Reflection on the standardized training of geriatric specialists under the background of "the aging of population" / 中华医学教育探索杂志

With the intensive aging of the population, it's imperative and important to train a number of geriatric specialists. Essential clinical knowledge and skills as well as accomplishment of medical humanistic spirit are core competences of an eligible geriatrician. The standardized training of geriatric specialists is facing a few challenges such as incomplete comprehension of the training program and trainees, a lack of enough trainees, and a lack of standardized management for the program. An efficient social support system, a normative educational training system, an effective supervision and evaluation system, first-class teaching staff, and qualified trainees are important guarantees for the standardized training program.

Application of multi-modal neuroimaging three-dimensional reconstruction and virtual reality in neurosurgical specialists training / 中华医学教育探索杂志

Neurosurgery is considered as one of the most difficult areas in the field of medicine, and the complexity of nervous system is a leading cause. Therefore, it demands neurosurgeons possess basic knowledge, spatial thinking, and practical experiences. Here, we introduce a rapid developing technique applying multi-modal neuroimaging reconstruction and virtual reality, which constitutes a novel learning model for boosting the growth of neurosurgeons. The incorporation of multi-modal neuroimaging and virtual reality builds a bridge from two-dimensional image to actual surgical view. Neurosurgeons are able to perform surgical planning and simulation with naked eyes under the constructed three-dimensional hologram. The technique also provides evidence of accurate localization and guidance for operation. Therefore, multi-modal neuroimaging reconstruction and virtual reality are expected to tremendously promote the progress of young trainees, and can further enhance their all-round abilities. In short, this revolutionary learning model would impact the neurosurgical specialists training profoundly.

La formación y desarrollo de competencias profesionales en especialistas en cirugía general. Fundamentos teóricos

El nivel de competencia de los profesionales, ha constituido una preocupación en los sistemas de salud para incrementar la calidad de los servicios y de las universidades médicas, y aportar así un profesional con adecuado desempeño. Ante las tendencias actuales, los autores se trazaron como objetivo revisar los fundamentos teóricos que sustentan la formación y desarrollo de competencias profesionales en los especialistas en cirugía general, en correspondencia con las exigencias del sistema de salud cubano. Se realizó una búsqueda de información actualizada, entre enero y mayo de 2022, utilizando recursos disponibles a través de Infomed. Se consultaron las bases de datos electrónicas PubMed, SciELO y LILACS, así como Google Académico. El proceso de sistematización y análisis documental permitió, como resultado, la fundamentación teórica para la formación y desarrollo de las competencias profesionales de los especialistas en cirugía general. Como conclusión se consideró que, dadas las funciones y acciones que deben cumplimentar los cirujanos generales, es imprescindible que estos posean las competencias requeridas, y constituye una prioridad la formación y desarrollo de las mismas para perfeccionar el desempeño, lo que enriquece a las ciencias de educación médica.

The level of competence of the professional staff has been a concern in health systems to increase the quality of services and medical universities, thus providing a professional with adequate performance. Given the current trends, the authors set out as an objective to review the theoretical fundaments that support the training and development of professional skills in general surgery specialists, in accordance with the requirements of the Cuban health system. An updated information search was conducted between January and May 2022, using resources available through Infomed. Electronic databases PubMed, SciELO and LILACS, as well as Google Academic, were consulted. The process of systematization and documentary analysis allowed, as a result, the theoretical foundation for the training and development of the professional skills of specialists in general surgery. In conclusion, it was considered that, given the functions and actions that general surgeons must perform, it is essential that they possess the required competencies, and it is a priority to train and develop them to improve performance, which enriches medical education sciences.

Estrategia de superación para la formación académica en segundo grado

Introducción: El proceso de formación y superación de profesionales de las ciencias médicas para alcanzar el segundo grado de las especialidades constituye una prioridad y objetivo del MINSAP en el año 2021. Objetivo: Diseñar una estrategia de superación que prepare a los profesionales de las ciencias médicas para lograr el segundo grado de las especialidades en la atención primaria de salud del municipio Sagua la Grande. Métodos: Se realizó un estudio descriptivo transversal en la Facultad de Ciencias Médicas de Sagua la Grande durante el período comprendido entre 2019 y 2021. La población de estudio estuvo constituida por la totalidad de especialistas de primer grado médicos y estomatólogos de la Atención Primaria de Salud (247). La muestra fue seleccionada por un muestreo no probabilístico por criterios. La muestra quedó finalmente constituida por 173 profesionales. La información fue recogida a través de una encuesta, análisis documental y empleando la triangulación de fuentes. Resultados: De los profesionales de la atención primaria estudiados, 0,8 % tenía título de especialista de segundo grado y 2,9 % con los requisitos para optar por el segundo grado. Conclusiones: La estrategia de superación que prepare a los profesionales de las ciencias médicas para lograr el segundo grado contó de un conjunto de cursos y talleres que contribuirán a la superación de los profesionales en temas identificados como necesidades de aprendizaje. La totalidad de los expertos valoraron la estrategia como bastante adecuada.

Introduction: The training and upgrading process for medical sciences professionals to achieve the second degree of their respective specialties is a priority and objective of the Ministry of Public Health in the year 2021. Objective: To design an upgrading strategy that provides training for medical sciences professionals to achieve the second degree of their respective specialties in primary healthcare in Sagua la Grande Municipality. Methods: A cross-sectional and descriptive study was carried out in the School of Medical Sciences of Sagua la Grande, during the period from 2019 to 2021. The study population consisted of all the first-degree medical and dental specialists from the primary healthcare sector (247). The sample was selected using nonprobabilistic sampling by criteria. The sample finally consisted of 173 professionals. The information was collected by means of a survey, documentary analysis and triangulation of sources. Results: 0.8 % of the studied primary care professionals had a diploma of second-degree specialist, while 2.9 % had the requirements to opt for the second degree. Conclusions: The upgrading strategy aimed at medical sciences professionals, in order for them to achieve the second degree in their respective specialties, included a set of courses and workshops that contributed to professional upgrading in topics identified as learning needs. All the experts assessed the strategy as quite adequate.

Validity and reliability of the SBI (Spanish Burnout Inventory) in medical surgical specialists / Validez y contabilidad del CESQT en médicos especialistas quirúrgicos

Abstract Introduction: Burnout Syndrome is the term used to describe the psychological response to patient care-related chronic work stress. Studies have found that the prevalence of practitioner burnout in Colombia ranges between 17.6% and 45%. Given the importance of this phenomenon in our setting, we decided to carry out a validation and reliability study of the Spanish Burnout Inventory (SBI). Objective: To assess the validity and reliability of the SBI in medical surgical specialists working in fourteen health care facilities in Antioquia (Colombia) in 2018. Methods: The study was conducted in 14 healthcare institutions among 8 surgical specialties. The tool consists of 20 items collected by means of face-to-face interviews under the supervision of a psychologist, and maintaining confidentiality. The psychometric assessment included content validity (CV), construct validity using confirmatory factor analysis (CFA) and reliability using Cronbach's Alpha. Results: The study sample consisted of 234 participants. CV of the tool was 0.82. The CFA showed acceptable model fit, with the results of goodness-of-fit being X2=384.578 (p<0.00i; df: 165), RMSEA = 0.075 [90% CI: 0.066 - 0.085], CFI = 0.953, TLI = 0.946 and WRMR=1.074. The SBI Cronbach's alpha was 0.79. Conclusions: The SBI showed acceptable CV levels for all the items and domains. The SBI is a valid tool with adequate reliability for use in medical surgical specialists of healthcare institutions in Antioquia-Colombia.

Resumen Introducción: El síndrome de Quemarse por el Trabajo es la respuesta psicológica al estrés laboral crónico relacionado con la atención de pacientes. La prevalencia del síndrome en médicos colombianos varía entre el 17 % y el 45 %, usando cuestionarios no validados. Objetivo: Evaluar la validez y fiabilidad del Cuestionario para la Evaluación del Síndrome de Quemarse por el Trabajo (CESQT), en médicos especialistas quirúrgicos que laboraban en instituciones de salud de Antioquia, Colombia en 2018. Métodos: El estudio se realizó en 14 instituciones hospitalarias con 8 especialidades quirúrgicas, el instrumento consta de 20 ítems cuya recolección se hizo presencial, supervisado por una psicóloga, manteniendo la confidencialidad; la evaluación psicométrica incluyó validez de contenido (VC), validez de constructo mediante análisis factorial confirmatorio (AFC) y fiabilidad con alfa de Cronbach. Resultados: Se encuestaron 234 especialistas. La VC del instrumento fue de 0,82. Los índices de bondad de ajuste en el AFC fueron: X2=384,578 (p < 0,001; gl: 165), RMSEA = 0,075 [IC 90 %: 0,066-0,085], CFI = 0,953, TLI = 0,946 y WRMR = 1,074. El alfa de Cronbach fue 0,79. Conclusiones: El CESQT tiene niveles aceptables de VC para los ítems y sus dimensiones. El CESQT es un instrumento válido con adecuada fiabilidad para ser utilizado en médicos especialistas quirúrgicos de instituciones de salud de Antioquia, Colombia.

A preliminary study on index system construction of the merging reform of doctoral degree education in clinical medicine with the standardized training of specialists / 中华医学教育探索杂志

Objective:To explore the reform plan for the integration of doctoral degree education in clinical medicine and standardized training for specialists.Methods:Using the literature analysis method and expert interview method, the preliminary framework of the merger training program was initially constructed, and Delphi method was used to determine the final index system. Excel 2010 was used to make data entry, and SPSS 19.0 was used for statistical analysis.Results:After two rounds of inquiry, the preliminary framework of the merger training program was finally determined from six aspects: enrollment methods, training resources, training content, training methods, training assessment and quality control, including 6 first-level indicators, 26 second-level indicators and 72 third-level indicators.Conclusion:By scientifically formulating systematic training programs, establishing the core training content and comprehensive evaluation system with post competency, and using flexible academic system, it provides a basis for carrying out the reform of the integration of doctoral education of clinical medicine and standardized training of specialists.

Study on the influencing factors of teaching quality in standardized training of psychiatry specialists / 中华医学教育探索杂志

Objective:To explore the influencing factors of teaching quality in standardized training of psychiatry specialists, and to provide evidence for improving the training quality.Methods:Both qualitative and quantitative methods were combined in the study. First, information was collected by stratified random sampling and individual interviews, and NVivo 11.0 was used in coding the information and reducing the information to the main concepts. Then, the qualitative research results were compiled into a questionnaire Investigation on Influencing Factors of Standardized Training of Specialists to investigate and analyze all previous specialized training doctors and teaching teachers. SPSS 23.0 was used to perform Mann-Whitney U test. Results:①The teaching abilities of teachers, the attitudes on study and work of the specialists, the teaching initiative of teachers were found to be the important influencing factors of teaching quality. The recognition degree of the specialists was 89.5%, 57.9% and 55.3%, while that of the teachers was 68.4%, 66.7% and 52.6%. ②The teachers' attitudes, the busy degree of the teachers' work and policy orientation were found to be the important influencing factors of teaching initiative. The recognition degree of the specialists was 68.4%, 57.9% and 47.7%, while that of the teachers was 68.4%, 59.6% and 47.4%. ③The mentors' reserve of professional knowledge and skills, the reserve of educational knowledge and skills and the study and exploration in education were found to be the important influencing factors of teaching ability. The recognition degree of the specialists was 89.5%, 81.6% and 57.9%, while that of the teachers was 82.5%, 82.5% and 68.4%.Conclusion:The early cultivation of teaching attitude should be emphasized; the workload of the teachers should be distributed reasonably; the training on both the teaching ability and professional ability should be paid attention to.

Importancia teórica de la capacidad coordinativa de diferenciación de los gestos técnicos en fútbol sub-12 / Importância teórica da capacidade de coordenação da diferenciação de gestos técnicos no futebol sub-12 / Theoretical importance of the coordinative capacity of differentiation of technical gestures in U-12 soccer

RESUMEN La coordinación motriz se define como la capacidad neuromuscular de trabajar conjuntamente diferentes componentes de la preparación deportiva, de los sentidos y segmentos corporales con precisión. Por ello, mejorar los alcances y limitaciones teóricas de los entrenadores nacionales, en términos de utilidad e importancia del entrenamiento coordinativo en general y la capacidad de diferenciación de los gestos técnicos en particular, posibilita potenciar prospectivamente el proceso docente-educativo. El objetivo de esta investigación consiste en validar teóricamente algunos indicadores que rigen la importancia y la prioridad del entrenamiento coordinativo y de diferenciación de los gestos técnicos en futbolistas sub-12. Esta investigación descriptivo-explicativa es de orden correlacional y se basa en cuatro indicadores teóricos, evaluados por 22 especialistas nacionales e internacionales, clasificados en dos grupos independientes (grupo 1: especialistas nacionales; grupo 2: especialistas internacionales). De forma general, no se evidencian diferencias significativas en las calificaciones de dos indicadores estudiados (ImC: p=0.974 y PeC: p=0.923), existiendo diferencias significativas en el resto (ImD: p=0.000 y PeD: p=0.003); en estos dos últimos, se obtiene un mayor rango promedio, a favor del grupo 2 (grupo 1: ImD=6.92; grupo 2: ImD=17.00; grupo 1: PeD=7.83; grupo 2: PeD=15.90). La validación por especialista evidencia la importancia teórica que reviste el entrenamiento de la capacidad de coordinación en futbolistas de iniciación. Además, se evidencia un nivel significativo de importancia y prioridad en los especialistas internacionales en el entrenamiento de la diferenciación del fútbol sub-12, con respecto a los especialistas nacionales.

RESUMO A coordenação motora é definida como a capacidade neuromuscular de trabalhar em conjunto diferentes componentes da preparação desportiva, dos sentidos e dos segmentos corporais com precisão. Assim, a melhoria do âmbito e das limitações teóricas dos treinadores nacionais, em termos de utilidade e importância da formação de coordenação em geral e da capacidade de diferenciar gestos técnicos em particular, torna possível melhorar prospectivamente o processo ensino-educativo. O objetivo desta investigação é validar teoricamente alguns indicadores que regem a importância e a prioridade da formação coordenadora e a diferenciação dos gestos técnicos nos jogadores de futebol sub-12. Esta investigação descritiva-explicativa é de ordem correlativa e baseia-se em quatro indicadores teóricos, avaliados por 22 especialistas nacionais e internacionais, classificados em dois grupos independentes (grupo 1: especialistas nacionais; grupo 2: especialistas internacionais). Em geral, não há diferenças significativas nas classificações de dois indicadores estudados (ImC: p=0,974 e PeC: p=0,923), com diferenças significativas no resto (ImD: p=0,000 e PeD: p=0,003); nos dois últimos, obtém-se um intervalo médio mais elevado, a favor do grupo 2 (grupo 1: ImD=6,92; grupo 2: ImD=17,00; grupo 1: PeD=7,83; grupo 2: PeD=15,90). A validação por especialistas evidencia a importância teórica da formação da capacidade de coordenação em jogadores de futebol principiantes. Além disso, é evidenciado um nível significativo de importância e prioridade nos especialistas internacionais no treino de diferenciação no futebol sub-12, no que diz respeito aos especialistas nacionais.

ABSTRACT Motor coordination is defined as the neuromuscular capacity to work together different components of sports training, senses and body segments with precision. Therefore, improving the theoretical scope and limitations of national coaches in usefulness and importance terms of coordination training in general, and the capacity to differentiate technical gestures in particular, makes it possible to prospectively enhance the teaching-educational process. The objective of this work is theoretically validate some indicators that govern the importance and priority of coordination training and differentiation of technical gestures in U-12 soccer players. This is a descriptive-explanatory correlational research, studied four theoretical indicators evaluated by 22 national and international specialists classified into two independent groups (Group 1: National Specialists; Group 2; International Specialists), comparing results and deducing future national strategies to improve the coordinating component and the differentiation of technical gestures in U-12 players. In general, there are no significant differences in the scores of two indicators studied (ImC: p=0.974 and PeC: p=0.923), with significant differences in the rest (ImD: p=0.000 and PeD: p=0.003); in the latter two, a higher average range is obtained, in favor of group 2 (group 1: ImD=6.92; group 2: ImD=17.00; group 1: PeD=7.83; group 2: PeD=15.90). The validation by specialist evidences the theoretical importance of the training of the coordination capacity in initiation soccer players. In addition, a significant level of importance and priority is evidenced in the international specialists in the training of differentiation in U-12 soccer, with respect to the national specialists.

Astenopia digital em controladores de tráfego aéreo: diagnóstico e avaliação na Força Aérea Portuguesa / Digital-related eye strain in air traffic control specialists: diagnosis and evaluation in the Portuguese Air Force staff

RESUMO A função de controlador aéreo exige várias horas de visualização de ecrãs, o que torna esses profissionais um grupo particularmente exposto à astenopia digital. Procuramos, com este artigo de revisão, compreender quais os métodos quantitativos e qualitativos usados atualmente para diagnosticar e avaliar a fadiga ocular em controladores de tráfego aéreo. Trata-se de pesquisa bibliográfica utilizando as bases de dados PubMed® e ClinicalKey®, usando palavras-chave, tendo sido selecionados artigos de revisão e estudos observacionais com publicação posterior ao ano 2000, de modo que os termos buscados estivessem no título e/ou resumo do trabalho. Excluímos artigos em línguas que não inglesa. Existem vários métodos para melhor caracterizar a astenopia digital, destacando-se os subjetivos, como questionários, e os objetivos, que procuram, por um lado, diagnosticar o olho seco, bem como alterações da acomodação e da convergência. Da análise efetuada, ressaltou-se uma escassez de estudos prospectivos com Níveis de Evidência moderados e altos relacionados com a aplicação dos vários métodos de diagnóstico. A Computer-Vision Symptom Scale parece ser um questionário confiável e que pode ser aplicado aos controladores de tráfego aéreo, para diagnóstico de astenopia digital. Vários métodos objetivos podem também ser utilizados para essa avaliação, sendo importante, numa fase posterior, aplicar esses dois tipos de métodos de diagnóstico para avaliar a prevalência dessa patologia em controladores de tráfego aéreo.

ABSTRACT The work of air traffic control specialists require several hours looking at screens, and they comprise a group particularly exposed to digital-related eye strain. In this review we aim to understand the quantitative and qualitative methods currently used to diagnose and evaluate asthenopia in air traffic control specialists. A bibliographic search was carried out at the databases PubMed® and ClinicalKey®, using keywords, and selecting review articles and observational studies, dated after 2000, containing the keywords in the title and/o abstract. Articles not published in English were excluded. There are several subjective and objective methods to better describe digital-related eye strain, including questionnaires, aiming to make diagnosis of dry eye disease or changes in accommodation and convergence. From our analysis, there are few prospective studies with moderate and high levels of evidence regarding these diagnostic methods. The Computer-Vision Symptom Scale seems to be a reliable questionnaire to be applied to air traffic control specialists, for diagnosis of digital-related eye strain. Several objective methods can also be employed in this evaluation, and, in a later stage, it will be important to apply both diagnostic methods to evaluate the prevalence of this condition in air traffic control specialists.

Evaluation of training mode and effect of diagnosis and treatment of early gastric cancer for digestive specialists / 中华消化内镜杂志

Objective:To explore the approach of continuing education for digestive specialists through the establishment of training mode for diagnosis and treatment of early gastric cancer and the evaluation of training effect.Methods:A total of 48 participants of 3 sessions in the training course of early gastric cancer in Peking Union Medical College Hospital from September 2019 to January 2020 were enrolled in this study. Effects of six training methods were evaluated subjectively and objectively by a questionnaire survey and an on-site test.Results:After the training course of early gastric cancer, the diagnostic awareness (100.0%, 48/48), basic theoretical knowledge (97.9%, 47/48), endoscopic diagnosis ability (95.8%, 46/48) and endoscopic operation skills (87.5%, 42/48) of early gastric cancer of the trainees were significantly improved.The most effective training sessions were endoscopic images recognition, lectures of theoretical knowledge, case discussion and hands-on workshop. The results of theoretical knowledge test (79.38±8.10 VS 48.33±9.96, t=-21.176, P<0.001)and image diagnosis test (81.50±8.32 VS 49.58±13.48, t=-15.408, P<0.001) after training were significantly improved compared with those of before. Conclusion:The systematic training program of early gastric cancer that includes a variety of training methods is effective and should be widely promoted in the continuing education of digestive specialists.

Cognition on diagnosis and treatments of bronchiectasis among respiratory specialists / 中华健康管理学杂志

Objective:To investigate the cognition of the diagnosis and management of bronchiectasis among respiratory specialists.Methods:Between May and June 2020, a questionnaire survey based on expert consensus and guidelines was conducted among respiratory specialists from 50 hospitals from Sichuan and Yunnan provinces. Total 691 questionnaires were distributed and 641 were received. 601 valid questionnaires were chosen for further analysis with an effective recovery rate of 87.0%. The respondents were required to finish the e-questionnaires independently in terms of cognition of diagnosing, severity assessment, treatments and Chinese medicines of bronchiectasis. The responses were collected online and the cognitive levels were evaluated by calculating the correct rates of corresponding questions.Results:540 (89.9%) of the respondents agreed that high-resolution computed tomography (HRCT) was the gold standard for diagnosing of bronchiectasis, but 318 (52.9%) had an incomplete understanding of common radiographic manifestations of bronchiectasis, and different cognitive degrees of common radiographic manifestations of bronchiectasis existed among respondents with different qualifications or working in different levels of hospitals ( P<0.05). Only 118 (19.6%) of the respondents were familiar with severity assessments of bronchiectasis, but 65 (55.1%) of the 118 respondents said they won′t apply these severity assessments to patient during their clinical works. For the treatment of patients with stable bronchiectasis, airway clearance techniques were most recommended by specialists surveyed [410 (68.2%)], among which, postural drainage was the most known method [559 (93.0%)]. For patients undergoing an acute exacerbation, most respondents recommended antibiotics [600 (99.8%)] as the primary treatment, and examinations such as sputum culture [544 (90.5%)], inflammatory markers [523 (87.0%)] should be performed as well. 504 (83.9%) thought that pseudomonas aeruginosa was the most common conditioned pathogen for bronchiectasis. For patients with frequent exacerbations (≥3 per year), 385 (64.1%) of the respondents supported the therapeutic effect of long-term antibiotics, however, among the 385 respondents supporting long-term antibiotics, only [113 (29.4%)] were willing to recommend long-term antibiotic treatment actively during their clinical practice. Besides, 304 (50.6%) respondents held a positive attitude to the clinical effect of traditional Chinese medicine therapies. Among 304 respondents holds the point of supporting, only 86 (28.3%) were willing to recommend traditional Chinese medicine to patients actively, differences about the attitude and clinical behaviors were found between respondents working in different levels of hospitals ( P<0.05). Conclusions:Respiratory specialists′ cognition on diagnosis and treatments of bronchiectasis remains inadequate, and cognitive levels differ among respondents working in different levels of hospitals. There is a gap between respondents′ cognition and clinical practice. Further education and trainings are necessary for improving respiratory specialists′ knowledge for timely diagnosis and standard treatment of bronchiectasis.

Medicine amongst Health Care Specialists and University Students in Health Colleges in Saudi Arabia

Aim: There are a few studies about the populations' knowledge and perceptions on personalized medicine in Saudi Arabia until now. Therefore, the aim of this study was to assess the knowledge and awareness on personalized medicine amongst health care specialists and university students in health colleges in Saudi Arabia.Methodology: This is a cross-sectional study that include a survey targeting health care specialists. The survey translated to Arabic and after validation, it was converted to an online survey using google forms.Results: About 52.34% of the participants have heard about different terms regarding personalized medicine (personalized medicine, healthcare reform, individualized care and pharmacogenomics). Most of the health care specialists in the present study said that they have poor knowledge about personalized medicine (68.75%). Most of the participants in the present study were interested to learn about personalized medicine and showed a positive attitude about it.Conclusion: The present study found that health care specialists had a poor knowledge about personalized medicine but they are interested to learn more about this field. Therefore, more training and awareness programs about personalized medicine are needed to facilitate its introduction in Saudi Arabia. Moreover, more focus on this field should be introduced into the health colleges’ curricula

Conocimientos sobre el rol del tutor en Medicina General Integral. Policlínico Jimmy Hirzel. 2019 / Knowledge about the role of the tutor in Integral General Medicine. Jimmy Hirzel Polyclinic. 2019 / Conhecimento sobre o papel do tutor em Medicina Geral Integral. Policlínica Jimmy Hirzel. 2019

RESUMEN Introducción: la formación en el trabajo garantiza la competencia y desempeño adecuado del futuro especialista en la atención no solo del individuo, sino también de la familia y la comunidad. Objetivo: identificar el nivel de conocimientos que poseen los especialistas de Medicina General Integral sobre su rol de tutor en la formación de futuros especialistas del Policlínico Jimmy Hirzel. Bayamo. 2019. Método: se utilizaron métodos teóricos, empíricos y estadísticos. Fueron estudiadas las variables: edad, sexo, años de graduados en función de la tutoría, categoría docente en relación a los años como tutor, nivel de conocimientos sobre el rol del tutor. Se aplicó el coeficiente alfa de Cronbach para medir la confiabilidad del cuestionario aplicado. El universo quedó constituido por todos los especialistas pertenecientes al policlínico Jimmy Hirzel y la muestra por 38 que estaban ejerciendo como tutores en el año 2019. Resultados: predominaron las féminas sobre los masculinos con un 63,2%. El grupo etario más representativo fue de 35 a 39 años con un 31,6%, los especialistas carecen de experiencia y no se han enfrentado a la tutoría, obteniéndose un 52,6%. El 89.5% fueron especialistas sin categoría docente. El nivel de conocimientos de los tutores sobre su rol en la formación de especialistas de Medicina General Integral fue bajo con un 50%. Conclusiones: se demuestra que existen insuficiencias en el conocimiento del rol del tutor en la formación de especialistas en Medicina General Integral y marca un reto para la preparación del claustro en cada institución.

ABSTRACT Introduction: on-the-job training guarantees the competence and adequate performance of the future specialist in the care not only of the individual, but also of the family and the community. Objective: to identify the level of knowledge that the specialists in Comprehensive General Medicine possess about their role as tutor in the training of future specialists of the Jimmy Hirzel Polyclinic. Bayamo. 2019. Method: theoretical, empirical and statistical methods were used. The variables were studied: age, sex, years of graduates depending on the tutoring, teaching category in relation to the years as tutor, level of knowledge about the role of the tutor. Cronbach's alpha coefficient was applied to measure the reliability of the applied questionnaire. The universe was made up of all the specialists belonging to the Jimmy Hirzel polyclinic and the sample of 38 who were working as tutors in 2019. Results: females predominated over males with 63.2%. The most representative age group was 35 to 39 years old with 31.6%, specialists lack experience and have not faced tutoring, obtaining 52.6%. 89.5% were specialists without a teaching category. The level of knowledge of the tutors about their role in the training of specialists in Comprehensive General Medicine was low with 50%. Conclusions: it is shown that there are insufficiencies in the knowledge of the role of the tutor in the training of specialists in Comprehensive General Medicine and marks a challenge for the preparation of the faculty in each institution.

RESUMO Introdução: o treinamento no local de trabalho garante a competência e o desempenho adequado do futuro especialista no cuidado não apenas ao indivíduo, mas também à família e à comunidade. Objetivo: identificar o nível de conhecimento que os especialistas em Medicina Geral Compreensiva possuem sobre seu papel de tutor na formação de futuros especialistas da Policlínica Jimmy Hirzel. Bayamo. 2019. Método: foram utilizados métodos teóricos, empíricos e estatísticos. As variáveis ​​estudadas foram: idade, sexo, anos de egressos, dependendo da tutoria, categoria de ensino em relação aos anos de tutor, nível de conhecimento sobre o papel do tutor. O coeficiente alfa de Cronbach foi aplicado para medir a confiabilidade do questionário aplicado. O universo foi composto por todos os especialistas pertencentes à policlínica Jimmy Hirzel e a amostra de 38 que estavam trabalhando como tutores em 2019. Resultados: o sexo feminino predominou sobre o masculino, com 63,2%. A faixa etária mais representativa foi de 35 a 39 anos, com 31,6%, os especialistas não têm experiência e não enfrentaram aulas particulares, obtendo 52,6%. 89,5% eram especialistas sem categoria de ensino. O nível de conhecimento dos tutores sobre o seu papel na formação de especialistas em Medicina Geral Integral foi baixo, com 50%. Conclusões: mostra-se insuficiente o conhecimento do papel do tutor na formação de especialistas em Medicina Geral Compreensiva e marca um desafio para a preparação do corpo docente em cada instituição.

Massive Open Online Courses for continuing education for nursing professionals in Peru / Massive Open Online Courses para educação continuada em profissionais de enfermagem no Peru / Massive Open Online Courses para la educación continua en profesionales de enfermería en Perú

Objective: to determine the global offer of Massive Open Online Courses (MOOCs) in health and nursing, and to know the characteristics of its content, for continuing education in nursing professionals in Peru. Method: exploratory study was carried out on the websites: Coursera, edX, FutureLearn, XuetangX and Udacity, Class Central and MOOC List. The courses were classified according to the five nursing areas recognized by the Peruvian College of Nurses (Colegio de Enfermeros del Perú, CEP). From each course, data was collected on institution and country of origin, hours per week and total duration in weeks, audio and subtitle language. Results: a total of 654 courses in this modality are offered in health were found, covering the five areas contemplated by the Peruvian College of Nurses. Fourteen courses were specifically developed for nursing with an average duration of five weeks (3.2 hours per week of activities). Eleven came from Anglo-Saxon institutions, with content in English. Only two courses were offered in Spanish and one in Turkish. Conclusion: Massive Open Online Courses would be a useful tool for the continuing education of the Peruvian nurse given the wide offer, including some specifically for nurses, in the different areas of nursing. The content of the course is mostly in English. Expanding the range of languages or subtitles would facilitate the participation of a larger audience.

Objetivo: determinar a oferta global de Massive Open Online Courses (MOOCs) em saúde e enfermagem e conhecer as características de seu conteúdo para a educação continuada em profissionais de enfermagem. Método: estudo exploratório realizado nos sites Coursera, edX, FutureLearn, XuetangX e Udacity, Class Central e MOOC List. Os cursos foram classificados de acordo com as cinco áreas de enfermagem reconhecidas pelo Colégio Peruano de Enfermeiros (Colegio de Enfermeros del Perú, CEP). Para cada curso foram coletadas as variáveis instituição e país de origem, horas semanais e duração total em semanas, idioma do áudio e das legendas. Resultados: foram encontrados 654 cursos nessa modalidade em saúde, cobrindo as cinco áreas contempladas pelo Colégio Peruano de Enfermeiros. Quatorze cursos foram desenvolvidos especificamente para enfermagem, com duração média de cinco semanas (3,2 horas por semana de atividades). Onze procediam de instituições anglo-saxônicas, com conteúdo em inglês. Apenas dois cursos foram oferecidos em espanhol e um em turco. Conclusão: Massive Open Online Courses é uma ferramenta útil para a educação continuada do enfermeiro peruano, dada a ampla oferta, incluindo alguns especificamente para enfermeiros, nas diferentes áreas da enfermagem. O seu conteúdo é oferecido principalmente em inglês. Expandir a variedade de idiomas ou incluir legendas facilitaria a participação de um público maior.

Objetivo: determinar la oferta global de Massive Open Online Courses (MOOCs) en salud y enfermería, y conocer las características de su contenido, para la educación continua de profesionales de enfermería en Perú. Método: estudio exploratorio se llevó a cabo en sitios web Coursera, edX, FutureLearn, XuetangX y Udacity, Class Central y MOOC List. Los cursos se clasificaron según las cinco áreas de enfermería reconocidas por el Colegio de Enfermeros del Perú (CEP). De cada curso se recopilaron datos sobre institución y país de origen, horas por semana y duración total en semanas, idioma de audio y de subtítulos. Resultados: se encontró un total de 654 cursos en esta modalidad en salud, que abarcaron las cinco áreas contempladas por el Colegio de Enfermeros del Perú. Catorce cursos fueron elaborados específicamente para enfermería con una duración promedio de cinco semanas (3,2 horas semanales de actividades). Once procedían de instituciones anglosajonas, con contenido en inglés. Solo dos se ofrecieron en español y uno en turco. Conclusión: Massive Open Online Courses es una herramienta útil para la educación continua del enfermero peruano dada la amplia oferta, incluyendo algunos específicamente para enfermeros, en las distintas áreas de la enfermería. El contenido de los cursos se ofrecen mayoritariamente en inglés. Ampliar la oferta de idiomas o subtítulos facilitaría la participación de un mayor público.

European Society of Retina Specialists guidelines for management of diabetic macular edema / 国际眼科杂志(Guoji Yanke Zazhi)

@#Diabetic retinal disease(DRD)is a disease with a sharp increase in the proportion of retinal disease(RD). Diabetic macular edema is the leading cause of vision loss. The treatment of diabetic macular edema has always been a hot topic in medicine. The diagnosis and treatment of diabetic macular edema is the latest treatment guideline for diabetic macular edema published by the European Association of Retinal Experts. It is considered to be the most representative guide at present. Detailed interpretation in this article will help the majority of ophthalmologists have a new understanding of the diagnosis and treatment of diabetic macular edema.

Correlation of Facial Injury Severity Scale (FISS) with Length of Stay, The Need for Surgery and The Involvement of Other Specialists in Maxillofacial Trauma Patients at H. Adam Malik General Hospital Medan

Background:Facial Injury Severity Severity Score (FISS) has been used to assess the severity of facial injuries. However, FISS scores as a useful predictor of length of stay and changes between FISS scores and injuries to other parts of the body have not evaluated. In this study, we want to know the relationship between FISS score as the clinical assessment of maxillofacial trauma with the length of stay, the need for surgery, and the involvement of other specialist elds.Method:This research was conducted using analytical research through a retrospective approach by looking at the medical records of patients who suffered maxillofacial trauma at H. Adam Malik General Hospital Medan from June to August 2019.Result :From a total of 43 patients included in the study, there were 22 mandibular fractures, with mandibular angulus (29.0%), parasymphysis (22.4%), and mandibular corpus (21.5%). Thirty subjects (69.8%) needed surgery, and xation of the fracture and subjects without intervention were 13 (30.2%). Patients who needed surgical intervention, the average time needed for hospitalization was 10.98 + 7.72 days (p = 0.007). The most collaboration found with neurosurgeons specialists, 39.53% of subjects who performed the surgery. A total of 55.8% of surgeries performed by a single operator from the plastic surgery department. Relationship between the length of stay with FISS, obtained for FISS> 3 (OR 14.37) (p = 0.01), meaning that patients with FISS> 3 are likely to stay longer for 14 times. Subsequent results related to the need for surgery obtained signicant results (OR = 8.26, p = 0.026). signicant (p = 0.059).Conclusion:A FISS score signicantly affects the length of stay for a maxillofacial trauma patient. FISS score also affects the involvement of other specialists in maxillofacial trauma patients but not statistically signicant.

Representaciones sociales del cáncer de mama en pacientes, familiares acompañantes y especialistas / Social Representations of Breast Cancer in Patients, Accompanying Relatives and Specialists

RESUMEN Fundamento: develar las representaciones sociales del cáncer mamario puede acercar a profesionales de las ciencias psicológicas a comprender actitudes, conductas y las influencias que ejercen en pacientes, familiares y especialistas. Objetivo: determinar la estructura de las representaciones sociales (actitud, información, campo representacional) del cáncer mamario en los sujetos del estudio. Métodos: estudio exploratorio, transversal, de metodología mixta, en el período comprendido entre mayo 2014 a diciembre de 2015. Se aplicaron como técnicas: formulario datos sociodemográficos y clínicos, entrevista semiestructurada, composición, asociación libre. Las variables analizadas fueron: direccionabilidad de la actitud hacia el diagnóstico del cáncer mamario, direccionabilidad de la actitud hacia los tratamientos, en la dimensión información: conocimientos sobre conceptualización de la enfermedad, conocimientos de los síntomas, conocimientos sobre tratamientos, creencias sobre factores de riesgo, opiniones sobre las consecuencias del cáncer mamario, opiniones sobre necesidad de brindar conocimientos de la enfermedad a pacientes, familiares. Se efectuó análisis estadístico descriptivo de frecuencias. Se procesó la información de las variables en la base de datos del paquete estadístico SPSS 15.0 para Windows. Los resultados se expresaron en frecuencias absolutas y relativas. Resultados: pacientes, familiares mostraron direccionabilidad de la actitud negativa hacia el diagnóstico y tratamientos. Prevalencia de respuestas ajustadas en las áreas exploradas de la dimensión información, aunque con nivel de profundidad homogéneo los familiares. El campo representacional del cáncer mamario dio cuenta de modelos mayoritariamente de desafío a la enfermedad en los sujetos del estudio. Conclusiones: cómo se comportaron el conocimiento de la estructura de las representaciones sociales del cáncer mamario en los sujetos del estudio, contribuye al análisis del marco de referencia de la actuación sanitaria, desde un abordaje integral, holístico, por coexistir sentido común y ciencia.

ABSTRACT Background: unveiling the social representations of breast cancer can bring professionals in the psychological sciences to understand attitudes, behaviors and the influences they exert on patients, family members and specialists. Objective: to determine the structure of the social representations (attitude, information, representational field) of breast cancer in the study subjects. Methods: exploratory, cross-sectional study, of mixed methodology, in the period from May 2014 to December 2015. Applied as techniques: sociodemographic and clinical data form, semi-structured interview, composition, free association. The variables analyzed were: addressability of the attitude towards the diagnosis of breast cancer, addressability of the attitude towards treatments, in the information dimension: knowledge about disease conceptualization, knowledge of symptoms, knowledge about treatments, beliefs about risk factors , opinions on the consequences of breast cancer, opinions on the need to provide knowledge of the disease to patients, relatives. Descriptive statistical analysis of frequencies was performed. The information of the variables in the database of the statistical package SPSS 15.0 for Windows was processed. The results were expressed in absolute and relative frequencies. Results: patients, relatives showed addressability of the negative attitude towards diagnosis and treatment. There was a prevalence of adjusted responses in the explored areas of the information dimension, although with a homogeneous level of depth, in family members. The representative field of breast cancer accounted for mostly models of disease challenge in the study subjects. Conclusions: the subjects of the study in relation to breast cancer showed a negative attitude, there was a predominance of adjusted answers about the pathology information and mostly models of disease challenges.

Knowledge and attitude of general and specialist dentist in pediatric dentistry: A pilot study in Odisha, India

Background: Pediatric dentists (PDs) treat children in a manner that builds a positive dental attitude in them. The treatment modalities for pulpally involved teeth in children are different by general dentists (GDs) as compared to PDs. Aim and Objectives: The aim of this study is to determine the attitudes of PDs, GDs, and dentists of other specialties toward endodontic treatment of primary teeth. Materials and Methods: A structured 14-item questionnaire was formulated in English and distributed to PD, GDs, and dentists of other specialties. The filled questionnaire survey was statistically analyzed using simple descriptive analysis, and inferential analysis was performed. Results: Of the total survey respondents, 12 (20.68%) were PDs, 28 (48.27%) were GDs, and 18 (31.03%) were from other specialties. About 91.6% of the total respondents preferred endodontic procedures in the primary teeth. Conclusion: The study concluded that the GDs, PDs, and dentists of other specialties differ in their treatment recommendations for primary teeth. The GDs and dentists of other specialties were regularly performing pulp therapy in the primary teeth and should frequently update their knowledge about endodontic procedures in the primary teeth.

Research progress on general practitioners-specialists joint consultation service / 中华医院管理杂志

At present, general practitioners in China lack both specialist knowledge and ability, which calls for close cooperation between general practitioners and specialists to better guarantee medical quality and patient safety. The authors reviewed the connotation, research status, development trend, problems and suggestions of general practitioners-specialists joint consultation service. Based on such, they pointed out that such a general practitioner-specialist joint clinic is quite new in the country, but numerous literature has confirmed that it can not only make up for services fragmentation, but also reduce referral rate.Furthermore, it can improve the quality of people′s lives, improve the general practitioner′s professional knowledge and skills, standardize general practitioner′s rational drug use. All these prove the reform an effective measure and deserves further promotion and greater supervision.

Investigation and analysis of medical students' recognition of standardized training for specialists / 中华医学教育探索杂志

Objective In order to understand the identity of medical students for the standardized training for specialists,and provide theoretical support and policy reference for it.Methods Using the method of stratified sampling and quota sampling,2 367 medical students were selected from 17 universities in 7 administrative regions of the country to carry out anonymous electronic questionnaire survey.The results were analyzed by SPSS 19.0,with methods of mean comparison,ratio constituent and Chi-square test.Results In the survey,only 231 samples had a good understanding of specialist training for specialists,which accounted for 9.8％.And there were statistical differences between different types of medical students (x2=40.5,P＜0.05) and different administrative areas (x2=33.7,P＜0.05).17.0％ of the samples have shown that they would take participate in the special training system initiatively;641 samples (22.9％) had a positive attitude towards the system,and 782 samples (33％) did not.The main reasons for non-support included low treatment (71.8％),long training time for becoming a doctor (87.7％) and the difficulty of ensuring the training quality (59.1％).Conclusion The research can shed some lights on standardized training for specialists including establishing a network communication platform to improve the efficiency,increasing financial investment,setting up a mechanism to link the capital input to training quality to ensure the treatment of trainees,exploring the training mode of combining standardization training and doctorate training to shorten the training period,reforming the personnel system and incorporating specialists training system into the promotion conditions of professional titles.