ABSTRACT
Una de las competencias en la Medicina Familiar y Comunitaria es la atención a la patología urgente, ya sea en el ámbito hospitalario o extrahospitalario. El programa de la especialidad así lo recoge y la formación de los profesionales de Medicina Familiar y Comunitaria se establece de forma muy polivalente y capacita para la atención en todas las etapas de la vida. Es muy relevante la necesidad de formación cualificada y polivalente en el ámbito rural por la intensa variabilidad de situaciones que hay que resolver. Para analizar esa polivalencia en el ámbito de la Atención Primaria frente a la urgencia, se diseñó un cuestionario, que se difundió entre nuestros socios y socias a través de internet, mediante el que se pretendía recoger las diferencias y las oportunidades de mejora para las/los profesionales. La encuesta de este estudio transversal se difundió a través de las sociedades federadas de la Sociedad Española de Medicina Familiar y Comunitaria (semFYC) y se obtuvieron datos del 88% del territorio. Aunque la muestra evaluada es pequeña, se concluye que el 92% cree que es positivo poder trabajar en ambos ámbitos, ya que aporta seguridad y mejor manejo del paciente más allá del entorno donde se desarrolle la atención.(AU)
One of the skills in family and community medicine is care of emergency pathology, whether in the hospital or out-of-hospital setting. The specialty programme includes this and family and community medicine professional training is set out in a very versatile way and enables care at all stages of life. The need for qualified and versatile training in rural areas is especially relevant due to the intense variability of situations to be tackled. To analyze this versatility in the field of primary versus emergency care, an online questionnaire was devised to be disseminated among our members over the Internet. By means of this questionnaire it was intended to collate the differences and opportunities for professional improvement. The survey of this cross-sectional study was disseminated by means of the Federated Societies of the Spanish Society of Family and Community Medicine and data were obtained from 88% of Spain. Although the sample evaluated is small, it is concluded that 92% believe that it is positive to be able to work in both areas, since it provides security and better management of the patient beyond the setting where she was treated.(AU)
Subject(s)
Humans , Male , Female , Family Practice/education , Staff Development , Primary Health Care , Emergency Medical Services , Surveys and QuestionnairesABSTRACT
OBJETIVO: Evaluar la validez, aceptabilidad e impacto en el nivel de conocimientos y de habilidades de profesionales sanitarios de Atención Primaria de un modelo formativo para mejorar la atención del paciente crítico. DISEÑO: Estudio multicéntrico de intervención cuasiexperimental. Emplazamiento: En 8 equipos de Barcelona. PARTICIPANTES: En total 272 profesionales. INTERVENCIONES: Programa formativo con 48 simulacros de infarto agudo de miocardio (IAM) y de ictus. Mediciones principales: Con una checklist se evaluaron las habilidades en el abordaje del paciente crítico, el efecto de la formación en los conocimientos de los participantes y la satisfacción. La formación se realizó tras 2 series de simulacros (infarto agudo de miocardio+ictus). En la segunda serie se efectuaron 3evaluaciones: in situ, una semana después y a las 3 semanas. Se analizó la concordancia y la fiabilidad. Las diferencias de medias se analizaron mediante la t de Student para datos emparejados. RESULTADOS: Se respondieron 449 tests de conocimientos; la mayor puntuación se obtuvo al finalizar cada simulacro (3,89 [DE 1,01] vs. 3,21 [DE 1,09]). Obtuvieron mejores puntuaciones los médicos que las enfermeras (3,81 [DE 0,87] vs. 3,32 [DE 1,15]), y los profesionales con la especialidad finalizada que los MIR (3,6 [DE 1,08] vs. [DE 1,18]). La puntuación media de la checklist en la primera evaluación fue de 7,7 puntos (DE 1,56), que mejoró hasta llegar a 9,1 puntos (DE 0,78). El índice kappa fue mayor de 0,40 en todos los casos. CONCLUSIONES: Una metodología formativa para manejar urgencias en Atención Primaria con simulacros es válida, fiable y bien aceptada. Mejora el nivel de conocimientos y habilidades de los profesionales participantes
OBJECTIVE: To evaluate the validity, acceptability, and impact on the level of knowledge and skills of Primary Care health professionals of a training model aimed at improving the care of critical patients. DESIGN: A quasi-experimental interventional, multicentre study. LOCATION: Eight health care teams in Barcelona. PARTICIPANTS: A total of 272 professionals. INTERVENTIONS: A training program consisting of 48 simulations of acute myocardial infarction and stroke. MAIN MEASUREMENTS: A checklist was used to evaluate critical patient skills, effect of training on the knowledge of the participants, and a satisfaction survey. The training was carried out after 2 series of simulations (AMI+Stroke). In the second series, 3 evaluations were made: in situ, one week after, and at 3 weeks. Concordance and reliability were measured. The differences in means were analysed using the Student t test for paired data. RESULTS: A total of 449 knowledge tests were answered, with a higher score being obtained at the end of each simulation (3.89 -SD 1.01 vs. 3.21 -SD 1.09). Doctors obtained better medical scores than nurses (3.81 - SD 0.87 vs. 3.32 - SD 1.15), and professionals with a specialty completed scored more than those in training (MIR) (3.6 - SD 1.08 vs. 3.4 - SD 1.18). The mean score was 7.7 points (SD 1.56) in the first evaluation, and improved to 9.1 points (SD 0.78). The kappa index was greater than 0.40 in all cases. CONCLUSIONS: A training methodology in the management of emergencies in Primary Care based on simulations is valid, reliable and well accepted, achieving an improvement in the level of knowledge and skills of the participating professionals
Subject(s)
Humans , Male , Female , Adult , Critical Care/methods , Emergency Medical Services , Primary Health Care , Critical Illness/therapy , Health Personnel/education , Simulation Exercise , 35156ABSTRACT
OBJECTIVE: To evaluate the validity, acceptability, and impact on the level of knowledge and skills of Primary Care health professionals of a training model aimed at improving the care of critical patients. DESIGN: A quasi-experimental interventional, multicentre study. LOCATION: Eight health care teams in Barcelona. PARTICIPANTS: A total of 272 professionals. INTERVENTIONS: A training program consisting of 48 simulations of acute myocardial infarction and stroke. MAIN MEASUREMENTS: A checklist was used to evaluate critical patient skills, effect of training on the knowledge of the participants, and a satisfaction survey. The training was carried out after 2 series of simulations (AMI+Stroke). In the second series, 3evaluations were made: in situ, one week after, and at 3weeks. Concordance and reliability were measured. The differences in means were analysed using the Student t test for paired data. RESULTS: A total of 449 knowledge tests were answered, with a higher score being obtained at the end of each simulation (3.89 -SD 1.01 vs. 3.21 -SD 1.09). Doctors obtained better medical scores than nurses (3.81 - SD 0.87 vs. 3.32 - SD 1.15), and professionals with a specialty completed scored more than those in training (MIR) (3.6 - SD 1.08 vs. 3.4 - SD 1.18). The mean score was 7.7 points (SD 1.56) in the first evaluation, and improved to 9.1 points (SD 0.78). The kappa index was greater than 0.40 in all cases. CONCLUSIONS: A training methodology in the management of emergencies in Primary Care based on simulations is valid, reliable and well accepted, achieving an improvement in the level of knowledge and skills of the participating professionals.
