Perception of training and job perspectives among final-year residents in the specialty of Endocrinology and Nutrition.

INTRODUCTION: The medical specialisation model in Spain is carried out in the context of specialised health training, through the residency programme. The aim of the study is to analyse, by an anonymous survey, the opinion on three aspects among final-year residents in Endocrinology and Nutrition (E&N): self-assessment of the knowledge acquired, working prospects, care and training consequences arising from the pandemic COVID-19. MATERIALS AND METHODS: Cross-sectional observational study using a voluntary and anonymous online survey, shared among final-year national interns in the last year of the E&N programme, carried out between June-July 2021. RESULTS: 51 responses were obtained, 66% of the fourth-year residents. Overall perception of their knowledge was 7.8 out of 10. Most external rotations were in thyroid and nutrition areas. A total of 96.1% residents, carried out some activity associated with COVID-19, with a training deterioration of 6.9 out of 10. 88.2% cancelled their rotations and 74.5% extended their working schedule. The average negative emotional impact was 7.3 out of 10. 80.4% would like to continue in their training hospital, remaining 45.1%. 56.7% have an employment contract of less than 6 months, most of them practising Endocrinology. CONCLUSION: The perception of the knowledge acquired during the training period is a "B". Residents consider that the pandemic has led to a worsening of their training, generating a negative emotional impact. Employment outlook after completing the residency can be summarised as: temporality, practice of Endocrinology and interhospital mobility.

Virtual meetings on morbidity and mortality in Colombia: An exploratory study / Reuniones virtuales de morbilidad y mortalidad en Colombia: un estudio exploratorio

Resumen Introducción: la pandemia por la Covid-19 modificó la educación médica con estrategias apoyadas en plataformas virtuales y en escenarios no convencionales. Un ejemplo de ello son las reuniones de morbilidad y mortalidad (M y M). El objetivo de este estudio es describir las características de las M y M virtuales en las instituciones de práctica de los residentes de cirugía general en Colombia; así como la percepción de los participantes sobre su funcionamiento, comparado con las M y M presenciales o tradicionales. Método: estudio observacional y descriptivo realizado en 21 instituciones hospitalarias de práctica, de 17 programas de cirugía general de Colombia en donde operan M y M virtuales. Se obtuvo información sobre sus objetivos, características operativas y alcances. Con encuestas autodiligenciadas se investigó, además, la percepción de los participantes acerca de su utilidad y funcionamiento, producto del cambio a la virtualidad. Participaron 82 residentes y 65 docentes de diferentes programas de posgrado de cirugía general del país. Resultados: las M y M virtuales se ejecutan en el 53 % de los sitios de práctica de los residentes de Colombia, con el predominio en las instituciones privadas. Si bien hay diferencias en su organización, persiste el modelo tradicional de M y M: objetivos, estructura y alcances. Hay una duración mayor de las reuniones, se realizan en horarios no convencionales, con una percepción de un menor nivel académico. Se respira un menor ambiente de hostilidad con el uso de la virtualidad. Conclusión: las reuniones de morbilidad y mortalidad se realizan en un escenario de virtualidad. Su funcionamiento es similar a las reuniones presenciales y su ejecución ofrece oportunidades de mejora en términos de forma y fondo.

Summary Introduction: The Covid-19 pandemic changed medical education, with strategies supported by virtual platforms and non-conventional scenarios. An example of this is the morbidity and mortality meetings (M&M). The objective of this study is to find the characteristics of virtual M&M meetings in different institutions focused on general surgery resident´s students in Colombia, and how medical residents and professors feel about them compared to the traditional face-to-face meetings. Methodology: This is an observational, and descriptive study in 21 hospital practice institutions of 17 General Surgery programs in Colombia, where virtual M&M operate. Information was obtained on their objectives, operational characteristics and scope. Additionally, in self-completion surveys, the participants' perception about the usefulness and operation was investigated, this, because of the shift to virtuality. There was participation of 82 residents and 65 professors from different postgraduate programs in General Surgery in the country. Results: Virtual M&Ms continue in 53 % of the practice sites, with a predominance in private institutions. There are differences in their organization, although the traditional M&M model persists: objectives, structure, and scope. There is a longer duration of meetings, unconventional schedules and the perception of a reduced academic level. There is an improvement in the hostile environment, within the virtuality. Conclusion: M&Ms have a place in a virtual scenario. Its operation is like face-to-face meetings, and its execution offers opportunities for improvement in terms of form and content.

Operative autonomy and supervision of the surgical resident: A look at the COVID-19 pandemic / Autonomía y supervisión operatorias del residente de cirugía: Una mirada en la pandemia por COVID-19

Introducción. Al declararse la pandemia por SARS-CoV-2, se establecieron múltiples cambios en los sistemas de salud y en las instituciones hospitalarias, influyendo en la actividad quirúrgica global. El objetivo de este estudio fue evaluar el impacto de la pandemia en los niveles de autonomía y supervisión operatorias de los residentes de cirugía. Métodos. Estudio analítico cuasi-experimental, que incluyó los procedimientos quirúrgicos registrados por residentes de cirugía general de la Universidad de La Sabana, de febrero de 2019 a agosto de 2021. Se analizaron la autonomía y la supervisión mediante la escala Zwisch en los periodos prepandemia y pandemia. Resultados. Se recolectaron datos de 10.618 procedimientos en el periodo establecido, la mayoría realizados con abordaje abierto (57,4 %) y en rotaciones tronculares de cirugía general (65 %). Los procedimientos realizados más frecuentes fueron apendicectomía (18,6 %), colecistectomía (18,4 %) y herniorrafías (8,6 %). Se encontró una disminución estadísticamente significativa en los niveles globales de autonomía y supervisión entre los periodos analizados de 2, 4/4, 0 a 2, 2/4, 0 (p<0,001). Discusión. La disminución en la autonomía percibida por los residentes podría corresponder al impacto negativo en la motivación intrínseca de los individuos, en la disminución objetiva en el logro de las competencias esperadas en su proceso de formación quirúrgica y a la pérdida del relacionamiento colectivo propiciado por los aislamientos y limitaciones vividos. Conclusión. La pandemia por COVID-19 impactó negativamente en la autonomía y supervisión operatoria de los residentes de cirugía general de la Universidad de La Sabana, Chía, Colombia.

Introduction. Changes in health systems and hospital institutions due to the coronavirus pandemic influenced global surgical activity. The objective of this study was to evaluate the impact of the pandemic on the levels of autonomy and supervision in general surgery residents. Methods. Quasi-experimental analytical study. It included the surgical procedures recorded by general surgery residents of the University of La Sabana from February 2019 to August 2021. Autonomy and supervision were analyzed using the Zwisch scale in the pre-pandemic and pandemic periods. Results. 10,618 procedures were collected in the established period. Most surgeries were performed with an open approach (57,4%), in rotations of general surgery (65%). The most frequent procedures performed were appendectomy (18,6%), and cholecystectomy (18,4%), and herniorrhaphy (8,6%). There was a decrease in levels of autonomy and supervision compared between the analyzed periods from 2, 4/4, 0 to 2, 2/4, 0 (p<0.001). Discussion. The decrease in the autonomy perceived by the residents could correspond to the negative impact on the intrinsic motivation of the individuals, a decrease in the achievement of the competencies expected in their surgical training process, and the loss of the collective relationship produced by the isolation and limitations experienced. Conclusion. The COVID-19 pandemic had a negative impact on autonomy and supervision in general surgery residents of the University of La Sabana, Chia, Colombia

Academic supervision of doctors in indigenous areas during the Covid-19 pandemic / Supervisão acadêmica de médicos em áreas indígenas durante a pandemia de Covid-19 / Supervisión académica de médicos en áreas indígenas durante la pandemia de Covid-19

Trata-se de estudo qualitativo sobre o papel da supervisão acadêmica do Grupo Especial de Supervisão do Projeto Mais Médicos para o Brasil de Roraima (GES-RR) durante a pandemia de Covid-19. Foi realizada uma cartografia, com entrevistas e uma roda de conversa. Durante a pandemia, a Atenção à Saúde Indígena passou por rearranjos e a supervisão acadêmica do GES-RR exerceu-se remotamente, o que reduziu seu potencial, mas manteve sua relevância. O acolhimento dos médicos pelos supervisores potencializou a capacidade transformadora da assistência e diminuiu a sensação de isolamento e abandono. O GES-RR foi importante para a mediação de conflitos com a gestão, para a qualificação do trabalho médico, para a reflexão sobre as relações e condições de trabalho e como espaço privilegiado de Educação Permanente em Saúde. O estudo mostrou a importância dos papéis exercidos e da retomada presencial em momento oportuno.(AU)

We conducted a qualitative study to investigate the academic supervision role of the Special Supervision Group for the More Doctors Project for Brazil in Roraima (GES-RR) during the Covid-19 pandemic. We constructed a map based on interviews and conversation circles. During the pandemic, indigenous health care underwent reshaping and academic supervision was performed by the GES-PR remotely, reducing its potential but maintaining its relevance. The support provided to the doctors by the supervisors enhanced the transformative capacity of care and reduced the sensation of isolation and abandonment. The GES-RR played an important role in mediating conflicts with management, improving the quality of medical work, and stimulating reflection on working relations and conditions, and is uniquely positioned to provide permanent health education. The findings highlight the importance of the roles and of returning to face-to-face working at the appropriate time.(AU)

Se trata de un estudio cualitativo sobre el papel de la supervisión académica del Grupo Especial de Supervisión del Proyecto Más Médicos para Brasil de Roraima (GES-RR) durante la pandemia de Covid-19. Se realizó una cartografía, con entrevistas y una ronda de conversaciones. Durante la pandemia, la Atención de la Salud Indígena pasó por reorganizaciones y la supervisión académica del GES-RR se ejerció remotamente, pero mantuvo su relevancia. La acogida a los médicos por parte de los supervisores potencializó la capacidad transformadora de la asistencia y disminuyó la sensación de aislamiento y abandono. El GES-RR fue importante en la mediación de conflictos con la gestión, calificación del trabajo médico, para la reflexión sobre las relaciones y condiciones de trabajo y como espacio privilegiado de Educación Permanente de Salud. El estudio mostró la importancia de los papeles ejercidos y de la retomada presencial en momento oportuno.(AU)

Digital educational resources as support tools for teaching general pathology in undergraduate health courses / Recursos educativos digitales como herramientas de apoyo para la enseñanza de patología general en cursos de pregrado del área de la salud

Los recursos educativos digitales se han transformado en un importante material de apoyo al proceso de enseñanza- aprendizaje, especialmente durante la pandemia por COVID-19. Estos corresponden a recursos de autoaprendizaje, generalmente en línea y de dominio público cuya disponibilidad inmediata a todo tipo de dispositivos electrónicos permite una rápida interacción del estudiante con materiales didácticos programados. El objetivo de este estudio fue evaluar el grado de satisfacción de cinco recursos educativos digitales, desarrollados como herramientas de apoyo para la enseñanza de la patología general, en estudiantes de carreras de pregrado del área de la salud de la Universidad Austral de Chile. Estudio descriptivo y exploratorio. Se desarrollaron cinco recursos educativos digitales donde se visualizan imágenes microscópicas correspondientes a procesos patológicos ocurridos en diferentes tejidos. Estos recursos fueron alojados en repositorios de la universidad y se encuentran actualmente disponibles en el canal de YouTube. Para conocer el grado de satisfacción, en sus aspectos pedagógicos y técnicos, se realizó una encuesta digital, anónima y voluntaria a estudiantes que cursaron asignaturas de patología, la que contempló cuatro dominios con sus respectivas preguntas: forma; control de usuario; contenido educativo y valoración global. El 94 % de los estudiantes calificaron el recurso de excelente o muy bueno y todos los dominios obtuvieron sobre el 80 % de satisfacción. Los contenidos representan lo que el recurso dice ofrecer, ayuda a resolver dudas y facilita la comprensión de la materia. El tamaño y color del texto es el adecuado y las imágenes presentan una excelente calidad y resolución. Los recursos cumplen con una alta calidad técnica y pedagógica, que asegura un gran potencial de uso para la enseñanza de la patología general, guiar el trabajo autónomo del estudiante y las actividades prácticas con el microscopio.

SUMMARY: Digital educational resources have become an important material to support the teaching-learning process, especially during the COVID-19 pandemic. These correspond to self-learning resources, generally online and the public domain, whose immediate availability to all types of electronic devices allows for rapid learner interaction with programmed didactic materials. The public domain and its immediate availability to all types of electronic devices allows a quick interaction of the student with self-explanatory didactic materials. The objective of this study was to evaluate the degree of satisfaction of five digital educational resources, developed as support tools for the teaching of general pathology, in undergraduate students of the health area of the Universidad Austral de Chile. Descriptive and exploratory study. Five digital educational resources have been developed where microscopic images corresponding to pathological processes occurring in different tissues are visualized these resources were hosted in university repositories and uploaded to the YouTube channel. To determine the degree of satisfaction, in their pedagogical and technical aspects, an anonymous and voluntary digital survey was carried out among students taking pathology courses, which included four domains with their respective questions: form; user control; educational content and overall assessment. The 94 % of the students evaluated the resource as excellent or very good and all domains obtained over 80 % satisfaction. The contents represent what the resource says it offers, helps to resolve doubts and facilitates the understanding of the subject. The size and color of the text is adequate, and the images present excellent quality and resolution. The resources developed offer a high technical and pedagogical quality, which guarantees a great potential for use in the teaching of general pathology, guiding the student's autonomous work and practical activities with the microscope.

The consequences Sars-CoV-2 pandemic on medical education in the combat leprosy / As consequências da pandemia de Sars-CoV-2 sobre a educação médica no combate à hanseníase / Las consecuencias de la pandemia de Sars-CoV-2 en educación médica en combate à lepra

Background and objectives: Leprosy is an infectious disease in which early diagnosis is a decisive factor to prevent disability and disabilities. This study sought to analyze the panorama of leprosy between 2016 and 2021 in the state of Rio Grande do Sul and unveil the importance of medical education in the context of Neglected Tropical Diseases during the Sars-CoV-2 pandemic. Methods: Cross-sectional study using the State Center database of Health Surveillance of Rio Grande do Sul. In the data collection, were included leprosy data of individuals residents in the state of Rio Grande do Sul (RS), in the 2016 period 2021. The variables analyzed were confirmed leprosy cases, notified cases, the number of cases in terms of operational classifications of leprosy, the therapeutic scheme, and the number of cases according to the degrees of physical disability. Results: Over this period, 725 cases were confirmed as leprosy, 70% in the years 2016, 2017 and 2018. Of the total number of cases, 88% were Multibacillary form of the disease, 50% had some degree of disability at diagnosis time and 80% underwent the standard treatment regimen. Conclusion: There is a delay in leprosy diagnosis, and there is underdiagnosis of the disease in the state of Rio Grande do Sul: which highlights the need to reaffirm educational practices on mycobacteriosis.(AU)

Justificativa e objetivos: A hanseníase é uma doença infectocontagiosa na qual o diagnóstico precoce é fator decisivo para prevenir incapacidade e deficiências. O presente estudo buscou analisar o panorama da hanseníase entre os anos de 2016 e 2021 no estado do Rio Grande do Sul, desvelando a importância da educação médica no contexto das Doenças Tropicais Negligenciadas durante a pandemia da Sars-CoV-2. Métodos: Estudo transversal por meio da base de dados do Centro Estadual de Vigilância em Saúde do Rio Grande do Sul. Na coleta de dados, foram incluídos os dados de hanseníase em indivíduos residentes do estado do Rio Grande do Sul (RS), no período de 2016 a 2021. As variáveis analisadas foram os casos confirmados de hanseníase, os casos notificados, o número de casos quanto às classificações operacionais de hanseníase, o esquema terapêutico e o número de casos de acordo com os graus de incapacidade física. Resultados: No período analisado, foram confirmados 725 casos de hanseníase, sendo 70% nos anos de 2016, 2017 e 2018. Do número total de casos, 88% eram a forma multibacilar da doença, 50% apresentaram algum grau de incapacidade física no momento do diagnóstico e 80% realizaram o esquema terapêutico padrão. Conclusão: Existe atraso no diagnóstico de hanseníase e há subdiagnóstico da doença no estado do Rio Grande do Sul, o que evidencia a necessidade de reafirmação das práticas educacionais sobre a micobacteriose.(AU)

Justificación y objetivos: La lepra es una enfermedad infecciosa en la que el diagnóstico precoz es un factor decisivo para prevenir la incapacidad y las discapacidades. Este estudio buscó analizar el panorama de la lepra entre 2016 y 2021 en el estado de Rio Grande do Sul y develar la importancia de la educación médica en el contexto de las Enfermedades Tropicales Desatendidas durante la pandemia Sars-CoV-2. Métodos: Estudio transversal con datos del Centro Estatal de Vigilancia en Salud de Rio Grande do Sul. La recolección de datos incluyó datos sobre lepra en individuos residentes en el estado de Rio Grande do Sul (RS), de 2016 a 2021. Las variables analizadas fueron casos confirmados de lepra, casos notificados, el número de casos en términos de clasificaciones operativas de lepra, el esquema terapéutico y el número de casos según los grados de discapacidad física. Resultados: En el período analizado se confirmaron 725 casos de lepra, 70% en los años 2016, 2017 y 2018. Del total de casos, 88% fueron la forma multibacilar de la enfermedad, 50% tenían algún grado de discapacidad física en el momento del diagnóstico y el 80% realizó el régimen terapéutico padrón. Conclusiones: Hay un retraso en el diagnóstico de la lepra y hay un infradiagnóstico de la enfermedad en el estado de Rio Grande do Sul: lo que pone de relieve la necesidad de reafirmar las prácticas educativas sobre micobacteriosis.(AU)

Percepción de la formación y perspectiva laboral de la especialidad de Endocrinología y Nutrición entre residentes de último año

Resumen Introducción El modelo de especialización médica en España se realiza a través de la formación sanitaria especializada, mediante el sistema médico interno residente (MIR). El objetivo del estudio es analizar, con una encuesta anónima, la percepción de tres aspectos entre los MIR de último año de Endocrinología y Nutrición (EyN): autoevaluación de conocimientos adquiridos, futuro laboral, consecuencias asistenciales y formativas derivadas de la pandemia COVID-19. Materiales y métodos Estudio observacional transversal tipo encuesta online, voluntaria y anónima, distribuida entre los MIR de último año de EyN a nivel nacional, realizada en junio y julio de 2021. Resultados Se han obtenido 51 respuestas, el 66% de los MIR de cuarto año. La percepción global de sus conocimientos es 7,8 sobre 10. La mayoría de las rotaciones externas han sido en las áreas de tiroides y nutrición. El 96,1% de los residentes han desarrollado alguna actividad relacionada con la pandemia, con un deterioro formativo calificado de 6,9 sobre 10. El 88,2% han cancelado sus rotaciones, ampliando su jornada laboral el 74,5%. Un 80,4% querrían continuar trabajando en el hospital donde se han formado, siguiendo un 45,1%. El 56,7% tienen un contrato inferior a 6 meses, ejerciendo mayoritariamente Endocrinología. Conclusión La percepción de los conocimientos adquiridos durante la formación es de un notable. Los residentes consideran que la pandemia ha supuesto un empeoramiento formativo generando un impacto emocional negativo. La perspectiva laboral tras finalizar la residencia se resume en temporalidad, ejercicio de Endocrinología y movilidad interhospitalaria. Introduction The medical specialisation model in Spain is carried out in the context of specialised health training, through the residency programme. The aim of the study is to analyse, by an anonymous survey, the opinion on three aspects among final-year residents in Endocrinology and Nutrition (E&N): self-assessment of the knowledge acquired, working prospects, care and training consequences arising from the pandemic COVID-19. Materials and methods Cross-sectional observational study using a voluntary and anonymous online survey, shared among final-year national interns in the last year of the E&N programme, carried out between June-July 2021. Results 51 responses were obtained, 66% of the fourth-year residents. Overall perception of their knowledge was 7.8 out of 10. Most external rotations were in thyroid and nutrition areas. A total of 96.1% residents, carried out some activity associated with COVID-19, with a training deterioration of 6.9 out of 10. 88.2% cancelled their rotations and 74.5% extended their working schedule. The average negative emotional impact was 7.3 out of 10. 80.4% would like to continue in their training hospital, remaining 45.1%. 56.7% have an employment contract of less than 6 months, most of them practising Endocrinology. Conclusion The perception of the knowledge acquired during the training period is a “B”. Residents consider that the pandemic has led to a worsening of their training, generating a negative emotional impact. Employment outlook after completing the residency can be summarised as: temporality, practice of Endocrinology and interhospital mobility.

COMPETENCIAS ESENCIALES EN LA FORMACIÓN DE RESIDENTES ¿QUÉ NOS HA ENSEÑADO LA PANDEMIA POR COVID-19?

Resumen Durante la pandemia por COVID-19 los residentes han desarrollado competencias relevantes en situaciones críticas como el trabajo en equipo, el profesionalismo y la comunicación. Afrontar la nueva enfermedad supuso un contexto de aprendizaje inédito que hizo necesarias nuevas competencias. Siguiendo el modelo de Competencias-Cruces 2008 adaptado, analizamos los aspectos más relevantes del aprendizaje de los residentes en los dominios del citado modelo. Abordamos el cuidado de los pacientes hospitalizados por equipos multidisciplinares, el uso de la telemedicina para reducir el contacto físico en pacientes ambulatorios, la comunicación a distancia, el desarrollo de los métodos de enseñanza online y la simulación para compensar el déficit en el aprendizaje de técnicas. La toma de decisiones en un sistema sanitario con recursos escasos y los conflictos éticos derivados de ello ha hecho priorizar el bien común sobre otros principios. Competencias como la gestión de la información, la investigación y la seguridad del paciente se vieron especialmente afectadas por la toma de decisiones basadas en escasa evidencia. Finalmente, se revisa el autoaprendizaje del residente que durante la pandemia se canalizó a través de la formación remota cuyo futuro pasa por una mayor estructuración y fundamentalmente complementando a la formación presencial. During COVID-19 pandemic, residents developed essential competencies for critical situations, such as teamwork, professionalism and communication. Facing the new disease led to an unprecedented learning context in which new competencies were needed. Through this study, we analyzed the most relevant aspects of residents' learning during the pandemic with the competencies-based Cruces 2008 model. We address inpatient care by multidisciplinary teams, the use of telemedicine to reduce physical contact and the development of online teaching methods and simulation to compensate for the deficit in other learning techniques. Decision-making in a resource-poor setting and its ethical conflicts taught the residents to prioritize the common good over other principles. Competencies such as information management, scientific research and patient safety were particularly affected by low evidence-based decision-making. Furthermore, the self-learning of the residents was reviewed through remote training. This new method requires better structuring and should be used as a complement to face-to-face training in the near future.

Virtual meetings on morbidity and mortality in Colombia: An exploratory study / Reuniones virtuales de morbilidad y mortalidad en Colombia: un estudio exploratorio

Resumen Introducción: la pandemia por la Covid-19 modificó la educación médica con estrategias apoyadas en plataformas virtuales y en escenarios no convencionales. Un ejemplo de ello son las reuniones de morbilidad y mortalidad (M y M). El objetivo de este estudio es describir las características de las M y M virtuales en las instituciones de práctica de los residentes de cirugía general en Colombia; así como la percepción de los participantes sobre su funcionamiento, comparado con las M y M presenciales o tradicionales. Método: estudio observacional y descriptivo realizado en 21 instituciones hospitalarias de práctica, de 17 programas de cirugía general de Colombia en donde operan M y M virtuales. Se obtuvo información sobre sus objetivos, características operativas y alcances. Con encuestas autodiligenciadas se investigó, además, la percepción de los participantes acerca de su utilidad y funcionamiento, producto del cambio a la virtualidad. Participaron 82 residentes y 65 docentes de diferentes programas de posgrado de cirugía general del país. Resultados: las M y M virtuales se ejecutan en el 53 % de los sitios de práctica de los residentes de Colombia, con el predominio en las instituciones privadas. Si bien hay diferencias en su organización, persiste el modelo tradicional de M y M: objetivos, estructura y alcances. Hay una duración mayor de las reuniones, se realizan en horarios no convencionales, con una percepción de un menor nivel académico. Se respira un menor ambiente de hostilidad con el uso de la virtualidad. Conclusión: las reuniones de morbilidad y mortalidad se realizan en un escenario de virtualidad. Su funcionamiento es similar a las reuniones presenciales y su ejecución ofrece oportunidades de mejora en términos de forma y fondo.

Summary Introduction: The Covid-19 pandemic changed medical education, with strategies supported by virtual platforms and non-conventional scenarios. An example of this is the morbidity and mortality meetings (M&M). The objective of this study is to find the characteristics of virtual M&M meetings in different institutions focused on general surgery resident´s students in Colombia, and how medical residents and professors feel about them compared to the traditional face-to-face meetings. Methodology: This is an observational, and descriptive study in 21 hospital practice institutions of 17 General Surgery programs in Colombia, where virtual M&M operate. Information was obtained on their objectives, operational characteristics and scope. Additionally, in self-completion surveys, the participants' perception about the usefulness and operation was investigated, this, because of the shift to virtuality. There was participation of 82 residents and 65 professors from different postgraduate programs in General Surgery in the country. Results: Virtual M&Ms continue in 53 % of the practice sites, with a predominance in private institutions. There are differences in their organization, although the traditional M&M model persists: objectives, structure, and scope. There is a longer duration of meetings, unconventional schedules and the perception of a reduced academic level. There is an improvement in the hostile environment, within the virtuality. Conclusion: M&Ms have a place in a virtual scenario. Its operation is like face-to-face meetings, and its execution offers opportunities for improvement in terms of form and content.

How the COVID-19 pandemic has affected the training of Endocrinology and Nutrition Residents. Results of a survey by the Spanish Society of Endocrinology and Nutrition.

INTRODUCTION: COVID-19 disease has become a priority for our healthcare system. The resident physicians training in endocrinology and nutrition (E&N residents) have been integrated into the COVID-19 teams. This study has been designed with the aim of analysing the educational, occupational and health impact on E&N residents. MATERIAL AND METHODS: Cross-sectional observational study via a web survey, aimed at E&N residents who are members of the SEEN, carried out in November 2020. The following data were analysed: demographic variables, number of beds in the training hospital, alteration of rotations, integration in COVID-19 teams, participation in telemedicine, scientific activity and impact on physical and emotional health. RESULTS: 87 responses were obtained (27% of all E&N residents), 67.8% women, 28.1 ±â€¯1.8 years, 60% 4th year E&N residents. 84% participated in COVID-19 teams and 93% in the telemedicine consultations of their service. Most have had their rotations interrupted. 97.7% have participated in scientific meetings or virtual congresses and a third of them have collaborated in scientific work on COVID-19 in relation to endocrinology and nutrition. Overall, 75.8% think the pandemic has affected their mood a lot or quite a lot, and 73.8% think that the pandemic has negatively impacted their training. CONCLUSIONS: The SARS-CoV-2 pandemic has compromised the training, work activity and health of E&N residents. They have been integrated both in COVID-19 teams and in the restructured activity of their departments. However, they have managed to continue their training in virtual format and have participated in scientific work.

The need for changes in medical education and the perception of teachers before the Covid-19 pandemic / Necessidade de mudanças na educação médica e a percepção de professores antes da pandemia da Covid-19 / Necesidad de cambios en la educación médica y la percepción de profesores antes de la pandemia de Covid-19

Este estudo objetiva analisar questões da educação médica evidenciadas pelas medidas de distanciamento social provocadas pela pandemia do coronavírus19 associadas às percepções de professores de medicina sobre esses mesmos aspectos, em um momento prévio à eclosão da crise sanitária. Realizamos um recorte de resultados de uma pesquisa de natureza qualitativa e conduzimos a discussão com base na triangulação de dados entre observações de campo e entrevistas com professores. A pandemia reacendeu debates sobre a relevância de conteúdos, a utilização de tecnologias digitais para fins pedagógicos e o valor do trabalho colaborativo. Além disso, resgatou questões que envolvem habilidades de comunicação e a saúde de estudantes nas práticas do cuidado. Discutiremos a experiência passada articulando-a às experiências recentes e o que poderemos recolher para (re)construirmos os rumos da formação dos médicos.(AU)

El objetivo de este estudio es analizar cuestiones de la educación médica puestas en evidencia por las medidas de distancia social adoptadas por la pandemia del coronavirus 19, asociadas a las percepciones de profesores de medicina sobres esos mismos aspectos, en un momento previo a la eclosión de la crisis sanitaria. Realizamos un recorte de resultados de una investigación de naturaleza cualitativa y dirigimos la discusión a partir de la triangulación de datos entre observaciones de campo y entrevistas con profesores. La pandemia reencendió debates sobre la relevancia de contenidos, la utilización de tecnologías digitales para fines pedagógicos y el valor del trabajo colaborativo. Además, rescató cuestiones que envuelven habilidades de comunicación y la salud de estudiantes en las prácticas del cuidado. Discutiremos la experiencia pasada articulándola con las experiencias recientes y lo que podremos recoger para (re)construir los rumbos de formación de los médicos.(AU)

This study aims to analyze medical education issues evidenced by the measures of social distancing due to the coronavirus pandemic19, associated with the perceptions of medical professors about these same aspects, in a moment prior to the outbreak of the health crisis. We focused in the results of a qualitative research and conducted a discussion based on the triangulation of data between field observations and interviews with professors. The pandemic has rekindled debates about the relevance of contents, the use of digital technologies for educational purposes and the value of collaborative work. Additionally, it provoked the emergence of issues involving communication skills and the health of students in care practices. We discuss past experiences articulating them with recent experiences and what we can collect to (re)build the direction of medical training.(AU)

[Impact of the Covid-19 pandemic on specialized healthcare training in a teaching center]. / Impacto de la pandemia COVID-19 en la formación sanitaria especializada en un centro docente.

OBJECTIVE: Evaluation of the impact of the health crisis caused by the Covid-19 pandemic on specialized healthcare training in a teaching center. METHODS: Cross-sectional descriptive study, by means of an electronic questionnaire sent to 167 residents in June 2020, to evaluate the burden of care, suspension of rotations and Covid-19 symptoms. The impact on the acquisition of professional competencies was measured using a four-level Likert scale (none, a little, quiet, a lot). The profile of acquired competencies was constructed and its association with the professional profile was studied using Generalized Linear Models. The qualitative approach was carried out through an open question on how it influenced their learning and the different categories were extracted through triangulation. RESULTS: The impact on learning was important for 94.8% of the residents. A total of 81.4% left the rotations they were doing and reported high workload, loss of training opportunities, uncertainty and ethical conflicts. They appreciated significant learning in the competencies of teamwork (93.2%), professionalism (86.2%), ethics (79.9%) and communication (78%). Technical competencies were deficient. The final balance of learning was perceived as positive by 54.4%, especially residents in central services and medical specialties. A total of 67.8% felt overwhelmed at times due to fatigue-emotional impact, care overload, ethical conflicts and lack of resources. CONCLUSIONS: The Covid-19 pandemic had an exceptional impact on specialized health care training. It is necessary to re-evaluate training programs to ensure the acquisition of the technical competencies that are lacking.

New clinical anatomical interpretation of COVID-19 pandemic infection / Nueva interpretación anatómica y clínica de la infección pandémica COVID-19

SUMMARY: Sever acute respiratory syndrome SARS-CoV-2 which is coronavirus disease-2019. It is transmitted by droplet transmission and other methods such aerosols transmission and faecal-oral transmission. The clinical features of Sever acute respiratory syndrome SARS-CoV-2 are fever, cough, dyspnea and gastrointestinal symptoms which present based on affected organ. The current study is anatomical study and provide interpretation of transmission and clinical features as well as the clinical investigation. Further, current study explains complication of coronavirus disease-2019. With explanation of COVID-19 which includes spread clinical features and investigations as well as the consequences by using anatomical clarification result in the intensification of understanding infection and provide high quality in teaching and medical services in future. Therefore, the new disease is a start to learn basic and clinical skills to encourage scientist and physician to improve medical education.

RESUMEN: El síndrome respiratorio agudo grave (SARS CoV-2) es una enfermedad por coronavirus-2019. Se transmite por transmisión de gotitas y otros métodos como la transmisión por aerosoles y la transmisión fecal-oral. Las características clínicas del síndrome respiratorio agudo severo SARS-CoV-2 son fiebre, tos, disnea y síntomas gastrointestinales y se presentan según el órgano afectado. El reporte actual es un estudio anatómico y proporciona una interpretación de la transmisión y las características clínicas, así como la investigación clínica. Además, el estudio explica la complicación de la enfermedad por COVID-19, que incluye las características clínicas y las investigaciones difundidas, así como las consecuencias. Mediante la aclaración anatómica, se profundiza la comprensión de la infección y se proporciona una alta calidad en la enseñanza y los servicios médicos en el futuro. Por lo tanto, la nueva enfermedad es un comienzo para aprender habilidades básicas y clínicas para alentar a los científicos y médicos a mejorar la educación médica.

Opportunities in the teaching of medical specialties, regarding influenza and COVID-19.

Medical specialties' teaching is an area of health systems that deserves special consideration in light of the lessons learned from influenza and COVID-19; educational programs and implementation of the training strategies that are used must be reevaluated, since the level of training of most specialty students does not allow to consider them as personnel who can face these global problems. The number of specialization courses has exponentially grown, and their main threat is the cancellation or partial execution of their academic programs as a consequence of not implementing functional operational strategies during a contingency.

La enseñanza en las especialidades médicas es un rubro de los sistemas de salud que merece consideraciones especiales de acuerdo con las lecciones aprendidas de la influenza y COVID-19. Deben reevaluarse los programas educativos y las estrategias de capacitación implementadas, ya que la preparación escolar de la mayoría de los alumnos no les permite ser considerados como personal que pueda enfrentar esos problemas globales. Los cursos de especialización han crecido en número, pero su principal amenaza es la suspensión de los programas académicos o que sean parcialmente cubiertos como consecuencia de no implementar estrategias operativas funcionales durante una contingencia.