% well. It was not evaluated the transfer stage or impact in the society, for the short of time of labor experience of the graduate. Conclusions: the applied methodology allowed to know the medium impact in the formation of graduate in Intensive Medicine and Emergencies in Matanzas, for a contrast among the initial diagnosis and during the formation of excellent with the final diagnosis of well (AU).

What Dental Hygienists Learned through Training with Simulated Patient and How They Applied it in Practice? / 医学教育

Introduction: This study aims at investigating what dental hygienists learned through training with a simulated patient and how they applied their learning in practice. Method: Open-ended questionnaire surveys on their perceptions and experiences of health communication were undertaken by 21 dental hygienists before and after communication trainings. Result: Before the training, they felt it difficult to cope with patients’ negative responses to their communication. However, after the training, they deeply considered how they should be as health professional through reflection on their own communication style. In their practice, they tried to communicate while considering the patient’s situation. Discussion: Participants’ critical reflection, which was encouraged in this training, resulted in application of their learning to clinical practice.

Discussion on the importance of laboratory teaching of assisted reproductive technology to the cultivation of postgraduate students in reproductive medicine / 中华医学教育探索杂志

Due to the particularity of assisted reproductive technology, almost all colleges and universities have not included the reproductive technology experiment course into the scope of postgraduate teaching. Based on the rapid development of the reproductive medicine and the shortage of qualified personnel, through the questionnaire survey, the paper investigates the willingness of reproductive medicine postgraduate students to learn assisted reproductive technology, the current status of experimental courses on assisted reproductive technology, student satisfactory with the courses, the necessity of setting up an experimental course for assisted reproductive technology, and so on. By analyzing the current situation of postgraduate teaching in reproductive medicine and the results of questionnaire survey, we explores the necessity and limitations of strengthening laboratory teaching of assisted reproductive technology in the process of reproductive medicine postgraduate training, and proposes corresponding teaching strategies.

Educação interprofissional em saúde: revisão integrativa da literatura brasileira (2008-2018) / Interprofessional education in healthcare: integrative review of brazilian literature (2008-2018) / Educación interprofesional en salud

Este estudo teve como objetivo estabelecer um panorama da produção científica nacional relativa à Educação Interprofissional em Saúde (EIP), com ênfase nas pesquisas desenvolvidas junto a pós-graduandos ou profissionais de saúde ao longo de uma década (2008-2018). Trata-se de uma revisão integrativa realizada mediante consultas às bases de dados MEDLINE, LILACS, SciELO-Brasil e Scopus. Compuseram o corpus de análise 31 referências, as quais foram examinadas segundo um conjunto de dimensões analíticas. Evidenciou-se que as referências se concentram nos últimos cinco anos e, predominantemente, foram assinadas por pesquisadores vinculados a universidades públicas, derivam de pesquisas qualitativas voltadas à prática interprofissional e tiveram como participantes profissionais de saúde inseridos em serviços de atenção primária. Conclui-se que o fortalecimento da EIP no país se afigura como um importante caminho a ser percorrido no sentido da integralidade das ações e dos serviços de saúde, e que novas pesquisas são necessárias para tanto.

This study aimed to establish an overview of the Brazilian scientific production related to Interprofessional Education in Healthcare (IPE), emphasizing researches developed with graduate students or healthcare personnel participation along a decade (2008-2018). This is an integrative review carried out in MEDLINE, LILACS, SciELO-Brasil and Scopus databases. The corpus of analysis consisted of 31 references, which were examined according to a set of analytical dimensions. It was evidenced that the references are concentrated in the last five years, and, predominantly, were signed by researchers from public universities, derive from qualitative research focused on interprofessional practice, and had as participants professionals inserted in primary healthcare services. It can be concluded that the strengthening of IPE in Brazil is an important way towards the integrality of health actions and services, and that new research is needed for this purpose.

Este estudio tuvo como objetivo establecer una visión general de la producción científica brasileña relacionada con la Educación Interprofesional en Salud (EIP), con énfasis en investigaciones realizadas con la participación de estudiantes de posgrado o profesionales de salud a lo largo de una década. Esta es una revisión integradora realizada a través de consultas a las bases de datos MEDLINE, LILACS, SciELO-Brasil y Scopus. El corpus de análisis comprendió 31 referencias, que fueron examinadas de acuerdo con un conjunto de dimensiones analíticas. Se evidenció que las referencias se concentraron en los últimos cinco años, y, predominantemente, fueron firmadas por investigadores vinculados a universidades públicas, son derivadas de investigaciones cualitativas centradas en la práctica interprofesional y tuvieran como participantes profesionales de salud de servicios de atención primaria. Se puede concluir que el fortalecimiento de la IPE en Brasil es una forma importante de avanzar hacia la integralidad de las acciones y servicios de salud, y que se necesita más investigaciones para este fin.

Factores de riesgos que influyen en el desempeño del proceso de formación de posgrado / Risk factors that influence performance in the process of postgraduate training

Introducción: En el Centro Nacional de Cirugía de Mínimo Acceso desde 2015 se implementó el Sistema de Gestión de la Calidad NC-ISO 9001:2015. Sin embargo, en el proceso de posgrado los riesgos no se han gestionado de forma sistemática e integral, lo que puede afectar su desempeño. Objetivo: Identificar los factores de riesgo que influyen en el desempeño del proceso de formación de posgrado y planificar las acciones para su tratamiento. Métodos: Se realizó un estudio de tipo cualitativo, no experimental, en el período comprendido entre febrero y marzo de 2019. Para el diagnóstico de los riesgos se emplearon las técnicas de grupo focal, la matriz DAFO, la encuesta y el análisis de causa-efecto de Ishikawa. Además, la matriz de probabilidad-consecuencia se utilizó para evaluar la prioridad de los riesgos identificados. Resultados: El diagnóstico permitió fundamentar la necesidad de gestionar integralmente los riesgos que inciden en el proceso de formación de posgrado. Nueve de los riesgos identificados se consideran altos y tienen la máxima prioridad para el establecimiento de medidas de control. Siete son moderados y también se toman medidas para su minimización. Conclusiones: Los riesgos identificados están en relación con la planificación inadecuada de los indicadores del proceso y la no inclusión de todos los aspectos que inciden sobre la gestión del posgrado. El tratamiento de los riesgos según su prioridad permitirá elevar el desempeño del proceso y cumplir los requisitos de la norma NC-ISO 9001:2015(AU)

Introduction: In the National Center for Minimally Invasive Surgery, the NC-ISO 9001: 2015 Quality Management System was implemented since 2005. However, in the postgraduate process, the risks have not been systematically and comprehensively managed, which may affect performance. Objective: To identify the risk factors that influence performance of the postgraduate training process and to plan the actions for their treatment. Methods: A qualitative, non-experimental study was carried out in the period between February and March 2019. For the diagnosis of risks, some techniques were used, such as focus group, the SWOT matrix, the survey, and Ishikawa's cause-and-effect analysis. In addition, the probability-consequence matrix was used to assess the priority of the identified risks. Results: The diagnosis allowed to provide the foundations for the need to manage comprehensively the risks that affect the postgraduate training process. Nine of the identified risks are considered high and have the highest priority for the establishment of control measures. Seven are moderate and also measures are taken for their minimization. Conclusions: The risks identified are related to inadequate planning of the process indicators and the non-inclusion of all aspects that affect management in the postgraduate level. The treatment of the risks according to their priority will allow to increase the performance of the process and meet the requirements of the NC-ISO 9001: 2015 standard(AU)

Metodología para monitoreo del impacto de la formación de especialistas en la Universidad Médica matancera / Methodology for monitoring the impact of specialists training in the University of Medical Sciences of Matanzas

RESUMEN Introducción: el impacto de un programa de formación de posgrado con enfoque profesional puede ser definido como su repercusión en cambios favorables en los niveles de competencia de los estudiantes, su desempeño en el puesto de trabajo, la eficiencia y la competitividad de las organizaciones y sus efectos en el entorno interno y externo. No siempre las instituciones educativas cuentan con los instrumentos adecuados para la evaluación de estos impactos, aspecto que resulta medular para valorar la pertinencia y el impacto social de los programas de formación. Objetivo: elaborar una metodología para la evaluación del monitoreo del impacto de la formación en las especialidades médicas. Material y Método: la metodología elaborada se fundamenta en el Subsistema de Evaluación y Acreditación de Especialidades de Posgrado (SEA-EP) y el análisis de los modelos de evaluación del impacto de la formación existentes, la cual incluye un instrumento propio para evaluar el impacto de dicha formación, el cual se apoya esencialmente en un grupo de encuestas y entrevistas. Resultados: se muestra una contribución a la evaluación sistémica e integradora del proceso de formación, demostrando la pertinencia de la metodología diseñada, con la inclusión del instrumento propio. Conclusión: La metodología propuesta se concibió con una visión integral, sistémica y abarcadora de la formación. Los cuestionarios diseñados recogen gran cantidad de información, alineados al Patrón de Calidad del SEA-EP, por lo que son más eficaces para valorar su impacto, la calidad intrínseca del proceso formativo y determinar oportunidades de mejora en el mismo (AU).

SUMMARY Introduction: The impact of a program of postgraduate training with professional view could be defined as its repercussion in favorable changes in the students´ competence levels, their performance in their work places, the efficiency and competitiveness of the organizations and their effectiveness in the internal and external environment. The educative institutions do not always have the effective instruments for evaluating these impacts, important aspect to assess the pertinence and the social impact of the training programs. Objective: to elaborate a methodology for evaluating the monitoring of the training impact in medical specialties. Materials and methods: the elaborated methodology is based on the Subsystem of Evaluation and Accreditation of Postgraduate Specialties [Subsistema de Evaluación y Acreditación de Especialidades de Posgrado (SEA-EP) en español] and the analysis of the patterns of evaluating the impact of the existent training which includes a proper tool to evaluate the impact of that training, based mainly in a group of enquiries and interviews. Results: it confirms a contribution to the systemic and integrative evaluation of the training process, showing the pertinence of the designed methodology, with the inclusion of a proper instrument. Conclusion: the proposed methodology was conceived with an integrative, systemic and comprehensive point of view of the training. The designed questionnaires gather great quantity of information, according to the Quality Pattern of SEA-EP, being therefore more efficacious to assess its impact, the intrinsic quality of the training process and to determine opportunities of improvement in it (AU).

Experiencia sobre monitoreo del impacto en la formación de dermatólogos en la Universidad Médica matancera / Experience on monitoring the impact in dermatologists training in the Medical University of Matanzas

RESUMEN Introducción: la evaluación y acreditación de la calidad en la formación conceptualiza el monitoreo del impacto como el proceso dirigido a evaluar la correspondencia entre los objetivos del programa y los resultados alcanzados por los participantes en el entorno social concreto, con el propósito de valorar el proceso formativo y propiciar la necesaria retroalimentación para elevar su pertinencia social. Objetivo: aplicar la metodología diseñada para el monitoreo del impacto de la formación para las especialidades médicas en el Programa de la Especialidad de Dermatología. Materiales y método: el estudio se desarrolló tomando como referente la metodología diseñada para las especialidades médicas en la Universidad de Ciencias Médicas de Matanzas, teniendo en cuenta los resultados obtenidos en las autoevaluaciones para el proceso de formación de especialistas en dicha especialidad, el cual se desarrolló en la institución objeto de estudio y abarcó el período comprendido de septiembre del 2014 a junio del 2019. Resultados: la metodología empleada arrojó un balance satisfactorio a partir de cada una de sus categorías, predominando el rango de alta y media en el proceso formativo. Se obtuvo el 60,2% en la categoría alta al concluir la formación y es de destacar que no se obtiene categoría baja, es decir, según la clasificación en el rango mínimo de 70 a 79 puntos. Conclusión: el estudio denotó la necesidad y pertinencia de la metodología aplicada, lo que permitió conocer impactos fundamentales del proceso de formación de especialistas en Dermatología e identificar oportunidades de mejora (AU).

SUMMARY Introduction: the quality evaluation and accreditation in training conceptualizes the impact monitoring as the process aimed to evaluate the correspondence between the objectives of the program and the results achieved by the participants in the concrete social environment, with the purpose of assessing the training process and propitiating the necessary feedback to increase its social pertinence. Objective: to apply the methodology designed for monitoring the impact of training for medical specialties on the Program of the Specialty Dermatology. Materials and methods: the study was developed taking as referent the methodology designed for medical specialties in the University of Medical Sciences of Matanzas and taking into account the results of the auto-evaluations for the process of specialists´ training in those specialties, that was developed in the studied institution in the period from September 2014 to June 2019, Results: the used methodology revealed a satisfactory balance from each of the categories, predominating High and Medium range in the training process. 60.2 % got the High category at the end of the training, and it is to be highlighted that Low category was not found. Conclusions: the study showed the necessity and pertinence of the applied methodology, allowing to know the main impacts of the training process of specialists in Dermatology and to identify improvement opportunities (AU).

O programa de aprimoramento profissional em psicologia na perspectiva do egresso / The professional improvement programs in psychology in the perspective of the egress

Os Programas de Aprimoramento Profissional foram criados na década de setenta e tem seu valor reconhecido como formação de pós-graduação na modalidade latu sensu dentro do território do estado de São Paulo. O presente estudo teve por objetivo identificar o impacto dos Programas de Aprimoramento Profissional na formação e exercício profissional do psicólogo, especialmente na área da saúde, de acordo com a percepção dos egressos. Trata-se de um estudo transversal, descritivo, de abordagem quanti-qualitativa. Grande parte dos egressos (93,1%) encontra-se inserida no mercado de trabalho, atuando como psicólogo. As atividades práticas foram melhores avaliadas do que as atividades teóricas. Observou-se que a realização do Programa de Aprimoramento Profissional possibilitou o aperfeiçoamento e a capacitação do profissional para atuação qualificada e diferenciada na área da saúde. Por fim, cabe ressaltar, a necessidade de adequação dos Programas de Aprimoramento às novas demandas em saúde.

Professional Enhancement Programs were created in the 1970s and had the post-graduate training in the lato sensu modality within the territory of the state of São Paulo. The present study aimed to identify the impact of the learning programs in the health and exercise area of the psychologist, especially in the health area, according to the perception of the graduates. This is a cross-sectional, descriptive, quantitative-qualitative study. Most of the graduates (93.1%) are in the job market, working as a psychologist. The practical activities were better evaluated than the theoretical activities. It was observed that the realization of the Professional Improvement Program enables the improvement and the qualification of the professional to perform qualified and differentiated in the health area. Finally, it is worth mentioning the need to adapt the Enhancement Programs to the new health demands.

La formación de posgrado para la gestión del proceso de evaluación de tecnologías sanitarias desde una perspectiva teórica / Postgraduate training for the management of the health technologies evaluation from a theoretical perspective

Los profesionales de la salud desempeñan un papel clave en la utilización racional y la regulación de los recursos sanitarios disponibles. En este artículo se presentan los fundamentos teóricos y las tendencias históricas que caracterizan la formación de posgrado de los gestores de ciencia, tecnología e innovación en salud para la gestión de la evaluación de tecnologías sanitarias. Asimismo, se define el concepto de formación de posgrado para la gestión de la evaluación de tecnologías sanitarias y se determinan las tres etapas que han caracterizado la evolución de este proceso, asociadas con las demandas que provienen del contexto histórico del desarrollo de esta actividad en las instituciones de salud. Se constató que no existe una propuesta teórico-metodológica que permita la apropiación, actualización y profundización en los conocimientos y las habilidades para la gestión de la evaluación de tecnologías sanitarias.

Health professionals play a key role in the rational use and regulation of the available health resources. The theoretical bases and the historical tendencies that characterize the postgraduate training of the science, technology and innovation in health agents for the management of the health technologies evaluation are presented in this work. The training postgraduate concept for the management of the health technologies evaluation is defined. The three stages which have characterized the course of this process, associated with the demands coming from the historical context of the development of this activity in the health institutions are determined. It was verified that a methodological theoretical proposal that allows the appropriation, updating and deepening in the knowledge and skills for the management of the health technologies evaluation doesn't exist.

McIsaac Modification of Centor Score in Diagnosis of Streptococcal Pharyngitis and Antibiotic Sensitivity Pattern of Beta-hemolytic Streptococci in Chennai, India

Objective: Toassess the validity of modified Centor Score in predicting streptococcalpharyngitis, and describe the antibiotic sensitivity of streptococcal strains. Methods: A cross-sectional study of 120 children (age 1-18 y) with signs and symptoms of pharyngitis wasundertaken in the pediatric department of a tertiary care teaching hospital in Chennai fromJuly 2015 to April 2016. Modified Centor score was calculated for all children, andstreptococcal sore throat was confirmed by throat swab culture. Predictive validity of Centorscore was assessed by Receiver Operating Curve (ROC) analysis. Results: Streptococcalculture positivity was 35%. The Area Under the Curve (AUC) value for modified Centor scorewas 0.589 (95% CI 0.481 to 0.697, P=0.11) in predicting streptococcal pharyngitis. Coughhad the highest sensitivity (63.4%), but poor specificity (36.7%) for streptococcal pharyngitisconfirmed by culture. The specificity was 100% for palatine petechiae, followed by palatineexudates (97.5%) and tender anterior cervical nodes (88.6%) to diagnose streptococcalpharyngitis. The proportion of antibiotic resistance was highest for cotrimoxazole (16.7%).Conclusion: Predictive validity of modified Centor score was not satisfactory, and resistanceto cotrimoxazole, fluoroquinolones and macrolides was high among S. pyogenes strains.

Application of holistic integrative medicine in clinical teaching of postgraduates in burn surgery / 中华医学教育探索杂志

In order to improve the quality of the clinical teaching of postgraduates in burn surgery and cultivate high-quality interdisciplinary talents , this study explores the significance and role of the concept of holistic integrative medicine in the clinical teaching of postgraduates in burn surgery. By cultivating the thinking of holistic integrative medicine among teachers and students, a variety of teaching methods are used to integrate burn surgery with multiple disciplines such as rehabilitation medicine, plastic surgery, psychology , and pathophysiology in the clinical teaching of postgraduates . The results show that the introduction of the concept of holistic integrative medicine in the clinical teaching of postgraduates can enhance their enthusiasm for learning, improve the quality of teaching, and provide a reference for exploring the training model for high-quality talents in burn surgery.

A preliminary study of the cultivation of clinical research thinking for academic postgraduate students in critical care medicine / 中华医学教育探索杂志

The training of academic postgraduate students in critical care medicine emphasizes basic knowledge and underestimates the importance of clinical practice. Research objectives are innovative, but with a lack of practicability, and thus cannot meet the huge needs for clinical research in this major. Under the guidance of the concept of translational medicine , the training of academic postgraduate students should strengthen clinical observation and systematic learning of clinical knowledge, enhance the accumulation of clinical data, improve the quality of data statistics, reinforce the training on clinical research processes, standards, and methods, and emphasize interdisciplinary and multicenter communication and cooperation, so as to break the barrier between basic and clinical research, broaden scientific research thinking , and improve the comprehensive quality of academic postgraduate students in critical care medicine.

Necesidades de aprendizaje de Bioestadística y Metodología de la Investigación en la formación de posgrado de profesionales de la salud / Necessities of learning on Biostatistics and Methodology of Investigation in the training of post-graduate health professionals

Se realizó un estudio pedagógico y descriptivo de 46 residentes que se incorporaron a la formación de posgrado en el Hospital General Docente Dr Juan Bruno. Zayas Alfonso de Santiago de Cuba en el curso escolar 2016-2017, con vistas a identificar las necesidades de aprendizaje de Bioestadística y Metodología de la Investigación en estos profesionales de la salud. Los resultados más importantes fueron la falta de correlación entre necesidades sentidas y reales, con un coeficiente de correlación de Pearson = 0,058; asimismo, ninguno de los evaluados alcanzó 50 por ciento de los puntos del test. Se concluye que los profesionales, al iniciar su formación de posgrado, no tienen los conocimientos necesarios para su desempeño estadístico-investigativo.

A pedagogical and descriptive study of 46 residents who began the postgraduate training in Dr Juan Bruno. Zayas Alfonso Teaching General Hospital was carried out in Santiago de Cuba in the period 2016-2017, with the aim of identifying the learning necessities of Biostatistics and Methodology of Investigation in these health professionals. The most important results were the lack of correlation between felt and real necessities, with a Pearson correlation coefficient = 0.058; also, none of the evaluated reached 50 percent of the test points. It is concluded that the professionals don't have the necessary knowledge for their statistical-investigative acting, when beginning their postgraduate training.

A national curriculum for ophthalmology residency training

We present a residency curriculum for Ophthalmology in India. The document derives from a workshop by the All India Ophthalmological Society (AlOS) which adapted the International Council of Ophthalmology residency curriculum and refined and customized it based on inputs by the residency program directors who participated in the work shop. The curriculum describes the course content, lays down the minimum requirements of infrastructure and mandates diagnostic and therapeutic procedures required for optimal training. It emphasises professionalism, management, research methodology, community ophthalmology as integral to the curriculum. The proposed national ophthalmology residency curriculum for India incorporates the required knowledge and skills for effective and safe practice of ophthalmology and takes into account the specific needs of the country.