RESUMO
RATIONALE: Acute hypoxemic respiratory failure is a condition that comprises a wide array of entities. Obtaining a histological lung sample might help reach a diagnosis and direct an appropriate treatment in a select group of patients. OBJECTIVE: To describe our experience in the use of cryobiopsy for the diagnosis of acute hypoxemic respiratory failure of undetermined origin. METHODS: Retrospective analysis of case series of patients with acute hypoxemic respiratory failure who underwent lung cryobiopsy at the Intensive Care Unit of the Hospital Italiano de Buenos Aires, Argentina. RESULTS: Cryobiopsy yielded a histological diagnosis in all patients (n = 10, 100%). This led to either a change in therapy or continuation of a specific treatment in eight of these patients. Cryobiopsy was found to be contributive in all the patients who did not meet Berlin criteria for acute respiratory distress syndrome. No major complications were associated with the procedure. CONCLUSIONS: Cryobiopsy is a safe procedure with a high diagnostic yield in a selected group of patients.
RESUMO
The evaluation of the clinical teacher's performance provides feedback to motivate them to improve their teaching skills. To perform the cross-cultural adaptation of the Maastricht Clinical Teaching Questionnaire, the International Guide for the Adaptation of the Questionnaires was followed. The validity of content, response process, construct and reliability were investigated. After cross-cultural adaption, residents of two University hospitals evaluated 187 clinical teachers. Content and answering process were validated. In the confirmatory factor analysis, all indexes and criteria for a good fit suited the 5 factors and 14 items model. The Cronbach's alpha coefficient was 0.80. The G coefficient was > 0.70, with low variance of the absolute error. Every clinical teacher should receive at least 6 evaluations to achieve a reliable evaluation of every domain and of their global performance. The Spanish version of the questionnaire is a valid, reliable instrument for medical residents to evaluate teachers.
La evaluación del desempeño del docente clínico permite proporcionar feedback para motivarlo a mejorar sus habilidades docentes. Se realizó la validación transcultural del Cuestionario de Enseñanza Clínica de Maastricht, mediante la guía internacional para la adaptación de los cuestionarios. Se investigó validez de contenido, proceso de respuesta, constructo y confiabilidad. Luego de la adaptación, residentes de dos hospitales universitarios evaluaron a 187 docentes clínicos. La validación del contenido y del proceso de respuesta fue adecuada. En el análisis factorial confirmatorio, todos los índices y criterios se ajustaron bien con el modelo de 5 factores y 14 ítems. El alfa de Cronbach fue de 0,80. El coeficiente G fue > 0,70, con bajos valores de varianza del error absoluto. Fueron necesarias 6 evaluaciones por docente para una evaluación confiable en cada dominio y en el desempeño global. La versión en castellano del Cuestionario es válida y confiable para evaluar a los docentes.
Assuntos
Características Culturais , Educação de Pós-Graduação em Medicina/normas , Docentes de Medicina , Competência Profissional , Inquéritos e Questionários , Humanos , Reprodutibilidade dos TestesRESUMO
La evaluación del desempeño del docente clínico permite proporcionar feedback para motivarlo a mejorar sus habilidades docentes. Se realizó la validación transcultural del Cuestionario de Enseñanza Clínica de Maastricht, mediante la guía internacional para la adaptación de los cuestionarios. Se investigó validez de contenido, proceso de respuesta, constructo y confiabilidad. Luego de la adaptación, residentes de dos hospitales universitarios evaluaron a 187 docentes clínicos. La validación del contenido y del proceso de respuesta fue adecuada. En el análisis factorial confirmatorio, todos los índices y criterios se ajustaron bien con el modelo de 5 factores y 14 ítems. El alfa de Cronbach fue de 0,80. El coeficiente G fue > 0,70, con bajos valores de varianza del error absoluto. Fueron necesarias 6 evaluaciones por docente para una evaluación confiable en cada dominio y en el desempeño global. La versión en castellano del Cuestionario es válida y confiable para evaluar a los docentes.
The evaluation of the clinical teacher's performance provides feedback to motivate them to improve their teaching skills. To perform the cross-cultural adaptation of the Maastricht Clinical Teaching Questionnaire, the International Guide for the Adaptation of the Questionnaires was followed. The validity of content, response process, construct and reliability were investigated. After cross-cultural adaption, residents of two University hospitals evaluated 187 clinical teachers. Content and answering process were validated. In the confirmatory factor analysis, all indexes and criteria for a good fit suited the 5 factors and 14 items model. The Cronbach's alpha coefficient was 0.80. The G coefficient was > 0.70, with low variance of the absolute error. Every clinical teacher should receive at least 6 evaluations to achieve a reliable evaluation of every domain and of their global performance. The Spanish version of the questionnaire is a valid, reliable instrument for medical residents to evaluate teachers.