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Int J Environ Res Public Health ; 19(15)2022 07 25.
Article in English | MEDLINE | ID: covidwho-1957321


The COVID-19 pandemic has changed the way cancer patients should be managed. Using published literature on best practices on oncology patient management, we developed checklists to establish which recommendations were followed and differences between healthcare staff and institutions in a local health unit (overseeing two regional hospitals and 14 primary Healthcare Centers) in an interior region in Portugal. Checklists were delivered and completed by 15 physicians, 18 nurses and 5 pharmacists working at the Hospitals, and 29 physicians and 46 nurses from primary healthcare centers. Hospital staff do not show statistically significant differences regarding most proposed recommendations for the oncology clinical pathway, human resources, treatments, patient management and service management. Primary healthcare centers seem to follow a similar trend. As a local health unit, general recommendations for Oncology Patient Management show statistically significantly different values on education of suspected cases, identification, isolation procedures and samples collection; extension of work schedules; and education on cancer patient and COVID-19 positive referral procedures. All the checklists indicated good-to-high internal consistency. Our analysis showed cohesive work between groups regarding control and prevention of sources of infection; therefore, it is considered the highest priority to ensure that all other services, including oncology, continue functioning. Patient management measures such as adjustments in treatments, analysis, patient care, referrals and emergencies were not ranked higher by responders.

COVID-19 , Neoplasms , COVID-19/epidemiology , Humans , Medical Oncology , Neoplasms/epidemiology , Neoplasms/therapy , Pandemics , Pharmacists
Educación Médica ; 2021.
Article in English | ScienceDirect | ID: covidwho-1347586


Introduction Assessment takes a fundamental role in medical education. In Portugal, the main assessment method used is multiple-choice questions (MCQ). The virtual interactive patients (VIP) as an assessment method can be indicated for the development of clinical reasoning for medical students of the clinical years. This study compared the use of MCQ and VIP as assessment methodologies in medical students. Methods A randomized crossover study carried out, which 35 Portuguese medical students from clinical years evaluated by MCQ and VIP in four medical specialties. In each specialty, students randomized into two groups. One group started being evaluated by MCQ and finished with VIP, the other vice-versa. After the evaluation, students asked to complete a satisfaction questionnaire. Results The final score was higher with the VIP than MCQ method (MCQ: 67.40±8.96 vs. VIP: 73.34±10.8;p<0.01) with significant differences higher in Clinical History and Physical Examination. The satisfaction quiz showed although both methodologies are adequate and satisfactory, but VIP method allows to improve knowledge. Conclusion VIP is more accurate for clinical reasoning, accepted by medical students and should be integrated into the pre-graduate medical curriculum with other methodologies already used. The COVID-19 pandemic allowed a digital transformation of medical education and VIP will have a crucial role as a knowledge and evaluation method. Resumen Introducción La evaluación tiene un papel fundamental en la educación médica. En Portugal, el principal método de evaluación utilizado son las preguntas de opción múltiple (MCQ). El paciente virtual interactivo (VIP) como método de evaluación puede estar indicado para el desarrollo del razonamiento clínico para estudiantes de medicina en años clínicos. Este estudio comparó el uso de MCQ y VIP como metodologías de evaluación en estudiantes de medicina. Métodos Se realizó un estudio cruzado, aleatorizado, en el que 35 estudiantes de medicina portugueses de años clínicos fueron evaluados por MCQ y VIP en cuatro especialidades médicas. En cada especialidad, los estudiantes se asignaron al azar en dos grupos. Un grupo comenzó a ser evaluado por MCQ y terminó con VIP, el otro viceversa. Después de la evaluación, los estudiantes pidieron completar un cuestionario de satisfacción. Resultados La puntuación final fue mayor con el método VIP que con MCQ (MCQ: 67,40±8,96 vs. VIP: 73,34±10,8;p<0,01) con diferencias significativas mayores en historia clínica y exploración física. El cuestionario de satisfacción mostró que ambas metodologías son adecuadas y satisfactorias, pero el método VIP mejora el conocimiento. Conclusión VIP es más preciso para el razonamiento clínico, aceptado por los estudiantes de Medicina y debe integrarse en el plan de estudios de Medicina de pregrado con otras metodologías ya utilizadas. La pandemia por la COVID-19 permitió una transformación digital de la educación médica y VIP tendrá un papel crucial como método de conocimiento y evaluación.

Telemed J E Health ; 27(10): 1194-1199, 2021 10.
Article in English | MEDLINE | ID: covidwho-954955


The objective of this communication is to offer a better understanding of the value of telemedicine in health care, particularly its role in creating opportunities for continuity of care to patients in a complex and novel setting as were the circumstances of the early COVID-19 pandemic times. Crisis time is also a time for opportunities. With regard to telehealth, all players (providers, staff, and patients) should be informed about its benefits and should also become familiar with the use of the various telehealth options and this will only be achieved through large information campaigns necessary enriched by local teaching and training programs in both public and private institutions. The final aim is to launch the debate and foster ideas useful throughout the pandemic. This article covers the experiences of physicians as well as health professionals in the Iberian Peninsula (Spain and Portugal), to provide a clearer idea of what has happened and how we can improve it with the possibilities provided by telemedicine, while at the same time to put in evidence that public health systems need to be rethought to provide solutions to situations such as that we are experiencing.

COVID-19 , Telemedicine , Delivery of Health Care , Humans , Pandemics , SARS-CoV-2