Postgraduate medical education in Colombia. Proposals to improve it

After 70 years of the formalization of medical specialties in Colombia, very little progress has been made in the educational models for the acquisition of clinical competencies in these postgraduate programs. Furthermore, although there is already a law on human resources in health, the Colombian medical education system lacks specific regulations on the training of health professionals (physicians) in the different medical specialty programs offered in the country. Likewise, at present, factors such as the financial crisis of public hospitals, the limited number of accredited hospitals and the growing number of medical schools and specialization programs, affect the comprehensive and equal development of medical competencies of professionals who are trained as specialists in the different postgraduate medical programs offered in Colombia. In view of the above, the purpose of this article is to present a proposal for postgraduate medical education that prioritizes the adequate acquisition of competencies over compliance with the time required to complete the curricula of the different medical specialties. However, this involves several prerequisites: a regulatory body in charge of overseeing and monitoring the training of medical residents or specialists in the country; strong training in university teaching for professors practicing in medical schools and university hospitals; the standardization of the graduates profile; adequate financing of university hospitals, as well as appropriate support in the process of accreditation as such, and the self-evaluation and continuous improvement of postgraduate medical programs.

Después de 70 años de la formalización de las especialidades médicas en Colombia, ha habido muy pocos avances en los modelos educativos para la adquisición de competencias clínicas en estos programas de posgrado. Además, a pesar de que ya hay una ley sobre el talento humano en salud, en el sistema educativo médico colombiano no hay regulaciones específicas sobre la formación de profesionales de la salud (médicos) en los diferentes programas de especialidades médicas ofrecidos en el país. Igualmente, en la actualidad factores como la crisis financiera de los hospitales públicos, el escaso número de hospitales acreditados y el creciente número de facultades de medicina y de programas de especialización afectan la adquisición integral e igualitaria de competencias médicas de los profesionales que se forman como especialistas en los diferentes programas de posgrado médico ofrecidos en Colombia. Teniendo en cuenta lo anterior, el propósito de este artículo es presentar una propuesta de educación médica de posgrado que priorice la adecuada adquisición de competencias por encima del cumplimiento del tiempo fijado para completar los planes de estudios de las diferentes especialidades médicas. Sin embargo, para esto se requieren varios aspectos: un ente regulatorio encargado de vigilar y monitorear la formación de los residentes o especialistas médicos en el país; una fuerte capacitación en docencia universitaria a los profesores que ejercen en las facultades de medicina y hospitales universitarios; la homogenización del perfil de los egresados; una adecuada financiación de los hospitales universitarios, así como un apropiado acompañamiento en su proceso de acreditación como tal, y la autoevaluación y mejoramiento continuo de los posgrados médicos.

Application of thinking visual guidance teaching model in anesthesia clinical practice teaching / 中华医学教育探索杂志

Objective:To analyze the application of thinking visual guidance teaching model in anesthesia clinical practice teaching.Methods:Taking the implementation time (March 2019) of thinking visual guidance teaching model in our hospital as the limit, 56 interns who came to our hospital for anesthesia practice before the implementation were included as control group, and 61 interns enrolled after the implementation (from March 2019 to March 2020) were included in study group. The mastery status of professional skills (duration of anesthesia operation, success rate of one-time anesthesia puncture and success rate of one - time tracheal intubation), professional knowledge assessment results and professional attitude changes were compared between the two groups at 2 months and 6 months of training. Self-evaluation after 6 months of training was compared between the two groups. SPSS 18.0 was used for t test and chi-square test. Results:After 6 months of training, the mastery status of professional skills (duration of anesthesia operation, success rate of one-time anesthesia puncture, and success rate of one-time tracheal intubation) of the two groups of interns were significantly improved compared with those after 2 months of training, and the above indicators of study group were significantly better than those of control group (all P<0.05). After 6 months of training, the scores of assessment results of professional knowledge (basic knowledge, understanding and memory, case analysis, emergency handling) and professional attitude (behavior, language, initiative and adaptability) in the two groups of interns were significantly higher than those after 2 months of training, and the above indicators scores of study group were significantly higher than those of control group (all P<0.05). The scores of self-evaluation (learning efficiency, learning atmosphere, learning ability, self-confidence and satisfaction) of study group at 6 months of training were significantly higher than those of control group at the same period (all P<0.05). Conclusion:Thinking visual guidance teaching model can effectively improve the professional knowledge and operation skills of anesthesia clinical interns, and it has a good application effect.

Formación permanente y autopercepción de competencia: un estudio con entrenadores de tenis / Continuing education and self-perception of competence: a study with tennis coaches

Resumen Este estudio tuvo como objetivo asociar la formación permanente de entrenadores con la autopercepción y la importancia atribuida al constructo - competencia profesional. La muestra fueron 69 entrenadores de tenis, que participaron de acciones de capacitación promovidas por la Federación Paranaense de Tenis, estando constituida mayormente por profesionales: con más de ocho años de experiencia profesional; con experiencia como practicante; y graduados en Educación Física. Para la recolección de datos se utilizó una ficha con variables socio demográficas y la Escala de Auto Percepción de Competencia. Los resultados indicaron que la participación en actividades/cursos no tuvo asociación significativa con la autopercepción de competencia de los entrenadores para los Conocimientos Profesionales. Para la dimensión de Habilidades Profesionales, involucrarse en actividades de capacitación se relacionó significativamente con la autopercepción de dominio, con énfasis en las habilidades relacionadas con el Planeamiento y Gestión Deportiva, y Evaluación Deportiva, habilidades consideradas centrales en el ejercicio profesional de los entrenadores. La importancia atribuida a los Conocimientos y Habilidades Profesionales fue elevada, siendo siempre superior a la autopercepción de dominio.

Resumo Este estudo teve como objetivo associar a formação continuada dos treinadores com a autopercepção e a importância atribuída ao constructo - competência profissional. A amostra foi composta por 69 treinadores de tênis, participantes de ações de capacitação promovidas pela Federação Paranaense de Tênis constituída, majoritariamente, por profissionais: com mais de oito anos de experiência profissional; com experiência como praticante; e graduados em Educação Física. Para recolha de dados utilizou-se uma ficha contendo as variáveis sociodemográficas e a Escala de Autopercepção de Competência. Os resultados indicaram que a participação em atividades/cursos não demonstrou associação significativa com a autopercepção de competência dos treinadores para os Conhecimentos Profissionais. Para a dimensão Habilidades Profissionais, o envolvimento nessas ações relacionou-se significativamente com a autopercepção de domínio, com destaque para as habilidades relacionadas ao Planejamento e Gestão Esportiva, e Avaliação Esportiva, habilidades consideradas centrais no exercício profissional do treinador. A importância atribuída aos Conhecimentos e Habilidades Profissionais foi elevada, sendo sempre superior à autopercepção de domínio.

Abstract This study aimed to relate the continuing education of coaches and self-perception with the importance attributed to the construct of professional competence. The sample included 69 tennis coaches participating in professional training sessions promoted by the Paraná Tennis Federation, who have more than eight years of professional experience, as well as ample experience as tennis players, and a university degree in Physical Education. A chart with sociodemographic variables and the Self-Perceived Competence Scale was used to collect data. Results indicated that participation in workshops/courses showed no significant relationship with the coaches self-perceived competences for the Professional Knowledge dimension. For the Professional Skills dimension, training was significantly related to self-perceived mastery, particularly on skills related to Sports Management and Planning and Sports Assessment, which are skills considered to be crucial in the professional lives of coaches. The importance given to Knowledge and Professional Skills was not only high but was always higher than the self-perception of the domain.

Formação continuada e autopercepção de competência: um estudo com treinadores de tênis / Continuing education and self-perception of competence: a study with tennis coaches

Resumo Este estudo teve como objetivo associar a formação continuada dos treinadores com a autopercepção e a importância atribuída ao constructo - competência profissional. A amostra foi composta por 69 treinadores de tênis, participantes de ações de capacitação promovidas pela Federação Paranaense de Tênis constituída, majoritariamente, por profissionais: com mais de oito anos de experiência profissional; com experiência como praticante; e graduados em Educação Física. Para recolha de dados utilizou-se uma ficha contendo as variáveis sociodemográficas e a Escala de Autopercepção de Competência. Os resultados indicaram que a participação em atividades/cursos não demonstrou associação significativa com a autopercepção de competência dos treinadores para os Conhecimentos Profissionais. Para a dimensão Habilidades Profissionais, o envolvimento nessas ações relacionou-se significativamente com a autopercepção de domínio, com destaque para as habilidades relacionadas ao Planejamento e Gestão Esportiva, e Avaliação Esportiva, habilidades consideradas centrais no exercício profissional do treinador. A importância atribuída aos Conhecimentos e Habilidades Profissionais foi elevada, sendo sempre superior à autopercepção de domínio.

Resumen Este estudio tuvo como objetivo asociar la formación permanente de entrenadores con la autopercepción y la importancia atribuida al constructo - competencia profesional. La muestra fueron 69 entrenadores de tenis, que participaron de acciones de capacitación promovidas por la Federación Paranaense de Tenis, estando constituida mayormente por profesionales: con más de ocho años de experiencia profesional; con experiencia como practicante; y graduados en Educación Física. Para la recolección de datos se utilizó una ficha con variables socio demográficas y la Escala de Auto Percepción de Competencia. Los resultados indicaron que la participación en actividades/cursos no tuvo asociación significativa con la autopercepción de competencia de los entrenadores para los Conocimientos Profesionales. Para la dimensión de Habilidades Profesionales, involucrarse en actividades de capacitación se relacionó significativamente con la autopercepción de dominio, con énfasis en las habilidades relacionadas con el Planeamiento y Gestión Deportiva, y Evaluación Deportiva, habilidades consideradas centrales en el ejercicio profesional de los entrenadores. La importancia atribuida a los Conocimientos y Habilidades Profesionales fue elevada, siendo siempre superior a la autopercepción de dominio.

Abstract This study aimed to relate the continuing education of coaches and self-perception with the importance attributed to the construct of professional competence. The sample included 69 tennis coaches participating in professional training sessions promoted by the Paraná Tennis Federation, who have more than eight years of professional experience, as well as ample experience as tennis players, and a university degree in Physical Education. A chart with sociodemographic variables and the Self-Perceived Competence Scale was used to collect data. Results indicated that participation in workshops/courses showed no significant relationship with the coaches self-perceived competences for the Professional Knowledge dimension. For the Professional Skills dimension, training was significantly related to self-perceived mastery, particularly on skills related to Sports Management and Planning and Sports Assessment, which are skills considered to be crucial in the professional lives of coaches. The importance given to Knowledge and Professional Skills was not only high but was always higher than the self-perception of the domain.

Survey on the current situation of professional knowledge and protection consciousness in CSSD practitioners in Shanghai / 上海交通大学学报（医学版）

Objective · To conduct a survey on the current status of professionalism and personal protection in Central Sterile Supply Department (CSSD) practitioners in Shanghai, analyze the existing problems and provide suggestions, in order to improve work quality and management level of CCSD. Methods · Cluster sampling was used to extract 23 different level hospitals with CSSDs among 4 districts in Shanghai including Jing'an, Jinshan,Qingpu and Jiading. A total of 147 participants consisted of 104 employees and 43 heads of CSSDs. Field investigation and questionnaire survey were applied into CSSD practitioners for investigating their essential information, professionalism and personal protection status. Results · Practitioners in different hospitals showed different professional knowledge, especially practitioners in private hospital performed worse than those in secondary and tertiary-level hospitals in this survey of professionalism. Daily protection measures were defective due to lacking of consciousness of personal protection.Conclusion · There was problem of personal professionalism and protection consciousness in CSSD practitioners. It is important to optimize the allocation of CSSD human resource, reinforce skill training and improve quality management.

A Survey of Professional Cognitive Level and Its Influencing Factors of Fresh Nursing Students in Yunnan / 昆明医科大学学报

ObjectiveThe aim of this study was to investigate the professional cognitive level and its influencing factors of fresh nursing students in Yunnan,in order to provide a basis for nursing education workers, improve the situation and put forward a series of interventions.MethodsA questionnaire survey was done among 623 fresh nursing students in 5 universities of Yunnan province,and the data were collected and analyzed using the descriptive analysis and chi-square test of software SPSS22.0.Results There were 313 peoples choose nursing for easy future employment in qualified 599 questionnaires. The professional cognitive level in Yunnan was not comprehensive compared with other provinces,and the ratio of the nursing mission and etc were lower than other provinces with statistical significance(P < 0.05). However,there were 50 people(40.98%)would like to choose other major of 122 people who come from other provinces,which was higher than that of Yunnan (34.98%). There were 324 students(63.11%)were proud of nursing,327 students(63.70%)think nursing have a good development prospect who received the freshmen entrance education,which were higher than 35.62% and 42.47% of who could not receive the freshmen entrance education,with a statistical significance(P < 0.05). ConclusionSchool should reinforce the new students entrance education and professional publicity to cultivate the professional emotion of nursing freshmen.

(In)consciência e saberes profissionais: repercussões da ação reflexiva na prática pedagógica / Unconsciousness and professional knowledge: repercussions of the reflective action in the pedagogical practice / Incosciencia y saberes profesionales: repercusiones de la acción reflexiva en la práctica pedagógica

O texto objetiva analisar como o ato reflexivo contribui para a articulação entre os saberes profissionais e experienciais de professoras de Educação Física ao ministrar o conteúdo dança em sua prática pedagógica. A pesquisa colaborativa acompanhou três professoras, da rede municipal de ensino, integrantes do Projeto Dança na Escola, João Pessoa/PB. Utilizaram-se 6 técnicas de coleta: narrativa de formação; 6 seminários temáticos, com 4 grupos focais, 10 laboratórios, 10 autorreflexões, 10 vídeos etnográficos e a sessão reflexiva coletiva. A análise foi a hermenêutica dialética. O estudo revela que a ação reflexiva contínua minimizou o nível de "inconsciência" na ação pedagógica e ampliou as capacidades das professoras atuarem como pesquisadores em suas práticas cotidianas.

The text aims at analyzing how the reflective act contributes to the articulation among the professional and experience knowledge of physical education teachers while teaching the content related to dance in their pedagogical practice. The collaborative research encompassed three teachers, from the municipal teaching, who are part of the Dance Project in the school, João Pessoa/PB. A total of six techniques of data collection were used, such as: formation narrative; six theme seminars, with four focal groups, ten laboratories, ten self-reflections, ten ethnographic videos and the collective reflection session. The dialectic hermeneutic analysis was used. The study reveals that the continuous reflection action minimized the "unconsciousness" level in the pedagogical act and broadened the capacities of the teachers to act as researchers in their daily practices.

El texto objetiva analizar cómo la acción reflexiva contribuye para la articulación entre los saberes profesionales y experienciales de profesoras de Educación Física al impartir el contenido danza en su práctica pedagógica. La Investigación Colaborativa acompañó tres profesoras de la red municipal de enseñanza, las que integran el Proyecto Danza en la Escuela, João Pessoa/PB. Utilizamos seis técnicas para recoger los datos: narrativa de formación; seis seminarios temáticos con cuatro grupos focales, diez laboratorios, diez auto-reflexiones, diez videos etnográficos y la sección reflexiva colectiva. El análisis fue hermenéutico dialéctico. El estudio evidencia que la acción reflexiva continua disminuyó el nivel de "inconsciencia" en la acción pedagógica y aumentó las capacidades de las profesoras actuaren como investigadoras en sus prácticas cotidianas.

PROPOSTAS CONCEITUAIS A RESPEITO DO CONHECIMENTO PROFISSIONAL DO TREINADOR ESPORTIVO / CONCEPTUAL PROPOSES ABOUT THE PROFESSIONAL KNOWLEDGE OF THE SPORTS COACH

RESUMO O reconhecimento da importância do treinador esportivo na formação de jovens tem exigido nível de qualificação a este profissional que atenda as demandas sociais de prática esportiva. Assim, o objetivo deste ensaio foi abordar as principais propostasa respeito do conhecimento profissional do treinador esportivo, procurando destacar as semelhanças e os contrastes bem como as implicações na intervenção, formação e nas pesquisas sobre o treinador. Os estudos empíricos com treinadores e também sobre aspectos particulares ao contexto de prática esportiva, implementados a partir das abordagens de "Modelo Mental" e de "Mapa Conceitual", têm apresentado importantes contribuições para a estrutura formal que serve de base para a intervenção do treinador. Para responder aos apelos de formação e qualificação do treinador, a abordagem do "Mapa Conceitual" parece ser a mais apropriada, por retratar elementos e episódios do processo de treino, bem como fornecer uma estrutura conceitual passível de transferência aos diversos contextos de atuação do treinador esportivo.

ABSTRACT Recognition of the importance of the sport coach in youth development has required level of professional qualification to this that meets the social demands of sports. The objective of this paper was to discuss the main proposals regarding the professional knowledge of the sports coach, seeking to highlight the similarities and contrasts as well as the implications for intervention and research training on the coach. Empirical with coaches and also on the particular context of sports practice, implemented by the perspectives of "Mental Model" and "Concept Map" aspects studies have yielded important contributions to the formal structure that serves as the basis for intervention coach. To fulfill the demands of training and qualifications of the coach, the approach of "Concept Map" seems more appropriate for depicting episodes and elements of the coaching process as well as provide a conceptual framework capable of transfer to different contexts of performance coach sports.

Agencias, significados y aprendizajes en la construcción de conocimiento profesional para el abordaje de las violencias en las escuelas / Agencies, meanings and learnings in the construction of professional knowledge for addressing problems of violence at schools

El trabajo presenta categorías conceptuales y estrategias metodológicas para la Tesis "Perspectivas de Agentes Educativos ante situaciones y problemas de violencia en contextos de práctica profesional". El estudio de la construcción de conocimiento profesional sobre problemas de violencias en escuelas en investigaciones marco, es vinculado con debates teóricos y posicionamientos desarrollados en bibliografía especializada. Se propone una metodología de investigación basada en la reflexión sobre la práctica, apoyada teóricamente en la "doble estimulación" de Vigotsky, para analizar la apropiación participativa de significados y herramientas en la experiencia profesional, administrando Cuestionarios de Situación-Problema antes y después del intercambio en zonas de construcción social. Las nociones Sistemas de Actividad, Interagencialidad, Historización y Aprendizaje Expansivo (Engeström), articuladas con el enfoque contextualista del cambio cognitivo, se eligen como categorías relevantes para analizar procesos de construcción de conocimiento en la trama psico-social que los integra. A modo de ejemplo, se desarrollan dos experiencias profesionales para visualizar recursos, fortalezas y "nudos críticos" en el conocimiento y acción de agentes participantes.

The work presents conceptual categories and methodologychal strategies for the Thesis ""Perspectives of Educational Agents addressing situations and problems of violence in contexts of professional practice". The study of the construction of professional knowledge about problems of violence at school in framework research is linked with theoretical debates and positions developed in specialized bibliography. It is proposed a methodology of research based in reflection on practice, theoretically supported in Vygotsky "dual stimulation", to analyze the participative appropriation of meanings and tools in professional experience, applying Questionnaires of Situated Problems before-and-after the exchange in zones of social construction. The notions of Activity Systems, Interagency, Historization and Expansive Learning (Engeström), linked with the contextualist approach of cognitive change, are chosen as relevant categories to analyse the processes of knowledge construction in the psycho - social weft that integrates them. As an example, two professional experiences are developed, to appreciate resources, strengths and "critical knots" in knowledge and action of participant agents.

Embedment of professional knowledge into literature retrieval course of traditional Chinese medicine / 中华医学图书情报杂志

The online teaching quality assessment system that was established by embedding the professional knowledge into the teaching of literature retrieval course, can help the students master the methods and skills to ac-cess and use the literature information they need and the basic knowledge of subjects in which they major .

O conhecimento do profissional de Educação Física e sua relação com o ambiente de trabalho durante a intervenção profissional / The professional's knowledge and its relation with the work environment during professional intervention / El conocimiento profesional y su relación con el ambiente del trabajo durante la intervención profesional

A formação do profissional e os conhecimentos que ele adquire em sua história de vida, fazem parte da caracterização da intervenção do profissional de Educação Física. Nesta perspectiva, o objetivo deste estudo foi o de averiguar as características do conhecimento empregado pelo profissional de Educação Física em sua intervenção profissional. Utilizamos a abordagem qualitativa empreendendo um estudo de tipo etnográfico. Após a realização da análise dos dados conseguimos mapear os elementos que constituem o trabalho para a profissional. Concluímos que entender o que faz parte do tema trabalho está relacionado com as representações culturais que a Educação Física tem para os profissionais e para a sociedade

The professional education and the knowledge he/she acquires in his/her life history are part of the characterization of the Physical Education professional's intervention. Based on this, the purpose of this study was to discover the characteristics of the knowledge used by the Physical Education professional in his/her professional intervention. The qualitative approach was used, carrying out an ethnographic-like study. After the data analysis, it was possible to recognize the elements that constitute work for the professional. It is concluded that the cultural representations that the Physical Education has toward the professionals as well as the society, are related to the understanding of what is part of the theme dealt with

La educación profesional y el conocimiento que él/ella adquiere en su historia de vida son parte de la caracterización de la intervención del profesional de Educación Físico. Basado en esto, el propósito de este estudio era descubrir las características del conocimiento usadas por el profesional de Educación Físico en el su la intervención profesional. El acercamiento cualitativo fue usado, mientras llevando a cabo un el estudio tipo etnográfico. Después del análisis de los datos, era posible reconocer los elementos que constituyen el trabajo para el profesional. Se concluye que las representaciones culturales que la Educación Física tiene hacia las profesionales así como la sociedad, se relaciona a la comprensión de qué la parte del tema se reparte con

O desafio teórico-prático da gestão dos serviços de saúde / Health services management challenges in theory and practice / El desafío teórico práctico de la gestión de los servicios de salud

Trata-se da temática da gestão de serviços e organizações de saúde, focando os saberes como recurso de ação que se revertem em fontes de autonomia, autoridade e poder dos sujeitos nos contextos de suas práticas. O movimento de consolidação do SUS coloca como desafio a "adequação" dos trabalhadores de saúde aos seus princípios e diretrizes, estabelecendo instrumentos como a gerência de serviços, para a reorganização do processo de trabalho em saúde. Na gestão hospitalar tomou-se o conceito de "ambiência" para compreender e reorganizar a funcionalidade do hospital dando destaque ao espaço físico e tecnológico, considerando que esses elementos não se conformam sem a mediância do social e do afetual.

This article deals with the management of health services and organizations, focusing on knowledge as an action resource, which turns into a source of autonomy, authority and power for subjects in the context of their practices. The movement towards the consolidation of the Single Health System (SUS) gives rise to the challenge of "adapting" health workers to its principles and guidelines, establishing instruments such as service management with a view to the reorganization of the health work process. In hospital management, the concept of "ambience" was adopted to understand and reorganize hospital functionality, highlighting the physical and technological space, in view of the fact that these elements cannot be constituted without the intermedation of the social and affectual.

Este artículo se trata de la temática de gestión de servicios y organizaciones de salud, enfocando los saberes como recursos de acción que revierten a fuentes de autonomía, autoridad y poder de los sujetos en los contextos de sus prácticas. El movimiento de consolidación del Sistema Único de Salud (SUS) pone como desafío la "adecuación" de los trabajadores de salud a sus principios y directrices, estableciendo instrumentos tales como la gerencia de servicios, con vistas a la reorganización del proceso de trabajo en salud. En la gestión hospitalaria, se tomó el concepto de "ambiencia" para comprender y reorganizar la funcionalidad del hospital, destacando el espacio físico y tecnológico y considerando que esos elementos no se conforman sin el intermedio del social y del afectual.