Situación actual de la formación sanitaria especializada en pediatría y sus áreas específicas: retos y necesidades / Current situation of Specialized Health Training in pediatrics and its specific areas: challenges and needs

El desarrollo de las subespecialidades pediátricas constituye uno de los hechos más destacados de la pediatría de nuestro país desde mediados del siglo XX. La formación sanitaria especializada (FSE) en pediatría está actualmente basada en la orden SCO/3148/2006, de 20 de septiembre, por la que se aprueba y publica el programa formativo de la especialidad de pediatría y sus áreas específicas. Es un programa formativo estructurado en cuatro años que consigue formar al residente en las competencias necesarias de la pediatría, incluyendo la formación en unas competencias transversales, una formación en pediatría general y debe incluir además la formación en las diferentes áreas específicas. En 1995, el Consejo Nacional de Especialidades Médicas aprueba el concepto de área de capacitación específica (ACE). En Pediatría las ACE son necesarias para garantizar una adecuada asistencia sanitaria a la población infanto-juvenil, al mismo nivel que la medicina del adulto, asegurando mediante una formación reglada, una asistencia de calidad y uniforme. Se trata de dar un reconocimiento oficial a lo que hoy en día es una realidad asistencial en los hospitales españoles, en cualquier Comunidad Autónoma. (AU)

The development of pediatric subspecialties constitutes one of the most outstanding events in pediatrics in our country since the mid-20th century. The specialized health training (SHT) in pediatrics is currently based on order SCO/3148/2006, of September 20, which approves and publishes the training program for the specialty of pediatrics and its specific areas. It is a training program structured in 4 years that manages to train the resident in the necessary skills of pediatrics, including training in transversal skills, training in general pediatrics and must also include training in different specific areas. In 1995 was approved the specific training area (STA). In pediatrics, STAs are necessary to guarantee adequate health care for the child and adolescent population, at the same level as adult medicine, ensuring through regulated training, quality and uniform care. We want to give official recognition to what today is a healthcare reality in all the Spanish hospitals. (AU)

Current situation of Specialized Health Training in pediatrics and its specific areas: Challenges and needs.

The development of pediatric subspecialties constitutes one of the most outstanding events in pediatrics in our country since the mid-20th century. The FSE in pediatrics is currently based on order SCO/3148/2006, of September 20, which approves and publishes the training program for the specialty of pediatrics and its Specific Areas. It is a training program structured in 4 years that manages to train the resident in the necessary skills of pediatrics, including training in transversal skills, training in general pediatrics and must also include training in different specific areas. In 1995 was approved the Specific Training Area (ACE). In pediatrics, ACEs are necessary to guarantee adequate health care for the child and adolescent population, at the same level as adult medicine, ensuring through regulated training, quality and uniform care. We want to give official recognition to what today is a healthcare reality in all the Spanish hospitals.

Medical School Location and Sex Affect the In-State Retention of Pediatric Residency Program Graduates in Hawai'i.

The objective of this study was to assess the impact of medical school, sex, career choice, and location of practice of one pediatric residency program on physician workforce. This is a retrospective study of all categorical pediatric graduates of a residency program located in Honolulu, Hawai'i from 1968 to 2015. Information on medical school training, sex, career choice (general pediatrics or specialty), and location of practice were studied by examining data into five 10-year graduation periods. The program graduated 319 residents over nearly a 50-year timespan. Of these, 181 (56.7%) residents remained in Hawai'i to practice (adjusted odds ratio [OR] = 7.46, 95% confidence interval [CI]: 3.61-15.43). There were 125 (39.1%) graduates who relocated to the continental US with the majority moving to the West (55.2%), while other graduates moved to the South, Midwest, and Northeast (25.6%, 13.6%, and 5.6%, respectively). The remaining 13 (4.1%) graduates moved internationally. Female residents steadily increased over time (P < .001), with females significantly choosing general pediatrics (OR = 3.05, 95% CI: 1.91-4.89). In the time periods with the highest percentage of University of Hawai'i medical school graduates, there was an increased percentage of graduates staying in Hawai'i. This study examined the regional and national impact of a small residency program. The results indicated that trends in gender and the impact of medical school location were important in establishing a pediatrician workforce for local communities. Support of both medical school and residency education should be considered when assessing future workforce needs.

Assessing the Association Between Maternal Education and Access to Pediatric Specialty Care.

Background. Timely access to pediatric specialty care continues to be a pervasive issue. We aimed to identify factors associated with unmet pediatric specialty care needs by assessing the association with maternal level of education. Methods. A sample was extracted from the 2011-2012 National Survey of Children's Health, which identified a subset of patients with unmet specialty care needs. Logistic regression models determined the strength of association between our sample and maternal level of education. Results. An estimated 12.5% of US children had unmet specialty care needs. Independent of confounding variables, children with mothers educated at a level of high school or less were 41% more likely to have unmet specialty care needs compared to those with mothers who were educated at a level greater than high school. Conclusions. Maternal level of education can be used as a risk factor to assess whether a child will have unmet specialty care needs.

Pharmacy quality improvement project to enhance the medication management process in pediatric patients.

BACKGROUND: Improvement in the quality of the medication management process is a crucial component of twenty-first-century medicine. AIM: To improve the quality of medication management process within pediatric specialty through designing a quality improvement project for the pharmaceutical care services in a children' hospital to solve the drug-related problems during drug prescribing, administration, and monitoring. METHODS: A total of 900 medical files were evaluated (100 file/month) from the pediatric medical ward to detect any medication errors during prescribing, administration, or monitoring of the drugs. Three pharmacy quality indicators were designed to detect any medication errors during prescribing, administration, or monitoring of the drugs, then a collective datasheet was designed to record any defect in the system during drug management process within the hospital. A quality improvement project was designed using many quality improvement techniques to decrease the rates of medication errors in each drug handling stage. Brainstorming, fishbone chart, questionnaire, and voting were the main quality tools used to detect the causes of medication errors problem in pediatric patients. Certain actions were implemented which included educational program, implementation of clinical pharmacy, intravenous admixture, and drug information services. RESULTS: The quality improvement interventions succeeded in decreasing the rates of medication errors in each stage. These interventions succeeded in decreasing the rates of medication errors in prescribing, administration, and monitoring stages from 47, 60, and 56% respectively to ≤ 15% within 9 months. CONCLUSION: Pharmacists can have a key role in improving the health-care system's quality in developing countries' health-care systems.