Ibero-American consensus on learning outcomes for the acquisition of competencies by medical students through clinical simulation.

OBJECTIVE: Our aim was to reach expert consensus on specific learning outcomes (LOs) that can be achieved through clinical simulation aimed at developing the competencies that medical students need to be able to successfully manage patients and assume general clinical responsibilities. MATERIALS AND METHODS: The six-member scientific committee peer-reviewed Spanish reference documentation (in line with the Bologna Process) on required competencies in medical undergraduate students to select an initial set of 16 competencies that could feasibly be developed through simulation and a corresponding set of 75 LOs. Snowball sampling was used to identify candidates for an international panel of simulation experts. Applying a set of pre-defined criteria, 19 panelists from seven Spanish-speaking regions were recruited to participate in a modified two-round Delphi procedure based on electronic questionnaires and aimed at reaching formal consensus on appropriate LOs for simulated medical training. RESULTS: Final agreement between the panelists was high: no mean score fell below 7.26 of a maximum of 9, and all 75 LOs were agreed on, 74 in the first round and only one requiring the second round. The 16 LOs with mean scores in the top 25th percentile were selected as a set of core LOs to attain via simulation. CONCLUSIONS: This Ibero-American consensus on observable and measurable LOs, reflecting competencies that can feasibly be developed via clinical simulation, is a framework that aims at helping medical schools' plans and delivering specific kinds of undergraduate medical training through simulation. It is also proposed in a set of core LOs as a starting point for less experienced schools to design a simulated training program.

[Primary Care research: attitudes and hindrances perceived by our doctors]. / Investigación en atención primaria: actitud y dificultades percibidas por nuestros médicos.

OBJECTIVES: To discover how much research doctors in our area do; to describe their attitudes to research; and to evaluate the hindrances to developing research that they found. DESIGN: Cross-sectional, descriptive study. SETTING: Area 7 of Primary Care, Madrid. PARTICIPANTS: Area 7 doctors. MAIN MEASUREMENTS: An anonymous self-administered questionnaire was designed in order to gather the following information: age, gender, professional details, training in research methodology, research activity, questions from a previously validated questionnaire for finding attitudes towards research (scores from 0 to 80), and a question for assigning a value to 6 hindrances to research. RESULTS: 174 were returned (49.4% response). 65.9% of the doctors were women, with an average age of 43.23+/-7.33 years; and 55.5% were specialists in Family and Community Medicine. Over the last 5 years, 49.4% had published a scientific paper and 38% had given reports at congresses. The mean score on attitudes to research was 53.49+/-10.59. Hindrances to research were given in the following order, from greatest to least: case-load, lack of time, structural deficiencies, absence of multi-centred research lines, lack of incentives, lack of training, no motivation. CONCLUSIONS: The research activity of our doctors is similar to that found in other studies. Attitude to research is no better than "acceptable." The main hindrances stated were: case-load and lack of time.

Investigación en atención primaria: actitud y dificultades percibidas por nuestros médicos / Primary Care Research: Attitudes and hindrances perceived by our doctors

Objetivo. Conocer de forma cuantitativa la actividad investigadora de los médicos de nuestra área, describir su actitud hacia la investigación y valorar las dificultades encontradas para el desarrollo de la investigación. Diseño. Estudio descriptivo transversal. Emplazamiento. Área 7 de atención primaria de Madrid. Participantes. Médicos del Área 7. Mediciones principales. Se diseñó un cuestionario anónimo autoadministrado en el que se recogieron la edad, el sexo, los datos profesionales, la formación en metodología de investigación, la actividad investigadora, las preguntas de un cuestionario previamente validado para conocer la actitud hacia la investigación (puntuación entre 0 y 80) y una pregunta con 6 dificultades para realizar actividades investigadoras para asignar un valor. Resultados. Se recibieron 174 cuestionarios (49,4% de respuestas). El 65,9% de los que respondieron fue mujer, con una edad media de 43,23 ± 7,33 años, y el 55,5% era especialista en medicina familiar y comunitaria (MFyC). En los últimos 5 años, el 49,4% había publicado un trabajo científico y el 38% había presentado comunicaciones a congresos. La media de la actitud hacia la investigación fue 53,49 ± 10,59. Las dificultades para la investigación a las que otorga un mayor valor fueron, en orden decreciente, la presión asistencial, la escasez de tiempo, las deficiencias estructurales, la ausencia de líneas de investigación multicéntricas, la falta de incentivación y preparación, y la ausencia de motivación. Conclusiones. La actividad investigadora de nuestros médicos es semejante a la de otros estudios. La actitud hacia la investigación es sólo aceptable. Las principales dificultades declaradas son la presión asistencial y la escasez de tiempo (AU)

Objectives. To discover how much research doctors in our area do; to describe their attitudes to research; and to evaluate the hindrances to developing research that they found. Design. Cross-sectional, descriptive study. Setting. Area 7 of Primary Care, Madrid. Participants. Area 7 doctors. Main measurements. An anonymous self-administered questionnaire was designed in order to gather the following information: age, gender, professional details, training in research methodology, research activity, questions from a previously validated questionnaire for finding attitudes towards research (scores from 0 to 80), and a question for assigning a value to 6 hindrances to research. Results. 174 were returned (49.4% response). 65.9% of the doctors were women, with an average age of 43.23±7.33 years; and 55.5% were specialists in Family and Community Medicine. Over the last 5 years, 49.4% had published a scientific paper and 38% had given reports at congresses. The mean score on attitudes to research was 53.49±10.59. Hindrances to research were given in the following order, from greatest to least: case-load, lack of time, structural deficiencies, absence of multi-centred research lines, lack of incentives, lack of training, no motivation. Conclusions. The research activity of our doctors is similar to that found in other studies. Attitude to research is no better than "acceptable." The main hindrances stated were: case-load and lack of time (AU)

[How are the patients informed at a hospital emergency service?]. / Cómo se informa a los pacientes en un servicio de urgencias hospitalario?

OBJECTIVE: To evaluate the clarity and efficacy of the information given to patients by doctors, in the hospital emergency ward (HEW) and the influence of accompanying people on such information. DESIGN: Descriptive transverse study. SETTING: HEW of the Hospital General of Segovia. PATIENTS AND OTHER PARTICIPANTS: 171 patients seen at the HEW between July and September of 1993. MEASUREMENTS AND MAIN RESULTS: An oral questionnaire consisting on 15 items including: age, sex and sociocultural profile of the patient, presence of a companion, knowledge the doctor's identity, oral information recived during the stay and oral and written recommendations at the time of discharge, was used. The report of discharge delivered to the patient was used for contrast. Only 20 patients (11.7%) knew the name of the doctor who attended them; a statistically significant difference (p > 0.01) was found in favour of those who were accompanied. In spite of the fact that 97.6% of the patients said that they had received a clear information and that 88.9% of them did referred to have no doubts, only 71.9% of them were able to repeat correctly the treatment recommended at the time of discharge. A 50% of the patients were able to read and understand the written report, while 19% of them did not understand it and another 20% considered it illegible. CONCLUSIONS: In order to guarantee the patient's compliance with recommendations given at the time of discharge of a HEW, it is necessary to improve oral and written information given to them, relying on the presence of a companion and checking their assimilation.