[How can continuing education in general and visceral surgery be organized in a hospital performing basic and regular care?] / Wie organisiere ich die Weiterbildung in der Allgemein- und Viszeralchirurgie in einem Krankenhaus der Grund- und Regelversorgung?

Recruitment of the next generation in surgery is more important than ever. Patients must be able to rely on the fact that the care provided by a hospital is safeguarded by sufficient medical personnel with the correct levels of qualification. Continuing education is an important pillar in this respect. This necessitates the engagement of the medical leadership and personnel to invest in the new medical generation. The readiness for continuing education must be financially borne by the provider. Continuing education in general and visceral surgery in a hospital responsible for basic and routine care is also essential in the future in order to guarantee a broad spectrum of care in Germany. The new continuing education regulations and the planned hospital reformation will make this more difficult; therefore, clever concepts are necessary.

Bridging the Gap Between Competencies and Uncertainties in Postgraduate Training in Family Medicine: Results and Psychometric Properties of a Self-Assessment Questionnaire.

Purpose: One of the reasons for postgraduate trainees not to choose working in a rural area is uncertainty related to the lack of competencies. The aim of this study was to investigate the concept of uncertainty by measuring competencies and to examine the psychometric properties of an instrument that measures competencies related to uncertainty in the self-assessment of postgraduate trainees in family medicine. Patients and Methods: A questionnaire was created based on pre-existing instruments. It was distributed to participants of postgraduate training seminars in the federal states of Baden-Württemberg and Schleswig-Holstein, Germany in 2016. Descriptive statistics and a partial correlation analysis were calculated for measuring the degree of association between year of postgraduate training and items' responses. Psychometric properties were assessed by calculating descriptive item analysis, factor analysis and internal consistency. Results: The response rate was 85% (105/124). More than one-fifth of the participants stated to show only seldom or sometimes the following skills: ability to balance work and life (N=25, 24%), letting a mild disorder run its own way (N=24, 23%) and ability to conduct interventions that decreased aggression from the patient (N=22, 21%). More than half of the participants felt (very) insecure in performing routine child check-ups, the application of a below elbow backslab and the partial removal of a toenail. Nine out of 21 items showed positive statistically significant correlation between level of competence and progress in training. Factor analysis led to a final instrument with 12 items (Cronbach's α=0.736) and a three-factor-structure: "doctor well-being and resilience", "communication" and "skills". Conclusion: In order to reduce uncertainty with all its consequences, a focus on teaching of competencies regarding the physicians' well-being and resilience, communication and skills has to be continued in postgraduate training.

Estructura conceptual de la competencia intervención comunitaria desde el paradigma emancipador de autodesarrollo / Conceptual structure of community intervention competence from the emancipatory paradigm of self-development

RESUMEN Objetivo: El artículo que se presenta aporta como resultado científico la descripción de la estructura conceptual de la competencia intervención comunitaria desde el paradigma emancipador de autodesarrollo para su formación en el contexto universitario. Métodos: Los métodos del nivel teórico empleados fueron el histórico-lógico, analítico-sintético, inductivo-deductivo, sistémico-estructural-funcional y del nivel empírico, el análisis de documentos. Resultado: A partir de la sistematización teórica realizada resultó posible develar las particularidades de la competencia objeto de análisis que apuntan hacia su identificación. Se determinaron los problemas contextuales a los que da solución, los ejes procesuales que de ella se derivan, los criterios de desempeño y las evidencias requeridas. Además se proponen niveles y patrones de logro que facilitan su formación y evaluación por cada uno de sus ejes procesuales, constituyendo un valioso instrumento para el trabajo metodológico. Conclusión: La investigación constituye un antecedente teórico necesario para sustentar un modelo pedagógico conducente a la formación de la competencia intervención comunitaria como expresión de la pertinencia social de la universidad y calidad del desempeño profesional en este ámbito.

ABSTRACT Objective: The article that is presented provides as a scientific result the description of the conceptual structure of community intervention competence from the emancipatory paradigm of self-development for its training in the university context. Method: The theoretical level methods used were the historical-logical, analytical-synthetic, inductive-deductive, systemic-structural-functional and the empirical level, the analysis of documents. Results: From the theoretical systematization carried out, it was possible to reveal the particularities of the competence under analysis that point towards its identification. The contextual problems to which it gives a solution, the procedural axes that derive from it, the performance criteria and the required evidence were determined. In addition, levels and patterns of achievement are proposed that facilitate their formation and evaluation for each of their process axes, constituting a valuable instrument for methodological work. Conclusion: The research constitutes a necessary theoretical background to support a pedagogical model conducive to the formation of community intervention competence as an expression of the social relevance of the university and the quality of professional performance in this field.

Controle da dor por meio da educação, pesquisa, assistência e gerência de enfermagem / Pain control through education, research and nursing care and management

Relatar a experiência do processo de implantação do controle da dor por meio da educação, pesquisa, assistência e gerenciamento de enfermagem. Estudo realizado em um Hospital Privado em 2010/2011 com curso de 100 horas teórico-práticas em 7 meses, o qual capacitou enfermeiros na temática dor e propiciou a realização de estudos frente ao tema - situações problemas nos diversos cenários da Instituição. obteve-se a formatura de 41 expertises em dor e 16 Trabalhos de Conclusão que pontuaram aspectos distintos e complexos que encontram-se em fase de implementação nas unidades. A capacitação dos enfermeiros realizou-se no tempo previsto e a avaliação dos discentes mostrou 98% de satisfação com o curso (muito bom e ótimo); identificou-se situações problemas e medidas intervencionistas foram realizadas integrando ações de pesquisa, gerência, educação em serviço e assistência. Espera-se que a divulgação desses achados possam ser replicados e contribuam com a qualidade da assistência e controle da dor.