ABSTRACT
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Subject(s)
Humans , Male , Female , Biopsy, Fine-Needle/methods , Biopsy, Fine-Needle , Foreign Bodies/surgery , Foreign Bodies , Dementia/complications , Dementia/diagnosis , Foreign Bodies/complications , Foreign Bodies/diagnosis , Neurosurgery/standardsABSTRACT
La formación de los residentes es una labor apasionante y muy exigente, para la que los tutores necesitamos formación y contar con herramientas adecuadas. Una de ellas es la entrevista estructurada, que puede apoyarse en el concepto de feedback (retorno de información sobre el proceso de aprendizaje del residente de acuerdo con unos objetivos preestablecidos). El feedback estructurado y centrado en quien aprende es una técnica de aprendizaje adulto caracterizada por la autorreflexión del estudiante, la preparación previa de las entrevistas y la relación de confianza tutor-residente. Para su aplicación es muy útil el establecimiento de entrevistas periódicas y estructuradas, usando un guión que las facilite. Y hay algo más. Esta entrevista presenta múltiples retos para el tutor y el residente, ya que requiere una adaptación continua entre ambos, se debe procurar que haya empatía y debe ser un estímulo continuo para incentivar, impulsar e ilusionar (AU)
Training residents is a task that is both exciting and demanding for which tutors need appropriate training and tools. One of the tools that have been developed is the structured interview, which is based on providing residents with feedback about the learning process according to pre-established goals. Structured feedback focused on the learner is an adult learning technique characterized by the student's self-reflection, preparation for the interviews, and relationship of trust between the tutor and the resident. Periodic structured interviews using a script are very useful. But there is something more. An interview poses multiple challenges for the tutor and for the resident, because both parts must continuously adapt. It is important to create a climate of empathy and ensure that the interview motivates, stimulates, and inspires the resident (AU)
Subject(s)
Humans , Male , Female , Internship and Residency/classification , Internship and Residency/ethics , Internship and Residency/statistics & numerical data , Education, Medical/methods , Education, Medical/trends , Training Support/organization & administration , Training Support/standards , Education, Medical/ethics , Education, Medical/organization & administration , Education, Medical/standards , Competency-Based Education/organization & administration , Competency-Based Education/standards , Education/methods , Training Support/methods , Training Support/trendsABSTRACT
Training residents is a task that is both exciting and demanding for which tutors need appropriate training and tools. One of the tools that have been developed is the structured interview, which is based on providing residents with feedback about the learning process according to pre-established goals. Structured feedback focused on the learner is an adult learning technique characterized by the student's self-reflection, preparation for the interviews, and relationship of trust between the tutor and the resident. Periodic structured interviews using a script are very useful. But there is something more. An interview poses multiple challenges for the tutor and for the resident, because both parts must continuously adapt. It is important to create a climate of empathy and ensure that the interview motivates, stimulates, and inspires the resident.
Subject(s)
Internship and Residency , Interprofessional Relations , Interviews as Topic/methods , Mentors , FeedbackABSTRACT
Objetivo: evaluar prospectivamente la relación entre frecuencia cardíaca y calidad de imagen, y determinar el intervalo de reconstrucción óptimo para las arterias coronarias en estudios de tomografía computarizada de doble fuente (TCDF). Material y métodos: se analizaron 28 sujetos consecutivos en que se realizó coronariografía mediante TCDF (Somatom Definition, Siemens). Las imágenes se reconstruyeron a lo largo del ciclo cardíaco en intervalos del 5% R-R. Dos observadores independientes evaluaron la calidad diagnóstica de las imágenes para las arterias coronarias (izquierda, circunfleja y derecha) (1=no evaluable; 4=calidad excelente). Resultados: la frecuencia cardíaca media de los pacientes fue 73,1±14,8lpm (rango, 49107lpm). En el mejor intervalo de reconstrucción se obtuvo excelente calidad de imagen (4 puntos) en el 98,8% (83/84) de las arterias coronarias. La concordancia interobservador para la puntuación de calidad de imagen y selección del intervalo de reconstrucción óptimo fue muy buena (k=0,77 y k=0,86). La puntuación media de calidad para todo el árbol coronario fue 2,84±0,31. No se observó correlación entre la frecuencia cardíaca media y la calidad de la imagen de las arterias coronarias (r=0,108). No hubo diferencias estadísticamente significativas al comparar la calidad de imagen obtenida en las reconstrucciones sistólicas y diastólicas en cada paciente. Conclusiones: la TCDF permite obtener coronariografías de excelente calidad diagnóstica independientemente de la frecuencia cardíaca. Las reconstrucciones se pueden realizar tanto en sístole como en diástole sin que hayan diferencias estadísticamente significativas en la calidad, incluso con frecuencias cardíacas elevadase (AU)
Objective: To evaluate the effect of average heart rate on the quality of images of the coronary arteries and to determine the optimal reconstruction interval in nonselected patients undergoing DSCT coronary imaging. Materials and methods: We studied 28 consecutive subjects (26 men, 2 women; mean age 60±12 years) undergoing contrast-enhanced DSCT (Somatom Definition, Siemens) coronary angiography. Data sets were reconstructed in 5% steps from 30% to 80% of the R-R interval. Two blinded independent readers assessed the image quality of the whole coronary tree and of each coronary artery using a four-point scale (1: impossible to evaluate, 4: excellent quality). Results: Mean heart rate during scanning was 73.1±14.8bpm (range, 49107bpm). In the best reconstruction interval, excellent diagnostic image quality (score 4) was achieved for 98.8% (83/84) of coronary arteries. Very good interobserver agreement was observed for image quality rating (k=0.77) and for selection of the optimal reconstruction interval (k=0.86). Mean image quality score for the whole coronary tree was 2.84±0.31. No significant correlation was found between the average heart rate and the mean quality scores (r=0.108). No significant differences were found in the quality of images of the coronary arteries in systolic and diastolic reconstructions in each patient. Conclusions: DSCT makes it possible to obtain excellent coronary angiograms independent of the heart rate. Reconstructions can be obtained in either the diastolic or systolic phase without significant differences in image quality, even at high heart rates (AU)
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , /instrumentation , Heart Rate , Coronary Vessels , Clinical Protocols , Hyperlipidemias/complications , Hyperlipidemias , Informed Consent , AngiographyABSTRACT
OBJECTIVE: To evaluate the effect of average heart rate on the quality of images of the coronary arteries and to determine the optimal reconstruction interval in nonselected patients undergoing DSCT coronary imaging. MATERIALS AND METHODS: We studied 28 consecutive subjects (26 men, 2 women; mean age 60+/-12 years) undergoing contrast-enhanced DSCT (Somatom Definition, Siemens) coronary angiography. Data sets were reconstructed in 5% steps from 30% to 80% of the R-R interval. Two blinded independent readers assessed the image quality of the whole coronary tree and of each coronary artery using a four-point scale (1: impossible to evaluate, 4: excellent quality). RESULTS: Mean heart rate during scanning was 73.1+/-14.8 bpm (range, 49-107 bpm). In the best reconstruction interval, excellent diagnostic image quality (score 4) was achieved for 98.8% (83/84) of coronary arteries. Very good interobserver agreement was observed for image quality rating (kappa=0.77) and for selection of the optimal reconstruction interval (kappa=0.86). Mean image quality score for the whole coronary tree was 2.84+/-0.31. No significant correlation was found between the average heart rate and the mean quality scores (r=0.108). No significant differences were found in the quality of images of the coronary arteries in systolic and diastolic reconstructions in each patient. CONCLUSIONS: DSCT makes it possible to obtain excellent coronary angiograms independent of the heart rate. Reconstructions can be obtained in either the diastolic or systolic phase without significant differences in image quality, even at high heart rates.