Methodology for the Development of Clinical Practice Guidelines for Chinese Patent Medicine（Part 3）： Identification of Clinical Questions / 中医杂志

The identification of clinical questions for clinical practice guidelines of Chinese patent medicine （CPM） is important for subsequent evidence retrieval， evaluation of evidence quality， formation of recommendations. This paper described a methodological proposal for the identification of clinical questions for CPM guidelines to highlight the characteristics of Chinese patent medicine and reflect its effect in specific stage of the disease. Considering four aspects， namely， the drug of Chinese patent medicine （D）， the specific disease stage （S）， comparison （C）， and specific outcome （O）， DSCO framework has been proposed to formulate the clinical questions. Multi-source information through scientific research， policy or standard documents， and clinical data are suggested for collecting clinical questions， and clear selection criteria should be set to finalize the clinical questions to be addressed by the guideline. In addition， the above process needs to be transparently and publicly reported in order to ensure the clarity and completeness of the guidelines.

¿Cuántos años tienes?, ¿estás casado?, ¿tienes hijos? preguntas irrelevantes y discriminación encubierta en la selección de personal / How old are you? are you married? do you have children? irrelevant questions and covert discrimination in personnel selection / Quantos anos você tem? você é casado? você tem filhos? perguntas irrelevantes e discriminação oculta na seleção de pessoal

La selección de personal ha demostrado ser un procedimiento de incalculable valor para las organizaciones. Sin embargo, en la práctica los empleadores suelen (y prefieren) utilizar los métodos de selección de escaza y cuestionable evidencia. En el contexto boliviano, el uso de preguntas personales relacionadas a la edad, estado civil, sexo, raza, embarazo, entre otros, parece estar bastante extendido. Aunque, la utilidad que justifique su inclusión sigue sin demostrarse. En el presente artículo, analizo la relevancia y el soporte de las preguntas personales en función de su contribución para tres propósitos de la selección de personal: validez para predecir el desempeño laboral, reclutamiento y discriminación. Finalmente, proporciono algunas sugerencias: (1) para mejorar la eficiencia de los procesos de selección, y (2) para enmendar y fortalecer las leyes contra la discriminación en la selección de la legislación laboral boliviana.

The selection of personnel has proven to be an invaluable procedure for organizations. However, in practice employers often (and prefer) to use the selection methods of scarce and questionable evidence. In the Bolivian context, the use of personal questions related to age, marital status, sex, race, pregnancy, among others, seems to be quite widespread. Although the usefulness that justifies its inclusion remains unproven. In this article, I analyze the relevance and support of personal questions based on their contribution to three purposes of personnel selection: validity to predict job performance, recruitment, and discrimination. Finally, I provide some suggestions: (1) to improve the efficiency of the selection processes, and (2) to amend and strengthen the laws against discrimination in the selection of Bolivian labor law.

A seleção de pessoal provou ser um procedimento inestimável para as organizações. No entanto, na prática, os empregadores costumam (e preferem) usar métodos de seleção de evidências escassas e questionáveis. No contexto boliviano, o uso de perguntas pessoais relacionadas à idade, estado civil, sexo, raça, gravidez, entre outros, parece ser bastante difundido. Embora a utilidade que justifique a sua inclusão permaneça não comprovada. Neste artigo, analiso a relevância e o suporte de perguntas pessoais com base em sua contribuição para três propósitos de seleção de pessoal: validade para prever o desempenho no trabalho, recrutamento e discriminação. Finalmente, apresento algumas sugestões: (1) melhorar a eficiência dos processos de seleção e (2) alterar e fortalecer as leis contra a discriminação na seleção da legislação trabalhista boliviana.

Effects of an easy neuroanatomy book with schematics on student learning / Efectos de un libro sencillo de neuroanatomía con esquemas sobre el aprendizaje de los estudiantes

SUMMARY: Numerous students perceive neuroanatomy as a particularly difficult subject due to its overwhelming complexity. Therefore, a neuroanatomy book that concentrates on easy-to-read stories with schematics rather than exhaustive details has been published. This study evaluates the effect of a trial of the new neuroanatomy book on student learning. From the book, a printout on the brainstem and cranial nerve was extracted. Medical students read the printout, and subsequently were examined on their knowledge of and interest in neuroanatomy. Students who read the extract answered examination questions relatively well and were more interested in neuroanatomy. The printout seemed to enhance the knowledge and concentration of the students. After grasping the fundamental information in the book, students are expected to be able to learn advanced concepts comfortably and confidently. In addition, the book with its concise and simple content is suitable not only for short- duration neuroanatomy courses but also for self-learning.

Muchos estudiantes perciben la neuroanatomía como un tema particularmente difícil debido a su abrumadora complejidad. Por lo tanto, se ha publicado un libro de neuroanatomía que se concentra en historias fáciles de leer con esquemas en lugar de detalles exhaustivos. Este estudio evalúa el efecto de una prueba del nuevo libro de neuroanatomía en el aprendizaje de los estudiantes. Del libro, se extrajo una impresión sobre el tronco encefálico y los nervios craneales. Los estudiantes de medicina leyeron la copia impresa y, posteriormente, se les examinó su conocimiento e interés por la neuroanatomía. Los estudiantes que leyeron el extracto respondieron relativamente bien a las preguntas del examen y estaban más interesados en la neuroanatomía. La impresión parecía mejorar el conocimiento y la concentración de los estudiantes. Después de comprender la información fundamental del libro, se espera que los estudiantes puedan aprender conceptos avanzados con comodidad y confianza. Además, el libro con su contenido conciso y simple es adecuado no solo para cursos de neuroanatomía de corta duración, sino también, para el autoaprendizaje.

Discussion on the relationship between yuan-source points of yang meridians and diseases of fu- organs / 中国针灸

Huangdi Neijing (Yellow Emperor 's Canon of Medicine) establishes the theory that yuan-source points are indicated in zangfu diseases. However, compared with the yuan-source points of yin meridians for the treatment of zang-organ diseases, there is less attention to the indication of yuan-source points of yang meridians for fu-organ diseases, and this statement is even questioned. Collating the early literature and associating with the researches of medical experts, it is found that Nanjing (Classic of Difficult Questions) should be the theoretic origin that yuan-source points of yang meridians are indicated in fu-organ diseases. Regarding the reasons why this theory has not received clinical attention, the three aspects are involved, i.e. the theoretic completion of "he-sea points of three-foot-yang meridians for the diseases of six fu-organs", the limitation of the theory itself, and the lack of literature materials. It is proposed that the exploration on this theory should be deepened in views of the essence of yuan-source points relevant with the characteristic of the wrist-ankle pulse palpation region, acupoint combination, modern technology, etc.

A survey on clinical practice of digestive endoscopy in county-level hospitals of Yunnan Province / 中华消化内镜杂志

Objective:To analyze general information, diagnosis and treatment of digestive endoscopy departments in county-level hospitals of Yunnan Province, thus to provide evidence for improving the endoscopic diagnosis and therapy in these hospitals.Methods:An online survey was performed to collect quality-related information of digestive endoscopy centers (departments) at county-level hospitals of Yunnan from January 2019 to January 2020, including endoscopic equipment, endoscopic techniques, staffing, number of operations, and quality control.Results:A total of 143 county-level hospitals were involved in this study. Each hospital owned only 1.74 endoscopy operation rooms on average, 1.42 regular endoscopy workstation, 4 endoscopes. There were only 10 endoscopic ultrasonography workstations and 2 enteroscopy workstations respectively installed in these hospitals. Endoscopic retrograde cholangiopancreatography was independently performed in only 4 hospitals. There were 392 professional endoscopists in all 143 hospitals, 18.62% (73/392) of whom were able to perform endoscopic therapy of grade 4, while only 6.12% (24/392) of whom could perform endoscopic submucosal dissection (ESD) independently. In 2019, the early diagnostic rate of gastrointestinal tract cancer in these hospitals was 19.48% (1 133/5 817). The early diagnostic rate was 21.04% (276/1 312) for esophageal cancer, 19.53% (397/2 033) for gastric cancer, and 18.61% (460/2 472) for colorectal cancer. The colorectal adenoma detection rate was 12.83% (12 207/95 148). The rate of reaching cecum during colonoscopy was 70.49% (67 067/95 148). The complete resection rate of ESD was 12.54% (221/1 763).Conclusion:The general situation of digestive endoscopy in county-level hospitals of Yunnan is far from being well-developed, which may be attributed to slow upgrading of equipments, inadequate training of endoscopic professionals and undemanding quality control. It is highly significant to improve medical service and quality of diagnosis and treatment of digestive endoscopy in these hospitals, on the basis of a complete endoscopy quality control system with a high standard.

Planteamiento del problema de un proyecto de investigación: escritura y formulación en ciencias de la salud

El planteamiento del problema de investigación es el punto de partida de toda investigación científica y es de suma importancia que se realice adecuadamente. Por esta razón, es fundamental tener claro que el desarrollo de un adecuado problema de investigación es un proceso complejo y está compuesto por cinco partes. En primer lugar, se debe definir la condición clínica de interés y tener total claridad sobre ella; se recomienda escribir una pequeña descripción de la enfermedad que sirva como marco de referencia para el problema. Posteriormente, se debe expresar el problema en términos de una situación adversa o negativa (morbilidad, mortalidad, costos, entre otros), bien sea para el paciente, su familia, el sistema de salud o la sociedad. En tercer lugar, el problema de investigación implica que haya un vacío o discrepancia en el conocimiento sobre dicha situación negativa; para identificarlo es necesario llevar a cabo una revisión completa y precisa de la literatura, idealmente una revisión sistemática, con el fin de tener presente las respuestas encontradas en investigaciones previas. Luego, se deben estimar las implicaciones o beneficios prácticos que pueda traer el resolver dicho problema. Finalmente, el problema de investigación se debe concretar de forma justificada y estructurada, dando lugar a la pregunta de investigación. Además, el investigador debe determinar si su pregunta de investigación cumple con los elementos necesarios para ser adecuada, los cuales se resumen en la mnemotecnia FINER (factible, interesante, novedosa, ética y relevante).

The research problem statement is the starting point of all scientific research, and it is crucially important that this step is carried out correctly. For this reason, it is essential to be aware that the development of a suitable research problem is a complex process that has five parts. First, the clinical condition of interest must be defined, and it is essential to have total clarity about it; it is recommended to write a short description of the disease that serves as a frame of reference for the problem. Subsequently, the problem must be expressed regarding an adverse situation (morbidity, mortality, costs, among others), either for the patient, family, the health system, or society. Third, the research problem implies that there's a gap or discrepancy in current knowledge about said negative situation; to identify it, it is necessary to carry out a comprehensive review of the literature to consider the answers found in previous research. Then, the practical implications or benefits of solving said problem must be estimated. Finally, the research problem must be specified in a justified and structured manner giving place to the research question. In addition, the researcher must be able to determine if his research question meets the necessary elements to be adequate, which are summarized in the mnemonic FINER (feasible, interesting, novel, ethical and relevant).

¿Cuántos años tienes?, ¿estás casado?, ¿tienes hijos? preguntas irrelevantes y discriminación encubierta en la selección de personal

La selección de personal ha demostrado ser un procedimiento de incalculable valor para las organizaciones. Sin embargo, en la práctica los empleadores suelen (y prefieren) utilizar los métodos de selección de escaza y cuestionable evidencia. En el contexto boliviano, el uso de preguntas personales relacionadas a la edad, estado civil, sexo, raza, embarazo, entre otros, parece estar bastante extendido. Aunque, la utilidad que justifique su inclusión sigue sin demostrarse. En el presente artículo, analizo la relevancia y el soporte de las preguntas personales en función de su contribución para tres propósitos de la selección de personal: validez para predecir el desempeño laboral, reclutamiento y discriminación. Finalmente, proporciono algunas sugerencias: (1) para mejorar la eficiencia de los procesos de selección, y (2) para enmendar y fortalecer las leyes contra la discriminación en la selección de la legislación laboral boliviana.

The selection of personnel has proven to be an invaluable procedure for organizations. However, in practice employers often (and prefer) to use the selection methods of scarce and questionable evidence. In the Bolivian context, the use of personal questions related to age, marital status, sex, race, pregnancy, among others, seems to be quite widespread. Although the usefulness that justifies its inclusion remains unproven. In this article, I analyze the relevance and support of personal questions based on their contribution to three purposes of personnel selection: validity to predict job performance, recruitment, and discrimination. Finally, I provide some suggestions: (1) to improve the efficiency of the selection processes, and (2) to amend and strengthen the laws against discrimination in the selection of Bolivian labor law.

A seleção de pessoal provou ser um procedimento inestimável para as organizações. No entanto, na prática, os empregadores costumam (e preferem) usar métodos de seleção de evidências escassas e questionáveis. No contexto boliviano, o uso de perguntas pessoais relacionadas à idade, estado civil, sexo, raça, gravidez, entre outros, parece ser bastante difundido. Embora a utilidade que justifique a sua inclusão permaneça não comprovada. Neste artigo, analiso a relevância e o suporte de perguntas pessoais com base em sua contribuição para três propósitos de seleção de pessoal: validade para prever o desempenho no trabalho, recrutamento e discriminação. Finalmente, apresento algumas sugestões: (1) melhorar a eficiência dos processos de seleção e (2) alterar e fortalecer as leis contra a discriminação na seleção da legislação trabalhista boliviana.

Efecto del orden de las preguntas de selección múltiple en los resultados de exámenes de cardiología / Effect of order of multiple-choice questions on the results of cardiology exams

RESUMEN Introducción: Algunos autores han señalado que el armado de un examen con preguntas aleatorias puede perjudicar el rendimiento de los estudiantes. A partir de la pandemia por COVID -19 y del aislamiento social obligatorio, las actividades de educación médica de posgrado pasaron a la modalidad virtual y los exámenes se implementaron online. Objetivo: Estudiar si el ordenamiento al azar de las preguntas tiene algún efecto en los resultados de los exámenes. Material y métodos: Se redactaron 2 exámenes: uno sobre Prevención de la enfermedad cardiovascular y otro sobre Valvulopatías. Para cada uno de los temas se confeccionaron dos cuestionarios: una versión con las preguntas en el orden lógico y según dificultad estimada, y otra con las mismas preguntas distribuidas al azar. Cada examen tenía 50 preguntas de selección múltiple con 3 opciones. Puntaje máximo posible: 50 Los exámenes fueron administrados en plataforma Moodle, modalidad sincrónica, tiempo disponible 75 minutos. Los resultados se expresaron en puntajes obtenidos (rango y valores de tendencia central) y según el índice de dificultad de las preguntas. Resultados: Respondieron 284 residentes, alumnos del Curso Bianual de Cardiología. Dos grupos de 1° año (tema Prevención) y dos grupos de 2° año (Valvulopatías). No hubo diferencia entre los resultados de las dos versiones del mismo examen. Conclusiones: Este estudio careció de la potencia suficiente para fundamentar una u otra forma de ordenar las preguntas de los exámenes de ciencias clínicas. Surgieron nuevas preguntas que deberán ser respondidas en futuros estudios.

ABSTRACT Background: Some authors have pointed out that setting up an exam with random questions can impair student performance. Since the COVID-19 pandemic and compulsory social isolation, postgraduate medical education activities became virtual and exams were implemented online. Objective: The aim of the study was to analyse whether the random order of questions has any effect on test results. Method: Two exams were written: one on the Prevention of Cardiovascular Disease and another on Heart Valve Diseases. For each topic, two questionnaires were designed: a version with the questions in logical order and according to the estimated difficulty and another with the same questions randomly distributed. Each exam had 50 multiple-choice questions with 3 options, and the maximum possible score was 50 The exams were taken on the Moodle platform, with synchronous modality, and the time available was 75 minutes. The results were expressed as scores obtained (range and central tendency) and according to the index of difficulty of the questions. Results: The number of respondents was 284 residents, students of the Biannual Cardiology Course: two 1st year groups (Prevention topic) and two 2nd year groups (Valve diseases). There was no difference between the results of the two versions of the same exam. Conclusions: This study lacks sufficient power to support either way of question order in clinical sciences exams, giving rise to new queries.

ANALYSIS OF STUDENT'S FEEDBACK ON DIFFERENT FORMATS OF WRITTEN ASSESSMENT IN UNDERGRADUATE MEDICAL EDUCATION

OBJECTIVE: To assess the undergraduate medical student's preference among different formats of written assessment. MATERIAL AND METHOD: Cross sectional study was conducted on Phase I and phase II undergraduate medical students with prior information and consent. Lecture was delivered on a topic for both phases followed by a test with same question in different formats and a questionnaire on student's feedback on these formats. RESULTS: Majority of students of both phases preferred Multiple choice questions over other three formats as it was easier to answer, time saving, enjoyable, can fetch more marks and free of evaluator bias. Other formats also had their advantages and drawbacks. CONCLUSION:Assessment of any format of written assessments can usually assess any level of cognitive domain with properly framed questions and model answers although students may prefer a particular one

Prospective of scientific questions and key techniques in radiological health / 中华放射医学与防护杂志

The radiological health in China has been comprehensively progressing since The People′s Republic of China was founded. The outstanding achievement in radiological health field has been obtained, after lots of research work and practical applications have been completed. In order to provide the references and enlighten the ideas for domestic scientific institutes and colleagues in radiological health, this paper explicated the scientific questions and the bottleneck of techniques which needs to be explored in near future. The fields are including not only the protection and safety in occupational radiation, medical radiation, population radiation and emergency radiation, but also the radiation biological effects and its mechanism.

Análise da adequação dos itens do Teste de Progresso em medicina / Item analysis of Progress Test in medicine

Resumo: Introdução: A avaliação do estudante deve induzir aprendizagem e ser baseada em competência, ou seja, avaliar (habilidades cognitivas, psicomotoras e afetivas). Para avaliar conhecimento e a habilidade para sua utilização no contexto profissional, o Teste de Progresso (TP) tem sido usado em larga escala, com finalidade somativa e principalmente formativa. Objetivo: Este estudo teve como objetivo verificar a adequação e qualidade de itens que compõem os TP realizados pelos estudantes. Método: Trata-se de estudo exploratório descritivo e retrospectivo que analisou todos os itens de seis provas do TP aplicado a estudantes de Medicina do primeiro ao sexto ano da Faculdade de Medicina de Ribeirão Preto/USP, no período de 2013 a 2018. Os sete indicadores de boas práticas foram: 1. abordar tema relevante na formação médica; 2. ter enunciado maior que as alternativas; 3. avaliar aplicação do conhecimento; 4. definir pergunta clara para o item no enunciado; 5. avaliar apenas um domínio do conhecimento em cada item; 6. ter resposta correta e distratores homogêneos e plausíveis; 7. ausência de erros no item que acrescentam dificuldade desnecessária ou dão pistas da resposta correta. Dois avaliadores independentes analisaram as questões e, quando necessário, revisavam em conjunto os itens discordantes. Resultado: A análise das provas permitiu identificar boa qualidade técnica na maioria dos itens das seis provas, além de indicar que a não adesão foi mais frequente nos indicadores 4 e 5, que podem comprometer tanto a validade quanto a interpretação dos resultados da prova em termos de lacunas do conhecimento por parte dos estudantes. Conclusão: A qualidade das questões das provas analisadas é muito boa, mas foi possível identificar oportunidades de melhoria no processo de elaboração de itens, que servem de base para o desenvolvimento docente dos elaboradores da instituição.

Abstract: Introduction: Assessment drives learning and should follow a competence-based approach. The Progress Test (PT) has been used on a large scale for summative and mainly formative purposes to assess knowledge and the ability to use it in the professional context. Objective: To check the adequacy and quality of the items and that make up the progress tests sat by students. Method: Descriptive and retrospective exploratory study that analyzed all the items of six PT exams applied to medical students from the first to the sixth year of the Faculty of Medicine of Ribeirão Preto/USP, from 2013 to 2018. The seven indicators of good practices were: 1. Addresses a relevant topic in medical training; 2. Statement longer than key answer and distractors; 3. Application of knowledge evaluated; 4.Clear lead-in defined for the item in the statement; 5. Only one domain of knowledge assessed in each item; 6.Plausible and homogeneous key answer and distractors; 7.Absence of flaws that add unnecessary difficulty or give clues to the correct answer. Two independent evaluators analyzed the items and, if necessary, they jointly reviewed any disagreement. Result: The analysis showed a good technical quality of most items in the six PT exams. In addition, they indicated that non-adherence was a bit more frequent for indicators 4 and 5, which can compromise both the validity and the interpretation of the test results in terms of knowledge gaps on the part of students. Conclusion: In general, the quality of the items was very good but there are some opportunities for improvement in the process of item writing based on faculty development within the institution.

Twenty key issues on severe acute respiratory syndrome coronavirus-2 vaccination in children / 中华实用儿科临床杂志

Severe acute respiratory syndrome coronavirus-2(SARS-CoV-2)infection is still worldwide.As a vulnerable group, severe and dead pediatric cases are also reported.Under this severe epidemic situation, children should be well protected.With the widespread vaccination of SARS-CoV-2 vaccine in adults, the infection rate have decreased.Therefore, SARS-CoV-2 vaccine inoculation for children groups step by step is of great significance to the protection of children and the prevention and control of corona virus disease 2019(COVID-19) as a whole.But the safety of children vaccinated with SARS-CoV-2 vaccine is a main concern of parents.Therefore, in order to ensure the safety of vaccination and the implementation of vaccination work, National Clinical Research Center for Respiratory Diseases, National Center for Children′s Health and the Society of Pediatrics, Chinese Medical Association organized experts to interpret the main issue of parents about SARS-CoV-2 vaccine for children, in order to answer the doubts of parents.

A educação física no ensino médio e os exames estandardizados: uma análise das questões do enem / La educación física en la enseñanza secundaria y los exámenes estandarizados: un análisis de las preguntas del enem / Physical education in high school and standardized exams: an analysis of the issues in enem

Resumo O artigo analisa as questões do novo Enem que apresentam objetos de conhecimento da Educação Física, compreendendo as relações que se estabelecem por e entre as áreas do conhecimento mediadas pelas competências e habilidades. De natureza qualitativa, utiliza a análise crítico-documental como metodologia. As fontes são compostas por: 49 questões relacionadas com a Educação Física no exame (2009 a 2017), as Diretrizes Nacionais para o Ensino Médio, o Documento Básico do Enem e a Matriz de Referência do Enem. Os usos e apropriações dos objetos de conhecimento da Educação Física, devido à sua natureza multidisciplinar, favorecem a exigência da elaboração das questões do exame visando à interdisciplinaridade por e entre as áreas do conhecimento, explorando as relações cotidianas dos sujeitos. A interação entre os objetivos da área de Linguagens e suas Tecnologias, promovida pelo exame, permite-nos compreender a Educação Física dentro de um contexto amplo de formação, para além do saberes de domínio.

Resumen El estudio analiza las preguntas del Nuevo Enem (Examen Nacional de la Enseñanza Media) que presentan objetos de conocimiento de la Educación Física, abarcando las relaciones que se establecen por y entre las áreas de conocimiento mediadas por competencias y habilidades. De naturaleza cualitativa, utiliza el análisis crítico-documental como metodología. Las fuentes están compuestas por: 49 preguntas relacionadas con la Educación Física en el examen (2009 a 2017), las Directrices Nacionales para la Enseñanza Media, el Documento Básico del Enem y la Matriz de Referencia del Enem. Los usos y apropiaciones de los objetos de conocimiento de la Educación Física, por su carácter multidisciplinario, favorecen la exigencia de elaborar las preguntas del examen buscando la interdisciplinariedad por y entre las áreas de conocimiento, explorando las relaciones cotidianas de los sujetos. La interacción entre los objetivos del área de Lenguas y sus Tecnologías, impulsada por el examen, nos permite comprender la Educación Física dentro de un amplio contexto de formación, más allá de los saberes del campo.

Abstract The article analyzes the issues that contain the Physical Education present in Novo Enem, understanding the relationships established by and between the areas of knowledge mediated by competences and abilities. Of the qualitative type, it uses documentary critical analysis as a methodology. The sources are composed of: 49 questions related to Physical Education in the exam (2009 to 2017), the National Guidelines for Secondary Education, the Basic Document of Enem and the Reference Matrix of Enem. The uses and appropriations of the contents of Physical Education, due to its multidisciplinary nature, favors the requirement to elaborate the exam questions aiming at interdisciplinarity by and between the areas of knowledge, exploring the subjects' daily relationships. The interaction between the objectives of the Languages, Codes and their Technologies area, promoted by the exam, allows us to understand Physical Education within a broad context of training, in addition to domain knowledge.

Parliament's (lack of) agenda-setting power over the executive decision agenda: evidence from Belgium, France and Portugal / (La falta de) Poder de definición de agenda del parlamento sobre la agenda de decisiones ejecutivas: evidencias de Bélgica, Francia y Portugal / (A falta de) Poder de definição de agenda do parlamento sobre a agenda de decisões executivas: evidências da Bélgica, França e Portugal

Abstract One of the functions of parliamentary questions in modern legislatures is to pressure executives to pay attention to specific issues. But can these questions effectively influence executive decisions? There is surprisingly little empirical research in this area. Adopting an agenda-setting perspective, this article examines the extent to which issue attention in oral parliamentary questions influences the issues addressed in the weekly meetings of the Council of Ministers in three countries (Belgium, France and Portugal). Our findings suggest that the agenda-setting power of parliaments vis-à-vis the executive is usually weak in the contexts studied here. In Belgium, we find evidence that the executive does pick up on issues debated in parliament but that the media seems to play a crucial role in focusing attention. These conclusions testify to the dominance of the executive power in many Western democracies. The findings also demonstrate that agenda-setting patterns are more complex than single-country studies often suggest, and that comparative research is the way forward.

Resumen Una de las funciones de las preguntas parlamentarias en los espacios legislativos modernos es presionar para que los actores del ejecutivo presten atención a cuestiones específicas. Pero, ¿pueden estas preguntas influir de hecho en las decisiones del ejecutivo? Aunque parezca increíble, existen pocas investigaciones empíricas en esa área. Adoptando una perspectiva de agenda-setting, este artículo examina hasta qué punto la atención dada a las preguntas formuladas oralmente por parlamentarios influencia los temas abordados en las reuniones semanales del consejo de ministros en tres países (Bélgica, Francia y Portugal). Nuestras conclusiones sugieren que, en los contextos analizados, el poder de definición de agenda de los parlamentos en relación con el ejecutivo generalmente es débil. En Bélgica, no obstante, hay evidencia de que el Poder Ejecutivo aborda las preguntas de los parlamentarios. En este caso, vale enfatizar que los medios desempeñan un papel crucial al influir para que las cuestiones planteadas en el Legislativo reciban atención. Esas conclusiones demuestran el dominio del poder ejecutivo en muchas democracias occidentales. Además, los resultados variados sugieren que los parones de definición de agenda son más complejos de lo que frecuentemente se observa en los estudios que se enfocan solamente en un país, lo que lleva a pensar que la investigación comparativa es el camino a seguir.

Resumo Uma das funções das perguntas parlamentares nos espaços legislativos modernos é pressionar que os atores do executivo prestem atenção a questões específicas. Mas será que essas perguntas podem de fato influenciar as decisões do executivo? Por incrível que pareça, são poucas as pesquisas empíricas nessa área. Adotando uma perspectiva de agenda-setting, este artigo examina até que ponto a atenção dada às perguntas formuladas oralmente por parlamentares influencia os tópicos abordadas nas reuniões semanais do Conselho de Ministros em três países (Bélgica, França e Portugal). Nossas conclusões sugerem que, nos contextos analisados, o poder de definição de agenda dos parlamentos em relação ao executivo geralmente é fraco. Na Bélgica, no entanto, há evidências de que o poder executivo aborda as perguntas dos parlamentares, ressaltando-se, nesse caso, que a mídia desempenha um papel crucial ao influenciar que as questões levantadas no legislativo recebam essa atenção. Essas conclusões demonstram o domínio do poder executivo em muitas democracias ocidentais. Além disso, os resultados variados sugerem que os padrões de definição de agenda são mais complexos do que frequentemente se observa nos estudos que focam em somente um país, o que leva a crer que a pesquisa comparativa é o caminho a seguir.

El arte de preguntar en psicoterapia / The art of asking in psychotherapy

Antecedentes: la pregunta es un instrumento esencial de la comunicación humana. No solamente porque las respuestas introducen información en los sistemas, sino porque constituyen un verdadero gatillo estratégico en la psicoterapia. Método: estudio teórico. Resultados y conclusiones: el artículo explora la teoría del arte de preguntar y la técnica del hablar el lenguaje del paciente como maniobra que sostiene la forma en que se ejecuta la pregunta. Intenta, además, reunir una tipología de preguntas que fueron recabadas en la práctica clínica de diferentes terapeutas. De ninguna manera son todos los tipos de preguntas que se clasificaron, sino que es un trabajo original, pensado desde el paradigma sistémico y el modelo sistémico estratégico en psicoterapia, que posibilita sistematizar numerosas preguntas que se encuentran solamente a merced de la creatividad y la espontaneidad del terapeuta.

Background: the question is an essential instrument of human communication. Not only because the answers introduce information into the systems, but because they constitute a true strategic trigger in psychotherapy. Method: theoretical study. Results and conclusions: the paper explores the art's theory of asking and the technique of speaking the patient's language as a maneuver that supports the way in which the question is executed. It also tries a typology of questions that were collected in the clinical practice of different therapists. In no way are all the types of questions that were classified, but it is an original work, thought from the systemic paradigm and the strategic systemic model in psychotherapy that makes it possible to systematize numerous questions that are only at the mercy of the creativity and spontaneity of the therapist.

Pediatric dentistry content in civil service examinations in the state of paraíba: how is this specialty being addressed? / Conteúdo de odontopediatria em concursos públicos na paraíba: de que forma essa especialidade está sendo abordada?

This research study aimed at evaluating the content related to pediatric dentistry addressed in civil service examinations in the state of Paraíba through the analysis and classification of questions. Questions related to pediatric dentistry addressed in civil service examinations for the dentist position in the Family Health Program, held in the state of Paraíba, between the years 2001 and 2017 were evaluated. Across the state, 107 civil service examinations were identified and, when applying the exclusion criteria, 9 identical tests were found, consequently, being removed, totaling 98 examinations. After the analysis, 3,949 questions were obtained and only 54 questions were related to pediatric dentistry, representing 1.36% of total questions. The questions were classified according to the topic and the cognitive level according to the BLOOM's revised taxonomy. Results showed that topics related to oral rehabilitation and surgical management, including questions regarding anesthesia, surgery, pulp therapy, endodontic treatment, operative and restorative dentistry, dental materials, traumatic injuries and prosthesis/rehabilitation corresponded to 42% of the questions. The most prevalent cognitive domains were recall and analyze, corresponding to 45% and 29%, respectively. Thus, questions concerning oral rehabilitation and surgical management were the most addressed in civil service examinations, in which the domains remember and analyze were predominant. There were no questions requiring complex cognitive domain such as assessing and creating.

Esse trabalho teve como objetivo verificar o conteúdo de Odontopediatria abordado em concursos públicos da Paraíba através da análise e classificação de questões. Foram extraídas questões que versavam sobre os assuntos da área de Odontopediatria de certames disponíveis realizados e encerrados, de todas as cidades do estado da Paraíba para o cargo de cirurgião-dentista do Programa Saúde da Família entre os anos de 2001 e 2017. De todo o estado foram coletados 107 certames e ao aplicar os critérios de exclusão, foram removidas 9 provas idênticas, totalizando 98. Após análise destas, obteve-se 3949 questões e dessas apenas 54; 1,36% do total, versavam sobre Odontopediatria. As questões foram classificadas de acordo com o tópico genérico de que se tratavam e o nível cognitivo que exigiam de acordo com a Taxonomia Revisada de BLOOM. Os resultados mostraram que o tópico referente à reabilitação bucal e manejo cirúrgico, foi o de maior prevalência correspondendo a 42% das questões e as dimensões cognitivas mais prevalentes foram lembrar e analisar que corresponderam a 45% e 29%, respectivamente. Foi possível concluir que questões referentes à reabilitação bucal e manejo cirúrgico foram as mais abordadas em concursos públicos no contexto da Odontopediatria e que as dimensões lembrar e analisar foram as de maior prevalência. Não houve ocorrência de questões que exigiam dimensões cognitivas mais complexas, como avaliar e criar.

Developing a Bank of Faculty-authored, Valid and Reliable Objective Questions for Institutional Use: Sharing the Experience

@#Introduction: With the increasing number of institutions implementing competency-based education which demands to provide feedback to students at regular intervals, there is an increase in the frequency of assessments. For this purpose, the written examinations using multiple choice questions (MCQs) are the most feasible form of assessment. However, constructing MCQs is an arduous task and significantly adds to the work-load of the academic staff members. To ease this burden, the institutions may consider to develop banks of valid and reliable MCQs. Methods: Based and built on our experience and literature review, the steps – relating to the process of constructing valid and reliable questions and development of question banks (QBs) – are the actions needed to develop new QBs or improve on the existing ones. Results: We have described ten practical steps for developing and banking of MCQs. The first five steps relate to the development of quality items and the remaining steps relate to the development of QBs, their maintenance, growth and safety and security. We have also established the criteria for selection and the frequency of reuse of questions. Conclusion: Using QBs will alleviate some of the burden of constructing novel quality questions needed for frequent assessments of students using 21st century teaching/learning approaches. The use of banked questions with known psychometric properties would allow the authorities to take charge and control of items’ quality and overall examination standards.

Mexican ENARM: performance comparison of public vs. private medical schools, geographic and socioeconomic regions / ENARM: comparación del desempeño de escuelas de medicina públicas y privadas, regiones geográficas y socioeconómicas

Abstract: Objectives: This study aimed to compare the performance in the National Assessment for Applicants for Medical Residency (ENARM in spanish) of private versus public medical schools, geographic regions and socioeconomic levels by using three different statistical methods (summary measurements, the rate of change and the area under the receiver operator characteristics [AUROC]). These methods have not been previously used for the ENARM; however, some variations of the summary measurements have been reported in some USA assessments of medical school graduates. Materials and methods: Cross-sectional study based on historical data (2001-2017). We use summary measures and colour-filled map. The statistical analysis included Mann-Whitney U, Kruskal-Wallis, Spearman correlation coefficient (Rs), and linear regression. Results: A total of 113 medical schools were included in our analysis; 60 were public and 53 private. We found difference in the median of total scores for type of schools, MD= 54.07 vs. MD= 57.36,p= 0.011. There were also significant differences among geographic and socioeconomic regions (p<0.05). Conclusions: Differences exist in the total scores and percentage of selected test-takers between type of schools, geographic and socioeconomic regions. Higher scores are prevalent in the Northeast and Norwest regions. Additional research is required to identify factors that contribute to these differences. Unsuspected differences in examination scores can be unveiled using summary measures.

Resumen: Objetivo: Comparar el desempeño en el Examen Nacional de Aspirantes a Residencias Médicas (ENARM) de escuelas de medicina privadas y públicas, regiones geográficas y niveles socioeconómicos mediante el uso de tres métodos estadísticos diferentes (medidas de resumen, tasa de cambio y el área bajo las características del operador receptor [AUROC en inglés]). Estos métodos no han sido utilizados previamente para el ENARM; sin embargo, se han informado algunas variaciones de las mediciones de resumen en algunas evaluaciones de graduados de medicina de Estados Unidos. Material y métodos: Estudio transversal basado en datos históricos (2001-2017). Se usaron medidas de resumen y un mapa lleno de color. El análisis estadístico incluyó Mann Whitney U, Kruskal-Wallis y coeficiente de correlación de Spearman (Rs). Resultados: Se incluyeron 113 escuelas de medicina en el análisis; 60 eran públicas y 53 privadas. Se encontraron diferencias en la mediana de las puntuaciones totales para el tipo de escuelas, MD= 54.07 vs. MD= 57.36,p= 0.011. También hubo diferencias significativas entre las regiones geográficas y socioeconómicas (p<0.05). Conclusiones: Existen diferencias en los puntajes totales y el porcentaje de examinados seleccionados entre el tipo de escuelas, regiones geográficas y socioeconómicas. Las puntuaciones más altas prevalecen en las regiones noreste y noroeste. Se requieren investigaciones adicionales para identificar los factores que contribuyen a estas diferencias. Las diferencias insospechadas en los puntajes de los exámenes se pueden revelar usando medidas de resumen.

Perceptions of undergraduate medical students about teaching-learning methods adopted by faculty members in community medicine

Background: Effective learning is closely associated with effective teaching. Achieving effective learning requires a student cantered and outcome-focused approach.4 Various interactive techniques like Problem Based Learning (PBL), facilitated group discussion, E-learning, Massive Open Online Courses (MOOCS) etc., are being implemented in TL sessions in medical schools. These methods are found to be effective to foster better learning among medical students. The present study was an attempt to understand the perceptions of undergraduate medical students, posted at Government Medical College and Hospital, Mehabubnagar, Telangana about different teaching methodologies Methods: A cross sectional study was conducted among 56 MBBS students of 4th semester. A pre-tested, self-administered, structured questionnaire was devised which consisted of ten questions with three to four options each. Study participants were asked to fill up the questionnaire under strict supervision and they were allotted 15 minutes to complete the same. Entire data was entered into Microsoft Office Excel Sheet and analysed. Results: Out of 56, 32 (57.14%) female students and 24 (42.85%) male students voluntarily participated in the study. large number of participants i.e., 66.07% thought that FGD is the best method of teaching. Most of participants i.e. 96.42% had favourable attitudes towards PPT as they felt that it improves their learning. Conclusions: Maximum number of undergraduate medical students knew about E learning. Facilitated Group Discussion (FGD) was the most preferred teaching learning methodology by students. The majority of them had positive perceptions towards the use of Power Point Presentation (PPT) as a powerful teaching tool in medical education.

Cambios en el desempeño de estudiantes de pensamiento matemático desde la evaluación formativa con un banco de preguntas en línea / Changes in the performance of students of a mathematical thinking course through formative assessment with an online question bank

El uso de entornos digitales en línea en la Universidad Jorge Tadeo Lozano ha permitido implementar una base de preguntas con retroalimentación para apoyar al estudiante en el proceso de aprendizaje en la asignatura Pensamiento Matemático. Se desarrolló un proyecto de innovación pedagógica en dos semestres académicos, con el fin de observar si el uso de una base de preguntas con retroalimentación en línea mejora el proceso de apropiación de los conceptos matemáticos de los estudiantes. Las preguntas que conformaron la base se diseñaron siguiendo indicaciones sobre elaboración de preguntas de múltiples opciones con única respuesta; se utilizaron exámenes modelo con los temas vistos en cada uno de los tres momentos en que se divide un periodo académico de la Universidad; dichas evaluaciones formativas fueron puestas a disposición de los estudiantes dos semanas antes de cada evaluación. Debido al carácter del examen -en línea-, con múltiples intentos y accediendo desde cualquier dispositivo, el estudiante podía preparar sus evaluaciones con mayor autonomía y al ritmo que él estableciera. Se realizaron encuestas, entrevistas y grupos focales para identificar algunas características cualitativas que han permitido realizar ajustes y mejoras a la base de preguntas. Los datos obtenidos de cada modelo de examen y los resultados de los estudiantes durante los semestres fueron analizados estadísticamente. Los resultados, tanto cualitativos como cuantitativos, indican que en general, sí hay mejora en el desempeño y apropiación de los conceptos matemáticos en aquellos estudiantes que acceden a los exámenes en línea frente a aquellos que no los usan.

The use of online digital environments at Jorge Tadeo Lozano University has allowed the implementation of a question bank, with feedback, with the purpose of supporting students in their learning process for the subject of Mathematical Thinking; this subject is taught through lectures and workshops that are interrelated and leaded by different professors, one lecture session and two workshop sessions per week. A pedagogical innovation project was developed along two academic periods with the purpose of observing if the use of this online question bank with feedback improved the appropriation of mathematical concepts. The questions that are part of this bank were designed following recommendations for elaborating multiple choice questions with one answer; the selection of distractors for each question was made following conceptual or procedural reasons, which is where most of the difficulties for students are when solving an evaluation on this subject. For each question a detailed description was made, including conceptual aspects and key features such as type of question, question statement, answer choices, reasons for each choice, key information that must be included in feedback (graphics, concepts, solved examples, etc.), cognitive and conceptual domain, level of difficulty, date of elaboration and revision, name of who elaborated the question and name of who reviewed it. Each question was made available on this bank, located at the Virtual Classrooms System at Jorge Tadeo Lozano University (AVATA is the name of this Learning Management System working over Moodle) and corresponding to the Mathematical Thinking course, organized on folders separated by topics and levels of difficulty, according to the available syllabus of the subject. Evaluation models that gathered the topics covered on each of the three segments that form the academic period were used; such formative assessment was made available for students two weeks before each course evaluation. Due to the features of this evaluation, online, with multiple attempts and accessible from multiple devices, students were able to prepare their evaluations with a higher level of autonomy and at the pace, they would establish. Surveys, interviews and focus groups from students and professors that were part of the Mathematical Thinking course were carried out, with the purpose of identifying qualitative features that could eventually lead to adjustments and improvements to the question bank, although not many students participated in these interviews and surveys. Among the qualitative aspects that were highlighted is the fact that students felt comfortable when using this kind of evaluation, as they did not feel the pressure of the results; they also pointed out the role of workshop professors as a motivating element to consult the question bank in order to prepare the evaluations and strengthen mathematical concepts. The data obtained from each evaluation model and the results from students during the academic periods were analyzed statistically, allowing to conclude that there is a significant difference on course grades, both partial and finals, for students who used the evaluation models and students who did not. Results, both qualitative and quantitative, indicated that in general terms there is an improvement in performance for students who access to these online evaluation models compared to students who don't. In order to continue progressing on the work presented here, it is necessary to feed the bank with more questions, considering the aspects indicated from students and professors and also as a way of expanding the possibilities of randomizing the questions as students use the bank. It is also important to carry out statistical analysis to questions, with the purpose of establishing with better precision their levels of difficulty and the levels of difficulty of the evaluation models themselves.