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1.
An. Facultad Med. (Univ. Repúb. Urug., En línea) ; 8(2): e602, dic. 2021. ilus, graf, tab
Article in Spanish | LILACS, BNUY, UY-BNMED | ID: biblio-1358268

ABSTRACT

El proceso de docencia-aprendizaje de las disciplinas clínicas tiene entre sus desafíos la adquisición de habilidades del estudiante con el paciente. Las oportunidades de prácticas clínicas se han reducido. La menor cantidad de consultas pediátricas en el año 2020 durante la pandemia por Coronoavirus exacerbó este hecho. Objetivo: Comunicar la experiencia de simulación in situ y madre simulada realizada por docentes del Departamento de Emergencia Pediátrica del Centro Hospitalario Pereira Rossell, dirigida al entrenamiento de estudiantes de la Unidad Curricular Pediatría (Facultad de Medicina-UdelaR), en la realización de la anamnesis de un paciente con patología respiratoria. Metodología: estudio descriptivo. Madre simulada: docentes/residentes. Simulador: lactante-tecnología intermedia. Participantes del escenario: 2 estudiantes. Lugar: DEP-CHPR. Período: setiembre-diciembre 2020. Resultados: Participaron de la simulación 327 estudiantes, 255 contestaron el censo. Utilidad de la simulación: 53,2% muy útil/excelente, poco o nada útil 24,8%, no contesta 22%. Credibilidad: aceptable 38%, muy creíble/excelente 27,5%, 12,5% poco o nada creíble, 22% no contesta. Participación grupal en el debriefing 64,5%, participación parcial 11,4%, sin debriefing 2,1%, no contesta 22%.Discusión: De los 327 estudiantes que realizaron la simulación al menos 24,% la percibió como poco o nada útil. La falta de información previa, la participación en el escenario de 2 estudiantes por grupo y la poca interacción en el debriefing en algunos grupos pudo haber influído. Conclusiones: La experiencia comunicada generó nuevas oportunidades de docencia aprendizaje. Se identificaron aspectos metodológicos que pueden mejorarse.


The teaching-learning process in clinical disciplines includes amongst its challenges the acquisition of the student's skills with the patient. Opportunities for clinical practice have diminished. A smaller number of pediatric visits in 2020 during the Coronavirus pandemic increased this fact. Objective: to communicate the experience of in situ simulation and simulated mother carried out by the faculty of the Pediatric Emergency Department of the Pereira Rossell Hospital Center, address to students in the Pediatrics Curricular Unit (School of Medicine- UdelaR), in the case of an infant patient with respiratory pathology. Methods: Descriptive study. Simulated mother: faculty members/residents. Simulator: intermediate technology infant. Participants in the scenario: 2 students. Location: DPE.PRHC. Period: September- December 2020.Results: 327 students participated in the simulation, 255 answered the census. Usefulness of the simulation: 53.2% very useful / excellent, little or not at all useful 24.8%, no answer 22%. Credibility: acceptable 38%, very credible / excellent 27.5%, 12.5% ​​little or not at all credible, 22% do not answer. Group participation in the debriefing 64.5%, partial participation 11.4%, without debriefing 2.1%, no answer 22%. Discussion: Of the 327 students who carried out the simulation at least 24,8 % perceived it as little or not useful. The lack of previous information, the participation in the scenario of 2 students per group and the little interaction in the debriefing in some groups could have influenced. Conclusions: The communicated experience generated new teaching-learning opportunities. Methodological aspects that can be improved were identified.


O processo de ensino-aprendizagem de disciplinas clínicas tem entre seus desafios a aquisição de habilidades do aluno com o paciente. As oportunidades de estágio clínico foram reduzidas. O menor número de consultas pediátricas em 2020 durante a pandemia de Coronoavirus exacerbou esse fato. Objetivo: Comunicar a experiência de simulação in situ e simulação materna realizada pela docentes do Serviço de Urgência Pediátrica do Centro Hospitalar Pereira Rossell, com alunos da Unidade Curricular Pediatria (Faculdade de Medicina-UdelaR), na anamnese de paciente com doença respiratória. Metodologia: estudo descritivo. Mãe simulada: professores / residentes. Simulador: lactente de tecnologia intermédia. Participantes do cenário: 2 alunos. Local: DEP-CHPR. Período: setembro a dezembro de 2020. Resultados: 327 alunos participaram da simulação, 255 responderam a pesquisa. Utilidade da simulação: 53,2% muito útil / excelente, pouco ou nada útil 24,8%, sem resposta 22%. Credibilidade: aceitável 38%, muito credível / excelente 27,5%, 12,5% pouco ou nada credível, 22% não respondem. Participação do grupo no debriefing 64,5%, participação parcial 11,4%, sem debriefing 2,1%, sem resposta 22%. Discussão: Dos 327 alunos que realizaram a simulação, pelo menos 24,% a perceberam como pouco ou nada útil. A falta de informação prévia, a participação no cenário de 2 alunos por grupo e a pouca interação no debriefing em alguns grupos podem ter influenciado. Conclusões: A experiência comunicada gerou novas oportunidades de ensino-aprendizagem. Aspectos metodológicos que podem ser melhorados foram identificados.


Subject(s)
Humans , Pediatrics/education , Students, Medical , High Fidelity Simulation Training , Medical History Taking , Retrospective Studies
2.
Arch. argent. pediatr ; 119(4): 270-273, agosto 2021. tab, ilus
Article in English, Spanish | LILACS, BINACIS | ID: biblio-1280932

ABSTRACT

En pacientes con infección por SARS-CoV-2 la intubación endotraqueal es un procedimiento con riesgo elevado de contagio. La videolaringoscopia complementa la protección del profesional, pero los videolaringoscopios comerciales son caros y no siempre están disponibles en las terapias intensivas pediátricas argentinas. El objetivo fue describir la práctica de intubación en un modelo de cabeza de simulación de lactante con un videolaringoscopio artesanal de bajo costo.Quince pediatras sin experiencia previa con el dispositivo participaron de una práctica de intubación en una cabeza de simulación con un videolaringoscopio artesanal. El tiempo promedio del primer intento fue de 116,4 segundos (intervalo de confianza del 95 % [IC95 %]: 84,8-148,0) y, el del siguiente fue de 44,2 segundos (IC95 %: 27,7­60,6). El tiempo disminuyó de forma significativa en el segundo intento (p : 0,0001). El dispositivo permitió la intubación exitosa en todos los intentos acortando la duración del procedimiento en la segunda práctica


In patients with SARS-CoV-2 infection, endotracheal intubation is a procedure with a high risk for transmission. A videolaryngoscopy is a supplementary level of health care provider protection, but commercial videolaryngoscopes are expensive and not always available in pediatric intensive care units in Argentina. Our objective was to describe intubation practice using an infant head mannequin with a low-cost, handcrafted videolaryngoscope.Fifteen pediatricians with no prior experience using the device participated in an intubation practice in a head mannequin with a handcrafted videolaryngoscope. The average time for the first attempt was 116.4 seconds (95 % confidence interval [CI]: 84.8-148.0) and, for the second one, 44.2 seconds (95 % CI: 27.7-60.6). Time decreased significantly for the second attempt (p: 0.0001).A successful intubation was achieved with the device in all attempts, and the procedure duration decreased with the second practice


Subject(s)
Humans , Infant , Pediatrics/education , Laryngoscopes/economics , Simulation Training/methods , COVID-19/prevention & control , Intubation, Intratracheal/instrumentation , Laryngoscopy/economics , Pediatrics/economics , Time Factors , Video Recording , Health Care Costs , Clinical Competence/statistics & numerical data , Education, Medical, Continuing/methods , Learning Curve , COVID-19/transmission , Internship and Residency/methods , Intubation, Intratracheal/economics , Intubation, Intratracheal/methods , Laryngoscopy/education , Laryngoscopy/instrumentation , Laryngoscopy/methods , Manikins
3.
Rev. bras. educ. méd ; 45(2): e098, 2021. graf
Article in English | LILACS | ID: biblio-1279833

ABSTRACT

Abstract: Introduction: A medical residency is the specialization par excellence in medical training and the program is responsible for ensuring that the recently graduated doctor reaches the established level of competence. A well-prepared assessment system with feedback is an effective tool to enhance the performance of future specialists and guarantee their qualification. Objective: To analyze the assessment system for pediatric residents at a university hospital, aiming to promote teaching training in assessment methods. Methodology: educational action research (research-teaching), conducted with teachers and preceptors in the pediatric residency of a university hospital. The stages consisted of: a) the application of a questionnaire on participant profile and assessment methods used to evaluate the medical residents; b) intervention (workshop) on the assessment of clinical skills and feedback; c) immediate assessment after the workshop, by applying another questionnaire based on level 1 of the Kirkpatrick model. Simple statistical analysis was used for the objective data and the content analysis, according to recommendations by Malheiros (2011) and Bardin (2013), for the qualitative part. Result: Ten (48%) of the 21 participants declared not being formally trained in assessment and that they applied the more traditional methods learned from personal experience. Regarding the assessment methods, 81% (17/21) of the participants used more than one, aiming to obtain a more encompassing and reliable assessment. However, none of the teachers/preceptors used a systematized assessment of the clinical skills or provided feedback to the medical residents. After the workshop, with a focus on assessing performance in a simulated 'Objective Structured Clinical Examination' (OSCE) environment, all the participants were favorable to apply the OSCE in their teaching-learning practice with residents and undergraduate students, reaching Kirkpatrick level 3. Conclusion: The action research helped identify limitations in the assessment and feedback system of the pediatric resident physician. The methodology used revealed an aggregating effect and contributed to the development of the collaborative and integrative sense in the group. However, it was not enough to positively interfere with the pediatric medical residency assessment in the short term.


Resumo: Introdução: A residência médica é a especialização por excelência na formação do médico, e cabe ao programa assegurar que o residente egresso atinja o nível almejado de competência. Um sistema avaliativo bem elaborado e com feedback é ferramenta efetiva para aprimorar o desempenho do futuro especialista e garantir a qualificação dele. Objetivo: Este estudo teve como objetivo analisar o sistema de avaliação do médico residente em pediatria de um hospital universitário, com o intuito de promover a formação docente em métodos avaliativos. Método: Trata-se de uma pesquisa-ação educacional (pesquisa-ensino) realizada com docentes e preceptores da residência médica em pediatria de um hospital universitário. As etapas consistiram em: 1. aplicação de questionário sobre o perfil dos participantes e os métodos avaliativos utilizados com os residentes; 2. intervenção com a realização de um workshop sobre avaliação de habilidades clínicas e feedback; 3. avaliação imediata, após o workshop, com aplicação de outro questionário, elaborado com base no nível 1 do método Kirkpatrick. Utilizaram-se a análise estatística simples, para os dados objetivos, e a análise de conteúdo, segundo recomendações de Malheiros e Bardin, para a parte qualitativa. Resultado: Dos 21 participantes, dez (48%) informaram que não tinham capacitação formal em avaliação e que utilizavam métodos avaliativos mais tradicionais. Quanto aos métodos, 81% (17/21) dos participantes informaram que utilizavam mais de um, com finalidade somativa, para obter uma avaliação mais abrangente e fidedigna. No entanto, nenhum utilizava uma avaliação sistematizada de habilidades clínicas com fornecimento de feedback. Após o workshop com enfoque em avaliação de desempenho em ambiente simulado, em que se adotou o Objective Structured Clinical Examination (OSCE), os participantes utilizaram, com os internos, o método avaliativo do aprendizado na sua prática cotidiana, e, dessa forma, o treinamento atingiu o nível 3 de Kirkpatrick. Conclusão: A pesquisa-ação propiciou identificar limitações no sistema de avaliação e feedback do médico residente em pediatria. A metodologia utilizada revelou um efeito agregador e contribuiu para desenvolver o sentido colaborativo e integrativo no grupo. No entanto, não foi suficiente para interferir positivamente, em curto prazo, na avaliação da residência médica em pediatria.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Pediatrics/education , Education, Medical/methods , Teacher Training/methods , Internship and Residency , Surveys and Questionnaires , Clinical Competence , Educational Measurement , Formative Feedback , Hospitals, University
4.
Rev. bras. educ. méd ; 45(2): e076, 2021. tab, graf
Article in Portuguese | LILACS | ID: biblio-1251126

ABSTRACT

Resumo: Introdução: O modelo tradicional de ensino médico possui uma ideia biocêntrica dos problemas de saúde, hipervalorizando os aspectos biológicos do paciente, sem considerar os demais aspectos envolvidos no processo saúde-doença. Esse método é centrado no professor, e o aluno atua como receptor passivo do conhecimento. Em contrapartida, nas metodologias ativas, o estudante possui papel ativo no processo de ensino-aprendizagem, construindo um conhecimento crítico e reflexivo. Objetivo: Este estudo teve como objetivos analisar a importância das metodologias ativas no ensino de Pediatria I do curso de Medicina da Universidade Federal de Minas Gerais (UFMG) e propor adaptações que permitam a aplicação dessas metodologias no período de ensino remoto emergencial (ERE). Método: Trata-se de uma revisão narrativa, com dados obtidos de forma independente pelos autores, por meio de busca abrangente e não sistemática no PubMed e na SciELO. Primeiro, realizaram-se a busca e a análise de dados das principais metodologias ativas, e, posteriormente, os achados foram aplicados à disciplina de Pediatria I do curso de Medicina da UFMG, incluindo suas adaptações para a implementação no ERE. Resultados: Analisaram-se a problematização, a aprendizagem baseada em problemas e o fishbowl como recursos didáticos das metodologias ativas. Esses métodos reforçam a curiosidade, a autonomia, a motivação e as capacidades crítica e reflexiva do aluno. Ademais, promovem integração entre teoria e prática, incentivo do trabalho em equipe e estímulo para o estudante se conscientizar sobre os problemas sociais existentes. Conclusão: Assim, o uso das metodologias ativas no ensino em Pediatria I possibilita alcançar os objetivos da disciplina, tanto no modo presencial quanto no ERE, e atingir as expectativas das diretrizes brasileiras sobre a formação médica.


Abstract: Introduction: The traditional model of medical education has a biocentric perspective of health problems, overestimating biological aspects of the patient, without considering the other aspects involved in the health-disease process. This method is teacher-centered and the student acts as a passive recipient of knowledge. On the other hand, in active methodologies the student plays an active role in the teaching-learning process, building critical and reflective knowledge. Objective: This study aims to analyze the importance of active methodologies in the teaching process of Pediatrics I on the Medicine course at the Federal University of Minas Gerais and to propose changes in these methodologies so they can be employed during the period of Emergency Remote Education (ERE). Method: It is a narrative review, with data obtained independently by the authors through a broad and non-systematic search in PUBMED and SCIELO. Data on the main active methodologies were collected and analyzed, and the findings were subsequently applied to Pediatrics I, including their adaptation to implementation in the ERE. Results: The problematization, problem-based learning and fishbowl methodologies were analyzed as didactic resources of active methodologies. These methods reinforce the student's curiosity, autonomy, motivation and critical and reflective thinking skills. Furthermore, they promote integration between theory and practice learning, encourage teamwork and encourage students to become aware of existing social problems. Conclusion: Using active methodologies in the teaching process of Pediatrics I makes it possible to achieve the objectives of this discipline, both in face-to-face and remote learning, and reach the expectations of the Brazilian Guidelines on medical education.


Subject(s)
Humans , Pediatrics/education , Problem-Based Learning/methods , Education, Distance/methods , Education, Medical/methods , Schools, Medical , Mentoring
5.
Interface (Botucatu, Online) ; 25: e210059, 2021. ilus, tab
Article in Portuguese | LILACS | ID: biblio-1350860

ABSTRACT

O feedback formativo é central na educação médica. Contudo, estudos sobre a aplicação da estratégia na Pediatria são escassos. Objetivando compreender como o feedback pode ser incorporado ao aprendizado do estudante de Medicina no contexto pediátrico, conduziu-se uma revisão narrativa da literatura. A partir da consulta às bases de dados Medline, Lilacs, SciELO, Embase e Scopus e Web of Science, selecionaram-se 13 artigos, publicados entre 1986 e 2020, focados em feedback de alunos de Pediatria na graduação. A análise da literatura evidenciou a utilidade do feedback de múltiplas fontes e a importância de ferramentas como formulários e cartões de encontro clínico para fornecer feedback quanto às habilidades necessárias ao bom exercício da Pediatria. Os trabalhos pouco exploraram o feedback com auxílio da internet, o que deve ser tema de pesquisas futuras. (AU)


Formative feedback is central to medical education. However, studies on the application of the technique in pediatrics are scarce. We conducted a narrative literature review to understand how feedback can be incorporated into medical student training in pediatrics. Searches of the MEDLINE, LILACS, SciELO, Embase, Scopus and Web of Science databases resulted in the selection of 13 articles focusing on feedback and pediatrics graduate students published between 1986 and 2020. The findings highlight the usefulness of multiple-source feedback and importance of tools such as forms and clinical meeting cards for providing feedback on necessary pediatrician skills. The articles paid little attention to feedback with the help of the internet, which should be the theme of future studies. (AU)


El feedback formativo es central en la Educación Médica; sin embargo, son escasos los estudios sobre la aplicación de la estrategia en la Pediatría. Con el objetivo de comprender cómo el feedback puede incorporarse al aprendizaje del estudiante de medicina en el contexto pediátrico, se realizó una revisión narrativa de la literatura. A partir de la consulta a la base de datos de MEDLINE, Lilacs, SciELO, EMBASE, Scopus y Web of Science, se seleccionaron 13 artículos, publicados entre 1986 y 2020, enfocados en feedback y alumnos de Pediatría en la graduación. El análisis de la literatura puso en evidencia la utilidad del feedback de múltiples fuentes y la importancia de herramientas como formularios y tarjetas de encuentro clínico para proporcionar feedback con relación a las habilidades necesarias para el buen ejercicio de la Pediatría. Los trabajos exploraron poco el feedback con el auxilio de internet, lo que debe ser tema de investigaciones futuras. (AU)


Subject(s)
Humans , Pediatrics/education , Students, Medical , Formative Feedback , Review Literature as Topic , Education, Medical , Learning
6.
Rev. bras. educ. méd ; 45(3): e161, 2021. tab
Article in English | LILACS | ID: biblio-1288313

ABSTRACT

Abstract: Introduction: a specific instrument is needed to monitor the development of competencies in pediatric surgery during the residency. Objective: to develop an instrument in conformity with the "Milestone Project", using the competencies determined by the Brazilian Association of Pediatric Surgery, for use in the Pediatric Surgery Residency in Brazil. Method: the research was developed in three stages: the development of the initial instrument, qualification with a focal group of experts, and instrument evaluation by Brazilian pediatric surgeons in order to validate and quantify the instrument's acceptance. Result: The initial instrument was created with 4 competencies and 13 sub-competencies, each with 5 levels of assessment. Four experts performed the initial qualification, which resulted in 44 adaptations, and the instrument was finalized with 4 competencies subdivided into 10 sub-competencies, each with 5 levels of assessment. Subsequently, the instrument was evaluated by the Brazilian Pediatric Surgery Group and the Brazilian Pediatric Urology Group. There were 40 expert responses, with a total of 2394 positive responses from the 50 assessment items. The instrument had a general acceptance of 91.2%, being considered applicable (96.7%), reproducible (93.3), relevant to the covered topics (96%), technically (93.6%) and theoretically appropriate (93.3%), reliable (85.5%), and dependable (79.8%). Conclusion: an instrument was developed to assist in the assessment of competencies developed during residency in pediatric surgery in conformity with the Milestone Project. This instrument has been validated by experts and considered applicable, reproducible, relevant, technically and theoretically adequate, reliable and dependable.


Resumo: Introdução: Uma adequada formação na residência em cirurgia pediátrica deve avaliar e acompanhar constantemente o desenvolvimento de competências e, para isso, necessita de um instrumento específico como ferramenta de avaliação. Objetivo: Este estudo tem como objetivo apresentar um instrumento de avaliação nos moldes do "Milestone Project" com base nas competências determinadas pela Associação Brasileira de Cirurgia Pediátrica, para uso nos programas de residência médica em cirurgia pediátrica no Brasil. Método: Adotaram-se as seguintes etapas: desenvolvimento do instrumento, qualificação de um grupo de especialistas e avaliação do instrumento por cirurgiões pediatras brasileiros, a fim de validar e quantificar a aceitação do instrumento quanto à fidedignidade, confiabilidade, aplicabilidade, reprodutibilidade, relevância dos temas abordados e adequação dos pontos de vista técnico e teórico. Resultados: O instrumento inicial possuía quatro competências gerais e 13 subcompetências específicas, com cinco níveis de avaliação. Quatro experts realizaram a qualificação que gerou 44 adaptações, finalizando o instrumento com quatro competências gerais subdividias em dez subcompetências, com cinco níveis avaliativos. Sequentemente, o instrumento foi avaliado pelo Grupo Brasileiro de Cirurgia Pediátrica e pelo Grupo Brasileiro de Urologia Pediátrica. Houve 40 respostas de especialistas, 2.394 respostas positivas dos 50 itens. O instrumento teve aceitação de 91,2% e foi considerado aplicável (96,7%), reprodutível (93,3), relevante (96%), tecnicamente adequado (93,6%), teoricamente adequado (93,3%), confiável (85,5%) e fidedigno (79,8%). Conclusão: Esse instrumento nos moldes do "Milestone Project" foi validado por cirurgiões pediatras e considerado aplicável, reprodutível, relevante, adequado, sob os pontos de vista técnico e teórico, confiável e fidedigno.


Subject(s)
Humans , Pediatrics/standards , Specialties, Surgical/standards , Clinical Competence , Internship and Residency , Pediatrics/education , Specialties, Surgical/education , Focus Groups , Educational Measurement
7.
Article in English | LILACS, SES-SP | ID: biblio-1136789

ABSTRACT

ABSTRACT Objective: To assess personal, professional, medical, and scientific educational characteristics and issues reported by pediatricians. Methods: Cross-sectional study based on an online survey including 614 pediatricians who graduated in the last 15 years at a University Pediatric Department in Brazil. Results: The response rate was 331/614(54%). The majority were females (82%), the median age was 33 years (27-40) and median years of pediatric practice was 5 (1-13). High workload (>60 hours/week) occurred in 25% and 47% earned ≥15 minimum wages/month. The most work-related issues reported were long working hours, poor social life and a sedentary lifestyle (>50%). Pediatricians were further divided into two groups, according to years of pediatric clinical practice: group 1 (≤5 years) and group 2 (>5 years). The median of overall satisfaction with pediatric residency [8(0-10) vs. 9 (4-10); p=0.002] was significantly reduced in group 1. The frequencies of workload >60 hours, work on pediatric ward and pediatric intensive care were significantly higher in the first group (p<0.05). Regarding main issues related to clinical practice in the last year, long working hours (73 vs. 53%; p<0.001), poor social life (75 vs. 62%; p=0.018) and harassment (23 vs. 4%; p=0.003) were significantly higher in the first group. Conclusions: Very early career pediatricians (≤5 years) reported higher workload, lower income, work-related issues and different location of pediatric practice compared to early career pediatricians (>5 years). The overall satisfaction with pediatric residency was good, however, reduced in very early career pediatricians.


RESUMO Objetivo: Avaliar características e problemas pessoais, profissionais, médicos e de educação científica reportados por pediatras. Métodos: Estudo transversal com base em uma pesquisa online, incluindo 614 pediatras formados nos últimos 15 anos no Departamento de Pediatria de uma universidade brasileira. Resultados: A taxa de resposta foi de 331/614 (54%). A maioria dos participantes era do sexo feminino (82%), a mediana de idade foi de 33 anos (27-40 anos) e a mediana de tempo de prática pediátrica foi de 5 anos (1-13). Jornada de trabalho elevada (>60 horas/semana) foi relatada por 25% dos entrevistados e 47% recebiam ≥15 salários mínimos/mês. Os problemas relacionados ao trabalho mais frequentes foram jornadas longas de trabalho, vida social insatisfatória e sedentarismo (>50%). Os pediatras foram divididos em dois grupos de acordo com os anos de prática clínica pediátrica: grupo 1 (≤5 anos) e grupo 2 (>5 anos). A mediana de satisfação geral com a residência pediátrica [8 (0-10) versus 9 (4-10); p=0,002] foi significativamente menor no grupo 1. As frequências de jornada de trabalho >60 horas, trabalho na enfermaria pediátrica e na terapia intensiva pediátrica foram significativamente maiores no primeiro grupo (p<0,05). Quanto aos principais problemas relacionados à prática clínica no ano anterior, jornadas longas de trabalho (73 versus 53%; p<0,001), vida social insatisfatória (75 versus 62%; p=0,018) e assédio (23 versus 4%; p=0,003) foram significativamente mais elevados no grupo 1. Conclusões: Pediatras em início de carreira (≤5 anos) relataram maior jornada de trabalho, menor renda, problemas relacionados ao trabalho e diferentes locais de trabalho em comparação com pediatras mais experientes (>5 anos). A satisfação geral com a residência pediátrica foi boa, porém menor em pediatras do primeiro grupo.


Subject(s)
Pediatrics/education , Attitude of Health Personnel , Pediatricians/psychology , Internship and Residency , Brazil , Cross-Sectional Studies , Surveys and Questionnaires , Work-Life Balance , Job Satisfaction
8.
Rev. cuba. pediatr ; 92(3): e1010, jul.-set. 2020. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1126775

ABSTRACT

En las últimas décadas se ha prestado mayor atención a los resultados de la actividad quirúrgica debido a factores económicos, la mejora de los cuidados perioperatorios y la preocupación por la calidad de la asistencia y satisfacción de la población. A este propósito han contribuido el desarrollo y aplicación de guías de práctica clínica. Estas guías reducen la variación en los cuidados del paciente quirúrgico, aumentan la eficiencia de dicho cuidado y proporcionan que los pacientes se beneficien de iniciativas institucionales encaminadas a mejorar la calidad de la asistencia sanitaria. La cirugía de alta precoz es un modelo de atención médico-quirúrgica encaminado a disminuir los costos de la atención médica mediante esfuerzos coordinados que permitan la reducción de la estancia hospitalaria en los pacientes, sin que ocurra incremento de complicaciones posoperatorias, ni insatisfacción de pacientes y familiares con el servicio prestado. Su empleo ha ido incrementándose en afecciones pediátricas. En el hospital pediátrico de Cienfuegos se aplica el modelo hace varios años y la guía fue aprobada en el Servicio de Cirugía Pediátrica en diciembre de 2018. Compartir esta guía mediante su publicación permitiría a otros servicios de cirugía pediátrica del país emplearla como referencia para la aplicación del modelo en sus propias instituciones y beneficiar a un mayor número de pacientes(AU)


In the last decades, there has been more attention on the results of the surgical activity due to economic factors, the improvement of perioperative cares and the concern on the quality of the care and the population´s satisfaction. The development and implementation of the clinical pratice´s guides had contributed to that purpose. These guides reduce the variations in the cares to the surgical patients, increase efficiency in that kind of care and foster that the patients are benefited with institutional initiatives addressed to improve health care quality. The Fast Track Pediatric Surgery is a model of medical-surgical care directed to lower the costs of medical care by means of coordinated efforts that allow the reduction of the hospital stay in patients without increasing the rates of postoperative complications, or dissatisfaction of the patients and relatives with the service given. The use of this procedure has been increasing in pediatric conditions. It has been implemented since some years ago in the Pediatric Hospital of Cienfuegos province, and the guide was approved in the Pediatric Surgery service in December, 2018.To share this guide by publishing it will be a way to allow other pediatric surgery services in the country to use it as a reference for the implementation of that model in their institutions and in that way to benefit a higher number of patients(AU)


Subject(s)
Humans , Male , Female , Pediatrics/education , Ambulatory Surgical Procedures/methods , Patient Discharge/standards
9.
Hist. ciênc. saúde-Manguinhos ; 27(2): 467-484, abr.-jun. 2020.
Article in Portuguese | LILACS | ID: biblio-1134064

ABSTRACT

Resumo O artigo analisa as atividades científicas de Carlos Artur Moncorvo de Figueiredo desenvolvidas na Policlínica Geral do Rio de Janeiro, fundada por ele. As ações profissionais e políticas desse médico foram fundamentais à implementação da pediatria, tanto no campo do estabelecimento de um espaço técnico de cura como na formação de uma cátedra especial de ensino da pediatria nas faculdades de medicina do Império, à época sediadas na Corte e em Salvador. O que se encontrará aqui é uma defesa de que a pediatria surgiu como desdobramento de um movimento pela implementação da medicina experimental, e não como uma questão social em torno do combate à mortalidade infantil, como comumente se encontra implícito na historiografia.


Abstract The scientific activities of Carlos Artur Moncorvo de Figueiredo at the General Polyclinic of Rio de Janeiro (Policlínica Geral do Rio de Janeiro), which he himself founded, are analyzed. His professional and political actions were fundamental for the introduction of pediatrics both in the establishment of a technical space for healing and in the formation of a specific discipline for the teaching of pediatrics at the faculties of medicine in the Empire, then based in the Court and in Salvador. Rather than arising in response to the social issue surrounding the fight against infant mortality, as is often implied in the historiography, pediatrics seems to have emerged from a movement for the implementation of experimental medicine.


Subject(s)
Humans , Child , History, 19th Century , History, 20th Century , Pediatrics/history , Ambulatory Care Facilities/history , Pediatrics/education , Brazil , Biomedical Research/history , Education, Medical/history
10.
Salud colect ; 16: e2727, 2020. tab, graf
Article in Spanish | LILACS | ID: biblio-1101901

ABSTRACT

RESUMEN Este artículo aborda el problema de la mortalidad infantil en la provincia de Santiago, Chile, y el desarrollo de la medicina pediátrica durante la segunda mitad del siglo XIX e inicios del XX, a través de especialistas que contribuyeron a organizar los conocimientos y prácticas que estructuraron su ejercicio profesional. Para emprender este objetivo y sistematizar este nuevo campo médico, se analizan los antecedentes relativos a la formación de la Facultad de Medicina y el quiebre que representó la aparición de una asignatura dedicada a las enfermedades de la niñez. La investigación se encuentra respaldada en diversas fuentes históricas, entre ellas, la prensa escrita, bibliografía médica, memorias de titulación y el Anuario Estadístico de la República de Chile. La inauguración de los hospitales de niños expresa una institucionalidad, en la que los facultativos posicionaron su labor, pusieron en práctica los tratamientos científicos y, lo más importante, se convirtieron en espacios que permitieron la disminución de la mortalidad infantil.


ABSTRACT This article deals with the problem of infant mortality in Santiago, Chile, and the development of pediatric medicine during the second half of the nineteenth century and the beginning of the twentieth century. Emphasis is placed on the specialists who contributed to organizing the knowledge and practices that structured their professional field. In order to pursue the objective and systematize this new medical field, our analysis suggests the decisive role of the establishment of the Faculty of Medicine and the appearance of coursework dedicated specifically to childhood diseases. Our research is based on various historical sources including the press, medical literature, thesis archives, and the Anuario Estadístico de la República de Chile [Statistical Yearbook of the Republic of Chile]. Likewise, the inauguration of children's hospitals expresses an institutional setting where physicians position their work, put scientific treatments into practice, and most importantly, they become spaces that allow for the reduction of infant mortality.


Subject(s)
Humans , Infant , History, 19th Century , History, 20th Century , Pediatrics/history , Schools, Medical/history , Infant Mortality/history , Hospitals, Pediatric/history , Pediatrics/education , Chile , Infant Mortality/trends
11.
ABCD arq. bras. cir. dig ; 33(4): e1559, 2020. graf
Article in English | LILACS | ID: biblio-1152632

ABSTRACT

ABSTRACT Background: Pediatric procedures have the difficulty of being performed in reduced spaces. Training in reduced spaces has proven to be different in complexity compared to adult laparoscopic endotrainers. Aim: To develop and validate a new neonatal/reduced-space endotrainer. Methods: The simulator was tested and assessed by users with different skill levels and experience in laparoscopic pediatric surgery through an 8-item questionnaire. Construct validity was determined by evaluating the performance of each subject on nine exercises. Results: A 10.5 x 10 x 18 cm acrylic simulator was created, with an internal working surface of 9 x 9 cm. An HD camera was incorporated, with a 0-180° range of movement. All exercises of a Basic Laparoscopic Training Program were adapted on a scale of 1:0.5 to fit in. From 49 participants, 42 (85.71%) answered the survey; 80.5% considered that the simulator reproduces similar conditions to procedures performed in children under one year of age; 61.1% thought that the simulator represents a difficulty identical to procedures performed in newborns; 73.7% considered that the neonatal simulator is more complicated than the adult simulator. Experts showed significantly better performance in all proposed exercises. Conclusion: The simulator has a high-quality image and design that allows training with basic tasks. The endotrainer permitted to discriminate between these different skill levels and was well evaluated by users with diverse surgical experience.


RESUMO Racional: Os procedimentos pediátricos têm dificuldade de serem realizados em espaços reduzidos. O treinamento nesses espaços provou ser diferente em dificuldade em comparação aos endotrainers laparoscópicos adultos. Objetivo: Desenvolver e validar um novo endotrainer neonatal com espaço reduzido. Métodos: O simulador foi criado, testado e avaliado por usuários com diferentes níveis de habilidade e experiência em cirurgia pediátrica laparoscópica por meio de um questionário de oito itens. A validação do método foi determinada pela avaliação do desempenho de cada participante em nove exercícios. Resultados: Foi criado um simulador acrílico de 10,5 x 10 x 18 cm, com uma superfície de trabalho interna de 9 x 9 cm. Uma câmera HD foi incorporada com faixa de movimento de 0-180°. Todos os exercícios do Programa de Treinamento Laparoscópico Básico foram adaptados em escala de 1:0,5 para se ajustarem. Dos 49 participantes, 42 (85,71%) responderam à pesquisa; 80,5% consideraram que o simulador reproduz condições semelhantes às de procedimentos realizados em crianças menores de um ano; 61,1% consideraram que o simulador representa dificuldade semelhante aos procedimentos realizados em recém-nascidos; 73,7% consideraram que o simulador neonatal é mais difícil que o simulador adulto. Especialistas apresentaram desempenho significativamente melhor em todos os exercícios propostos. Conclusão: O simulador possui imagem de alta qualidade e design que permitem o treinamento com exercícios básicos. O aparelho permitiu discriminar entre os diferentes níveis de habilidade e foi bem avaliado por usuários com experiência cirúrgica diversificada.


Subject(s)
Humans , Male , Female , Infant, Newborn , Child , Adult , Middle Aged , Pediatrics/education , General Surgery/education , Clinical Competence , Laparoscopy/education , Simulation Training/standards , Computer Simulation , User-Computer Interface , Surveys and Questionnaires , Reproducibility of Results , Laparoscopy/standards
12.
Clinics ; 75: e1392, 2020. tab
Article in English | LILACS | ID: biblio-1101093

ABSTRACT

OBJECTIVE: This study aimed to determine the personal and professional characteristics, and the physical, psychiatric/psychological, and professional issues that exist among master's-, doctoral-, and post-doctoral-level health professionals. METHODS: A cross-sectional, online, self-reported survey of 452 postgraduates who completed master's, doctoral, or post-doctoral degrees in one graduate program in pediatrics in São Paulo, Brazil, was conducted. RESULTS: The response rate was 47% (211/453). The majority of participants were women (78%) and physicians (74%), and the median age was 47 years (28-71). Master's, doctoral, and post-doctoral degrees were reported by 73%, 53%, and 3%, respectively. High workload (>40 hours/week) occurred in 59%, and 45% earned ≥15 minimum wages/month. At least one participation in scientific meeting in the past year was reported by 91%, and 79% had published their research. Thirty-nine percent served as a member of a faculty of an institution of higher learning. The data were analyzed by two age groups: participants aged ≤48 years (group 1) and participants aged >48 years (group 2). The median rating of overall satisfaction with the profession in the past year [8 (0-10) vs. 9 (1-10), p=0.0113]; workload >40 hours/week (53% vs. 68%, p=0.034); and ≥15 minimum wages/month (37% vs. 56%, p=0.0083) were significantly lower in group 1. Further analysis by gender revealed that the median rating of overall satisfaction with the profession in the past year [8 (0-10) vs. 9 (3-10), p=0.0015], workload >40 hours/week (53% vs. 83%, p=0.0002), and ≥15 minimum wages/month (37% vs. 74%, p=0.0001) were significantly lower in women compared with men. The median rating of overall satisfaction with the mentorship supervision provided was significantly higher among the women 10 (5-10) vs. 10 (2-10), p=0.0324]. CONCLUSIONS: The majority of master's-, doctoral-, and post-doctoral-level health professionals were women and physicians, and had published their thesis. Younger postgraduates and women reported low salaries, less likelihood of working >40 hours/week, and less overall satisfaction with their profession. Further longitudinal and qualitative studies are warranted to assess career trajectories after graduation.


Subject(s)
Humans , Male , Female , Child , Adult , Middle Aged , Aged , Pediatrics/education , Physicians , Quality of Life , Brazil , Cross-Sectional Studies , Sex Distribution , Age Distribution , Education, Medical, Graduate
14.
Rev. cuba. pediatr ; 91(2): e494, abr.-jun. 2019. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1003960

ABSTRACT

Introducción: Existen numerosos factores que influyen en la prescripción de analgésicos en pediatría, algunos relacionados con el prescriptor y otros no relacionados directamente. Para determinar los factores de mayor impacto en este problema, se construyó un cuestionario que se sometió a una validación por un grupo de expertos y a test estadísticos. Objetivos: Evaluar la fiabilidad del instrumento construido. Métodos: Se utilizó el método Delphi, con una circulación en tres rondas de un cuestionario remitido a un grupo de expertos de la provincia La Habana, durante los meses de mayo a octubre de 2016. Resultados: Participaron 23 expertos, en las dos primeras rondas se determinaron los ítems a incluir y en la tercera las preguntas. En esta última se logró un consenso de 89,3 por ciento. Las 43 preguntas aceptadas se condensaron en 19 con múltiples incisos y se obtuvo el cuestionario final. Para los factores no dependientes del prescriptor, el alfa de Cronbach fue de 0,179 y el coeficiente de Spearman-Brown de 0,231, mientras que para los factores que sí dependieron del prescriptor los valores fueron de 0,506 y 0,717, respectivamente. Conclusiones: El alto nivel de consenso obtenido y los resultados de los test estadísticos referentes a los factores que sí dependen del prescriptor, indican que las preguntas incluidas en el cuestionario son marcadores válidos para evaluar de forma confiable el manejo del dolor en el área de pediatría(AU)


Introduction: There are numerous factors that influence the prescription of analgesics in Pediatrics, some of them are related to prescriptors and other are not directly related to them. In order to determine the factors of bigger impact in this problem, a questionnaire was developed and submitted later to a group of experts in order to be validated. Objectives: To determine the contents to include in the questionnaire and to evaluate its reliability. Method: The Delphi method was used, with a circulation in 3 rounds of a questionnaire remitted to a group of experts of Havana province from May to October of 2016. Results: 23 experts participated in the study; in the two first rounds they determined the items to include and in the third round the questions. In this last round the consensus was of 89.3 percent, so, it was decided to finish the circulation of the questionnaire. They condensed the 43 accepted questions into 19 with multiple clauses and the final questionnaire was obtained. For the factors not dependents of the prescriptor, Cronbach's alpha value was 0.179 and Spearman-Brown coefficient´s value was 0.231; while for the factors that depended on the prescriptor, the values were 0.506 and 0.717, respectively. Conclusions: The high level of consent obtained and the results of statistics test referred to factors depending on the prescriptor are indicators that the questions included in the questionnaire are valid markers to evaluate in a reliable way the handling of pain in Pediatric areas(AU)


Subject(s)
Humans , Male , Female , Pediatrics/education , Delphi Technique , Pain Management/statistics & numerical data , Pain Measurement/statistics & numerical data , Surveys and Questionnaires , Validation Study
15.
Med. infant ; 26(1): 27-30, Marzo 2019.
Article in Spanish | LILACS | ID: biblio-994858

ABSTRACT

Introducción: Los programas de residencia médica son uno de los principales sistemas de formación de especialidades básicas y posbásicas. A partir del análisis "evaluación participativa" de la OPS en 2002 y el informe de la dra. M. Rosa Borrell en 2005, el Ministerio de Salud de la Nación definió bloques transversales en las bases curriculares. Los contenidos transversales abordan problemas centrales del campo de la salud y de la atención, comunes a todas las profesiones médicas. Contextualizan y determinan el ejercicio profesional. El propósito de este trabajo es contribuir a la evaluación del programa de residencias tomando como objeto de interés a los sujetos participantes de las residencias. Objetivo comprender las percepciones de los residentes de Pediatría del Hospital Garrahan sobre la formación en contenidos transversales. Población y métodos. 4 grupos focales, con 4-6 residentes de tercer y cuarto año de pediatría del Hospital Garrahan. Con ejes de discusión previamente planificados, con un tiempo de duración (120 minutos), en un ambiente no directivo, con múltiples disparadores. Análisis: los contenidos de los grupos focales se analizaron a través de la metodología de "teoría fundamentada en los datos" asistido por el programa ATLAS. Ti (versión 8). Resultados. Participaron 20 residentes, con una mediana de edad de 27 +/- 2 años. A partir de los tres ejes de discusión planificados para los grupos focales se elaboraron núcleos temáticos: normativo institucional, programa de formación, dinámicas de aprendizaje, sectores y climas de trabajo, el paciente y su familia, displicencia. En primer lugar, se reconocieron ingresando a una institución con normas de funcionamiento, en donde "la planta" se describió como la figura normativa predominante. En cuanto al programa de formación, hubo satisfacción con las capacidades alcanzadas. Sin embargo, se debatió si el perfil de profesional alcanzado permite reconocer determinantes de salud más allá de las comorbilidades estrictamente médicas. Surgieron problemáticas vinculadas a los límites del modelo médico hegemónico y la necesidad de nuevos enfoques de aprendizaje a través de la problematización del paciente en su contexto social. Definieron los casos clínicos como la mejor forma de abordar el conocimiento sobre un tema. Surgió espontáneamente el tema de la discriminación. Conclusión: a través de los grupos focales, como espacio de escucha activa de la experiencia cotidiana de trabajo de los residentes del Hospital Garrahan surgieron problemáticas vinculadas a los límites del modelo médico hegemónico y la necesidad de enfoques de aprendizaje a través de la problematización del paciente en su contexto social (AU)


Introduction: Medical residency programs are one of the main systems for the training in basic and post-basic specialties. Based on the "participatory evaluation" analysis by the PAHO in 2002 and the report by dr. M. Rosa Borrell in 2005, the National Ministry of Health defined cross-curricular groups to form the basis of the curriculum. The cross-curricular contents address core subjects in the health care field, common to all medical professions. These subjects contextualize and determine the professional practice. The aim of this study was to contribute to the evaluation of the residency program focusing on the participants in the residency programs. Objective: To assess the perceptions of the residents in Pediatric Hospital Garrahan regarding the training and crosscurricular contents. Population and methods: 4 focus groups, with 4-6 residents of the third and fourth year of Pediatrics at Garrahan Hospital using previously determined lines of discussion, in a time slot of 120 minutes, in a non-directive environment, with multiple triggers. Analysis: The contents of the focus groups were analyzed using the "grounded theory data" methodology supported by the ATLAS program, Ti (version 8). Results: 20 residents, with a median age of 27 +/- 2 years, participated in the program. Based on the three discussion lines planned for the focus groups, six core topics were developed: Institutional norms, training program, learning dynamics, sectors and work environments, the patients and their families, displeasure. In the first place, the subjects recognized they entered an institution with its proper norms, in which "the staff" describes itself as the predominant normative figures. Regarding the training program, subjects were satisfied with skills obtained. However, there was debate as to whether the professional profile achieved included knowledge on determining health factors beyond the strictly medical comorbidities. Issues came up related to the limits of the hegemonic model of the physician and the need for new learning targets through the problematization of the patient in his or her social context. Clinical cases were defined as the best way to approach the knowledge on this subject. The subject of discrimination came up spontaneously. Conclusion: Through focus groups, as an active listening space for the experience in the daily practice of the residents at Garrahan Hospital Garrahan, issues appeared related to the limits of the hegemonic model of the physician the need for new learning targets through the problematization of the patient in his or her social context (AU)


Subject(s)
Humans , Adult , Pediatrics/education , Focus Groups , Education, Medical/methods , Internship and Residency , Cross-Sectional Studies , Qualitative Research
16.
Acta cir. bras ; 34(7): e201900709, 2019. graf
Article in English | LILACS | ID: biblio-1038117

ABSTRACT

Abstract Purpose: To develop a new low-cost, easy-to-make and available training model using chickens' intestine for infant intestinal anastomosis. Methods: Segments of chicken intestine were used to create an intestinal anastomosis simulator. We tried to perform an end-to-end, end-to-side and side-to-side anastomosis. Handsewn sutured anastomosis were performed in single layered with interrupted prolene 5-0 suture. The parameters analyzed were cost, intestine's diameter and length, anastomosis patency and flow-through and leakage amount. Results: In all cases it was possible to make the anastomosis in double layered without difficulties, different from the usual ones. There was a positive patency at all anastomoses after the end of the procedure, with no need for reinterventions. Conclusion: The new training model using chickens' intestine for infant intestinal anastomosis is low-cost, easy-to-make and easy available.


Subject(s)
Humans , Animals , Child , Pediatrics/education , Anastomosis, Surgical/education , Intestines/surgery , Anastomosis, Surgical/instrumentation , Anastomosis, Surgical/methods , Chickens , Suture Techniques , Models, Animal
17.
Rev. méd. Maule ; 33(2): 51-54, sept. 2018.
Article in Spanish | LILACS | ID: biblio-1292535

ABSTRACT

A methodology of significant clinical learning is described for medical students who take the subject of Pediatrics in an external office situation.


Subject(s)
Humans , Pediatrics/education , Learning , Teaching/standards , Chile , Education, Medical/methods , Methodology as a Subject
19.
Arch. pediatr. Urug ; 89(1): 21-25, feb. 2018. tab, ilus
Article in Spanish | LILACS | ID: biblio-887808

ABSTRACT

Resumen: La evaluación formativa es uno de los ejes principales del proceso de enseñanza-aprendizaje del posgrado de Pediatría. El Mini Clinical Evaluation Exercise (Mini CEX) es un método de observación directa de la práctica profesional dirigido a evaluar competencias semiológicas y de razonamiento clínico. Los objetivos fueron describir la utilización y valorar la confiabilidad de esta herramienta en la evaluación de posgrados de Pediatría. Se realizaron 76 encuentros a 38 estudiantes de posgrado en una rotación de 6 meses por una unidad de internación de cuidados moderados. Las evaluaciones fueron realizadas por 2 docentes en forma simultánea e independiente. Se evalúo el puntaje obtenido en cada una de las competencias, siendo las de mejor puntajes el profesionalismo, el criterio clínico, el asesoramiento y la competencia clínica global. El instrumento fue bien aceptado por parte de los docentes y estudiantes. El promedio del tiempo de duración de las observaciones fue de 21 minutos y el de devolución (feed back) de 12 minutos. La confiabilidad del instrumento y la concordancia entre los observadores para los diferentes ítems evaluados fueron muy satisfactorias. Nuestra experiencia en el uso de MiniCEX para la evaluación de estudiantes de posgrado de Pediatría en el Uruguay, sugiere que se trata de un instrumento confiable y bien aceptado por docentes y estudiantes.


Summary: Formative assessment is one of the cornerstones of the teaching-learning process in Pediatric training. The Mini Clinical Evaluation Exercise (MiniCEX) is one of the tools available for direct observation to assess performance-based clinical skills.The study aims to describe the use of MiniCEX for the evaluation of Pediatrics fellows and to evaluate its reliability. 76 observations were performed to 38 students of Pediatrics during a 6 months rotation in a secondary care setting. Observations were carried out simultaneously and independently by 2 clinical teachers. Scores were obtained for each competency evaluated, the higher ones being professionalism, clinical judgement, patient and family education and counseling and overall clinical care. The tool was positively accepted by both teachers and students. Average observation time was 21 minutes, and feedback accounted for 12 minutes. Reliability and inter-observer agreement for the different skills evaluated were very satisfactory. Finally, our experience with the MiniCEX performed to Pediatric students proved it is not only a feasible and reliable tool to assess clinical skills, attitudes and behaviors, but also it is well accepted by teachers and students.


Subject(s)
Humans , Pediatrics/education , Clinical Competence/statistics & numerical data , Educational Measurement , Uruguay , Epidemiology, Descriptive , Prospective Studies , Education, Medical, Graduate , Observational Study
20.
West Indian med. j ; 67(spe): 387-397, 2018.
Article in English | LILACS | ID: biblio-1045873

ABSTRACT

ABSTRACT The University of the West Indies (UWI) Faculty of Medical Sciences (FMS) at Mona, established in 1948, has had a long history of improving the lives of Caribbean people, including its children, through teaching and training of medical staff, research and intellectual leadership and public service. Similar to the history of child health development worldwide, the most rapid advances occurred subsequent to the establishment and development of a Department focussed on the needs of children. The FMS staff were initially expatriate lecturers and general paediatricians who trained Jamaican and Caribbean graduates. In 1972, 24 years after the establishment of the UWI and the FMS, the Paediatric Department was fully staffed by Caribbean nationals for the first time. Today, the Department of Child and Adolescent Health at the Mona Campus has almost every recognized paediatric subspecialty among its current staff of Caribbean nationals. The intake of undergraduate medical students moved from 33 in 1948 to 380 in 2013. Undergraduate training was the initial focus of the new university, but when the need for postgraduate training was, the UWI responded and postgraduate training commenced in 1969, some 21 years into the life of the Faculty. Postgraduate medical training was pioneered by the Department of Paediatrics. Postgraduate paediatric training, initially only available at the Mona Campus, was later extended to other Caribbean countries. This paper reports on the development of a Department of Child and Adolescent Health, with a focus on the development of undergraduate and postgraduate teaching and training programmes and their impact. Departmental successes and challenges in this area are also discussed.


RESUMEN Facultad de Ciencias Médicas (FCM) de la Universidad de West Indies (UWI) en Mona, establecida en 1948, ha tenido una larga historia en su empeño por mejorar la vida de la gente del Caribe - incluidos sus hijos -, a través de la enseñanza y formación del personal médico, la investigación y el liderazgo intelectual, y el servicio público. De manera similar a la historia del desarrollo de la salud infantil a nivel mundial, los avances más rápidos ocurrieron tras el establecimiento y desarrollo de un departamento destinado a la atención de las necesidades de los niños. El personal de la FCM estuvo inicialmente constituido por profesores expatriados y pediatras generales que tuvieron a cargo la formación de graduados jamaicanos y caribeños. En 1972 - veinticuatro años después del establecimiento de UWI y la FMS -- el Departamento de Pediatría estaba ya completamente formado por personal de nacionales del Caribe. En la actualidad, el Departamento de Salud del Niño y del Adolescente del Campus Mona, tiene ya entre su personal actual de nacionales del Caribe, casi todas las subespecialidades pediátricas reconocidas. El ingreso de estudiantes de medicina de pregrado pasó de 33 en 1948 a 380 en 2013. La formación de pregrado fue el enfoque inicial de la nueva universidad. Pero cuando se produjo la necesidad de la formación de posgrado, UWI respondió y la formación de posgrado comenzó en 1969, tras unos 21 años de vida de la Facultad. La formación médica de posgrado fue lidereada por el Departamento de Pediatría. La formación pediátrica de posgrado, inicialmente sólo disponible en el campus de Mona, se extendió posteriormente a otros países del Caribe. El presente trabajo informa sobre el desarrollo de un departamento - el Departamento de Salud del Niño y el Adolescente - enfocado al desarrollo de programas de enseñanza y formación de pregrado y posgrado, y su consiguiente impacto. Asimismo, se examinan los éxitos y desafíos en esta área departamental.


Subject(s)
Humans , Child , Adolescent , History, 20th Century , History, 21st Century , Pediatrics/education , Schools, Medical/history , Pediatrics/history , Jamaica
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