Cirurgiões plásticos como cirurgiões de mão: a visão dos residentes / Plastic surgeons as hand surgeons: residents' perceptions

INTRODUÇÃO: Pesquisas prévias têm revelado que residentes têm conhecimentos equivocados sobre a atuação dos cirurgiões plásticos como especialistas em cirurgia da mão. No entanto, até o momento, não existem dados específicos abordando tal aspecto na literatura científica brasileira. Portanto, o objetivo deste estudo foi avaliar os conhecimentos e as percepções dos residentes sobre o papel dos cirurgiões plásticos no campo cirurgia da mão no Brasil. MÉTODO: Residentes brasileiros escolheram um ou dois especialistas que eles acreditassem ser experts para oito cenários relacionados à cirurgia de mão. Os padrões de respostas foram distribuídos como "cirurgiões plásticos" ou "sem cirurgiões plásticos", e "apenas cirurgiões plásticos", "cirurgiões plásticos combinados com outros especialistas" ou "cirurgiões plásticos ausentes". RESULTADO: "Sem cirurgiões plásticos" e "cirurgiões plásticos ausentes" foram mais (p<0,05, para todas as comparações) escolhidos que todos os outros padrões de respostas, em todos os cenários. Cirurgiões plásticos foram menos (p<0,05, para todas as comparações) reconhecidos que cirurgiões ortopédicos (seis cenários), cirurgiões gerais (um cenário) e neurocirurgiões (um cenário). CONCLUSÃO: Os conhecimentos e as percepções dos residentes brasileiros sobre o trabalho realizado por cirurgiões plásticos no campo cirurgia da mão são limitados.

INTRODUCTION: Previous studies have revealed that residents have misconceptions about plastic surgeons as hand surgery specialists. Until now, however, there have been no specific data on this trend in Brazilian scientific literature. Therefore, the aim of this study was to evaluate Brazilian residents' knowledge and perceptions about the role of plastic surgeons in the field of hand surgery. METHOD: Brazilian residents chose one or two specialists they believed to be experts for eight scenarios related to hand surgery. The responses were categorized as "plastic surgeons", "without plastic surgeons", "only plastic surgeons", "plastic surgeons combined with other specialists", or "plastic surgeons absent". RESULT: Responses without plastic surgeons and with plastic surgeons absent were chosen more often than all other responses in all scenarios (p<0.05 for all comparisons). Plastic surgeons were less often recognized as experts compared to orthopedic (six scenarios), general (one scenario), and neurosurgeons (one scenario) (p<0.05 for all comparisons). CONCLUSION: Brazilian residents have limited knowledge and perceptions about hand surgery performed by plastic surgeons.

Developing a national trauma management workshop in Iran applying an animal model

Traumas take a heavy toll throughout the world and Iran is increasingly involved in this problem. So, education and training of medical staff for successful handling of traumatic patients seem necessary. In this study, we tried to develop and evaluate a national training program on trauma management to use animal models through a trauma management workshop. After primary survey and designing an advanced trauma management workshop, 144 practitioners of one armed force were randomly selected to be trained. Participants could experience some practical and new aspects. For example, they handled high velocity traumas and were involved throughout the different phases of trauma management under the supervision of experienced leaders. To assess the program, participants completed open-ended [essay], multiple-choice question [MCQ], and skill exams before and after the workshop. A trauma training program was developed and evaluated. In essay exam, scores significantly increased from 26 to 58, MCQ scores significantly rose from 49 to 65, and the participant's practical competency significantly improved from 46 to 75. Immense attention is required to optimize doctors' training in trauma care to avoid fossilization of cognitive knowledge and skills

Avaliação das capacitações de hanseníase: opinião de médicos e enfermeiros das equipes de saúde da família / Evaluación de las capacitaciones de Hanseníasis: la visión de médicos y enfermeros de los equipos de salud de la familia / Evaluation of training programs in Hansen's Disease: opinion of physicians and nurses of family health teams

A hanseníase é uma doença milenar, infectocontagiosa, causada pelo Mycobacterium leprae; manifesta-se em células cutâneas e nervos periféricos. Na década de 1990, as ações de controle foram descentralizadas, passando do estado para o município. Um estado do nordeste brasileiro elaborou, então, uma série de treinamentos em hanseníase para capacitar os profissionais da rede básica. O objetivo deste estudo foi avaliar esses treinamentos a partir da opinião de médicos e enfermeiros das equipes de saúde da família. Os resultados indicam que os profissionais avaliaram os treinamentos positivamente quanto à sua implementação e ao objetivo de capacitá-los para a detecção da doença. Conclui-se que os treinamentos precisam ser continuados e lançam-se algumas reflexões para os próximos.

Hansen's Disease is a contagious, milenar disease caused by the Mycobacterium leprae that manifests itself in the cutaneal cells and the peripheral nerves. In the decade of 1990, the control for the disease was descentralized from the state to the municipality level. A northeastern state in Brazil implemented a series of training programs for health professionals in primary attention. The objective of this study was to evaluate these training programs, based on the opinions of the physicians and nurses in the family health teams. The results indicate that the professionals evaluated the training program positively as to its implementation and the achievement of its objective. It is concluded that the training programs need to continue with changes that can contribute to future programs.

La Lepra es una enfermedad milenaria, infectocontagiosa, provocada por el Mycobacterium leprae; se manifiesta en células cutáneas y nervios periféricos. En la década del 1990, las acciones de control fueron descentralizadas, pasando de la provincia para el municipio. Una provincia del nordeste brasileño elaboró, entonces, una serie de entrenamientos en hanseniasis para capacitar a los profesionales de la red básica. El objetivo de este estudio fue evaluar esos entrenamientos, a partir de la opinión de médicos y enfermeros de los equipos de salud de la familia. Los resultados indican que los profesionales evaluaron los entrenamientos positivamente en cuanto a su implementación y el objetivo de capacitarlos para la detección de la enfermedad. Se concluye que los entrenamientos necesitan ser continuados y se lanzan algunas reflexiones para los próximos.

Knowledge, attitude and practices about leprosy among medical officers of Hyderabad urban district of Andhra Pradesh.

In India, MDT was implemented through vertical programme staff of the National Leprosy Eradication Programme till the year 2001, when it was integrated into general health services (GHS). Human resource development of GHS is a vital, preparatory action for successful integration of leprosy into GHS. District Technical Support Teams (DTST) have been formed with responsibility for building the capacity of medical and paramedical staff of urban health posts (UHPs). In this context, it is necessary to know the current levels of Knowledge, Attitude and Practices (KAP) about leprosy prevailing among health staff at a given point in time, so that required knowledge and skills can be imparted, if need be. The present study is an attempt in this direction for assessing the KAP status of health staff working in Hyderabad city. 402 staff members (352 females and 50 males) working in urban health posts, the Employees State Insurance Corporation and the Central Government Health Services dispensaries in Hyderabad urban district in Andhra Pradesh were included in the study carried out in 2004 in order to assess KAP, and some operational parameters. A questionnaire was used to elicit responses of 110 medical officers in urban Hyderabad and the data were analysed and discussed. Medical officers have shown consistent higher knowledge on leprosy, followed by nursing staff as compared to other paramedical workers Only 40% of the medical officers had the opportunity of seeing at least 1 case of leprosy in their practice. Medical Officers who received training in leprosy and possessed reference material on leprosy have shown higher knowledge and practice. More than half of the study subjects did not have specific training in leprosy. Two major operational problems expressed by the medical officers were managing big crowds in OPD and time lost in meetings. 96 (87.3%) of 110 medical officers felt integration of leprosy services into general health services can be effectively implemented. 78 (71%) expressed that a leprosy patient with severe reaction needed priority attention at the out-patient department indicating good understanding of reactions in leprosy and a positive attitude towards such patients. There is a need to organize training at regular intervals to cover new persons as well as reinforcing and updating the knowledge of those already trained.