Scale to measure medical, nursing and midwifery students' engagement in an e-learning histology course / Escala para medir la participación de estudiantes de medicina, enfermería y obstetricia en un curso de histología e-learning

SUMMARY: E-learning courses become increasingly important and relevant in medicine and health sciences over the last decade. However, there are few teaching experiences of e-learning histology courses published in the literature worldwide. Moreover, most of these studies focus on the didactic aspects of the course without exploring student participation. The study presented below aimed to validate a scale to measure student participation in an e-learning histology course. We provide evidence of validity of the instrument based on its internal structure for use with medical, nursing, and midwifery students. The participants in this study were a group of 426 Chilean medical, nursing and midwifery students from a public university who completed the questionnaire in two consecutive semesters (2020-2021). Data from the first group of students were used to perform an exploratory factor analysis (EFA), while data from the second group of participants were used to perform a confirmatory factor analysis (CFA). The three factors identified according to the CFA were: "Habits of online," "Motivation for online learning," and "Interaction of online". After eliminating one of the initial items of the instrument, the scale showed acceptable psychometric properties suggesting that it is a useful instrument to measure students' perception of their participation in e-learning histology courses. The factors identified through the validation of the instrument provide relevant information for teachers and curriculum developers to create and implement different ways of encouraging student participation in e- learning histology courses to support online learning.

Los cursos e-learning han tomado mayor importancia y relevancia durante la ultima década en carreras de medicina y ciencias de la salud. No obstante, existen escasas experiencias docentes de cursos de histologia e-learning publicadas en la literatura mundial. Además, la mayoría de estos estudios se centran en los aspectos didácticos del curso sin explorar la participación de los estudiantes. El estudio que presentamos a continuación tuvo por objetivo validar una escala para medir la participación de los estudiantes en un curso de histología e-learning. Aportamos evidencia de validez del instrumento basada en su estructura interna para su uso con estudiantes de medicina, enfermería y obstetricia. Los participantes de este estudio fueron un grupo de 426 estudiantes chilenos de medicina, enfermería y obstetricia de una universidad pública quienes completaron el cuestionario en dos semestres consecutivos (año 2020-2021). Los datos del primer grupo de estudiantes se utilizaron para realizar un análisis factorial exploratorio (AFE), mientras que los datos del segundo grupo de participantes se utilizaron para realizar un análisis factorial confirmatorio (AFC). Los tres factores identificados según el AFC fueron: "Hábitos de los estudiantes en línea", "Motivación por el aprendizaje en línea", "Interacción de los estudiantes en línea". Luego de la eliminación de uno de los ítems iniciales del instrumento, la escala mostró propiedades psicométricas aceptables sugiriendo que es un instrumento útil para medir la percepción de los estudiantes sobre su participación en cursos de histología en formato e-learning. Los factores identificados mediante la validación del instrumento entregan información relevante para que los profesores y curriculistas desarrollen e implementen diferentes formas de estimular la participación de los estudiantes en cursos de histología e- learning y así apoyar el aprendizaje en formato online.

A regulação do trabalho em saúde em tempos complexos e instáveis / Health workforce regulation in complex and unstable times

Resumo No Brasil, a saúde é considerada direito de todos e dever do Estado. A regulação do trabalho em saúde é atividade essencial para garantir a segurança, qualidade e eficácia dos serviços de saúde prestados, que exigem profissionais com competências, habilidades e atitudes condizentes. O trabalho em saúde deve ainda ser exercido com condições de trabalho dignas aos profissionais de saúde e aos pacientes. Este ensaio apresenta uma análise crítica e atual das principais características do modelo de regulação do trabalho em saúde no Brasil. O texto descreve, inicialmente, de que forma está estruturada a regulação do exercício profissional na área da saúde, abordando temas como a autonomia regulatória dos Conselhos Profissionais, a regulação de novas profissões de saúde e a judicialização dos conflitos regulatórios. Finalmente, são analisadas as características da regulação da formação de nível superior na área da saúde e o papel protagonista do Ministério da Educação nesse campo regulatório. As reflexões aqui apresentadas objetivam apontar possíveis caminhos para o aperfeiçoamento do modelo de regulação do trabalho em saúde no Brasil, tendo como norte a consolidação do Sistema Único de Saúde (SUS) e a plena efetivação do direito à saúde no Brasil.

Abstract In Brazil, health is considered a right of all and a duty of the State, and health workforce regulation is essential to ensure the safety, quality and effectiveness of the health services provided, which require professionals with skills, abilities and attitudes consistent with the service in question, as well as to guarantee dignified working conditions for health professionals and patients. This essay is a critical and up-to-date analysis of the main characteristics of Brazil's health workforce regulation model. We first describe how the health workforce regulation is structured, addressing topics such as the regulatory autonomy of Professional Councils, the regulation of new healthcare professions and the judicialization of conflicts in the field. We then analyze the regulation of health higher education and the leading role of the Ministry of Education in this regulatory field. The present reflections point out possible ways to improve Brazil's health workforce regulation model, having the consolidation of the Brazilian National Health System (SUS) and the full implementation of the right to health as guides.

A competência normativa frente aos novos atores políticos: um estudo de caso da telemedicina / The normative competence in the face of new political actors: a case study of telemedicine

Resumo A regulação da prática de telemedicina no Brasil tem se mostrado tortuosa desde seu reconhecimento pela Resolução nº 1.643/2002, do Conselho Federal de Medicina (CFM), havendo questionamentos quanto à competência deste para inserção da prática. Em 2018, o conselho editou nova resolução, mas que foi revogada em função da repercussão negativa. A pandemia de covid-19 pressionou os serviços de saúde de tal forma que o Poder Legislativo Federal foi impelido ao conflito e editou a Lei nº 13.989/2020, permitindo a prática de telemedicina durante o período da crise sanitária. O art. 6º da lei delegou ao CFM a competência para regulação da prática pós-pandemia, acirrando ainda mais as discussões. Este trabalho constitui um estudo de caso sobre a regulação da telemedicina no Brasil, buscando identificar os conflitos jurídicos impostos pela atuação do CFM em substituição ao Poder Legislativo. Utiliza o modelo político de implementação de políticas públicas de William Clune como base da análise, empregando o método da pesquisa documental qualitativa. Conclui-se que a implementação da telemedicina deve considerar as forças políticas em atuação, compreendendo o papel do CFM no processo normativo, para que se obtenha, no texto legal, uma política pública compatível com a realidade e apta a ser implementada.

Abstract The regulation of telemedicine in Brazil has been tortuous since its recognition by the Resolution No. 1,643/2002, of the Federal Council of Medicine (CFM), with issues regarding its competence to insert this practice. In 2018, the council issued a new resolution but it was revoked due to negative repercussions. The covid-19 pandemic put pressure on health services in such a way that the National Congress was pushed into conflict and enacted the Federal Law No. 13,989/2020, which allowed the practice of telemedicine during the period of health crisis. The article 6 of the law delegated the competence to regulate the post-pandemic practice to the CFM, further intensifying the discussions. This work is a case study on the regulation of telemedicine in Brazil, seeking to identify the legal conflicts imposed by the action of CFM in substitution of the Legislative Power. It uses the political model of implementation of public policies by William Clune as the basis for the analysis, using the qualitative documentary research method. In conclusion, the implementation of telemedicine must consider the political forces involved, understanding the CFM's role in the normative process, to obtain, in the legal text, a public policy compatible with reality and capable of being implemented.

Consolidating medical education in Sudan during war

Providing quality medical education in Sudan faces challenges due to armed conflicts. This short communication explores practical solutions for ensuring the continuity of medical education during the conflict in the Sudanese context. Methods: A comprehensive literature review covered relevant articles published from 1915 to 2023. Four major databases (PubMed, Scopus, Web of Science, and Google Scholar) were searched using keywords related to medical education, war, armed conflict, and affected countries. Data synthesis identified common themes, challenges, and trends and suggested solutions for medical education in conflict zones. Case studies from Ukraine, Liberia, and Iraq were included for a comprehensive understanding. Results: Collaborative alliances among medical schools facilitate resource sharing and support. Engaging the Sudanese diaspora through virtual collaborations, mentorship programs, and faculty exchanges enhance educational experiences. Stable regions as educational hubs ensure uninterrupted academic progress for students from conflict-affected areas. Online and remote education, including asynchronous learning and social media platforms, overcome access barriers and fosters knowledge sharing. Ambulatory teaching provides practical experience and adaptability. Prioritizing faculty well-being and professional development through training and support is crucial. Emphasizing resilience and adaptability in student education prepare them for healthcare delivery in resource-limited settings. Research and innovation contribute to evidence-based strategies. International collaboration and support offer opportunities for knowledge exchange and infrastructure improvement. Conclusion: Implementing collaborative strategies and innovative approaches helps Sudanese medical schools overcome challenges during armed conflicts and maintain quality medical education. These solutions empower students and faculty, enhance resilience, and contribute to improving healthcare systems in post-war Sudan.

Current status and future perspectives of health related professions in China / 中华放射医学与防护杂志

Since the Academic Degrees Committee of the State Council and the Ministry of Education officially listed medical technology as a first-level discipline in 2011, China has witnessed a rapid development in the classification of medical technology disciplines, the number of practitioners and professional level, the higher education of medical technology. The paper analyzes and summarizes the current status of the development in medical technology disciplines, explores the key difficult points therein and provides the relevant suggestions. The aim is to promote the discipline construction of medical technology, contribute to the cultivation of medical technical professionals and boost the development of medical and health services in our country.

Implementation of a remote interprofessional education module on role understanding of community health workforce

Background and Objectives@#Interprofessional education (IPE) is considered by the World Health Organization “a necessary step in producing collaborative practice-ready health professionals.” In the Philippines, the ability to “work collaboratively within interprofessional and multi professional teams”, was identified by the Commission on Higher Education as one of the outcomes common to all health-related professions programs. Although steps were taken to integrate IPE in health professions education, majority of academic institutions in the country are yet to implement this. This study aimed to present the implementation of an online IPE module about the community health workforce among dental, medical and pharmacy students in a national health sciences university. @*Methodology@#The IPE module was developed and facilitated jointly by an interprofessional team of faculty engaged with the Community Health and Development Program of the University of the Philippines Manila. A total of 48 students from the Colleges of Dentistry, Medicine and Pharmacy participated. Teaching-learning activities used in the sessions included lectures, small group discussions, interviews, case study, large group discussions, and reflections. @*Results@#Insights gained by the participants included the complementary roles of health care workforce in the community, importance of communication and role understanding for better provision of care, the challenges that the workforce experience and their roles as future health workers in promoting collaborative practice by demonstrating respect and professional equality. @*Conclusion@#The module has shown that IPE activities may be successfully implemented through remote learning if done with proper planning and execution with the commitment of faculty facilitators.

2. How can We Establish Mindfulness Education for Future Healthcare Professions? / 医学教育

Mindfulness can be defined as awareness of physical and psychological processes in a nonjudgmental way. The purpose of adapting the ideas of mindfulness in health professions education is twofold. First, mindfulness education can develop stress management skills and self-care ability. Consequently, it can promote personal and professional identity formation. Second, mindfulness education can urge future healthcare professionals to improve the quality of patient care. Thus, this article will present practical reports from three medical schools that introduced mindfulness education for developing stress management skills and improving patient care and then discuss how universities can establish mindfulness education for future healthcare professions.

A inserção de técnicos em saúde bucal: questões em disputa na Política Nacional de Saúde Bucal / La inserción de técnicos en salud bucal: cuestiones en disputa en la Política Nacional de Salud Bucal / The insertion of oral health technicians: issues in dispute in the National Oral Health Policy

Analisou-se a inserção de técnicos em saúde bucal (TSB) na equipe de saúde bucal a partir de 2003 e questões em disputa na Política Nacional de Saúde Bucal. Estudo de abordagem sócio-histórica apoiado na sociologia de Pierre Bourdieu. Realizou-se análise documental, da literatura e entrevistas em profundidade com agentes formuladores e gestores da Política Nacional de Saúde Bucal. Houve baixa adesão à equipe com TSB pelos municípios brasileiros e evidências de manutenção das relações tradicionais de divisão do trabalho odontológico, subutilização do TSB e maior atuação em prevenção. A dominação simbólica do polo do mercado prevalece no serviço público e no espaço odontológico mais amplo, mesmo com conquistas na regulamentação profissional. Essa inserção ainda não se consolidou. As limitações das apostas da política, particularmente a questão do TSB, devem subsidiar novas ações, considerando a dominação simbólica e possíveis formas de enfrentá-la.(AU)

Se analizó la inserción de técnicos en salud bucal (TSB) en el equipo de salud bucal a partir de 2003 y cuestiones en disputa en la Política Nacional de Salud Bucal. Estudio de abordaje sociohistórico apoyado en la sociología de Pierre Bourdieu. Se realizó un análisis documental de la literatura y entrevistas en profundidad con agentes formuladores y gestores de la Política Nacional de Salud Bucal. Hubo baja adhesión al equipo con TSB por parte de los municipios brasileños y evidencias de mantenimiento de las relaciones tradicionales de división del trabajo odontológico, subutilización y mayor actuación en prevención. La dominación simbólica del polo del mercado prevalece en el servicio público y en el espacio odontológico más amplio, incluso con conquistas en la reglamentación profesional. Esa inserción aún no se ha consolidado. Las limitaciones de las apuestas de la política, particularmente la cuestión del TSB, deben subsidiar nuevas acciones, considerando la dominación simbólica y posibles formas de enfrentarla.(AU)

The research analyzed the insertion of Oral Health Technicians (OHT) in the oral health team from 2003 and issues in dispute in the National Oral Health Policy. The study used a social-historical approach based on Pierre Bourdieu's sociology. Documentary and literature analysis and interviews were carried out with formulators and managers of oral health policy. The municipalities presented low adhesion to teams with OHT, as well as there was evidence of maintenance of the traditional relationships of division of dental work, underutilization and greater performance in prevention. The symbolic domination of the market axis prevails in the public service and in the wider dental space, even with achievements in professional regulation. This insertion has not yet been consolidated. The limitations of policy bets, in particular this issue of OHT, should subsidize new actions, considering this symbolic domination and possible ways to tackle it.(AU)

As práticas corporais na legislação imperial e a construção de uma sociologia da profissão para a educação física / Bodily practices in imperial legislation and constructing a professional sociology for physical education

Resumo O artigo aborda os ofícios ligados à educação física, perante leis e decretos oficiais do período imperial (1822-1889), tendo em vista traçar uma trajetória dos primeiros passos articulados pelos profissionais nos contextos civil e militar da sociedade brasileira antes de eles serem reconhecidos como membros de uma categoria profissional. Optou-se por um estudo documental de leis e decretos imperiais que mencionam os ofícios vinculados às práticas corporais. Nesse contexto foi identificado que, ao contrário dos trabalhos intelectuais, a baixa atratividade dos trabalhos práticos dificultava a dedicação exclusiva, assim como a estabilidade no exercício do trabalho. Esses elementos eram obstáculos para reivindicações mais organizadas da educação física, necessárias para sua profissionalização.

Abstract This documentary study examines official texts related to physical education in legislation and decrees from Brazil's imperial period (1822-1889) to trace the initial steps of professionals in this area within the civil and military context of Brazilian society, before they were recognized as a professional category. We found that unlike intellectual efforts, practical work was less attractive, which made it difficult for these professionals to work exclusively and maintain stability in this area. These elements were obstacles to more organized demands from physical education that were required for professionalization.

Questionário de Condições de Trabalho: evidências de validade para trabalhadores de equipes de saúde / Working conditions questionnaire: Evidences of validity for health care workers / Cuestionario de condiciones de trabajo (cct): evidencias de validez para trabajadores de la salud

Consideramos as repetitivas queixas acerca das condições de trabalho no sistema público de saúde, bem como as necessidades de diagnósticos acurados que subsidiem ações de gestores, profissionais e usuários. Então, desenvolvemos pesquisa para avaliar a validade do Questionário de Condições de Trabalho (QCT) para trabalhadores das equipes atuantes na atenção primária e secundária do Sistema Único de Saúde (SUS). Participaram 434 trabalhadores de Belo Horizonte e de outros municípios de Minas Gerais. Aplicamos análises fatoriais exploratórias e confirmatórias na identificação dos fatores empíricos para as categorias das condições de trabalho. Os resultados atestaram que os fatores encontrados representam as categorias das condições de trabalho para tais participantes. Corroboraram a adequação do uso do QCT em pesquisas e diagnósticos ocupacionais no sistema de saúde. Eles poderão contribuir para a construção de versões reduzidas do QCT.

We consider the repetitive complaints to working conditions in the public health system, as well as the need for accurate diagnoses that support actions of managers, professionals and users. Then, we developed research to evaluate the validity of the Working Conditions Questionnaire (QCT) to workers in the teams, which act in basic and secondary attention of the Unified Health System (SUS). In the study, 434 workers from Belo Horizonte and other municipalities of Minas Gerais participated. We applied exploratory and confirmatory factor analyses for the categories of working conditions. The results attested that the found factors represent the categories of working conditions for such participants. They corroborated the suitable use of QCT for occupational research and diagnostics in the health system. The results can contribute to build of simplified version of QCT.

Consideramos las repetitivas quejas acerca de las condiciones de trabajo en el sistema público de salud, así como necesidad de diagnósticos precisos que respalden acciones de gerentes, profesionales y usuarios. Entonces, desarrollamos investigación para evaluar la validez del Cuestionario de Condiciones de Trabajo (CCT) para trabajadores de los equipos actuantes en atención primaria y secundaria del Sistema Único de Salud (SUS). Participaron 434 trabajadores de Belo Horizonte y otros municipios de Minas Gerais. Aplicamos análisis factoriales exploratorias y confirmatorias en la identificación de factores empíricos para las categorías de condiciones de trabajo. Los resultados atestiguaron que los factores encontrados representan las categorías de las condiciones de trabajo para tales participantes. Corroboraron la adecuación del uso de QCT en investigaciones y diagnósticos ocupacionales en el sistema de salud. Ellos podrán contribuir para la construcción de versiones reducidas del QCT.

Student learning needs during the pandemic

@#COVID-19 has disrupted daily living globally due to increased deaths and lockdowns that heavily affected 156 million learners as of July 2021. Over 28 million Filipino students had their classes cancelled for more than 41 weeks; hence, educational institutions have endeavored to continue teaching via alternative learning modes with remote learning as the most feasible. However, literature has mixed views of online education, citing positive and negative factors affecting learning. Thus, the objective of the article is to synthesize existing literature on the potential factors influencing student learning during the COVID-19 pandemic. Curricular design should take note of both physical and human factors. Physical factors include internet access and EdTech, while human factors include instructor's characteristics, curricular design, and student characteristics, attitudes, and psychosocial needs. Various steps such as ensuring internet access, training teachers, and characterizing students, alongside continuous feedback and timely preparation, are recommended to properly execute remote learning in emergencies.

"MEDC's Learning Space" - A Step-by-step Learning Program at Gifu University to Help Leaders Grow / 医学教育

Over the past 20 years, the Center for Medical Education Development Center, Gifu University has been working on training medical educators across the country. The Center offers a wide variety of programs to meet participants’ various needs and levels, targeting medical educators and administrative staff in various fields such as dentistry, pharmacy, nursing, physical therapy, and occupational therapy. This paper introduces the “Medical Education Starter Kit,” “Fellowship Program,” and “Master’s Course of Health Professions Education” among the programs. The objectives, target participants, and features of each program are outlined, including future prospects.

Designing a Program for Learning Health Professions Education / 医学教育

This paper outlines the essentials that each organizer of Faculty and Staff Development (FSD) programs in Health Professions Education should focus on when designing a program. The essentials are as follows: the reasons for studying at FDS, the place of practice, content, participants, peers, location, methods, timing, and evidence of learning. These will also help FSD participants think about their perspectives when they choose to participate in the program. It is hoped that more people will get involved in Health Professions Education to increase their knowledge and spice up their daily teaching practice. It is also hoped that those who complete the course will become Faculty Developers in their own areas and professions, revitalizing health professions education and cooperatively increasing the presence of Japanese Health Professions Education.

Assessment of the Knowledge and Self-medication Practices towards Antibiotics among Future Healthcare Professionals in Ajman, United Arab Emirates

Objectives:The aim of the study is to assess the knowledge and self-medication behavior among healthprofessionsstudents regarding antibiotic usage.Methods:A cross-sectional study was performed using a self-administrated questionnaire. A sample of 424 questionnaireswas distributed randomly among health science students of a medical university in Ajman, UAE.The questionnaire is categorized into three sections which are Socio-demographic details of the participant, knowledge and self-medication practice of antibiotic.The data was entered in MS Excel spread sheet and analyzed as per the study objectives Key Findings:Upon assessing the knowledgeof respondents,authors found85.8% of the students were familiar with the term ‘antibiotic resistance’.Half ofthe students agreedthat antibiotics treat common cold quickly.Regarding the self-medication practices,55.6% (n=236) of students reported that they always take antibioticwithout prescription. Cold and flu was the common reason for using antibiotics. Augmentin (amoxicillin and clavulanic acid) was the common medication used among the students. Nearly one third of the respondents (32.78%;n=139)saved theantibiotics in case of reinfection.Conclusions:In conclusion,antibiotic usage was common among study respondents. Preventive strategies, antibiotic stewardship programs, training, education programs and more restriction towards antibiotic dispensing should be implementedto avoid the misuse and antibiotic resistance.

A Proposal for Educational Curriculum on Conflicts of Interest from Undergraduate through Postgraduate and Continuing Health Professions Education / 医学教育

To ensure public trust in health professions, it is imperative for health professionals to understand the concept of conflict of interest (COI) in health professions education and manage it appropriately. However, there are not enough formal curricula on COI in health professions education in Japan. We propose an educational curriculum on COI in health professions education which focuses on relationship between physicians and for-profit corporations. We hope that this proposed curriculum stimulates educational activities on the ground while taking context into account. We also hope the proposed curriculum leads to the formal incorporation of COI in health professions education and educational policies nationwide.

Eliot Freidson's sociology of professions: an interpretation for Health and Nursing / Sociología de las profesiones de Eliot Freidson: interpretación para la Salud y la Enfermería / Sociologia das profissões de Eliot Freidson: interpretação para a Saúde e Enfermagem

ABSTRACT Objectives: to analyze theoretical conceptions of Eliot Freidson's Sociology of Professions scoped on health and nursing professions. Methods: Eight nurses were interviewed, all involved in the development of the professional Council on the timeframe from 1975 to 1986. Documental resources were Laws, Ordinances, Resolutions, Reports, Meeting Minutes and Public Deeds. Information was organized as from literature and Eliot Freidson's conceptions, and thematic content analysis was carried out. Results: the concepts authored by Eliot Freidson allowed for the development of a concept chart that portrays the nursing profession and that may be expanded for the other occupations in the health field, in consonance with professional organization in the country. Final Considerations: Eliot Freidson's framework, in interpretation for nursing, consolidates the profession with relative autonomy, expertise by Nursing Care Systematization and credentialism by professional normalizations.

RESUMEN Objetivos: analizar las concepciones teóricas de la Sociología de las Profesiones de Eliot Freidson para el alcance de las profesiones de salud y enfermería. Métodos: estudio sociohistórico cualitativo, con fuentes orales y documentales. Se entrevistó a ocho enfermeras involucradas en el desarrollo del Consejo Profesional en el período de 1975 a 1986. Los documentales fueron Leyes, ordenanzas, resoluciones, informes, actas de reuniones y escrituras públicas. La información se organizó a partir de la literatura y las concepciones de Eliot Freidson, y se realizó un análisis de contenido temático. Resultados: los conceptos emitidos por Eliot Freidson permitieron la creación de un marco conceptual que represente a la profesión de enfermería, que podría ampliarse a otras profesiones de la salud, en línea con la organización profesional del país. Consideraciones Finales: el marco de Eliot Freidson, en interpretación de enfermería, consolida la profesión con relativa autonomía, experiencia en Sistematización de la Atención de Enfermería y credencialismo en los estándares profesionales.

RESUMO Objetivos: analisar as concepções teóricas da Sociologia das Profissões de Eliot Freidson para o âmbito das Profissões da Saúde e da Enfermagem. Métodos: estudo qualitativo sócio-histórico, com fontes orais e documentais. Foram entrevistados oito enfermeiros envolvidos no desenvolvimento do Conselho profissional no recorte temporal de 1975 a 1986. As documentais foram Leis, Portarias, Resoluções, Relatórios, Atas de Reuniões e Escrituras Públicas. As informações foram organizadas a partir da literatura e concepções de Eliot Freidson, e realizada análise de conteúdo temática. Resultados: os conceitos emitidos por Eliot Freidson permitiram a criação de um Quadro conceitual que representa a Profissão Enfermagem, podendo ser ampliado para as demais profissões da área da Saúde, em consonância com a organização profissional no país. Considerações Finais: o referencial de Eliot Freidson, em interpretação para a Enfermagem, consolida a profissão com autonomia relativa, expertise pela Sistematização da Assistência de Enfermagem e credencialismo pelas normalizações profissionais.

Factores asociados con somnolencia diurna excesiva en estudiantes de Medicina de una institución de educación superior de Bucaramanga / Factors Associated with Excessive Daytime Sleepiness in Medical Students of a Higher Education Institution of Bucaramanga

RESUMEN Introducción: La somnolencia diurna excesiva (SDE) puede llegar a interferir en el desempeño académico y profesional, debido a que las personas afectadas tienden a quedarse dormidas en situaciones que exigen un alto nivel de atención. Los estudiantes de Medicina representan una población en riesgo de SDE, dada la exigencia académica de numerosas horas de estudio, debido al gran número de créditos por asignatura contenidos en el plan de estudios del programa académico, las prácticas docentes asistenciales y los turnos nocturnos, que pueden generar privación o déficit acumulado del sueño. Por esta razón, es importante estimar la prevalencia de SDE y los factores asociados en estudiantes de Medicina de una institución de educación superior (IES) de Bucaramanga, con el objetivo de implementar estrategias de prevención primaria que disminuyan la presentación de este problema y mejoren la calidad de vida y el desempeño académico de los estudiantes. Material y métodos: Estudio transversal analítico observacional, con una muestra poblacional de 458 estudiantes de Medicina matriculados en el segundo semestre de 2015 en la Universidad Autónoma de Bucaramanga (UNAB), quienes respondieron a 4 cuestionarios: variables sociodemográficas, escala de somnolencia de Epworth, índice de calidad del sueño de Pittsburg (ICSP) e índice de higiene del sueño (IHS). Se realizó el análisis bivariable y multivariable en busca de asociación con SDE. Resultados: Los estudiantes tenían una media de edad de 20,3 arios; de los 458 encuestados, el 62,88% eran mujeres. Se estableció que el 80,75% de los participantes tenían SDE y el 80,55%, una percepción negativa de la calidad del sueño (OR = 1,91;IC95%, 1,11-3,29; p = 0,019). En el análisis multivariable, se encontró que el hecho de estar cursando ciencias clínicas disminuye el riesgo de SDE respecto a quienes estaban cursando el ciclo básico. Además, se observó que una puntuación > 15 en el IHS aumenta de manera significativa el riesgo de padecer SDE. Conclusiones: Aunque es frecuente encontrar SDE en los estudiantes de Medicina, solo un pequeño porcentaje de ellos sufren la forma severa de este trastorno del sueño. Estar cursando asignaturas del ciclo básico se asocia con mayor riesgo de SDE, por lo cual es importante que los comités curriculares de las IES evalúen regularmente la cantidad de horas de trabajo supervisado e independiente que realizan los estudiantes de Medicina. Finalmente, es importante emprender campañas orientadas a mejorar la percepción de riesgo sobre el uso de bebidas energizantes de los estudiantes universitarios y realizar, desde el ingreso al programa académico, recomendaciones sobre los hábitos de higiene del sueño.

ABSTRACT Introduction: Excessive daytime sleepiness (EDS) can interfere with academic and professional performance, as affected individuals tend to fall asleep in situations that demand a high level of alertness. Medical students are often a population at risk of suffering from EDS due to the demanding number of study hours, the significant number of credits per subject in the academic curriculum, practical teaching sessions and hospital night shifts, which can lead to sleep deprivation or sleep debt. It is for these reasons that it is important to estimate the prevalence of EDS and its associated factors in medical students of a Higher Education Institution (HEI) in Bucaramanga, in order to implement early prevention strategies to reduce the occurrence of this problem and to improve the students' quality of life and academic performance. Material and methods: An observational, cross-sectional analytical study with a population sample of 458 medical students enrolled in the second semester of 2015 at the Universidad Autonomade Bucaramanga (UNAB), who completed four questionnaires: Sociodemographic Variables, Epworth Sleepiness Scale, Pittsburgh Sleep Quality Index and Sleep Hygiene Index (SHI). A bivariate and multivariate analysis was performed to identify any correlations with EDS. Results: Mean student age was 20.3 years and 62.88% of the 458 respondents were women. We were able to establish that 80.75% of participants suffered from EDS and 80.55% had a negative perception of their sleep quality (OR=1.91; 95% CI, 1.11-3.29; p =0.019). In the multivariate analysis, it was found that the risk of EDS is lower in the clinical sciences than in the basic cycle. Furthermore, it was noted that a score higher than 15 in the Sleep Hygiene Index significantly increases the risk of suffering from EDS. Conclusions: Although EDS is very common in medical students, only a small percentage present the most severe form of this sleep disorder. Being enrolled in basic cycle subjects is associated with a higher risk of suffering EDS, so it is important for the curriculum committees of higher education institutions to regularly evaluate the number of hours of supervised and independent work performed by medical students. Finally, it is important to implement campaigns aimed at improving university students' perception of the risk of taking energy drinks and to establish sleep hygiene recommendations from the start of the academic programme.

Evidências de validade baseadas na estrutura interna para escala de atitude empreendedora (ATEBr) / Validity evidences through internal structure for entrepreneurial attitude scale (ATEBr) / Evidencia de validez a través de la estructura interna para escala de actitud emprendedora (ATEBr)

O empreendedorismo é um fenômeno multideterminado, sendo relevante a compreensão dos aspectos pessoais associados ao tema. O presente estudo objetivou analisar evidências de validade baseada na estrutura interna para uma medida adaptada de atitude empreendedora numa amostra de 272 estudantes universitários. Para análise da estrutura interna da escala foi realizada análise fatorial exploratória. Foi encontrada uma solução fatorial de cinco fatores para o contexto brasileiro (liderança, realização, risco, controle e criatividade). A confiabilidade dos fatores da medida foi estimada por meio dos coeficientes alfa e ômega para dados ordinais variando entre 0,56 e 0,74. Recomenda-se o uso da escala em estudos ulteriores, a fim de apurar evidências de validade em outros contextos e investigar variáveis antecedentes e consequentes de atitude empreendedora que otimizem as condições de avaliação do empreendedorismo nas práticas de orientação profissional.

Entrepreneurship is a multidetermined phenomenon, being relevant the understanding of the personal aspects associated with it. The present study aimed to analyze evidence of validity based on the internal structure for an adapted measure of entrepreneurial attitude in a sample of 272 university students. For the analysis of the internal structure of the scale, an exploratory factorial analysis was performed. It was found a factorial solution of five factors for the Brazilian context (leadership, achievement, risk, control and creativity). The reliability of the measurement factors was estimated by means of the alpha and omega coefficient for ordinal data varying between 0.56 and 0.74. It is recommended to use the scale in further studies in order to ascertain evidence of validity in other contexts and to investigate relevant variables and consequent of an entrepreneurial attitude that optimize the conditions for evaluating entrepreneurship in professional orientation practices.

El emprendedorismo es un fenómeno multideterminado y resulta relevante la comprensión de las características personales implicadas. El presente estudio tuvo como objetivo encontrar evidencias de validez de estructura interna en la escala de medición de actitud emprendedora en una muestra de 272 estudiantes universitarios brasileños. Para analizar la estructura interna de la escala, se realizó un análisis factorial exploratorio. Se encontró una solución compuesta por cinco factores para el contexto brasileño (liderazgo, necesidad de logro, riesgo, control y creatividad). Se estimó la confiabilidad usando coeficientes alfa y omega ajustados a datos de nivel ordinal, varando entre 0.56 y 0.74. Se recomienda el uso de la escala en estudios posteriores para establecer evidencias de validez en otros contextos e investigar variables antecedentes y consecuentes de actitud emprendedora que optimicen las condiciones de evaluación del emprendedorismo en las prácticas de orientación profesional.

Attitudes toward rehabilitating inmates among occupational therapy students in the United States / 보건의료교육평가

PURPOSE: This study was to examine occupational therapy (OT) students' attitudes toward rehabilitating inmates and validate an instrument used to measure their attitudes. METHODS: OT students (n=128) from one university in Alabama, United States, completed an online survey exploring their attitudes toward rehabilitating inmates, which was assessed using the Rehabilitation Orientation Scale (ROS), a 7-point scale. Dimensional structure, internal consistency reliability, construct validity, and relations to other variables of the ROS was evaluated using factor analyses, Cronbach's alpha, known-groups method, and univariable correlations, respectively. RESULTS: Unidimensionality of the ROS was confirmed with an alpha coefficient of 0.90. The mean ROS score of the respondents was 5.1; a score toward 7 indicated a more supportive attitude. About 60% of the respondents reported supportive attitudes (i.e., an ROS score ≥5). Respondents' ROS scores were significantly higher than those of the public and criminal justice professionals. Female students reported a more supportive attitude than males. Multiple regression analysis indicated that respondents' consideration of working in prison settings after graduation and their perception that OT has a role in prison settings were significantly associated with support for rehabilitating inmates, after controlling for gender and an acquaintance with someone who has been incarcerated. CONCLUSION: Results indicated that the ROS demonstrated adequate psychometric properties as it applied to this population. The majority of respondents reported supportive attitudes toward rehabilitating inmates. Consideration of working in prison settings after graduation and the perception that OT has a role in prison settings were 2 independent factors associated with respondents' attitudes toward rehabilitating inmates.

Applying a mixed methods design for needs assessment of an international fellowship training program for Mongolian health professions / 한국의학교육

PURPOSE: Continuing professional development is essential for improving health care services, especially in developing countries. Most of the training programs in Mongolia were not based on a targeted needs assessment. Therefore, we aimed to apply a mixed methods design to assess the training needs of Mongolian health professions. METHODS: We conducted a needs assessment using a convergent parallel mixed methods design in two steps. The survey and interview questions were developed to identify priority areas, targeted trainees, and effective training methods. A survey on 60 respondents, 15 individual interviews, and a focus group interview with 14 participants were conducted in the first step. In the second step, 12 representatives of key stakeholders were invited to a second focus group interview. RESULTS: Current health policy areas, areas related to future national plans, and areas not currently receiving governmental or international support were suggested as the main priorities. The stakeholder suggested that trainees should be selected based on their professional experience and language level, as well as each hospital’s needs. Building teams including various professions, such as nurses, technicians, and biomedical engineers, was recommended as a way to exchange ideas with each other and to build teamwork for future collaboration. CONCLUSION: Medical training needs are dynamic and complex; therefore, a deep understanding of the context and setting is necessary. In this study, we assessed the targeted training needs of Mongolian health professions through a mixed methods design, which could be an effective way to conduct needs assessments for training programs.