Manejo de la vía aérea ante un caso de paro respiratorio en un escenario clínico simulado. Experiencia en una residencia de pediatría / Airway management during a respiratory arrest in a clinical simulation scenario. Experience at a pediatric residency program

Introducción. La insuficiencia respiratoria es la causa más común de paro cardíaco en pediatría; su reconocimiento y el manejo adecuado son cruciales. La simulación se utiliza para mejorar las habilidades médicas. El objetivo del trabajo fue determinar la proporción de residentes de pediatría que reconocieron un paro respiratorio (PR) pediátrico en un centro de simulación. Métodos. Se realizó un estudio observacional con 77 médicos residentes. Se utilizó un caso simulado de un paciente con dificultad respiratoria que progresa a PR. Resultados. De los 77 participantes, 48 reconocieron el paro respiratorio (62,3 %). El tiempo medio para reconocer el PR fue de 34,43 segundos. Conclusión. El 62,3 % de los participantes logró reconocer el paro respiratorio. Entre aquellos que lo identificaron, el tiempo promedio fue de 34,43 segundos. Se observaron graves deficiencias en algunas de las intervenciones esperadas.

Introduction. Respiratory failure is the most common cause of cardiac arrest in pediatrics. Recognizing and managing it adequately is critical. Simulation is used to improve medical skills. The objective of this study was to establish the proportion of pediatric residents who recognized a respiratory arrest in a child at a simulation center. Methods. This was an observational study in 77 residents. A simulation of a patient with respiratory distress that progressed to respiratory arrest was used. Results. Among the 77 participants, 48 recognized respiratory arrest (62.3%). The mean time to recognize respiratory arrest was 34.43 seconds. Conclusion. Respiratory arrest was recognized by 62.3% of participants. Among those who did so, the average time was 34.43 seconds. Severe failures were noted in some of the expected interventions.

Efecto de la "ley de residentes" sobre el bienestar laboral en cirugía: resultados de un estudio nacional de métodos mixtos en Colombia / Effect of the "residents' law" on occupational well-being in surgery: Results of a national mixed methods study in Colombia

Introducción. El efecto de las políticas para el mejoramiento del bienestar de los residentes, en términos de desgaste profesional y compromiso laboral, es controversial y su resultado tras la implementación de la "ley de residentes" (1917/2018) en Colombia es desconocido. Este estudio explora el efecto de esta ley en médicos residentes de cirugía colombianos. Métodos. Estudio de métodos mixtos secuencial explicativo. Inicialmente, se invitó a todos los residentes de cirugía del país a autodiligenciar los cuestionarios UWES-17 y MBI-HSS para evaluar el compromiso laboral (vigor, dedicación y absorción) y desgaste profesional (agotamiento emocional, despersonalización y baja realización personal) antes (2019) y después (2022) de la implementación de la ley. Se probaron diferentes hipótesis mediante modelos de ecuaciones estructurales. Los resultados fueron explorados con cirujanos mediante grupos focales. La información cualitativa fue analizada manualmente y por inteligencia artificial, y reportada en temas principales. Resultados. Participaron en el estudio 400 residentes. La tasa de desgaste profesional fue de 24,8 % antes y 15,8 % después (p=0,032). El análisis de ecuaciones estructurales confirmó que el agotamiento emocional sobre el desgaste profesional fue menor en 2022 (p=0,022). No se identificaron cambios significativos en el compromiso laboral. La principal explicación fue atribuida a los beneficios económicos de la ley. Conclusión. La tasa de desgaste profesional en médicos residentes de cirugía colombianos se redujo significativamente tras la implementación de la "ley de residentes". Estos hallazgos tienen implicaciones para la practica y el mejoramiento de la calidad de la educación.

Introduction. The effect of policies to improve residents' well-being, in terms of professional burnout and work commitment is controversial, and its result after the implementation of the "residents' law" (1917/2018) in Colombia is unknown. This study explores the effect of this law on Colombian surgical residents. Methods. Explanatory sequential mixed methods study. Initially, all surgical residents in the country were invited to self-complete the UWES-17 and MBI-HSS questionnaires to evaluate work commitment (vigor, dedication, and absorption) and professional burnout (emotional exhaustion, depersonalization, and low personal accomplishment) before (2019) and after (2022) the implementation of the law. Different hypotheses were tested using structural equation models. The results were explored with surgeons through focus groups. Qualitative information was analyzed manually and by artificial intelligence, and reported into main themes. Results. 400 residents participated in the study. Burnout rates were 24.8% before and 15.8% after (p=0.032). The structural equations analysis confirmed that emotional exhaustion over professional burnout was lower in 2022 (p=0.022). No significant changes in work commitment were identified. The main explanation was attributed to the economic benefits of the law. Conclusion. The burnout rate in Colombian surgical residents was significantly reduced after the implementation of the "residents' law". These findings have implications for practice and improving the quality of education

Effect of the COVID-19 pandemic on cataract surgery by residents who had routine surgical simulator training during residency

ABSTRACT Purpose: To assess the effect of the coronavirus disease 2019 (COVID-19) pandemic on cataract surgery by residents who had mandatory surgical simulator training during residency. Methods: In this retrospective, observational analytical study, the total number of cataract surgeries and surgical complications by all senior residents of 2019 (2019 class; prepandemic) and 2020 (2020 class; affected by the reduced number of elective surgeries due to the COVID-19 pandemic) were collected and compared. All residents had routine mandatory cataract surgery training on a virtual surgical simulator during residency. The total score obtained by these residents on cataract challenges of the surgical simulator was also evaluated. Results: The 2020 and 2019 classes performed 1275 and 2561 cataract surgeries, respectively. This revealed a reduction of 50.2% in the total number of procedures performed by the 2020 class because of the pandemic. The incidence of surgical complications was not statistically different between the two groups (4.2% in the 2019 class and 4.9% in the 2020 class; p=0.314). Both groups also did not differ in their mean scores on the simulator's cataract challenges (p<0.696). Conclusion: Despite the reduction of 50.2% in the total number of cataract surgeries performed by senior residents of 2020 during the COVID-19 pandemic, the incidence of surgical complications did not increase. This suggests that surgical simulator training during residency mitigated the negative effects of the reduced surgical volume during the pandemic.

Egressos de um programa de residência multiprofissional em cardiopneumologia e inserção no mercado de trabalho / Egresses from a multiprofessional residency program in cardiopneumology and insertion in the labor market / Egresos de un programa de residencia multiprofesional en cardiopneumología e inserción en el mercado de trabajo

A Residência Multiprofissional é uma importante estratégia de Educação Permanente (EPS) no Sistema Único de Saúde (SUS), sendo a primeira oportunidade para muitos recém-graduados de exercer sua profissão e adquirir experiência. O objetivo do presente estudo foi conhecer o perfil de profissionais egressos de um programa de Residência Multiprofissional em Cardiopneumologia no Ceará e sua inserção no mercado de trabalho. No estudo, transversal e quantitativo, coletaram-se dados socioeconômicos, sociodemográficos e sobre histórico no mercado de trabalho, entre junho e outubro de 2022, via formulário eletrônico enviado aos egressos. A grande maioria estava empregada, atuando no SUS como terceirizados, vinculados como celetistas ou cooperados, em áreas de atuação diversas, destacando o potencial de contribuição na saúde, na educação e na gestão pública. Estudos com profissionais egressos de outros programas hospitalares são necessários para melhor elucidar as potencialidades, contribuições e lacunas do processo formativo à inserção dos profissionais no mercado de trabalho.

Multiprofessional Residency is an important strategy for Continuing Education (PDE) in the Unified Health System (SUS), being the first opportunity for many recent graduates to exercise their profession and acquire experience. The aim of this study was to know the profile of professionals graduating from a Multiprofessional Residency in Cardiopneumology program in Ceará and their insertion in the labor market. In this cross-sectional and quantitative study, socioeconomic, sociodemographic and labor market history data were collected between June and October 2022, via an electronic form sent to the graduates. The vast majority were employed, working in the SUS as outsourced, contracted, or cooperative workers, in diverse areas, highlighting the potential to contribute to health, education, and public management. Studies with professionals graduating from other hospital programs are necessary to better elucidate the potentialities, contributions, and gaps of the formative process to the insertion of the professionals in the labor market.

La Residencia Multiprofesional es una importante estrategia de Educación Continuada (PDE) en el Sistema Único de Salud (SUS), siendo la primera oportunidad para muchos recién graduados de ejercer su profesión y adquirir experiencia. El objetivo de este estudio fue conocer el perfil de los profesionales egresados de un programa de Residencia Multiprofesional en Cardoneumología en Ceará y su inserción en el mercado de trabajo. En este estudio transversal y cuantitativo, se recogieron datos socioeconómicos, sociodemográficos y de historia laboral entre junio y octubre de 2022, a través de un formulario electrónico enviado a los graduados. La gran mayoría estaba empleada, trabajando en el SUS como tercerizados, contratados o cooperativistas, en diversas áreas, destacando el potencial de contribución a la salud, educación y gestión pública. Estudios con profesionales egresados de otros programas hospitalarios son necesarios para dilucidar mejor las potencialidades, contribuciones y lagunas del proceso formativo para la inserción de los profesionales en el mercado de trabajo.

Mini entrevistas múltiples para la selección de residentes y fellows en un centro cardiovascular. Experiencia a 5 años / Multiple Mini Interviews for Selection of Residents and Fellows in a Cardiovascular Center. A 5-year Experience

RESUMEN Introducción las mini entrevistas múltiples (MME) son un modelo para evaluar las habilidades no cognitivas en la selección de profesionales ingresantes a instituciones médicas. Objetivo el objetivo de este trabajo fue evaluar la factibilidad, confiabilidad y la aceptabilidad de las MME para la selección de residentes y fellows en un centro cardiovascular en los últimos 5 años. Material y métodos se realizó un estudio observacional, en el cual se incluyeron consecutivamente postulantes a la residencia de Cardiología y a las especialidades de Medicina Nuclear y Ultrasonido en los años 2018, 2019 y 2022. Se desarrollaron diez estaciones para evaluar diferentes dominios no cognitivos. La confiabilidad se evaluó mediante el coeficiente G de generalización. Además, se encuestó a postulantes y entrevistadores para evaluar la aceptabilidad de las MME, y se evaluó la factibilidad en términos de tiempo dedicado al proceso. Resultados un total de 75 postulantes participaron de las MME. A partir del estudio G se obtuvieron coeficientes de confiabilidad de 0,62 y 0,61 acorde al diseño. Fue factible su implementación y el 92% de los postulantes valoró de manera muy positiva a las MME. El 90% de los entrevistadores refirió tener suficiente tiempo para evaluar a los participantes y que el proceso no era excesivamente agotador Conclusiones las MME son un método novedoso en nuestro medio. Demostraron ser confiables y con un elevado nivel de aceptabilidad para la evaluación de habilidades no cognitivas en el proceso de selección de postulantes a residencia de Cardiología y de subespecialidades en un centro cardiovascular.

ABSTRACT Background Multiple mini-interviews (MMIs) serve as a model to evaluate non-cognitive skills in the admission process of health care professionals. Objective The aim of this study was to evaluate the feasibility, reliability and acceptability of the MMI model for the selection of residents and fellows in a cardiovascular center in the past 5 years. Methods We conducted an observational study including applicants to the cardiology residency program and to the fellowship in Nuclear Medicine and Cardiovascular Ultrasound in 2018, 2019 and 2022. Ten stations were developed to evaluate different non-cognitive domains. Reliability was assessed using G-coefficient. Applicants and interviewers were also surveyed to assess the acceptability of the MMI model and its feasibility in terms of the time required for the process. Results A total of 75 applicants participated in the MMIs. The G study showed reliability coefficients of 0.62 and 0.61 according to the design. Implementation was feasible; 92% of applicants gave positive reviews to the MMI model, and 90% of interviewers reported they had sufficient time to assess the participants and that the process was not an excessively exhausting. Conclusion MMIs are a novel method in our setting, demonstrating reliability and a high level of acceptability for evaluating non-cognitive skills in the selection process of applicants to the cardiology residency program and fellowships in a cardiovascular center.

Residencia de Medicina Física y Rehabilitación en el Perú: número de vacantes y análisis de los planes de estudios

Introducción. En el Perú existe un déficit de médicos fisiatras y los estándares para la formación de especialistas en Medicina Física y Rehabilitación (MFyR) no han sido actualizados desde el 2002. No existen estudios que aborden esta problemática. Objetivos. Describir el número de vacantes y analizar los planes de estudios de los programas de residencia de MFyR. Métodos. Estudio observacional descriptivo. Revisamos el número de vacantes para MFyR ofertadas en el período 2017-2022. Asimismo, recolectamos las variables de interés de los planes de estudios de los programas de residencia, incluyendo el abordaje de 30 competencias básicas recomendadas por la Sociedad Internacional de MFyR (ISPRM). Resultados. Durante el periodo 2017-2022, 11 universidades ofertaron 283 vacantes para MFyR, de las cuales 89,4% correspondieron a la ciudad de Lima. El número de vacantes mostró una tendencia a la baja desde el 2018 hasta el 2021. 7 de 11 planes de estudios abordaron por lo menos el 75% de las competencias básicas recomendadas por la ISPRM, y ninguno abordó el 100% de estas competencias. Además, encontramos heterogeneidad respecto a los cursos teóricos, el número de créditos académicos y las rotaciones externas permitidas. Conclusiones. En el Perú, el número de vacantes para MFyR disminuyó durante la pandemia por COVID-19, a pesar de su rol fundamental en la atención de la población afectada por la enfermedad y del déficit de médicos fisiatras. Ningún plan de estudios incluye todas las competencias básicas recomendadas por la ISPRM, lo cual alerta sobre la necesidad de actualizarlos y reestructurarlos.

Introduction. In Peru there is a shortage of physiatrists, and the standards for the training of specialists in Physical Medicine and Rehabilitation (PM&R) have not been updated since 2002. There are no studies that have focused on this problem. Objectives. To describe the number of PM&R positions and analyze the PM&R residency programs' curriculums. Methods. Descriptive observational study. We reviewed the number of PM&R positions offered in the 2017-2022 period. Likewise, we collected the variables of interest from the curriculums that offer this residency program, including the approach of 30 basic competencies recommended by the International Society of PM&R (ISPRM). Results. During the 2017-2022 period, 11 universities offered 283 PM&R positions, of which 89.4% corresponded to the city of Lima. The number of positions showed a downward trend from 2018 to 2021. 7/11 curriculums addressed at least 75% of the basic competencies recommended by the ISPRM, and none of them addressed 100% of these competencies. In addition, we found heterogeneity between universities respect to the theoretical courses taught, the number of academic credits and the external rotations allowed. Conclusions. In Peru, the number of PM&R positions decreased during the COVID-19 pandemic, despite its crucial role in caring for the affected population and the shortage of physiatrists. No curriculum includes all the basic competencies recommended by ISPRM, highlighting the need to update and restructure them.

Pensamiento suicida en médicos residentes con la escala de Plutchik en dos instituciones de salud en Ciudad Obregón, Sonora, México

Objetivo: Evaluar la incidencia y factores asociados al pensamiento suicida en una muestra de médicos residentes de dos instituciones. Materiales y métodos: Se realizó un estudio de tipo descriptivo, observacional, prospectivo y transversal, entre los meses de septiembre a octubre del 2022, para estimar el pensamiento suicida en los médicos residentes de dos hospitales con la escala de Plutchik, además de buscar factores asociados. Se aplicó la estadística descriptiva con medidas de tendencia central y de dispersión, frecuencias relativas y absolutas; las pruebas ji al cuadrado de Pearson y de bondad de ajuste, así como la prueba de Kruskal-Wallis se emplearon para examinar las diferencias entre especialidades, y la prueba post-hoc de Tukey para evaluar la especialidad diferente. Resultados: Se respondió un total de 225 encuestas, de las cuales se eliminaron 20 por inadecuado diligenciamiento, y quedaron 205. El promedio de edad fue de 28,66 años (DS ± 2,360) y el 71,2 % correspondió al sexo femenino. En cuanto a las especialidades, se encontró a pediatría con el 28,8 % y a anestesiología con el 20,5 %. Se evidenció asociación significativa entre especialidades, con un valor de p = 0,0000, y grado académico de p = 0,003 (p ≤ 0,05). Según la especialidad, se encontraron diferencias en cuanto al pensamiento suicida; la prueba de Kruskal-Wallis mostró un valor de p = 0,000 y la prueba post-hoc de Tukey reveló que la especialidad de ginecología fue la diferente. Conclusiones: De acuerdo con los resultados de la muestra, alrededor de una cuarta parte de los médicos residentes manifiesta pensamiento suicida. La prevalencia en dicha muestra no presenta diferencia significativa con respecto a la incidencia a nivel latinoamericano. Se encontró una asociación entre ideas suicidas, especialidades médicas y grado académico. En cuanto a comparación entre las especialidades, ginecología fue la que mostró mayor ideación suicida. Este trabajo presenta algunas limitaciones, por ejemplo, existe una gran heterogeneidad de grupos, no se empleó una técnica de selección probabilística y las pruebas estadísticas empleadas fueron no paramétricas.

Objective: To evaluate the incidence and factors associated with suicidal ideation in a sample of resident physicians from two institutions. Materials and methods: A descriptive, observational, prospective and cross-sectional study was carried out to estimate the suicidal ideation and associated factors with the Plutchik Suicide Risk Scale among resident physicians from two hospitals between September and October 2022. Descriptive statistics were used with measures of central tendency and dispersion, as well as relative and absolute frequencies. In addition, Pearson's chi-square goodness of fit test and Kruskal-Wallis H test were used to examine the differences between specialties, and Tukey's Honest Significant Difference test to determine which specialty was different. Results: A total of 225 surveys were answered, out of which 20 were eliminated due to inadequate completion, leaving 205 complete surveys for analysis. The average age was 28.66 years (SD ± 2.360) and 71.2 % were females. Concerning the specialties, pediatrics was found in 28.8 % of the respondents and anesthesiology in 20.5 %. A significant association between specialties with a value of p = 0.0000 and academic degrees with p = 0.003 (p ≤ 0.05) was evidenced. Differences regarding suicidal ideation were found by specialty: Kruskal-Wallis H test showed a value of p = 0.000 and Tukey's Honest Significant Difference test revealed that the specialty of gynecology was the different one. Conclusions: According to the results of the study sample, approximately one fourth of the resident physicians had suicidal ideation. Its prevalence in this sample showed no significant difference with respect to its incidence in Latin America. An association between suicidal ideation, medical specialties and academic degree was found. As for the comparison between specialties, gynecology was the one with the highest suicidal ideation rate. This work had some limitations; for example, the groups were very heterogeneous, a probabilistic selection technique was not used, and the statistical tests were nonparametric.

Autonomía en actividades profesionales confiables luego de la pandemia por COVID-19: perspectivas de residentes y docentes / Autonomy in entrustable professional activities after the COVID-19 pandemic: the perspectives of residents and teachers

Introducción. Las actividades profesionales confiables (APROC) son 13 actividades que los médicos recién graduados deberían poder realizar sin supervisión directa. Nuestro objetivo fue evaluar la percepción de residentes y docentes acerca de la autonomía para realizar las APROC, luego de 2 años del inicio de la pandemia. Materiales y métodos. Estudio de corte transversal, que incluyó residentes de primer año de especialidades clínicas y quirúrgicas, y sus docentes. Se enviaron cuestionarios electrónicos y anónimos. Resultados. Se incluyeron 31 residentes y 20 docentes. La mayoría de los residentes creía que podía realizar en forma autónoma 8 de las 13 APROC. Para la mayoría de los docentes, los residentes requerían supervisión directa para 11 de las 13 actividades. Se observaron diferencias significativas entre la percepción de residentes y docentes en 8 de las 13 APROC. Conclusión. La percepción de autonomía para realizar las APROC al inicio de la residencia fue considerablemente mayor en residentes que en sus docentes.

Introduction. The entrustable professional activities (EPAs) are 13 activities that new medical graduates should be able to perform without direct supervision. Our objective was to assess the perceptions of residents and teachers regarding their autonomy to perform the EPAs 2 years after the onset of the COVID-19 pandemic. Materials and methods. Cross-sectional study of first-year residents of clinical and surgical specialties and their teachers. Electronic, anonymous questionnaires were used. Results. Subjects were 31 residents and 20 teachers. Most residents believed that they were able to perform 8 of the 13 EPAs independently. According to most teachers, residents required direct supervision to perform 11 of the 13 EPAs. Significant differences were observed between residents' and teachers' perceptions in 8 of the 13 EPAs. Conclusion. The perception of autonomy to perform the EPAs in the beginning of the residency program was considerably better among residents than their teachers.

Residências em saúde: análise de uma política estadual de formação de profissionais para o SUS / Residencies in health: analysis of a state policy for training professionals for the SUS

RESUMO As residências em saúde constituem-se importante estratégia de Estado na regulação da formação de profissionais para o Sistema Único de Saúde (SUS) no âmbito da política de gestão do trabalho e educação na saúde. Foi realizada uma investigação que objetivou analisar como a política de residência em área profissional da saúde tem sido implementada no estado de Pernambuco, Brasil, no período de 2010 a 2021, nos aspectos gestão, características dos programas de residência e recursos investidos. O trabalho é uma pesquisa social, do tipo estudo de caso e abordagem de métodos mistos, com pesquisa documental e dados governamentais, que utilizou como referencial teórico-analítico a Abordagem do Ciclo de Políticas. Foi desenvolvida análise de conteúdo temática com base no que foi coletado, na teoria e na perspectiva dos pesquisadores, identificando as categorias: atores da política e governança; expansão da formação e financiamento; áreas temáticas prioritárias; formação nas residências multiprofissionais em saúde. Foram identificadas experiências de gestão com participação dos diversos atores locais, investimento incremental em bolsas de residência e ampliação das residências multiprofissionais em saúde. Persiste o desafio de implementar uma política de formação em saúde, que, pautada pelo ensino em serviço, atue como força motriz para fazer avançar o SUS.

ABSTRACT Health residencies constitute an important State strategy in regulating the training of professionals for the Unified Health System (SUS) within the scope of work management and health education policy. An investigation was carried out to analyze how the residency policy in the professional health area has been implemented in the state of Pernambuco, Brazil, from 2010 to 2021, in terms of management, characteristics of residency programs, and resources invested. The work is a social research, of the case study type and mixed methods approach, with documental research and government data, which used the Policy Cycle Approach as a theoretical-analytical framework. We developed thematic content analysis based on what was collected, on theory and on the researchers' perspective, identifying the categories: policy actors and governance; expansion of training and funding; priority thematic areas; training in multiprofessional health residencies. We identified management experiences with the participation of different local actors, incremental investment in residency grants, and expansion of multiprofessional residencies in health. The challenge of implementing a health training policy remains, which, based on in-service education, acts as a driving force to advance the SUS.

Burnout syndrome in nursing residents in COVID-19 pandemic / Burnout syndrome in nursing residents in COVID-19 pandemic

Introduction: The incidence of Burnout Syndrome (BS) among nurses is higher. For this group, nursing residents undergo periodic assessments regarding compliance with the care workload in closed sectors, such as Intensive Care and Emergency Care, that put them at higher risk for the syndrome. Objective: Identify the prevalence and related factors for BS in nursing residents. Material and Methods: Quantitative, analytical, cross-sectional study with 106 nurses enrolled in the Residency program in Rio de Janeiro, Brazil, based on the following instruments: Maslach Burnout Inventory-General Survey Scale and an occupational sociodemographic questionnaire. Non-parametric statistical tests for independent samples were applied and Mann-Whitney test 15 was used for quantitative variables. Results: The results show that variable changes in relationships indicates stage 4 of the BS when compared to the other stages. For the other variables, there were no statistically significant differences. Discussion: Studies reveal that work-family balance is closely related to how job satisfaction is affected and mitigates the negative effects of BS. Conclusions: Consequences on relation patterns are among the most affected symptoms in the lives of nursing residents. This study is expected to contribute to raising awareness of the problem in question and to improve the quality of work life of resident nurses, detecting and preventing their illness.

Introducción: La incidencia del síndrome de burnout en profesionales de enfermería es mayor. Los residentes de enfermería se someten a evaluaciones periódicas sobre el cumplimiento de la carga de trabajo asistencial en servicios cerrados, como unidades de cuidados intensivos y urgencias, que les exponen a un mayor riesgo de padecer este síndrome. Objetivo: Identificar la prevalencia y factores relacionados del síndrome de burnout en residentes de enfermería. Materiales y métodos: Estudio cuantitativo, analítico y transversal que incluyó 106 enfermeros residentes matriculados en el programa de residencia en Río de Janeiro, Brasil, y empleó el Inventario de Burnout de Maslach - Encuesta General y un cuestionario sociodemográfico y ocupacional. Se aplicaron pruebas estadísticas no paramétricas para muestras independientes y se utilizó la prueba de Mann-Whitney para las variables cuantitativas. Resultados: Los resultados muestran que la variable "cambios en las relaciones" se encuentra en etapa 4 del síndrome de burnout en comparación con las demás etapas. En cuanto a las demás variables, no hubo diferencias estadísticamente significativas. Discusión: Los estudios revelan que el equilibrio trabajo-familia está estrechamente relacionado con el modo en que se ve afectada la satisfacción laboral y mitiga los efectos negativos del síndrome de burnout. Conclusiones: Las consecuencias en los patrones de relación se encuentran entre los síntomas más afectados en la vida de los residentes de enfermería. Se espera que este estudio contribuya a concientizar sobre el problema en cuestión y a mejorar la calidad de vida laboral de las enfermeras residentes, detectando y previniendo esta enfermedad.

Introdução: A incidência da Síndrome de Burnout (SB) entre os enfermeiros é maior. Para esse grupo, os residentes de enfermagem são submetidos a avaliações periódicas quanto ao cumprimento da carga horária de cuidados em setores fechados, como Terapia Intensiva e Emergência, o que os coloca em maior risco para a síndrome. Objetivo: Identificar a prevalência e os fatores relacionados à SB em residentes de enfermagem. Material e métodos: Estudo quantitativo, analítico, transversal com 106 enfermeiros matriculados no programa de Residência no Rio de Janeiro, Brasil, com base nos seguintes instrumentos: Maslach Burnout Inventory-General Survey Scale e um questionário sociodemográfico ocupacional. Foram aplicados testes estatísticos não paramétricos para amostras independentes e o teste de Mann-Whitney 15 foi usado para variáveis quantitativas. Resultados: Os resultados mostram que as mudanças variáveis nos relacionamentos indicam o estágio 4 do BS quando comparado com os outros estágios. Para as outras variáveis, não houve diferenças estatisticamente significativas. Discussão: Estudos revelam que o equilíbrio entre trabalho e família está intimamente relacionado à forma como a satisfação no trabalho é afetada e atenua os efeitos negativos da SB. Conclusões: As consequências nos padrões de relacionamento estão entre os sintomas mais afetados na vida dos residentes de enfermagem. Espera-se que este estudo contribua para aumentar a conscientização sobre o problema em questão e para melhorar a qualidade de vida profissional dos enfermeiros residentes, detectando e prevenindo suas doenças.

Caracterización de estilos de aprendizaje, satisfacción y acceso a residencia médica en participantes de un programa de educación médica continuada bimodal/virtual en Medellín, Colombia, 2017

Introducción: los estilos de aprendizaje son rasgos del estudiante que pueden ayudar a la planificación curricular en educación médica. No se conoce con certeza si algún estilo de aprendizaje específico se relaciona con la satisfacción en educación médica continuada o si aumenta las probabilidades de acceder a una residencia médica. Objetivo: este trabajo buscó categorizar los estilos de aprendizaje en una cohorte de médicos, describir su satisfacción según cada estilo de aprendizaje y el acceso a una residencia médica. Materiales y métodos: estudio de corte transversal en médicos cursando un diplomado de actualización médica. Se categorizaron estilos de aprendizaje y sus combinaciones (activo, reflexivo, teórico y pragmático). Se calculó la diferencia de medias de satisfacción del curso. Posteriormente, se evaluó la asociación entre el estilo de aprendizaje y el acceso a un cupo de residencia médica. Resultados: trescientos once médicos (n=311) aceptaron participar. El 75 % tenían entre uno y dos estilos dominantes, siendo el más frecuente el reflexivo/teórico (n=108; 34,7%). No se encontró una mayor satisfacción global asociada a un estilo en particular. Conclusión: el estilo de aprendizaje dominante es el reflexivo/teórico. La satisfacción global es mayor en la modalidad bimodal. No se encontró asociación con ningún estilo de aprendizaje y el acceso a residencia médica.

Introduction: learning styles are student traits that can aid in curriculum planning in medical education. It is not known for certain if any specific learning style is related to satisfaction in continuing medical education or if it increases the chances of accessing a medical residency. Objective: the learning styles are student traits that can aid in curriculum planning in medical education. This study aimed to categorize learning styles within a cohort of physicians, describe their satisfaction according to each learning style, and assess access to a medical residency program. Methods: a cross-sectional study was conducted with physicians attending a diploma in clinical and surgical areas. Learning styles were categorized according to the CAMEA40 questionnaire. The median differences of course satisfaction was calculated. Subsequently, the association between each learning styles and access to a medical residency post was evaluated. Results: three hundred eleven (n = 311) agreed to participate. A total of 75 % had between one and two dominant learning style, the most frequent being the reflective/theoretical (n = 108; 34,7 %). No greater overall satisfaction associated with a particular learning style was found. Conclusion: one-third of the doctors had a reflective/theoretical profile. The overall satisfaction and access to a medical residency were no associated with any learning style.

A Study of the Current Scenario of the Obstetrics and Gynecology Residency during the COVID-19 Pandemic / Um estudo do cenário atual da residência em obstetrícia e ginecologia durante a pandemia de COVID-19

Abstract Objective To analyze the impact of the COVID-19 pandemic on the residency of gynecology and obstetrics in São Paulo. Methods Cross-sectional study developed by representatives of residents of the Association of Gynecology and Obstetrics of the State of São Paulo (SOGESP, in the Portuguese acronym). Data were collected from questionnaires applied to gynecology and obstetrics residents registered on the SOGESP website in February 2022. The interviewees answered about the repercussions of the pandemic on medical residency and whether they had technical and psychological support during the period. Results A total of 247 questionnaires were collected from residents of gynecology and obstetrics. The residents had an age of 28.3 ± 3 years old, and most of them were female (88.4%). The displacement to COVID care was reported by 62.34% of the students, but only 35.6% reported completely adequate personal protective equipment and only 7.7% reported complete theoretical and technical instruction to support these patients. Almost all of the interviewees stated that the gynecology sector was the most affected. The majority of the interviewees considered that the second-year residents had the greatest loss, and more than half of the residents in the 1st and 2nd year said they wished to give up their residency during the pandemic. More than 80% of the residents reported online theoretical classes and/or presentation of articles, reinforcing the fact that virtual activities gained a greater space within the medical residency. Conclusion The pandemic impacted the residency in greater proportion in outpatient clinics and gynecological surgeries, also interfering with the physician's desire to continue with the program.

Resumo Objetivo Analisar o impacto pandemia de COVID-19 sobre a residência de ginecologia e obstetrícia do Estado de São Paulo. Métodos Estudo transversal desenvolvido por representantes dos residentes da Associação de Ginecologia e Obstetrícia do Estado de São Paulo (SOGESP). Foram coletados dados de questionários aplicados aos residentes de ginecologia e obstetrícia cadastrados no site da SOGESP em fevereiro de 2022. Os entrevistados responderam sobre repercussões da pandemia sobre a residência médica e se tiveram suporte técnico e psicológico durante o período. Resultados Foram levantados 247 questionários de residentes de ginecologia e obstetrícia. Os residentes apresentaram idade de 28,3 ± 3 anos, sendo a maioria do sexo feminino (88,4%). O deslocamento para "covidários" foi referido por 62,34% dos avaliados, porém somente 35,6% referiram equipamento de proteção individual completamente adequado e apenas 7,7% referiram instrução completa teórica e técnica para o suporte destes pacientes. Quase a totalidade dos entrevistados afirmou que o setor de ginecologia foi o mais afetado. A maioria dos entrevistados considerou que o os residentes do segundo ano foram os que tiveram maior prejuízo, sendo que mais da metade dos residentes do 1° e 2° ano afirmou ter desejado desistir da residência durante a pandemia. Mais de 80% dos residentes referiram aulas teóricas e/ou apresentação de artigos online, reforçando o fato de que as atividades virtuais ganharam um espaço maior dentro da residência médica. Conclusão A pandemia impactou nas residências em maior proporção nos ambulatórios e cirurgias ginecológicas, interferindo também sobre o desejo do médico de seguir com o programa.

Rúbricas como instrumento de evaluación de ateneos en una residencia de Bioquímica Clínica de un hospital universitario. Estudio sobre su confiabilidad e impacto educativo / Rubrics as an evaluation instrument for conferences in a Clinical Biochemistry residency at a university hospital. Study on its reliability and educational impact / Rubricas como instrumento de avaliação de congressos em uma residência de Bioquímica Clínica de um hospital universitário. Estudo sobre sua confiabilidade e impacto educacional

Resumen El objetivo del estudio fue describir el uso de rúbricas para la evaluación formativa de la participación de profesionales en formación en el desarrollo de ateneos. Se realizó un estudio observacional, descriptivo, transversal y retrospectivo sobre la rúbrica de ateneos de programas de formación de posgrado de Bioquímica Clínica y se analizó la confiabilidad (por medio del coeficiente alfa de Cronbach) y su impacto educativo. Se analizaron 51 rúbricas sobre 41 ateneos de 9 profesionales en formación (residentes y becarios) por 19 evaluadores. La estimación de confiabilidad arrojó un alfa de Cronbach de 0,71 (nivel de confianza del 95%, p≤0,05). La rúbrica aquí analizada ha servido para clarificar las metas de aprendizajes de una actividad tradicional en la formación de posgrado en servicio. Se ha logrado generar un instrumento de evaluación confiable que puede ser utilizado en otras profesiones y especialidades del equipo de salud.

Abstract The objective of the study was to describe the use of rubrics for the formative evaluation of the participation of professionals in training in the development of conferences. An observational, descriptive, cross-sectional and retrospective study was carried out on the rubric of athenaeums of postgraduate training programmes in Clinical Biochemistry, analysing its reliability (by means of Cronbach's alpha coefficient) and its educational impact. Fifty-one rubrics difewere analysed on 41 athenaeums of 9 professionals in training (residents and fellows) by 19 evaluators. The reliability estimate yielded a Cronbach's alpha of 0.71 (95% confidence level, p≤0.05). The rubric analysed here has served to clarify the learning goals of a traditional activity in postgraduate training in service. It has been possible to generate a reliable evaluation instrument that can be used in other professions and specialties of the health team.

Resumo O objetivo do estudo foi descrever a utilização de rubricas para avaliação formativa da participação de profissionais em formação no desenvolvimento de ateneus. Foi realizado um estudo observacional, descritivo, transversal e retrospectivo da rubrica de ateneus dos programas de formação pós-graduação em Bioquímica Clínica, analisando a sua fiabilidade (através do coeficiente alpha de Cronbach) e o seu impacto educacional. Cinquenta e uma rubricas de 41 ateneus de 9 profissionais em formação (residentes e bolsistas) foram analisadas por 19 avaliadores. A estimativa de confiabilidade resultou em um alfa de Cronbach de 0,71 (nível de confiança de 95%, p≤0,05). A rubrica aqui analisada serviu para esclarecer os objetivos de aprendizagens de uma atividade tradicional na formação pós-graduação em serviço. Foi possível gerar um instrumento de avaliação confiável que pode ser utilizado em outras profissões e especialidades da equipe de saúde.

Clinical Simulation in the Training of Obstetrics and Gynecology Resident from the Perspective of Medical Residency Programs / A Simulação Clínica na Formação do Residente em Obstetrícia e Ginecologia na Perspectiva do Programa de Residência Médica

Abstract Objective This study analyzes the role of clinical simulation in internal medical residency programs (IMRP) in Obstetrics and Gynecology (OB/GYN), attributed by the supervisors, in the training of residents in the city of São Paulo (SP). Methods Cross-sectional descriptive, qualitative, and exploratory approach. Semi-structured interviews were performed with ten supervisors of Medical Residency programs in Obstetrics and Gynecology. Interviews were analyzed by means of content analysis under the thematic modality, starting with the core the role of clinical simulation in Obstetrics and Gynecology Medical Residency Programs. Results Supervisors view Clinical simulation as: a complementary tool for the teaching and learning process, a possibility of a safe teaching and learning environment, an opportunity to learn from mistakes, a support for professional practice committed to patient safety, a learning scenario for teamwork, a scenario for reflection on the work process in Obstetrics and Gynecology, a scenario for evaluative processes in the medical residency. Still according to supervisors, Clinical Simulation favors decision-making and encourages the resident participation in activities. Conclusion Supervisors recognize Clinical Simulation as a powerful pedagogical tool in the learning process of resident doctors in Obstetrics and Gynecology Residency Programs.

Resumo Objetivo O presente estudo analisa o papel da Simulação Clínica em programas de Residência Médica (PRM) de Obstetrícia e Ginecologia, atribuído pelos supervisores, na formação do residente no município de São Paulo (SP). Métodos Abordagem qualitativa, transversal, de natureza exploratória e descritiva. Foram realizadas entrevistas semiestruturadas com dez supervisores de programas de Residência Médica de Obstetrícia e Ginecologia. Para análise das entrevistas foi realizada análise de conteúdo na modalidade temática partindo do seguinte núcleo: o papel da simulação clínica nos Programas de Residência Médica de Obstetrícia e Ginecologia. Resultados A Simulação Clínica, na visão dos supervisores, emerge como: ferramenta complementar para o processo de ensino e aprendizagem; possibilidade de um ambiente de ensino e aprendizagem seguro; possibilidade de aprendizagem a partir do erro; suporte para prática profissional comprometida com a segurança do paciente; cenário de aprendizagem para o trabalho de equipe; cenário de reflexão sobre o processo de trabalho em Obstetrícia e Ginecologia; favorecimento na tomada de decisão; cenários de processos avaliativos na residência; e, por fim, estímulo à participação dos residentes nas atividades. Conclusão Os supervisores reconhecem a Simulação Clínica como uma ferramenta pedagógica potente no aprendizado dos médicos residentes em Obstetrícia e Ginecologia.

Uso e adesão de equipamentos de proteção individual por residentes: validação de instrumento de medida / Use and adherence to personal protective equipment by residents: validation of a measuring instrument / Uso y adhesión de equipos de protección individual por parte de los residentes: validación de un instrumento de medida

RESUMO Objetivo: Validar o instrumento de medida que avalia o uso e a adesão de equipamentos de proteção individual entre os residentes de saúde. Método: Estudo metodológico desenvolvido em ambiente virtual entre agosto de 2020 e março de 2021 com residentes da atenção primária e hospitalar das cinco regiões do Brasil. Os participantes responderam a versão adaptada para residentes do "E.P.I.-APS". Utilizou-se a análise fatorial confirmatória para validação do instrumento. Resultados: Participaram 227 residentes, sendo maioria mulher cis (82,8%), atuavam na região Sudeste (58,1%) e em atenção hospitalar (47,6%). A estrutura em oito domínios (gorro/touca; luvas; comportamento de segurança; máscara N95; higienização das mãos; avental/capote; máscara cirúrgica; óculos de proteção/protetor facial) foi confirmada. Apenas dois itens com carga fatorial inferior a 0,5 foram mantidos. Conclusão: O instrumento é válido para mensurar o uso e adesão aos equipamentos de proteção individual entre residentes, o que contribui para direcionar a formação e a segurança laboral.

ABSTRACT Objective: To validate the measuring instrument that assesses healthcare residents' use and adherence to personal protective equipment. Method: Methodological study developed in a virtual environment between August 2020 and March 2021 with primary care and hospital residents from the five regions of Brazil. The participants answered the adapted version of the "P.P.E.-PHC" for residents. Confirmatory factor analysis was used to validate the instrument. Results: 227 residents took part, the majority of whom were cis women (82.8%), worked in the Southeast region (58.1%), and in-hospital care (47.6%). The structure in eight domains (cap, gloves, safety behavior, N95 mask, hand hygiene, apron/coat, surgical mask, goggles/face shield) was confirmed. Only two items with a factor load of less than 0.5 were kept. Conclusion: The tool is valid for measuring residents' use of and adherence to personal protective equipment, which helps to guide training and occupational safety.

RESUMEN Objetivo: Validar el instrumento de medición que evalúa el uso y la adhesión de los equipos de protección individual entre los residentes de salud. Método: Estudio metodológico desarrollado en un entorno virtual entre agosto de 2020 y marzo de 2021 con residentes de atención primaria y hospitalaria de las cinco regiones de Brasil. Los participantes respondieron a la versión adaptada del "E.P.I.-APS" para residentes. Se utilizó un análisis factorial confirmatorio para validar el instrumento. Resultados: Participaron 227 residentes, en su mayoría mujeres cis (82,8%), que trabajaban en el sureste (58,1%) y en cuidados hospitalarios (47,6%). Se confirmó la estructura en ocho dominios (gorro; guantes; comportamiento de seguridad; mascarilla N95; higiene de las manos; delantal/abrigo; mascarilla quirúrgica; gafas/protector facial). Sólo se mantuvieron dos ítems con una carga factorial inferior a 0,5. Conclusión: La herramienta es válida para medir el uso y la adhesión de los equipos de protección individual entre los residentes, lo que ayuda a orientar la formación y la seguridad laboral.

Prevalência e fatores associados à violência no trabalho contra residentes multiprofissionais durante a pandemia / Prevalence and factors associated with workplace violence against Brazilian multiprofessional residents during the pandemic

RESUMO Estudo transversal cujo objetivo foi identificar a prevalência e os fatores associados à violência no trabalho (física e/ou verbal) contra residentes multiprofissionais que atuam em um hospital universitário durante a pandemia da Covid-19. Foi desenvolvido um censo, em julho de 2020, com 67 residentes. Dados foram coletados por meio de questionário eletrônico, avaliando-se a violência física e verbal mediante autorrelato. Associações entre a ocorrência de violência vivida durante a pandemia e as variáveis independentes (sociodemográficas, psicoemocionais e atendimento ao paciente com Covid-19) foram analisadas mediante testes estatísticos e Regressão de Poisson (RP) com variância robusta. A prevalência de violência foi de 22,4%. Diferenças entre grupos foram observadas ao comparar as ocupações e o grau de satisfação com a residência, com maior proporção de fisioterapeutas e assistentes sociais, assim como de residentes insatisfeitos entre os que relataram violência (p≤0,005). Após análise de regressão, a violência esteve associada ao aumento da idade (RP=1,25; IC95% 1,12-1,40) e a níveis de ansiedade moderados/graves (RP =2,87; IC 95% 1,12-1,40). Os achados apontam para a necessidade de implementação de medidas institucionais de prevenção e controle da violência no trabalho, considerando os fatores associados durante a pandemia.

ABSTRACT Cross-sectional study which objective was to identify the prevalence and factors associated with workplace violence (physical and/or verbal) against multiprofessional residents working at a Brazilian university hospital during the COVID-19 pandemic. A census was developed in July 2020 with 67 residents. Data were collected through an electronic questionnaire, evaluating physical and verbal violence through self-report. Associations between the occurrence of violence experienced during the pandemic and independent variables (sociodemographic, psycho-emotional, and patient care with COVID-19) were analyzed using statistical tests and Poisson Regression (PR) with robust variance. Differences between groups were observed when comparing occupations and the degree of satisfaction with the residence, with a higher proportion of physical therapists and social workers, as well as dissatisfied residents among those who reported violence (p≤0.005). After regression analysis, violence was associated with increase in age (PR=1.25; 95%CI 1.12-1.40) and moderate/severe anxiety levels (RP=2.87; 95%CI 1.12-1.40). The findings point to the need to implement institutional measures for the prevention and control of workplace violence considering the factors associated with it during the pandemic.

Análise temporal da inserção de Profissionais e Residentes de Educação Física no Sistema Único de Saúde de 2009 a 2021 / Temporal analysis of the inclusion of Physical Education Professionals and Residents in the Brazilian Unified Health System (SUS) from 2009 to 2021

Resumo Dentre as categorias que fazem parte da força de trabalho do SUS está a Educação Física. Por meio de estudo ecológico de séries temporais, com base no Cadastro Nacional de Estabelecimentos de Saúde, os objetivos do artigo foram analisar a inserção de Profissionais de Educação Física (PEF) e residentes no SUS entre 2009 e 2021 com vistas a traçar um panorama da inserção da Educação Física e analisar a distribuição de PEF e residentes entre as diferentes regiões. Foi revelado um aumento de 476,01% no número de PEF e de 10.366,67% entre os residentes. A taxa de PEF por 100.000 habitantes aumentou 13,7% ao ano entre 2009 e 2021, com aumento de 28,1% entre 2009 e 2014 e de 7,8% entre 2014 e 2019, e redução de 3,4% entre 2019 e 2021. A taxa de residentes aumentou 36,2% ao ano entre 2009 a 2021, com aumento de 45,9% entre 2009 e 2017 e de 18,7% entre 2017 e 2021. Foram reveladas desigualdades regionais na distribuição de PEF e residentes, com maior concentração, em 2021, respectivamente nas regiões Nordeste e Sul. O aumento de PEF e residentes no SUS pode ser relacionado com políticas e programas de práticas corporais e atividades físicas, enquanto o decréscimo, possivelmente, se relaciona com o Programa Previne Brasil e à pandemia de COVID-19.

Abstract Physical Education is one of the categories featured in the SUS workforce. An ecological time series study, based on the National Registry of Health Establishments, was conducted to analyze the inclusion of Physical Education Professionals (PEFs) and residents in the SUS between 2009 and 2021. The scope of the article was to establish a panorama of the inclusion of Physical Education and analyze the distribution of PEFs and residents in the different regions. An increase of 476.01% in the number of PEFs and 10,366.67% among residents was revealed. The PEF rate per 100,000 inhabitants increased by 13.7% per year from 2009 to 2021, with an increase of 28.1% between 2009 and 2014 and 7.8% between 2014 and 2019, and a decrease of 3.4% between 2019 and 2021. The resident rate increased by 36.2% per year between 2009 and 2021, with a 45.9% increase between 2009 and 2017 and 18.7% between 2017 and 2021. Regional inequalities in the distribution of PEFs and residents were revealed, with the highest concentration, in 2021, in the Northeast and South regions, respectively. The increase in PEFs and residents in the SUS can be linked to policies and programs of physical exercise and activities, while the decrease is possibly related to the Previne Brasil Program and the COVID-19 pandemic.

The Impact of Resident Involvement on Patient Outcomes in Revision Total Hip Arthroplasty / O impacto do envolvimento do residente nos resultados dos pacientes na revisão da artroplastia total do quadril

Abstract Objective The aim of the present study was to determine the influence of resident involvement on acute complication rates in revision total hip arthroplasty (THA). Methods Using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database, 1,743 revision THAs were identified from 2008 to 2012; 949 of them involved a resident physician. Demographic information including gender and race, comorbidities including lung disease, heart disease and diabetes, operative time, length of stay, and acute postoperative complications within 30 days were analyzed. Results Resident involvement was not associated with a significant increase in the risk of acute complications. Total operative time demonstrated a statistically significant association with the involvement of a resident (161.35 minutes with resident present, 135.07 minutes without resident; p< 0.001). There was no evidence that resident involvement was associated with a longer hospital stay (5.61 days with resident present, 5.22 days without resident; p= 0.46). Conclusion Involvement of an orthopedic resident during revision THA does not appear to increase short-term postoperative complication rates, despite a significant increase in operative times.

Resumo Objetivo O objetivo do presente estudo foi determinar a influência do envolvimento dos residentes nas taxas de complicações agudas na revisão da artroplastia total do quadril (ATQ). Métodos Utilizando o banco de dados do American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP, na sigla em inglês), foram identificadas 1.743 revisões de ATQs entre 2008 e 2012; 949 delas envolveram um médico residente. Foram analisadas informações demográficas, incluindo gênero e raça, comorbidades, incluindo doenças pulmonares, doenças cardíacas e diabetes, tempo de permanência e complicações agudas pós-operatórias no prazo de 30 dias. Resultados O envolvimento dos residentes não foi associado a um aumento significativo no risco de complicações agudas. O tempo de operação total demonstrou associação estatisticamente significativa com o envolvimento de um residente (161,35 minutos com residente presente, 135,07 minutos sem residente; p< 0,001). Não houve evidência de que o envolvimento do residente tenha sido associado a um maior tempo de internação hospitalar (5,61 dias com residente presente, 5,22 dias sem residente; p= 0,46). Conclusão O envolvimento de um residente ortopédico durante a revisão da ATQ não parece aumentar as taxas de complicações pós-operatórias de curto prazo, apesar de um aumento significativo nos tempos operacionais.

Cardiac Surgery Training in Brazil - What Are We Discussing in Our Journal?

ABSTRACT Introduction: Cardiovascular surgery has undergone numerous changes over the last decades. Transcatheter technologies, endovascular procedures, hybrids, and minimally invasive surgery have undoubtedly advanced as a therapy for patients. Thus, the discussion about the training of residents in the face of new technologies in the specialty is in check. In this article, it is proposed a review to discuss the challenges in this scenario as well as the current training in cardiovascular surgery in Brazil. Methods: A comprehensive review was performed in the Brazilian Journal of Cardiovascular Surgery. All editions from 1986 to 2022 were included. The research was carried out using the search engine on the journal's website (https://www.bjcvs.org) and an individual analysis of the titles and abstracts of each article published. Results: All the studies are summarized in the appropriate table with a discussion along this review. Conclusion: Most articles that discuss training in cardiovascular surgery in the national context are editorials and expert points of view with no observational studies evaluating the residency programs.

Barreras para las actividades de investigación en los programas de residencia: estudio de métodos mixtos / Barriers for research activities in residency programs: A mix-methods study

Introducción Las actividades de investigación tienen un impacto positivo en el rendimiento de los médicos residentes. Falta información sobre investigaciones desarrolladas por residentes de países en vías de desarrollo. Nuestro objetivo fue evaluar las barreras y facilitadores para la investigación en programas de residencia en una Facultad de Medicina de América Latina. Métodos Se llevó a cabo un diseño de estudio de metodología mixta. Utilizamos un enfoque de teoría fundamentada para la fase cualitativa, recopilando los datos a través de entrevistas semiestructuradas y grupos focales con profesores y residentes. Para la fase cuantitativa, se administraron encuestas a residentes y profesores. Para evaluar las propiedades psicométricas de las encuestas utilizamos análisis factorial y scree plot (validez); alfa de Cronbach y coeficiente de Correlación Intraclase (confiabilidad). Resultados Se realizaron grupos focales que incluyeron diez profesores y quince residentes, y se identificaron los siguientes dominios: a) facilitadores para la participación de los residentes, b) barreras, c) estrategias para introducir la investigación en el currículo, d) argumentos que respaldan las actividades de investigación durante la residencia, y e) perfil de los residentes motivados en la investigación. Tanto los residentes como el profesorado identificaron la falta de tiempo protegido y la ausencia de tutoría adecuada como las principales barreras. Se encontró una brecha de género relacionada con las publicaciones internacionales (34% vs 66% mujeres/hombres), las mujeres percibieron que las actividades de investigación 'compiten con otras actividades' (OR: 2.04, IC 95% 1.03 a 4.07). Conclusiones Los residentes y profesores de una universidad latinoamericana de alta productividad valoran mucho la investigación. La presencia de brecha de género, la falta de tiempo protegido y de tutorías destacan como las principales barreras. Las estrategias propuestas para mejorar la investigación dentro de los programas de residencia son: establecer un programa de tutoría interdisciplinario entre residentes e investigadores; promover las rotaciones electivas; y premiar propuestas que consideren la equidad de género.

Introduction Research activities have a positive impact on the performance of residents. However, information on research conducted by residents from developing countries is scarce. Our study sought to identify the barriers and facilitators for developing research in medical residency programs in a Latin-American faculty of medicine. Methods A mixed methodology study design was carried out. We used a grounded theory approach for the qualitative phase, collecting data through semi-structured interviews and focus groups with faculty and residents. For the quantitative phase, surveys were administered to residents and teachers. We used factor analysis and scree plot (validity), Cronbach's alpha, and Intraclass correlation coefficient (reliability) to evaluate the surveys' psychometric properties. Results Focus groups involving ten faculty members and 15 residents were conducted, and the following domains were identified: a) facilitators for resident participation, b) barriers, c) strategies for introducing research into the curriculum, d) arguments supporting research activities throughout medical residency, and e) profile of research-motivated residents. Both residents and faculty members identified a lack of protected time and adequate mentoring as the major barriers. A gender gap was found related to international publications (34% vs. 66% women/men); women perceived that research activities 'compete with other activities' (OR: 2.04, 95% CI 1.03 to 4.07). Conclusions Research is highly valued by both residents and faculty members at a Latin-American university with a strong academic output. Major barriers to promoting research in this context include lack of protected time and effective mentoring, and gender gaps. Strategies proposed to improve research within medical residency programs include: establishing an interdisciplinary mentoring program between residents and researchers, promoting elective rotations, and rewarding proposals that consider gender equity.