Dreyfus and Dreyfus and Indicators of Behavioral Performance: A Study of Measurement Convergence.

INTRODUCTION: Assessment of efficacy of continuous professional development is an important part of continuing professional development programing as one of its goals is to increase the performance of the clinicians that serve the community. A frequently used and researched classification system for skill mastery is the Dreyfus and Dreyfus Model of Skill Acquisition. An alternative approach is the core competency framework that informs the assessment of residents and forms the foundation of the American Board of Medical Specialties Program for Maintenance of Certification. There are a number of methods of assessment of each competence. One of the most broadly employed and researched methods is a multisource assessment (360°) methodology. METHODS: Three hundred sixty-degree data were collected from 264 raters of physicians holding supervisory roles. Raters included the physicians' leaders, peers, and support/reports. The scale items were taken from an instrument developed for the assessment of interpersonal and communications skills, professionalism, and system-based practice. The Dreyfus scale was purposely built for this application. RESULTS: The Dreyfus scale was reduced to a single dimension, and raters assigned their score on that dimension as the indicator of their assessment of the physician's level of mastery. Results of a multivariate analysis of variance indicated a significant relationship between Dreyfus mastery score and competency items (P < .0001). DISCUSSION: These findings demonstrate a relationship between a measure of Dreyfus skill acquisition and measures based on the American Board of Medical Specialties/Accreditation Council for Graduate Medical Education six core competency framework. Results have implication for continuing professional development design and assessment.

Self-assessment in clinical health psychology: a model for ethical expansion of practice.

Society expects autonomous professions to ensure the competency of it practitioners, and professions should facilitate the continuing education and training of its members. Given the shift from psychology as a mental health profession to that of a health profession, the authors propose a self-assessment model for the individual practitioner to gauge his or her readiness to provide professional service in expanded areas of practice. This model could also be useful to the American Psychological Association, state psychological associations, and other purveyors of continuing education programs in systematically developing postgraduate experiences. A template for self-assessment that reflects well-accepted core domains of knowledge and skills is presented.

Support and counseling after maternal death.

Teamwork, communication, critical incident debriefing, and grief counseling surrounding the events of an unexpected maternal death are important continuing education and practice topics for health care employees working with pregnant women. Social technologies have impacted health care institutions and systems. Ethical dilemmas have been created in hospitals as they develop policies and procedures regarding electronic communications and social networking Web sites.

La formación continuada en oftalmología, un derecho, un deber y una responsabilidad / Continuing education in ophthalmology, a right, a duty and a responsibility

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La Unidad de Neonatología del Hospital Universitario Miguel Servet en la actualidad. Nuevos retos / Neonatology Unit of the Hospital Universitario Miguel Servet at present: new challenges

La presente revisión resume las características de la actual Unidad de Neonatología del Hospital Universitario Miguel Servet en Zaragoza. La Unidad de Neonatología es una unidad de nivel IIIB de acuerdo con la clasificación del Comité de Estandares y la Junta Directiva de la Sociedad Espñola de Neonatología de 2013, siendo la unidad neonatal de referencia de la Cornunidad Autónoma de Aragón. En una primera aproximación, se describen la misión, visión y valores, seguido de una resña estructural y de la cartera de servicios de la Unidad de Neonatología. La actividad asistencia de la Unidad de Neonatología se presenta teniendo en cuenta tanto la hospitalización neonatal como el seguimiento ambulatorio en el área de consultas externas. La actividad docente e investigadora son otros aspectos importantes a considerar en la actual Unidad de Neonatología. Finalmente se revisan los retos de la Unidad de Neonatología para los proximos afios (AU)

This review summarizes the characteristics of the current Neonatology Unit of the Universitary Hospital Miguel Servet in Zaragoza. The Neonatology Unit is a type IIIB unit according to the classification of the Standards Committee and the Board of the Spanish Society of Neonatology in 2013, being the reference neonatal unit for the Autonomous Community of Aragon. In a first approximation, the mission, vision and values are described, followed by a structural review and all the services that de Neonatology Unit provides. The health care activity of the Neonatology Unit is presented taking care of neonatal hospitalization and its subsequent follow-up out patient clinic. The teaching and investigation activity is another important aspect to consider in the current Neonatology Unit. Finally, the challenges of the Neonatology Unit for the next years are been reviewed (AU)

La Unidad de Cuidados Intensivos Pediátricos del Hospital Universitario Miguel Servet de Zaragoza en el año 2015 / The pediatric intensive care unit of the Hospital Universitario Miguel Servet of Zaragoza in the year 2015

El presente documento representa un resumen de la organización actual de la Unidad de Cuidados Intensivos Pediatricos (UCIP). Describiremos la historia y actividad asistencial de nuestra Unidad así como la actividad docente de grado, la formación especializada en Pediatría y la formacion continuada. Se comentaran los proyectos de investigación y los de mejora de calidad y las actividades para fomentar la humanizacion dc nuestra asistencia (AU)

This document represents a summary of the current organization of the Pediatric Intensive Care Unit (PICU). We will describe the history, and clinical and grade educational activities, pediatric specialized formation and continuous training. We will comment research projects, healthcare quality improvement and activities to encourage humanization of our assistance (AU)

Online survey tools: ethical and methodological concerns of human research ethics committees.

A SURVEY OF 750 UNIVERSITY HUMAN Research Ethics Boards (HRECs) in the United States revealed that Internet research protocols involving online or Web surveys are the type most often reviewed (94% of respondents), indicating the growing prevalence of this methodology for academic research. Respondents indicated that the electronic and online nature of these survey data challenges traditional research ethics principles such as consent, risk, privacy, anonymity, confidentiality, and autonomy, and adds new methodological complexities surrounding data storage, security, sampling, and survey design. Interesting discrepancies surfaced among respondents regarding strengths and weaknesses within extant guidelines, which are highlighted throughout the paper. The paper concludes with considerations and suggestions towards consistent protocol review of online surveys to ensure appropriate human subjects protections in the face of emergent electronic tools and methodologies.

Calidad de los resultados de la enseñanza de la medicina: percepción de la profesión / Quality of the results of the medical education: perception of the profession

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Teaching resources for genetics.

Genetics education is essential for preparing the public to engage in an informed debate about the future of genetics research and how its applications affect human health and the environment. This article provides an overview of genetics education resources that are available online, and is relevant to students in secondary education, health professionals, geneticists and the public. It also describes an integrated approach to teaching genetics, emphasizes the need for continuing teacher education, and encourages the involvement of geneticists and health professionals in providing a teaching resource.

A busca de uma identidade para o médico de família / In search of identity for the family doctor

Este artigo reflete algumas preocupações em relação ao médico de família, no sentido de se perguntar quem é esse sujeito dentro de uma formação médica “biologizante”, que não valoriza a atenção primária, deixando confuso seu ideal de profissão. Tem o objetivo de disponibilizar uma discussão que, na inter-relação entre educação e trabalho, invoca uma reflexão sobre a identidade profissional do médico de família. Realiza uma abordagem qualitativa sobre as práticas dos médicos de família do município do Rio de Janeiro enquanto objeto de análise. Resulta em considerações que refletem a reprodução de um modelo de atenção tradicional, fazendo crer que a educação permanente é uma estratégia importante na busca do acolhimento da população.

This paper discusses some concerns about the family doctor, wondering who is this subject within a biologicist medical formation, who does not valueprimary attention, making his professional ideal confused. It aims to present a discussion that, in theinter-relation between education and work, demands reflection on the professional identity of the familydoctor. It carries out a qualitative approach on family doctors’ practices in the City of Rio de Janeiro, as object of analysis. As a result, it presentsconsiderations that reflect the reproduction of a traditional attention model, leading to the idea that continuing education is an important strategy in the search of population reception.

La educación en bioética, camino para la profesionalidad / Education in bioethics, a way for professionalism

Uno de los elementos que han definido históricamente las profesiones diferenciándolas de los oficios es que sus responsabilidades se han definido más en términos morales que jurídicos. Porque no es el obligado respeto a la ley, sino la tendencia a la excelencia moral la característica fundamental de las profesiones. La profesionalidad es la base del contrato de la medicina con la sociedad y exige colocar los intereses de los pacientes por encima de los del médico, suministrando estándares de competencia e integridad, y proporcionando asesoría experta a la sociedad en cuestiones de salud. Un instrumento adecuado para conseguirla es la educación en bioética en cuanto estudio interdisciplinario de los problemas creados por los progresos médicos, biológicos y sus correspondientes tecnologías, para encontrar lo que es más humano en su aplicación práctica(AU)

One of the elements that have historically defined professions making them different from mere occupations is the fact that their responsibilities have been defined more in moral than juridical terms. Because it is not the due respect to the law but the tendency to moral excellence the fundamental characteristic of professions. Professionalism is the base of medicine's contract with society and it obliges to put patients’ interests above the doctors’ ones, supplying competence and integrity standards, and providing expert help to society in health matters. Education in bioethics is an appropriate instrument to reach this goal, as it promotes an interdisciplinary analysis of the problems created by the medical and biological progress and its correspondent technologies, to find what is most human in its practical application(AU)

El quién, cómo y dónde de la formación continuada de un área de salud / The who, how and where of continuing education in a health area

Introducción. El objetivo de nuestro estudio es describir el Plan de Formación Continuada de nuestra área en 2009 y el perfil académico de nuestros profesionales. Material y métodos. Estudio descriptivo transversal realizado en el Área 9 de Atención Primaria de Madrid. Las variables analizadas se obtuvieron del sistema de información del Plan de Formación Continuada 2009 y de una encuesta estructurada autocumplimentada diseñada por el grupo investigador. Se incluyeron los profesionales que solicitaron alguna actividad formativa en 2009 y los que contestaron la encuesta. La medida de asociación se calculó a través del test ji cuadrado. La magnitud del efecto se expresó a través de la razón de prevalencias (IC 95%). Resultados. Se gestionaron 1.557 inscripciones. El 94,9% de los profesionales del área han realizado al menos una actividad formativa. El 37,6% de las inscripciones se realizaron por enfermeras, 15,7% auxiliares administrativos y 15,4% médicos. El 61,7% (IC 95%; 59,2-64,1) recibieron el certificado. La mediana del número de participantes por curso fue 16 (rango intercuartílico [RI]=9-22,7) y del coste 500 € (RI=250-1.287,5). Por áreas temáticas, el 60% se forman en práctica asistencial y más del 50% realizan la formación en la institución. Hay diferencias significativas entre las profesiones en cuanto a experiencia docente (p=0,01) y pertenencia a grupo o sociedad (p<0,001). Conclusiones. Casi todos nuestros profesionales han realizado alguna actividad formativa, aunque un porcentaje considerable no llega a recibir certificado. Mayoritariamente se forman en práctica asistencial y a través de la organización sanitaria. Las enfermeras se inscriben más y reciben más la certificación (AU)

Introduction. The aim of our study is to describe the 2009 Continuing Education Plan in our area and the academic profile of our professionals. Material and methods Descriptive cross-sectional study performed in Primary Care Area 9 Madrid. The variables analysed were obtained from the information system of Continuing Education Plan 2009 and a self-completed structured questionnaire designed by the research team. We included professionals who applied for some education activity in 2009 and those who filled in the questionnaire. The measure of association was calculated by the chi-squared test. The magnitude of the effect was expressed as the prevalence ratio (95%). Results. A total of 1557 registrations were handled, and 94.9% of professionals had attended at least one training activity. Nurses accounted for 37.6% of registrations, followed by administrative assistants, 15.7% and physicians 15.4%. A continuing education certificate was received by 61.7% of the professionals (95% CI, 59.2-64.1). The median number of participants per course was 16 (RI=9 to 22.7) and cost 500 € (IR=250 to 1287.5). As regards the training location, 60% took place in the clinical practice and more than 50% reported training in the institution. There were significant differences between professions in terms of teaching experience (P=.01) and group or society membership (P<.001). Conclusions. Almost all of our professionals had completed a training activity, although a considerable percentage failed to receive a certificate. Most took place in clinical practice and through the health care organization. Nurses are enrolling more and received more certificates (AU)

Procesos asistenciales integrados: una herramienta para la mejora continua de la asistencia sanitaria / Integrated care processes: a tool for the continuing improvement of health care

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XVI Congreso Nacional de la Sociedad Española de Educación Médica (SEDEM): Madrid, 22-25 de octubre de 2003 / No disponible

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Comitês de ética em pesquisa e os desafios da educação permanente / Research ethics committees: continuous training challenges

O processo de educação continuada desenvolvido pelos Comitês de Ética em Pesquisa (CEPs) ultrapassa a capacitação dirigida a seus membros e inclui distintos atores sociais envolvidos nesse contexto, entre os quais, investigadores, estudantes de diferentes áreas do conhecimento, representantes leigos e a sociedade em geral. Esse processo tem como objetivo contribuir para aprimorar as práticas de revisão ética, manter a integridade das pesquisas e promover a proteção dos participantes inseridos nos estudos. Porém, a responsabilidade de um comitê não se esgota com a aprovação inicial de um protocolo, uma vez que compartilha com os pesquisadores a manutenção dos padrões éticos e científicos durante a condução do estudo. Os CEPs devem desenvolver estratégias para manter a transparência sobre o trabalho desenvolvido, difundir amplamente os procedimentos operacionais que utilizam para que as pessoas possam conhecer o marco avaliativo sob o qual os protocolos serão revisados. Isso contribui para o fortalecimento operativo do comitê e para a capacitação das pessoas envolvidas no contexto das práticas científicas. Aprende-se, também, por meio da análise das experiências vivenciadas e, justamente por isso, apresenta-se ao final do texto o relato da experiência das atividades desenvolvidas por um CEP do Distrito Federal.

Continuous education developed by Research Ethics Committees (CEPs) overlaps the educational programmes directed to their members and includes distinct social actors involved in the context of scientific practice, such as researchers, students of different areas of knowledge, lay members and society at large. This process contributes to strengthen ethics review practices, guarantee the research integrity and promote the participants protection. The committee's responsibility does not finalize with the initial approval of a protocol, because it is necessary to share with researchers the maintenance of ethical and scientific standards while the study is carried out. CEPs must develop strategies to maintain the transparency of its work development and disseminate operational procedures used during the review process. The scientific community needs to know the framework under protocols is reviewed. This strategy increases the operational practice of the committee and amplifies the capabilities of its members. It is possible to learn analyzing the daily life experiences and the activities developed by a CEP in Federal District, Brazil are presented at the end of the text.

Curso de Formação de Monitores para as Ações de Educação Permanente para o Controle Social” - Supervisão Técnica de Saúde Pirituba/Perus/Coordenadoria Regional de Saúde Norte / Monitors Training Course for Continuing Education Actions for Social Control - Health Technical Supervision Pirituba / Perus / Northern Regional Health Coordination

A Supervisão Técnica de Saúde Pirituba/Perus (STS–PP) comprometida com o fortalecimento da Gestão Pública, do Controle Social, vem realizando a capacitação de conselheiros de forma continua no território, sem que se observe intensificação nas ações de controle social. Pautado nessas preocupações passa a implementar a formação de conselheiros tendo como a base a educação permanente, com a capacitação de monitores para acompanhar os trabalhos, tendo como propósito a consolidação dos conhecimentos obtidos e a aquisição de uma visão critica, principalmente sobre a política de saúde e os dispositivos necessários para o controle social consciente. No 1º semestre de 2014 foi realizado o curso para 20 monitores, sendo 4 do segmento usuários e 16 servidores, que foram habilitados. Dessa forma se ampliou a formação de monitores na perspectiva da Educação Permanente, permitindo atuar efetivamente no território e no processo de trabalho da ação conselheira (AU)