Promoting reflective practice in an infant and early childhood training program.

Reflective practices provide a supportive base through which preservice infant and early childhood teachers and allied professionals can achieve knowledge, skills, and professional dispositions to support young children and their families. This paper is a program description that describes the rationale for infusing reflective practices into the learning goals for preservice early childhood training, highlighting the specific reflection skills from the Infant and Early Childhood Mental Health Competency Guidelines. We describe how one university early childhood training program promotes student reflection skills referencing three distinct perspectives: (1) why reflection is essential to developing knowledge and skills; (2) the role group reflection plays in sustaining deep knowledge and skill development for students and faculty; (3) how faculty promote students' awareness of the connection between personal experience and professional dispositions through reflection during practicum experiences. The benefits and challenges of embedding reflective practices in preservice early childhood training are also discussed.

Las prácticas de reflexionar proveen una base de apoyo a través de la cual los maestros y profesionales aliados en el pre-servicio de infantes y la temprana niñez pueden lograr conocimientos, habilidades y disposiciones profesionales para apoyar a los pequeños niños y sus familias. Este ensayo es la descripción de un programa que describe la razón fundamental para incluir las prácticas de reflexionar dentro de los objetivos de aprendizaje para el entrenamiento del pre-servicio en la temprana niñez, subrayando las habilidades de reflexionar específicas que parten de los Preceptos Guías para la Competencia en la Salud Mental de la Infancia y la Temprana Niñez. Describimos cómo el programa de entrenamiento en la temprana niñez en una universidad promueve las habilidades de reflexionar en el estudiante, haciendo referencia a tres perspectivas distintas: 1. Por qué el reflexionar es esencial para desarrollar el conocimiento y las habilidades; 2. El papel que juega el grupo de reflexión para sostener el profundo desarrollo del conocimiento y las habilidades para estudiantes y profesores; 3. Cómo el profesorado promueve la concienciación de los estudiantes sobre la conexión entre la experiencia personal y las disposiciones profesionales a través de la reflexión durante las experiencias de práctica. También se discuten los beneficios y retos de incluir prácticas de reflexión en el entrenamiento del pre-servicio en la temprana niñez.

Les pratiques de réflexion offrent une base de soutien au travers de laquelle les enseignants et professionnels allies de la petite enfance et des services aux nourrissons peuvent développer et acquérir des connaissances, des compétences et des dispositions professionnelles afin de soutenir les jeunes enfants et leurs familles. Cet article est une description qu'un programme qui décrit la rationnelle pour l'infusion de compétences de réflexions dans les objectifs d'apprentissage pour la formation pré-service de la petite enfance, mettant en évidence les compétences de réflexion spécifiques qui se trouvent dans les Grandes Lignes de Compétence en Santé Mentale de la Petite Enfance. Nous décrivons la manière dont le programme de formation pour la petite enfance d'une université promeut des compétences de réflexion des étudiants en faisant référence à trois perspectives distinctes: 1. Pourquoi la réflexion est essentielle au développement des connaissances et des compétences; 2. Le rôle que joue la réflexion de groupe pour le maintien de connaissances profondes et le développement des compétences pour les étudiants et les professeurs; 3. La manière dont les professeurs promeuvent la prise de conscience de la part des étudiants du lien entre l'expérience personnelle et les dispositions professionnelles au travers de la réflexion durant les expériences en stages. Les bénéfices et les défis qu'il y a à intégrer des pratiques de réflexion dans la formation pré-service de la petite enfance sont aussi discutés.

Identifying and developing effective post-2020 conservation bridging leaders.

Effective bridging leaders interact within and outside their group to facilitate collaboration required in multistakeholder contexts. This is particularly crucial to community-based conservation interventions that strive to achieve both ecological and social objectives by actively engaging or devolving decision-making and management authority to local communities. Although a viable approach in many contexts, achieving "unprecedented collaboration" called for by the Post-2020 Global Biodiversity Framework in community-based conservation is problematic given the multiple and diverse actors affecting and affected by these interventions. Therefore, effective leadership becomes crucial to implementing necessary strategies to engage actors and resolve conflict inclusively. Yet, weak leadership commonly constrains these interventions. I reviewed relevant literature and devised a framework of effective bridging leadership characteristics. I then used this framework to appraise bridging leadership in two African coastal-marine community-based conservation cases. I employed social network analysis and semistructured and group interviews in the two cases. Several local leaders emerged as key (potential) bridging leaders. Furthermore, I found that effective bridging leaders require not only legal recognition but also perceived legitimacy resulting from building trust with other actors. Additionally, the inclusive collaboration required multiple sources of emotionally intelligent bridging leaders with the integrity, humility, empathy, and cultural awareness necessary to mitigate elite capture, effectively communicate, and empower and provide support to others. Because emotional intelligence in conservation leadership remains a knowledge gap, particularly in community-based conservation research, insights from this study should be useful to diverse conservation actors.

Los líderes vinculantes efectivos interactúan dentro y fuera de su grupo para facilitar la colaboración requerida en contextos con múltiples actores. Esto es crucial para las intervenciones de conservación basada en la comunidad que buscan alcanzar objetivos ecológicos y sociales mediante la participación y transferencia de la autoridad gestora y la toma de decisiones a la comunidad local. Aunque es una estrategia viable, es problemático lograr la "colaboración sin precedentes" en la conservación basada en la comunidad que exige el Marco Mundial de Biodiversidad Post-2020 debido a los múltiples y diversos actores que afectan y han sido afectados por estas intervenciones. Por lo tanto, el liderazgo efectivo se vuelve crucial para la implementación de las estrategias necesarias para involucrar a los actores y resolver los conflictos de manera inclusiva. Sin embargo, es común que el liderazgo deficiente limite estas intervenciones. Revisé la literatura relevante y diseñé un marco de trabajo de las características del liderazgo vinculante efectivo. Después usé este marco para valorar el liderazgo vinculante en dos casos de conservación costera-marina basada en la comunidad en África. Analicé las redes sociales y realicé entrevistas grupales y semiestructuradas en ambos casos. Además, descubrí que los líderes vinculantes efectivos requieren no sólo de un reconocimiento legal, sino también de la legitimidad resultante de la construcción de la confianza con otros actores. Asimismo, la colaboración inclusiva requirió de líderes vinculantes de múltiples orígenes con inteligencia emocional y con la integridad, humildad, empatía y conciencia cultural para mitigar la captura elite, comunicar efectivamente y empoderar y proporcionarles apoyo a los demás. Ya que la inteligencia emocional todavía es un vacío de conocimiento en el liderazgo de la conservación, particularmente en la investigación sobre la conservación basada en la comunidad, el conocimiento que brinda este estudio debería ser útil para diversificar a los actores de la conservación.

Sparking collaboration and instilling core competencies through training a statewide workforce in Infant Mental Health: Report from the field.

Fostering collaboration and instilling core competencies across the diverse Infant Mental Health systems and understanding their training needs are crucial endeavors to support the delivery of evidence-based care and treatment continuity for infants and their families. This paper details the Connecticut Association for Infant Mental Health's use of a comprehensive infant mental health training series as a vehicle to achieve these aims. The training series, and the steps taken to execute and evaluate it are described to provide a framework for future collaborative training initiatives. Evaluation efforts were designed to address knowledge sought and gained and included pre and posttraining tests, participant reports of their training goals and needs, and interviews with trainers regarding the series' strengths and limitations. Findings suggest significant improvements in participants' knowledge of training content across trainings. Participants indicated a desire for trainings on working with the whole family and their plan to integrate skills from the training into their work. Recommendations from trainers and evaluators are provided to spark future trainings and collaborative efforts.

Fomentar la colaboración e inculcar las competencias centrales entre los diversos sistemas de Salud Mental Infantil, así como comprender las necesidades de entrenamiento son iniciativas cruciales para apoyar la continuidad del ofrecimiento del cuidado y el tratamiento con base en la evidencia para infantes y sus familias. Este ensayo detalla el uso de una serie de entrenamientos de salud mental infantil comprensiva de la Asociación de Connecticut para la Salud Mental Infantil como un vehículo para lograr las metas mencionadas. La serie de entrenamientos y los pasos que se toman para ejecutarlo y evaluarlo se describen para aportar un marco de trabajo para futuras iniciativas colaborativas de entrenamiento. Los esfuerzos de evaluación se diseñaron para tomar en cuenta el conocimiento que se busca y se recibe e incluyeron exámenes previos y posteriores al entrenamiento, el reporte de los participantes sobre sus metas y necesidades en el entrenamiento, así como entrevistas con entrenadores acerca de los puntos fuertes y limitaciones de la serie. Los resultados sugieren mejoras significativas en cuanto al conocimiento de los participantes acerca del contenido del entrenamiento a lo largo de las sesiones de entrenamiento. Los participantes manifestaron su deseo de ser entrenados en trabajar con la familia entera y su plan de integrar habilidades aprendidas en el entrenamiento en su trabajo. Se incluyen las recomendaciones de los entrenadores y evaluadores con el fin de motivar futuros entrenamientos y esfuerzos colaborativos.

Le fait de cultiver des collaborations et le fait d'instiller des compétences fondamentales au travers des divers systèmes de Santé Mentale du Nourrisson, tout comme le fait de comprendre leurs besoins en formation sont des tentatives cruciales de soutenir la prestation de soins factuels et la continuité de traitement pour les nourrissons et leurs familles. Cet article détaille l'utilisation qu'a faite l'Association de Santé Mentale du Nourrisson de l'état du Connecticut aux Etats-Unis d'une série de formation complète en santé mentale du nourrisson en tant que véhicule afin d'achever ces buts. La série de formation et les mesures prises pour la mettre en place et l'évaluer sont ici décrites afin d'offrir une structure d'initiatives collaboratives de formation. Les efforts d'évaluation ont été conçus afin d'aborder les connaissances désirées et acquises et ont inclus des tests pré- et post-formation, des rapports des participants sur leurs buts et leurs besoins de formation, et des entretiens avec les formateurs concernant les points forts et les limitations de la série. Les résultats suggèrent des améliorations importantes dans les connaissances sur le contenu de la formation de la part des participants au travers des formation. Les participants ont indiqué le désir de formation sur le travail avec toute la famille et les intentions qu'ils avaient d'intégrer les compétences acquises durant la formation dans leur travail. Des recommandations pour les formateurs et les évaluateurs sont présentées afin de faire naître dans le future d'autres formations et efforts collaboratifs.

Pros and cons of innovations in medical education.

Medical education has implemented various innovative strategies with the purpose to attain better learning achievements. An evaluation is made of the experiences in the competencies approach, new learning technologies, curricular alternatives, professional evaluation and distance education technologies in order to locate them in the areas they belong.

La educación médica ha puesto en práctica diversas estrategias innovadoras con el propósito de alcanzar mejores logros de aprendizaje. Se hace una evaluación de las experiencias relacionadas con el enfoque por competencias, las nuevas tecnologías educativas, las alternativas curriculares, la profesionalización de la evaluación y las técnicas educativas a distancia, para ubicarlas en el lugar que les corresponde.

[Competency-based Neurosurgery Residency Programme]. / El nuevo programa de Residencia en Neurocirugía basado en competencias.

A programme proposal for competency-based Neurosurgery training adapted to the specialization project is presented. This proposal has been developed by a group of neurosurgeons commissioned by the SENEC (Spanish Society of Neurosurgery) and could be modified to generate a final version that could come into force coinciding with the implementation of the specialization programme. This document aims to facilitate the test of the new programme included in the online version of our journal. DURATION OF THE PROGRAMME: Total training period is 6 years; initial 2 years belong to the surgery specialization and remaining 4 years belong to core specialty period. STRUCTURE OF THE PROGRAMME: It is a competency-based programmed based on the map used by the US Accreditation Council for Graduate Medical Education (ACGME) including the following domains of clinical competency: Medical knowledge, patient care, communication skills, professionalism, practice-based learning and improvement, health systems, interprofessional collaboration and professional and personal development. Subcompetencies map in the domains of Knowledge and Patient care (including surgical competencies) was adapted to the one proposed by AANS and CNS (annex 1 of the programme). A subcompetency map was also used for the specialization rotations. INSTRUCTION METHODS: Resident's training is based on personal study (self-learning) supported by efficient use of information sources and supervised clinical practice, including bioethical instruction, clinical management, research and learning techniques. EVALUATION METHODS: Resident evaluation proposal includes, among other instruments, theoretical knowledge tests, objective and structured evaluation of the level of clinical competency with real or standardised patients, global competency scales, 360-degree evaluation, clinical record audits, milestones for residents progress and self-assessment (annex 2). Besides, residents periodically assess the teaching commitment of the department's neurosurgeons and other professors participating in rotations, and annually assess the overall operation of the programme. Results of evaluations are registered, together with other relevant data, in the Resident's Book. PROGRAMME'S NATIONAL COMMITTEE: The creation of a Programme Committee directly attached to the SENEC (National Commission) that, aside from generating a final version of the programme, monitors its implementation (level of adherence and operation in the different departments), assumes the creation of test banks and the centralized administration of knowledge tests (in the middle of the residency and/or at the end of it) and centralizes information collected by tutors that could be used for re-accreditation of the services, is proposed.

Do primary health centres and hospitals contribute equally towards achievement of the transversal clinical competencies of medical students? Performance on the Objective Structured Clinical Examination (OSCE) in competency acquisition.

OBJECTIVES: The adaptation of the educational programmes of European faculties of medicine to the European Higher Education Area guidelines has focused curricula design on competence acquisition. Competencies are defined as the achievements of a predetermined level of efficacy in real-world scenarios. Our objective was to assess whether performance on a common competence evaluation test, the Objective Structured Clinical Examination (OSCE), resulted in different scores for second-year students after a practical medical training course took place in a primary health centre (PHC) or in a hospital. DESIGN: A descriptive study was conducted during the 2010-2014 academic year of the OSCE test scores obtained by all second-year students. LOCATION: Faculty of Medicine at the University of Lleida (Catalonia, Spain). MAIN MEASUREMENTS: We performed a correlation analysis between students who completed their practical medical training at the PHC and hospitals utilising Student's t-test for comparison of means. RESULTS: 423 students who completed internships at the PHC and at hospitals obtained OSCE mean scores of 7.32 (SD; IC) (0.82; 7.18-7.47) points and 7.17 (0.83; 6.07-7.26) points, respectively (p=0.07). CONCLUSIONS: Second-year medical students acquired similar competency levels in the two analysed training scenarios. The two areas both serve their teaching purpose.

PERSONAL COMPETENCIES, SOCIAL RESOURCES, AND PSYCHOSOCIAL ADJUSTMENT OF PRIMIPAROUS WOMEN OF ADVANCED MATERNAL AGE AND THEIR PARTNERS.

The present study aimed to (a) characterize the personal competencies, the social resources, and the psychosocial adjustment (psychological distress, quality of life, and parenting self-perceptions) during the early postpartum period of primiparous women of advanced age (≥35 years at the time of delivery) and their partners (older parents) compared with that of younger first-time mothers (20-34 years) and their partners (younger parents); and (b) explore the role of personal competencies and social resources in couples' psychosocial adjustment, depending on the age group. Older (n = 74) and younger parents (n = 71) completed self-report measures to assess personal competencies and social resources (third trimester of pregnancy), psychological distress, and quality of life (third trimester of pregnancy and 1-month' postpartum) and parenting self-perceptions (1-month' postpartum). Older parents were more similar than different from younger parents regarding personal competencies, social resources, and psychosocial adjustment during the first postnatal month. Regardless of the age group, higher personal competencies and social resources predicted lower anxiety and more positive parenting self-perceptions in women. Beyond higher personal competencies, older maternal age also predicted higher quality of life. In men, higher personal competencies were protective against anxiety, but only at older maternal age.

[Transferable skills of healthcare professionals in providing homecare in chronically ill patients]. / Competencias transversales de los profesionales que facilitan atención domiciliaria a pacientes crónicos.

AIM: To determine the relevance level of non-technical skills of those professionals dedicated to the healthcare of patients with chronic diseases, from an analysis of home care professionals. DESIGN: Quantitative and qualitative research conducted in 2 phases: 1.st from November 2010 to March 2011 and 2.nd from December 2012 to August 2013. SETTING: Health Region of Barcelona city. PARTICIPANTS: During the 1.st phase, 30 professionals from homecare teams (3 from Primary Care and 3 from Hospitals). In 2.nd phase, 218 professionals from 50 Primary Healthcare Centres and 7 home care programmes. METHOD: Purposive sampling in was used in the1st phase, and randomized sampling in the 2.nd phase. Likert scales and focus group were used. RESULTS: A total of 19 skill categories were identified in the 1.st phase. In the 2.nd phase 3 metacategories were established: comprehensive patient-centered care, interprofessional organization, and inter-health care fields and interpersonal skills. CONCLUSIONS: It is necessary to improve and secure the professionals relationships between levels of healthcare, continuity of healthcare, biopsychosocial model and holistic attention to patients and relatives, looking at emotions, expectations, feelings, beliefs and values. It is essential to design and implement continuing training in transferable skills in every healthcare centre, through active methodologies.

[Innovations in continuing/permanent education methods for the intensive care nurses]. / Innovaciones en los métodos de formación continuada/permanente de las enfermeras de cuidados intensivos.

Intensive care nursing is carried out in a dynamic environment characterized by the continuous incorporation of new technologies, approaches to care and a request for safety, participation and transparency by the public. Continuing/permanent intensive care nursing training in the acquisition of new competencies is key in this setting. In order to achieve this goal, simulation and problem based learning should be incorporated as essential methodologies to teach these skills. At the same time research should be done on which attitudes, competences, and knowledge are necessary to increase their intellectual knowledge. The core characteristics of ICU and its nursing should allow a deep change in their approach to continuing/permanent nursing education.

Training in intensive care medicine. A challenge within reach.

The medical training model is currently immersed in a process of change. The new paradigm is intended to be more effective, more integrated within the healthcare system, and strongly oriented towards the direct application of knowledge to clinical practice. Compared with the established training system based on certification of the completion of a series or rotations and stays in certain healthcare units, the new model proposes a more structured training process based on the gradual acquisition of specific competences, in which residents must play an active role in designing their own training program. Training based on competences guarantees more transparent, updated and homogeneous learning of objective quality, and which can be homologated internationally. The tutors play a key role as the main directors of the process, and institutional commitment to their work is crucial. In this context, tutors should receive time and specific formation to allow the evaluation of training as the cornerstone of the new model. New forms of objective summative and training evaluation should be introduced to guarantee that the predefined competences and skills are effectively acquired. The free movement of specialists within Europe is very desirable and implies that training quality must be high and amenable to homologation among the different countries. The Competency Based training in Intensive Care Medicine in Europe program is our main reference for achieving this goal. Scientific societies in turn must impulse and facilitate all those initiatives destined to improve healthcare quality and therefore specialist training. They have the mission of designing strategies and processes that favor training, accreditation and advisory activities with the government authorities.

Academic training of nurses developing advanced practice roles.

The nursing profession, without losing its essence, is in continuous evolution in order to face and respond to the ever-changing health challenges of the population. Advanced Practice Nursing is a clear example of this development. The performance of advanced practice roles entails greater responsibility, expansion and depth of nursing practice, which is only possible with additional education beyond the bachelor's degree - a master's or doctoral degree in nursing - and greater expertise in clinical practice in a particular area of specialization. Advanced practice nursing is intrinsically linked to the level of education since, further academic development of nursing promotes the advancement of autonomous practice. This article addresses the education of Advanced Practice Nurses, and focuses on its core aspects; providing detailed information on competencies, curricular structure, curriculum and key components of training programs. Finally, special mention is made of advanced role training in the critical care setting.

Reliability of the Mental Health Nurse Competency Assessment Tool (ECOEnfSM): A pilot study.

AIM: To evaluate the reliability of the ECOEnfSM scale as a tool to assess the professional competencies of Mental Health Nurse Practitioners (MHNP) in their clinical practice. METHOD: A pilot study, observational, descriptive and cross-sectional, focuses on MHNP who have completed their Specialized Health Training Program (SHTP) in Spain. The data were collected by general and collaborators mentors of the Multiprofessional Teaching Units (MTUs). The Mental Health Nursing Competency Assessment Tool (ECOEnfSM) was used, which consists of three subscales and eight Competence Units (CU). A reliability and validity analysis were conducted (Cronbach's alpha and Spearman's correlation coefficient). RESULTS: The Rotation Assessment subscales showed excellent reliability (r > 0.90) with high and very high correlations (r > 0.6) in all UCs with high levels of significance (P < .01). The Annual Assessment subscale showed good reliability (r > 0.80) with a medium and very high correlation (r > 0.4) with high levels of significance (P < .01). All UCs showed a good to excellent consistency (r > 0.80). The "Home Visits" assessment criterion showed heterogeneity of data due to there are few MTUs that fully develop it. CONCLUSION: The ECOEnfSM scale showed very high reliability in MHNP during their training program in Spain. The ECOEnfSM is considered the only objective tool in Spain to assess the professional competencies in this population.

Self-perceived competences in evidence-based practice of clinical-teaching nurses versus clinical nurses.

AIM: To compare the evidence-based practice (EBP) self-perceived competences of clinical teacher nurses (CTN) versus clinical nurses (CN) to detect areas for improvement in practical training. METHOD: A cross-sectional study by means of a self-assessment questionnaire sent to nurses of two public hospitals of Castilla y León was performed, between February to May 2020. Variables included competences in evidence based practice (EBP) - attitude, knowledge, skills and use-, sociodemographic, job, academic, teaching relations and training in investigation methodology and/or EBP. A validated questionnaire EBP-COQ prof© of 35 questions with answers type Likert (1, very disagree-5, very agree) was used. Data analysis (descriptive and bivariate) was performed by means SPSS v.24 program. RESULTS: 171 questionnaires were answered by nurses. CN 52%, CTN 48%. There were no significant differences between both groups regarding sociodemographic variables. Mean age was 43.6 ±â€¯9.9 and 42.9 ±â€¯8.5 for CN and CTN, respectively. Total sample showed a mean EBP competency score of 3.54 ±â€¯1.00 (attitudes: 4.40 ±â€¯0.60; knowledge: 3.08 ±â€¯0.94; skills: 3.57 ±â€¯0.66; utilization: 3.36 ±â€¯0.75). The CTN group obtained higher mean scores in knowledge dimension, compared with CN (P = .02) and with total sample (P = .02). There were no significant differences in other dimensions. CONCLUSION: CTN showed better self-perceived competences scores only in the knowledge dimension compared with CN. Taking in account the level of responsibility they support in their daily practice, it would be advisable to design management strategies in order to improve attitudes, skills and utilize EBP, acting as professional role models for students and peer mentors.

[The role of the nurse in the field of public health]. / El rol de la enfermería en el ámbito de la salud pública.

OBJECTIVE: Identify the role of public health nurses and differentiate it from that of community care nurses in the context of Catalonia, through the experiences and perspectives of professionals in the field of public health. METHOD: Descriptive phenomenological qualitative study. Fourteen interviews were conducted with key informants, from the field of public health and community care, selected by i purposive sampling. Content analysis using thematic methodology, creation of categories from the triangulation of results. RESULTS: The professional competencies and functions performed by nursing in the field of public health are analysed. Most of the specific functions were the ones related to "care" and the "global vision" of health. The indeterminacy of functions and roles, related to gender inequality, leads to a low recognition of the profession and a lack of appropriateness of the professional category, reflected in a low presence of nurses in management positions in public health. Although some competencies are shared with the family and community nurse, there are also differences. CONCLUSIONS: This study sheds light on the role of public health nursing, often overlooked. It is urgent to define public health nurses role and functions, in order to avoid inequalities and increase their recognition.

Diseño de un instrumento para evaluar las actividades profesionales confiables en cirugía general.

AIM: Competency-based medical education has become increasingly prevalent among surgical accreditation bodies that conduct assessments to ensure the competency of future professionals and judge the adequacy of training programs. MATERIALS AND METHODS: Cross-sectional study to validate an instrument to evaluate entrustable professional activities (EPA) according to the Single Program of Medical Specialties through content and construct validity by expert judgment, and internal consistency with Cronbach's alpha. RESULTS: Four of the rubrics scored high to optimal for univocity and relevance. Only one rubric had to be modified in two of its items. Internal consistency was high (Cronbach's alpha of 0.97). When applying the instrument, the residents showed differences in the level of competence according to postgraduate year, identifying better performance in the last year. DISCUSSION: The instrument was validated with a high degree of reliability in univocity and relevance, and high internal consistency. The residents demonstrated appropriate EPA to manage surgical patients safely, efficiently, with quality and warmth. The ability to reach the strategic level of performance is the main component of the competency-based medical education through the EPA.

OBJETIVO: La educación médica basada en competencias se ha vuelto cada vez más frecuente entre los organismos de acreditación quirúrgica que realizan evaluaciones para asegurar la competencia de los futuros profesionales y juzgar la idoneidad de los programas de formación. MATERIAL Y MÉTODOS: Estudio transversal para validar un instrumento para evaluar las actividades profesionales confiables (APC) según el Programa Único de Especialidades Médicas mediante validez de contenido y constructo por juicio de expertos, y consistencia interna con alfa de Cronbach. RESULTADOS: Cuatro de las rúbricas obtuvieron nivel alto a óptimo para univocidad y relevancia. Solo una rúbrica debió ser modificada en dos de sus ítems. La consistencia interna fue alta (alfa de Cronbach de 0.97). Al aplicar el instrumento, los residentes mostraron diferencias en el nivel competencial según el año de posgrado, identificando mejor desempeño el último año. DISCUSIÓN: El instrumento fue validado con un alto grado de fiabilidad en univocidad y relevancia, y una alta consistencia interna. Los residentes demostraron poseer las APC necesarias para tratar pacientes quirúrgicos de manera segura, eficiente, con calidad y calidez. La capacidad para alcanzar el nivel estratégico de desempeño es el componente principal de la educación médica basada en competencias a través de las APC.

Description of basic competencies in clinical ultrasound imaging for emergency departments. / Competencias básicas de la ecografía clínica en los servicios de urgencias y emergencias.

TEXT: Recent years have seen great advances in the use of clinical ultrasound imaging in both hospital emergency departments and out-of-hospital settings. However, all new techniques require up-to-date definitions of competencies relevant to the clinical realities of different specialties and the geographic settings in which specialists work. To that end, a group of experts in clinical ultrasound reviewed the evidence available in the literature and strictly applied the Delphi method to define the competencies relevant to emergency physicians. The group worked with the starting premise that clinical ultrasound imaging should be a common competency across the specialty.

TEXTO: En los últimos años, la ecografía clínica (EC) ha sufrido un avance muy importante en su implantación dentro de los servicios de urgencias, tanto hospitalarios como extrahospitalarios, pero como toda técnica requiere un ámbito competencial definido, actualizado y enmarcado, tanto en la realidad clínica de la especialidad que desempeñamos como en la geográfica del país donde ejercemos. Por ello, un grupo de expertos en la materia ha desarrollado el presente documento en el que basándose por un lado en la evidencia disponible en la bibliografía científica y por otro en una metodología Delphi, planteó el objetivo de establecer un claro marco competencial base para todos los urgenciólogos, asumiendo como premisa inicial que la EC debería ser una competencia transversal común.

[Impact of the Covid-19 pandemic on specialized healthcare training in a teaching center]. / Impacto de la pandemia COVID-19 en la formación sanitaria especializada en un centro docente.

OBJECTIVE: Evaluation of the impact of the health crisis caused by the Covid-19 pandemic on specialized healthcare training in a teaching center. METHODS: Cross-sectional descriptive study, by means of an electronic questionnaire sent to 167 residents in June 2020, to evaluate the burden of care, suspension of rotations and Covid-19 symptoms. The impact on the acquisition of professional competencies was measured using a four-level Likert scale (none, a little, quiet, a lot). The profile of acquired competencies was constructed and its association with the professional profile was studied using Generalized Linear Models. The qualitative approach was carried out through an open question on how it influenced their learning and the different categories were extracted through triangulation. RESULTS: The impact on learning was important for 94.8% of the residents. A total of 81.4% left the rotations they were doing and reported high workload, loss of training opportunities, uncertainty and ethical conflicts. They appreciated significant learning in the competencies of teamwork (93.2%), professionalism (86.2%), ethics (79.9%) and communication (78%). Technical competencies were deficient. The final balance of learning was perceived as positive by 54.4%, especially residents in central services and medical specialties. A total of 67.8% felt overwhelmed at times due to fatigue-emotional impact, care overload, ethical conflicts and lack of resources. CONCLUSIONS: The Covid-19 pandemic had an exceptional impact on specialized health care training. It is necessary to re-evaluate training programs to ensure the acquisition of the technical competencies that are lacking.

Diploma on Basic Echocardiography training and competencies for Intensive Care and Emergency medicine: Consensus document of the Spanish Society of Anesthesiology and Critical Care (SEDAR) and the Spanish Society of Emergency Medicine (SEMES).

Cardiac ultrasound has become an essential tool for diagnosis and hemodynamic monitoring in critically ill patients. Scientific societies need to work toward developing a training program that will allow clinicians to acquire competence in performing cardiac ultrasound and understanding its indications. The Clinical Ultrasound for Intensive Care task force of the Spanish Society of Anesthesiology and Critical Care (SEDAR) and the Spanish Society of Emergency Medicine (SEMES) have drawn up this position statement defining the learning objectives and training required to acquire the competencies recommended for basic ultrasound management in the intensive care and emergency setting in order to obtain a diploma in Basic Ultrasound in Intensive Care and Emergency Medicine. This document defines the training program and the competencies needed for basic skills in ultrasound in Intensive Care and Emergency Medicine-part of the Diploma in Ultrasound for Intensive Care and Emergency Medicine awarded by SEDAR/SEMES. The Spanish Society of Anesthesia (SEDAR), Spanish Society of Internal Medicine (SEMI) and Spanish Society of Emergency Medicine (SEMES) have drawn up a position statement determining the competencies and training program for a diploma in ultrasound (lung, abdominal and vascular) in Intensive Care and Emergency Medicine. To obtain the SEDAR/SEMES Diploma in Ultrasound in Intensive Care and Emergency Medicine, clinicians must have completed the SEDAR, SEMI and SEMES Diploma in basic ultrasound and the Diploma in lung, abdominal, and vascular ultrasound.

[Talent and competencies in clinical nutrition]. / Talento y competencias en la nutrición clínica.

Introduction: The formation of medical students in clinical nutrition is scattered throughout the curriculum and is insufficient in many cases. This article reviews the status of nutrition in the curriculum, giving some keys for an effective inclusion therein. Also, basic concepts regarding talent are explained from a practical point of view, and the importance of talent in clinical nutrition and how to work with talent is discussed.

Introducción: La formación en nutrición clínica de los estudiantes de medicina está disgregada a lo largo de la carrera y es insuficiente en muchos casos. En este artículo se revisa la situación de la nutrición en los planes de estudio y se dan algunas claves para su inclusión de manera efectiva en el currículo. Además, se explican conceptos básicos relacionados con el talento, desde un punto de vista práctico, y se discute la importancia del talento en la nutrición clínica y cómo trabajarlo.

[Characteristics and contents of the Master's programs in public health in Spain]. / Características y contenidos de los programas de maestría en salud pública en España.

OBJECTIVE: To compare the main academic characteristics and contents of the different master's programs in public health currently offered in Spain. METHOD: A systematic search has been carried out in the Register of Universities, Centers and Degrees of the Ministry of Education, Culture and Sports. The main academic characteristics and the contents (mandatory and optional) of the programs of 11 official master's degrees with the renewed accreditation in 2018 were analyzed based on the data published on the universities' web pages. RESULTS: Most programs are 60 ECTS (European Credit Transfer and Accumulation System), face-to-face, taught in Spanish, include in their curriculum the completion of a master's thesis but not professional practices. Only contents related to statistics and basic epidemiology, and the training activity of master's thesis, are offers by all programs. CONCLUSIONS: The majority of public health master's programs in Spain shows a certain homogeneity regarding their academic characteristics, but a great heterogeneity in relation to their contents. There is also a great heterogeneity in the credits granted to the different subjects, especially optional subjects. It would be advisable to standardize a common core, especially in the mandatory contents.