Animal experimentation in transgenesis: evaluating course design in large classrooms.

Teachers are guided by an ethical code of conduct. Teacher behavior can be perceived as normative and can set standards; for example, in the field of animal experimentation. The importance of ethical standards raises the question of its transmission. This survey addressed the relevance of using large amphitheater teaching groups to educate students on the ethical aspects of animal experimentation. A course was built to include interactivity sequences to gather feedback from students about moral dilemmas or assertions about animal experimentation. To that end, surveys were conducted on third-year students, prior to the course, shortly after the course and at the end of the academic year. Students were asked to indicate whether the experimental protocols were satisfactory. Before the course, few students reported ethical dimensions in the proposed protocols; animals were considered scientific objects, not sentient beings. The situation was noticeably different for students on courses with an emphasis on the animal as the unit of study. Although large classrooms are not considered to be relevant places to question ethical issues, the proportion of students discussing ethical aspects of protocols increased shortly after the lecture, and this increased at the end of the academic year. These observations suggest that the effect of teaching on ethical considerations was sustainable despite the lectures being performed in a large classroom.

Conocimientos del médico sobre responsabilidad profesional médica / Physician ́s knowledge about professional medical responsibility

Justificación: Las fallas en la responsabilidad profesional médica representan un problema de interés por el impacto que tienen en la salud de los pacientes y de los médicos. Objetivo: Evaluar cuál es el nivel de conocimientos de los profesionales de la medicina hondureños sobre aspectos relevantes de la responsabilidad profesional o mala praxis médica. Metodología:Se realizó un estudio transversal descriptivo; la recolección de datosse hizo mediante un instrumento tipo encuesta electrónica con formato de Google®, la cual se validó con un grupo de expertos y cubrió, variables sociodemográficas; de los encuestados, así como cinco ámbitos de conocimiento definidos como: el ámbito legal,el conceptual, el de derechos de los pacientes, el de deberes del médico y el de condicionantes para la denuncia. La población encuestada: estudiantes de medicina con seis o más años cursados de la carrera, indistintamente de la universidad donde estudiaron; médicos residentes y profesionales, ya sea médicos generales o especialistas, todos hondureños. El análisis de los datos se realizó utilizando Excel® 2010, y el Programa R, versión 3.6. Para mejor comprensión de los resultados se construyó una escala descriptiva de acuerdo a los porcentajes de acierto obtenidos. De 0-39% "deficiente", de 40-59% "insuficiente", de 60 a 80% "aceptable", 81-90% "adecuado", de 91% en adelante se clasificócomo "conoce el tema". Resultados: El nivel de conocimiento de los médicos, indistintamente de su formación académica, edad, sexoocentro donde labora, se ubicó en un nivel entre insuficiente y aceptable,siendo el ámbito donde se observó el menor puntaje, con 51,2% de aciertos. Conclusiones: Las fallas en la responsabilidad profesional podrían estar estrechamente ligadas al déficit de competencias y habilidades adecuadas de estudiantes y médicos durante el acto médico...(AU)

Ethical Rationales and Guidelines for the Continued Use of Archival Collections of Embryonic and Fetal Specimens.

Benefits from the use of cadavers in anatomical education are well described. Historically, human embryos and fetal cadavers were used in anatomy education to understand development and congenital malformations. Recently, three-dimensional printed models produced from archival fetal specimens, and online repositories of images from archival collections of embryos and fetuses, have been used as an educational tool in human development courses. Given that the archival specimens were likely obtained prior to the era of informed consent, this raises questions about their appropriate and ethical use. Because some institutions in the United States retain archival collections of embryonic and fetal specimens that were once used as educational tools, their existence and utility require frequent reexamination against contemporary ethical frameworks to guide appropriate use or utilization. Four ethical rationales for uses of these collections are examined, including destruction, indefinite storage, use in research, and use in health professions education. Guidelines for the use of archival collections of human embryos and fetuses are presented. Indefinite storage and use in health professions education are supported, while use in research is also permitted, however, such use is limited and dependent on circumstance and purpose. The development of current digital repositories and three-dimensionally printed models based on archival collections that were collected without informed consent, or those promoting commercial opportunity, are not supported. New embryonic and fetal donations obtained with informed consent should include reference to potential uses with new technology and virtual, genetic, or imaging applications.

Naming the Dead: What information do Physical Therapy and Physician Assistant Anatomy Faculty Share With Students?

In this novel study, the researchers quantify cadaver information provided to Physical Therapy (PT) and Physician Assistant (PA) anatomy faculty and ask what portion of that information is then shared with students. Descriptive statistics were used to the describe demographics of the study respondents and to report survey responses. The majority (60% or greater) of faculty who teach anatomy to PT and PA students have clinical degrees matching the student groups they teach. Chi-square analysis showed no appreciable difference (P < 0.001) between PT and PA anatomy faculty in the amount of cadaver information they receive or then share with students. There was a difference in the type of cadaver information (identifying vs. non-identifying) that is received and then shared by these faculty. Faculty are more likely to receive non-identifying cadaver information (93%) than identifying information (40%) (P < 0.0001) and share non-identifying information (83%) than identifying information (26%) with students (P < 0.0003). Interestingly, there is no consensus as to whether sharing cadaver information is respectful or disrespectful to those who donate their bodies for anatomy education and research. Further research is warranted into the reasons anatomy faculty withhold cadaver information from students and in the value, if any, for students knowing more about the cadavers they are learning from.

A Systematic Literature Review of US Engineering Ethics Interventions.

Promoting the ethical formation of engineering students through the cultivation of their discipline-specific knowledge, sensitivity, imagination, and reasoning skills has become a goal for many engineering education programs throughout the United States. However, there is neither a consensus throughout the engineering education community regarding which strategies are most effective towards which ends, nor which ends are most important. This study provides an overview of engineering ethics interventions within the U.S. through the systematic analysis of articles that featured ethical interventions in engineering, published in select peer-reviewed journals, and published between 2000 and 2015. As a core criterion, each journal article reviewed must have provided an overview of the course as well as how the authors evaluated course-learning goals. In sum, 26 articles were analyzed with a coding scheme that included 56 binary items. The results indicate that the most common methods for integrating ethics into engineering involved exposing students to codes/standards, utilizing case studies, and discussion activities. Nearly half of the articles had students engage with ethical heuristics or philosophical ethics. Following the presentation of the results, this study describes in detail four articles to highlight less common but intriguing pedagogical methods and evaluation techniques. The findings indicate that there is limited empirical work on ethics education within engineering across the United States. Furthermore, due to the large variation in goals, approaches, and evaluation methods described across interventions, this study does not detail "best" practices for integrating ethics into engineering. The science and engineering education community should continue exploring the relative merits of different approaches to ethics education in engineering.

Observaciones sobre el artículo Concepción educativa integradora para el desarrollo de los valores humanismo y responsabilidad en el proceso formativo de estudiantes de ciencias médicas / Integrative educational conception for the development of the values humanism and responsibility in the teaching process of the medical sciences students

La perfección del proceso formativo en ciencias médicas es una premisa fundamental en el contexto actual de la sociedad cubana, por lo que profundizar sus referentes y lograr una mayor integración en las acciones y la función del profesor, son tareas imprescindibles en dicho proceso. En el actual artículo se exponen los referentes epistemológicos, el sistema categorial y las dimensiones de la concepción educativa integradora; asimismo, se enfatiza en la integración formativo-asistencial-comunitaria como eje conductor en la lógica pedagógica de la concepción propuesta, y se tiene en cuenta que el proceso formativo en ciencias médicas no solo considera la instrucción, sino que prioriza el desarrollo de valores fundamentales de la profesión y de la personalidad del futuro profesional. Por último, se admite la importancia del vínculo del estudio con el trabajo, como forma fundamental de enseñanza en la educación médica superior, para el desarrollo de habilidades profesionales y de los valores humanismo y responsabilidad.

The improvement of the formative process in medical sciences is a fundamental premise in the current context of the Cuban society, so that deepening in its referents and achieving a wider integration in the professor's activities and role, are indispensable tasks in this process. In the present work, the epistemological referents, category system and dimensions of the integrative educational conception are exposed; also, it is emphasized in the formative-care giving-community integration as conductive axis in the pedagogical logic of the proposed conception, and it is taken into account that the formative process in medical sciences not only considers the instruction, but also prioritizes the development of fundamental values of the profession and of the personality of the future professional. Lastly, the importance of the link study and work is admitted, as fundamental form of teaching in the higher medical education, for the development of professional skills and for the values humanism and responsibility.

Percepción de estomatólogos sobre atención estomatológica a pacientes sordos. La Habana, 2016 / Dentists´ perception of dental care of deaf patients. Havana, 2016

Introducción: La sordera es una discapacidad neurosensorial que provoca un problema de salud pública que afecta no solo al individuo que la padece sino también a su entorno familiar y social. Objetivo: Identificar la percepción de los estomatólogos sobre la atención estomatológica a los pacientes sordos. Material y Método: Se realizó un estudio descriptivo de corte transversal, con una muestra de 42 estomatólogos, entre 29 y 69 años de edad, de ambos sexos, pertenecientes a las Clínicas Estomatológicas de los Policlínicos Docentes del Municipio Marianao en La Habana, en los meses de junio y julio de 2016. Se realizó encuesta. Las variables estudiadas fueron: edad, sexo, conocimientos sobre las reglas de comunicación con el paciente sordo, conocimiento de las posibles causas de insatisfacción de los pacientes sordos durante la atención estomatológica, reconocimiento de los elementos a considerar durante la atención estomatológica al paciente sordo y conocimiento de factores capaces de generar estímulos negativos durante la atención estomatológica al paciente sordo.Resultados: El sexo femenino fue el de mayor predominio con 73.8 por ciento. El 66.7 por ciento de los Estomatólogos no conoce las reglas de comunicación de los pacientes sordos y 78.6 por ciento no conoce los aspectos a tener en cuenta durante la atención al paciente sordo. El 100 por ciento de los encuestados no reconoce los estímulos negativos ni las posibles causas que provocan insatisfacción en dicha población. Conclusiones: La mayoría de los estomatólogos encuestados son del sexo femenino, no reconocen las reglas de comunicación ni los aspectos a tener en cuenta durante la atención al paciente sordo; mientras que la totalidad de ellos desconoce los factores capaces de generar estímulos negativos o las posibles causas que provocan insatisfacción en la atención a estos pacientes(AU)

Introduction: Deafness is a neurosensorial disability which causes a public health problem that affects not only the individual who suffers from it, but also his social and family environment. Objective:To identify the dentists´ perception of dental care they deliver to deaf patients. Material and methods:A descriptive cross-sectional study was conducted, which comprised a sample of 42 dentists aged from 29 to 69 years, of both sexes, who work in the Dental Clinics of the Teaching Polyclinics located in Marianao Municipality, Havana, in June-July, 2016. A survey was made. The variables studied were: age, sex, knowledge about the rules for communication with the deaf patient, knowledge of the possible causes of dissatisfaction of the deaf patients with dental care, recognition of the elements to consider during dental care of the deaf patient, and knowledge of the factors which are capable to generate negative stimuli during the dental care of the deaf patient. Results:The highest predominance was observed in females (73.8 percent). The 66.7 percent of dentists do not know the rules for communication with deaf patients, and the 78.6 percent of them are unaware of the aspects to keep in mind during the care of the deaf patient. The 100 percent of the surveyed dentists do not recognize neither the negative stimuli nor the possible causes that lead to dissatisfaction in this population. Conclusions: Most of the surveyed dentists are female, they do not know neither the communication rules nor the aspects to keep in mind during the care of the deaf patient; whereas the totality of them are unaware of the factors that are capable to generate negative stimuli or the possible causes which lead to dissatisfaction in the attention to these patients(AU)

Valores: utopía o necesidad para enfermeros / Values: utopia or necessity for nurses

La globalización es un fenómeno reciente, que avalado por adelantos científicos técnicos interrelaciona todos los países del mundo, esta interacción en esferas: económicas, políticas, socioculturales ha creado una cultura global que en muchos casos ha resquebrajado el sistema de valores de cada país. Nuestro sistema de valores respaldado y formado por años de historia y lucha, ha creado un pueblo identificado por sus ansias de solidaridad e internacionalismo manifiesto, a pesar de todo, la crisis económica mundial ha incidido directamente en la formación de valores en los profesionales de la salud de nuestro país sobre todo el personal de enfermería y específicamente los enfermeros de cuidados progresivos. Se diseñó un estudio longitudinal y prospectivo en el Hospital Pediátrico General Docente Eliseo N. Caamaño, con el objetivo de cualificar y reforzar el conjunto de valores específicos que se consideran ideales para un enfermero de nuestros tiempos. El universo de estudio se constituyó por la totalidad de los enfermeros físicos(112), se definió una muestra de estudio de forma aleatoria conformada por 60 enfermeros, y una pequeña representación comparativa de familiares acompañantes.(30) Creamos un panel de apoyo compuesto por varios especialistas que tipificaron de forma práctica los valores morales específicos ideales para nuestros enfermeros, de esta manera conformamos un cuestionario con las variables objetos de estudio que se aplicó en dos tiempos, antes y después de impartir un taller didáctico sobre el tema que nos ocupa, los datos obtenidos en ambos tiempos se tabularon y compararon demostrando la eficacia de nuestro proyecto para reforzar valores morales específicos y necesarios para nuestro personal de enfermería (AU).

Globalization is a recent phenomenon interrelating all the countries around the world supported by scientific and technical advances. This interrelation in the economic, political and socio-cultural spheres has created a global culture that has crashed the values´ system of every country. Cuba is not out of the reach of these globalization´s negative effects. Our values´ system, formed in years of history and struggles, has created a sui generis people identified by its freedom eagerness, solidarity and internationalism. The world economic crisis has directly struck on the health professionals´ values formation in our country, especially in the case of the Nursing staff and mostly in progressive care nurses. This motivated the design of a prospective, longitudinal study in the Teaching Pediatric Hospital ¨Eliseo N. Caamaño¨ to qualify and strengthen the whole of specific values considered ideal for a nurse. The study universe were the totality of the hospital´s nurses, and the sample was randomly formed by 60 nurses and a little comparative representation of the family companions. It was created a panel of specialists who typified the ideal moral values specific for nurses. That way a questionnaire was elaborated with the variables that were object of study, to be applied before and after carrying out a didactic workshop on the theme. The obtained data were tabulated and compared, showing the efficacy of the project to reinforce moral values that are necessary and specific in the nursing staff (AU).

¿Cómo contribuir desde el pase de visita a la formación integral del estudiante de medicina? / How to contribute from the doctor´s visit to the medicine student's comprehensive training?

Se efectuó una revisión bibliográfica exhaustiva, con la finalidad de definir acciones para la ejecución del pase de visita, lo cual contribuirá al desarrollo integral del estudiante de medicina. Para ello se realizaron intercambios con profesores de experiencia y se valoró la importancia de la vinculación del estudio con el trabajo, así como del desarrollo de habilidades profesionales y valores. Se precisaron aspectos, tales como responsabilidad del profesor, participación de todos los integrantes, disciplina y principios éticos de la profesión, así como organización y forma de realizarlo.

An exhaustive literature review was carried out, with the purpose of defining actions for the implementation of the doctor's visit, which will contribute to the medicine student's comprehensive development. For this, exchanges with experienced professors were carried out and the importance of the link between study and work was evaluated, as well as of the development of professional skills and values. Aspects, such as the professor's responsibility, all the members' participation, discipline and ethical principles of the profession, as well as organization and the way to carry it out, were defined.

Evaluation of the work of hospital districts' research ethics committees in Finland.

The main task of research ethics committees (RECs) is to assess research studies before their start. In this study, 24 RECs that evaluate medical research were sent questionnaires about their structure and functions. The RECs were divided into two separate groups: those working in university hospital districts (uRECs) and those in central hospital districts (non-uRECs). The two groups were different in many respects: the uRECs were bigger in size, covered a wider range of disciplines (both medical and non-medical), had better resources and more frequent and regular meetings. After the survey was performed and analysed, the Medical Research Act was amended so that only hospital districts with a medical faculty in their region had a duty to establish ethics committees. After the amendment, the number of RECs evaluating medical research in Finland decreased from 25 to 9. The ethics committees that remained had wider expertise and were better equipped already by the time of this survey. Only one non-uREC was continuing its work, and this was being done under the governance of a university hospital district. Simple measures were used for qualitative analysis of the work of RECs that evaluate medical research. These showed differences between RECs. This may be helpful in establishing an ethics committee network in a research field or administrational area.

Ethics and best practice guidelines for training experiences in global health.

Academic global health programs are growing rapidly in scale and number. Students of many disciplines increasingly desire global health content in their curricula. Global health curricula often include field experiences that involve crossing international and socio-cultural borders. Although global health training experiences offer potential benefits to trainees and to sending institutions, these experiences are sometimes problematic and raise ethical challenges. The Working Group on Ethics Guidelines for Global Health Training (WEIGHT) developed a set of guidelines for institutions, trainees, and sponsors of field-based global health training on ethics and best practices in this setting. Because only limited data have been collected within the context of existing global health training, the guidelines were informed by the published literature and the experience of WEIGHT members. The Working Group on Ethics Guidelines for Global Health Training encourages efforts to develop and implement a means of assessing the potential benefits and harms of global health training programs.

Formación de valores ético-morales en el profesional de la salud / Forming ethic-moral values in health professionals

Se establece la relación del valor con las formas de la conciencia social y la moral, sintetizando algunos principios que favorecen la formación de valores éticos profesionales desde un enfoque psicológico, se definen categorías psicológicas como: necesidad, toma de decisiones, voluntad, motivo, jerarquía de motivos, objetivo, sentido de la vida, actitud, valoración, autovaloración y carácter, argumentando como participa cada una de ellas en la autorregulación de la conducta; y qué características deben tener para que la persona sea portadora de valores éticos morales, esenciales para el desempeño profesional del profesional de la salud.

We state the relation of value with the forms of social conscience and moral, synthesizing some principles favoring the formation of professional ethical values from a psychological approach, defining psychological categories like necessity, taking decisions, will, motive, motives hierarchy, objective, life sense, attitude, valuation, selfvaluation and character, explaining how every of them takes part in the behavior's self regulation; and which characteristics they should have for the person to have ethic-moral values, indispensable for the professional performance of the health professional.