Modelo del especialista en Medicina Intensiva y Emergencias por competencias profesionales / A model of the intensive care and emergency medicine specialist based on professional competences

Introducción: el desempeño profesional del especialista en medicina intensiva y emergencia en la actualidad está dado por el incremento del perfil ocupacional y los escenarios laborales, que provoca el desarrollo de funciones y competencias profesionales diferentes a las del currículo. Objetivo: diseñar un modelo del especialista en medicina intensiva y emergencia que contribuyan a su desempeño en los servicios, en correspondencia con el perfil profesional actual de la especialidad en Cuba. Métodos: investigación de desarrollo, prospectiva y propositiva que se efectuó sobre la base de funciones y competencias identificadas en estudios anteriores. Se utilizaron indagaciones teóricas y empíricas, mediante grupo de discusión y método Delphi con expertos seleccionados. Resultados: se definieron las características y principios en el modelo propuesto, se sustentaron en fundamentos de varias ciencias, se identificaron sus relaciones internas y externas; se evidencian relaciones entre las actividades de formación, el cumplimiento de funciones y competencias profesionales con su desempeño en los servicios. El modelo posee carácter sistémico, flexible, permite ser modificado en función de la solución de problemas ante las necesidades de la sociedad. Promueve transformaciones en el comportamiento de residentes y especialistas. Se valida teóricamente por dos grupos de expertos. Conclusiones: se diseña un modelo científico del especialista en medicina intensiva y emergencia por competencias profesionales que contribuye al perfeccionamiento del perfil profesional, la educación en el trabajo, la integración docente-asistencial-investigativa, la educación tutorial del residente, a estimular la educación continuada posgraduada y a lograr un mejor desempeño en los servicios(AU)

Introduction: The current professional performance of the intensive care and emergency medicine specialist is given by the broadening of the occupational profile and working settings, which causes the development of functions and professional competences different from those in the curriculum. Objective: To design a model of the intensive care and emergency medicine specialist that contributes to the performance at services, in correspondence with the current professional profile of such specialty in Cuba. Methods: Developmental, prospective and propositive research carried out upon the base of functions and competences identified in previous studies. We used theoretical and empirical insights, through discussion group and the Delphi method with selected experts. Results: The characteristics and principles were defined in the proposed model. They were based on foundations given by several sciences. Their internal and external relations were identified. We perceived relationships between the training activities, the fulfillment of professional functions, and the competences with their performance in services. The model has a systemic, flexible character, allows to be modified according to the solution of problems considering the needs of the society. It promotes transformations in the behavior of residents and specialists. It is theoretically validated by two groups of experts. Conclusions: A scientific model of the intensive care and emergency medicine specialist is designed, based upon professional competences, and which contributes to the improvement of the professional profile, education at work, the integration of teaching, care delivery and investigation, and the tutor-related education of the resident, in order to stimulate ongoing postgraduate education and to achieve a better performance at services(AU)

Identificación y normalización de las competencias profesionales específicas del especialista en Medicina Intensiva y Emergencia / Identification and standardization of specific profesional competencies of the intensive and emergency medicine specialist

Introducción: la calidad de la formación y de la práctica médica es expresión del nivel de competencias alcanzado por sus profesionales. La especialidad de Medicina Intensiva y Emergencia (MIE) en Cuba no ha definido sus competencias profesionales. Objetivo: establecer las bases teórico-metodológicas que sustenten la identificación y normalización de las competencias profesionales del especialista en MIE. Métodos: investigación de desarrollo en la que se aplican métodos teóricos y empíricos, y fundamentalmente técnicas cualitativas. Resultados: se definió la utilización de una metodología mixta basada en el análisis ocupacional funcional a partir de las funciones claves y específicas identificadas en estudio anterior. Se delimitaron los criterios de selección de los profesionales que integran los grupos de expertos que continuarán su trabajo en la investigación. Se expresa la primera aproximación a la identificación de los elementos y unidades de competencias pertenecientes al área de competencias asistenciales del médico intensivista. Se definen las bases para la normalización de las competencias identificadas y se ejemplificó su despliegue en una ficha de normalización, que se convierte en una norma o estándar para la especialidad. Conclusiones: se establecen las bases metodológicas para la identificación y normalización de las competencias profesionales del especialista en MIE. Se presentan los primeros resultados en la identificación y normalización de las competencias asistenciales del intensivista cubano, que deberá continuar con la participación activa de otros grupos de expertos y destacados profesores de la especialidade.

Introduction: the quality of medical formation and practice expresses the level of competencies attained by the health professionals. The professional competencies of the intensive and emergency medicine in Cuba have not been so far defined. Objectives: to set the theoretical and methodological basis supporting the identification and standardization of professional competencies in the intensive and emergency medicine specialist. Methods: developmental research that applies theoretical and empirical methods, mainly the qualitative techniques. Results: the use of a combined methodology, based on the functional occupational analysis covering the key specific functions identified in a previous study, was defined. The selection criteria of professionals who are members of the expert groups were also specified. There was expressed the first approach to identification of elements and units of competencies within the area of assistance competencies of the intensive physician. The basis for standardization of the set competencies were defined along with their exemplification in a standardization index that turns into a standard for this specialty. Conclusions: the methodological basis for identification and standardization of professional competencies of intensive and emergency specialist are set. The first results of the identification and standardization of assistance competencies of the Cuban intensive medicine expert are presented. This research work will be continued with the active involvement of other groups of experts and outstanding professors in this specialty.

Hospital social workers in Saudi Arabia: characteristics and functions.

Social work practitioners are important members of the health care team and the hospital sector has been a traditional employer of social workers. Social work practitioners have become increasingly involved in hospital work as a result of the growing recognition of the important link between the biophysical aspects of health and the surrounding psychosocial circumstances, which require multidisciplinary interventions and demand the involvement of specialized social work personnel to deal with such issues. The article has been carried out in order to contribute to the literature by exploring to see if the characteristics and functions of contemporary professional social workers (who practice in the health sector in western Saudi Arabia) are achieving best practice.

An Investigation on Evaluation Structure of the Patient for Ingestion Instruction in Community Pharmacies / 医薬品情報学

<b>Objective: </b>Many studies on patient satisfaction are conducted in community pharmacies.  In contrast, the present study assess the community pharmacy function and to the best of our knowledge, appears to be the first to evaluate the professional functions of pharmacists.<br><b>Methods: </b>In September 2010, in 1 week, we conducted a survey that focused on pharmacists’ professional abilities.  I subjected the responses to factor analysis and covariance structure analysis.<br><b>Results: </b>We obtained 2,506 effective responses (appropriately completed and returned questionnaires) of the 4,633 questionnaires originally distributed.  Data of seven dimensions were obtained for factor analysis.  In all, the various information provision services rendered by a pharmacist were not significant.  According to the covariance structure analysis, “safety” (a pharmaceutical management item) and “responsiveness” (a complimentary element) were significant factors.  Differences in the degree of influence were confirmed for each parameter in the analysis, depending on the parameter.  In addition, the information provision services were significant during the acute period.<br><b>Conclusion: </b>Because the information provision services were not significant, the influence of “asymmetric information” warrant further analysis according to the specialty.  I believe that it is necessary to examine asymmetric information in greater detail in the future.  In addition, I think that an interventional study that is based on these results is also necessary.

What is the role of the pharmacist? Physicians' and nurses' perspectives in community and hospital settings of Santiago de Cuba

This study was carried out to understand the perceptions and expectations of the other health care professionals about pharmacists' role in primary health care centers and hospitals in Santiago de Cuba (Cuba). A cross-sectional descriptive study was conducted, applying a self-administered questionnaire to health care professionals. The sample included 763 professionals (40.9% physicians and 59.1 % nurses) from hospitals and primary health care clinics, chosen by random stratified sampling,. The most common activity performed by pharmacists was the distribution of medications or the drug supply management (51.5 percent) and adverse drug reactions reporting (29.4 percent), activities performed daily by pharmacists. Pharmaceutical care practice was considered as poor by the professionals, and only 15.6 percent of them have collaborated in these programs in the past. For nurses and physicians, interprofessional communication occurs sometimes (56.9%) and never (25.8 percent). Pharmacists' integration into the health team was considered as fair (50.7 percent). A total of 70.1 percent perceived the pharmacist as a drug expert and 60.1 percent as a professional who provides medication counseling. The main expectations these health care professionals expressed were that pharmacists provide more education about medication (97.4 percent) and improve their interprofessional communication techniques in order to communicate more effectively with the other members of the health care team (96.6 percent)(AU)

O presente trabalho analisa o papel do farmacêutico na atenção primária de saúde e em hospitais, na percepção de profissionais da saúde na província de Santiago de Cuba. Um estudo descritivo transversal foi conduzido, através da aplicação de um questionário autoadministrado a uma amostra de 763 profissionais de atenção primária e hospitalar, 40,9 por cento de médicos e 59,1 por cento de enfermeiros. As funções farmacêuticas mais reconhecidas pelos profissionais desta amostra foram o fornecimento e distribuição de medicamentos (51,5 por cento) e o relato de reações adversas medicamentosas (29,4 por cento), funções desenvolvidas diariamente. A prática da atenção farmacêutica é limitada na percepção dos profissionais e apenas 15,6 por cento têm participado em programas desse tipo. Comunicação interprofissional ocorre às vezes (56,9 por cento) e nunca (25,8 por cento), com maiores dificuldades na atenção primária de saúde. A integração do farmacêutico na equipe de saúde foi considerada regular (50,7 por cento). Um total de 70,1 por cento dos profissionais percebeu o farmacêutico como especialista em medicamentos e 64,1 por cento como o profissional que aconselha sobre o uso de medicamentos. As principais expectativas colocam-se na necessidade de que o farmacêutico ofereça educação sobre o uso de medicamentos (97,4 por cento) e reforce as suas técnicas da comunicação na equipe multidisciplinar (96,6 por cento).