Empoderamento estrutural: potencializando as competências dos enfermeiros de um hospital de alta complexidade / Structural empowerment: enhancing the skills of nurses in a high-complexity hospital / Empoderamiento estructural: potenciar las competencias de los enfermeros en un hospital de alta complejidad

Objetivo: analisar o empoderamento estrutural de enfermeiros em um hospital de alta complexidade. Métodos: estudo quantitativo, analítico e transversal, realizado com 93 enfermeiros, utilizando um questionário sociodemográfico e ocupacional e o Questionário de Condições de Eficácia no Trabalho II. Os dados foram coletados entre fevereiro e março de 2023. A análise dos dados deu-se por meio de estatística descritiva, teste de Kolgomorov-Smirnov, teste do qui-quadrado e regressão de Poisson. Resultados: os enfermeiros apresentaram nível moderado de empoderamento estrutural, com média de 20,67 (p<0,000). O componente mais pontuado foi a oportunidade (4,22 dp±0,80). Não foram encontradas diferenças significativas nos níveis de empoderamento estrutural relacionadas às unidades de trabalho (p-Valor 0,381), vínculo empregatício (p-Valor 0,352) e grau de instrução (p-Valor 0,839). O modelo de regressão de Poisson indica que tanto pode haver altos ou baixos níveis de empoderamento a depender do setor. Conclusão: os enfermeiros demonstraram possuir níveis moderados de empoderamento estrutural.

Objective: to analyze the structural empowerment of nurses in a high-complexity hospital. Methods: a quantitative, analytical, cross-sectional study was carried out with 93 nurses, using a sociodemographic and occupational questionnaire and the Questionnaire of Conditions of Effectiveness at Work II. The data was collected between February and March 2023. The data was analyzed using descriptive statistics, the Kolgomorov-Smirnov test, the chi-square test, and Poisson regression. Results: the nurses had a moderate structural empowerment level, with a mean of 20.67 (p<0.000). The highest scoring component was opportunity (4.22 sd±0.80). No significant differences were found in the structural empowerment levels related to work units (p-Value 0.381), employment relationship (p-Value 0.352) and education level (p-Value 0.839). The Poisson regression model indicates that there can be either high or low empowerment levels depending on the sector. Conclusion: nurses showed moderate structural empowerment levels.

Objetivo: analizar el empoderamiento estructural del enfermero en un hospital de alta complejidad. Métodos: estudio cuantitativo, analítico y transversal, realizado con 93 enfermeros, utilizando un cuestionario sociodemográfico y ocupacional y el Cuestionario de Condiciones de Efectividad en el Trabajo II. Los datos se recolectaron entre febrero y marzo de 2023. El análisis de los datos se realizó mediante estadística descriptiva, prueba de Kolgomorov-Smirnov, prueba de chi-cuadrado y regresión de Poisson. Resultados: los enfermeros presentaron un nivel moderado de empoderamiento estructural, la media fue de 20,67 (p<0,000). El componente con mayor puntaje fue oportunidad (4,22 DE±0,80). No se encontraron diferencias significativas en los niveles de empoderamiento estructural relacionados con las unidades de trabajo (valor p 0,381), la relación laboral (valor p 0,352) y el nivel de formación (valor p 0,839). El modelo de regresión de Poisson indica que pueden existir niveles altos o bajos de empoderamiento dependiendo del sector. Conclusión: los enfermeros demostraron niveles moderados de empoderamiento estructural.

Factors to Effective Clinical Experience, Willingness to pursue Career in Rural Health Facilities among Nursing Students on Clinical Placement in Southeast Nigeria and Rural Development / Factores para una experiencia clínica eficaz, voluntad de seguir una carrera en instalaciones de salud rurales entre estudiantes de enfermería en prácticas clínicas en el sudeste de Nigeria y desarrollo rural / Fatores para experiência clínica eficaz, vontade de seguir carreira em unidades de saúde rurais entre estudantes de enfermagem em estágios clínicos no sudeste da Nigéria e desenvolvimento rural

Objective. To describe the Factors to Effective Clinical Experience and Willingness to pursue Career in Rural Health Facilities among Nursing Students on Clinical Placement in southeast Nigeria. Methods. The study was conducted among 48 rural health centres and general hospitals with 528 respondents from different higher institutions of learning serving in these health facilities for their clinical experience. The study applied survey design and utilized questionnaire instrument for data collection. Results. Majority of the students (60%) agreed that their school lacked functional practical demonstration laboratory for students' clinical practice, 66.7% agreed that their school lab lacked large space for all the students to observe what is being taught, 79.9% that their school lab lacked enough equipment that can enable many students to practice procedures; majority of the students (79.9%) answered that the hospitals where they are on clinical placement lacked enough equipment needed for the students on each shift of practice, 59.9% agreed that student/client ratio in each ward during clinical experience periods was not enough for students' practice under supervision, while 73.3% indicated that their school lacked library with current nursing texts for references. Personal, socioeconomic and institutional factors explain the 76% of the variance of effective clinical experience and the 52% of the variance of the willingness to work in rural health facilities in the future if offered employment. Conclusion. The factors surrounding effective clinical experience in rural healthcare facilities in southeastern Nigeria are unfavorable and could discourage future nurses from working there. It is necessary to implement strategies to improve the management of these centers in order to promote the perspective of improving sustainable rural health in this region.

Objetivo. Describir la experiencia clínica efectiva entre los estudiantes de enfermería en prácticas clínicas en las instalaciones sanitarias rurales en el sudeste de Nigeria. Métodos. Este estudio descriptivo se llevó a cabo entre 48 centros de salud rurales y hospitales generales con 528 encuestados de diferentes instituciones de enseñanza superior que prestaban servicio en estas instalaciones sanitarias para su experiencia clínica. Resultados. 60% de los estudiantes comentaron que su centro carecía de un laboratorio de simulación para las prácticas clínicas de los estudiantes, el 66.7% indicó que el laboratorio de su centro carecía de un espacio para que todos los estudiantes pudieran observar lo que se enseñaba. Un 79.9% indicó que el laboratorio de su centro no disponía de equipos suficientes para practicar los procedimientos, y otro porcentaje igual (79.9%) manifestaron que los hospitales carecían del equipo necesario para realizar adecuadamente las prácticas clínicas. El 59.9% indicaron que la razón de estudiantes por paciente en cada sala durante los periodos de experiencia clínica era insuficiente para que los estudiantes realizaran prácticas bajo supervisión, y el 73.3% indicaron que los recursos de la biblioteca en textos de enfermería eran insuficientes para sus necesidades. Los factores personales, socioeconómicos e institucionales explican el 76% de la varianza en la experiencia clínica efectiva y el 52% en la disposición a trabajar en centros sanitarios rurales en el futuro. Conclusión. Los factores que rodean la experiencia clínica efectiva en los centros sanitarios rurales del sudeste de Nigeria son desfavorables y podrían desanimar a los futuros enfermeros a trabajar en ellos. Es necesario implementar estrategias de mejoramiento de la gestión de estos centros con el fin de impulsar la perspectiva de mejorar la salud rural sostenible en esta región.

Objetivo. Descrever a experiência clínica eficaz entre estudantes de enfermagem em estágios clínicos em unidades de saúde rurais no sudeste da Nigéria (África). Métodos. Este estudo descritivo foi realizado em 48 centros de saúde rurais e hospitais gerais com 528 entrevistados de diferentes instituições de ensino superior que atendem essas unidades de saúde pela sua experiência clínica. Resultados. 60% dos alunos comentaram que seu centro não possuía laboratório de simulação para as práticas clínicas dos alunos, 66.7% indicaram que o laboratório de seu centro carecia de espaço para que todos os alunos pudessem observar o que estava sendo ensinado. 79.9% indicaram que o laboratório do seu centro não possuía equipamentos suficientes para a realização dos procedimentos e outro percentual igual (79.9%) afirmou que os hospitais não possuíam os equipamentos necessários para a realização adequada das práticas clínicas. 59.9% indicaram que a proporção de estudantes por pacientes em cada sala durante os períodos de experiência clínica era insuficiente para que os estudantes realizassem as práticas sob supervisão e 73.3% indicaram que os recursos da biblioteca em textos de enfermagem eram insuficientes para suas necessidades. Fatores pessoais, socioeconómicos e institucionais explicam 76% da variação na experiência clínica efetiva e 52% na vontade de trabalhar em centros de saúde rurais no futuro. Conclusão. Os fatores que rodeiam a experiência clínica eficaz em unidades de saúde rurais no sudeste da Nigéria são desfavoráveis e podem desencorajar futuros enfermeiros de trabalhar lá. É necessário implementar estratégias para melhorar a gestão destes centros, a fim de promover a perspectiva de melhorar a saúde rural sustentável nesta região.

Competências do enfermeiro no cuidado a pacientes com acidente vascular cerebral elegíveis à terapia trombolítica / Competencias de enfermería en el cuidado de personas con accidente cerebrovascular elegibles para terapia trombolítica / Nursing competencies in the care of patients with stroke who are eligible for thrombolytic therapy

Resumo Introdução: O acidente vascular cerebral isquêmico tem como tratamento a terapia trombolítica, aplicada ainda na fase aguda, promovendo melhora importante nas sequelas acarretadas por este agravo. Considerando a complexidade da terapia trombolítica, torna-se necessário que os enfermeiros compreendam suas competências para auxiliar no cuidado. Objetivo: Identificar evidências científicas acerca das competências do enfermeiro no cuidado a pacientes com acidente vascular cerebral elegíveis à terapia trombolítica. Metodologia: Revisão integrativa composta por seis etapas em seis etapas (elaboração da questão, busca na literatura, coleta de dados, análise, discussão e apresentação da revisão), realizada nas bases de dados MEDLINE, LILACS, BDENF, IBECS, PubMed, Scopus, Web of Science, Embase e CINAHL. A busca foi realizada entre agosto e setembro de 2022 adotando como critérios de inclusão estudos primários; gratuitos, disponíveis eletronicamente na íntegra; nos idiomas inglês, português e espanhol. Foram obtidos inicialmente 2.830 estudos, os quais passaram por uma seleção, onde foram incluídos aqueles que atendiam os critérios previamente estabelecidos. Resultados: Com base nos doze estudos incluídos nesta revisão identificaram-se competências voltadas à três atividades do cuidado: gestão do cuidado como trabalho em equipe, códigos, fluxos e protocolos, assistência ao paciente antes, durante e após a utilização da terapia trombolítica e educação em saúde para equipe, pacientes e familiares. Conclusão: Os achados desta revisão puderam evidenciar as competências do enfermeiro no cuidado aos pacientes elegíveis a terapia trombolítica, as quais perpassam diferentes áreas de atuação do enfermeiro. Para este estudo prevaleceram as competências assistências, seguida por competências gerenciais.

Resumen Introducción: El accidente cerebrovascular isquémico se trata con terapia trombolítica, aplicada incluso en la fase aguda, que promueve una mejoría significativa de las secuelas provocadas por este padecimiento. Considerando la complejidad de la terapia trombolítica, es necesario que las personas profesionales de enfermería comprendan sus competencias para ayudar en el cuidado. Objetivo: Identificar evidencias científicas sobre las competencias del personal de enfermería en el cuidado de pacientes con accidente cerebrovascular elegibles para terapia trombolítica. Metodología: Revisión integradora que consta de seis etapas (elaboración de la pregunta, búsqueda bibliográfica, recolección de datos, análisis, discusión y presentación de la revisión), realizada en las bases de dados MEDLINE, LILACS, BDENF, IBECS, PubMed, Scopus, Web of Science, Embase y CINAHL. La búsqueda se realizó entre agosto y septiembre de 2022. Los criterio de inclusión fueron: estudios primarios, gratuito, disponible electrónicamente en su totalidad, en inglés, portugués y español. Inicialmente se obtuvieron 2830 estudios, los cuales fueron sometidos a un proceso de selección, que incluyó aquellos que cumplían con los criterios previamente establecidos. Resultados: A partir de los doce estudios incluidos en esta revisión, se identificaron competencias centradas en tres actividades asistenciales: gestión del cuidado como trabajo en equipo, códigos, flujos y protocolos, atención a pacientes antes, durante y después del uso de la terapia trombolítica y educación en salud para personal, pacientes y familias. Conclusión: Los hallazgos de esta revisión pudieron resaltar las competencias de las personas profesionales en enfermería en el cuidado de personas elegibles para terapia trombolítica, que abarcan diferentes áreas de actuación del personal de enfermería. Para este estudio, prevalecieron las habilidades asistenciales, seguidas de las competencias gerenciales.

ABSTRACT Introduction: Ischemic stroke is treated with thrombolytic therapy, applied even in the acute phase, promoting a significant improvement in the after-effects caused by this condition. Considering the complexity of thrombolytic therapy, it is necessary for nurses to understand the skills required to assist in care. Objective: To identify scientific evidence about the competencies of nurses in the care of patients with stroke who are eligible for thrombolytic therapy. Methodology: An integrative review consisting of six stages (elaboration of the question, literature review, data collection, analysis, discussion, and presentation), conducted in MEDLINE, LILACS, BDENF, IBECS, PubMed, Scopus, Web of Science, Embase, and CINAHL databases. The search was carried out between August and September 2022 using primary studies as the inclusion criteria: free of charge, fully available electronically, published in English, Portuguese, or Spanish. Initially, 2.830 studies were obtained, which underwent a selection process that included only those studies that met the previously established criteria. Results: Based on the twelve studies included in this review, competencies focused on three care activities were identified: care management such as teamwork; codes; flows and protocols; patient care before, during, and after the use of thrombolytic therapy; and education health education for staff, patients, and families. Conclusion: The findings of this review highlighted the nurses' competencies in the care of patients eligible for thrombolytic therapy, which encompass different areas of the nurse's work. For this study, assistance competencies prevailed, followed by management competencies.

Competências para o atendimento multiprofissional da PCR em pediatria: percepções da equipe de enfermagem / Skills for multiprofissional care for cardiorespiratory arrests in pediatrics: perceptions of the nursing team / Habilidades para el cuidadod multiprofesional de las paradas cardiorrespiratorias en pediatria: percepciones del equipo de enfermería

Estudo exploratório descritivo, quantitativo, realizado em um hospital pediátrico filantrópico, com objetivo de compreender as competências profissionais da enfermagem no atendimento da parada cardiorrespiratória em pediatria, além de investigar suas percepções. Participaram 30 profissionais da equipe de enfermagem e a coleta de dados foi realizada por meio de um questionário fechado. Os resultados, analisados por meio de estatística descritiva, mostraram que os profissionais de enfermagem, em sua maioria, apresentaram conhecimento sobre o atendimento da emergência investigada. Em relação às suas percepções sobre as habilidades técnicas necessárias, notou-se que a maioria dos participantes se perceberam seguros para as manobras de ressuscitação e para a administração de medicações durante o atendimento; contudo, ao abordar o manuseio do desfibrilador e a realização de punção venosa, a maior parte da amostra afirmou não se sentir totalmente segura para estas atividades. Concluiu-se que a maioria dos participantes apresentam conhecimento teórico-prático para a execução do atendimento.

Descriptive, quantitative exploratory study, carried out in a philanthropic pediatric hospital, with the objective of understanding the nursing professional competencies in the care of cardiorespiratory arrests in pediatrics, besides investigating. 30 professionals from the nursing team participated and data was collected using a closed questionnaire. The results, analyzed using descriptive statistics, showed that the majority of nursing professionals had knowledge about the care of the investigated emergency. In relation to their perceptions about the necessary technical skills, the majority of participants perceived themselves to be confident in resuscitation maneuvers and the administration of medications during care. However, when approaching the handling of the defibrillator and performing a venipuncture, most of the sample stated that they did not feel complete confidence for these activities. Study concluded that the majority of participants had theoretical-practical knowledge to perform the service.

Estudio exploratorio descriptivo, cuantitativo, realizado en un hospital pediátrico filantrópico, con el objetivo de comprender las competencias profesionales de enfermería en el cuidado de la parada cardiorrespiratoria en pediatría, además de investigar sus percepciones. Participaron 30 profesionales del equipo de enfermería y la recolección de datos se realizó mediante cuestionario cerrado. Los resultados, analizados mediante estadística descriptiva, mostraron que la mayoría de los profesionales de enfermeira tenían conocimiento sobre la atención de la emergencia investigada. En relación a sus percepciones sobre las habilidades técnicas necesarias, se observa que la mayoría de los participantes se observó que la mayoría de los participantes se percibió confiada en las maniobras de reanimación y la administración de medicamentos durante la atención. Sin embargo, al abordar el manejo del desfibrilador y realizar una punción venosa, la mayoría de la muestra manifestó no sentirse completamente segura para estas actividades. Estudio concluyó que la mayoría de los participantes presentó conocimientos teórico-prácticos para realizar el servicio.

Definición, Dimensiones y Atributos del Profesionalismo en Odontología para el Contexto Chileno

El profesionalismo ha tomado gran relevancia en la educación para profesionales de la salud, debido a que existe evidencia de su impacto en la calidad de atención a los pacientes. Se ha reportado que las prácticas poco profesionales incurridas por estudiantes tienden a repetirse posteriormente en su actividad profesional. El profesionalismo es un constructo que refleja valores, cultura, idioma y acuerdos sociales, por lo cual no se sugiere extrapolar una definición desde un contexto a otro. Por ello, un punto de partida es obtener una definición de profesionalismo adaptada culturalmente al contexto donde se encuentra inmersa. El objetivo de este estudio fue obtener una definición de profesionalismo en odontología, sus dimensiones y atributos consensuados por representantes de distintos programas de odontología de universidades chilenas. Se utilizó una metodología mixta en dos fases. En la fase 1 el diseño cualitativo exploratorio tuvo una aproximación por Teoría Fundamentada, donde se desarrollaron dos grupos focales (docentes y estudiantes de odontología) y se analizó la data con método de comparación constante y codificación abierta. En la fase 2 se realizó una consulta a expertos utilizando un diseño explicativo secuencial, a través de un Panel Delphi y un cuestionario con preguntas cerradas y abiertas, donde se realizó análisis de contenido. Se obtuvo una definición de profesionalismo en odontología, consensuada, transversal y adaptada al contexto nacional, con cinco dimensiones (contextual, formativa, personal, interpersonal y social) y trece atributos. El profesionalismo es un constructo complejo, por lo que se hace necesario obtener una definición común que guíe la incorporación de sus dimensiones y atributos en los procesos educacionales de las instituciones formadoras de cirujanos dentistas, de tal manera que ellos/ ellas puedan cumplir su rol social desde la excelencia contribuyendo a mejorar la calidad de atención en salud.

Professionalism has become highly relevant in health professional education since there is evidence of its impact on the quality of patient care. It has been reported that unprofessional practices incurred by students tend to be repeated later in their professional activities. Professionalism is a construct that reflects values, culture, language and social arrangements; therefore, it is not suggested to extrapolate a definition from one context to another. Thus, a starting point is to obtain a definition of professionalism culturally adapted to the context in which it is embedded. The aim of the study was to obtain a definition of professionalism in dentistry, its dimensions and attributes agreed upon by stakeholders of different dentistry programs of Chilean universities. A mixed methodology was used in two phases. In phase 1, an exploratory qualitative design with a Grounded Theory approach, two focus groups were developed (dental teachers and students), and the data was analyzed using a constant comparison method and open coding. In phase 2, an expert consultation was carried out using a sequential explanatory design through a Delphi Panel (consensus method) and a questionnaire with closed and open questions, where content analysis was conducted. A consensus definition of professionalism in dentistry was obtained, transversal and adapted to the national context, with five dimensions (contextual, formative, personal, interpersonal and social) and thirteen attributes. Professionalism is a complex construct, requiring a common definition to guide the incorporation of its dimensions and attributes in the educational processes of dental education institutions, enabling them to play their social role with excellence, contributing to improving the quality of health care.

Anesthesia training: Are we doing enough in three years? Cross-sectional study

Introduction: The mínimum number of procedures required to be performed during anesthesia training has not been officially defined in Colombia. Although a number is no guarantee of acquired competencies, it does indicate the level of opportunity offered by the different programs. This study describes the practical training afforded to residents in a graduate anesthesia program in Colombia, and compares its results with international standards. Objective: Describe exposure to procedures performed by residents enrolled in a three-year anesthesia specialization program in Colombia between 2015 and 2020, and compare with the standards proposed by ASCOFAME and ACGME. Methods: Descriptive, cross-sectional study which included residents who did their specialization in a Colombian anesthesia program between 2015 and 2020. Complexity, anesthesia techniques, invasive monitoring and airway approach were described. Finally a descriptive comparison was made with the published references of the Colombian Association of Medical Schools (ASCOFAME) and the Accreditation Council for Graduate Medical Education (ACGME). Results: The results for 10 residents were included. Each resident had a median of 978 cases (IQR 942-1120), corresponding to 25 surgical specialties, the most frequent being general surgery (18%), orthopedics (16%), pediatric surgery (19%), and obstetrics (10.8%). According to the American Society of Anesthesiology (ASA) classification, the majority of patients were ASA II (39.63%) and ASA III (28.4%). Adequate exposure was achieved in 11 of the 15 categories proposed by ACGME and in 6 of the 15 proposed by ASCOFAME. Conclusions: A detailed description of the practice component acquired by the residents during their three years of training was obtained. This baseline provides insight into the national landscape and allows to describe the relationship with international standards.

Introducción: En Colombia no se encuentra oficialmente definido el número mínimo de procedimientos que se deben realizar durante el entrenamiento en anestesiología. Aunque el número no garantiza la adquisición de competencias de la especialidad, sí es un indicador de la oportunidad ofertada por parte de los programas. Este estudio describe el entrenamiento práctico que tienen los médicos residentes en un programa de posgrado de anestesiología en Colombia y compara sus resultados con estándares internacionales. Objetivo: Describir la exposición a procedimientos realizados por los médicos residentes de un programa de especialización en anestesiología de tres años en Colombia, entre 2015 y 2020, y compararlo con los estándares propuestos por ASCOFAME y el ACGME. Métodos: Estudio descriptivo de corte transversal; se incluyeron los residentes que cursaron su programa de especialidad en un programa colombiano de anestesiología entre 2015 y 2020. Se describieron la complejidad, técnicas anestésicas, monitoría invasiva y abordaje de la vía aérea. Finalmente, se compararon los resultados de manera descriptiva con lo referenciado por la Asociación Colombiana de Facultades de Medicina y el Accreditation Council for Graduate Medical Education (ACGME). Resultados: Se incluyeron los resultados de 10 médicos residentes. El número de casos por residente tuvo una mediana de 978 casos (RIQ942-1120), correspondientes a 25 especialidades quirúrgicas; cirugía general (18 %), ortopedia (16 %), cirugía pediátrica (19 %) y obstetricia (10,8 %) fueron las más frecuentes. Según la clasificación de la Sociedad Americana de Anestesiología (ASA), la mayoría de los pacientes tenían ASA 2 (39,63 %), ASA 3 (28,4 %). Se alcanzó una exposición adecuada en 11 de las 15 categorías propuestas por el ACGME y en 6 de las 15 propuestas por la Asociación Colombiana de Facultades de Medicina. Conclusiones: Se obtuvo una descripción detallada del aspecto práctico de los residentes de anestesiología durante sus tres años de formación. Esta línea de base permite ampliar el panorama a escala nacional y describir la relación con estándares internacionales.

La investigación en las escuelas de las ciencias de la salud / Research in schools of health sciences

RESUMEN La investigación se erige como un pilar fundamental que distingue a la universidad como una entidad de relevancia institucional y social. Esta afirmación es particularmente verídica en el ámbito de las ciencias de la salud, donde no solo se espera que las instituciones educativas generen conocimiento en beneficio de la sociedad, sino que también moldeen individuos capacitados para sumergirse en la investigación y fortalecer esta premisa vital. En este contexto, emergen conceptos intrincados que delinean la naturaleza y el propósito de la investigación en el ámbito académico. La investigación científica, por un lado, se alza como el motor principal que impulsa el avance del conocimiento, y pone énfasis en el método riguroso y sistemático para desentrañar los misterios de la realidad. Por otro lado, la formación para la investigación se erige como un vehículo educativo primordial para cultivar mentes analíticas y curiosas, que dota a los futuros profesionales con las herramientas necesarias para indagar y contribuir al progreso científico. Asimismo, la investigación formativa, si bien menos conocida, desempeña un rol crucial al integrar la investigación en la experiencia de aprendizaje, lo cual fomenta habilidades de pensamiento crítico y resolución de problemas desde etapas tempranas. En esta travesía educativa e investigativa, diversos actores y componentes adquieren protagonismo. Los institutos de investigación se presentan como pilares fundamentales, ya que proporcionan el ambiente propicio para la colaboración interdisciplinaria y el florecimiento de ideas innovadoras. Los docentes, por su parte, ejercen un rol de guías y mentores, transmitiendo su experiencia y conocimientos a las nuevas generaciones de profesionales. Además, las actividades extracurriculares o extraprogramáticas en el área de la investigación surgen como terrenos fértiles para la expansión de horizontes intelectuales, que ofrecen espacios para la exploración creativa y la aplicación práctica de los conocimientos adquiridos por los alumnos. No obstante, estos conceptos y componentes no están exentos de desafíos y controversias en su integración dentro de los programas académicos. La implementación de estos enfoques en los niveles de pregrado y posgrado requiere un análisis profundo de sus objetivos y metas específicas. Las discusiones en torno a la ponderación del tiempo y los recursos dedicados a la investigación frente a otros aspectos curriculares son una constante. La presente revisión se propone delinear y definir de manera precisa los conceptos de investigación científica, formación para la investigación e investigación formativa, así como subrayar el papel cardinal que desempeñan los institutos de investigación, los docentes y las actividades extracurriculares en la configuración de programas académicos en el ámbito de las ciencias de la salud.

ABSTRACT Research stands as a fundamental pillar that recognizes the university as an entity of institutional and social relevance. This statement is particularly true in the field of health sciences, where educational institutions are expected not only to generate knowledge for the benefit of society but also to shape individuals capable of immersing themselves in research and strengthening this vital premise. In this context, intricate concepts that outline the nature and purpose of research in the academia emerge. Scientific research, on the one hand, arises as the driving force behind the advancement of knowledge, emphasizing rigorous and systematic methods to unravel the mysteries of reality. On the other hand, research training stands as a pivotal educational vehicle for nurturing analytical and curious minds, providing future professionals with the necessary tools to inquire and contribute to scientific progress. Similarly, formative research, although less known, plays a crucial role in integrating research into the learning experience, which fosters critical thinking skills and problem-solving abilities from early stages. In this educational and research journey, various actors and components take center stage. Research centers arise as fundamental pillars, as they provide the conducive environment to interdisciplinary collaboration and development of innovative ideas. Educators, on their part, play the role of counselors and mentors by sharing their experience and knowledge with the new generations of professionals. Furthermore, extracurricular or nonacademic activities in the area of research emerge as fertile grounds for the expansion of intellectual horizons, offering spaces for creative exploration and practical application of the knowledge acquired by students. However, these concepts and components are not free of challenges and controversies when integrating into the academic programs. Implementing these approaches at the undergraduate and graduate levels requires an in-depth analysis of their specific objectives and goals. Discussions regarding the balance of time and resources devoted to research versus other curricular aspects remain a constant. This review aims to accurately outline and define the concepts of scientific research, research training and formative research, as well as to highlight the leading role played by research centers, educators and extracurricular activities in shaping academic programs in the field of health sciences.

Transformando la educación médica del siglo xxi: El rol de la educación médica basada en competencias / Transforming medical education in the 21st century: The role of competency-based medical education

RESUMEN Introducción: Con el panorama cambiante de la educación médica, es crucial examinar críticamente los enfoques y marcos existentes. La educación médica basada en competencias (EMBC) surge como un prometedor cambio de paradigma, que prioriza el desarrollo de habilidades, conocimientos y actitudes explícitas centrado en el alumno y orientado a los resultados. Objetivo: Identificar los ajustes estructurales y procedimentales esenciales necesarios para una implementación eficaz de la EMBC. Se subraya la importancia de reorganizar las instituciones educativas, adaptar las técnicas de instrucción y evaluación y fomentar la adopción de la EMBC en el aula. Resultados: Para impartir con eficacia la EMBC, es imperativo reestructurar las instituciones educativas para que se centren en planes de estudios basados en competencias y en la enseñanza personalizada. Asimismo, es necesario modificar las estrategias de enseñanza y evaluación para facilitar la evaluación continua y el aprendizaje activo. Conclusiones: Adoptar los principios de EMBC puede permitir que la educación médica produzca profesionales equipados con las habilidades necesarias para satisfacer las demandas dinámicas de la medicina moderna.

ABSTRACT Introduction: With the changing landscape of medical education, it is crucial to critically examine existing approaches and frameworks. competency-based medical education (CBME) emerges as a promising paradigm shift, which prioritizes learner-centered, outcome-oriented development of skills, knowledge, and attitudes. Objective: To identify the essential structural and procedural adjustments needed for effective implementation of CBME. It underscores the importance of reorganizing educational institutions, adapting instructional and assessment techniques, and fostering acceptance of CBME in the classroom. Results: To effectively deliver CBME, it is imperative to restructure educational institutions to focus on competency-based curricula and personalized instruction. Also, there is a need to modify teaching and assessment strategies to facilitate continuous assessment and active learning. Conclusions: Adopting CBME principles can enable medical education to produce professionals equipped with the skills necessary to meet the dynamic demands of modern medicine.

Desempeño docente percibido por una población de estudiantes asociado al nivel de satisfacción autorreportada por los profesores de la Licenciatura de Cirujano Dentista de la Facultad de Estudios Superiores Zaragoza de la Universidad Nacional Autónoma de México / Teaching performance perceived by a population of students associated with the level of satisfaction self-reported by the professors of the Degree of Dental Surgeon of the Facultad de Estudios Superiores Zaragoza of the Universidad Nacional Autonoma de México / Desempenho docente percepcionado por uma população de estudantes associado ao nível de satisfação autoreportado pelos professores do curso de Cirurgião Dentista da Facultad de Estudios Superiores Zaragoza da Universidad Nacional Autónoma de México

RESUMEN Objetivo : Describir la asociación del desempeño docente percibido por una población de estudiantes y el nivel de satisfacción autorreportada por los profesores de la Licenciatura de Cirujano Dentista de la Facultad de Estudios Superiores Zaragoza de la Universidad Nacional Autónoma de México. Materiales y métodos: Estudio observacional, prolectivo, transversal, descriptivo, realizado en dos fases. En la primera se mostró la satisfacción laboral autorreportada por 123 académicos; en la segunda fase se encuestó a 120 estudiantes para que evaluaran a sus 6 docentes muy satisfechos, y a 140 para los 7 muy insatisfechos, para lo cual se les aplicó una encuesta adaptada del Departamento de Evaluación Docente de la facultad. Resultados : Al asociar el desempeño de los 6 docentes más satisfechos laboralmente con la percepción que de ellos tienen sus 120 estudiantes, los resultados muestran que el 2 % (n = 2) considera que los académicos tienen un mal desempeño vs. el 44 % (n = 53) que considera que tienen un desempeño excelente. En cuanto a los 7 docentes identificados como muy insatisfechos, desde la mirada de los estudiantes, el 10 % (n = 14) considera que el desempeño es malo; y para el 49 % (n = 68) es excelente. La satisfacción laboral autorreportada por los 13 académicos y el desempeño docente percibido por sus estudiantes no mostró diferencias estadísticamente significativas. Para los estudiantes, un docente tiene un excelente ejercicio de su actividad pese a su insatisfacción laboral, así como un mal desempeño aun cuando se autopercibe como muy satisfecho. Conclusiones : Los resultados de la investigación muestran que no hay una asociación entre el rendimiento docente y la satisfacción laboral según los estudiantes. La actitud de un profesor hacia los estudiantes no siempre coincide con su nivel de satisfacción laboral.

ABSTRACT Objective : To describe the association between the teaching performance perceived by a population of students and the level of satisfaction self-reported by the professors of the bachelor's degree program in Dental Surgery of the Facultad de Estudios Superiores Zaragoza of the Universidad Nacional Autónoma de México. Materials and methods : Observational, prolective, cross-sectional, descriptive study, conducted in two phases. The first phase showed the self-reported job satisfaction of 123 academics; in the second phase, 120 students were surveyed to evaluate their 6 very satisfied teachers and 140 for the 7 dissatisfied ones, for which a survey adapted from the Department of Teaching Evaluation of the faculty was applied. Results : When associating the performance of the 6 teachers most satisfied with their job with the perception that their 120 students have of them, the results show that 2 % (n = 2) consider that the academics have a poor performance vs. 44 % (n = 53) who consider that they have an excellent performance. As for the 7 teachers identified as very dissatisfied, from the students' point of view, 10 % (n = 14) consider the performance poor; and for 49 % (n = 68), it is excellent. The job satisfaction self-reported by the 13 academics and the teaching performance perceived by their students did not show statistically significant differences. For the students, a teacher has excellent performance despite job dissatisfaction and poor performance even when he or she perceives himself or herself as very satisfied. Conclusions : The research results show no association between teaching performance and job satisfaction according to students. A teacher's attitude towards students does not always coincide with his or her level of job satisfaction.

RESUMO Objetivo : Descrever a associação entre o desempenho docente percepcionado por uma população de estudantes e o nível de satisfação autoreportado pelos professores da Licenciatura em Cirurgia Dentária na Facultad de Estudios Superiores Zaragoza da Universidad Nacional Autónoma de México. Materiais e métodos : Estudo observacional, proletivo, transversal e descritivo realizado em duas fases. Na primeira fase, foi analisada a satisfação profissional autorreferida de 123 académicos; na segunda fase, 120 estudantes foram inquiridos para avaliar os seus 6 professores altamente satisfeitos e 140 para os 7 insatisfeitos, utilizando um inquérito adaptado do Departamento de Avaliação do Ensino da faculdade. Resultados : Ao associar o desempenho dos 6 professores mais satisfeitos com o seu trabalho à percepção que os seus 120 alunos têm deles, os resultados mostram que 2 % (n = 2) consideram que os académicos têm um mau desempenho contra 44 % (n = 53) que consideram que têm um excelente desempenho. Quanto aos 7 professores identificados como muito insatisfeitos, do ponto de vista dos estudantes, 10 % (n = 14) consideram que o seu desempenho é mau; e para 49 % (n = 68) é excelente. A satisfação profissional autorrelatada pelos 13 académicos e o desempenho docente percepcionado pelos seus estudantes não revelaram diferenças estatisticamente significativas. Para os estudantes, um professor tem um desempenho excelente apesar da sua insatisfação profissional e tem um desempenho fraco mesmo quando se considera muito satisfeito. Conclusões : Os resultados da investigação mostram que não existe uma associação entre o desempenho docente e a satisfação profissional, segundo os estudantes. A atitude de um professor em relação aos alunos nem sempre coincide com o seu nível de satisfação profissional.

Analysis of death cases in the oral emergency department / 北京大学学报(医学版)

In order to analyze the clinical characteristics of death cases in the oral emergency depart-ment of the stomatological hospital,and to improve the first aid technique before and in hospitals,we col-lected the clinical data of death cases in the Department of Oral Emergency in Peking University School and Hospital of Stomatology from January 2010 to January 2023 for retrospective analysis.General cha-racteristics,such as the patients'gender,age,chief complaint,maxillofacial diseases,systemic under-lying diseases,rescue situation,cause of death and seasonal distribution of death were summarized.The results showed that a total of 8 death cases(5 males and 3 females)occurred during the 13-year period,ranging in age from 40 to 86 years,with a median age of 66 years.Among the 8 patients,5 reported bleeding from oral cancer,1 reported chest tightness and dyspnea after oral cancer surgery,1 reported loss of consciousness after maxillofacial trauma,and 1 reported oral erosion and aphagia.All the 8 pa-tients had one or more underlying diseases,such as hypertension,coronary heart disease,diabetes,renal failure,and cerebral infarction,etc.and 2 of them showed dyscrasia.Among them,the cause of death in 5 cases was respiratory and circulatory failure caused by oral cancer rupture and hemorrhage or poor sur-gical wound healing and hemorrhage;1 case was uremia and hyperkalemia leading to circulatory failure;1 case was asphyxia caused by swelling of oral floor tissue after maxillofacial trauma;and the other case was acute myocardial infarction caused circulatory failure after oral cancer surgery.According to the vital state at the time of treatment,6 patients had loss of consciousness,respiratory and cardiac arrest before hospital,and 2 patients suffered from loss of consciousness,respiratory and cardiac arrest during treat-ment.All the patients received cardiopulmonary resuscitation and some advanced life support measures,and the average rescue time was 46 min.Due to the low incidence of death in the oral emergency depart-ment,medical personel have little experience in first aid.First aid training and drills and assessment should be organized regularly.First aid facilities should be always available and regularly maintained by special personnel,such as electrocardiogram(ECG)monitor,defibrillator,simple breathing apparatus,oxygen supply system,negative pressure suction system,endotracheal intubation and tracheotomy equip-ment.The death cases mainly occurred in the elderly patients with oral cancer bleeding and systemic un-derlying diseases.Education of emergency awareness for the elderly patients with oral cancer after surgery should be enhanced.Medical staff should strengthen first aid awareness and skills.

Construction of evaluation index system and theory-skill-humanity model for core competence of radiation specialist nurses / 中国实用护理杂志

Objective:To construct of evaluation index system and theory-skill-humanity (TSH) model for core competence of radiation specialist nurses, to provide reference for clinical training of radiation specialist nurses.Methods:In January 2023, the draft of the evaluation index system of core competence for radiation specialist nurses was development by literature reviews and semi-structured interviews; from February to March 2023, 20 experts were consulted with 2 rounds of Delphi consultations to determine the index system and determine indicator weights based on the importance assigned by experts to each indicator.Results:Among 20 experts, 17 were female and 3 were male, aged 35-65 (46.48 ± 8.19) years old. The effective recovery rate of the questionnaires was 100.0% (20/20) and 95.0% (19/20) in the first and second round, respectively. The authority coefficient of the experts was 0.937 in the second round, the Kendall coefficients of concordance in the first-level indexes, second-level indexes and third-level indexes were 0.448, 0.407, 0.464, respectively, the difference was statistically significant ( χ2 = 53.60, 148.81, 58.18, all P<0.001). The final evaluation index system of the core competence of radiation specialist nurses included 3 first-level indicators, 11 second-level indicators and 56 third-level indicators. Conclusions:The evaluation index system of the core competence of radiation specialist nurses constructed based on TSH model in the present study has certain feasibility and practicality, which can be used as the basis for the training and evaluation of radiation specialized nurses.

Melatonin improves the in vitro developmental competence of benzophenone-3 exposed mouse embryos / 实用医学杂志

Objective To investigate the protective effects of melatonin(MT)on early embryo in vitro development of mice after exposure to benzophenone-3(BP-3).Methods Fertilized mouse oocytes at the synge-neic stage were cultured in KSOM culture medium,0.8 μmol/L BP-3 culture medium,and 1×10-7 mol/L MT + 0.8 μmol/L BP-3 mixed culture medium,respectively.The rescue effect of MT on the early embryos developmental potential of BP-3-exposed mice in vitro was explored by detecting the blastocyst rate,gene transcription level,protein expression level,and the degree of DNA damage in the three groups of embryos.Results MT improved the developmental potential of mouse embryos exposed to BP-3 in vitro.Compared with the control group,MT treatment significantly increased the protein expression of ATP5A and ATP5B and decreased the DNA damage(P<0.05).Furthermore,the transcription levels of antioxidant gene Gpx1 and pluripotency related genes Pou5f1 and Cdx2 were significantly up-regulated in MT-treated blastocysts,and the expression of pro-apoptotic gene Bax was decreased.Compared with the control group,BP-3 treatment enhanced the signal intensity of γ-H2AX in blastocysts(P<0.05),while adding MT could effectively alleviate DSBs(P<0.05).Conclusion The physiological concentration of BP-3 exposure has reproductive toxicity,but the addition of appropriate con-centration of MT could significantly improve the in vitro developmental potential and quality of BP-3-exposed early embryos.

Application of simulation-based medical education in standardized training of residents / 中国小儿急救医学

The standardized training of residents is an important stage for medical students to transition from medical theory to clinical practice,and the only way to become a qualified clinician.In recent years,the development of standardized resident training in China has changed from system construction to quality connotation construction.Medical simulation education,as an important bridge between medical theoretical teaching and practical teaching,has been recognized to a higher degree for its appropriate safety and high repeatability.However,there are still many restrictions in the practical application,so that the actual effect is difficult to reach the expectation.This review discussed the application and practice of medical simulation in the standardized training of residents.

Research on the creating scenarios method in the experimental teaching reform of food hygiene / 中华医学教育探索杂志

Objective:To explore the effect of creating scenarios method in the experimental teaching of food hygiene.Methods:A total of 170 students from two grades of preventive medicine major were selected as the research objects, and the students from grade 2016 were selected as the experimental group ( n=88) taking the creating scenarios method, and the students from grade 2015 were selected as the control group ( n=82) taking the traditional method. The scores of the two groups were compared, and the evaluation from students and teachers on the course was collected. Meanwhile, the qualitative interviews with senior students and practice teachers were taken as the reference. The teaching effects was comprehensively evaluated from the student side and the teacher side. SPSS 20.0 was used for t test, and Chi-square test. Results:The scores of thinking questions in experimental reports from experimental groups (course 1, P=0.038; course 2, P=0.043) and food hygiene paper ( P=0.034) were significantly higher than those of the control group. Eighty percent of the teachers who attended the course [8 teachers of the department (80.00%), 4 teaching supervisors (80.00%)] believed that creating scenarios method fully embodied the cultivation of professional knowledge, skills, cross-professional ability and comprehensive practical ability. The qualified rates of students' self-mastery in professional knowledge, skills, cross-professional ability and comprehensive practical ability were 100% (80 students), 100% (80 students) and 97.75% (79 students), respectively. The students' satisfaction with teaching methods reached 90% (70 students). The results of qualitative interview gave a full recognition to the application of creating scenarios method. Conclusions:The application of creating scenarios method in the experimental course of food hygiene not only improves the course results of students, but also improves their cognition of the course. In addition, it can fully display the cultivation of the core competence of students majoring in preventive medicine.

On the construction of the core competence training system of ICU specialized nurses in Yunnan Province based on patient safety / 中华医学教育探索杂志

Objective:To construct an objective and scientific core competence training system for intensive care unit (ICU) specialized nurses in Yunnan Province, and to provide references for formulating a homogeneous and standardized ICU specialized nurse training strategy and assessment.Methods:Based on the theoretical basis of the nurse-patient safety competency framework, the relevant literature of nursing job competence was consulted, the core competency training system of ICU specialized nurses in Yunnan Province was constructed, and the expert letter questionnaire was designed through theoretical analysis. From January to May 2020, 15 experts of critical care medicine from Yunnan Province were consulted by Delphi method to establish a core competency training system for ICU specialized nurses in Yunnan Province. SPSS 21.0 was used to input and analyze the data.Results:A total of 2 rounds of Delphi expert consultation were carried out. The final core competency indicators for ICU specialized nurses included effective communication, teamwork, safety risk management, nursing quality improvement and professionalism, including 5 first-level indicators, 14 second-level indicators and 59 third-level indicators. The effective recovery rates of the two rounds of Delphi expert consultation questionnaires were 100.00% (15/15) and 86.67% (13/15), the expert authority coefficient values were 0.863 and 0.881 respectively, the Kendall harmony coefficients of the first-level index, the second-level index and the third-level index were 0.381, 0.299 and 0.250, and χ2 value was 22.86, 58.22 and 217.30, with statistically significant differences ( P<0.001). The 5 first-level indicators were safety risk management (0.360), professionalism (0.280), teamwork (0.200), nursing quality improvement (0.120), and effective communication (0.040) in descending order. Conclusions:The established core competence training system for ICU specialized nurses in Yunnan Province based on patient safety is reliable and scientific, which can provide objective basis for the on-the-job training, evaluation and development of patient safety education courses for ICU specialized nurses in Yunnan Province.

Factors influencing medical narrative competence and its correlation with psychological resilience in pediatric staff / 中华医学教育探索杂志

Objective:To investigate the medical narrative competence of pediatric staff, and analyze its influencing factors and correlation with psychological resilience, and to discuss strategies to improve narrative competence.Methods:From January 11 to February 25, 2022, by convenience sampling, we sampled pediatric personnel and those on refresher training at Children's Hospital, Zhejiang University School of Medicine for a questionnaire survey involving general information, the narrative competence scale, and the 14-item resilience scale. With the use of SPSS 26.0, the narrative competence of different populations was compared, and factors affecting narrative competence were determined through Pearson correlation analysis and multiple regression analysis.Results:A total of 361 valid questionnaires were included in this study, and there was significant differences in the narrative competence score between different ages, professional titles, working years, income levels, and whether they wrote parallel charts ( P<0.05). The total score of narrative competence of pediatric staffs was (147.13±18.76), and positively correlated with the total resilience score and the score of each dimension ( P≤0.001). The regression analysis showed that writing parallel charts and resilience could explain 53.10% of the variation in narrative competence ( P<0.001). Conclusions:Pediatric staff's narrative competence is at low or intermediate levels. Parallel chart writing and resilience training can improve narrative competence and promote a harmonious doctor-patient relationship.

Application of the excellent doctor-oriented teaching evaluation method in the clinical teaching of dermatology and venereology / 中华医学教育探索杂志

Objective:To investigate the application value of the teaching evaluation method guided by cultivating "excellent doctors" in the clinical teaching of dermatology and venereology.Methods:A non-simultaneous control study was conducted, and the medical students who received theoretical learning and clinical internship in Department of Dermatology and Venereology, Affiliated Hospital of North Sichuan Medical College, from March 2020 to February 2022, were enrolled as subjects. According to the order of enrollment, 32 students who were enrolled from March 2020 to February 2021 were set up as control group, and 31 students who were enrolled from March 2021 to February 2022 were set up as experimental group. The students in the control group received lecture-based learning, and those in the experimental group received clinical teaching using a teaching and evaluation method guided by cultivating "excellent doctors". After the course ended, the two groups were compared in terms of the scores of theoretical knowledge and operation skills, clinical thinking ability [Self-Assessment of Clinical Reasoning and Reflection (SACRR)], core competence [Mini-Clinical Evaluation Exercise (Mini CEX)], and degree of satisfaction with teaching. SPSS 25.0 software was used to perform the independent samples t-test, the Mann-Whitney U test, the chi-square test, and the rank sum test. Results:One student in the control group voluntarily withdrew from the study, and one student in the experimental group did not complete the contents of internship. Finally, 31 students in the control group and 30 in the experimental group were included in the study. After 4 weeks of internship, compared with the control group, the experimental group had significantly higher scores of theoretical knowledge (88.00±4.30 vs. 85.71±4.12, t=2.12, P=0.040) and operation skills (91.87±3.99 vs. 88.23±3.84, t=3.63, P<0.05). After 4 weeks of internship, compared with the control group, the experimental group had significantly higher information systematization score (47.23±3.11 vs. 45.16±3.00), analysis problem score (34.87±2.30 vs. 31.29±2.30), truth finding score (16.30±1.49 vs. 14.45±1.52), reflective ability score [3.50 (3.00, 4.00) vs. 3.00 (3.00, 3.00)], and total score of SACRR (101.87±4.47 vs. 93.90±4.47), with significant differences between the two groups ( t/ Z=2.65, 6.17, 4.79, 3.15, and 6.96, all P<0.05). After 4 weeks of internship, the experimental group had a significantly better core competence than the control group ( Z=2.12, P=0.030); compared with the control group, the experimental group had significantly higher classroom teaching score (20.17±1.98 vs. 18.45±2.23, t=3.17, P<0.05), clinical practice score (19.83±2.10 vs. 17.65±2.17, t=4.00, P<0.05), learning plan score (18.63±2.24 vs. 17.03±2.15, t=2.85, P<0.05), teaching resource score (20.07±1.82 vs. 18.58±2.00, t=3.04, P<0.05) and total score (78.70±3.67 vs. 71.71±4.13, t=6.98, P<0.05). Conclusions:The application of the teaching and evaluation method guided by cultivating "excellent doctors" in the clinical teaching of dermatology and venereology can improve clinical theoretical knowledge, practical operation skills, clinical thinking ability, and core ability among interns and thus help to improve teaching quality. Therefore, it holds promise for clinical application.

Study on the correlation between home rearing environment and social emotional competence of infants and toddlers / 中国儿童保健杂志

【Objective】 To understand the current situation of social emotional competence of infants and toddlers, and analyze its relationship with home rearing environment, in order to provide the basis for improving the level of infant social emotional development. 【Method】 A study was conducted on 390 individuals from a child health institution in Hubei and Henan provinces.The "Infant and Toddler Social-Emotional Assessment Scale" and "1 - 3 Years Child Home Rearing Environment Scale" were used to investigate the social emotions ability and home rearing environment of infants and toddlers. 【Results】 A total of 390 valid questionnaires were collected in this survey, of which 199 were boys (51.0%) and 191 girls (49.0%). The average age of infants was (27.13±6.86)months.The age distribution is mainly among infants and young children aged 24 to 36 months, with a total of 305 people (78.2%). The caregiver′s registered residence (Z=-3.570), father′s education level (H=17.106), mother′s education level (H=7.980), per capita monthly income of the family (H=13.986), and the home rearing environment (Z=-8.881) had statistical significance on the social emotional competence of infants(P<0.05 or <0.01).There was a significant positive correlation between family rearing environment and infants′ social emotion (r=0.582, P<0.01).Multiple regression analysis showed that the social adaptation/self-care(β=0.30, 95%CI: 0.18 - 0.52, P<0.01)and language cognition dimensions(β=0.22, 95%CI: 0.07 - 0.59, P<0.05) in the home rearing environment had a statistically significant impact on the social emotional ability of infants and toddlers. 【Conclusion】 The home rearing environment is closely related to the social emotional development of infants and young children.Improve the parenting knowledge and skills of the main caregivers of infants and young children, build a good family rearing environment for infants and young children, which is beneficial to promote the development of children′s social emotions.

The significance and path of narrative turn in the course of “doctor-patient communication” / 中国医学伦理学

By integrating the concept of narrative medicine and relevant models and tools into the Doctor-patient Communication course， this paper expounds the connotation of narrative medicine under the context of “new medicine” and “big health” and the practical significance of the shift to narrative in Doctor-patient Communication course in three aspects： academic frontier， social needs and practical needs. This paper analyzes the four dimensions of innovation that narrative medicine， as the frontier of the discipline， historical accumulation， educational philosophy and professional skills， provides for the Doctor-patient Communication course， and explores the effective path to realize the narrative transformation of the course. It is expected to achieve the purpose of forging students’ humanistic medical skills and literacy through teaching innovation， realizing the coordination of medical education and competency orientation， adapting to the psychological and social increase， the change of people and health， and promoting the reform of the supply side of medical talents.

Analysis of the current situation and influencing factors of clinical nurses’ medical narrative competence / 中国医学伦理学

ObjectiveTo investigate the current situation of medical narrative competence of clinical nurses，analyze its influencing factors，and provide a theoretical basis for improving the medical narrative competence of nurses. MethodsA total of 1，511 nurses from different hospitals in Shaanxi Province were selected as the research object from May 30，2023，to June 30，2023，by using the convenience sampling method. The general information questionnaire and the Medical Narrative Competence Scale were used to investigate the current situation of nurses’ medical narrative competence and analyze the influencing factors. ResultsThe total score of the medical narrative competence of clinical nurses was （152.75±23.98）. Multiple linear regression showed that implementation of humanistic care for patients in clinical practice familiarity with narrative medicine，views on narrative nursing，narrative-related practical experience，sense of identity and accomplishment in the nursing profession，satisfaction with nursing work，and being employed in a gynecology department were the influencing factors of nurses’ medical narrative competence. ConclusionThe medical narrative competence of clinical nurses was above average. Hospital managers should provide targeted training based on their influencing factors，care for nurses’ mental health，reduce nurses’ professional pressure，and improve nurses’ job satisfaction，to improve their medical narrative competence and promote professional growth.