Effect of professional certification on employees' return-to-work rate after occupational injuries in Korea: focusing on vulnerable groups

BACKGROUND@#One effective way to improve return-to-work (RTW) performance may be to convince the employer that the worker has the necessary skills. The aim of this paper is to investigate the effect of having a professional certification among workers injured in occupational injuries on their return to work.@*METHODS@#The Panel Study of Workers' Compensation Insurance (PSWCI) targets workers who completed medical care in 2012 after an occupational injury. The study population (n = 2000) was stratified by gender, age, region, disability grade, and rehabilitation service use. A total of 1458 workers were finally selected for this study. The effect of having a certification on RTW status was calculated with an odds ratio and 95% confidence intervals using binomial and multinomial logistic regression analyses. In the binomial logistic regression analysis, the RTW group was made up as a combination of the return to original work and the reemployment groups.@*RESULTS@#The ORs of RTW among those with a certification compared to those without certification were 1.38 (1.16-1.65) in Model 1, 1.25 (1.05-1.50) in Model 2, and 1.22 (1.01-1.47) in Model 3. Among female workers with a certification, the OR of RTW was 4.60 (2.68-7.91), that of return to original work was 3.21 (1.74-5.91), and that of reemployment was 5.85 (3.34-10.27). Among daily workers with a certification, the OR of RTW was 1.32 (1.03-1.69) and that of reemployment was 1.37 (1.07-1.76).@*CONCLUSION@#In conclusion, injured workers with a certification generally had a higher RTW rate. In particular, the RTW rate was higher among female workers and daily workers with a certification than among those without.

Professional training and autonomy of nursing teachers in the qualification of higher education in nursing / Formación y autonomía profesional de docentes de enfermería en la titulación de educación superior en enfermería / Formação e autonomia profissional dos docentes de enfermagem na qualificação do ensino superior em enfermagem

ABSTRACT Objectives: to identify the aspects related to professional training and autonomy of undergraduate nursing teachers of a public institution in Brasília, Federal District, in order to contribute to the course management and qualification. Methods: mixed method study conducted with 77 teachers. A semi-structured questionnaire was applied, where quantitative items were evaluated through the Student's T and ANOVA (p<0.05%) parametric tests. The qualitative part underwent content analysis with use of the IRAMUTEQ software and descending hierarchical classification. Results: the training of professionals was focused mostly (67.5%) on their initial area of expertise, and their mean values in autonomy-related factors were low and moderate. Two categories emerged in the qualitative analysis: "Identifying teacher autonomy" and "Applying teacher autonomy". Conclusions: understanding the meaning and degree of autonomy perceived by teachers can foster the reflection on the praxis and enhance their performance.

RESUMEN Objetivos: identificar aspectos relacionados con la formación profesional y la autonomía de los docentes universitarios de enfermería de una institución pública en Brasilia, Distrito Federal, para contribuir a la gestión y calificación del curso. Métodos: investigación de método mixto realizada con 77 docentes. Se aplicó un cuestionario semiestructurado, donde los ítems cuantitativos se evaluaron mediante las pruebas paramétricas T de Student y ANOVA (p<0.05%). La parte cualitativa se sometió a análisis de contenido con el uso del software IRAMUTEQ y clasificación jerárquica descendente. Resultados: con la formación enfocada principalmente (67.5%) en su área inicial de experiencia, los profesionales expresaron promedios bajos y moderados en factores relacionados con la autonomía. En el análisis cualitativo surgieron dos categorías: "Identificar la autonomía del docente" y "Aplicar la autonomía del docente". Conclusiones: comprender el significado y el grado de autonomía percibido por los docentes puede fomentar la reflexión de la praxis y mejorar su desempeño.

RESUMO Objetivos: identificar aspectos relativos à formação profissional e à autonomia dos docentes de graduação em Enfermagem de uma instituição pública de Brasília, Distrito Federal, de forma a contribuir na gestão e na qualificação do curso. Métodos: estudo misto, realizado com 77 docentes. Aplicou-se questionário semiestruturado, onde os itens quantitativos foram avaliados por testes paramétricos: Teste t-student e ANOVA (p<0,05%). A parte qualitativa passou por análise de conteúdo com subsídio do software IRAMUTEQ, e foi empregada a Classificação Hierárquica Descendente. Resultados: com formação voltada majoritariamente (67,5%) à sua área de atuação inicial, os profissionais expressaram médias baixas e moderadas nos fatores relacionados à autonomia. Na análise qualitativa emergiram duas categorias: "Identificando a autonomia docente" e "Aplicando a autonomia docente". Conclusões: entender o significado e o grau de autonomia percebido pelo docente pode fomentar a reflexão da práxis e potencializar sua atuação.

Relación entre el desempeño en el examen de ingreso a la residencia y en el de especialización en pediatría en la ciudad de Buenos Aires / Correlation between results of the residency admission test and of pediatric certification test in Buenos Aires, Argentina

En la Ciudad de Buenos Aires (CABA) los ingresantes al sistema de residencia en pediatría lo hacen mediante un examen unificado y, al finalizar, rinden su examen de especialización en la Universidad de Buenos Aires (UBA). Existe evidencia de que el desempeño en determinadas evaluaciones podría predecir el rendimiento posterior. El objetivo de este estudio es evaluar si existe relación entre el examen de ingreso a la residencia (EIR) y el de especialización (EE) en pediatría. Se trata de una investigación transversal que incluye todos los sujetos que aprobaron el EIR de pediatría en CABA en 2004-2009 y que rindieron EE de pediatría en la UBA. Se obtuvo el puntaje de cada sujeto en ambos exámenes y se calculó la correlación correspondiente. Las notas fueron divididas en quintiles, calculando la proporción de alumnos que mejoró su ubicación en el segundo examen con respecto al primero. Se obtuvieron datos de 303 participantes. El examen de ingreso (calificación máxima de 60 puntos) mostró una mediana de 45.0 puntos (IIC: 43.0-48.7) y el examen de especialización (calificación máxima de 10 puntos) mostró una mediana de 6 puntos (IIC: 6-8), verificándose una correlación significativa entre la calificación del EIR y la del EE (r = 0.37, p < 0.001). En relación al quintil de referencia, 43.8% de los alumnos mejoró su ubicación en el EE respecto de la obtenida en el EIR, sin que se registraran diferencias entre residentes de hospitales pediátricos y de hospitales generales (45.6 vs. 31.5%; p = 0.1).

In the city of Buenos Aires (CABA), pediatric residents enter the residency program after taking a unified admission test. After completion of the program and passing a final test, the Universidad de Buenos Aires (UBA) provides a professional certification. The objective of this study is to determine if the results obtained in the residency admission test (RAT) and those of the professional certification test (PCT) correlated. This is a cross-sectional study, that included all subjects who passed the pediatrics RAT in CABA in 2004-2009, and that attended the pediatric PCT of the UBA. The score for each subject in both tests was obtained and the corresponding correlation was calculated. Results were divided in quintiles, and the proportion of subjects who improved their position in the PCT with respect to the RAT was calculated. Data from 303 subjects was obtained. The RAT showed a median of 45.0 (over 60 maximum) (IC-range: 43.0-48.7), and the PCT showed a median of 6 points (over 10 max.)(IC-range: 6-8). A significative correlation between results in RAT and PCT was observed (r = 0.37, p < 0.001). Based on their position in the RAT, 43.8% of subjects improved their position in the PCT, without differences between residents attending pediatric and general hospitals (45.6 vs. 31.5%; p = 0.1). In the case of pediatric residents, results of the residency admission test correlate with those obtained in the professional certification test.

Odontólogos del Registro Nacional de Prestadores Individuales de Salud / Characterization of dentists registered in the National Register of Individual Health Providers, Chile

Objetivo Caracterizar a los odontólogos que ejercen la profesión en Chile, inscritos en el Registro Nacional de Prestadores Individuales. Material y método Estudio descriptivo, transversal, efectuado con la base de datos del Registro Nacional de Prestadores Individuales de la Superintendencia de Salud, solicitada vía Ley de Transparencia. Resultados A fecha de septiembre de 2014, se encontraban registrados 15.901 odontólogos titulados, desde 1945 en adelante. Su promedio de edad es 42,9 ± 11,46 años. El 54% son varones, y el 46%, mujeres. El 89,6% de los odontólogos chilenos estudió en Chile, el 73% de ellos en universidades tradicionales. Un 7,3% de los profesionales registrados son extranjeros, cuya gran mayoría estudió fuera del país. Para ellos, la vía más común de revalidación de título es mediante convenios con el Ministerio de Relaciones Exteriores. La universidad tradicional con más titulados es la Universidad de Chile, mientras que la Universidad Mayor es la privada con mayor egreso. En el último quinquenio, la cantidad total de titulados de universidades privadas superó al total de egresados de universidades tradicionales. Existen 4.339 registros de especialidad, un 49% de ellos certificado en el quinquenio 2009-2013. La especialidad más frecuente es Ortodoncia, con un 19,5% del total. La vía de certificación más frecuente es el posgrado universitario. Conclusiones Esta investigación constituye uno de los escasos estudios con información oficial y no especulativa sobre odontólogos en Chile. Consideramos que el Registro Nacional de Prestadores Individuales debe mejorar el acceso y registro de sus datos, para así caracterizar de forma adecuada, tanto demográfica como académicamente, a estos profesionales.

Objective To characterise dentists who practice in Chile, enrolled in the National Register of Individual Providers. Material and method Descriptive and cross-sectional study conducted with the database of the National Register of Individual Providers of the Superintendency of Health, requested through the Transparency Law. Results In September 2014, there were 15,901 registered dentists, of whom 54% were male, and graduated from 1945 onwards. Their mean age was 42.9 ±11.46 years. The large majority (89.6%) of Chilean dentists studied in Chile, 73% of them in traditional universities, and 7.3% of registered professionals are foreigners, most of whom studied abroad. For them, the most common route of degree equivalency is through agreements with the Chilean Ministry of Foreign Affairs. The traditional university with most graduates is the University of Chile, while Universidad Mayor is the private university with most graduates. In the last 5 years, the total number of graduates from private universities surpassed the total of graduates from traditional universities. There are 4,339 specialty records in the register, 49% of them certified in the period 2009-2013. The most common specialty is orthodontics (19.5% of the total). The most common route of certification is a university degree. Conclusions This study is one of the few with official, non-speculative information about dentists in Chile. We believe that the National Register of Individual Providers should improve access and registration of their data, with the purpose of properly characterising these professionals, demographically and academically.

Certificación y recertificación de especialistas en anestesiología: una mirada desde CONACEM / Certification and recertification specialist anesthesiology: a look from CONACEM

Desde 1984 la Corporación Autónoma de Certificación de Especialidades Médicas (CONACEM) ha certificado 12.294 especialistas médicos en Chile. La disciplina de Anestesiología inició su certificación en 1985, habiendo reconocido hasta diciembre de 2012 a 716 especialistas. Para la certificación existen tres vías posibles: a) haber aprobado un Programa de Formación Universitario Acreditado, lo que hizo el 53 por ciento de los postulantes; b) cumplir los requisitos de Adiestramiento en Práctica durante 5 años, lo que hizo un 41 por ciento de los postulantes. c) haber sido formado en el extranjero de acuerdo a programas convalidados. Existen 7 programas universitarios acreditados, de 3 años de duración, con un cupo total anual de 39 alumnos que se desarrollan en Santiago y provincias. Salvo los médicos aprobados en los Programas Universitarios acreditados, el resto de los postulantes requieren dar un examen práctico; desde 2002 se ha agregado un examen escrito, cuya aprobación es requisito para dar el práctico, y que ha resultado tener buena discriminación (49 por ciento de rechazo promedio en el período de 11 años de existencia). Las certificaciones dadas hoy, tienen una duración de 10 años al inicio y serán de 7 años en la recertificación. La caducidad de las certificaciones está aparejada al proceso de recertificación, de lo cual se discuten las razones que lo avalan; se presentan los requisitos y tabla de créditos a cumplir, elaborada por CONACEM. La legislación vigente y en proceso, requiere la actuación de al menos una entidad certificadora, condición que ha sido otorgada legalmente en forma única por el Ministerio de Salud a CONACEM a partir del 11/02/2014...

Since 1984, 12.294 different medical specialists have been certified in Chile by the Corporación Autónoma de Certificación de Especialidades Médicas (CONACEM). The certification in Anestesiology specialty was initiated in 1985 reaching 716 candidates approved until December 2012. Three ways are available to achieve certification: a) to be approved by a reputable university program in the specialization; this way has been used by 53 percent of postulants; b) to fulfill the requirements of a 5 years practical training program, as 41 percent of postulants did; c) to have passed a training program abroad, similar to those in force in Chile (< 5 percent). There are 7, three-year-long reputable university programs with a total annual capacity of 39 students; half of it is for programs developed in provinces. With the exception of doctors completing reputable university programs, others postulants are require to pass a five days practical examination. Since 2002 a written test has been added, which must be taken and approved as a condition of the practical examination. Written examinations have demonstrated good discriminative capacity (52 percent average approval in 11 years). Extended certifications currently have a 10 years duration for the first time and 7 years for subsequent recertification. Revocation of certification involves installing a recertification mechanism. The reasons that support the recertification are analyzed, and also present the requirements to obtaining it. Current legislation requires that certification and recertification are done by accrediting entities. CONACEM has been legally recognized by de Ministery of Health since February 2014 as the unique entity to perform that labor...

Resultado del examen de certifcación de médico pediatra de la Sociedad Argentina de Pediatría, años 2001-2010 / Performance on the Board of Pediatrics certifcation examination by the Sociedad Argentina de Pediatría, 2001-2010

Introducción. La certifcación de los profesionales garantiza su adecuado desempeño, pero el examen correspondiente debe ser periódicamente evaluado. Objetivo. Describir el resultado del examen de certifcación de médico pediatra (ECMP) de la Sociedad Argentina de Pediatría (SAP), analizando el impacto de edad y el tiempo desde la graduación de los inscriptos. Métodos. Se analizaron los examinados por el ECMP, valorando tasa de aprobación e institución formadora (2001-2010), y edad y años transcurridos desde la graduación (2001- 2005). Resultados. De 2527 profesionales pertenecientes a 138 instituciones, aprobó el 69,6%. Los aprobados presentaron edades (31,7 ± 4,1 contra 35,6 ± 6,2; p <0,0001) y años desde la graduación (6,3 ± 4,0 contra 9,0 ± 5,9; p <0,0001) menores que los desaprobados. La proporción de aprobados fue mayor en instituciones acreditadas por SAP por 5 años (78,4% contra 48,8%; OR= 3,8 IC95%= 3,1-4,7; p <0,001). Conclusión. Aprobaron el ECMP 69,6%. Los más jóvenes, con menos años de graduación y pertenecientes a programas acreditados por SAP, tuvieron mayor probabilidad de aprobar.

Introduction. Professional certifcation guarantees professional's performance, but the examination tool must be periodically evaluated. Objective. To describe the result of the pediatric certifying examination (PCE) of the Sociedad Argentina de Pediatría (SAP), between 2001-2010 analyzing the impact of the age and the elapsed time since the graduation and to describe the performance of training institutions in this period. Methods. Cross-section study. Data were ob-taind from the records of Board of Pediatrics of the SAP. The results of the PCE, were analyzed assessing examination pass rate and training institutions (2001-2010), and age and elapsed time since graduation of the examined professionals (2001-2005). Results. Of 2527 professionals from 138 institutions, 69.6% passed. Those that passed were younger (31.7 ± 4.1 vs. 35.6 ± 6.2 years; p <0.0001) and had less years since graduation (6.3 ± 4.0 vs. 9.0 ± 5.9; p <0.0001) than those who did not pass. The examination pass rate was higher in institutions accredited by SAP (78.4% vs. 48.8%; OR= 3,8 IC95%= 3,1-4,7; p <0.001). The pass rate was signifcantly higher in institutions with accredited programs for 5 years than those not accredited (78.4% vs. 48.8%, OR= 3.8 95% CI= 3.1 to 4.7, p <0.001). The pass rate at accredited institutions for 3 years (53.7%) and 1 year (48.7%) showed no statistically signifcant differences with non-accredited institutions. Conclusion. The certifying examination pass rate was 68.5%. Younger professionals with fewer years since graduation, and trained in SAP 5 years accredited programs were signifcantly more likely to pass the examination.

Certificación de la mortalidad materna / Certification of maternal mortality

Las estadísticas de mortalidad deben utilizarse como fuente de información en salud de una población, porque reflejan los casos en que no pudo actuarse oportunamente y en donde no podía hacerse mayor acción. El diagnóstico correcto por el profesional de salud en la certificación como causa básica de la muerte materna permite producir y analizar datos relacionados con condiciones de vida y problemas de salud que desencadenaron la muerte, en determinado lugar...

Estado actual de las especialidades médicas en Chile: realidad en el sistema público no municipalizado / Present status of medical specialties in the Chilean public health system

To adequately plan the post graduate training of physicians, we need to know the needs for specialists in the country and the most prevalent diseases and causes of consultations. In 2004, the National System of Health Services assessed the number of hours and types of specialities available, their regional distribution and calculated an approximate number of physicians in charge of those specialities, determining an equivalent per 44 weekly hours of physician. This number of hours is the maximum that a physician is allowed to work per week. Fifty six percent of specialists correspond to basic specialities (3,688 physicians equivalent to 44 hours, 33 percent to primary specialities (2,205 physicians) and 10 percent to subspecialties (666 physicians). The regional distribution of basic specialties is proportional to the population of each region. However, there are gaps in the distribution of primary specialties and subspecialties. The demand for specialists, assessed measuring the yield in minutes of each hired hour, determined that 54 percent of specialist hours are delicated to the new health program that guaranties the access to certain specialties in a predefined lapse, to all beneficiaries (AUGE). Moreover the demand for attentions to cover this health system has a gap of 30 percent in hours or 800 specialists. This motivated the creation of new posts for specialties during 2005 and 2006, equivalent to 250 physicians hired for 44 hours per week.

Análisis de un Programa Universitario de Formación de Postgrado en Endocrinología, luego de 24 años de su inicio / Analysis of a university training program in endocrinology

The Pontificia Universidad Católica de Chile has a two decades experience in training endocrinology specialists. This communication explains the operation of the training program and the results of a survey, answered by 90 percent of Endocrinologists that were trained at the center. This survey covers different aspects of the program such as the strengths and weaknesses of the academic teaching and the present position of the trainees. Questions about the working environment and the relationship with their teachers during the application of the program are also included. These results can be useful for other University centers that are planning a training program in endocrinology and for those physicians that are planning to become endocrinologists.

Disponibilidad de médicos en Chile al año 2004 / Availability of physicians in Chile at the year 2004

Background: The number of physicians available in a given country, their efficiency, quality and specialization is of utmost epidemiological importance. Aim: To evaluate the availability of physicians in Chile. Material and methods: The information about the number of physicians in Chile up to the year 2004, was obtained from the Ministry of Health, national universities and the register of immigrant physicians since 1950. Results: The total number of physicians licensed to practice was 25,542, of whom 2,700 are immigrants. The physician/inhabitant ratio increased from 1/921 in 1998 to 1/612 in 2004. The greater impact in the increment of available physicians was given by the immigration of professionals and by the increase in the number of physicians graduated from national universities, mainly from the new private universities. Forty two percent of physicians work at public services and 61 percent of these are certified specialists. The regional distribution of general practitioners and basic specialists is adequate. Along the country, the mean physician/beneficiary ratio is 8.45/10,000, the specialist/beneficiary ratio is 4.9/10,000 and the general practitioner/beneficiary ratio is 2.3/10,000. Conclusions: The national information of available physicians, especially in the private sector, should be improved. Immigration of physicians should be regulated, maintaining validation examinations and a National Medical Test to assess medical proficiency should be instituted.