Disinfection of flexible fibre-optic endoscopes out-of-hours: confidential telephone survey of ENT units in England - 20 years on.

BACKGROUND: Flexible upper aerodigestive endoscopy is often performed in the emergency setting. To prevent nosocomial infection on-call clinicians must have access to decontaminated endoscopes. METHODS: A telephone survey of 104 ENT units in England replicated previous cycles conducted 10 and 20 years ago. The on-call clinician was asked about decontamination practices, training and cross-cover. RESULTS: Seventy-one clinicians participated of which 68 had an endoscope available out-of-hours. Twenty-five (36.8 per cent) used single-use endoscopes. Twenty-three (51.1 per cent) of the 45 clinicians using re-usable endoscopes decontaminated them themselves, an increase from 43.3 per cent in 2013 and from 35.1 per cent in 2002. Overall 91.2 per cent had safe practices, up from 68.7 per cent in 2013 and 48 per cent in 2002. One hundred per cent had been trained in decontamination, compared to 37.3 per cent in 2013 and 12.1 per cent in 2002. On-call clinicians from the ENT department increased to 91.5 per cent, compared to 63 per cent in 2013. CONCLUSION: There has been a dramatic increase in patient safety, underpinned by the introduction of single-use endoscopes, increased training and reduced cross-cover.

The impact and the challenges of implementing a faculty development program on health professions education in a Brazilian Medical School: a case study with mixed methods.

PURPOSE: Faculty development in health professions education is still challenging in developing countries like Brazil. Work overload and the lack of financial support hinder faculty members' participation. Ribeirão Preto Medical School founded its Center for Faculty Development in 2016. Since then, an essential skills module (ESMo) on health professions education (HPE) has been offered regularly to faculty members and preceptors of seven undergraduate programs. This case study aims to evaluate the impact of this Essential Skills Module on the educational practices of participants two years after attending the module and the challenges faced during the process. METHOD: The study used a mixed-method approach with a description of the demographic and professional profile data of the ESMo participants. Immediate post-ESMo perceptions (satisfaction and learning) of the participants were determined with structured instruments. Two years later, a semi-structured interview was conducted and recorded to determine the long-term effects (application of learning and behavior changing as an educator). NVIVO® software was used to store and systematize the thematic discourse analysis with a socio-constructivist theoretical framework interpretation. RESULTS: One hundred forty-six participants were included: 86 (59%) tenured faculty members, 49 (33,5%) clinical preceptors, and 11 (7,5%) invited teachers. Most were female (66%), and 56% had teaching experience shorter than ten years. 52 (69%) out of 75 eligible participants were interviewed. The immediate reaction to participating in the module was quite positive and 80% have already implemented an educational intervention in their daily activities. Discourses thematic analysis showed five emerging themes appearing in different frequencies: Changes in teaching activities (98%); Lack of previous pedagogical training (92.3%); Commitment and enthusiasm towards teaching (46.15%); Overlapping functions inside the institution (34.6%) and Challenges for student assessment (23%). CONCLUSION: This first in-depth evaluation of the long-term effects of a faculty development intervention in a Brazilian Health Profession Education school showed that participation positively changed participants' teaching & learning practices. These interventions consistently fostered a community of practice and valued faculty development processes in local and national scenarios.

Otisma: an integrated application and humanoid robot as an educational tool for children with autism.

Autistic children have difficulty communicating wants, needs, and thoughts. In cases of low functioning autism, an individual can have serious speech and language disabilities. In response to the need of parents and therapists dealing with autistic children, social robots have been developed and incorporated into assisting children with autism. Research studies have proved the possibility of improving autistic children's lives using social robots. However, not any social robot can successfully fulfil this task, since autistic children are sensitive to certain behaviours, shapes, and colours. The proposed integrated application and humanoid robot, Otisma has been designed and developed after an intensive literature research. Otisma can be used as an educational and communicational tool with autistic children. Otisma aids educators by using applied behaviour analysis (ABA) which is a scientifically validated method that helps autistic children work through areas of severe developmental delay, like language and nonverbal communication. Different lessons can be explored using an application that is controlled by the therapist. Otisma is an efficient educational tool that facilitates the learning process to maximise social skills for children with autism. Otisma is portable, affordable, user friendly, and can be equally used by therapists in clinics or parents at home.

Overcoming Cough and Angioedema: Advocating for the Use of ARBs Over ACE Inhibitors.

Angiotensin II receptor blockers (ARBs) and angiotensin-converting enzyme (ACE) inhibitors have comparable efficacy, but ARBs have a preferential safety profile with particular regard to cough and angioedema. Although guidelines have historically advocated for ACE inhibitor use before ARBs simply because of earlier market entry, data accumulation, and generic availability, updated verbiage advises an "ACE inhibitor or ARB" recommendation, as opposed to the classic "ACE inhibitor then ARB" approach. Despite these updates, clinical inertia in favor of ACE inhibitor use before ARBs overwhelmingly remains. Prescribers and educators should consider an "ARBs only" mentality, especially in high angioedema-risk groups such as black patients.

The Evolution of Drug Information Services to Asynchronous Delivery of Pharmacist eConsults.

Drug information (DI) services provided an avenue to expand the role of pharmacists as the medication experts. The focus of DI has shifted from general questions submitted to DI centers to patient-specific questions that optimize care. One method to increase access to pharmacist expertise is through pharmacy eConsults. Pharmacy eConsults provide specialist care for medically complex patients using a patient-centered, asynchronous approach. The purpose of this article is to describe the evolution of consults from formal drug information services and describe one academic medical center's implementation of a pharmacy eConsult service to provide patient-specific DI.

Práticas corporais de aventura como conteúdo nas aulas de Educação Física do IFPB / Adventure bodily practices as content in the IFPB Physical Education classrooms / Prácticas corporales de aventura como contenido en las aulas de Educación Física de la IFPB

Objetivou-se analisar a presença das Práticas Corporais de Aventura (PCA's) enquanto conteúdo nos planos de ensino da Educação Física no Instituto Federal da Paraíba ­ IFPB. Trata-se de uma pesquisa qualitativa, baseada na análise documental. Os dados foram compostos por meio de busca eletrônica em sites oficiais do IFPB que possibilitou analisar 129 planos da disciplina Educação Física. Os resultados apontam que as PCA's constituem conteúdo pouco ofertado nas aulas de Educação Física, visto que identificou-se a ausência deste conteúdo em alguns campi, a oferta do referido tema em apenas um momento do curso ou somente em séries iniciais, dispondo apenas dois campi com o conteúdo em quase todo o ensino médio. Conclui-se que as PCA's necessitam ser inseridas nos planos de ensino, uma vez que há inúmeras possibilidades de aplicação deste conteúdo. Sugere-se a realização de formações continuadas afim de ampliar as possibilidades de aplicabilidade destes conteúdos na escola.

The objective is to analyze the presence of adventure corporal practices (ACP's) as content in our physical education plans at the Federal Institute of Paraíba- IFPB. It is a qualitative research, based on documentary analysis. The data were composed by means of electronic searches on official IFPB websites that made it possible to analyze 129 plans of the discipline of physical education.  The results indicate that the (ACP's) constitute a little- offered contended in the physical education classrooms, in view of the fact that the absence of this contended in some college campus was identified. The offer of this topic in just one moment of the course or only in initial series, having only in two university camps with the content in almost the entire secondary education. It is concluded that the (ACP's) need to be included in the teaching plans, since there are innumerable possibilities of application of this content. It is suggested that continuous training should be carried out in order to expand the possibilities of applicability of this content in the school.

El objetivo es analizar la presencia de las practicas corporales de aventura (PCA's) como contenido en nuestro planes de enseñanza de educación física en el Instituto Federal da Paraíba ­ IFPB.  Se trata de una investigación cualitativa, basada en análisis documental. Los datos fueron compuestos por medio de búsquedas electrónicas en sitios web oficiales del IFPB que hizo posible analizar 129 planes de la disciplina de educación física.  Los resultados apuntan que las (PCA's) constituyen un contendió poco ofertado en las aulas de educación física, en vista que se identifico la ausencia de este contendió en algunos campos, la oferta del referido tema en apenas un momento del curso o solamente en series iniciales, disponiendo tan solo dos campos con el contenido en casi toda la enseñanza media. Se concluye que las (PCA's) necesitan ser incluidas en los planes de enseñanza, ya que existen innumerables posibilidades de aplicación de este contenido. Se sugiere la realización de formaciones continuas afín de ampliar las posibilidades de aplicabilidad de este contenido en la escuela.

Extravasation of Noncytotoxic Drugs.

Objective: Commonly used drugs may be dangerous in case of extravasation. The lack of information from health care teams can lead to delays in both diagnosis and treatments. This review aims at alerting health care professionals about drugs and risk factors for extravasation and outlines recommendations for the diagnosis and treatment of extravasation. Data Source: A literature search of MEDLINE/PubMed, Scopus, the Cochrane Library, and Google Scholar was performed from 2000 to December 2019 using the following terms: extravasation, central venous line, peripheral venous line, irritant, and vesicant. Study Selection and Data Extraction: Overall, 140 articles dealing with drug extravasation were considered potentially relevant. Each article was critically appraised independently by 2 authors, leading to the inclusion of 80 relevant studies, guidelines, and reviews. Articles discussing incidents of extravasation in the neonatal and pediatric population of patients were excluded. Data Synthesis: Training of health care teams and writing care protocols are important for an optimal management of extravasations. A prompt consultation should be achieved by a specialist surgeon. The surgical procedure, if necessary, will consist of wound debridement followed by an abundant lavage. Relevance to Patient Care and Clinical Practice: This review discusses the management of drug extravasations according to their mechanism(s) of toxicity on tissues. It highlights the importance of a close monitoring of patients and the training of health care teams likely to face this type of adverse event. Conclusions: Extravasations still contribute to significant morbidity and mortality. A good knowledge of risk factors and the implementation of easily and quickly accessible standardized care protocols are 2 key elements in both prevention and treatment of extravasations.

El uso de sistemas de evaluación formativa y compartida en las aulas de educación física en educación primaria / The use of formative and shared assessment systems in physical education classrooms in primary education / O uso de sistemas de avaliação formativa e compartilhada nas aulas de educação física em educação primária

Objetivo: establecer si maestros de educación física utilizan sistemas de Evaluación Formativa y Compartida en sus aulas, y observar las ventajas e inconvenientes que supone la implementación de este tipo de evaluación. Método: estudio con diseño de metodología mixta. Se seleccionó una muestra a conveniencia de 17 maestros. Como instrumentos para la obtención de datos se aplicó un cuestionario cerrado con escala tipo Likert y se realizaron entrevistas semi-estructuradas. Resultados y conclusión: se encontró que los docentes sí utilizan sistemas de Evaluación Formativa y Compartida en el aula, y consideran que la ventaja fundamental es que el alumnado se hace consciente y mejora su proceso de enseñanza aprendizaje. Como inconveniente principal, los maestros destacan la carga de trabajo que supone, tanto para el profesorado, como para el alumnado.

Objective: To establish if physical education teachers use formative and shared assessment systems in their classrooms, and to observe the advantages and disadvantages of using this type of assessment. Method: Study with mixed methodology design. A sample of 17 teachers was selected at the convenience. As instruments for obtaining data, a closed questionnaire with a Likert-type scale was applied, and semi-structured interviews were carried out. Results and Conclusion: It was found that teachers do use formative and shared assessment systems in their classrooms, and they consider that the fundamental advantage is that students become aware and improve their teaching-learning process. As the principal disadvantage, teachers highlight the workload that it entails for both, teachers and students.

Objetivo: estabelecer se os professores de educação física usam sistemas de avaliação formativa e compartilhada nas aulas, bem como observar as vantagens e desvantagens que supõe este tipo de avaliação. Método: estudo com desenho de uma metodologia mista. Selecionou-se uma amostra por conveniência de 17 professores. Nessa metodologia foram usados como instrumentos de recolha de dados: um questionário fechado com escala tipo Likert e entrevistas semiestruturadas. Resultados e conclusão: evidenciou-se que os professores usam sistemas de avaliação formativa e compartilhada nas suas aulas e consideram que sua vantagem principal é que os alunos são conscientes e melhoram o seu processo de ensino-aprendizagem. Como principal desvantagem, os professores destacam o volume de trabalho que isso implica tanto para os professores quanto para os alunos.

El feedback como clave de la evaluación formativa. Un estudio de casos en el Prácticum de educación física. / Feedback as a key to formative assessment. A case study in the physical education practicum / O feedback como chave para a avaliação formativa. Um estudo de caso no prácticum de educação física

Objetivo: analizar la comunicación no verbal centrada en el estudio del feedback o retroalimentación en el ámbito de la educación primaria, buscando mejorar la práctica docente. Método: investigación a partir de la acción, tipo estudio de caso, mediante observación a la práctica docente de una estudiante de formación inicial del profesorado de educación física, con un grupo alumnos de 4º grado de educación primaria. La observadora (maestra cooperante) registró en una ficha de control sus valoraciones, y se elaboró un informe con base en sus anotaciones y reflexiones sobre cada sesión, incluyendo posibles mejoras para las siguientes. Para procesar la información se usó el software ATLAS.ti. Resultados: el empleo del feedback en el aula, tanto en número como en tipología, fue incrementando durante el desarrollo de la unidad didáctica. Conclusión: existe una relación entre el tipo de feedback aplicado y el contenido impartido, aunque mayormente predomina el de tipo correctivo.

Objective: To review non-verbal communication focused on the study of feedback in primary education, to improve teaching practice. Method: Research from the action, case study type, by observing the teaching practice of a student of initial teaching training in physical education, with a group of 4th-grade primary school students. The observer (cooperating teacher) recorded her evaluations on a control sheet, and a report based on her notes and reflections on each session was prepared, including possible improvements for the following ones. ATLAS.ti software was used to process the information. Results: The use of feedback in the classroom, both in number and typology, increased during the development of the teaching unit. Conclusion: There is a relationship between the type of feedback applied and the content taught, although the corrective type predominates.

Objetivo: analisar a comunicação não verbal centrada no estudo do feedback ou retroalimentação no âmbito da educação primária, no intuito de melhorar a prática docente. Método: investigação-ação, tipo estudo de caso, através da observação do estágio docente de uma estudante de formação inicial de professorado com um grupo de alunos de 4º de educação primária. A observadora (professora assistente) registrou suas valorações num relatório, feito a posteriori com as respetivas notas e reflexões sobre cada sessão, incluindo possíveis melhorias para as sessões seguintes. Para sistematizar as informações usou-se o software ATLAS.ti. Resultados: o uso do feedback na sala de aula foi aumentando tanto em número quanto em tipologia, à medida que o tempo de desenvolvimento da unidade didática avançava. Conclusão: comprovamos que, apesar de ter havido uma predominância de feedback corretivo, existe uma relação entre o tipo de feedback aplicado e o respetivo conteúdo de ensino.

Effectiveness of peer-assisted-learning model in teaching physical examination in Otorhinolaryngology to clerks and postgraduate interns

Background and Objective@#Peer-assisted learning (PAL) is an established concept in which students obtain mutual benefits by teaching and learning from each other. In the clinical environment, this often occurs intentionally or unintentionally in various formats such as same level or cross level peer tutoring, peer mentoring, cooperative learning and the like. This study determined the effectiveness of Peer Assisted Learning in achieving identified program outcomes in the curriculum for clerks and postgraduate interns rotating in Otorhinolaryngology specialty. @*Methodology@#Study has 2 parts. Part 1 was a one-group pre-test and post-test design that involved teaching training of 16 PGI to be peer tutors in Otorhinolaryngology Physical Examination (ORL PE) to clerks. Video recorded pre-training baseline and post-training actual skills demonstrations of the PGI were rated. Scores were compared using Wilcoxon Signed Ranks test with p value at 5% level of significance. Part 2 was a randomized controlled single-blind trial of Peer-Led vs. Expert Faculty-Led ORL PE training of 55 clerks. Tutees performed a post training video-recorded skills demonstration assessed by a faculty rater who was blinded as to who among the clerks underwent the PAL-Led or Expert Faculty-Led training. Scores of the tutees in the 2 models of instruction were compared using the Mann-Whitney U-test at 5% level of significance. @*Results@#Part 1 results showed significant improvement in the post-training scores of the 16 PGI in the identified micro skills and ORL PE skills. For Part 2, 33 and 22 clerks underwent PAL-Led and Expert Faculty-Led instruction respectively. Comparison of performance scores of the clerks in the 2 models of instruction showed no significant difference. @*Conclusion@#Teaching training for PGI improved their knowledge, skills and attitude in teaching ORL PE skills to clerks. There was no significant difference in the performance outcomes between clerks that underwent PALLed and Expert Faculty-Led model of instruction.

Change in Attitude among Nursing Undergraduate Students Following One-Month Exposure in a Mental Healthcare Setting.

BACKGROUND: Attitude of treating professionals plays an important role in the treatment of mental illnesses. Nursing professionals are an important part of the mental health care team. As a part of their nursing coursework, nursing students are posted in a mental health setting. It is important to assess the impact of such postings on their attitudes. MATERIALS AND METHODS: A total of 235 undergraduate nursing students posted in a mental healthcare setting for one month participated in the study. Their attitude towards mental illness and psychiatry was assessed before and after the posting, using Personal data sheet, Attitude Scale of Mental Illness (ASMI), and Attitude towards Psychiatry Scale (ATP). RESULTS: At pre-assessment, the nursing students had a negative attitude on all dimensions of ASMI except benevolence, and positive attitude on all the six domains of ATP. At post-assessment, attitude improved significantly on pessimistic prediction dimension of ASMI, and they were able to maintain their positive attitude on ATP. CONCLUSIONS: One-month posting had a weak positive impact on attitude towards mental illness and no detrimental impact on attitude towards psychiatry. There is a need for better efforts to increase the impact of training on attitude towards mental illness.

[Development of teaching training and assessment system for warming acupuncture].

A teaching training and assessment system for warming acupuncture is developed. This system is suitable for the technique operation of multi-acupoint warming acupuncture, and could evaluate the training effects of warming acupuncture at each acupoint. The hardware structure of this system is mainly composed of man-machine interface, control unit and training unit. The software program includes reset module, system clock module, needle depth signal control module, vibration control module and communication module. The teaching training and assessment system of warming acupuncture adopted touch-screen human-machine interface, which is simple to operate. The basic training unit, through multi-angle and multi-dimension adjustment of universal base, could realize the simulation training of warming acupuncture at different acupoints and angles of human body. Each training unit is relatively independent, and relevant parameters are set separately; the relevant parameters information is displayed in real time. The parameters of training unit includes needling time, vibration frequency and vibration time. In conclusion, the teaching training and assessment system for warming acupuncture could be used in the teaching and assessment of warming acupuncture. According to the criteria including operation time and effect, the students' technique ability of warming acupuncture could be evaluated objectively, which is helpful to set teaching objectives and technical operation requirements in warming acupuncture teaching.

La preparación profesoral para el desarrollo de la motivación profesional en estudiantes de la carrera de medicina / Teaching training for the development of profesional motivation in students of Medicine studies

RESUMEN En la formación de profesionales de la salud los docentes deberán desarrollar la motivación de sus educandos, como parte primordial del proceso de enseñanza aprendizaje, e intervenir de manera efectiva en la formación intelectual y creación de valores, indispensables para el desarrollo de su profesión. Se formuló como objetivo analizar algunas consideraciones en la preparación profesoral para el desarrollo de la motivación profesional en estudiantes de la carrera de Medicina. Se reflexionó sobre la escasa formación pedagógica de los docentes, en su totalidad graduados en Medicina, lo que dificulta la capacidad de los mismos para desarrollar la motivación profesional de sus estudiantes.

ABSTRACT In the health professionals´ training, the teaching staff should develop motivation in students, as a main part of the teaching-learning process, and take effective part in the intellectual training and the formation of values that are essential for their professional development. The aim was analyzing some considerations on the professional training for the development of the professional motivation in students of Medicine studies. We though over the scarce pedagogical training of the teaching staff, all of them graduated from Medicine studies, what difficult their competence for developing the professional motivation of the students.

La preparación profesoral para el desarrollo de la motivación profesional en estudiantes de la carrera de medicina / Teaching training for the development of profesional motivation in students of Medicine studies

RESUMEN En la formación de profesionales de la salud los docentes deberán desarrollar la motivación de sus educandos, como parte primordial del proceso de enseñanza aprendizaje, e intervenir de manera efectiva en la formación intelectual y creación de valores, indispensables para el desarrollo de su profesión. Se formuló como objetivo analizar algunas consideraciones en la preparación profesoral para el desarrollo de la motivación profesional en estudiantes de la carrera de Medicina. Se reflexionó sobre la escasa formación pedagógica de los docentes, en su totalidad graduados en Medicina, lo que dificulta la capacidad de los mismos para desarrollar la motivación profesional de sus estudiantes (AU).

ABSTRACT In the health professionals´ training, the teaching staff should develop motivation in students, as a main part of the teaching-learning process, and take effective part in the intellectual training and the formation of values that are essential for their professional development. The aim was analyzing some considerations on the professional training for the development of the professional motivation in students of Medicine studies. We though over the scarce pedagogical training of the teaching staff, all of them graduated from Medicine studies, what difficult their competence for developing the professional motivation of the students (AU).

Role of Approved Ohio High School Training Programs in the Demand for Pharmacy Technicians.

Objective: To provide an overview of Ohio Administrative Code 4729 and to identify the potential role of newly approved Ohio high school training programs in preparation of registration-ready pharmacy technicians. Data Sources: Relevant sections of the Ohio Administrative Code and the Ohio public high school pharmacy technician training program application were identified through the Ohio Board of Pharmacy website. Resources on employee training and pharmacy technician demand were used from the Bureau of Labor Statistics, Forbes magazine, Association for Talent Development, and ExploreGate. Information pertaining to the approved high school training programs was identified from the program-specific websites. Related materials were searched for via PubMed and Google Scholar from 2000 to present. Study Selection and Data Extraction: Portions of the Ohio Administrative Code pertaining to pharmacy technician training and registration. Articles describing the cost of employer-based training and the growth of pharmacy technician demand. Data Synthesis: Training and registration requirements for pharmacy technicians have increased over the past decade. In Ohio, pharmacy technicians must now complete an approved training program and become either a registered or certified technician with the Board of Pharmacy. Technicians may complete either a nationally recognized, employer-based, or public high school training program prior to becoming a registered or certified pharmacy technician. Ohio public high school training programs must be Board approved and must prepare students for national certification. After completing a high school training program, pharmacy technicians are adequately prepared to enter the workforce with minimal training burden to potential employers. Conclusions: Newly approved Ohio high school training programs have the potential to fulfill the increased demand for pharmacy technicians at a decreased cost to both students and employers.

Pharmacy Technicians Are People, Too! Let's Consider Their Personal Outcomes Along With Other Pharmacy Outcomes.

Studies have found that expanded pharmacy technician roles can help "free up" pharmacist time, leading to role optimization. However, these studies and the positions taken by many are quite pharmacist-centric. We seem to have underestimated the importance of support staff in pharmacy operations. If research demonstrates that technicians can perform a function safely and effectively, that alone should compel the function's allowance in practice. Freeing up pharmacist time for higher-order care is a positive corollary to technician advancement, but it need not be a precondition for it.

Development of teaching training and assessment system for warming acupuncture / 中国针灸

A teaching training and assessment system for warming acupuncture is developed. This system is suitable for the technique operation of multi-acupoint warming acupuncture, and could evaluate the training effects of warming acupuncture at each acupoint. The hardware structure of this system is mainly composed of man-machine interface, control unit and training unit. The software program includes reset module, system clock module, needle depth signal control module, vibration control module and communication module. The teaching training and assessment system of warming acupuncture adopted touch-screen human-machine interface, which is simple to operate. The basic training unit, through multi-angle and multi-dimension adjustment of universal base, could realize the simulation training of warming acupuncture at different acupoints and angles of human body. Each training unit is relatively independent, and relevant parameters are set separately; the relevant parameters information is displayed in real time. The parameters of training unit includes needling time, vibration frequency and vibration time. In conclusion, the teaching training and assessment system for warming acupuncture could be used in the teaching and assessment of warming acupuncture. According to the criteria including operation time and effect, the students' technique ability of warming acupuncture could be evaluated objectively, which is helpful to set teaching objectives and technical operation requirements in warming acupuncture teaching.

Prevención cuaternaria: como hacer, como ensiñar / Quaternary prevention: how to do, how to teach / Prevenção quaternária: como fazer, como ensinar

La prevención cuaternaria o P4 se define como las acciones que disminuyen los efectos de las intervenciones innecesarias, generadas por el contacto de las personas con los sistemas de salud. Se planteó como objetivo general desarrollar una estrategia para promover y difundir P4 em Iberoamérica; para cumplir dicha meta se realizó una investigación bibliográfica sobre los conceptos relacionados con P4; se aplicó una encuesta exploratoria para indagar sobre el conocimiento que tenían los participantes en la Cumbre y el Congreso respecto a P4. Existe múltiple literatura que define los términos relacionados con P4, lo que facilita su delimitación. Respecto a la encuesta, de las 309 personas que contestaron; 34% tenían entre 36 y 45 años; 88% eran profesionales en medicina; 69% conocía sobre P4 y más del 50% afirmó estar informado sobre los conceptos relacionados a P4; 92% consideró que P4 no es exclusiva de medicina familiar; 15% aseguró que después de la VI Cumbre se hicieron publicaciones sobre P4 en sus países; menos del 20% consideró que los políticos conocen sobre P4; 27% afirmó que los médicos de familia educan a los pacientes sobre P4. Se recomienda ampliar las campañas de educación sobre P4; facilitar el acceso a la información sobre P4 para profesionales del campo de la salud; incluir P4 en los programas académicos de pregrado y postgrado de las profesiones de la salud; crear alianzas con las entidades políticas de cada país para incluir P4 en políticas públicas.

Quaternary prevention or P4 is defined as any action taken to diminish the effects of unnecessary interventions generated when people interact with a health system. Methodology.The general objective was to develop a strategy to promote and spread P4 in Iberoamerica; to fulfill this goal a literature research was carried out, on the concepts related to P4; an exploratory survey was applied to inquire about the knowledge of the participates in the Summit and Congress, regarding P4 Results. There multiple literature sources that define the terms related to P4, which facilitated its delimitation. Regarding the survey, 69% knew about P4 and more that 50% declared that they where informed about the concepts related to P4; 92% considered that P4 is not only limited to family medicine; 15% assured that after the VI Summit publication regarding P4 where published in their countries; less than 20% stated that politicians knew about P4; 27% affirmed that family medicine doctors educate their patients about P4 Conclusions. It is recommended to expand the educational campaigns about P4; facilitate the access to information about P4 for professionals in the health field; include P4 in the academic programs of health professional for both graduate and post-graduate students; create alliances with political entities of each country to include P4 in public health policies.

A prevenção quaternária ou P4 é definida como ações que reduzem os efeitos de intervenções desnecessárias, geradas pelo contato das pessoas com os sistemas de saúde. O objetivo geral foi desenvolver uma estratégia para promover e disseminar o P4 na Ibero-América; Para atingir este objetivo, foi realizada uma pesquisa bibliográfica sobre os conceitos relacionados a P4; Uma pesquisa exploratória foi aplicada para indagar sobre o conhecimento que os participantes da Cúpula e do Congresso tinham sobre P4. Há uma diversidade de literatura que define os termos relacionados a P4, o que facilita sua delimitação. Em relação à pesquisa, das 309 pessoas que responderam; 34% tinham entre 36 e 45 anos; 88% eram profissionais de medicina; 69% conheciam o P4 e mais de 50% disseram que estavam informados sobre os conceitos relacionados ao P4; 92% consideraram que P4 não é exclusivo de medicina de família; 15% disseram que, após a VI Cúpula, foram feitas publicações sobre P4 em seus países; menos de 20% considerou que os políticos conhecem o P4; 27% disseram que os médicos de família educam os pacientes sobre o P4. Recomenda-se expandir as campanhas de educação sobre P4; facilitar o acesso à informação sobre P4 para profissionais da área da saúde; incluir P4 nos programas acadêmicos de graduação e pós-graduação das profissões de saúde; criar parceiras com as entidades políticas de cada país para incluir P4 nas políticas públicas

Problemas profesionales de los licenciados en enfermería en el desarrollo de habilidades pedagógicas / Profesional problems of the bachelors in nursing regarding the development of pedagogical skills

Introducción: la gestión del cuidado enfermero es el objeto de la enfermería. Para ello se necesita que los docentes responsabilizados con la formación de los futuros profesionales y técnicos en enfermería estén preparados desde el punto de vista pedagógico y debe manifestarse en el desarrollo de habilidades. Objetivo: determinar los problemas profesionales que presentan los licenciados en enfermería en el desarrollo de habilidades pedagógicas. Métodos: estudio descriptivo de corte transversal, se exploró el desarrollo de habilidades pedagógicas mediante un muestreo aleatorio simple. Se seleccionaron 30 docentes y 10 profesores principales y asesores metodológicos de la carrera de enfermería de la Facultad de Ciencias Médicas "10 de octubre"; se empleó la sistematización y la revisión bibliográfica para el análisis de los planes de clases, investigaciones relacionadas con palabras clave: problemas profesionales, habilidades pedagógicas y formación docente. Se aplicó un cuestionario, prueba de desempeño y se observaron los indicadores de las habilidades pedagógicas, entrevista a directivos y sesiones de trabajo metodológico. Resultados: los problemas profesionales fueron la no aplicación de principios del proceso pedagógico profesional, insuficiencias en el uso de los métodos de trabajo educativo, insuficiente utilización de la caracterización estudiantil, carencia de investigaciones educativas, utilización de formas de educación en el trabajo e insuficiencia de relaciones interdisciplinarias del plan de estudios. Conclusiones: los problemas profesionales guardan relación con la insuficiente superación en el área pedagógica, la identificación de estos sirve para trazar la vía hacia la superación profesional pedagógica de los docentes de enfermería(AU)

Introduction: Nursing care management is the object of nursing. For this, it is necessary for the teachers responsible for the training of future professionals and technicians in nursing to be prepared from the pedagogical point of view, which must be manifested in the development of skills. Objective: To determine the professional problems presented by nursing graduates in the development of pedagogical skills. Methods: Descriptive, cross-sectional study, in which the development of pedagogical skills was explored through simple random sampling. Thirty teachers and ten main professors and methodological advisers of the Nursing major of the School of Medical Sciences in Diez de Octubre Municipality were selected; systematization and bibliographic review were used for the analysis of lesson plans, research was developed in relation with the key words: professional problems, pedagogical skills and teacher training. A questionnaire was applied, performance test and indicators of pedagogical skills were observed, together with interviews with managers and methodological work sessions. Results: Professional problems were the non-application of principles of the professional pedagogical process, inadequacies in the use of educational work methods, insufficient use of student characterization, lack of educational research, use of forms of education at work, and inadequacy of interdisciplinary relationships in the curriculum. Conclusions: The professional problems are associated with the insufficient overcoming in the pedagogical area, the identification of which serves to trace the way towards the pedagogical professional improvement of Nursing teachers(AU)

An Interprofessional Evaluation of Health Literacy Communication Practices of Physicians, Pharmacists, and Nurses at Public Hospitals in Penang, Malaysia.

BACKGROUND: Health care practitioners carry a tremendous responsibility to differentiate the varying need of information and customized communication according to a patient's health literacy (HL) level. OBJECTIVES: To assess and compare the HL communication practices among physicians, pharmacists, and nurses serving at public hospitals in Penang, Malaysia. METHODS: A pretested, self-administered questionnaire was used to collect data from study participants of 6 public hospitals using stratified sampling. Descriptive and inferential statistics used to analyze the data with level of significance was set at P < 0.05. RESULTS: Of 600 distributed questionnaires, 526 (87.6%) were adequately filled and returned. Almost 19.0% (n = 98) of the respondents admitted that they did not frequently use simple language and avoid medical jargon during communication with patients. Only about half of the respondents reported frequently using other HL communication practices that include handing out education material to patients (52.2%, n = 275), asking the patient to repeat information (58.9%, n = 310), and asking patients' caregivers to be present during explanation (57.4%, n = 302). Comparatively, drawing pictures to ease patients' understanding (40.1%, n = 211) was the less-frequently practiced HL communication techniques. Health practitioners in the age group >41 years ( P = 0.046), serving 10 years and more ( P = 0.03) and those who have heard the term or concept of HL ( P = 0.004) have statistically significantly higher mean score of HL communication practices than other groups. CONCLUSIONS: The gap in the HL communication practices among physicians, pharmacists, and nurses warrants educational intervention, and standardized HL communication techniques guidelines are needed in the near future.