Practice tutors' readiness to support nursing students who require reasonable adjustments for clinical placement.

BACKGROUND: Preregistration nursing students (trainee nursing associates and student nurses) may have a disability or impairment that requires reasonable adjustments while they are on clinical placement. At The Open University, practice tutors support nursing students on clinical placement, which includes overseeing the facilitation of any such reasonable adjustments. However, they may not feel prepared to provide this support. METHOD: A qualitative approach with a broad interpretivist paradigm was adopted. Data were collected from three focus groups that included a total of 10 nursing practice tutors. Audio data were transcribed and analysed using complete coding followed by thematic analysis. FINDINGS: Three main themes were identified - it's complex; impact of engagement; and a cohesive approach - along with associated subthemes. CONCLUSION: Despite their clear interest in helping nursing students who require reasonable adjustments for practice-based learning, practice tutors can be hindered by barriers resulting from a lack of both training and guidelines. The complexity of the practice tutor role and student issues can compound this. Consistency in practice tutor training is recommended, as well as regular access to peer support to address these difficulties and develop the skills and knowledge.

Exploring the impact of a 'Clients-as-Tutors Program on speech-language pathology students' and graduates understanding of client-centred practice.

PURPOSE: This study explored the impact of an Australian regional university's Clients-as-Tutors Program (CTP) on speech-language pathology students' perception and understanding of client-centred practice. METHOD: Two focus group interviews comprising three final-year students and four newly graduated speech-language pathologists who had completed the CTP. An inductive thematic analysis was undertaken to identify salient themes. RESULT: Three themes were identified: (a) learning from theory, (b) learning from others, and (c) learning from yourself. These themes represented all participants' experiences in the CTP, yet there were unique, individual journeys that each participant experienced. CONCLUSION: Findings from this study have the capacity to affect change in how client-centred practice is taught at universities across speech-language pathology and other health courses, to disrupt the traditional power structure between client and clinician, and to provide an evidence base for the role of experiential learning in this area.

Addressing the educational challenges of urban poverty: a case for solution-based research.

Introduction: Math achievement for economically disadvantaged students remains low, despite positive developments in research, pedagogy, and funding. In the current paper, we focused on the research-to-practice divide as possible culprit. Our argument is that urban-poverty schools lack the stability that is necessary to deploy the trusted methodology of hypothesis-testing. Thus, a type of efficacy methodology is needed that could accommodate instability. Method: We explore the details of such a methodology, building on already existing emancipatory methodologies. Central to the proposed solution-based research (SBR) is a commitment to the learning of participating students. This commitment is supplemented with a strength-and-weaknesses analysis to curtail researcher bias. And it is supplemented with an analysis of idiosyncratic factors to determine generalizability. As proof of concept, we tried out SBR to test the efficacy of an afterschool math program. Results: We found the SBR produced insights about learning opportunities and barrier that would not be known otherwise. At the same time, we found that hypothesis-testing remains superior in establishing generalizability. Discussion: Our findings call for further work on how to establish generalizability in inherently unstable settings.

LIC in the time of COVID: experiences of LIC tutors during the COVID-19 pandemic in Scotland.

In March 2020, due to the escalating global coronavirus (COVID-19) pandemic, clinical placements for most medical students in the UK were suspended. A phased resumption of clinical placements started at the beginning of academic year 2020/2021. For the Scottish Graduate Entry Medicine programme (ScotGEM), 2020/21 was the first year that Dundee School of Medicine's comprehensive LIC was extended to all 54 students in the penultimate year of the ScotGEM programme. This cross-sectional qualitative study explored aspects of tutors' experiences of supporting LIC students in their practices. Thematic analysis of the data identified significant themes relating to the effects of the coronavirus pandemic on the organisation of the LIC placements and the experiences of the tutors, and the ways in which they adapted placements to the rapidly changing clinical and social landscapes. The changes necessitated by the pandemic posed significant challenges for practice-based tutors in ensuring that students had valuable educational experiences despite the constraints of social distancing requirements and the reduction in face-to-face consultations. However, tutors also identified several positive aspects of the changes which will be of interest to those involved in the organisation and delivery of both LIC and shorter General Practice based clinical attachments. Positive relationships between LIC students and practices enhanced the success of LIC placements. We will discuss how lessons learned from the experience of tutors in the pandemic could be used in the longer term to enrich the LIC experience and General Practice placements more generally.

Unravelling Tutors' Conceptions of Teaching Mathematics in Virtual School Using a Goal-Action Model.

This study explored the unique integration of mathematics tutors in teaching high school mathematics in a Virtual mathematics school (VMS). The tutors were three excelling STEM students who did not have any formal preparation for teaching before their work in the VMS. The goal of the study presented in this paper was to design a model of proficiency for these tutors. The model was designed using multiple case study methodology by tracking the learning through teaching of the tutors. Activity theory (Leontiev, 1978) framed the design of the study and led to a "goal-action" model of the tutors' proficiency in the VMS. The goals part of the model is rooted in the construct of students' mathematical potential (Leikin, 2021), and the action part was unraveled using the construct of a Teaching Triad (Jaworski in For the Learning of Mathematics, 12(1), 8-14, 1992). In this paper, we illustrate how our model can be used to analyze changes in the tutors' proficiency, and how it can be applied to descriptive, explanatory, and analytical power.

The impact of education on the knowledge and attitudes of Ghanaian nurse tutors towards the assessment and management of pain in children: A quantitative study.

BACKGROUND: Undertreatment of pain in children is an international problem as many children reports unresolved moderate to severe pain. One key factor which may contribute to under treatment of pain in children by nurses is lack of knowledge. In Ghana opportunities for nurses to learn about pediatric pain have been limited due to gaps in the undergraduate curriculum and inadequate continuing professional education post qualification. OBJECTIVE: To assess tutors' knowledge and attitudes to pediatric pain management before and after an educational workshop. DESIGN: Single group pre-test-post-test design. SETTING: One Ghanaian Nursing Training College. PARTICIPANTS: All (37) nursing tutors in the college. METHOD: Total population sampling was used to access 37 tutors, data were collected using the Knowledge and Attitude Survey Regarding Pain at 3 stages; pre-intervention, immediately after the train-the-trainer based Pediatric Pain Educational Workshop and at 3-months follow-up. Data from the survey were analyzed using descriptive and inferential statistics. RESULTS: Results at pre-intervention showed low scores in the survey. However, post-intervention results at both the immediate and 3-months follow-up stages revealed a significant increase from pre-intervention: Mean (SD) of 20.35 (4.56), to immediate follow-up Mean (SD) 26.93 (5.02), and 3-months follow-up Mean (SD) 25.19 (5.80) and a p-value of <0.001. CONCLUSION: The results suggest tutors' knowledge and attitudes regarding pediatric pain management can be directly improved through a nurse tutor focused educational program. However, knowledge declines with time and as such there is the need for regular update through Continuing Professional Development activities.

Factors influencing adoption of e-learning in healthcare: integration of UTAUT and TTF model.

BACKGROUND: The importance of successful implementation of e-learning, especially since the emergence of the Covid-19 pandemic, has become increasingly apparent to universities. Thus, identifying the effective factors in adopting e-learning in the Covid-19 pandemic is crucial. This study was conducted to identify determining factors in adopting E-learning in healthcare. METHOD: This was a descriptive-analytical study in which 143 faculty members from Iran were randomly selected. The faculty members' intentions, concerning the adoption of e-learning, were assessed by the conceptual path model of integration of unified theory of acceptance and use of technology (UTAUT) and The Task-Technology Fit (TTF). RESULTS: The results showed that the combination of the two classical theories, UTAUT and TTF, was an appropriate model to explain faculty members' intention in adopting e-learning. Moreover, the findings showed that technology and task characteristics, task- technology fit, social influences, effort expectancy, performance expectancy and facilitating conditions had direct and significant effect on e-learning adoption. CONCLUSION: By presenting a conceptual path model to elucidate users' behavior in adopting e-learning, this study investigated and identified the key determining factors in adopting e-learning. The findings of the present study can contribute to the design and implementation of e-learning by practitioners, policy makers, and curriculum designers.

Occupational (In)visibility: The emerging role of the Remote Education Tutor as an educational conduit.

Remote Education Tutors (RETs) are central to the delivery of distance schooling in Australia and are accountable for the face-to face supervision and educational support of students. They act as the government mandated adult supervisors of Australian primary and secondary school students enrolled in distance education, including geographically isolated learners. This paper draws on statistical data from a national survey (N = 575) that was designed to map the perceptions of Australian RETs. These data confirmed that RETs act as a conduit between the distance schooling teacher and student, and that their role requires complex capabilities to be performed within a structured framework. Time restrictions with competing demands present a constant challenge to the RETs' work satisfaction. Constraining this occupation is the reality that there is no formal qualification available for RETs. Without specific credentialling, it appears that the RETs' (in)visible role risks being overlooked as a substantive educational occupation.

The perceptions of diagnostic radiography clinical tutors transitioning from being radiographers to clinical educators in public hospitals in the Ethekwini district.

INTRODUCTION: This small-scale, qualitative research study explored the perceptions of Diagnostic Radiography clinical tutors transitioning from being radiographers to clinical educators in public hospitals in the eThekwini District of KwaZulu-Natal. Clinical instructors are known for having practical knowledge of teaching, but few understand the basic principles, theories, and concepts of the teaching and learning process. METHOD: This exploratory qualitative study involved seven Diagnostic Radiography clinical tutors sampled purposively, from whom data were gathered using individual interviews. Thematic analysis was subsequently used to analyse the data. FINDINGS: The theoretical framework used in the study was derived from Schlossberg's Transition Theory which comprises four main elements namely, Situation, Social supports factor, Strategy, and Self-factor. The findings of the study indicated that most participants have had major challenges in the transition process, which have led to negative experiences and only a few had positive experiences. Participants postulated that clinical tutors and teaching institutes must create a forum for clinical tutors whereby they will engage with the university to discuss the issues and challenges of students during clinical training and assist each other with teaching skills. CONCLUSION: Clinical tutors who participated indicated that they faced challenges that affected their ability to supervise students, which affected their clinical learning progress. This, therefore, calls for an extensive intervention of both the learning institution, the hospital management, and other relevant stakeholders to best figure out how these challenges can be addressed. This will allow for a smooth transition and improve students' supervision and ability to learn at the clinical venues.

[Emergency Ultrasound Training for and with Medical Students]. / Notfallsonografie für Studierende.

Emergency Ultrasound Training for and with Medical Students Abstract. Practical basic skills in sonography are a mandatory part of Swiss medical schools since 2018. The universities of Basel and Bern teach students the content of the POCUS component "Basic Emergency Sonography" of the SGUM and have developed the e-learning tool "POCUS Emergency Sonography" for this purpose in cooperation. By using this innovative blend- ed learning concept, students acquire basic skills in sonography and can build upon this know-how in their further education.

Psychometric properties of the Persian version of System for Evaluation of Teaching Qualities by students: A tool for assessing clinical tutors from students' viewpoint.

BACKGROUND: Effective clinical teaching is crucially important for patient care in future. Therefore, proper clinical training is essential to make physicians capable of delivering high-quality health care. MATERIALS AND METHODS: The present study was a cross-sectional research. After translating the questionnaire into Persian, it was distributed among medical students in the clinical years of medical education in teaching hospitals affiliated to Ahvaz Jundishapur University of Medical Sciences in 2018. The System for Evaluation of Teaching Qualities (SETQ) has 25 questions in a 6-scale Likert scale that evaluates clinical tutors in five dimensions of teaching and learning environment, professional attitude toward students, transferring of goals, evaluation of students, feedback, and promoting self-directed learning. Instrument reliability was assessed by calculating the Cronbach's alpha coefficient, whereas questionnaire content validity was evaluated by relative content validity ratio (CVR) and content validity index (CVI). To evaluate the structural validity, an exploratory factor analysis was conducted. RESULTS: The SETQ was completed by 127 medical students. Cronbach's alpha coefficient of the total questionnaire was estimated as 0.908. The factor analysis showed that the questionnaire was composed of six factors, explaining 66.14% of the total variance. The CVI and CVR indices of the individual items were also acceptable. CONCLUSION: The findings of our study showed that the Persian version of SETQ questionnaire had the acceptable reliability and validity to be used in assessing clinical tutors in different hospitals in Iran.

Designing an intelligent tutoring system for computer programing in the Pacific.

Intelligent Tutoring Systems (ITSs) are educational systems that reflect knowledge using artificial intelligence implements. In this paper, we give an outline of the Programming-Tutor architectural design with the core implements on user interaction. This pilot proposal is for designing a model domain of a subset in the computer programming language. The completed project would be adequate to show the idea of a completely developed computing Intelligent Tutoring System in online programming courses to offer benefits to students in the Pacific. This proposed concept would also provide students with an immersive learning experience in an online course to assist in a formative assessment to enhance student learning. A smart tutoring system can provide prompt input of high quality which not only conveys to students about the consistency of the solution but also provides them with information on the precision of the key concerning their existing solutions expertise. This Intelligent Tutoring System (ITS) is proposed to be designed using intelligent algorithms such as optimized ant colony to be able to support the online tutoring system that can initiate the complex learning principles in computing science courses. It is also hypothesized that, based on the performance of other Intelligent Tutoring Systems, students would be able to learn to program more easily in regional campuses and acquire experiences more rapidly and efficiently than students who are taught using conventional methods in an online mode.

Adding colour-realistic video images to audio playbacks increases stimulus engagement but does not enhance vocal learning in zebra finches.

Bird song and human speech are learned early in life and for both cases engagement with live social tutors generally leads to better learning outcomes than passive audio-only exposure. Real-world tutor-tutee relations are normally not uni- but multimodal and observations suggest that visual cues related to sound production might enhance vocal learning. We tested this hypothesis by pairing appropriate, colour-realistic, high frame-rate videos of a singing adult male zebra finch tutor with song playbacks and presenting these stimuli to juvenile zebra finches (Taeniopygia guttata). Juveniles exposed to song playbacks combined with video presentation of a singing bird approached the stimulus more often and spent more time close to it than juveniles exposed to audio playback only or audio playback combined with pixelated and time-reversed videos. However, higher engagement with the realistic audio-visual stimuli was not predictive of better song learning. Thus, although multimodality increased stimulus engagement and biologically relevant video content was more salient than colour and movement equivalent videos, the higher engagement with the realistic audio-visual stimuli did not lead to enhanced vocal learning. Whether the lack of three-dimensionality of a video tutor and/or the lack of meaningful social interaction make them less suitable for facilitating song learning than audio-visual exposure to a live tutor remains to be tested.

Tutor-Student Partnership in Practice OSCE to Enhance Medical Education.

BACKGROUND: Training of examiners is essential to ensure the quality of objective structured clinical examination (OSCE). We aimed to study a perceived effectiveness of tutor-student partnership in a practice OSCE module by novice OSCE tutors and medical students. METHOD: We implemented a practice OSCE at a medical faculty in France with novice tutors and third year medical students as partners. Each tutor (n = 44) served as a partner for the group of 5 students in the conception of the scenario and as an evaluator of the tutored station. Students (n = 303) were involved in the conception of a case and the roles of a physician, evaluator and a simulated patient. Data were obtained through self-assessment questionnaires. Descriptive statistics were used to analyze items of the questionnaires. Free-form answers were coded and analyzed thematically. RESULTS: A total of 36 tutors (82%) and 185 students (61%) responded to the questionnaires. The intervention was well perceived. Thirty-two percent of the tutors reported some difficulties in the assessment of student performance and were disposed to receive further training. Fifty-five percent of the students considered the participation in the OSCE case development appropriate to their level of knowledge, and 70% perceived it as beneficial allowing them to set their learning goals. CONCLUSION: This initiative provides a relevant method beneficial to OSCE tutors, medical students, and the faculty. Tutors learn how to assess student performance according to expected achievement levels. It allows students to be engaged as partners in co-creation of learning and teaching. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40670-021-01421-9.

Effectiveness of a Mindfulness and Self-Compassion Standard Training Program versus an Abbreviated Training Program on Stress in Tutors and Resident Intern Specialists of Family and Community Medicine and Nursing in Spain.

Stress is one of the most common problems among healthcare professionals, as they are exposed to potentially stressful and emotionally challenging situations in the workplace. Mindfulness-based stress reduction (MBSR) training programs have been shown to decrease stress. The objective of this study was to compare the effectiveness of an abbreviated 4-weeks MBSR training program in relation to a standard 8-weeks one on the stress levels. A controlled and randomized clinical trial was designed, in which 112 tutors and resident intern specialists in Family and Community Medicine and Nursing of six Spanish National Health System teaching units (TUs) participated. Participants included in the experimental groups (EGs) received a MBRS training program (standard or abbreviated), while control group (CG) participants did not receive any intervention. The stress levels were assessed by the Perceived Stress Questionnaire (PSQ) in three different moments during the study: before, immediately after, and 3 months after the intervention. Adjusted covariance analysis (ANCOVA), using pretest scores as the covariate, showed a significant reduction in stress (F(2,91) = 5.165; p = 0.008; η2 = 0.102) in the post-test visit, attributable to the implementation of the standard training program, but without the maintenance of its effects over time. No significant impact of the abbreviated training program on stress levels was observed in the intergroup comparison. A standard 8-weeks MBSR training program aimed at tutors and resident intern specialists in Family and Community Medicine and Nursing produces significant improvements in stress levels compared with the abbreviated intervention and no intervention. New studies about abbreviated training programs are needed to provide effective treatments which improve well-being of these professionals.

Psychometric Properties of Visual Indicators of Teaching and Learning Success "VITALS" Instrument for Evaluation of Clinical Teachers.

PURPOSE: We have previously developed an instrument for students' evaluation of clinical teachers that we called Visual Indicators of Clinical Teaching and Learning Success (VITALS). This study measures the reliability of VITALS as an instrument for student evaluation of clinical tutors. Additionally, the study explores the minimum number of student raters necessary for an acceptable reliability, and provides evidence of construct validity of the evaluation scores. MATERIALS AND METHODS: This retrospective study included 1825 evaluation forms completed by medical students evaluating clinical tutors using the VITALS instrument. Reliability was measured by applying generalizability theory (G-theory) analysis using a two-facet design (raters and items). A D-study was used to determine the minimum number of raters required to achieve a reliability ≥0.80. Face validity was tested by measuring tutors' degree of agreement with the items of the study instrument. RESULTS: The overall G-coefficient was 0.89. The subject of measurement (clinical tutors' scores) represented 15.8% of the variance across all tutors and items. The variance due to the interaction between raters (students) and tutors contributed to 43.5%, while the variance due to items was negligible. The remaining 40% of the variance was due to unexplained sources of error. The D-study demonstrated that a minimum of 12 raters (students) are required to achieve a reliability of 0.80. Finally, most of the clinical tutors agreed that all items in the instrument were appropriate. CONCLUSION: We demonstrate that VITALS exhibits good psychometric properties. There should be at least 12 students rating each clinical tutor to have an acceptable level of reliability for the study instrument. Face validity of the study instrument was evidenced by its high level of approval among clinical tutors.

Aprendizaje asistido por pares en la formación clínica de pregrado: percepción de tutores y tutorados / Peer-assisted learning in undergraduate clinical training: perception of tutors and tutees

Introducción: La tutoría por pares ofrece una experiencia valiosa para generar estrategias que permitan mejorar el aprendizaje. El objetivo fue evidenciar la importancia del apoyo tutorial por pares en la Escuela de Medicina de la Universidad Austral de Chile en estudiantes con rendimiento académico insatisfactorio en la disciplina clínica de Medicina interna. Sujetos y métodos: Se capacitó a 12 estudiantes de cursos superiores para realizar tutorías académicas a 35 estudiantes. Se aplicaron encuestas de opinión con preguntas de tipo Likert y abiertas para conocer la percepción de tutores y tutorados respecto al proceso tutorial realizado durante 2017 y 2018. Resultados: Veinticinco estudiantes (71%) y 12 tutores (100%) respondieron las encuestas, que revelaron un alto grado de satisfacción en ambos grupos. Los tutorados destacaron el desempeño del tutor y consideraron que las tutorías reforzaron su autoconfianza. Para los tutores fue una experiencia enriquecedora que los ayudó en su propio proceso de aprendizaje. Conclusiones: La tutoría de pares ayuda a la adquisición y el fortalecimiento de competencias específicas y genéricas, generando nuevos aprendizajes. Los tutores logran habilidades para la enseñanza y fortalecen competencias para su vida personal y profesional.(AU)

Introduction:Peer tutoring offers a valuable experience to generate strategies to improve learning. The aim was to demonstrate the importance of the peer tutorial support at the Medical School of Austral University of Chile to assist students with unsatisfactory academic performance in the clinical discipline of internal medicine. Subjects and methods:12 students from advanced courses were trained to provide academic tutoring to 35 students. Opinion surveys with open and Likert type questions were applied to know the perception of tutors and tutees regarding the tutoring process carried out during 2017 and 2018. Results: 25 students (71%) and 12 tutors (100%) answered the surveys, revealing a high degree of satisfaction in both groups. Students highlighted the tutor’s performance and felt that the tutoring strengthened their trust. For the tutors it was an enriching experience that helped them in their own learning process. Conclusions: The peer tutoring contributes to the acquisition and strengthening of specific and generic competencies, generating new learning. The tutors acquire teaching skills and strengthen competencies for their personal and professional life.(AU)

Atributos para caracterizar la satisfacción de estudiantes de enfermería en escenarios clínicos / Attributes for Characterizing Nursing Students' Satisfaction in Clinical Settings

Introducción: La evaluación de satisfacción de estudiantes de enfermería en entornos de aprendizaje clínico está mediada por atributos contextuales del clima de aprendizaje y acción tutorial. Objetivo: Explorar, desde la perspectiva cualitativa, atributos que identifican estudiantes de enfermería para caracterizar la satisfacción en escenarios clínicos. Métodos: Estudio de diseño descriptivo exploratorio. Las unidades de análisis fueron estudiantes de enfermería de dos unidades académicas de universidades chilenas, durante el período lectivo; marzo-noviembre del 2019. Se optó por un muestreo homogéneo. Se incluyeron al estudio alumnos regulares de enfermería, de tercero y cuarto año, que hayan tenido al menos un mes de prácticas clínicas ininterrumpidas y se excluyen, estudiantes de primer, segundo año e internos de enfermería. Para trabajo de campo se inició con vagabundeo y creación de mapas sociales y temporales y como técnica de recogida de información se usó grupo focal, cautelando saturación muestral y suficiencia del dato. Se cumplieron requisitos y principios éticos de investigación en seres humanos. Resultados: los estudiantes distinguen que los atributos para medir su satisfacción en espacios de enseñanza práctica están influenciados o afectados por condiciones del entorno clínico asistencial, profesionalismo del tutor que en su conjunto matizan su satisfacción y por ende el clima de aprendizaje. Conclusiones: Desde la categoría central del constructo de estudio se pudo verificar en los discursos las subcategorías y atributos para medir la satisfacción de los alumnos en los escenarios de prácticas clínicas(AU)

Introduction: Assessment of Nursing students' satisfaction in clinical learning environments is mediated by contextual attributes of the learning climate and tutorial action. Objective: To explore, from a qualitative perspective, attributes identified by Nursing students for characterizing satisfaction in clinical settings. Methods: Study with an exploratory descriptive design. The units of analysis were Nursing students from two academic units of Chilean universities, during school period: March-November 2019. Homogeneous sampling was chosen. Regular third- and fourth-year Nursing students who had had at least one month of uninterrupted clinical practice were included in the study, while first- and second-year students and Nursing interns were excluded. Fieldwork began with wandering and the creation of social and temporal maps, while focus group was used as a data collection technique, ensuring sample saturation and data sufficiency. Requirements and ethical principles for research in humans were met. Results: The students distinguish that the attributes for measuring their satisfaction in practical teaching settings are influenced or affected by conditions of the clinical care environment, as well as by tutor professionalism, which, as a whole, qualify their satisfaction and, therefore, the learning climate. Conclusions: From the central category of the study construct, it was possible to verify, within the discourses, the subcategories and attributes for measuring the students' satisfaction in the clinical practice settings(AU)

Fracturas Mandibulares Conminutadas por Impacto de Proyectil Balístico: Resultados Clínicos de Tratamiento Con Método de Fijación Alternativo

RESUMEN: Las fracturas mandibulares conminutadas por impacto de proyectil balístico son un desafío terapéutico debido a la presencia de múltiples fragmentos óseos y el compromiso a nivel de periostio, plano muscular y mucoso. Su tratamiento inicial requiere de una estabilización de las urgencias médico - quirúrgicas y posteriormente tratar los segmentos óseos fracturados. La fijación externa con tutores mandibulares permite estabilizar los segmentos mandibulares de forma cerrada manteniendo así la viabilidad de los fragmentos sin interrumpir su suministro de sangre. El objetivo de este trabajo es presentar los resultados post operatorios obtenidos en tres casos clínicos de pacientes con diagnóstico de fractura mandibular conminutada por trauma por impacto de proyectil balístico, tratados por un método alternativo a los tutores de fijación externa convencional.

ABSTRACT: Comminuted mandibular fractures from ballistic missile impact are a therapeutic challenge due to the presence of multiple bone fragments and the involvement of periosteum, muscle and mucous membrane. Their initial treatment requires emergency medical and surgical stabilization and later treatment of the fractured bone segments. External fixation with mandibular stakes makes it possible to stabilize the mandibular segments in a closed manner, thus maintaining the viability of the fragments without interrupting their blood supply. The aim of this work is to present the post-surgical results obtained in three clinical cases of patients with diagnosis of comminuted mandibularfracture by ballistic missile impact, treated by an alternative method to the conventional external fixation tutors.

Comparison of the Effectiveness of an Abbreviated Program versus a Standard Program in Mindfulness, Self-Compassion and Self-Perceived Empathy in Tutors and Resident Intern Specialists of Family and Community Medicine and Nursing in Spain.

Health professionals are among the most vulnerable to work stress and emotional exhaustion problems. These health professionals include tutors and resident intern specialists, due to the growing demand for the former and the high work overload of the latter. Mindfulness training programs can support these professionals during times of crisis, such as the current global pandemic caused by the coronavirus-19 disease. The objective of this study was to compare the effectiveness of an abbreviated Mindfulness-Based Stress Reduction (MBSR) and Mindful Self-Compassion (MSC) training program in relation to a standard training program on the levels of mindfulness, self-compassion, and self-perceived empathy in tutors and resident intern specialists of Family and Community Medicine and Nursing. A total of 112 professionals attached to six Spanish National Health System teaching units (TUs) participated in this randomized and controlled clinical trial. Experimental Group (GE) participants were included in the standard or abbreviated MBSR programs. The Five Facet Mindfulness Questionnaire (FFMQ), the Self-Compassion Scale short form (SCS-SF), and the Jefferson Scale of Physician Empathy (JSPE) were administered three times during the study: before, immediately after, and 3 months after the intervention. Adjusted covariance analysis (ANCOVA), using pretest scores as the covariate, showed a significant increase in mindfulness (F(2,91) = 3.271; p = 0.042; η2 = 0.067) and self-compassion (F(2,91) = 6.046; p = 0.003; η2 = 0.117) in the post-test visit, and in self-compassion (F(2,79) = 3.880; p = 0.025; η2 = 0.089) in the follow-up visit, attributable to the implementation of the standard training program. The standard MBSR and MSC training program improves levels of mindfulness and self-compassion, and promotes long-lasting effects in tutors and resident intern specialists. New studies are needed to demonstrate the effectiveness of abbreviated training programs.