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This paper is based on a symposium on mentoring in infant mental health that took place at the 18th World Association for Infant Mental Health (WAIMH) conference. The symposium commemorated Robert N. Emde who was one of the founders of the field of Infant Mental Health, and devoted much of his career to mentorship. From an IMH perspective, mentoring experiences are best thought of as relationships, significant for both mentor and mentee, with positive mentoring experiences crucial for the development of IMH clinicians and researchers. The symposium participants, two pairs of mentor-mentee dyads, first gave an opening statement about what mentoring meant for them generally and personally, and then addressed three issues: the goodness of fit between mentor and mentee, "light and shadow" in mentoring relationships, and balancing old wisdom with new trends in mentoring. The paper brings the participants' views and personal experiences regarding these issues in their own words, highlighting key personal and professional issues related to mentorship from the perspectives of both mentor and mentee.
Este artículo se basa en un simposio sobre Consejería en el campo de la Salud Mental Infantil que se llevó a cabo en el Decimoctavo Congreso de la Asociación Mundial para la Salud Mental Infantil (WAIMH). El simposio fue dedicado a Robert N. Emde, uno de los fundadores del campo de Salud Mental Infantil, quien dedicó gran parte de su carrera a la consejería y guía profesional. Desde una perspectiva de IMH, la mejor interpretación de las experiencias de consejería es verlas como una significativa relación tanto para el consejero como para el aconsejado, considerando que las positivas experiencias son cruciales para el desarrollo de los profesionales clínicos e investigadores de IMH. Los participantes en el simposio, dos pares de díadas consejeroaconsejado, dieron primero una presentación de apertura sobre lo que significaba para ellos la consejería general y personalmente, para entonces abordar tres asuntos: la bondad de ajuste entre consejero y aconsejado, "Luz y Sombra" en la relación de consejería, así como el equilibrio en la consejería entre la vieja sabiduría y los nuevos acercamientos. El ensayo presenta los puntos de vista y experiencias personales de los participantes sobre estos asuntos en sus propias palabras, subrayando asuntos personales y profesionales claves relacionados con la consejería desde la perspectiva tanto del consejero como del aconsejado.
Cet article est basé sur un symposium sur le Mentorat en Santé Mentale de la Petite Enfance qui s'est tenu lors de la 18ème conférence de l'Association Mondiale pour la Santé Mentale de la Petite Enfance (World Association Infant Mental Health WAIMH). Ce symposium a commémoré Robert N. Emde qui fut l'un des fondateurs du domaine de la Santé Mentale de la Petite Enfance et a consacré une large partie de sa carrière au mentorat. Du point de vue de la Santé Mentale de la Petite Enfance les expériences de mentorat sont davantage considérées comme des relations, importantes pour à la fois le et le ou la mentoré(e), avec des expériences de mentorat positives et cruciales pour le développement des cliniciens et des chercheurs IMH. Les participants au symposium, deux paires de dyades mentormentoré, ont d'abord fait un discours d'ouverture sur ce que le mentorat signifiait pour eux généralement et personnellement, et ont ensuite parlé de trois défis: le bon ajustement entre mentor et mentoré, « la lumière et l'ombre ¼ dans la relation de mentorat et l'équilibre de la vieille sagesse avec les nouvelles tendances dans le mentorat. Cet article récapitule les vues et les expériences personnelles des participants pour ce qui concerne ces défis, avec leurs propres mots, mettant en valeur les défis personnels et professionnels clés liés au mentorat de la perspective d'à la fois le mentor et le mentoré.
Assuntos
Saúde Mental , Tutoria , Humanos , Tutoria/métodos , Lactente , Mentores/psicologia , História do Século XX , Congressos como AssuntoRESUMO
Professional health literacy among nurses in Germany: Results of a quantitative, cross-sectional survey Abstract. Background: Little is known about the professional health literacy (HL) of nurses, i.e., how well they are able to promote patients' HL. Existing studies have focused on personal HL, which does not entirely align with professional HL. Therefore, a new concept and questionnaire for professional HL have been developed and implemented for the first time. The results obtained for nurses in Germany are analysed with this article. Research question: It is asked how professional health literacy (HL) is distributed among nurses and which factors are associated with it. Methods: Data were collected through an online survey where nurses were asked about the difficulties they encounter in managing tasks in four dimensions: (1) information and knowledge management, (2) explaining and conveying information, (3) patient-centered communication, and (4) professional digital health literacy. Descriptive and multivariate, linear regression methods were used for analysis. Results: The 624 respondents rated the fourth dimension as the most difficult. The first and second dimensions were rated as similarly difficult, while the third dimension was considered least difficult. Higher professional HL is linked to better self-assessed training and framework conditions. Conclusion: Despite a relatively positive self-assessment, the results indicate areas that require improvement and should be addressed urgently.
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Attachment-based interventions are important for improving parent-child outcomes. These interventions must be scaled and made available to under-resourced communities. An important part of scaling these interventions is delineating and reproducing high-quality training, including clinical training which often requires the completion of a supervised case. However, descriptions and guidelines for clinical training are frequently broad or not available in the literature. A detailed description of clinical training could lead to further research to improve the effectiveness and dissemination of evidence-based interventions. Mothering from the Inside Out (MIO) is an attachment-based parenting intervention effective at reducing substance use and depression, improving caregiving, and enhancing child attachment. It is now being brought from research to community settings. This paper outlines the didactic and clinical training components of MIO. We then present a qualitative case study of one community-based counselor participating in the clinical training of MIO and employ qualitative methods to describe the main themes that arose during the training. We aim to illustrate how the trainer assisted the counselor in implementing the core components of MIO, which included (a) refining the language used in MIO sessions, (b) making space to explore mental states, and (c) addressing trauma. We conclude by presenting the implications of these findings.
Las intervenciones con base en la afectividad son importantes para mejorar los resultados de relación progenitor-niño. Estas intervenciones deben ser adaptadas y estar disponibles para comunidades sin recursos suficientes. Una parte importante de la adaptación de estas intervenciones es delinear y reproducir el entrenamiento de alta calidad, incluyendo entrenamiento clínico que a menudo requiere completar un caso supervisado. Sin embargo, las descripciones y los parámetros de guía para entrenamiento clínico son frecuentemente generales o no están disponibles en el material escrito. Una detallada descripción del entrenamiento clínico pudiera llevar a una posterior investigación para mejorar la eficacia y diseminación de intervenciones con base en la afectividad. Cuidados Maternales de Adentro Hacia Afuera (MIO) es una intervención de crianza con base en la afectividad que es eficaz para reducir el uso de sustancias y la depresión, mejorar la prestación de cuidado y fortalecer la afectividad del niño. Ahora se le lleva de la investigación a los escenarios comunitarios. Este artículo subraya los componentes de didáctica y entrenamiento clínico de MIO. Presentamos entonces un caso de estudio cualitativo de un consejero con base en la comunidad que participó en el entrenamiento clínico de MIO y empleamos métodos cualitativos para describir los temas principales que surgieron durante el entrenamiento. Nos propusimos ilustrar cómo el entrenador ayudó al consejero a implementar los componentes centrales de MIO, los cuales incluyen (a) refinar el lenguaje usado en la terapia, (b) abrir un espacio para explorar estados mentales, y (c) ocuparse del trauma. Concluimos con la presentación de las implicaciones que conllevan estos resultados.
Les interventions basées sur l'attachement sont importantes quand il s'agit d'améliorer les résultats parent-enfant. Ces interventions doivent être mises à l'échelle et doivent être disponibles pour toutes les communautés ayant peu de moyens. Un côté important de la mise à l'échelle de ces interventions consiste à délinéer et à reproduire une formation de haute qualité, y compris une formation clinique qui souvent exige la réalisation d'un cas supervisé. Cependant les descriptions et les lignes directrices de la formation clinique sont fréquemment larges ou ne sont pas disponibles dans des publications. Une description détaillée de formation Clinique pourrait conduire à des recherches approfondies sur la manière d'améliorer l'efficacité et la dissémination d'interventions fondées sur des données probantes. Le maternage de l'intérieur (abrégé ici MIO pour reprendre l'anglais Mothering from the Inside Out) est une intervention de parentage basée sur l'attachement qui est efficace pour ce qui concerne la réduction de toxicomanie et de dépression, l'amélioration des soins ainsi que de l'attachement de l'enfant. On le fait en ce moment passer des recherches aux contextes communautaires. Cet article décrit les composantes de formation didactique et clinique du MIO. Nous présentons ensuite une étude de cas qualitative d'un thérapeute communautaire participant à une formation clinique du MOI et employons des méthodes qualitatives pour décrire les thèmes principaux qui sont apparus durant la formation. Nous nous donnons pour but d'illustrer la manière dont le formateur a aidé le thérapeute à mettre en place les composantes essentielles du MIO, y compris (a) l'affinage du langage utilisé en thérapie, (b) la nécessité de faire de la place afin d'explorer les états mentaux, et (c) la nécessité d'aborder le trauma. Nous concluons en présentant les implications de ces résultats.
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Mentalização , Transtornos Relacionados ao Uso de Substâncias , Feminino , Humanos , Preceptoria , Mães , Pesquisa QualitativaRESUMO
Journal clubs in nursing practice: An online survey of German university hospitals Abstract. Background: Journal clubs (JCs) are an evidence-based method for enabling nursing professionals to develop a scientifically based practice. Research results can be made available to nurses to directly influence their nursing practice. The level of implementation in German university hospitals is currently unknown. Aim: This study surveyed the current state of JCs at German university hospitals. The aim is to develop recommendations for the implementation of JCs for nursing practice. Methods: The online survey of all 27 representatives of the "Network of Nursing Science and Practice Development" of the VPU e.V. was conducted from October to November 2020. The questionnaire was developed based on literature. The data analysis was descriptive. Results: 15 of the 19 clinics surveyed currently implement, or have previously implemented, a JC (response rate 70,4%). In approximately half of the clinics, JC is an established structure that is also offered as part of advanced training and continuing education (46,6%) and is used to develop and expand methodological, scientific competencies (86,6%). Positive experiences, but also structural problems in the implementation of a JC were reported. Approximately one quarter of the clinics evaluate their JC regularly (26,7%). Conclusions: JCs at German university hospitals are currently being established. In order to establish JCs on a permanent basis, EBN knowledge must be continuously imparted in further education and training; in addition, JCs should be an essential component of academic role profiles.
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Hospitais Universitários , Humanos , Inquéritos e QuestionáriosRESUMO
Health visitors need competences to promote healthy early parent-infant relationships. The aims of this study were to explore whether there are differences between groups of health visitors with and without additional parenting program education in terms of their knowledge of infant-parent interaction and their observation and assessment skills of such interactions. The cross-sectional study included 36 health visitors' certified Marte Meo therapists and 85 health visitors without additional parenting program education. Health visitors' observation skills were measured assessing five video-recorded mother-infant interactions. A questionnaire was used to measure their intention, self-efficacy, and knowledge. More certified Marte Meo therapists than health visitors without additional parenting program education reported a significantly higher mean level of knowledge of the early relationship, 6.42 (95% CI; 6.18-6.66) versus 5.05 (95% CI; 4.86-6.10), p = .04; and more certified Marte Meo therapists than health visitors without additional parenting program education reported a higher mean level of knowledge of infant self-regulation, 2.44 (95% CI; 2.18-2.71) versus 1.83 (95% CI; 1.62-2.03), p < .001. In the latter group, 54% (95% CI; 0.43-0.64) reported a significantly higher need for further education versus 22% (95% CI; 0.11-0.39), p = .001. Compared to health visitors without any parenting program education, health visitors certified as Marte Meo therapists reported a significantly higher frequency of correct assessment of mothers' sensitivity in two of five video-recordings, with 77.78% (95% CI; 0.61-0.87) compared to 45.88% (95% CI; 0.35-0.57) in Video 3, p = .001, and 69.44% (95% CI; 0.52-0.82) compared to 49.41% (95% CI; 0.39-0.60) in Video 4, p = .04, respectively. The results of the present study support the use of video-based education of health visitors to increase their knowledge of and skills in assessing parent-infant interactions. Randomized controlled trials are needed to determine whether the improved level of health visitors' knowledge and observation skills may be assigned to participation in the Marte Meo education program.
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Competência Clínica , Visita Domiciliar , Relações Mãe-Filho , Enfermeiras e Enfermeiros , Estudos Transversais , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Modelos Logísticos , Pessoa de Meia-Idade , Enfermeiras e Enfermeiros/psicologia , Razão de Chances , Reprodutibilidade dos Testes , Autoeficácia , Inquéritos e Questionários , Gravação em VídeoRESUMO
This article describes findings from a project conducted in Western Australia (Mental Health Commission WA, 2015) that investigated the education and training needs of the Infant/Early Childhood Mental Health (I/ECMH) workforce. We examined international training programs and models of delivery in infant mental health, including a review of the current training available in Australia. Data collected from over 60 interviews were analyzed, and a staged delivery model for I/ECMH training and supervision that aligned with the Michigan Association for Infant Mental Health (2014) Competency Guidelines was recommended. These findings led to the purchase of the Michigan Association for Infant Mental Health (2014) for use in Western Australia. In a very short time, use of the Michigan Competency Framework by the Australian Association for Infant Mental Health West Australian Branch Incorporated has begun to change the training and education opportunities for upskilling the infant and early childhood workforce in Western Australia. It has resulted in a map to guide and develop training in the I/ECMH field for individual practitioners and professionals as well as for workplaces that will ultimately benefit Western Australian infants, young children, and their families during the perinatal period and in the early years.
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Pessoal de Saúde/educação , Saúde Mental/educação , Pediatria/educação , Pré-Escolar , Humanos , Lactente , Internacionalidade , Austrália OcidentalRESUMO
In 1828, the Society of Swiss Veterinarians (GST) raised a prize question in regard to the symptoms, etiology and prophylaxis of polyarthritis in the foal. The treatise of Matthias Anker on this subject was treated with distinction and published in 1830. His statements answered both the questions to the clinical aspects and referred also to epidemiological, pathological, economical and ethical issues as well as husbandry and relations with the breeders. The comprehensive article of Anker in a lucid language and obliging views still finds great interest today, as the septicemia is one of the big problems in stud medicine now as before. Moreover it is astonishing that the recommendations of Anker were disregarded too often. The reasons for this fact may be due to the inadequate transfer of knowledge, on the one hand because of the educational system in that time, on the other side due to the modest economical importance of horse breeding and the neglected formation in this field. The recommendations are still valid.
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Artrite/veterinária , Doenças dos Cavalos/diagnóstico , Doenças dos Cavalos/prevenção & controle , Medicina Veterinária/história , Animais , Animais Recém-Nascidos , Artrite/diagnóstico , Artrite/etiologia , Artrite/prevenção & controle , História do Século XVIII , História do Século XIX , Doenças dos Cavalos/etiologia , Cavalos , HumanosRESUMO
BACKGROUND: Since the WHO study "Family Health Nursing" (FHN) the concepts have been established different within Europe. Due to this, the international project "Family Health Nursing in European Communities" was started in order to develop a standardised educational concept. AIMS: The aim of this project was to gather the different requirements and to clarify problematic issues within the participating EU countries. METHOD: Thus, a literature review, a Delphi study in order to achieve consensus on definition of FHN, an analysis of competencies and requirements as well as an overview of available education/training with experts from the field of care was carried out. RESULTS: The results of the review reflect the varying level of occupation within the countries included in this analysis. Over the time, various conceptual orientations and professional designations have been established. Within this project the preferred job title was "Family Nurse" (46,3 %). Health promotion and prevention (85,8 %) were seen as main tasks of the Family Health Nurse. Therefore, the respondent experts state the need for more specialized training at an undergraduate (81,5 %) level. CONCLUSIONS: The project outlines the countries' effort towards a high-level in familial care which could be supported in long term by a consistent FHN concept.
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Comparação Transcultural , Educação Continuada em Enfermagem , Educação de Pós-Graduação em Enfermagem , Enfermagem Familiar/educação , Competência Clínica , Currículo , Técnica Delphi , Europa (Continente) , Humanos , Papel do Profissional de EnfermagemRESUMO
BACKGROUND: The prehospital placement of chest tubes is a rare but potentially life-saving procedure. A high level of subjective confidence with the procedure is essential for emergency medical doctors. This study aims to identify if there is a statistically significant difference in the subjective sense of confidence in prehospital chest tube placement regarding medical experience and qualification, clinical routine, and attendance at simulation courses. METHODS: Prehospital emergency physicians of three emergency medical services in Southwest Saxony, Greifswald, and Vechta, Germany, were invited to participate in an online survey from January to March 2022 using the online survey service limesurvey. The question "Do you feel confident in chest tube placement?" was used to measure the subjective level of confidence. Answers were compared with data concerning medical qualification, experience in prehospital emergency medicine, clinical routine, and attendance at simulation courses. Statistical analysis was performed using chi-squared test and Fisher's exact test. RESULTS: Three out of four participants felt confident in chest tube placement (53/71; 74.6%). More than half of the participants reported that they did not perform this procedure regularly (35/53, 66%). Subjective confidence was highest in physicians who regularly place chest tubes during their non-prehospital work (34/37; 91,9%; p<0.001), and more often when participants had clinical routine and attended simulation courses than when none of this applied (p=0.012). Attendance at simulation courses alone was not associated with a higher level of confidence (p=0.002). Specialists showed significantly more often subjective confidence in chest tube placement (p=0.0401). CONCLUSION: Prehospital chest tube placement is rare, but potentially lifesaving. An adequately high level of subjective confidence in the placement of chest tubes is a key condition for prehospital emergency doctors. Inhospital clinical routine and attendance at simulation courses are significantly associated with high levels of confidence. Our data indicate that working only in prehospital emergency settings without further clinical routine or medical specialization is not sufficient for achieving and ensuring subjective confidence in chest tube placement.
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Tubos Torácicos , Competência Clínica , Serviços Médicos de Emergência , Humanos , Alemanha , Feminino , Masculino , Inquéritos e Questionários , Adulto , Medicina de Emergência/educação , Atitude do Pessoal de Saúde , Pessoa de Meia-IdadeRESUMO
BACKGROUND/AIM: Evidence-based practice (EBP) provides an important basis for improving both the quality of care and patient safety. Formulating a research question, searching the literature, and critical appraisal are crucial to developing evidence-based practice. The aim of this survey was to provide an overview of how these topics are integrated into bachelor's degree programs in nursing in Austria, Germany, and the German-speaking part of Switzerland. We also aimed to show how teachers implement these subjects and how they experience and assess the implementation. METHOD: We conducted an exploratory cross-sectional study using an online survey sent out to program directors and teaching staff of all 58 bachelor's degree programs in nursing in Austria, Germany and the German-speaking part of Switzerland. For data collection, a questionnaire was developed containing items on general teaching conditions, contents, and methods of evidence-based nursing practice, as well as on the estimated thematic interest of students. The data were analysed descriptively. RESULTS: The program directors returned 24 questionnaires (41%). Of 75 questionnaires forwarded to the faculty, 17 (23%) were received from nine programs. On average, 5.6 teaching units (SD 2.6) are used for formulating a research question, 10 teaching units (SD 4.1) for literature review, and 11.3 teaching units (SD 6.9) for critical appraisal. Half of the teaching staff indicated that linkages between education and nursing care practice have been established. The traditional teaching method of frontal teaching is used predominantly. Student interest in topics was rated as moderate by most teachers. CONCLUSIONS: Topics on evidence-based practice are an integral part of bachelor's degree programs in nursing in German-speaking countries. An increase in teaching units, active learning methods and the growing interconnection between education and practice could improve the acquisition of competencies and attitudes of students regarding EBP and further advance its implementation in practice.
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Currículo , Bacharelado em Enfermagem , Enfermagem Baseada em Evidências , Áustria , Humanos , Alemanha , Suíça , Estudos Transversais , Enfermagem Baseada em Evidências/educação , Inquéritos e Questionários , Comparação TransculturalRESUMO
BACKGROUND: The delegation of medical tasks (DMT) plays a significant role in the everyday practice of inpatient care but also presents a potential challenge in interprofessional collaboration. Assessing the conditions of DMT in everyday work is crucial to identify areas for optimization. METHODS: In a nationwide exploratory study, physicians, nursing and allied health professionals working for inpatient care facilities were surveyed regarding various aspects of DMT using a standardized online questionnaire. RESULTS: The majority of the 757 participants (64.9% physicians), perceived DMT to be both economically and time-efficient (88.5% agreement) and in the best interest of patients (74%). For 78.7% of the respondents, DMT represents a potential conflict in their daily work, depending on the quality of interprofessional communication. Inadequate staffing was identified as a barrier to a broader implementation of DMT by 83.8% of participants. 63.2% of the participants considered their knowledge of legal aspects related to DMT to be at least good (participants with less than 5 years of professional experience: 52.6%). Physicians primarily acquire relevant knowledge through professional practice (71.3% vs. non-physicians 39.5%). CONCLUSION: Across the different professional groups DMT was considered beneficial and serving the interests of patients. Targeted promotion of safe and cost-effective DMT should be incorporated into medical education. Achieving greater benefits from DMT requires explicit legal frameworks, effective communication within the team and, in particular, adequate staffing among the professional groups responsible for delegated tasks.
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Relações Interprofissionais , Humanos , Alemanha , Inquéritos e Questionários , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Comunicação Interdisciplinar , Delegação Vertical de Responsabilidades Profissionais , Atitude do Pessoal de Saúde , Equipe de Assistência ao Paciente/organização & administração , Programas Nacionais de SaúdeRESUMO
Given the unprecedented events unfolding around the globe over the past four years, psychoanalytic communities near and far have sought to ask and ventured to answer the question: What does psychoanalysis have to offer individuals, and the collective, as a way of seeing and being with the reality of what is? Taking up these questions in such a time as this, feels, perhaps inevitably, unsafe. Sometimes it can feel as if there is a silent and unspoken mandate to ensure safety at all costs when we seek to find a spirit of the depth's response to the spirit of the times. I propose that the work of psychoanalysis is grounded in nothing but the journey through that which is unsafe. This article will take up Ann Ulanov's notion that one's own evil is the hinge door into collective and archetypal evil. To become unhinged means to risk well-formulated understandings, theories, and modalities about being and becoming for the other and instead to allow the other to penetrate that which is unknown in ourselves, upending our well-formed theories and pressing us to take up our own lives in new and unpredictable ways.
Compte tenu des événements sans précédent qui se sont déroulés dans le monde entier au cours des quatre dernières années, les communautés psychanalytiques proches et lointaines ont cherché à poser la question suivante et à y proposer des réponses: qu'estce que la psychanalyse peut offrir aux individus, et au collectif, comme moyen de voir et d'être avec la réalité de ce qui est ? Aborder ces questions dans un moment comme celuici nous fait nous sentir en danger, et c'est peutêtre inévitable. Parfois, on peut avoir le sentiment qu'il y a un décret silencieux et tacite d'assurer la sécurité à tout prix lorsque nous cherchons à trouver une réponse de l'esprit des profondeurs à l'esprit du temps. Je propose que le travail de la psychanalyse n'est fondé sur rien d'autre que le voyage à travers ce qui est dangereux, risqué. C'est, en effet, ce qu'implique la recherche d'une conversation active et vivante avec l'esprit des profondeurs et c'est ce qui distingue le travail de thérapie du travail de psychanalyse. Si nous nous enfermons dans des notions de sécurité, nous resterons liés à des notions similaires d'anonymat analytique et d'innocence, restant inconscients de notre propre implication dans les horreurs qui continuent d'aliéner, d'étouffer et d'isoler ceux qui sont en marge. Cette présentation reprendra la conception d'Ann Ulanov selon laquelle le mal d'une personne est la porte charnière du mal collectif et archétypal. Notre travail, individuellement et collectivement, est de descendre dans ce territoire dangereux à l'intérieur de nousmêmes pour voir ce qui s'y est passé et ce qui reste à vivre dans les zones d'ombre. Devenir déséquilibré signifie mettre en doute des compréhensions, des théories et des modalités bien formulées sur l'être et le devenir pour l'autre et, à la place, permettre à l'autre de pénétrer ce qui est inconnu en nousmêmes, bouleversant nos théories bien formées et nous poussant à prendre notre propre vie en main d'une manière nouvelle et imprévisible. En ce sens, la psychanalyse est intrinsèquement une forme d'activisme intérieur et extérieur. Ce qui est proposé ici est un regard sur la façon dont la psychanalyse, déséquilibrée, se déplace audelà des murs sécurisants et audelà des murs de la salle de consultation vers le monde au sens large.
Dados los acontecimientos sin precedentes que han tenido lugar en todo el mundo en los últimos cuatro años, las comunidades psicoanalíticas cercanas y lejanas han tratado de preguntarse y han intentado responder a la pregunta: ¿qué tiene el psicoanálisis que ofrecer a los individuos, y al colectivo, en términos de ver y estar con la realidad de lo que acontece? Abordar estas cuestiones en un momento como el actual puede resultar inevitablemente inseguro. A veces puede dar la sensación de que existe un mandato silencioso y tácito de garantizar la seguridad a toda costa cuando tratamos de encontrar una respuesta del espíritu de las profundidades al espíritu de los tiempos. Propongo que el trabajo del psicoanálisis no se basa en otra cosa que en el viaje a través de lo que es inseguro. Esto, de hecho, es lo que implica buscar una conversación activa y viva con el espíritu de las profundidades y es lo que distingue el trabajo de la terapia del trabajo del psicoanálisis. Si nos encerráramos en las nociones de seguridad, seguiríamos limitados por nociones similares de neutralidad analítica e inocencia, permaneciendo inconscientes de nuestra propia implicancia en los horrores que continúan ajenos, encerrando y aislando a aquellos que se encuentran en los márgenes. Esta presentación retomará la noción de Ann Ulanov de que el mal propio es la puerta de entrada al mal colectivo y arquetipal. Nuestro trabajo individual y colectivo es descender a este territorio inseguro dentro de nosotros mismos para ver lo que ocurrió allí y lo que permanece viviendo en las sombras. Perturbarse significa arriesgar comprensiones, teorías y modalidades bien formuladas sobre el ser y el devenir para el otro y, en su lugar, permitir que el otro penetre en lo que es desconocido en nosotros mismos, trastornando nuestras teorías bien formadas y presionándonos para que asumamos nuestras propias vidas de maneras nuevas e impredecibles. De este modo, el psicoanálisis es inherentemente una forma de activismo interior y exterior. Lo que se ofrece es una mirada sobre cómo el psicoanálisis, perturbado, traspasa los muros de la seguridad y va más allá de las paredes del consultorio analítico para adentrarse en el mundo en general.
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Emoções , Psicanálise , Humanos , Estudos ProspectivosRESUMO
BACKGROUND: Interprofessional training wards (IPTW) can contribute to the development of interprofessional competencies. In order to evaluate the acquisition of competencies, instruments are needed that record both team performance and individual competencies in the clinical teaching setting in third-party assessment. This paper describes the Interprofessional Ward Round Individual and Team Assessment-Tool, IP-VITA ("Interprofessionelle Visiten Individual und Team Assessment Tool") and its development. METHOD: Based on the empirical exploration of the three observation instruments "Teamwork Assessment Scale" (TAS), "McMaster-Ottawa Scale" and "Individual Teamwork Observation and Feedback Tool" (iTOFT) in at least four rounds each at the HIPSTA (with n=8 students and trainees each), a preliminary version of the IP-VITA was created. This preliminary version was then refined in subsequent empirical steps: a consensual validation in the research team was followed by a "member check" with the clinical colleagues of the HIPSTA, the input from external experts and an empirical test in an alternative setting. RESULTS: The IP-VITA is an empirically developed multimodal instrument to assess the interprofessional competencies of trainees and students as well as their team performance in clinical settings with patient interaction. It comprises three parts. In part A, structural data, the persons involved and the essential patient characteristics are recorded. Part B consists of 12 items and a free-text field for recording behaviour at the individual level. Part C also consists of 12 items and evaluates behaviour at team level. DISCUSSION: The IP-VITA instrument was developed specifically for the context of evaluating interprofessional ward rounds in a clinical educational setting. The instrument takes into account the ambiguous position of the assessment of interprofessional collaboration between individual competence and team performance. Beyond the HIPSTA, it can be used as a formative assessment instrument, and it may also be useful for summative assessments.
Assuntos
Relações Interprofissionais , Aprendizagem , Humanos , Alemanha , Competência Clínica , Comportamento Cooperativo , Equipe de Assistência ao PacienteRESUMO
Five Tips for Practical Ultrasound Teaching from the Perspective of Peer Tutors Abstract. Abtract: When learning diagnostic ultrasound, practical teaching in small groups is of particular importance. In this article, we present five tips that we consider particularly important for successful and effective ultrasound teaching from the perspective of peer tutors.
Assuntos
Educação de Graduação em Medicina , Currículo , Humanos , Aprendizagem , Grupo Associado , UltrassonografiaRESUMO
Interprofessional education has gained relevance in German-speaking countries, and interprofessional training wards (IPTW) can contribute to the acquisition of interprofessional competencies and thereby improve interprofessional collaborative practice and patient care. Professional socialization and identity development have proven to be critical for future clinical practice in addition to competency development. According to Khalili (2013) socialization through interprofessional education can result in a dual identity, i. e., a sense of belonging to one's own profession as well as to the interprofessional health care team. The aim of this study was to analyse to which extent interprofessional socialization takes place on the Interprofessional Training Ward in Heidelberg (HIPSTA) and how medical students in their practical year and nursing trainees in their third year of training experience their placement there. For this purpose, five semi-structured group discussions were conducted with undergraduates at the end of their placement on HIPSTA and analysed using the documentary method. Typification resulted in two types that differ with regard to interprofessional socialization. The type interprofessional responsiblepersons is characterized by the joint assumption of responsibility for patient care, open communication with each other and joint structuring of collaboration, which contributed to a removal of barriers and interprofessional role learning; the type interprofessional learners is characterized by their focus on learning processes and their anticipation of barriers between the professional groups, which would be relevant for future collaboration. All groups experienced a sense of belonging to their peer-student/learner group, regardless of their different professional background. Their professional identity underwent further development. These results show that placement on an IPTW does not warrant interprofessional socialization processes and the development of a dual identity. However, it can be a first step in the right direction.
Assuntos
Relações Interprofissionais , Estudantes de Medicina , Alemanha , Humanos , Equipe de Assistência ao Paciente , SocializaçãoRESUMO
Due to scientific progress and diversification in medicine and psychiatry, there is a need for specialization in sports psychiatry. Therefore, the SSSPP has been developing a curriculum on sports psychiatry. Different backgrounds and approaches within the above-mentioned areas are presented here since they have influenced the development of the three-level curriculum. The structure of the three-level curriculum, which contains theory, practical experience, and supervision, encompassing 80 hours of additional training, will also be explained. Within this curriculum, basic knowledge in sports medicine, sports psychology, sports science, and applied sports theory will also be taught. Other subjects include sports and exercise on mental disorders, mental disorders in competitive sports, sports as a coping strategy, and other contents. Moreover, different contents and key topics of the curriculum's three levels will be presented.
Assuntos
Psiquiatria , Medicina Esportiva , Esportes , Currículo , Atenção à Saúde , Humanos , Psiquiatria/educação , Esportes/psicologia , Medicina Esportiva/educaçãoRESUMO
Interprofessional Collaboration in Health Care Abstract. Interprofessional collaboration is a hallmark of good and efficient patient care, where several healthcare professionals put their competencies together to care for patients. Interprofessional education is a necessary first step to prepare the different professions for collaborations in their later professional practices. Shared training courses help to empower collaborative healthcare teams so they can respond in an adapted and effective way to individual and local health needs.
Assuntos
Relações Interprofissionais , Equipe de Assistência ao Paciente , Comportamento Cooperativo , Atenção à Saúde , Pessoal de Saúde , HumanosRESUMO
Clinical practice in Brazil has rapidly transformed. Doctor-patient relationships are the focus of these transformations, either within health policies or in the context of medical training. The Brazilian Curriculum Guidelines have emphasized the doctor-patient relationship as part of medical skills and competences, based on patient-centered care. In this article, we present the political advances in patient-centered care. In addition, we address an overview of the Brazilian status quo of decision aids tools. Finally, we share experiences in curriculum reform for the advances of communication skills and the interfaces with narrative medicine and the arts in curricular medical training as a means to advance towards the practice of shared decision making.
RESUMO
BACKGROUND: At the end of November 2020, four years after the adoption of the Masterplan Medizinstudium 2020, the Federal Ministry of Health presented the draft bill for the revision of the medical licensing regulations. This was adapted in August 2021 and stipulates, among other things, the completion of a mandatory scientific project up to the second stage of the medical examination, which is to be conducted within twelve weeks and based on the structured teaching of scientific skills using longitudinal courses. This study examines to what extent the mentioned aspects of the draft bill are already included in the current compulsory curricula in German medical study programs. METHODS: In a cross-sectional study, we conducted a document analysis and an online survey of the student deaneries of state and private, state-recognized faculties of medicine in Germany. The objective was to assess the integration of curricular science projects and longitudinal science modules. The data was analyzed descriptively. RESULTS: In total, 40 (93%) of 43 faculties were included in the document analysis. 26 (60.5%) of 43 academic deans responded to the online questionnaire. Only twelve (30%) of the faculties offer a mandatory science project according to the document analysis and eight (30.8%) according to the evaluation of the online survey. In relative terms, a mandatory science project is already a curricular component in the majority of model and reform degree programs (document analysis: 83.3%, n=10 / N=12; questionnaire: 87.5%, n=7 / N=8). This contrasts with a significantly smaller number of regular degree programs that currently offer a science project as a mandatory component (document analysis: 16.7%, n=2 / N=12; questionnaire: 12.5%, n=1 / N=8). In the majority of the model and reform courses, a compulsory (longitudinal) science module has already been integrated into the curriculum (document analysis: 75%, n=12 / N=16; questionnaire: 55.5%, n=6 / N=11). This is only true for 25% (n=4 / N=12; document analysis) and 44.5% (n=5 / N=11; questionnaire) of the regular courses. DISCUSSION: The results of the surveys indicate that the regular study programs, in particular, need to be restructured in order to integrate the intended time frame of twelve weeks for an obligatory science project into the current curriculum. How this is to be achieved without reducing the existing study content seems to be still unclear. Regardless of the current draft bill, however, this step appears to be necessary in order to strengthen the acquisition of scientific competencies in medical studies and to adapt it to international medical education. CONCLUSION: The majority of the current model and reformed medical study courses already fulfill the requirements of the draft bill for the new licensing regulations with regard to the curricular integration of an obligatory scientific project and longitudinal strand on scientific work, which offer hints on design possibilities for further faculties.