Evaluación del ambiente educacional en programas de especialización médica / Evaluation of the educational environment in medical specialty programs

Background: The Postgraduate Hospital Education Environment Measure (PHEEM) questionnaire, is a valid and reliable instrument to measure the educational environment (EE) in postgraduate medical education. Aim: To evaluate the EE perceived by the residents of a postgraduate training program using the PHEEM. Material and Methods: The PHEEM was applied in 2010-2011 in 35 specialty programs. We calculated their individual results and compared means of both global and individual domain scores of the PHEEM, by gender, university of origin and nationality. Cronbach's alpha coefficients and D study (Generalizability theory) were performed for reliability. Results: Three hundred eighteen residents were surveyed (75.7% of the total universe). The mean score of the PHEEM was 105.09 ± 22.46 (65.7% of the maximal score) which is considered a positive EE. The instrument is highly reliable (Cronbach's alpha = 0.934). The D study found that 15 subjects are required to obtain reliable results (G coefficient = 0.813). There were no significant differences between gender and university of origin. Foreigners evaluated better the EE than Chileans and racism was not perceived. The programs showed a safe physical environment and teachers with good clinical skills. The negative aspects perceived were a lack of information about working hours, insufficient academic counseling, and scanty time left for extracurricular activities. Conclusions: This questionnaire allowed us to identify positive aspects of the EE, and areas to be improved in the specialty programs. The PHEEM is a useful instrument to evaluate the EE in Spanish-speaking participants of medical specialty programs.

Hallazgos oftalmológicos en una población falcémica dominicana / Ophtalmology features in a sickle cell Dominican population

Con el objetivo de determinar las principales alteraciones oftalmológicas y factores sanguíneos asociados, se realizó un estudio prospectivo con 113 pacientes falcémicos que asistieron a la consulta externa de Hematología del hospital Padre Billini, en Santo Domingo, República Dominicana, durante el período comprendido entre noviembre de 1991 y mayo de 1992. A todos se les tomó hemoglobina, hematócrito y electroferesis y se les citó al servicio de oftalmología del Instituto Nacional de la Diabetes, donde se les evaluó agudeza visual, tensión ocular y fondo de ojo. De los 113 pacientes 73 fueron heterocigotos para A1 y 40 homocigotos para hemoglobina S. Del grupo de los heterocigotos 18 eran masculinos y 55 femeninos; mientras, de los homocigotos la proliferación neovascular fue la alteración más frecuente y en los heterocigotos el sunburst