Você está pensando, refletindo, analisando o que você vê e o que você faz o tempo todo: percepção de residentes de Medicina de Família e Comunidade sobre vídeo feedback / You are thinking, reflecting, analysing what you see and what you do all the time: perception of General Practice trainees about video feedback / Estás pensando, reflexionando, analizando lo que ves y lo que haces todo el tiempo: percepción de los residentes de Medicina Familiar y Comunitaria sobre vídeo feedback

Introdução: A comunicação é reconhecida como uma habilidade central por vários órgãos reguladores internacionais da educação médica. O ensino específico de habilidades de comunicação é fundamental para melhorar a comunicação dos médicos. As técnicas experienciais mostraram superioridade em comparação com os modelos tradicionais. A utilização de consultas reais ajuda os estudantes a visualizar melhor as suas competências de entrevista e a refletir sobre elas. Com os avanços da tecnologia, o uso de consultas médicas gravadas em vídeo tornou-se a abordagem padrão para o ensino da comunicação. No entanto, a eficácia dessa técnica depende do envolvimento ativo dos estudantes. As suas contribuições e comentários dos pares sobre a consulta gravada são essenciais para a aprendizagem. Contudo, a perspectiva do estudante sobre a utilidade dessa abordagem educativa recebeu pouca atenção. Objetivos: Compreender a percepção da aprendizagem dos residentes de medicina de família e comunidade resultante da atividade de vídeo feedback na sua formação profissional. Métodos: Estudo exploratório, qualitativo, realizado com residentes do primeiro ano de medicina de família e comunidade de um programa de residência estabelecido em São Paulo, Brasil. Os participantes foram entrevistados após as sessões educativas, que foram analisadas por meio de análise temática reflexiva. Resultados: A autopercepção de sua prática, o aprendizado de habilidades de comunicação e os ganhos afetivos foram identificados pelos participantes como pontos de aprendizado derivados da atividade de vídeo feedback. Além disso, sobre o aprendizado de habilidades específicas de comunicação, eles mencionaram comunicação não-verbal e verbal, conexões entre teoria e prática, estrutura de consulta e oportunidades para cristalizar conhecimentos. Os ganhos afetivos incluíram sentir-se parte de um grupo, melhora da autoestima, superação de inseguranças, percepção de consultas mais efetivas, reforço do gosto pelo trabalho e reconhecer a necessidade de mais aprendizado. Conclusões: Os ganhos de aprendizagem identificados em nosso estudo levaram a uma experiência de humanidade compartilhada, que permite aos participantes serem mais efetivos técnica e afetivamente com seus pacientes. Além disso, identificamos que a atividade educativa de vídeo feedback pode ser utilizada para outros possíveis fins educacionais além do ensino da comunicação.

Introduction: Communication is recognized as a central skill by various international medical education regulatory bodies. Specific teaching on communication skills is important to enhance doctors' communication. Experiential techniques appear to be superior compared to traditional models. Real-life consultation helps trainees visualize their interview skills and reflect on them. Upgraded by technology, the use of video-recorded medical visits became the standard approach for communication teaching. However, the effectiveness pf this technique relies on trainees' active involvement. Their inputs and peer feedback on the recorded consultation are essential to learning. Despite its importance, their perspective on the usefulness of video feedback in medical education has received limited attention. Objective: To understand the perception of learning among general practice trainees as a result of the video feedback activity in their vocational training. Methods: An exploratory, qualitative study, conducted with first-year general practice trainees from an established training program in São Paulo, Brazil. Participants were interviewed after educational session, which were analyzed using reflexive thematic analysis. Results: Self-perception of their practice, communication skills learning, and affective gains were identified by participants as learning points derived from the video feedback activity. Furthermore, for specific communication skills learning, they mentioned nonverbal and verbal communication, theory and practice connections, consultation structure and opportunities for crystallizing knowledge. Affective gains included feeling part of a group, improving self-esteem, overcoming insecurities, perception of more effective consultations, reinforcing fondness for their work, and need for more learning. Conclusions: The learning gains identified in our study led to an experience of common humanity, which allowed participants to be more technically and affectively effective with their patients. Also, we identified that the video feedback educational activity can be used for other possible educational purposes, beyond the teaching of communication.

Introducción: La comunicación es reconocida como una habilidad fundamental por varios organismos reguladores internacionales de educación médica. La enseñanza específica de habilidades de comunicación es importante para mejorar la comunicación de los médicos. Las técnicas experienciales parecen ser superiores a los modelos tradicionales. El uso de consultas reales ayuda a los estudiantes a visualizar y reflexionar mejor sobre sus habilidades de entrevista. Actualizado por la tecnología, el uso de consultas médicas grabadas en video se ha convertido en el enfoque estándar para la enseñanza de la comunicación. Sin embargo, para que la técnica funcione, la participación de los estudiantes es crucial. Sus contribuciones y comentarios de los compañeros sobre la consulta grabada son esenciales para el aprendizaje. Sin embargo, la perspectiva de los estudiantes sobre la utilidad de este enfoque educativo ha recibido poca atención. Objetivos: Comprender la percepción del aprendizaje por parte de los residentes de medicina de familia y comunitaria como resultado de la actividad de vídeo feedback en su formación profesional. Métodos: Estudio cualitativo exploratorio realizado con residentes de primer año de medicina familiar y comunitaria de un programa de residencia establecido en São Paulo, Brasil. Los participantes fueron entrevistados después de una sesión educativa, que fueron analizados mediante análisis temático reflexivo. Resultados: La autopercepción de su práctica, el aprendizaje de habilidades comunicativas y las ganancias afectivas fueron identificadas por los participantes como puntos de aprendizaje derivados de la actividad de vídeo feedback. Además, sobre el aprendizaje de habilidades comunicativas específicas, mencionaron la comunicación verbal y no verbal, las conexiones entre la teoría y la práctica, la estructura de consulta y las oportunidades para cristalizar conocimientos. En cuanto a las ganancias afectivas, relataron sentirse parte de un grupo, mejora de la autoestima, superación de las inseguridades, percepción de consultas más efectivas, refuerzo del gusto por el trabajo y necesidad de más aprendizaje. Conclusión: Los logros de aprendizaje identificados en nuestro estudio llevaron a una experiencia de humanidad compartida, que permite a los participantes ser técnica y afectivamente más efectivos con sus pacientes. Además, identificamos que la actividad educativa de vídeo feedback puede ser utilizada para otros posibles fines educativos, además de la enseñanza de la comunicación.

Factores relacionados al estado Todo-Menos-Tesis en la formación de grado de odontólogos de una universidad peruana / Factors Related to All-But-Dissertation Status in Undergraduate Dental Education at a Peruvian University

Resumen Introducción: Elaborar una tesis es un proceso complejo y algunos estudiantes no la culminan, la abandonan o entran en un estado de postergación permanente. Objetivo: Identificar los factores que se relacionan con la presencia del estado Todo-Menos-Tesis (TMT) en los graduados de un programa de odontología. Método: Estudio exploratorio con enfoque cualitativo donde participaron 21 graduados. Se utilizó la técnica de la encuesta y una entrevista semiestructurada. El cuestionario recopiló información relacionada a la condición laboral, características personales, tiempo de graduación y características familiares. La guía de entrevista recopiló las categorías de motivos (personales, académicos, económicos y laborales), consecuencias (repercusiones de la postergación de la tesis) y recomendaciones para evitar el estado TMT. Resultados: El 57,1 % (n = 12) fueron varones. Los principales motivos para postergar la tesis estuvieron relacionados con la adquisición de recursos económicos, pérdida de interés, prioridades familiares, alejamiento académico y sensaciones de habilidades inadecuadas. Los participantes recomiendan ofrecer otras modalidades de titulación, realizar capacitaciones académicas, mejorar las experiencias investigativas y brindar orientación al graduado. Conclusiones: Los graduados de la carrera de estomatología de la Universidad Científica del Sur presentan múltiples factores personales, cognitivos e institucionales que influyen en la decisión de continuar o retomar la elaboración de su tesis de licenciatura. La dedicación laboral y las responsabilidades familiares son los principales factores que limitan el tiempo de dedicación a la tesis.

Abstract Introduction: Preparing a thesis is a complex process and some students do not complete it, abandon it or enter a permanent state of procrastination. Objective: To identify the factors that are related to the presence of the All-But-Dissertation (ABD) state in the graduates of a Dentistry program. Method: Exploratory study with a qualitative approach in which 21 graduates participated. The survey technique and a semi-structured interview were used. The questionnaire collected information related to employment status, personal characteristics, time of graduation, and family characteristics. The interview guide collected the categories of reasons (personal, academic, economic, and labor), consequences (repercussions of postponing the thesis), and recommendations to avoid the syndrome. Results: 57.1% (n = 12) were male. The main reasons for postponing the thesis were related to the acquisition of economic resources, loss of interest, family priorities, academic distance and feelings of inadequate skills. The participants recommend offering other degree modalities, academic training, improving research experiences, and providing orientation to the graduate. Conclusions: Stomatology graduates of the Universidad Científica del Sur present multiple personal, cognitive, and institutional factors that influence the decision to continue or resume the elaboration of their degree thesis. Work dedication and family responsibilities are the main factors that limit the time devoted to the thesis.

Fortaleciendo la experticia adaptativa en la educación quirúrgica: un enfoque integral y estratégico / Strengthening adaptive expertise in surgical education: A comprehensive and strategic approach

Introducción. La formación integral de los residentes excede el conocimiento teórico y la técnica operatoria. Frente a la complejidad de la cirugía moderna, su incertidumbre y dinamismo, es necesario redefinir la comprensión de la educación quirúrgica y promover capacidades adaptativas en los futuros cirujanos para manejar efectivamente el entorno. Estos aspectos se refieren a la experticia adaptativa. Métodos. La presente revisión narrativa propone una definición de la educación quirúrgica con énfasis en la experticia adaptativa, y un enfoque para su adopción en la práctica. Resultados. Con base en la literatura disponible, la educación quirúrgica representa un proceso dinámico que se sitúa en la intersección de la complejidad de la cultura quirúrgica, del aprendizaje en el sitio de trabajo y de la calidad en el cuidado de la salud, dirigido a la formación de capacidades cognitivas, manuales y adaptativas en el futuro cirujano, que le permitan proveer cuidado de alto valor en un sistema de trabajo colectivo, mientras se fortalece su identidad profesional. La experticia adaptativa del residente es una capacidad fundamental para maximizar su desempeño frente a estas características de la educación quirúrgica. En la literatura disponible se encuentran seis estrategias para fortalecer esta capacidad. Conclusión. La experticia adaptativa es una capacidad esperada y necesaria en el médico residente de cirugía, para hacer frente a la complejidad de la educación quirúrgica. Existen estrategias prácticas que pueden ayudar a fortalecerla, las cuales deben ser evaluadas en nuevos estudios.

Introduction. The comprehensive training of residents exceeds theoretical knowledge and operative technique. Faced with the complexity of modern surgery, its uncertainty and dynamism, it is necessary to redefine the understanding of surgical education and promote adaptive capabilities in future surgeons for the effective management of the environment. These aspects refer to adaptive expertise. Methods. The present narrative review proposes a definition of surgical education with an emphasis on adaptive expertise, and an approach for its adoption in practice. Results. Based on the available literature, surgical education represents a dynamic process that is situated at the intersection of the complexity of surgical culture, learning in the workplace, and quality in health care, aimed at training of cognitive, manual, and adaptive capacities in the future surgeon, which allow them to provide high-value care in a collective work system, while strengthening their professional identity. Resident's adaptive expertise is a fundamental capacity to maximize his or her performance in the face of these characteristics of surgical education. In the available literature there are six strategies to strengthen this capacity. Conclusion. Adaptive expertise is an expected and necessary capacity in the surgical resident to deal with the complexity of surgical education. There are practical strategies that can help strengthen it, which must be evaluated in new studies.

El cirujano general en las urgencias hepatobiliares en Colombia desde la visión de los expertos: un estudio cualitativo / The general surgeon in hepatobiliary emergencies in Colombia from the experts' perspective: A qualitative study

Introducción. El manejo perioperatorio de las urgencias hepatobiliares por parte del cirujano general es una competencia esperada y se considera un reto por su relativa frecuencia, impacto en la salud del individuo y la economía, así como las implicaciones en el ejercicio clínico confiable y de alta calidad. Se desconocen los aspectos formales de la educación en cirugía hepatobiliar para el cirujano general en Colombia. El objetivo del presente estudio fue explorar la perspectiva de los cirujanos hepatobiliares sobre esta problemática. Métodos. Se realizó un estudio cualitativo, mediante entrevistas semiestructuradas con 14 especialistas en cirugía hepatobiliar colombianos, en donde se exploraron los desafíos del entrenamiento, el tiempo y las características de una rotación, la evaluación de la confiabilidad, el número de procedimientos y el rol de la simulación. Se hizo un análisis temático de la información. Resultados. Los expertos mencionaron la importancia de la rotación obligatoria por cirugía hepatobiliar para los cirujanos en formación. El tiempo ideal es de tres meses, en el último año de residencia, en centros especializados, con exposición activa y bajo supervisión. Conclusiones. Por las características epidemiológicas del país y la frecuencia de enfermedades hepatobiliares que requieren tratamiento quirúrgico, es necesario que el cirujano general cuente con una formación sólida en este campo durante la residencia. El presente estudio informa sobre las características ideales del entrenamiento en este campo desde la visión de los expertos colombianos.

Introduction. The perioperative management of hepatobiliary emergencies by the general surgeon is an expected competence and is considered a challenge due to its relative frequency, impact on the individual health and the economy, as well as the implications for reliable and high-quality clinical practice. The formal aspects of education in hepatobiliary surgery for the general surgeon in Colombia are unknown. The objective of the present study was to explore the perspective of hepatobiliary surgeons on this problem. Methods. A qualitative study was carried out through semi-structured interviews with 14 Colombian hepatobiliary surgery specialists, where the challenges of training, time and characteristics of the rotation, evaluation of reliability, number of procedures and role of simulation. A thematic analysis of the information was carried out. Results. The experts mentioned the importance of mandatory rotation for hepatobiliary surgery for surgeons in training. The ideal duration was three months, during the last year of residency, in specialized centers with active exposure and under supervision. Conclusions. Due to the epidemiological characteristics of the country and the frequency of hepatobiliary diseases that require surgical treatment, it is necessary for the general surgeon to have solid training in this field during residency. The present study reports on the ideal characteristics of training in this field from the perspective of Colombian experts.

Desenredando los nudos en cirugía: creando maestría con un simulador práctico en casa / Untangling the knots in surgery: Creating mastery with a practical at-home simulator

Introducción. Anudar es una de las habilidades quirúrgicas esenciales y de su correcta ejecución dependen procesos de vital importancia. La adquisición de estas competencias requiere trabajo motor, entornos amigables y realistas. Una estrategia para facilitar el aprendizaje de la técnica de anudado es generar instrumentos de simulación accesibles. Métodos. Se presenta un simulador de nudos quirúrgicos, construido con materiales de bajo costo y asequibles para la población en general, con un presupuesto de aproximadamente $5.000 COP (US$ 1,23). Resultados. Se desarrolló un simulador de nudos quirúrgicos que, al fijarse a la extremidad inferior desde una posición sentada, proporciona una superficie estable para llevar a cabo la práctica de anudado de manera efectiva. Conclusión. La cirugía moderna considera la seguridad del paciente como la principal prioridad, por lo que ya no es apropiado adoptar un método de formación de "ver uno, hacer uno, enseñar uno". Es la práctica constante mediante simuladores, el método más adecuado. Este trabajo presenta una alternativa de aprendizaje ininterrumpido de las técnicas quirúrgicas relacionadas con los nudos.

Introduction. Knotting is one of the essential surgical skills and vitally important processes that depends on its correct execution. The acquisition of these skills requires motor work, friendly and realistic environments. A strategy to facilitate learning the knotting technique is to generate accessible simulation instruments. Methods. A surgical knot simulator is presented, built with low-budget materials and affordable for the general population, with a budget of approximately $5,000 COP (US$ 1.23). Results. A surgical knot simulator has been developed in a way that, when attached to the thigh of a lower extremity from a seated position, provides a stable surface to effectively perform knot tying practice. Conclusion. Modern surgery considers patient safety as the top priority, so it is no longer appropriate to adopt a "see one, do one, teach one" training method. Constant practice using simulators is the most appropriate method. This work presents an alternative for uninterrupted learning of surgical techniques related to knots.

Ensino na Residência em Área Profissional da Saúde no Brasil: análise documental / Teaching in Residency in the Professional Health Area in Brazil: documental analysis

RESUMO Analisar discursivamente os objetivos educacionais presentes nos documentos oficiais referentes aos Programas de Residência em Área Profissional da Saúde. Análise de documentos oficiais brasileiros que configuram o ensino para os Programas de Residência em Área Profissional da Saúde. Busca realizada entre fevereiro e abril de 2023 em bancos de dados disponibilizados nos sites do Governo Federal do Brasil e do Sistema de Legislação da Saúde do Ministério da Saúde. Realizou-se Análise de Discurso Crítica, na perspectiva de Fairclough. Nove documentos oficiais abordavam os objetivos educacionais dos Programas de Residência em Área Profissional da Saúde. Os dados foram sistematizados em princípios, concepções, valores e estratégias educacionais que orientam os programas de residência e em modo de organização, a partir das atividades de ensino. Os objetivos educacionais dos Programas de Residência em Área Profissional da Saúde caminham rumo à formação técnica dos residentes, enquanto o discurso sobre o modelo educacional, expresso nas atividades de ensino, avança para a ampliação do conceito.

ABSTRACT Discursively analyze the educational objectives present in official documents referring to Residency Programs in the Professional Health Area. Analysis of official Brazilian documents that configure teaching for Residency Programs in the Professional Health Area. Search carried out between February and April 2023 in databases available on the websites of the Federal Government of Brazil and the Health Legislation System of the Ministry of Health. Critical Discourse Analysis was carried out, from Fairclough's perspective. Nine official documents addressed the educational objectives of Residency Programs in the Professional Health Area. The data were systematized into principles, conceptions, values, and educational strategies that guide the residency programs and organization mode, based on teaching activities. The educational objectives of Residency Programs in the Professional Health Area move towards the technical training of residents, while the discourse on the educational model, expressed in teaching activities, moves towards expanding the concept.

Ensino remoto emergencial no cotidiano de pós-graduandos em enfermagem à luz de Michel Maffesoli / Emergency remote teaching in the daily life of nursing graduates under the light of Michel Maffesoli / La enseñanza a distancia de emergencia en el cotidiano de los graduados de enfermería bajo la luz de Michel Maffesoli

Objetivo: descrever a experiência vivida por estudantes de um Programa de Pós-Graduação em Enfermagem acerca da formação na modalidade de Ensino Remoto Emergencial, adotado durante a pandemia da Covid-19. Métodos: relato de experiência fundamentado no referencial teórico da Sociologia Compreensiva e do Cotidiano, com enfoque na razão sensível de Michel Maffesoli e construído a partir do referencial metodológico do modelo da Aprendizagem Experiencial de Kolb. Resultados: o uso de tecnologias para comunicação tornou-se comum e acentuado durante o ensino remoto, sendo necessário adequar-se às novas propostas de ensino-aprendizagem e construir um novo modo de ser/fazer no cotidiano dos professores e dos estudantes. Conclusão: a experiência relatada mostra que o Ensino Remoto Emergencial foi essencial no cotidiano dos estudantes para o seguimento do aprendizado e manutenção dos vínculos educacionais, utilizando-o como complemento no (des) envolvimento de competências para a formação acadêmica. (AU)

Objective: to describe the experience lived by students of a Graduate Program in Nursing about training in the Emergency Remote Teaching modality, adopted during the Covid-19 pandemic. Methods: experience report based on the theoretical framework of Comprehensive Sociology and Daily Life, focusing on Michel Maffesoli's sensitive reason and built from the methodological framework of Kolb's Experiential Learning model. Results: the use of technologies for communication has become common and accentuated during remote teaching, making it necessary to adapt to the new teaching-learning proposals and to build a new way of being/doing in the daily lives of teachers and students. Conclusion: the reported experience shows that Emergency Remote Teaching was essential in the daily life of students to follow up on learning and maintain educational bonds, using it as a complement in the development of skills for academic training. (AU)

Objetivo: describir la experiencia vivida por estudiantes de un Programa de Posgrado en Enfermería sobre la formación en la modalidad de Enseñanza a Distancia de Emergencia, adoptada durante la pandemia de Covid-19. Métodos: relato de experiencia basado en el referencial teórico de la Sociología Integral y de la Vida Cotidiana, con foco en la razón sensible de Michel Maffesoli y construido a partir del referencial metodológico del modelo de Aprendizaje Experiencial de Kolb. Resultados: el uso de las tecnologías para la comunicación se ha vuelto común y acentuado durante la enseñanza a distancia, siendo necesario adaptarse a las nuevas propuestas de enseñanza-aprendizaje y construir una nueva forma de ser/hacer en la vida cotidiana de docentes y estudiantes. Conclusión: la experiencia relatada demuestra que la Enseñanza a Distancia de Emergencia fue fundamental en el cotidiano de los estudiantes para acompañar los aprendizajes y mantener los vínculos educativos, utilizándola como complemento en el desarrollo de competencias para la formación académica. (AU)

Diagnostico de competencia transversal autoevaluada de las y los tutores clínicos de Especializaciones en Enfermería / Diagnóstico da competência transversal autoavaliada dos tutores clínicos das Especializações de Enfermagem / Diagnosis of self-assessed transversal competence of clinical tutors of Nursing Specializations

Introducción: La evaluación diagnóstica de competencias transversales de los tutores clínicos de especialización en enfermería es necesaria para sistematizar la práctica clínica, en la cual un especialista acompaña a sus estudiantes. Objetivo: Analizar la competencia transversal de las y los Tutores Clínicos del Programa Único de Especializaciones en Enfermería de la UNAM. Metodología: Cuantitativo, descriptivo y transversal. Se diseñó y validó por jueces la "Escala de Autoevaluación de Competencias Transversales de la y el Tutor Clínico de Especialización en Enfermería". La muestra se obtuvo a partir de la fórmula de poblaciones finitas, y participaron 95 Tutores Clínicos del PUEE-UNAM. La recolección de los datos se llevó a cabo en noviembre del 2022 y se analizaron los datos a través del programa estadístico "IBM SPSS Statistics". Resultados: Los resultados muestran que 73% fueron mujeres y 27% hombres, 56% cuenta con actualización docente mediante cursos, diplomados o certificaciones. Con respecto a la competencia transversal, las y los tutores clínicos promediaron un 88.87% en "Nivel alto". Aunque en general la valoración de las competencias fue alta, se identificaron competencias con porcentajes bajos: Capacidad para diseñar escenarios de aprendizaje del cuidado especializado (68.40%), Capacidad para evaluar el aprendizaje en el entorno práctico (71.60%), Capacidad para promover el trabajo colaborativo (76.80%). Conclusiones: El diagnóstico de la competencia transversal de las y los tutores clínicos del PUEE-UNAM muestra que existen áreas de fortaleza y de oportunidad que demandan capacitación y formación continua en capacidades docentes, socioafectivas e interpersonales

Introduction: The diagnostic evaluation of transversal competencies of clinical tutors specializing in nursing is necessary to systematize clinical practice, in which a specialist accompanies their students. Objective: Analyze the transversal competence of the Clinical Tutors of the Unique Program of Specializations in Nursing of the UNAM. Methodology: Quantitative, descriptive and transversal. The "Self-Evaluation Scale of Transversal Competencies of the Nursing Specialization Clinical Tutor" was designed and validated by judges. The sample was obtained from the finite population formula, and 95 Clinical Tutors from PUEE-UNAM participated. Data collection took place in November 2022 and the data was analyzed through the statistical program "IBM SPSS Statistics". Results: The results show that 73% were women and 27% men, 56% have teaching updating through graduate courses or certifications. Regarding transversal competence, the clinical tutors averaged 88.87% in "High level". Although in general the assessment of the competencies was high, competencies with low percentages were identified: Ability to design specialized care learning scenarios (68.40%), Ability to evaluate learning in the practical environment (71.60%), Ability to promote collaborative work (76.80%). Conclusions: The diagnosis of the transversal competence of the PUEE-UNAM clinical tutors shows that there are areas of strength and opportunity that demand training and continuous training in teaching, socio-affective and interpersonal skills

Introdução: A avaliação diagnóstica das proficiências interdisciplinares dos tutores clínicos de especialização em enfermagem é necessária para sistematizar a prática clínica, na qual um especialista acompanha os seus estudantes. Objetivo: Analisar a proficiência transversal das e dos Tutores Clínicos do Programa Único de Especializações em Enfermagem da UNAM. Metodologia: Quantitativa, descritiva e interdisciplinar. Juízes desenharam e validaram a "Escala de Autoavaliação de Competências Transversais da e do Tutor Clínico de Especialização em Enfermagem. A amostra foi obtida a partir da fórmula de populações finitas, da qual participaram 95 Tutores Clínicos do PUEE-UNAM. A compilação de dados foi feita em novembro de 2022, na qual foram analisados dados mediante o programa estatístico "IBM SPSS". Resultados: Os resultados mostram que, do total de participantes, 73% foi de mulheres e 27% de homens; 56% conta com atualização docente ­ obtida mediante cursos, programas de graduação ou certificações. No que diz respeito à competência transversal, 88,87% das e dos tutores clínicos atingiu o "Nível Alto". Embora a apreciação tenha sido alta em geral, foram também identificadas percentagens baixas: Capacidade para projetar cenários de aprendizado de cuidado especializado (68,40%), Capacidade para avaliar o aprendizado em uma atmosfera prática (71,60%), Capacidade para promover o trabalho colaborativo (76,80%). Conclusões: O diagnóstico da competência transversal das e dos tutores clínicos do PUEE-UNAM demonstra que existem áreas de fortaleza e de oportunidade para melhorar que precisam de capacitação e de formatura contínua em capacidades docentes, socioafetivas e interpessoais

Efecto de la "ley de residentes" sobre el bienestar laboral en cirugía: resultados de un estudio nacional de métodos mixtos en Colombia / Effect of the "residents' law" on occupational well-being in surgery: Results of a national mixed methods study in Colombia

Introducción. El efecto de las políticas para el mejoramiento del bienestar de los residentes, en términos de desgaste profesional y compromiso laboral, es controversial y su resultado tras la implementación de la "ley de residentes" (1917/2018) en Colombia es desconocido. Este estudio explora el efecto de esta ley en médicos residentes de cirugía colombianos. Métodos. Estudio de métodos mixtos secuencial explicativo. Inicialmente, se invitó a todos los residentes de cirugía del país a autodiligenciar los cuestionarios UWES-17 y MBI-HSS para evaluar el compromiso laboral (vigor, dedicación y absorción) y desgaste profesional (agotamiento emocional, despersonalización y baja realización personal) antes (2019) y después (2022) de la implementación de la ley. Se probaron diferentes hipótesis mediante modelos de ecuaciones estructurales. Los resultados fueron explorados con cirujanos mediante grupos focales. La información cualitativa fue analizada manualmente y por inteligencia artificial, y reportada en temas principales. Resultados. Participaron en el estudio 400 residentes. La tasa de desgaste profesional fue de 24,8 % antes y 15,8 % después (p=0,032). El análisis de ecuaciones estructurales confirmó que el agotamiento emocional sobre el desgaste profesional fue menor en 2022 (p=0,022). No se identificaron cambios significativos en el compromiso laboral. La principal explicación fue atribuida a los beneficios económicos de la ley. Conclusión. La tasa de desgaste profesional en médicos residentes de cirugía colombianos se redujo significativamente tras la implementación de la "ley de residentes". Estos hallazgos tienen implicaciones para la practica y el mejoramiento de la calidad de la educación.

Introduction. The effect of policies to improve residents' well-being, in terms of professional burnout and work commitment is controversial, and its result after the implementation of the "residents' law" (1917/2018) in Colombia is unknown. This study explores the effect of this law on Colombian surgical residents. Methods. Explanatory sequential mixed methods study. Initially, all surgical residents in the country were invited to self-complete the UWES-17 and MBI-HSS questionnaires to evaluate work commitment (vigor, dedication, and absorption) and professional burnout (emotional exhaustion, depersonalization, and low personal accomplishment) before (2019) and after (2022) the implementation of the law. Different hypotheses were tested using structural equation models. The results were explored with surgeons through focus groups. Qualitative information was analyzed manually and by artificial intelligence, and reported into main themes. Results. 400 residents participated in the study. Burnout rates were 24.8% before and 15.8% after (p=0.032). The structural equations analysis confirmed that emotional exhaustion over professional burnout was lower in 2022 (p=0.022). No significant changes in work commitment were identified. The main explanation was attributed to the economic benefits of the law. Conclusion. The burnout rate in Colombian surgical residents was significantly reduced after the implementation of the "residents' law". These findings have implications for practice and improving the quality of education

Residencias médicas para graduados médicos extranjeros latinoamericanos en diferentes países / Medical residencies for foreign Latin American graduated physicians in different countries

RESUMEN La residencia médica es una de las alternativas que los médicos de países latinoamericanos pueden decidir tomar al finalizar su pregrado. Muchos de ellos migran debido a la situación socioeconómica y la falta de oportunidades en sus países de origen. La migración se realiza a países de diferentes regiones en las que los métodos de elegibilidad, criterios de selección, especialidades médicas disponibles, sistemas de remuneración y devengación difieren. En los países analizados en este artículo la mayor parte cuenta con exámenes de habilitación para el ejercicio de la medicina y sistemas de compensación económica para el médico residente. Los criterios de selección varían desde exámenes nacionales, sistemas de "matching" y evaluaciones o entrevistas institucionales.

SUMMARY Medical residencies are an alternative that Latin American physicians can adopt after finishing pre-graduate studies. Many of them migrate from their countries due to the current socio-economic crisis and lack of job opportunities. Migration occurs to countries with different eligibility criteria, medical specialties available, remuneration, and retirement plans. Most of the countries searched for in this paper have implemented knowledge tests to allow the practice of medicine and provide economic compensation for residents. Selection criteria vary from national exams to matching systems and interviews.

A study on knowledge, attitude and practices towards research among medical post graduate students

Background: Research is crucial for the scientific progress of the health of individuals and communities. Understanding the concept of evidence-based medicine needs strong research knowledge. Research assures understanding of the subject and improves the knowledge of the students. This study was aimed to assess the level of knowledge, attitude and practices among medical post graduate students and to study the sociodemographic factors. And to determine the association of knowledge with various sociodemographic factors. Methods: An analytical cross-sectional study conducted during a period of two months among the medical post graduate students studying in a private medical college. Knowledge, attitude and practice were assessed by using self- administered questionnaire among 117 post graduate students. Likert scale was used to assess the knowledge component. Results: Among 117 study subjects 47% were first year 27.4% were second year and 25.6% were third year among which the overall adequate knowledge was 86.3%, positive attitude was 95.7% and good practices according to the study scale was only 29.1%. Level of knowledge and practices were found to be having significant association with the academic year studying in (p value <0.05). Conclusions: The post graduate students had adequate knowledge and positive attitude but had poor practices towards research. Adequate research helps to bridge the gaps in research and help the future generations in developing new interventions.

Experiencia docente en un programa de formación de Medicina Familiar y General a distancia / Teaching experience in a distance learning program for Family and General Medicine

La distribución inequitativa del talento humano en salud afecta la capacidad de los sistemas de ofrecer servicios esenciales. En la provincia de Córdoba, el primer nivel de atención es responsabilidad de los municipios, pero el nivel provincial procura sostener la rectoría y ser garante del derecho a la salud. En ese marco, se desarrolló un programa para reducir las brechas en la distribución de médicos: el Plan Cordobés de Médicos del Interior. Acompañando ese plan se ejecutó un convenio específico con la Universidad Nacional de Córdoba para garantizar la formación en la especialidad de Medicina Familiar y General. Ingresaron al programa 170 personas, y hoy contamos con 98 médicos en formación o seguimiento. En este artículo damos cuenta de la experiencia docente, los desafíos y dificultades que supuso afrontar una formación en lugares de práctica variados, y con el aporte de las tecnologías de la información y comunicación. Esperamos que la experiencia sirva para transmitir los aprendizajes de nuestra práctica (AU)

The inequitable distribution of human talent in health affects the capacity of systems to offer essential services. In the province of Córdoba, the primary level of care is the responsibility of municipalities, but the provincial level aims to maintain leadership and guarantee the right to health. Within this framework, a program was developed to reduce gaps in the distribution of physicians: the Cordobés Plan for Interior Physicians. Accompanying this plan, a specific agreement was executed with the National University of Córdoba to ensure training in the specialty of Family and General Medicine. 170 individuals entered the program, and today we have 98 physicians in training or under supervision. In this article, we give an account of the teaching experience, the challenges, and difficulties involved in facing training in various practice settings, along with the contribution of information and communication technologies. We hope that this experience serves to transmit the lessons learned from our practice (AU)

Assessment of level of stress among post-graduate trainees working in tertiary care hospital in a district of Assam

Background: Medical education is itself very vast, stressful and challenging. Stressful condition can lead to many psychological responses like anxiety, depression, irritability, restlessness, sleep disturbances etc. The postgraduate students are at risk of developing stress due to their professional duties, workloads, peer pressure, academic activities and so on. Thus, the study has been initiated to find out the level of stress and its related factors among the post graduate students in a Tertiary care hospital of Assam. Methods: The cross-sectional study was conducted on all the postgraduate students in a tertiary care hospital during March’23 to June’23. By convenience sampling technique around 108 post graduate students were participated in the study. The level of stress had been assessed by perceived stress scale (PSS-10), stress related symptoms from self reporting questionnaire (SRQ-20), and sleep quality by insomnia severity index scale. Results: The study found out that 98 (90.74%) had moderate, 6 (5.55%) high and 4(3.74%) low level of stress. The stress was associated with marital status, gender, residence and clinical and non-clinical departments. Out of 75 male (69.45%), 72 (96% ) moderate, 2 (2.6% ) high and 1 (1.3%) low level of stress and 33 (30.55%) female participants, 81.8% had moderate, 4 (1212%) high, and 2 (6.06%) had low level of stress. Conclusions: The study had concluded that stress was found to be prevalent among the study participants.

A cross sectional study to assess knowledge and self-expressed practices regarding universal precautions among nursing students

Background: Each year, 2 million healthcare workers (HCWs) are exposed to HBV, 9 million to HCV and 1 lakh 70 thousand to HIV. To reduce disease transmission, blood and body fluid precautions were recommended in 1983 by the United States Centre for Disease Control (CDC). Objective was to assess the knowledge and Self-Expressed Practices (SEPs) regarding universal precautions among B.Sc. Nursing (BSN) students and the association between knowledge and SEPs. Methods: A descriptive approach and cross-sectional study design was used. A total of 200 students from BSN 1st year, 2nd year and 3rd years 60, 70 and 70, respectively, consented to participate in the study. Bio-data profile, a self-structured questionnaire to assess knowledge and a Likert scale to assess SEP. Results: Only 2.9% of students of BSN 2nd year fall in the adequate knowledge category, whereas 56.67 % (n=60) students of 1st year, 71.5% (n=70) students of 2nd year, and 68.6% (n=70) students of 3rd year belonged to moderate knowledge category. 86.67% of students in BSN 1st year, 78.57% of students 2nd year and 68.57% of students 3rd year fall in the adequate SEPs category. Only BSN 3rd year students showed a significant association between knowledge and SEPs sum total score (p=0.02). Conclusions: Maximum students had moderate knowledge, but SEPs were in an inadequate category. Students repeatedly receive training regarding universal precautions as they are the future of the health care system, and continuous surveillance of occupational hazards should be conducted to ensure safety and awareness among students and other Health Care Workers (HCWs).

Efecto de la deuda económica sobre el bienestar psicológico de los residentes de cirugía: Resultados de un estudio nacional en Colombia / Effect of financial debt on the psychological well-being of surgery residents: Results of a national study in Colombia

Introducción. La deuda económica durante la residencia en cirugía general puede afectar el desempeño profesional, las decisiones de vida y el bienestar psicológico. La información disponible en Colombia es limitada. El objetivo de este estudio fue cuantificar la deuda económica del residente de cirugía general, identificar los factores asociados y evaluar su efecto en el bienestar psicológico. Métodos. Estudio de corte transversal analítico. Se invitó a 380 residentes a diligenciar una encuesta sobre los aspectos relacionados con su deuda económica y se utilizó el WHO-index para evaluar su bienestar psicológico. Resultados. Un total de 259 residentes participaron en el estudio (67,6 %). El 56 % posee una deuda económica promedio de COP $88.000.000 ((US$21.826)). Un alto nivel de endeudamiento se relacionó con el año de residencia, el tipo de institución (privada) y la solicitud de préstamos. Se identificó algún trastorno mental en 14,7 % y un bajo nivel de bienestar psicológico en 56,4 % de los participantes. No se identificó ninguna asociación entre una elevada deuda económica y el bajo bienestar psicológico. Conclusiones. La deuda económica tiene un efecto sobre los residentes. El endeudamiento de los residentes de cirugía en Colombia es altamente prevalente, y no se correlaciona con un pobre bienestar psicológico. La autodeterminación favorece el bienestar psicológico en el posgrado en cirugía general. Existe la necesidad de educación financiera en los residentes. Se requieren nuevos estudios que evalúen las causas del pobre bienestar psicológico.

Introduction. Financial debt during surgery residency can affect professional performance, life decisions, and psychological well-being. The information available in Colombia is limited. The objective of this study is to quantify the financial debt of the general surgery resident, identify the associated factors and evaluate their effect on psychological well-being. Methods. A cross-sectional study was carried out. A total of 380 residents were invited to complete a survey on aspects related to their financial debt, and the WHO-index to evaluate their psychological well-being. Results. A total of 259 residents participated in the study (67.6%). 56% have an average economic debt of $88,000,000 COP (US$21,826). High debt was related to level of residence, type of institution (private), and loan application. Some mental disorder was identified in 14.7% and a low level of psychological well-being in 56.4% of the participants. No association was identified between high financial debt and low psychological well-being. Conclusions. Economic debt has an effect on residents. Financial debt among surgical residents in Colombia is highly prevalent; however, it does not correlate with poor psychological well-being. Self-determination favors psychological well-being in the postgraduate course in general surgery. Likewise, the need for financial education in residents is imminent. New studies are required that thoroughly evaluate the causes of poor well-being.

Percepción sobre la formación en cuidados paliativos de los estudiantes de las especializaciones de Cirugía general en Colombia / Perception of palliative care training among students of General Surgery specializations in Colombia

Introducción. Los cuidados paliativos responden al sufrimiento de pacientes terminales y requieren personal entrenado para la intervención. Forman parte de la actividad en cirugía, sin embargo, no encontramos información sobre la educación de postgrado en cirugía en Colombia. El objetivo de este estudio fue evaluar el nivel de conocimientos en cuidados paliativos, la calidad de la formación y las estrategias pedagógicas en los residentes. Métodos. Estudio observacional con recolección de la información autodiligenciada por medio electrónico. Resultados. Participaron 228 residentes, 7,8 % mencionaron asistir a rotación en cuidado paliativo y 66,6 % tener contacto con especialistas en cuidados paliativos. El 30,7 % no identificó una estrategia pedagógica clara. El 29,3 % tuvo alto nivel de conocimiento y 21,1 % adecuada calidad de formación. El 83,8 % tuvo un alto nivel en el manejo de obstrucción intestinal. No hubo asociación entre el nivel de conocimiento y las variables evaluadas (p>0,05). Conclusiones. Ni el aprendizaje recibido, ni el año de entrenamiento tuvieron efecto en el nivel percibido de conocimiento. Las competencias en cuidados paliativos, sus métodos y la calidad del aprendizaje son deficientes a nivel de postgrado en cirugía en Colombia. Probablemente está en un currículo oculto. Es necesario implementar estrategias pedagógicas en los currículos de estudios de los programas de formación de cirujanos.

Introduction. Palliative care responds to the suffering of terminal patients and requires trained personnel for intervention. They are part of the activity in surgery; however, we did not find information about postgraduate education in surgery in Colombia. The objective of this study was to evaluate the level of knowledge in palliative care, the quality of training and pedagogical strategies in residents. Methods. Observational study with self-completed information collection by electronic means. Results. A total of 228 residents participated, 7.8% mentioned a palliative care rotation and 66.6% mentioned having contact with palliative care specialists; 30.7% did not identify a clear pedagogical strategy; 29.3% had a high level of knowledge and 21.1% had adequate quality of training; 83.8% had a high level in the management of intestinal obstruction. There was no association between the level of knowledge and the variables evaluated (p>0.05). Conclusions. Neither the learning received nor the year of training had an effect on the perceived level of knowledge. Competencies in palliative care, its methods and the quality of learning are deficient at the postgraduate level in surgery in Colombia. It is probably on a hidden resume. It is necessary to implement pedagogical strategies in the study curricula of surgeon training programs.

Estrategias de traducción de textos médicos del inglés al español en el marco de la formación doctoral

Introducción: Perfeccionar las habilidades de comunicación y comprensión del inglés en los momentos actuales es una necesidad indispensable para aquellos que realizan estudios de maestría y doctorado, pues les permite divulgar los resultados de sus investigaciones con mayor precisión, así como asimilar claramente la literatura especializada que consulten. Objetivo: Analizar algunas de las principales estrategias de traducción empleadas por los participantes en el curso de comprensión y comunicación de los resultados de investigación. Métodos: Se realizó una investigación educativa en el periodo 2021-2022 en la Universidad de Ciencias Médicas de Cienfuegos, para lo cual se seleccionó una muestra de 42 profesionales, matriculados en los programas de formación doctoral en ciencias biomédicas, estomatológicas y psicológicas. A tal efecto, se empleó la observación como método para describir el proceso de entrenamiento en traducción de textos médicos del inglés al español. Resultados: La estrategia más empleada por los doctorandos fue la traducción literal, que se halló en los 107 fragmentos analizados y en 86,9 % de estos fue la única aplicada; a esta le siguió la transposición (70,0 %). Los calcos léxicos constituyeron la estrategia menos usada, pues solo figuraron en 11,2 % de los textos médicos traducidos del inglés al español. Conclusiones: Las estrategias más utilizadas fueron la traducción literal y la transposición, lo cual se debe a que las estructuras léxicas y sintácticas sirven de base para establecer analogías entre los idiomas español e inglés y, por tanto, facilitan la reexpresión que conlleva el proceso de traducción.

Introduction: Improving communication and understanding skills in English at present is an indispensable necessity for those who conduct masters and doctorate studies, since they allow them to disclose the results of research with more precision, as well as to clearly assimilate the specialized literature. Objective: To analyze some of the main translation strategies used by the participants in the course about understanding and communication research results. Methods: An educational study was carried out in the period 2021-2022 at the University of Medical Sciences in Cienfuegos, with a sample of 42 professionals enrolled in doctoral training programs of biomedical, stomatological and psychological sciences. For this purpose, observation was used as a method to describe the training process in translation of medical texts from English to Spanish. Results: The most used strategy by doctorate students was literal translation, which was found in the 107 fragments analyzed, and it was the only one applied in 86.9% of the cases; followed by transposition (70.0%). Lexical calque was the least used strategy, as it only appeared in 11.2% of the medical texts translated from English to Spanish. Conclusions: The most used strategies were literal translation and transposition, which is due to the fact that lexical and syntactic structures serve as a basis for establishing analogies between Spanish and English languages and, therefore, facilitate the re-expression involved in translation process.

Alcance para Colombia de la declaración de la World Society of Emergency Surgery 2022 sobre el entrenamiento en cirugía digestiva mínimamente invasiva de emergencia / Scope for Colombia of the World Society of Emergency Surgery 2022 declaration on training in emergency minimally invasive digestive surgery

Introducción. El currículo para la formación del cirujano general exige precisión, ajuste al contexto y factibilidad. En 2022, la World Society of Emergency Surgery formuló cinco declaraciones sobre el entrenamiento en cirugía digestiva mínimamente invasiva de emergencia que puede contribuir a estos propósitos. El objetivo del presente artículo fue examinar el alcance de estas declaraciones para la educación quirúrgica en Colombia. Métodos. Se analizó desde una posición crítica y reflexiva el alcance y limitaciones para Colombia de cada una de las declaraciones de la World Society of Emergency Surgery, con base en la evidencia empírica publicada durante las últimas dos décadas en revistas indexadas nacionales e internacionales. Resultados. La evidencia empírica producida en Colombia durante el presente siglo permite identificar que el país cuenta con fundamentos del currículo nacional en cirugía general, formulado por la División de Educación de la Asociación Colombiana de Cirugía en 2021; un sistema de acreditación de la educación superior; un modelo de aseguramiento universal en salud; infraestructura tecnológica y condiciones institucionales que pueden facilitar la adopción exitosa de dichas declaraciones para el entrenamiento de los futuros cirujanos en cirugía digestiva mínimamente invasiva de emergencia. No obstante, su implementación requiere esfuerzos mayores e inversión en materia de simulación quirúrgica, cooperación institucional y fortalecimiento del sistema de recertificación profesional. Conclusión. La educación quirúrgica colombiana está en capacidad de cumplir con las declaraciones de la World Society of Emergency Surgery en materia de entrenamiento en cirugía digestiva mínimamente invasiva de emergencia.

Introduction. The general surgeon training curriculum requires precision, contextual fit, and feasibility. In 2022, the World Society of Emergency Surgery formulated five statements on training in emergency minimally invasive digestive surgery, which can contribute to these purposes. This article examines the scope of these declarations for surgical education in Colombia. Methods. The scope and limitations for Colombia of each of the statements of the World Society of Emergency Surgery were analysed from a critical and reflective position, based on empirical evidence published during the last two decades in national and international indexed journals. Results. The empirical evidence produced in Colombia during this century allows us to identify that the country has the foundations of the national curriculum in general surgery, formulated by the Education Division of the Colombian Association of Surgery in 2021; a higher education accreditation system; a universal health insurance model; technological infrastructure, and institutional conditions that can facilitate the successful adoption of said statements for the training of future surgeons in emergency minimally invasive digestive surgery. However, its implementation requires greater efforts and investment in surgical simulation, institutional cooperation, and strengthening of the professional recertification system. Conclusion. Colombian surgical education is able to comply with the declarations of the World Society of Emergency Surgery regarding training in emergency minimally invasive digestive surgery.

Research on ethical dilemmas in scientific research among medical graduate students / 中国医学伦理学

The ethical dilemma in scientific research exists at all stages of the scientific research activities among medical graduate students， mainly involving conflicts of interest， clinical trials， animal experiments， and the relationship between teachers and students. If medical graduate students are in the ethical dilemma in scientific research for a long time， their research activities will be greatly affected. By discussing the connotation， evaluation tools， current situation， influencing factors， and improvement measures of ethical dilemmas in scientific research， this paper proposed some suggestions， such as comprehensively investigating the influencing factors of ethical dilemmas in scientific research， and formulating targeted improvement measures， with a view to helping medical graduate students identify and get rid of ethical dilemmas in scientific research， and promote the stability of research activities.

The mediating effect of psychological resilience and empathy on the relationship between job stress and job burnout among clinical medical graduate students / 中国职业医学

ObjectiveTo explore the mediating effect of psychological resilience and empathy on the relationship between job stress and job burnout in clinical medical graduate students. Methods A total of 437 graduated students of clinical medicine or related majors were selected as the research subjects using a stratified sampling method. The Connor-Davidson Resilience Scale, Interpersonal Reactivity Index, Perceived Stress Scale, and Maslach Burnout Inventory were used to measure their psychological resilience, empathy, job stress, and job burnout. Results The average scores for psychological resilience, empathy, job stress, and job burnout among the research subjects were (90.2±13.4), (93.8±10.1), (53.7±12.2) and (47.3±12.6), respectively. The detection rate of job burnout was 37.5%. The results of the structural equation model showed that psychological resilience and empathy partially mediated the relationship between job stress and job burnout, with psychological resilience accounting for 13.6% and empathy accounting for 41.3% of the mediating effect. Conclusion Psychological resilience and empathy play a significant mediating role in the relationship between job stress and job burnout among clinical medical graduate students.