Percepción de los médicos residentes de Pediatría sobre el impacto de la pandemia por COVID-19 en su proceso formativo / Pediatric residents' perceptions about the impact of the COVID-19 pandemic on their training

Introducción. Las residencias médicas experimentaron modificaciones que pudieron afectar la formación académica durante la pandemia por COVID-19. Objetivos. Describir la percepción de residentes de Pediatría en relación con el impacto de la pandemia en su formación. Efectuar la adaptación transcultural y validación al idioma español del instrumento "COVID-19 Resident Education and Experience Survey". Materiales y métodos. Estudio observacional, transversal. Participaron residentes de Pediatría de distintos hospitales del país. Se utilizó la encuesta de Ostapenko y col. modificada. Se realizó el análisis descriptivo utilizando SPSS vs. 21. El proyecto fue aprobado por el Comité de Ética institucional. Resultados. Completaron la encuesta 127 residentes. La mayoría dedicaba más de 50 horas a actividades asistenciales antes y durante la pandemia. El 43,3 % (IC95% 35-52) dedicaba hasta 1 hora diaria al estudio individual previo a la pandemia, y un 63 % (IC95% 54,3-70,9) dedicaba ese tiempo durante la pandemia. El 75,6 % (IC95% 67,4-82,2) reportó que el tiempo previo dedicado a actividades académicas era al menos de 4 horas semanales, descendiendo al 41,7 % (IC95% 33,5-50,4) en la pandemia. Más del 60 % (IC95% 54,3-70,1) percibió que la pandemia perjudicó su formación para convertirse en especialista y el 93,7 % (IC95% 88,1-96,8), que su nivel de estrés se incrementó. Conclusiones. La cantidad de horas destinadas a actividades académicas fue percibida como menor durante la pandemia. La mayoría de los encuestados refirió que su nivel de estrés aumentó y que la pandemia perjudicó su formación para convertirse en especialista.

Introduction. Medical residency programs suffered changes that may have affected academic training during the COVID-19 pandemic. Objectives. To describe the perceptions of pediatric residents about the pandemic's impact on their education. To transculturally adapt and validate the COVID-19 Resident Education and Experience Survey into Spanish. Materials and methods. Observational, cross-sectional study. Participants were pediatric residents from hospitals across the country. The survey by Ostapenko et al. was used. A descriptive analysis was done using the SPSS software, version 21. The project was approved by the Institutional Ethics Committee. Results. The survey was completed by 127 residents. Most did more than 50 hours of health care activities before and during the pandemic. Also, 43.3% (95% CI: 35­52) spent at least 1 hour a day studying individually before the pandemic, while 63% (95% CI: 54.3­70.9) did so during the pandemic. In relation to the time spent doing academic work, 75.6% (95% CI: 67.4­82.2) reported that, before the pandemic, they spent at least 4 hours a week doing academic activities, dropping to 41.7% (95% CI: 33.5­50.4) during the pandemic. More than 60% (95% CI: 54.3­70.1) perceived that the pandemic impaired their training to become a specialist and 93.7% (95% CI: 88.1­96.8), that their stress levels increased. Conclusions. The perception was that participants spent less hours doing academic activities during the pandemic. Most surveyed participants mentioned that their stress levels increased and that the pandemic impaired their training to become a specialist.

Impact of a formal manual small-incision cataract surgery curriculum in an American ophthalmology residency program

Purpose: Global ophthalmology educational activities often include the ability of ophthalmology residents to partake in low?resource clinical care at home and abroad. Low?resource surgical techniques have become a pillar of education during formalized global ophthalmology fellowships. A formal manual small?incision cataract surgery (MSICS) curriculum was started in the University of Colorado’s residency training program to meet the growing demand for this surgical skill and to allow for more sustainable outreach work from our graduates. The survey was conducted to collect evaluations on the value of formal MSICS training within a United States–based residency program. Methods: This was a survey study in a US ophthalmology residency program. A formal MSICS curriculum was created that included didactic lectures on epidemiology of global blindness, MSICS technique, and how MISCS compared to phacoemulsification in terms of cost and sustainability in low?resource settings, followed by a formal wet lab experience. Residents were then exposed to MSICS procedures in the operating room (OR) under supervision of an experienced MSICS surgeon. An anonymous online survey was conducted on three consecutive cohorts of recently graduated senior ophthalmology residents from 2019 to 2021 with the aim of eliciting opinions about and outcomes from the new curriculum. Results: Fifteen graduating senior residents comprised the three cohorts with a 100% survey response rate. All residents agreed or strongly agreed that “MSICS is a valuable skill to have”. Eighty percent of respondents agreed or strongly agreed that “exposure to MSICS has increased my likelihood of doing any type of outreach work in the future” and 86.67% agreed or strongly agreed that “exposure to MSICS increased my understanding about sustainable outreach work”. The average number of cases assisted or performed per resident was 8.2 (SD 2.7, range 4–12). Conclusion: A formal MSICS curriculum for US?based ophthalmology residents was well?received by the trainees. The majority felt it increased their likelihood of pursuing and improved their understanding of sustainable outreach work. The curriculum, which included lectures, wet lab training, and formal teaching in the OR, could add value to a residency program’s curriculum. Furthermore, a formal domestic program can avoid ethical pitfalls that can be seen with resident teaching during international mission work.

Application and analysis of competition based training mode for first aid skills in residency program / 中华急诊医学杂志

Objective:To explore the model of first aid skills training based on competition.Method:The second-year residents who participated in the competition in 2021 ( n = 142) were selected. According to whether they attended BLS training in the first year, they were divided into group A ( n = 88) who attended BLS training and group B ( n = 54) who did not. Chi-square test, T test, Wilcoxon rank sum test and Logistic regression were used in our study. Results:There was no significant difference in gender and specialty between both groups (female, 62.5% vs. 68.5%, P= 0.466; TCM, 50% vs. 53.7%, P= 0.668), but the real resuscitation experience of group A was more than that of group B (40.9% vs. 9.3%, P= 0.000). The qualified rate of CPR and the compression score in group A was higher than that in group B [(81.8% vs. 61.1%, P = 0.006; (30±5) vs. (25 ±10), P= 0.001], including compression frequency, depth, rebound and compression/respiration rate (73.9% vs. 55.6%, P= 0.024; 88.6% vs. 70.4%, P= 0.006; 96.6% vs. 87%, P= 0.031). In the theoretical examination, the correct rates of electrocardiogram [(53.63±2.9)% vs. (50.44±2.57)%] and first aid medication [(57.38±3.55)%, P = 0.001] in the two groups were significantly lower than the qualified rate. After adjusting other factors, Logistic regression analysis showed that the CPR qualification rate in group A was 2.769 times higher than that in group B ( P= 0.015, 95% CI 1.215~6.311) Conclusions:The first aid skills training mode based on competition can objectively reflect first aid skills level of residents. We found that the quality of CPR skills was not related to gender, specialty and real CPR experiences but experience of BLS training was an independent influencing factor. And how to identify and manage arrhythmias and how to choose different emergency drugs are urgent emergency skills for residents to improve.

Nurse residency program in the Philippines: A policy brief

@#This policy brief stems from the call to increase recruitment and hiring in the Philippine nursing service. It is important to consider the experiences of novice nurses in transitioning to the professional workforce. Bridging this gap leads to a direction of reinforcement or strengthening of competencies through a support system. Thereby, it is timely and relevant given the current situation of the nursing profession that a Nurse Residency Program (NRP) be proposed. The policy brief aims to reinforce technical knowledge and skills, enhance leadership and management skills, increase confidence in achieving the expected competencies, develop critical thinking and problem-solving skills, and deepen knowledge in health-related research among novice nurses. All these shall equip the novice nurse for a new role in a complex environment. The result of the Nurse Residency Program is the achievement of quality of care, patient safety, and better health outcomes. Novice nurses who respond to the needs of the Filipino people with confidence and competence help maintain the health and well-being of the country towards sustainable development and growth.

Residencia médica: el camino hacia la confección de un marco de referencia en neurocirugía / Medical residency: the path towards the creation of a frame of reference in neurosurgery

Las residencias médicas conforman la base de la educación médica de posgrado y es el método idóneo que permite el paso del médico graduado al médico general o especializado. Desde la asociación consideramos que es fundamental establecer estándares educativos válidos y confiables, absolutamente necesarios para la formación de postgrado. Luego de un trabajo de varios meses, que incluyó un censo y una encuesta de residencias, se arribó a la versión definitiva del marco de referencia sobre la residencia médica en la especialidad Neurocirugía. En la Argentina censamos, entre públicos y privados, 62 programas de residencia. La encuesta buscó diseñar un mapa de las residencias, relevando datos duros y características generales a través de una encuesta diseñada ad hoc. La necesidad de contar con una base teórica que regule y organice el desarrollo pedagógico de las residencias médicas, determinó el diseño y la implementación de un procedimiento de trabajo basado en acuerdos metodológicos y de contenidos, cuyo producto final fue el marco de referencia de la residencia. Su lectura y análisis propiciará propuestas y acciones que impulsen a una autoevaluación -siempre necesaria y beneficiosa- y, consecuentemente, al mejoramiento de la calidad de la formación que otorgamos y reciben los futuros especialistas en Neurocirugía

Medical residences form the basis of postgraduate medical education and is the ideal method that allows the passage of the graduate doctor to the general or specialized doctor. From the association we consider that it is essential to establishg valid and reliable educational standards, absolutely necessary for postgraduate training. After a work of several months, which included a census and a survey of residences, the final version of the framework on medical residence in the specialty Neurosurgery was reached. In Argentine we censure, between public and private, 62 residency programs. The survey sought to design a map of the residences, relieving hard data and general characteristics through a survey designed ad hoc. The need to have a theoretical basis that regulates and organizes the pedagogical development of medical residences, determined the design and implementation of a work procedure based on methodological and content agreements, whos final product was the reference framework of the residence. Its reading and analysis will propitiate proposals and actions that promote a self-evaluation -always necessary and beneficial- and, consequently, to improve the quality of the training that we grant and receive the future specialists in Neurosurgery

Programa de Simulación Neuroquirúrgica / Neurosurgical Simulation Program

Objetivo: Describir un programa de entrenamiento básico para implementar en la residencia de Neurocirugía con una metodología estructurada, diferentes niveles de complejidad y elementos de fácil adquisición. Introducción: La simulación se define como el uso de modelos para imitar experiencias de la vida real. Debido a la complejidad del aprendizaje en Neurocirugía, el programa de la Residencia debería incluir entrenamiento básico mediante simulación que permita al residente entrenarse en habilidades básicas fuera del quirófano, o bien, desarrollar y complejizar las ya aprendidas. Materiales y Métodos: Se realizó un programa de entrenamiento básico a desarrollar en el Centro de Simulación Quirúrgica del Hospital italiano, dividido en tres niveles de complejidad quirúrgica. Se idearon distintos ejercicios con materiales accesibles, de bajo costo y replicables. El programa se diseñó para ser llevarse a cabo con una frecuencia de una vez por semana durante cinco horas. Discusión: Los modelos propuestos presentan fácil acceso y alta disponibilidad; y permitieron el desarrollo de habilidades microquirúrgicas desde etapas muy tempranas de la residencia, abarcando la utilización del instrumental microquirúrgico y la magnificación microscópica, y simulando distintas técnicas quirúrgicas en materiales biológicos y sintéticos realistas; enmarcado por un programa basado en objetivos sin límites de repeticiones. La evaluación con un neurocirujano Senior permitió brindar un espacio relajado de enseñanza y debate, sin ser influenciado por las presiones propias de la cirugía. El aprendizaje de técnicas quirúrgicas se basa en la repetición de maniobras específicas, por lo que el desarrollo de habilidades quirúrgicas en ámbitos académicos no asistenciales es fundamental en cualquier aprendizaje quirúrgico. Conclusión: La simulación en el entrenamiento neuroquirúrgico sigue siendo un campo de estudio que requiere mayor investigación y validación en su implementación. En nuestra experiencia resulta una herramienta sumamente favorable para su posterior aplicación en procedimientos quirúrgicos reales, que podría mejorar y homogeneizar la enseñanza en programas de formación quirúrgica

Objective: To describe a basic training program to implement at neurosurgery residency with a structured methodology, different complexity levels, and easily acquired elements. Introduction: Simulation is defined as use of models to imitate real life experiences. Due to complexity of neurosurgery learning, residency program should include simulation training that allows the resident learning basic skills outside the operating room and develop practices learned. Materials and methods: A training program was developed at Centro de Simulación Quirúrgica del Hospital Italiano, divided into three surgical complexity levels. Different exercises were designed with accessible, low cost and replicable materials. This program is carried out with a frequency of once a week, five hours each. Discussion: The proposed models have easy acquisition and high availability, allowing the development of microsurgical skills since early stages in residency, including the use of microsurgical instruments and microscopic magnification, surgical techniques in realistic biological and synthetic materials, based on a program with objectives without repetition limits. The evaluation with a senior neurosurgeon allowed providing a relaxed teaching space, without pressures of surgery. Learning of surgical techniques is based on repetition, so the development of surgical skills in non-assistance academic fields is fundamental in any surgical learning. Conclusion: Simulation in neurosurgical training remains a field that requires further investigation and validation in its implementation. In our experience, it is an extremely favorable tool because its subsequent application in real life procedures, which could improve and standardize surgical programs teaching

Aprimoramento em enfermagem cardiovascular, modalidade residência: uma abordagem histórico-social (1981-2004) / Improvement in cardiovascular nursing, residency modality: a historical-social approach (1981-2004)

Introdução: O presente estudo teve como objeto o conhecimento sobre o Programa de Aprimoramento Profissional (PAP) em Enfermagem Cardiovascular na modalidade Residência do Instituto Dante Pazzanese de Cardiologia (IDPC). A investigação se justifica devido à necessidade de se revisitar o campo das lutas, avanços e conquistas do programa no período estudado, invocando o cenário das políticas e dos atores sociais envolvidos na criação do mesmo no IDPC. Objetivos: Descrever as circunstâncias históricas do processo de criação, implantação e consolidação do PAP de 1981 a 2004; analisar as razões e motivações para a sua fundação; discutir as lutas simbólicas dos atores sociais envolvidos com processo de criação do PAP. Método: Trata-se de um estudo histórico-social de abordagem qualitativa, no qual foi utilizada a técnica da história oral temática para entrevistar os sujeitos que vivenciaram este fenômeno. Assim, o critério de inclusão dos mesmos foi ter sido profissional envolvido na implantação do PAP no período. A coleta de dados ocorreu por meio de entrevista gravada, guiada por questões norteadoras. Após as entrevistas, foram realizadas a transcrição e a transcriação e, em seguida, a validação das mesmas com cada entrevistado. Na coleta de dados, foram utilizadas, além dos documentos orais, as fontes documentais institucionais. Observaram-se os aspectos éticos da pesquisa com base na Resolução 466/2012. Referencial teórico: Optou-se pelo sociólogo Pierre Bourdieu para análise dos dados, pois sua teorização possibilita compreender e discutir o fenômeno de interesse, a configuração dos espaços sociais, hierarquias, lutas simbólicas e capital cultural concernente à criação, implantação e consolidação do PAP. Resultados: Os dados empíricos foram organizados em três categorias temáticas: motivações para a criação do Curso de Aprimoramento na Modalidade Residência no IDPC; espaços de lutas e conquistas de alunos e enfermeiros da residência no IDPC; formação do habitus e aquisição de capitais pelo enfermeiro do PAP no IDPC. Análise dos dados: Com base nos pressupostos teóricos bourdieusianos, os achados evidenciaram os elementos históricos e sociais para a fundação e implementação do PAP-IDPC, os quais se fundamentam na ideia da criação no âmago da SES/SP, além da própria instituição (IDPC) e seus atores sociais, tendo em vista o interesse de ambos no atendimento das demandas sociais para a formação qualificada de enfermeiros na área de Cardiologia, como necessidade premente pós-graduada nessa área, a priori na modalidade de programa de capacitação na prática cotidiana em serviço e, posteriormente, com desdobramentos para a formação em residência propriamente dita nos moldes do MEC. Assim, além de enfermeiros do IDPC, outros profissionais de saúde (sobretudo médicos) também foram ativos no empreendimento inicial e na sustentação política da proposta do PAP, até os desdobramentos que se compuseram ao longo do tempo, como sinais das lutas, das conquistas e do almejado reconhecimento social dessa área de especialidade. Considerações finais: O presente estudo possibilitou o reconhecimento da memória histórica da construção do PAP no IDPC, no que tange às circunstâncias históricas e sociais para a criação e consolidação do PAP-IDPC no período estudado, assim como sua abrangência. Novos olhares são lançados, além de questionamentos, que podem ser colocados acerca da avaliação do próprio programa pelos egressos, docentes e preceptores, bem como os atuais programas de residências reconhecidos pelo MEC.

Introduction: The study object is the knowledge about the Professional Improvement Program (PAP) in Cardiovascular Nursing of Dante Pazzanese Cardiology Institute Residency Program (IDPC). The research is justified by the necessity to revisit the struggles, the advances and the achievements of this program during that period, invoking the scenario of policies and social actors involved in IDPC creation. Objectives: To describe the historical circumstances of creation process, implantation and consolidation of the PAP from 1981 to 2004; to analyze the reasons and motivations for its foundation; to discuss the symbolic struggles social actors involved in PAPs creating process. Methods: This is a qualitative historical-social study, in which it uses the thematic oral history technique to interview the individuals who experienced this phenomenon. Thus, the inclusion criterion was a professional involved in the PAP implantation in that period. The data collection took place through a recorded interview, conducted by guiding questions. After the interviews, transcription and transcreation were done, followed by a validation with each interviewee. In data collection, the documentary sources were used, besides the oral documents. The research ethical aspects were based on Resolution 466/2012. Theoretical reference: It was chosen the sociologist Pierre Bourdieu theories for data analysis since his theorizing makes it possible to understand and discuss the interest phenomena, the configuration of social spaces, hierarchies, symbolic struggles and cultural capital concerning the PAPs creation, implantation, and consolidation. Results: Empirical data were arranged into three thematic categories: motivations for the creation of the Residency Program Improvement Course at IDPC; spaces of struggles and achievements of students and nurses within residency at IDPC; habitus training and capital acquisition by PAP nurse in IDPC. Data analysis: Based on bourdieusian theories, the findings showed the historical and social elements for the PAP-IDPC's foundation and implementation, which are grounded on its creation at the core of SES/SP, as well as the institution itself (IDPC) and its social actors, owing to their interest in meeting the social demands for qualified training of nurses in Cardiology area, as an urgent postgraduate need in this area, a priori in training program in daily practice in service and, later, with unfolding for the residency formation in MEC's structures. Thus, besides IDPC nurses, other health professionals (mainly physicians) were also actives in the initial project and in the political support of the PAP proposal, to the unfolding shaped over time as symbols of struggles, conquers and desired social recognition of this specialty. Final considerations: The present study allowed the recognition of the historical memory of PAP construction at the IDPC, regarding the historical and social circumstances for creation and consolidation of PAP-IDPC in that period, as well as its comprehensiveness, however new thoughts are ongoing besides the questions that can be under evaluation of the Program itself by the graduates, teachers, and preceptors, as well as the current residency programs recognized by MEC.

Residency Program Coordinators' Perceptions of Their Roles and Attributes / 医学教育

Purpose: To clarify the awareness of residency program coordinators on their roles and attributes.　Methods: We asked residency program coordinator’s to describe their perception of “roles” and “attributes” that they consider important, We then, qualitatively and semi-quantitatively analyzed the data.　Results: Administrative work, public relations activities, coordination, pastoral and educational roles such as mental support, life support, and social education for trainees were extracted as the roles they identified. Regarding the attributes, humanity, the improvement of the quality of work, and various attributes for human resource development were extracted such as counselors, communication, harmonious human relationship, trainee-centeredness and educational mindset.　Discussion: The residency program coordinators perceived the importance of their “roles” and “attributes” for the development of trainees. Our results may be able to contribute to the development of current and future coordinators.

Pesquisa Apreciativa: características, utilização e possibilidades para a área da Saúde no Brasil / Appreciative Inquiry: characteristics, utilization and possibilities for the field of Health in Brazil / Investigación Apreciativa: características, utilización y posibilidades para el área de la Salud en Brasil

Nosso artigo apresenta e discute as características da Pesquisa Apreciativa como metodologia de pesquisa, utilizando um exemplo de uma residência multiprofissional integrada em Saúde no Brasil. A Pesquisa Apreciativa, conhecida em inglês como Appreciative Inquiry, é uma metodologia usada para identificar as melhores práticas desenvolvidas e empregadas pelas pessoas que trabalham em uma instituição. Essa metodologia permite a participação e o engajamento de profissionais da área da Saúde em pesquisas relacionadas à sua área de atuação, com potencial para ser aplicada em múltiplas áreas. Além disso, a Pesquisa Apreciativa incentiva debates reflexivos e críticos por parte dos participantes, estabelecendo um espaço de discussão para que mudanças ocorram. Os profissionais da Saúde que participaram desse trabalho consideram pertinente a finalidade de encorajar as pessoas a adotarem uma abordagem positiva, construtiva e dialógica para propor mudanças institucionais.(AU)

In this paper we present and discuss the characteristics of Appreciative Inquiry as a research methodology, utilizing an example from an integrated multi-professional residency program in Health in Brazil. Appreciative Inquiry is a methodology used to identify the best practices developed and utilized by people who work in the same institution. This methodology allows the participation and engagement of Health professionals in studies related to their area of work, potentially able to be used in several areas. In addition, Appreciative Inquiry promotes critical and reflexive debates among participants, establishing a space for the production of change. The Health professionals involved in our study considered relevant the goal of encouraging people to adopt a positive, constructive, and dialogical approach to propose institutional changes.(AU)

Nuestro artículo presenta y discute las características de la Investigación Apreciativa como metodología de investigación, utilizando un ejemplo de una residencia multi-profesional integrada en Salud en Brasil. La Investigación Apreciativa, conocida en inglés como Appreciative Inquiry, es una metodología usada para identificar las mejores prácticas desarrolladas y empleadas por las personas que trabajan en una institución. Esa metodología permite la participación y el compromiso de profesionales del área de la Salud en investigaciones relacionadas a su área de actuación, con potencial de aplicación en múltiples áreas. Además, la Investigación Apreciativa incentiva debates reflexivos y críticos por parte de los participantes, estableciendo un espacio de discusión para que ocurran cambios. Los profesionales de la Salud que participaron en ese trabajo consideran pertinente la finalidad de alentar a las personas para que adopten un abordaje positivo, constructivo y dialógico para proponer cambios institucionales.(AU)

Women's Health Training in Japan Primary Care Association Certified Family Medicine Residency Programs: Status of Programs, Residents and Medical Students / 日本プライマリ・ケア連合学会誌

Introduction: We conducted 3 surveys to elucidate the current status of Women's Health (WH) training in Japanese General Practice Residency Programs, and the opinions that the residency program directors and learners have about the training.Methods: Three questionnaire surveys were conducted during Aug-Nov, 2015. Subjects of the surveys were residency program directors (Survey 1), resident physicians (Survey 2) and medical students (Survey 3).Results: Survey 1 (response rate 42.7%): Regarding the programs, 6.8% and 38.9% provided compulsory WH rotations and selective rotations, respectively. Of the respondents, 71.4% wished to improve WH training, whereas 68.0% noted barriers, including the shortage of teaching physicians, and lack of understanding by teaching physicians regarding the needs and objectives of WH training. Survey 2 (response rate 45.8%): Of the residents, 14.5% and 27.9% had compulsory and selective WH rotations, respectively. The WH training was reported to be insufficient by 57.8% of the respondents. Survey 3 (response rate 85.4%): Of the medical students, 97% desired WH training and 97.7% wished to practice WH in the future.Conclusion: Our surveys revealed WH training in current Japanese General Practice Residency Programs to be inadequate, and both trainers and trainees desired further improvement of their training programs.

Oral and maxillofacial surgery residency training in the United States: what can we learn / 中华口腔医学杂志

China is currently in the process of establishing formal residency training programs in oral and maxillofacial surgery and other medical and dental specialties. Regulatory agencies, and educational and academic institutions in China are exploring mechanisms, goals and standards of residency training that meet the needs of the Chinese healthcare system. This article provides an introduction of residency training in oral and maxillofacial surgery in the United States, with emphasis on the accreditation standard by the Commission on Dental Accreditation. As there are fundamental differences in the medical and dental education systems between China and United States, the training standards in the United States may not be entirely applicable in China. A competency-based training model that focus on overall competencies in medical knowledge, clinical skills and values at the time of graduation should be taken into consideration in a Chinese residency training program in oral and maxillofacial surgery.

O mergulho no campo entre os nós da rede UNIFESP-BS: composições e interlocuções entre residentes e graduandos / A diving in the field of the nodes of network UNIFESPBS: compositions and interlocutions between residence in health and undergraduation / Uma zambullida en el campo entre los nodos de la red UNIFESP-BS: composiciones e interlocuciones entre residentes e estudiantes

Na Universidade Federal de São Paulo campus Baixada Santista (UNIFESP-BS) os estudantes de diferentes áreas profissionais se aproximam do estudo teórico e prático dos outros cursos por meio das aulas compartilhadas e também do contexto dos serviços públicos de saúde. Nesses e entre as paredes da própria universidade faz-se crescer uma rede: de trabalhos, de propostas, de projetos, de afetos e outros. Objetivou-se mapear e explorar os sentimentos, potencialidades, afecções da experiência de articulação da "rede UNIFESP-BS" especificamente entre as ações do Programa de Residência Multiprofissional em Atenção à Saúde e os outros projetos ­ extensão, módulo Trabalho em Saúde, PET-Saúde, estágio curricular, advindos e vinculados ao projeto político pedagógico da UNIFESP-BS, na perspectiva dos estudantes. Os dados foram coletados em encontros e produções coletivas e individuais, dos quais construíram narrativas, que demonstraram as dificuldades de comunicação entre os projetos, bem como a integração, o trabalho em rede, o compartilhamento do fazer e a fluidez das ações. O estágio é o que mais tende a cair na armadilha de se fechar em si mesmo. Nessa pesquisa foi possível descobrir e colher várias concepções sobre rede, desde a aproximação com a caça, passando por rede de linhas conectoras e uma rede em que bifurcações e convergências constituem os nós, até rede como superfície de produção. Pretendeu-se abrir possibilidades de pensamentos sobre as concepções de rede a partir da "rede UNIFESP-BS".

En la Universidad Federal de San Pablo, campus Baixada Santista (UNIFESPBS), los estudiantes de distintas áreas profesionales se acercan al estudio teórico y práctico de otras carreras a través de clases compartidas y también del contexto de los servicios públicos de salud. En estos, y entre las paredes de la propia universidad, cresce una red de trabajos, propuestas, proyectos, afectos y otros. El objetivo fue mapear y explorar sentimientos, potencialidades, afectos de la experiencia de articulación de la red UNIFESP-BS en particular, entre las acciones del Programa de Residencia Multiprofesional en Asistencia Médica y otros proyectos - extensión, módulo trabajo en salud, PET-Salud, pasantía curricular - derivados y vinculados al proyecto político pedagógico de la UNIFESP-BS, desde una perspectiva estudiantil. S e r e c o l e c t a r o n l os datos en encuentros y producciones coletivas e individuales, de los cuales s e construyeron narrativas que demuestran las dificultades de comunicación entre los proyectos, así como la integración, el trabajo en red, el compartir e l haber y la fluidez de las acciones. La pasantía es lo que más tiende a caer en la trampa de e n cerrarse en sí misma. En esta invetigación fue posible descubrir y recoger varias concepciones sobre la red, desde la aproximación con la caza, pasando por la red de líneas conectoras y una red donde bifurcaciones y convergencias constituyen nodos, hasta la red como superficie de producción. Se pretendió expandir las posibilidades de pensamiento sobre las concepciones de red, a partir de la red UNIFESP-BS.

In the Federal University of São Paulo, Baixada Santista Campus, (UNIFESP-BS), students from different professional areas approach to theoretical and practical studies from the others undergraduate courses through not only shared classes but also in teaching activities in public health services. A network increases among university walls: course works, projects, proposals, affections and others. The purpose of this study was draw and explore the feelings, potentialities and affections from the connection experience in the network UNIFESPBS, specifically among actions with relation to Health Multiprofessional Residency Program in Health Care and other projects ­ Extension activities, Working Process in Health disciplines, Educational Program for Health Work (PET-Saúde) and Curricular supervisioned traineeship, that come from and present bonds with pedagogic project from UNIFESP-BS, in the perspective of students. Data was assessed through encounters with individual and collective productions. Narratives that were produced demonstrated not only the difficulties of communication between the projects but also the difficulties to integration, network, sharing of knowledge and action fluidity. Curricular supervisioned traineeship tend more than other projects falls into a trap of close around itself. In this research was possible discover and obtain some conceptions about network, since the approximation with the chasing, passing through connection lines of network and a network in that bifurcations and connections represent nodes, until network with surface areas of production. The intention was open some thought possibilities about network conceptions since "network UNIFESP-BS".

Internet Information on Residency Programs is Insufficient for the Assessment of Risk Factors that Influence Career Development - A Web-based Complete Survey of Employment Information Provided by Family Medicine Residency Programs in Japan / 日本プライマリ・ケア連合学会誌

<b>Introduction</b> : Family medicine residency programs (PGs) have been increasing in Japan, but the Japan Primary Care Association (JPCA) does not publicly provide employment information. We conducted a complete survey on PGs, and elucidated the actual online provision of information required to assess risk factors influencing career development.<br><b>Methods</b> : We conducted an online investigation in January 2013 of the JPCA-certified PGs updated as of December 18, 2012, regarding the main facility type, benefits, terms of employment, and the type of employment by the duration of the contract.<br><b>Results</b> : There were 160 PGs in total. Those affiliated with universities were excluded and the remaining 129 PGs were analyzed. No salary/wage information was provided by 40 PGs (31.0%). Full-time employment was indicated by 64 PGs (49.6%), of which 6 had fixed-term employment. Only 11 PGs (8.5%) were confirmed to offer indefinite-term employment.<br><b>Conclusion</b> : From the information provided online, it was difficult to identify the type of employment by the duration of the contract. Currently, JPCA does not impose regulations on the terms of employment to be posted. Therefore, it would be desirable for the JPCA to take the initiative in collecting and disclosing accurate and adequate information.

Development of a structured situational interview or Multiple Mini Interview (MMI) for the pre-residency assessment system in a tertiary general hospital in the Philippines

BACKGROUND: Numerous selection criteria have been developed to assess the appropriate attributes and behavior expected of an Internist. The traditional personal interview format, however, cannot sufficiently evaluate professionalism competency and it has a low reliability and validity. OBJECTIVE: This study will conduct an extensive review and describe the existing interview portion of the residency selection process of the UP-PGH Department of Medicine and attempt to develop an effective structure multiple mini interview to replace the traditional format. METHODS: Review of Department records and consultant interviews will be conducted prior to the development of new structure situational interview. RESULTS: An MMI has been developed consisting of 6 domains evaluated in separate stations. Each domain pertains to an attribute or behavior deemed important in the resident's professional career, namely honesty, teamwork, respect for authority, time management, ethical behavior on the use of emerging technologies and in dealing with the pharmaceutical industry. A 5-point evaluation system will determine the interviewee's appropriateness and acceptability of behavior. CONCLUSION: An MMI has been developed to evaluate appropriateness of behavior when presented with actual situations that may occur on-the-job.

Reflexões sobre a prática do residente terapeuta ocupacional na estratégiasaúde da família no município de São Carlos / About the therapist occupational residence practice at family healthcarestrategy in São Carlos

O olhar dos residentes egressos de Terapia Ocupacional sobre suas práticas na Residência Multiprofissional em Saúde da Família e Comunidade da UFSCar foi o objetivo deste estudo.Durante o programa de pós-graduação “lato sensu”, de ensino em serviço, os residentes desenvolvem competências de cuidado individual e coletivo, gestão, educação permanente e pesquisa, na lógica do apoio matricial, inseridos em Unidades de Saúde da Família do município. Responderam a um questionário on-line, sete dos oito residentes formados de 2007 a 2011. O material empírico foi agrupado em blocos a partir de um entendimentoda hermenêutica dialética em diálogo com o referencial teórico e o projeto pedagógico da residência. Embora com diferenças, todos os residentes puderam reconhecer, de forma ampliada, aspráticas e os preceitos da Estratégia Saúde da Família. Nos relatos,associaram o cuidado individual e coletivo ao núcleo de saber da Terapia Ocupacional, e associaram as ações coletivas, de gestão e de educação permanente, ao campo de saber da Saúde Coletiva. Os egressos reconheceram a residência como fundamental para sua formação pessoal e profissional...

This study, based on dialectical hermeneutics, investigated the view of occupational therapists posgraduatesat University of São Carlos about their practices. During the residence, they worked in a Unit of Family Healthcare in which they are inserted in a matrix organization model and they hadpermanent education and research based in practice, learning about management of health services, individual and collective care. Seven graduates, who concluded the residence between 2007 and 2011, answered an on-line questionnaire. This materialwas grouped in accordance to comprehensive and critical social reality knowledge based in the pedagogic project and residence theory. Although each student has had different view, everyone experienced and recognized, generally, the practice accordingto Family Health Strategy precepts: comprehensive health care,interdisciplinary, intersectionality, networking, social control, co-responsibility, autonomy and protagonism. Moreover, the answers demonstrated an association between care (individual and collective) to occupational therapy center of knowledge, and groups management and permanent education were associated to community health. In conclusion, the posgraduates recognizedthe residence as a fundamental experience to their personal andprofessional formation...

Especialista en cardiología: diferentes caminos, ¿iguales resultados? / Do the Different Pathways to Become Specialist in Cardiology Have Similar Results? / Do the Different Pathways to Become Specialist in Cardiology Have Similar Results?

Una especialidad médica puede definirse como un conjunto de conocimientos correspondientes a un área específica. Estos conocimientos son adquiridos por medio de estudios de posgrado luego de obtener el título de médico. El propósito de este trabajo es hacer una revisión de las diferentes opciones disponibles en nuestro país para llegar a ser médico especialista en cardiología y, así, tratar de determinar si estos diferentes caminos podrían conducir a formaciones similares y equiparables entre los profesionales. La formación debe entenderse como un proceso de largo alcance a través del cual se modelan el pensamiento y el comportamiento socioprofesional. Este proceso debe ser permanente y debería ser regulado en forma centralizada de modo que permita asegurar la equidad y la homogeneidad en la formación del especialista. Existen diferentes maneras para llegar a ser médico especialista en cardiología, muchas son combinables y todas emplean diversas herramientas de selección, formación, supervisión, evaluación y control. En conclusión, esta heterogeneidad en la forma de instruir y peritar al especialista podría devenir en diferentes niveles de profesionales formados.

A medical specialty may be defined as the body of knowledge corresponding to a specific medical field. This knowledge is provided by postgraduate training programs after completing the medical doctor degree. The goal of the present study is to review the different options available in our country to become a specialist in cardiology and, thus, determine if these diverse pathways produce equally trained cardiologists. Training should be understood as a long-term process that shapes professional thinking and social behavior. This process must be permanent and should have core regulations to ensure equal and homogenous training in the specialty. There are many ways of becoming a specialist in cardiology; most of these pathways may be combined and all of them use different tools for selecting, training, supervising, evaluating and controlling trainees. Thus, these differences in training and evaluating specialists might produce professionals with different levels of competencies.

How can the postgraduate training program in pathology departments in India be improved.

There exists a wide variation in the competence of the postgraduate residents trained in pathology in different institutions across India. This results in strong disparities in the clinical diagnostic skills, teaching skills, research capabilities and the managerial skills of the graduates. The end users of this training, namely the community, clinicians and health care institutions would benefit from a more uniform and better trained pathologist. The article reviews the reasons for the variation in the quality of the training programs. The main deficiencies include, lack of well-defined criteria for recruitment of residents, training facilities, faculty resources, curriculum with well-defined learning objectives and competencies, hands-on experiences in diagnostic and research activities, diagnostic specimens and medical autopsies, exposure to molecular pathology, pathology informatics, electron microscopy, research experiences, communication skills, professional behavior and bioethics, business practices in pathology and quality assurance. There is also a lack of defined career tracks in various disciplines in laboratory medicine, standard protocols for evaluation and regional and national oversight of the programs. The steps for rectification should include defining the competencies and learning objectives, development of the curriculum including teaching methods, facilities and evaluation strategies, communication skills, professional behavior skills, teaching skills, legal aspects of practicing pathology and the various career pathways to subspecialties in pathology. The training should include defined exposure to molecular pathology, electron microscopy, quality control and assurance, laboratory accreditation, business aspects of pathology practice, review of literature, evidence-based medicine, medical autopsy and medical informatics. Efforts should be made to share human and laboratory resources between regional cooperation. The oversight and accreditation policies should be evolved and well-documented. Web-based platforms need to be developed for easy interaction among residents, faculty and administrators on a national level.

A questionnaire survey about community medicine in residency programs in the Tohoku–Hokuriku region of Japan / 医学教育

In 2004 a program of community health and medicine was included in the national residency system. However, the contents and achievements of this program have not been adequately studied. We surveyed residents, program directors, and collaborating facilities for clinical training in community medicine in the Tohoku–Hokuriku region of Japan about the contents, practices, training period, curriculum development, and other aspects of the program.<br>1)We conducted a survey of 230 residents who had completed the program, 82 program managers, and 101 collaborating facilities.<br>2)The survey consisted of surveys of residents (survey 1), of program directors (survey 2), and of collaborating facilities (survey 3) and asked about the programs' consistency with the training objectives of the Ministry of Health, Labour and Welfare and satisfaction with community medicine.<br>3)Approximately 70% of residents, program managers, and collaborating facilities believed the training period for community medicine is appropriate.<br>4)Furthermore, 69.1% of residents, 65.5% of program directors, and 85.2% of facilities believed that the community medicine program in the national system was important or very important.<br>5)Training programs should be enhanced so that residents "understand and practice health care in outlying and rural areas" and to increase active involvement of program directors.

Impact of a month-long training program on the clinical skills of ophthalmology residents and practitioners.

A cohort study was performed to assess the impact of an intensive, hands-on, supervised training program in ophthalmic clinical evaluation, for ophthalmology residents and private practitioners. All students underwent one-month training in comprehensive ophthalmology examination and investigations at a tertiary care center between January 2004 and January 2006. The training methodology included didactic lectures, video-demonstrations and hands-on training. The participants completed a self-assessment with a set of 23 questions designed to assess the level of confidence in various skills on the first and last day of the training. Of a total of 118 students, 67 (56.8%) were residents and 51 (43.2%) were practitioners. The mean score pre-training was 38.3 out of 92 (S.D. ±16.9), and was 70.6 out of 92 (S.D.± 10.1) post-training. The mean increase in the scores was 32.3 (P value < 0.001). We concluded that intensive, short-term training programs could improve the self-perceived level of confidence of ophthalmology residents and practitioners.

An evaluation of the structural components of the residency training program of the Department of Anesthesiology, UP-PGH

BACKGROUND:The residency training program in Anesthesiology of UP-PGH is the pioneer and biggest training program in the country. However, since its inception, the training program has not undergone any form of comprehensive evaluation. OBJECTIVE: The main objective of the study is to assess the different structural components of the training program and come up with recommendations on how to further improve it. METHODS: This is a descriptive study, utilizing both qualitative and quantitative research methods. Several validated survey instruments were used. RESULTS: The academic and neuro-psychiatric profiles of the residents were within the purview of mediocrity, while their socio-demographic profile was basically unremarkable. Their overall Quality of Life and Working Condition were both satisfactory. Although their Work Load was heavy and stressful, their Motivational Level was above par. Their performance from their trainers' perspective was generally satisfactory but needs improvement in the basic and theoretical knowledge. On the other hand, the trainees rated their trainers' performance from Good to Outstanding. The trainers' academic profile was excellent. Problems, weaknesses and strengths inherent to the program were also identified. CONCLUSION: To improve the training program, the quality of the residents must also necessarily be improved. A reduction in work load by increasing the number of residents as well as providing a more conducive learning environment are both recommended. The trainers'/mentors' teaching performance have been exemplary and needs to be maintained.