Design of a perceived quality scale in orthopaedic surgery education.

OBJECTIVES: The experience of students contributes to proactively identifying the changes necessary in training approaches and activities. The main objective of the Institutional Evaluation Programme was to design and validate a tool that permits discerning the experience of students from traumatology teaching. METHODS: Lecturers from the Orthopaedic Surgery Teaching Unit and experts in quality evaluation methodology, prepared the initial items. In this study, a descriptive analysis was carried out first, followed by an analysis of internal consistency and reliability, construction validity, and predictive validity. RESULTS: The results (Cronbach's alpha=0.58, Inter-Item Correlations >0.5, Eigenvalues >0.6, factor loadings, and the Student t-test values) confirmed its reliability and validity. CONCLUSIONS: The developed scale is reliable and valid to assess the experience of students. The use of a tool with these characteristics systematically contributes to improve teaching quality.

A Spanish-language patient safety questionnaire to measure medical and nursing students' attitudes and knowledge.

OBJECTIVE: To design and validate a questionnaire for assessing attitudes and knowledge about patient safety using a sample of medical and nursing students undergoing clinical training in Spain and four countries in Latin America. METHODS: In this cross-sectional study, a literature review was carried out and total of 786 medical and nursing students were surveyed at eight universities from five countries (Chile, Colombia, El Salvador, Guatemala, and Spain) to develop and refine a Spanish-language questionnaire on knowledge and attitudes about patient safety. The scope of the questionnaire was based on five dimensions (factors) presented in studies related to patient safety culture found in PubMed and Scopus. Based on the five factors, 25 reactive items were developed. Composite reliability indexes and Cronbach's alpha statistics were estimated for each factor, and confirmatory factor analysis was conducted to assess validity. After a pilot test, the questionnaire was refined using confirmatory models, maximum-likelihood estimation, and the variance-covariance matrix (as input). Multiple linear regression models were used to confirm external validity, considering variables related to patient safety culture as dependent variables and the five factors as independent variables. RESULTS: The final instrument was a structured five-point Likert self-administered survey (the "Latino Student Patient Safety Questionnaire") consisting of 21 items grouped into five factors. Compound reliability indexes (Cronbach's alpha statistic) calculated for the five factors were about 0.7 or higher. The results of the multiple linear regression analyses indicated good model fit (goodness-of-fit index: 0.9). Item-total correlations were higher than 0.3 in all cases. The convergent-discriminant validity was adequate. CONCLUSIONS: The questionnaire designed and validated in this study assesses nursing and medical students' attitudes and knowledge about patient safety. This instrument could be used to indirectly evaluate whether or not students in health disciplines are acquiring and thus likely to put into practice the professional skills currently considered most appropriate for patient safety.

Conservative management of burst fractures of the fifth lumbar vertebra.

Isolated fractures of the lumbar fifth vertebrae (L5) are very rare, and there is little information in the literature regarding comparisons between conservative management and surgical treatment of this entity. This retrospective analysis reports on five cases of isolated burst fractures of the fifth lumbar vertebra without neurologic deficit. All cases were managed nonoperatively with a short period of bed rest followed by protected mobilization. The current study reveals that conservative management is appropriate in the cases of burst fractures of the fifth lumbar vertebra with minimal canal compromise, with little deformity, and without neurologic damage.