The Interservice Physician Assistant Program: Education quantity and quality.

The Interservice Physician Assistant Program (IPAP) was formed in 1996 by the assimilation of three service programs (Army, Air Force, and Navy). Applicants are selected from each service and upon successful completion of the program become commissioned officers within their respective medical corps. Clinical training takes place within military treatment facilities across the United States. Located in San Antonio, Texas, the program graduates about 169 PAs a year. Graduates are deployed to attend to service personnel, refugees, civilians, and victims of epidemics. The IPAP is unique in that it is the largest PA program in the world and its applicant pool is restricted to military personnel.

A call to action: increasing health providers in underrepresented populations through the military.

The state of the nation's health and healthcare disparities looms large and is currently at crisis proportions, so much so, that these issues have been advanced as a national priority. These disparities are known to disproportionately afflict minorities and disadvantaged groups who become predisposed to certain risks. However, in light of the ever increasing racial and ethnic diversity of the American population, the visible absence of underrepresented minorities (URMs) in the health professions needed to meet these growing needs continues to fuel these crises. The purpose of this paper is thus fourfold. First, to examine the reason (s) for the persistent shortage of underrepresented minorities in the health professions and the associated barriers they encounter in pursuing opportunities in these professions. Second, to determine the degree to which the shortage of URMs contributes to the current state of health and healthcare disparities among certain groups. Third, to identify nontraditional mechanisms like the military as a medium to help increase the number of URMs in the health professions pipeline. Finally, the authors discuss the role of cultural competence as an essential skill set in rendering quality healthcare to minority patients; the strengths and limitations of their findings; and the implications of these findings for future research.

An Evaluation of Faculty Development Programs for Clinician-Educators: A Scoping Review.

PURPOSE: Faculty development (FD) has become increasingly important for clinician-educators. An array of FD programs has been developed, but the impact of these programs on clinician-educators and their learners and workplace is less known. The authors conducted a scoping review to explore the status of program evaluation in FD for clinician-educators to inform future planning and research. METHOD: Five databases were searched for articles published from January 1998 to August 2018 using Arksey and O'Malley's framework and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. Studies that described evaluation methods and outcomes of FD programs for clinician-educators were included. Data were collected and organized according to program domain (teaching, research/scholarship, leadership, or a combination of skills). A modified version of the Kirkpatrick model was used to compare results among studies. RESULTS: From a total of 2,091 articles, 1,095 were eligible for full review, and 31 met the inclusion criteria. Seven programs targeted only teaching skills, 3 research/scholarship skills, 7 leadership skills, and 14 a combination of skills. Eighteen programs required the completion of a project; fewer offered fellowships, master's degrees, or certificates. Participant surveys were the most common evaluation method across all domains. Often used metrics included participant satisfaction and self-reported knowledge, skills, behavior changes, scholarly output, and leadership positions. Less common evaluation methods included learner and peer evaluations, interviews, and focus groups. Change at the institutional level was evaluated in 11 programs. CONCLUSIONS: Program evaluation remains an underdeveloped area in FD for clinician-educators. Developers expend significant effort on program design and implementation but approach evaluation less purposefully. Rigorous metrics that align with program goals and are used longitudinally are needed to accurately assess the impact of FD programs on participants and their learners, workplace, and institutions at large.

Expansion of Physician Assistant Education.

Physician assistant (PA) educational programs were created in the 1960s to prepare a new type of health care practitioner. Physician assistant programs began as experiments in medical education, and later, they proved to be highly successful in preparing capable, flexible, and productive clinicians. The growth of PA educational programs in US medical education-stimulated by grants, public policy, and anticipated shortages of providers-has gone through 3 distinct phases. At present, such programs are in the midst of the third growth spurt that is expected to continue beyond 2020, as a large number of colleges and universities seek to sponsor PA programs and attain accreditation status. Characteristics of these new programs are described, and the implications of the current expansion of PA education are examined.

[Education in medical technology].

This year the education of Medical Technologists has reached the third turning point. The first turning point was the start of the two-year education of health laboratory technicians in 1958 and the second turning point was the start of the three-year education of Medical Technologists in 1971 and, this time, the third turning point is the start of the full-fledged university education. All 20 national education facilities for Medical Technologists and 2 public junior colleges have started the university education from this year. Adding the existing universities, about a half of education facilities for Medical Technologists are universities. From this situation, human resource development with not only knowledge and technique as medical technologists but also with humanly nurtured sentiment is expected in the future. In such situation, I'd like to discuss the progress of education of Medical technologists for 53 years, the current educational situation, and the future education of Medical technologists including the direction of desirable course for the three-year educational facilities.

Percepción sobre el desarrollo de competencias en seguridad de los pacientes de los estudiantes de la Carrera de Licenciatura en Enfermería en el período 2018 / Perception on the development of competencies in patient safety for students of the Bachelor of Nursing Degree in the period 2018

Introducción: En la Argentina de acuerdo al estudio Iberoamericano de Efectos Adversos se evidencio que, el 46% de los efectos adversos producidos por la atención sanitaria son evitables , por lo que la seguridad del paciente en la formación de los estudiantes de Licenciatura en Enfermería, debería ser uno de los ejes de fundamentales para comprender los riesgos que conllevan sus actividades, el impacto de los errores sobre los pacientes y el papel primordial que tiene la enfermería para evitar mayores daños al paciente. Objetivo: Describir la percepción sobre el desarrollo de competencias en seguridad de los pacientes de los estudiantes del segundo ciclo de la Carrera de Licenciatura en Enfermería en el período 2018. Metodología: Se realizó un estudio de tipo cuantitativo, descriptivo y transversal. La muestra fue de 61 estudiantes de 3°, 4° y 5° año de la Carrera de Licenciatura en enfermería, seleccionados por un muestro aleatorio simple. Para la recolección de los datos se utilizó un cuestionario adaptado, basándose en el cuestionario de la versión italiana validada de Educación profesional de salud en Seguridad del paciente. Resultados: En la percepción sobre el desarrollo de las competencias en seguridad del paciente la dimensión mejor valorada por los estudiantes fue la actitudinal, seguida por la cognoscitiva y la procedimental. Se observaron diferencias significativas en la valoración según sexo, no se observaron diferencias en las percepciones según edad. Conclusión: Los estudiantes de la carrera de licenciatura en Enfermería perciben el desarrollo de sus competencias en el área de seguridad del paciente como favorables acerca de los contenidos cognoscitivos, procedimentales y actitudinales. Se observaron diferencias significativas en las valoraciones según sexo en las tres dimensiones evaluadas.

Summary: Introduction: In Argentina, according to the Ibero-American study of Adverse Effects, it was evidenced that 46% of the adverse effects produced by health care are avoidable, so that the patient's safety in the training of Nursing students, it should be one of the fundamental axes to understand the risks involved in its activities, the impact of errors on patients and the primary role of nursing to avoid further damage to the patient. Objective: To describe the perception of the development of competencies in patient safety of students in the second cycle of the Bachelor of Nursing in the period 2018. Methodology: A quantitative, descriptive and transversal study was carried out. The sample was of 61 students of 3rd, 4th and 5th year of the Degree in Nursing, selected by a simple random sample. To collect the data, an adapted questionnaire was used, based on the questionnaire of the validated Italian version of Health Professional Education in Patient Safety. Results: In the perception of the development of competencies in patient safety, the dimension most valued by the students was attitudinal, followed by cognitive and procedural. Significant differences were observed in the assessment according to sex, no differences were observed in the perceptions according to age. Conclusion: The students of the Bachelor's Degree in Nursing perceive the development of their competencies in the area of patient safety as favorable about the cognitive, procedural and attitudinal contents. Significant differences were observed in the evaluations according to sex in the three dimensions evaluated

Resumo: Introdução: Na Argentina, de acordo com o estudo ibero-americano de efeitos adversos, evidenciou-se que 46% dos efeitos adversos produzidos pelos cuidados de saúde são evitáveis, de modo que a segurança do paciente na formação de estudantes de Enfermagem, Deve ser um dos eixos fundamentais para entender os riscos envolvidos em suas atividades, o impacto dos erros nos pacientes e o papel primordial da enfermagem para evitar mais danos ao paciente. Objetivo: Descrever a percepção do desenvolvimento de competências em segurança do paciente de escolares do segundo ciclo do Bacharelado em Enfermagem no período de 2018. Metodologia: Foi realizado um estudo quantitativo, descritivo e transversal. A amostra foi de 61 alunos do 3º, 4º e 5º ano do Curso de Graduação em Enfermagem, selecionados por amostra aleatória simples. Para coleta dos dados, utilizou-se um questionário adaptado, baseado no questionário da versão italiana validada de Educação Profissional em Saúde em Segurança do Paciente. Resultados: Na percepção do desenvolvimento de competências em segurança do paciente, a dimensão mais valorizada pelos estudantes foi a atitude, seguida pela cognitiva e processual. Diferenças significativas foram observadas na avaliação de acordo com o sexo, não foram observadas diferenças nas percepções de acordo com a idade. Conclusão: Os acadêmicos do Curso de Licenciatura em Enfermagem percebem o desenvolvimento de suas competências na área de segurança do paciente como favorável aos conteúdos cognitivo, procedimental e atitudinal. Diferenças significativas foram observadas nas avaliações de acordo com o sexo nas três dimensões avaliadas.

Physician assistants: from pipeline to practice.

For over four decades, physician assistants (PAs) have demonstrated that they are effective partners in a changing health care environment, readily adaptable to the needs of an evolving delivery system. With increased expectations of physician shortages, especially in primary care, PAs will be called on to fill provider gaps and new roles in interprofessional team-based delivery systems. There are over 90,000 certified PAs in the workforce and 173 accredited programs yielding an estimated 6,545 graduates annually, with an estimated 65 new programs seeking provisional accreditation by the end of 2016. New data on the PA pipeline and practice provide key information about the potential of this workforce; however, the overall impact of the PA pipeline on projected shortages remains unclear. Barriers exist to optimal deployment, including faculty shortages, scope-of-practice regulations, and a lack of clinical placement sites.This article brings together data from the Physician Assistant Education Association and the National Commission on Certification of Physician Assistants and its supporting organization, the nccPA Health Foundation. Primary sources include PA candidates, educational programs, students, and certified PAs. Collectively, these data provide a comprehensive picture of PAs' contributions to the health care workforce. Armed with pipeline and graduate practice data, policy makers and workforce planners will be equipped to design new models of practice that maximize the potential contributions of this growing PA workforce on health care teams.

La formación estadística del profesional médico desde la dimensión interpretativa procedimental / Statistical training of medical professional from procedural interpretive dimension

Fundamento: en la actualidad perduran insuficiencias en el proceso de formación estadística del profesional médico, existiendo reclamos orientados a focalizarlo hacia un mayor vínculo con el ejercicio de la práctica médica. Objetivo: proponer un conjunto de categorías didácticas que contribuyan a modelar la dinámica del proceso de formación estadística del profesional de Medicina. Metodología: investigación pedagógica realizada en la Universidad de Ciencias Médicas de Sancti Spíritus. Se emplearon los métodos histórico-lógico, el análisis y síntesis, el criterio de expertos y el holístico-dialéctico. Resultados: un conjunto de categorías didácticas a través de las cuales se expresa una de las dimensiones de la dinámica del proceso de formación estadística del profesional de Medicina. Conclusiones: el conjunto de categorías, además de su relevancia, posee una estructuración coherente y lógica en el tramado de relaciones que se establecen entre sus categorías, así como fundamentos teóricos argumentados. Se considera una herramienta didáctica mediante la cual es posible propiciar un acercamiento hacia la práctica médica desde la estadística(AU)

Background: at present there are still deficiencies in the statistical training of medical professional, therefore the oriented claims focused towards a greater connection with the exercise of medical practice. Objective: to propose a set of educational categories that help shape the dynamics of the statistical training process of Medical professional. Methodology: pedagogical research made in Sancti Spíritus Medical Sciences University. The methods used were: the logic-historic method, the analysis and synthesis, experts criterio and the holistic-dialectic method. Results: a set of didactic categories through which it is expressed one of the dynamics dimensions of the statistical training process of Medical professional. Conclusions: the set of categories, in addition to its relevance, has a consistent and logical structuring in the relationships established among its categories, as well as argued theoretical backgrounds. It is considered a didactic tool through which it is possible to propitiate an approach towards medical practice since statistics(AU)

La formación estadística del profesional médico desde la dimensión interpretativa procedimental / Statistical training of medical professional from procedural interpretive dimension

Fundamento: en la actualidad perduran insuficiencias en el proceso de formación estadística del profesional médico, existiendo reclamos orientados a focalizarlo hacia un mayor vínculo con el ejercicio de la práctica médica. Objetivo: proponer un conjunto de categorías didácticas que contribuyan a modelar la dinámica del proceso de formación estadística del profesional de Medicina. Metodología: investigación pedagógica realizada en la Universidad de Ciencias Médicas de Sancti Spíritus. Se emplearon los métodos histórico-lógico, el análisis y síntesis, el criterio de expertos y el holístico-dialéctico. Resultados: un conjunto de categorías didácticas a través de las cuales se expresa una de las dimensiones de la dinámica del proceso de formación estadística del profesional de Medicina. Conclusiones: el conjunto de categorías, además de su relevancia, posee una estructuración coherente y lógica en el tramado de relaciones que se establecen entre sus categorías, así como fundamentos teóricos argumentados. Se considera una herramienta didáctica mediante la cual es posible propiciar un acercamiento hacia la práctica médica desde la estadística.

Background: at present there are still deficiencies in the statistical training of medical professional, therefore the oriented claims focused towards a greater connection with the exercise of medical practice. Objective: to propose a set of educational categories that help shape the dynamics of the statistical training process of Medical professional. Methodology: pedagogical research made in Sancti Spíritus Medical Sciences Universitys. The methods used were: the logic-historic method, the analysis and synthesis, experts' criterio and the holistic-dialectic method. Results: a set of didactic categories through which it is expressed one of the dynamics dimensions of the statistical training process of Medical professional. Conclusions: the set of categories, in addition to its relevance, has a consistent and logical structuring in the relationships established among its categories, as well as argued theoretical backgrounds. It is considered a didactic tool through which it is possible to propitiate an approach towards medical practice since statistics.

Formação de profissionais de saúde no Brasil: uma análise no período de 1991 a 2008 / Formación de profesionales de salud en Brasil: un análisis en el período de 1991 a 2008 / Undergraduate programs for health professionals in Brazil: an analysis from 1991 to 2008

Estudo conduzido com o objetivo de contribuir para o planejamento e implementação de políticas de qualificação profissional no campo da saúde. Foram analisados 14 cursos de graduação da área da saúde: biomedicina, ciências biológicas, educação física, enfermagem, farmácia, fisioterapia, fonoaudiologia, medicina, medicina veterinária, nutrição, odontologia, psicologia, serviço social e terapia ocupacional, no período de 1991 a 2008. Dados sobre número de ingressantes, taxa de ocupação de vagas, distribuição de concluintes por habitante, gênero e renda familiar foram coletados a partir dos bancos do Ministério da Educação. Para o curso de medicina, a relação foi de 40 candidatos por vaga nas instituições públicas contra 10 nas privadas. A maioria dos ingressantes era composta por mulheres. A região Sudeste concentrou 57 por cento dos concluintes, corroborando o desequilíbrio de distribuição regional das oportunidades de formação de profissionais de saúde e indicando a necessidade de políticas de incentivo à redução dessas desigualdades.

Study conducted to support the planning and implementation of public policies on human health resources. Fourteen undergraduate health courses were analyzed: biomedicine, biological sciences, physical education, nursing, pharmacy, physical therapy, speech and language therapy, medicine, veterinary medicine, nutrition, dentistry, psychology, social work and occupational therapy between 1991 and 2008. Data on number of students admitted, college admission rates, rates of graduating student by inhabitant, gender, geographic area and family income were collected from the Brazilian Ministry of Education database. For medicine undergraduate programs there were 40 applicants per place at public institutions and 10 at private ones. Most students admitted were females. The Southeast region concentrated 57 percent of graduating students. The study revealed trends that indicates opportunity inequalities in the regional distribution of health professional education, thus supporting the need for policies aimed at reducing such inequalities.

Estudio conducido con el objetivo de contribuir a la planificación e implementación de políticas de calificación profesional en el campo de la salud. Fueron analizados 14 cursos de pregrado del área de la salud: biomedicina, ciencias biológicas, educación física, enfermería, farmacia, fisioterapia, fonoaudiología, medicina, medicina veterinaria, nutrición, odontología, psicología, servicio social y terapia ocupacional, en el período de 1991 a 2008. Datos sobre número de ingresos, tasa de ocupación de vagas, distribución de concluyentes por habitante, género y renta familiar fueron colectados a partir de bancos del Ministerio de Educación de Brasil. En el curso de medicina, la relación fue de 40 candidatos por vacante en las instituciones públicas contra 10 en las privadas. La mayoría de los ingresados estaba compuesta por mujeres. La región sudeste concentró 57 por ciento de los concluyentes, corroborando el desequilibrio de la distribución regional de las oportunidades de formación de profesionales de salud e indicando la necesidad de políticas de incentivo para la reducción de tales desigualdades.

Dinâmica das graduações em saúde no Brasil ­ 1995 a 2003 / Dynamics of graduations in health in Brazil - 1995 to 2003

O ensino médico no Brasil tornou-se realidade pela contingência da transferência da corte portuguesa. Os dois primeiros cursos médicos no Brasil foram estabelecidos na Bahia e no Rio de Janeiro em 1808. A terceira escola só surgiu 90 anos depois, e, com a Lei Carlos Maximiliano (1915), foram abertos novos rumos para o ensino médico no Brasil e a ampliação de 3 para 10 escolas médicas (Amaral, 2002). Na década de 1960 existiam 26 instituições para a formação de médicos no país