ABSTRACT
@#Client feedback is an integral part of the health care system’s quality and effectiveness. In health care operations, it is paramount as it serves as a vital tool for continuous improvement, ensuring patient-centric care delivery, and fostering trust and accountability within the health care system. Client feedback helps shape up new and existing policies and is, therefore, highly valued, considered, and acted upon. In health care institutions such as the Southern Philippines Medical Center (SPMC), incorporating client feedback into policy-making enhances health care operations and aligns services with patient needs and institutional goals. In SPMC, the Hospital Client Experience Survey is the primary feedback mechanism by which clients, both internal and external, can voice their opinions, concerns, and suggestions regarding its personnel, processes, and structure. Through directives from the Anti-Red Tape Authority (ARTA)1 and the Department of Health (DOH),2 SPMC uses the Hospital Client Experience Survey Tool (HCES) to enhance service delivery. Public Assistance and Complaints Desk (PACD) Officers conduct monthly surveys across 200 hospital areas. Each area expects 5 to 30 responses, based on a calculation by the HCES Online Report Generator (ORG). PACD officers actively engage staff within their designated areas, encouraging their participation in survey distribution per transaction and motivating clients to provide feedback during specified survey days. Highlighting the significance of these surveys, PACD Officers emphasize the invaluable insights gained from diverse client responses, which ultimately shape and validate the impact of service delivery initiatives within the hospital. At the end of each quarter, PACD officers analyze data using the HCES-ORG, collate comments and commendations, verify the accuracy of HCES results, and then post them for viewing by the different departments within the institution. Exceptional staff commendations are documented in the quarterly HCES results publication, prominently displayed within the hospital. These commendations contribute to individual performance evaluations. If a staff member receives negative feedback on the HCES form, their unit manager receives a photocopy of the form and may implement disciplinary action or enroll the staff in customer service seminars hosted by the Professional Education and Training Department (PETD). Consistent negative feedback over three consecutive months may trigger appropriate improvement plans or corrective actions among individual staff or even entire departments. The infographic displays the reports from the HCES for the first to the fourth quarters of 2023. Clients’ feedback comprises three domains: personnel, processes, and structures. Personnel covers attitude and character, processes involve system and organization, and structures include facilities and equipment. The feedback includes both positive and negative comments, with recommendations also identified. The HCES consists of statements rated on a scale from 1 (strongly disagree) to 5 (strongly agree). For this infographic, we computed the mean satisfaction scores for each domain and the proportion of clients who reported satisfaction with the service and timeliness of service they received. To summarize the recommendations from the HCES, we utilized the artificial intelligence (AI) chatbot-powered search engine Perplexity AI. We uploaded the recommendations in spreadsheet format and prompted Perplexity AI to "Summarize, in bullets, the recommendations into three categories: personnel, process, and structure," and then to "Count the times each of those summarized comments were mentioned in the file." We used the response of Perplexity AI to illustrate the results as a word cloud, with the sizes of the words in the cloud proportional to the frequency of mentions. In the HCES, the most frequently mentioned suggestion was to provide additional staff. Other suggestions included maintaining clean and functional restrooms, and improving overall cleanliness and sanitation. Infrastructure-related suggestions focused on better ventilation, air conditioning or fans, expanding wards and watchers’ areas, adding more hospital beds and chairs, ensuring a consistent water supply, and providing necessary diagnostic and therapeutic equipment and medicines. Process-related recommendations focused on reducing service delivery turnaround time, prioritizing senior citizens, PWD, and pregnant patients, improving billing and laboratory services, optimizing operation scheduling, and enhancing staff communication and coordination between and among offices. Personnel-related suggestions included improving staff interaction with patients, providing staff training, ensuring staff safety, and performing diligent patient checks. Client feedback helps SPMC retain positive responses, optimize health care delivery, and serve clients better through ongoing renovations, reorganizations, and transformations, affirming its vision of quality service.
Subject(s)
Feedback , Patient-Centered CareABSTRACT
@#The road to publication can seem long and daunting. Further, access to published work is often limited to larger institutions that can afford expensive journal subscription fees. Gold open-access publications aimed to change the landscape of evidence-based science, allowing papers to be widely accessible without a subscription, often requiring an article processing fee paid by the author or institution. Regardless of the access model, reputable journals are expected to adhere to the publishing code of ethics and provide transparency in the peer review process. While the latter can significantly increase the length of processing time through multiple revisions, editors and peer reviewers provide expert opinions and valuable feedback, thereby safeguarding the integrity of the journal and the scientific process.
Subject(s)
Publishing , Codes of Ethics , FeedbackABSTRACT
Objetivo: desarrollar y validar el contenido de un serious game sobre el manejo seguro de medicamentos intravenosos en pediatría. Método: estudio metodológico para el desarrollo y validación de contenido de una tecnología educativa. Los casos y desafíos del serious game se basaron en una revisión de la literatura y fueron validados por 11 enfermeros con formación y experiencia en el área. Se adoptaron índices de validez de contenido y concordancia para el análisis de concordancia y consistencia interna (mínimo de 0,8). Resultados: el contenido se basa en los principales antibióticos utilizados en el manejo clínico de infecciones en niños hospitalizados y en la seguridad del paciente. Se obtuvo una concordancia absoluta en 60 de los 61 ítems evaluados, y el mínimo obtenido fue de 0,82 en el índice de validación de contenido y 0,80 en concordancia. Los expertos sugirieron ajustes en la formulación de respuestas de un caso específico y se implementaron para mejorar la calidad del contenido de la tecnología. Conclusión: el contenido del serious game Nurseped fue validado por enfermeros expertos en salud infantil en cuanto a casos clínicos, enunciados de preguntas y respuestas de opción múltiple, además del feedback que presenta al usuario una respuesta basada en evidencia tras acertar o fallar en el desafío.
Objective: to develop and validate the content of a serious game on the safe management of intravenous medications in pediatrics. Method: methodological study for the development and content validation of an educational technology. The cases and challenges of the serious game were developed based on a literature review and validated by 11 nurses with training and experience in the area. Content validity and agreement indices were adopted to analyze agreement and internal consistency (minimum of 0.8). Results: the content is based on the main antibiotics used in the clinical management of infections in hospitalized children and patient safety. Absolute agreement was obtained in 60 of the 61 items evaluated, and the minimum obtained was 0.82 in the content validation index and 0.80 in agreement. Adjustments were suggested by experts in the response statement for a specific case and implemented to improve the quality of the technology content. Conclusion: the content of the serious game Nurseped was validated by nurse experts in child health regarding clinical cases, question statements and multiple-choice answers, in addition to feedback that presents the user with an evidence-based answer after getting the challenge right or wrong.
Objetivo: desenvolver e validar o conteúdo de um serious game sobre o manejo seguro de medicamentos endovenosos em pediatria. Método: estudo metodológico para o desenvolvimento e validação de conteúdo de uma tecnologia educacional. Os casos e desafios do serious game foram desenvolvidos com base em revisão da literatura e validados por 11 enfermeiros com formação e atuação na área. Adotou-se os índices de validade de conteúdo e concordância, para análise de concordância e consistência interna (mínimo de 0,8). Resultados: o conteúdo é baseado nos principais antibióticos utilizados no manejo clínico de infecções em crianças hospitalizadas e na segurança do paciente. Obteve-se concordância absoluta em 60 dos 61 itens avaliados, o mínimo obtido foi 0,82 no índice de validação de conteúdo e 0,80 na concordância. Ajustes foram sugeridos pelos experts no enunciado de respostas de um caso específico e implementados para o aprimoramento da qualidade do conteúdo da tecnologia. Conclusão: o conteúdo do serious game Nurseped foi validado por enfermeiros experts em saúde da criança quanto aos casos clínicos, aos enunciados das perguntas e às respostas de múltipla escolha, além do feedback que apresenta ao usuário uma resposta baseada em evidências após o acerto ou erro do desafio.
Subject(s)
Humans , Child , Child Health , Surveys and Questionnaires , Educational Technology , Feedback , Patient SafetyABSTRACT
The objective is to present a daily attitudes and professionalism assessment instrument for medical students in theoretical-practical activities. The development of the instrument was based on the manuals of the program for student integration with the community, on the program's pedagogical project, and on the National Curricular Guidelines for Undergraduate Programs in Medicine, and was carried out by professors. These were consulted in weekly 50-minute meetings held between August and November 2016. At the end of the process, a version of the instrument was consolidated with five items and six descriptors to discriminate learning situations that enable competency-based assessment from the simplest to the most complex level. With the use of the instrument, points considered important in medical training in theoretical-practical activities cannot be overlooked (AU).
Objetiva-se apresentar um instrumento de avaliação diária de atitudes e profissionalismo para estudantes de Medicina em atividades teórico-práticas. A elaboração do instrumento foi baseada nos manuais do programa de integração do aluno com a comunidade, projeto pedagógico do curso e nas Diretrizes Curriculares Nacionais da Graduação em Medicina, realizada por docentes. Os docentes foram consultados em reuniões com duração de 50 minutos, com periodicidade semanal, entre agosto e novembro de 2016. Ao final do processo foi consolidada uma versão do instrumento com cinco itens e seis descritores para discriminação de situações de aprendizagem que permitem a avaliação da competência de um nível mais simples até o mais complexo. Com a utilização do instrumento elaborado não se deixa de avaliar pontos considerados importantes para a formação médica em atividades teórico-prática (AU).
Subject(s)
Schools, Medical , Educational Measurement , Feedback , Academic PerformanceABSTRACT
To explore the role of forkhead box protein O1 (FOXO1) in the progression of glioblastoma multiforme (GBM) and related drug resistance, we deciphered the roles of FOXO1 and miR-506 in proliferation, apoptosis, migration, invasion, autophagy, and temozolomide (TMZ) sensitivity in the U251 cell line using in vitro and in vivo experiments. Cell viability was tested by a cell counting kit-8 (CCK8) kit; migration and invasion were checked by the scratching assay; apoptosis was evaluated by terminal deoxynucleotidyl transferase dUTP nick-end labeling (TUNEL) staining and flow cytometry. The construction of plasmids and dual-luciferase reporter experiment were carried out to find the interaction site between FOXO1 and miR-506. Immunohistochemistry was done to check the protein level in tumors after the in vivo experiment. We found that the FOXO1-miR-506 axis suppresses GBM cell invasion and migration and promotes GBM chemosensitivity to TMZ, which was mediated by autophagy. FOXO1 upregulates miR-506 by binding to its promoter to enhance transcriptional activation. MiR-506 could downregulate E26 transformation-specific 1 (ETS1) expression by targeting its 3'-untranslated region (UTR). Interestingly, ETS1 promoted FOXO1 translocation from the nucleus to the cytosol and further suppressed the FOXO1-miR-506 axis in GBM cells. Consistently, both miR-506 inhibition and ETS1 overexpression could rescue FOXO1 overactivation-mediated TMZ chemosensitivity in mouse models. Our study demonstrated a negative feedback loop of FOXO1/miR-506/ETS1/FOXO1 in GBM in regulating invasiveness and chemosensitivity. Thus, the above axis might be a promising therapeutic target for GBM.
Subject(s)
Animals , Mice , Humans , Brain Neoplasms/genetics , Cell Line, Tumor , Cell Proliferation , Drug Resistance, Neoplasm , Feedback , Gene Expression Regulation, Neoplastic , Glioblastoma/metabolism , MicroRNAs/metabolism , Temozolomide/therapeutic use , Forkhead Box Protein O1/metabolismABSTRACT
BACKGROUND@#Excessive proliferation and migration of vascular smooth muscle cells (VSMCs) are the main causes of restenosis (RS) in diabetic lower extremity arterial disease (LEAD). However, the relevant pathogenic mechanisms are poorly understood.@*METHODS@#In this study, we introduced a "two-step injury protocol" rat RS model, which started with the induction of atherosclerosis (AS) and was followed by percutaneous transluminal angioplasty (PTA). Hematoxylin-eosin (HE) staining and immunohistochemistry staining were used to verify the form of RS. Two-step transfection was performed, with the first transfection of Lin28a followed by a second transfection of let-7c and let-7g, to explore the possible mechanism by which Lin28a exerted effects. 5-ethynyl-2΄-deoxyuridine (EdU) and Transwell assay were performed to evaluate the ability of proliferation and migration of VSMCs. Western blotting and quantitative real-time polymerase chain reaction (qRT-PCR) were performed to detect the expression of Lin28a protein and let-7 family members.@*RESULTS@#Using a combination of in vitro and in vivo experiments, we discovered that let-7c, let-7g, and microRNA98 (miR98) were downstream targets of Lin28a. More importantly, decreased expression of let-7c/let-7g increased Lin28a, leading to further inhibition of let-7c/let-7g. We also found an increased level of let-7d in the RS pathological condition, suggesting that it may function as a protective regulator of the Lin28a/let-7 loop by inhibiting the proliferation and migration of VSMCs.@*CONCLUSION@#These findings indicated the presence of a double-negative feedback loop consisting of Lin28a and let-7c/let-7g, which may be responsible for the vicious behavior of VSMCs in RS.
Subject(s)
Rats , Animals , Down-Regulation , MicroRNAs/metabolism , Feedback , Cell Proliferation/genetics , AtherosclerosisABSTRACT
O objetivo do estudo foi investigar o impacto das variáveis habilidades sociais, resolução de problemas sociais, automonitoria, autoeficácia e coping na adaptação acadêmica em estudantes de instituições de ensino superior públicas e privadas. Participaram 637 estudantes de ambos os sexos, sendo 36,5% (115) homens de instituições públicas e 22,3% (72) de instituições privadas, com idade variando entre 18 e 38 anos (M=24,7; DP=6,3), de diferentes graduações. Foram utilizados o Inventário de Resolução de Problemas Sociais, o Inventário de Habilidades Sociais, a Escala de Automonitoria, a Escala de Autoeficácia Acadêmica de Estudantes do Ensino Superior, o Inventário de Estratégias de Coping e o Questionário de Vivências Acadêmicas-reduzido. A autoeficácia na gestão acadêmica (40,9%) e a autoafirmação na expressão de afeto positivo (13,7%) apresentaram maior impacto para os estudantes de instituições públicas e privadas, podendo contribuir com possíveis intervenções no processo de adaptação ao ensino superior. Pesquisas prospectivas podem investigar questões relacionadas a dados sociodemográficos.(AU)
The aim of the study was to investigate the impact of the variables Social Skills, Resolution of Social Problems, Self-monitoring, Self-efficacy and Coping on Academic Adaptation in students from public and private higher education institutions. 637 students of both sexes participated, being 36.5% (115) men from public institutions and 22.3% (72) from private institutions, aged between 18 to 38 years (M = 24.7; SD = 6.3), of different grades. The Social Problem Solving Inventory, the Social Skills Inventory, the Self-Monitring Scale, the Higher Education Students' Academic Self-Efficacy Scale, the Coping Strategies Inventory and the Academic Experiences-Reduced Questionnaire were used. Self-efficacy in Academic Management (40.9%) and Self-affirmation in the Expression of Positive Affection (13.7%) had a greater impact on students from public and private institutions, which may contribute to possible interventions in the process of adapting to Higher Education. Prospective research can investigate issues related to sociodemographic data.(AU)
El objetivo del estudio fue investigar el impacto de las variables Habilidades sociales, Resolución de problemas sociales, Autocontrol, Autoeficacia y Afrontamiento en la adaptación académica en estudiantes de instituciones de educación superior públicas y privadas. Participaron 637 estudiantes de ambos sexos, siendo 36,5% (115) hombres de instituciones públicas y 22,3% (72) de instituciones privadas, con edades entre 18 y 38 años (M = 24,7; SD = 6,3), de diferentes grados. Se utilizaron el Inventario de Resolución de Problemas Sociales, el Inventario de Habilidades Sociales, la Escala de Autocontrol, la Escala de Autoeficacia Académica de los Estudiantes de Educación Superior, el Inventario de Estrategias de Afrontamiento y el Cuestionario de Experiencias Académicas Reducidas. La Autoeficacia en la Gestión Académica (40,9%) y la Autoafirmación en la Expresión de Afecto Positivo (13,7%) tuvieron un mayor impacto en los estudiantes de instituciones públicas y privadas, lo que puede contribuir a posibles intervenciones en el proceso de adaptación a la Educación Superior. La investigación prospectiva puede investigar cuestiones relacionadas con los datos sociodemográficos.(AU)
Subject(s)
Humans , Male , Female , Adolescent , Adult , Young Adult , Social Adjustment , Universities , Adaptation, Psychological , Problem-Based Learning , Self Efficacy , Social Skills , Anxiety , Personal Satisfaction , Professional Competence , Psychology , Psychology, Social , Public Policy , Schools , Autoanalysis , Social Change , Social Class , Social Environment , Social Support , Social Values , Socialization , Sociology , Teaching , Thinking , Behavior and Behavior Mechanisms , Population Characteristics , Shyness , Career Choice , Career Mobility , Attitude , Mental Health , Statistics as Topic , Liability, Legal , Organizational Policy , Investigative Techniques , Time Management , Cognition , College Admission Test , Community-Institutional Relations , Competitive Behavior , Cultural Diversity , Cooperative Behavior , Lecture , Creativity , Personal Autonomy , Democracy , Trust , Education , Educational Measurement , Emotions , Employee Incentive Plans , Evaluation Studies as Topic , Planning , Faculty , Resilience, Psychological , Altruism , Feedback , Fellowships and Scholarships , Social Networking , Metacognition , Psychosocial Support Systems , Work-Life Balance , Academic Performance , Academic Success , Work Engagement , Scholarly Communication , Latent Class Analysis , Social Integration , Social Inclusion , Social Evolution , Self-Testing , Financial Stress , Community Resources , Sociodemographic Factors , Family Support , Coping Skills , Health Promotion , Intelligence , Interpersonal Relations , Learning , Learning Disabilities , Life Change EventsABSTRACT
Introduction. The use of simulation in surgery has made it possible to shorten learning curves through deliberate practice. Although it has been incorporated long ago, there are still no clear recommendations to standardize its development and implementation. This manuscript aims to share recommendations based on our experience of more than twelve years of employing and improving a methodology in laparoscopic surgical simulation. Topics for Reflection. To transfer surgical skills to a trainee, we base our methodology on a three-pillar framework: The hardware and infrastructure (tools to train with), the training program itself (what to do), and the feedback (how to improve). Implementing a cost-effective program is feasible: the hardware does not need to be high fidelity to transfer skills, but the program needs to be validated. These pillars have evolved over time by incorporating technology: the on-site guidance from experts has changed to a remote and asynchronous modality by video recording the trainee's execution, and by enabling remote and asynchronous feedback. The feedback provider does not necessarily have to be an expert clinician in the subject, but a person previously trained to be a trainer. This allows for deliberate practice until mastery has been reached and learning curves are consolidated. Conclusions. Recommendations based on the experience of our center have been presented, explaining the framework of our strategy. Considering these suggestions, it is hoped that our simulation methodology can aid the development and implementation of effective simulationbased programs for other groups and institutions.
Introducción. El uso de la simulación en cirugía ha permitido acortar las curvas de aprendizaje mediante la práctica deliberada. A pesar de que se ha incorporado previamente, aún no existen recomendaciones claras para estandarizar su desarrollo e implementación. Este manuscrito pretende compartir recomendaciones basadas en nuestra experiencia, con más de doce años empleando y mejorando una metodología en la simulación quirúrgica laparoscópica. Temas de reflexión. Para transferir las habilidades quirúrgicas a un aprendiz, basamos nuestra metodología en un marco de tres pilares: El hardware y la infraestructura (herramientas con las que entrenar), el programa de entrenamiento (qué hacer), y la retroalimentación (cómo mejorar). La implementación de un programa rentable es factible: el hardware no necesita ser de alta fidelidad para transferir las habilidades, pero el programa necesita ser validado. Estos pilares han evolucionado a lo largo del tiempo incorporando tecnología: la presencia de expertos ha evolucionado a una modalidad remota y asincrónica mediante la grabación en vídeo de la ejecución del alumno, y permitiendo su retroalimentación. Aquel que entrega retroalimentación no tiene que ser necesariamente un clínico experto en la materia, sino una persona previamente formada como instructor. Esto permite una práctica deliberada hasta dominar la habilidad y establecer curvas de aprendizaje. Conclusiones. Se han presentado recomendaciones basadas en la experiencia de nuestro centro, explicando el marco de nuestra estrategia. Teniendo en cuenta estas sugerencias, se espera que nuestra metodología de simulación pueda ayudar al desarrollo e implementación de programas efectivos basados en la simulación a otros grupos e instituciones.
Introdução. O uso de simulação em cirurgia tornou possível encurtar as curvas de aprendizagem por meio da prática deliberada. Embora tenha sido incorporado anteriormente, ainda não há recomendações claras para padronizar seu desenvolvimento e implementação. Este manuscrito pretende compartilhar recomendações com base em nossa experiência, com mais de doze anos usando e aprimorando uma metodologia em simulação cirúrgica laparoscópica. Temas de reflexão. Para transferir habilidades cirúrgicas para um aprendiz, baseamos nossa metodologia em uma estrutura de três pilares: o hardware e a infraestrutura (ferramentas para treinar), o programa de treinamento (o que fazer) e feedback (como melhorar). A implementação de um programa rentável é viável: o hardware não precisa ser de alta fidelidade para transferir as habilidades, mas o programa precisa ser validado. Esses pilares evoluíram ao longo do tempo incorporando a tecnologia: a presença de especialistas evoluiu para uma modalidade remota e assíncrona por meio da gravação em vídeo do desempenho do aluno e permitindo seu feedback. Quem dá feedback não precisa ser necessariamente um clínico especialista na área, mas sim uma pessoa previamente treinada como instrutor. Isso permite a prática deliberada até que a habilidade seja dominada e estabeleça curvas de aprendizado. Conclusões. Foram apresentadas recomendações baseadas na experiência do nosso centro, explicando o enquadramento da nossa estratégia. Levando em consideração essas sugestões, espera-se que nossa metodologia de simulação possa ajudar outros grupos e instituições a desenvolver e implementar programas eficazes baseados em simulação.
Subject(s)
General Surgery , Laparoscopy , Simulation Exercise , Education, Medical , Feedback , Simulation TrainingABSTRACT
INTRODUCTION: Maternal sensitivity and mentalization are fundamental for children's mental health development. These skills have been negatively associated with maternal postpartum depressive symptomatology. Moreover, its prevalence increases in low socioeconomic and psychosocial risk contexts, where the access to treatment is scarce. Even though Attachment Based Interventios, such as Video-Feedback has been internationally recognized as an effective intervention. Its cost, as well as the need for language translation and cultural adaptation makes it difficult to implement in Latinamerican countries. AIM: The present study aims to assess the feasibility and acceptability of an online Video-Feedback intervention informed n mentalization aimed at mother-infant dyads with depressive symptomatology who attend Chilean public health centers. METHOD: This is a pilot randomized clinical trial with two groups of 60 mother-infant dyads between 4 and 12 months of age. Participants will be randomly assigned to control and experimental groups in a 1:1 ratio. Even though both groups will receive usual treatment, the experimental group will also receive the present video-intervention. At the end of the study, feasibility will be assessed based on focus groups aimed at interveners and quantitative outcomes such as recruitment rate, questionnaire completion rate and intervention completeness. Acceptability will be assessed from in-depth interviews with participants. In addition, effect sizes of primary and secondary outcomes will be calculated. EXPECTED RESULTS: Results are expected to generate parameters to design a larger-scale clinical trial and to preliminary assess the effect of the reported mentalization-informed intervention on maternal sensitivity. Additionally, it seeks to contribute with a mental health intervention for low-income mother-infant dyads, which can be implemented remotely, at a low cost, and that would be suitable for implementation at a mental health care system policy. The protocol of this trial's design was registered at Clinical Trials (NCT04748731).
INTRODUCCIÓN: La sensibilidad y la mentalización materna constituyen competencias fundamentales para el desarrollo de la salud mental infantil. A su vez, dichas habilidades han sido negativamente asociadas con la presencia de sintomatología depresiva postparto, la cual aumenta su prevalencia en contextos de bajo nivel socioeconómico y riesgo psicosocial, en donde el acceso a tratamiento escasea. Paralelamente, si bien internacionalmente el video-retroalimentación constituye una herramienta efectiva en intervenciones basadas en el apego, el costo, idioma y necesidad de adaptación cultural dificultan su implementación en países latinoamericanos. OBJETIVO: Evaluar la factibilidad y aceptabilidad de una video-intervención informada por la mentalización, dirigida a díadas madre-bebé con sintomatología depresiva, atendidas en centros públicos de atención en salud mental en Chile. MÉTODOS: Ensayo clínico aleatorio piloto con dos grupos de 60 díadas madre-bebé de entre 4 y 12 meses de edad, quienes serán asignados aleatoriamente a grupos control y experimental en una proporción de 1:1. Si bien ambos grupos recibirán el tratamiento habitual, el grupo experimental recibirá también la video-intervención. Al término del estudio se evaluará la factibilidad a partir de grupos focales dirigidos a interventores e indicadores de resultados cuantitativos tales como tasa de reclutamiento, de completación de cuestionarios y finalización de la intervención. La aceptabilidad se evaluará a partir de entrevistas en profundidad a las participantes. Adicionalmente se calculará tamaño del efecto de indicadores de resultados primarios y secundarios. RESULTADOS ESPERADOS: Se espera que los resultados del estudio generen parámetros para diseñar un ensayo clínico de mayor escala y evaluar preliminarmente el efecto de la intervención informada en la mentalización en la sensibilidad materna. Se busca además contribuir con una intervención en salud mental basada en la teoría del apego dirigida a díadas madre-bebé de bajos ingresos, que pueda ser implementada de manera remota, a bajo costo y apta para ser escalada a los sistemas de atención en salud mental.
Subject(s)
Humans , Female , Infant , Depression/therapy , Mothers/psychology , Randomized Controlled Trials as Topic , Feasibility Studies , Mental Health , FeedbackABSTRACT
RESUMEN: El año 2020, la pandemia por COVID-19 forzó a que toda la docencia universitaria se dictase de forma telemática, lo que incluye la enseñanza de anatomía humana. El objetivo de este trabajo fue evaluar la percepción de los alumnos con respecto a los recursos digitales y estrategias activas utilizadas en la versión en línea de la asignatura de anatomía humana. La muestra estuvo constituida por 77 estudiantes de primer año de Odontología que cursaban la asignatura de anatomía. Para la recogida de datos se utilizó un cuestionario de auto aplicación y la realización de tres focus groups con preguntas semi-estructuradas. Los datos cuantitativos se analizaron con estadística descriptiva y los cualitativos mediante teoría fundamentada. El análisis cualitativo determinó 6 categorías relevantes expresadas por los estudiantes: posibilidad de trabajar colaborativamente, espacios de retroalimentación, tipo de información, uso del material, percepción del académico y el factor tiempo. Respecto al análisis cuantitativo, el manual de Anatomía Aplicada para Estudiantes de Odontología fue el recurso digital mejor evaluado (p< 0,005), lo cual fue estadísticamente significativo. Seguido por el atlas 3D de Visible Body como el segundo recurso digital mejor evaluado (p < 0,005). Mientras que el análisis de casos clínicos y la realización de dibujos fueron las estrategias activas mejor evaluadas, las cuales fueron estadísticamente significativas (p< 0,005). El recurso digital más recomendado por los estudiantes fue el manual (30,4 %) seguido por el atlas 3D de Visible Body (28,5 %). La estrategia activa más recomendada fue el rotulado grupal de modelos del manual (37,5 %). Los alumnos perciben positivamente la virtualización de la asigna- tura destacando el rol del docente mediante la retroalimentación y la interacción entre pares.
SUMMARY: In 2020, the COVID-19 pandemic forced all university teaching to be taught online, including the teaching of human anatomy. The objective of this work was to evaluate the students' perception regarding digital resources and active strategies used in the online version of the human anatomy subject. The sample consisted of 77 first-year dentistry students who were studying anatomy. For data collection, a self-application questionnaire and three focus groups with semi-structured questions were used. Quantitative data were analyzed with descriptive statistics and qualitative data using grounded theory. The qualitative analysis determined 6 relevant categories expressed by the students: possibility of working collaboratively, feedback spaces, type of information, use of the material, perception of the academic and the time factor. Regarding the quantitative analysis, the manual of Applied Anatomy for Dentistry Students was the best evaluated digital resource (p<0.005), which was statistically significant. It was followed by the Visible Body 3D atlas as the second best evaluated digital resource (p < 0.005). While the analysis of clinical cases and the making of drawings were the best evaluated active strategies, they were statistically significant (p<0.005). The most recommended digital resource by the students, was the manual (30.4%) followed by the Visible Body 3D atlas (28.5 %). The most recommended active strategy was group labeling of manual models (37.5 %). Students positively perceive the virtualization of the subject, highlighting the role of the teacher through feedback and peer interaction.
Subject(s)
Humans , Students, Dental/psychology , Education, Distance , COVID-19 , Anatomy/education , Perception , Surveys and Questionnaires , Problem-Based Learning , Education, Dental , FeedbackABSTRACT
To improve education, it is necessary to use evidence-based techniques, that is, techniques based on the scientific method proven to be effective in improving educational practices. One of the strategies indicated by the science of learning is the retrieval practice (trying to remember the content learned, strengthening the memory traces). This study synthesizes the research developed on retrieval practice in the teaching and learning process of children from a systematic review system based on the prismamethod. For this, a biblio-graphic search was carried out in the databases of the capes/mec, eric, Scielo, PubMed, Web of Science, and Psycinfo. Forty-one articles were included in the qualitative synthesis. The studies converge on stating there is a beneficial effect of using retrieval practice from an early age (18 months of age). This practice can help both long-term learning and new learning in children, especially when feedback is provided. Thus, there is a need to expand the recommendations to educators so that this audience also benefits from the use of this strategy.
Para mejorar la educación es necesario utilizar técnicas basadas en la evidencia, es decir, basadas en el método científico, utilizar estrategias que demuestren su eficacia para mejorar las prácticas educativas. Entre las prácticas muy recomendadas por la ciencia del aprendizaje se encuentra la práctica de recordar, que consiste en tratar de recordar el contenido aprendido, fortaleciendo así las huellas de la memoria. Este estudio resume la investigación desarrollada sobre la práctica de recordar en el proceso de enseñanza y aprendizaje de los niños, a partir de una revisión sistemática basada en el método prisma. Para ello, se realizó una búsqueda bibliográfica en las bases de datos de las revistas capes/mec, eric, Scielo, Pubmed, Web of Science y PsycINFO. Se incluyeron 41 artículos en una síntesis cualitativa. Los estudios convergen en que existe un efecto beneficioso de utilizar la práctica de recordar con bebés a partir de los 18 meses de edad, es decir, esta práctica puede ayudar tanto al aprendizaje a largo plazo como a facilitar nuevos aprendizajes en los niños, especial-mente cuando se brinda retroalimentación. Por lo tanto, existe la necesidad de ampliar las recomendaciones a los educadores para que ese público también pueda beneficiarse del uso de esta estrategia.
Para melhorar a educação, é necessário utilizar técnicas baseadas em evidências, ou seja, com base no método científico, usar estratégias que são comprovadamente eficazes para aperfeiçoar as práticas educativas. Entre as práticas altamente recomendadas pela ciência da aprendizagem, está a prática de lembrar, que envolve tentar evocar o conteúdo aprendido, fortalecendo assim, os traços de memória. Esse estudo sintetiza as pesquisas desenvolvidas a respeito da prática de lembrar no processo de ensino e aprendizagem de crianças, a partir de uma revisão sistemática baseada no método prisma. Para isso, foi realizada uma pesquisa bibliográfica nas bases de dados do portal de periódicos capes/mec, eric, Scielo, PubMed, Web of Science e PsycINFO. Foram incluídos em síntese qualitativa 41 artigos. Os estudos convergem para o fato de que há efeito benéfico do uso de prática de lembrar com bebês a partir dos 18 meses de idade, ou seja, essa prática pode auxiliar tanto a aprendizagem de longa duração, quanto facilitar novas aprendizagens em crianças, especialmente quando o feedback é fornecido. Dessa maneira, há necessida-de de ampliar as recomendações a educadores para que esse público também seja beneficiado com o uso dessa estratégia.
Subject(s)
Humans , Teaching , Education , Feedback , Learning , Literature , MemoryABSTRACT
Durante la última década las escuelas de medicina han incorporado herramientas de educación a distancia, existiendo numerosas áreas de intervención. El razonamiento clínico es un área que requiere una ejercitación continua y una retroalimentación efectiva. Dado esto se plantea la interrogante de la recepción de una herramienta de aprendizaje lúdico del razonamiento clínico médico que entregue la retroalimentación efectiva con fines de estimulación del aprendizaje. Para ello se desarrolló una herramienta multiplataforma compatible con dispositivos de escritorio y móviles basada en Ren'Py, la cual fue distribuida a estudiantes de cuarto y quinto año. Posteriormente, se aplicó una encuesta de percepción para evaluar la recepción de la herramienta. Dentro de los puntos evaluados destaca ser una forma motivante de reforzar los estudios, con entrega de información atingente y facilidad de uso. Permite además reconocer debilidades y es considerada un aporte a la formación por parte de los estudiantes. A raíz de esta implementación se pudo confirmar utilidad de la retroalimentación efectiva entregada de forma instantánea dentro de casos clínicos estructurados, abriendo nuevas posibilidades al abanico de herramientas disponibles en educación superior.
Over the last decade, medical schools have incorporated distance learning tools, with numerous intervention areas available. Clinical reasoning is an area that requires continuous training and effective feedback. Given this, arises the question about the reception of a gamified learning tool for medical clinical reasoning that delivers effective feedback intended for the stimulation of learning. For this, a multiplatform tool compatible with desktop and mobile devices was developed based on Ren'Py, which was distributed to fourth and fifth year students. Subsequently, a perception survey was applied to evaluate the reception of the tool. Among the points evaluated, it stands out to be a motivating way of reinforcing the studies, with delivery of pertinent information and ease of use. It also allows the recognition of weaknesses and is considered a contribution to training by the students. As a result of this implementation, it was possible to confirm the usefulness of the effective feedback delivered instantly within structured clinical cases, opening new possibilities to the range of tools available in higher education.
Subject(s)
Humans , Aptitude , Learning , Surveys and Questionnaires , Clinical Competence , Feedback , Clinical Reasoning , GamificationABSTRACT
SUMMARY: The information technology (IT) based "instant evaluation" is supported by IT, which allows instant evaluation of teaching phenomena based on certain evaluation criteria and provides instant feedback. In anatomy teaching, we explored and practiced the application of instant evaluation based on a platform called "Rain classroom." We found that IT-based instant evaluation had higher practicability and better student satisfaction, which could improve teaching efficiency during class time, help students improve learning methods, and promote knowledge mastery. Additionally, instant evaluation positively impacted teachers' evaluation ability and teaching skills.
RESUMEN: La "evaluación instantánea" basada en la tecnología de la información (TI) está respaldada por ésta y permite la evaluación instantánea de los fenómenos de enseñanza en función de ciertos criterios de evaluación proporcionando retroalimentación instantánea. En la enseñanza de la anatomía, exploramos y practicamos la aplicación de la evaluación instantánea basada en una plataforma llamada "Aula de lluvia" o Rain Classroom. Descubrimos que la evaluación instantánea basada en TI tenía una mayor practicidad y una mejor satisfacción de los estudiantes, lo que podría mejorar la eficiencia de la enseñanza durante el tiempo de clase, ayudar a los estudiantes a mejorar los métodos de aprendizaje y promover el dominio del conocimiento. Además, la evaluación instantánea tuvo un impacto positivo en la capacidad de evaluación y las habilidades de enseñanza de los maestros.
Subject(s)
Humans , Students , Educational Measurement/methods , Information Technology , Feedback , Anatomy/education , Teaching , Software , China , Surveys and QuestionnairesABSTRACT
Resumen El propósito del presente estudio fue examinar la efectividad del feedback aumentado (FA) en el desempeño y aprendizaje de destrezas motrices. La búsqueda de los estudios se realizó en bases de datos digitales, revisando referencias y consultando a personal experto del área. La selección de los estudios y la extracción de los datos fue realizada por las tres autoras de forma independiente. La calidad de los estudios se evaluó utilizando una modificación de la escala TESTEX. Con el modelo de efectos aleatorios se calculó el tamaño de efecto (TE) de la diferencia de medias estandarizada. Se examinó la heterogeneidad con la Q estadística y la consistencia con I 2 . Veinte estudios cumplieron los criterios de inclusión. Un total de 95 TE fueron calculados, lo cual representa a 949 participantes. El uso de FA durante la práctica física aumentó el desempeño significativamente entre el pretest y la adquisición (TE = 0.87; IC95% = 0.65, 1.10; n = 47; Q = 183.6, I 2 = 74.41%; p < 0.01); mientras que el desempeño disminuyó significativamente entre la prueba de adquisición y la retención, después de que el FA fue suspendido (TE = -0.74, IC95% = -1.04, -0.44; n = 45; Q = 377.45, I 2 . = 88.34%; p < 0.01). Se analizaron la edad y el nivel de habilidad de los sujetos participantes, el tipo de destreza y las características de la práctica y el tipo de FA como posibles variables moderadoras. Los resultados sugieren que el desempeño mejora en la adquisición al recibir FA durante la práctica física, y disminuye en la retención, una vez que no está disponible; no obstante, el uso de FA promueve significativamente el aprendizaje de destrezas motrices.
Abstract The purpose of this study was to use the meta-analytic approach to assess the effectiveness of augmented feedback (AF) on performance and learning of motor skills. Studies were retrieved by searching electronic databases, cross refereeing, and expert criteria. Studies were selected and data was extracted by the three authors independently. The quality of the studies was measured by a modify TEXTEX scale. Random effects models using the standardized mean difference effect size (ES) were used to pool results. Risk of bias, heterogeneity, and inconsistency was examined. Twenty studies met the inclusion criteria. A total of 95 ESs were calculated, representing 949 participants. During physical practice, performance increases from pretest to acquisition when receiving AF (ES = 0.87; 95%CI = 0.65, 1.10; n = 47; I 2 . = 74.41; Q= 183,6; p < 0.01); while performance significantly decrease between the acquisition and retention phase after AF was removed (ES = -0.74; 95%CI = -1.04, -0.44; n = 45; I 2 . = 88.34; Q = 377.45; p < 0.01). Age and skill level ability of the participants, type of task, and practice characteristics, and type of feedback were analyzed as potentially moderator variables. Results suggest that AF increases performance in motor skills during physical practice, but performance decreases after removing AF in retention; all due, AF enhances learning of motor skills.
Resumo O objetivo do presente estudo foi examinar a eficácia do aumento do feedback (AF) sobre o desempenho e a aprendizagem das habilidades motoras. Foram pesquisados estudos em bancos de dados digitais, verificando referências e consultando especialistas na área. A seleção do estudo e a extração de dados foi feita pelos três autores independentemente. A qualidade dos estudos foi avaliada utilizando uma modificação da escala TESTEX. Sob o modelo de efeitos aleatórios, foi calculado o tamanho do efeito (TE) da diferença média padronizada. A heterogeneidade foi examinada usando o Q estatístico e a consistência usando o I2. Vinte estudos preencheram os critérios de inclusão. Um total de 95 TE's foi calculado, representando 949 participantes. O uso de AF durante a prática física aumentou significativamente o desempenho entre o pré-teste e a aquisição (ET = 0,87; CI95% = 0,65, 1,10; n = 47; Q = 183,6, I2 = 74,41%; p < 0. 01); enquanto o desempenho diminuiu significativamente entre o teste de aquisição e a retenção, depois que o AF foi suspenso (SD = -0,74, 95% CI = -1,04, -0,44; n = 45; Q = 377,45, I2. = 88,34%; p < 0,01). A idade e o nível de habilidade dos participantes, tipo de habilidade e características de prática, e tipo de AF foram analisados como possíveis variáveis moderadoras. Os resultados sugerem que o desempenho melhora na aquisição ao receber AF durante a prática física, e diminui na retenção, uma vez que ela não está disponível; entretanto, o uso de AF promove significativamente o aprendizado das habilidades motoras.
Subject(s)
Humans , Exercise , Feedback , Motor SkillsABSTRACT
Abstract Introduction Electrophysiological evidence has reinforced the hypothesis that stuttering is associated with a deficit in modulation of the cortical auditory system during speech planning, contributing to an inefficient auditory feedback monitoring and, consequently, resulting in disfluencies. Objective To verify the impact of auditory feedback modifications on the spontaneous speech of individuals with stuttering. Methods Sixteen individuals, of both genders, aged 8-17 years and 11 months, with a diagnosis of persistent neurodevelopmental stuttering, were divided into two groups: Moderate Stuttering Group and Severe Stuttering Group. The testing procedures consisted of three stages: collection of identification data, audiological assessment and fluency evaluation of spontaneous speech in four auditory feedback conditions (non-altered, delayed, masked and amplified). The speech sample obtained in the non-altered feedback was considered the control; the others were considered as modified listening conditions. Results Regarding the stuttering-like disfluencies, a statistically significant difference was observed in the intragroup analysis of the Moderate Stuttering Group between non-altered and masked auditory feedback (p = 0.042), as well as between non-altered and amplified (p = 0.042). There was a statistically significant difference in the Severe Stuttering Group for all auditory feedback modifications in relation to the non-altered (delayed p = 0.012, masked p = 0.025 and amplified p = 0.042). There was also a reduction in flows of syllables and words-per-minute in the Moderate Stuttering Group for the delayed auditory feedback, as compared to non-altered (p = 0.017 and p = 0.025, respectively). Conclusion The effect of delayed auditory feedback was favorable for the Severe Stuttering Group, promoting speech fluency. The conditions of masked and amplified auditory feedback resulted in speech benefits in both groups, decreasing the number of stuttering-like disfluencies. The speech rate was not impaired by any listening condition analyzed.
Resumo Introdução Evidências eletrofisiológicas têm reforçado a hipótese de que a gagueira está associada a um déficit na modulação do sistema auditivo cortical durante o planejamento da fala, o que contribui para um monitoramento ineficiente da retroalimentação auditiva e, consequentemente, resulta em disfluências. Objetivo Verificar o impacto das modificações da retroalimentação auditiva na fala espontânea de indivíduos com gagueira. Método Participaram 16 indivíduos de ambos os sexos, na faixa de 8 a 17 anos e 11 meses, com diagnóstico de gagueira neurodesenvolvimental persistente, divididos em dois grupos: grupo de gagueira moderada e grupo de gagueira grave. Os procedimentos constaram de três etapas: coleta dos dados de identificação, avaliação audiológica e avaliação da fluência da fala espontânea em quatro condições de retroalimentação auditiva (habitual, atrasada, mascarada e amplificada). A amostra de fala obtida na retroalimentação habitual foi considerada controle; as demais foram consideradas como condições de escuta modificadas. Resultados Com relação às disfluências típicas da gagueira, na análise intragrupo do grupo de gagueira moderada, observou-se diferença estatisticamente significante entre a retroalimentação auditiva habitual e a mascarada (p = 0,042); assim como entre a habitual e a amplificada (p = 0,042). No grupo de gagueira grave, houve diferença estatisticamente significante em todas as modificações de retroalimentação auditiva em relação à habitual (atrasada p = 0,012; mascarada p = 0,025 e amplificada p = 0,042). Verificou-se, ainda, redução dos fluxos de sílabas e de palavras por minuto no grupo de gagueira moderada na retroalimentação auditiva atrasada, quando comparada com a habitual (p = 0,017 e p = 0,025; respectivamente). Conclusão O efeito da retroalimentação auditiva atrasada foi favorável para o grupo de gagueira grave, pois promoveu a fluência da fala. As condições de retroalimentação auditiva mascarada e amplificada ocasionaram benefícios na fala espontânea de ambos os grupos, diminuíram a quantidade de disfluências típicas da gagueira. A velocidade de fala não foi prejudicada por nenhuma condição de escuta analisada.
Subject(s)
Humans , Male , Female , Stuttering , Auditory Perception , Speech , Feedback , Feedback, SensoryABSTRACT
En esta época de los tiempos líquidos, la subjetividad fluida (Baumann,2007; 2018; Lewcowicz, 2004) y los amores líquidos podemos pensar ¿identidades sexuales líquidas? Siguiendo estos interrogantes Ansermet (2016) nos pone en el eje del asunto. "Los movimientos trans más progresistas nos interpelan a nosotros psicoanalistas, en la medida en que ponen en crisis la noción misma de identidad, es decir que la identidad está vacía, y este vacío está en el centro de algunas preocupaciones de los trans, en su forma de arreglárselas con este vacío, es un bricolage con este vacío, hacen algo con este vacío, buscan soluciones." En este sentido la "autopercepción" lejos de ser un vacío, o una creación ex nihilo es ya una respuesta, una posición, una decisión y como tal supone un pasaje por el Otro. Lacan hablaba del sinthome, Ansermet del bricolage, formas del anudamiento del uno por uno a la falla estructural, a la ausencia de relación sexual. Formas de posicionarse frente a esa nada sobre la que se teje la identidad de género
Subject(s)
Humans , Male , Female , Sexuality , Transgender Persons , Gender Identity , Psychoanalytic Interpretation , Psychoanalytic Theory , Feedback , Motion PicturesABSTRACT
Resumo Este artigo descreve e analisa o processo de devolutiva dos resultados do 2º ciclo avaliativo das boas práticas na atenção ao parto e nascimento em maternidades vinculadas à Rede Cegonha, estratégia do Ministério da Saúde implementada em 2011, com enfoque no potencial de contribuição para a melhoria da gestão e atenção obstétrica e neonatal. Trata-se de estudo qualitativo de análise documental de 27 relatórios dos estados e do Distrito Federal referentes às Oficinas de Devolutiva com 1.641 participantes, sendo 40% de profissionais e gestores das maternidades avaliadas, 25% de representantes estaduais, 20% das secretarias municipais de saúde e 15% de representantes da esfera federal. Entre janeiro e agosto de 2019, foram recebidos 46% dos planos de ação de maternidades de 11 estados. Os resultados demonstram o desafio de incorporar os processos de monitoramento e avaliação no cotidiano destas maternidades, por questões estruturais da cultura institucional. Essa situação interfere na análise local de informações de forma sistemática e na realização de ciclos nacionais de avaliação com retorno dos resultados de forma ágil e contínua, uma vez que o acesso a dados nacionais secundários é inexistente no caso das boas práticas de assistência ao parto e nascimento.
Abstract This paper describes and analyzes the process of providing feedback on the results of the second evaluation cycle of good practices of delivery and birth care in maternity hospitals linked to the Rede Cegonha, a Ministry of Health strategy implemented in 2011 to improve obstetric and neonatal healthcare and management. This is a qualitative study based on the documentary analysis of 27 reports from the states and the Federal District referring to the feedback workshops with 1.641 participants, 40% of whom were professionals and managers of the maternity hospitals evaluated, 25% of state representatives, 20% of municipal health secretariats and 15% of federal representatives. Around 46% of maternity hospitals' action plans in 11 states were received from January to August 2019. The results show the challenge of incorporating the monitoring and evaluation processes in these maternity hospitals' daily lives due to structural issues in institutional culture. This situation interferes with the local systematic analysis of information and the implementation of national evaluation cycles with the swift and continuous feedback of the results since access to secondary national data is non-existent in good delivery care practices.
Subject(s)
Humans , Female , Pregnancy , Infant, Newborn , Delivery of Health Care , Hospitals, Maternity , Brazil , Qualitative Research , FeedbackABSTRACT
RESUMEN Objetivos: medir el impacto en la calidad de la prescripción antibiótica empírica en los médicos generales luego de la implementación de un sistema de evaluación y retroalimentación. Métodos: estudio cuasiexperimental con pre y postintervención en una clínica de tercer nivel en Medellín. Se revisó las prescripciones de un grupo de antibióticos por un médico internista, un epidemiólogo y un infectólogo. Se midió el consumo de antibióticos, las retroalimentaciones realizadas, el diagnóstico de la sepsis, tiempo de inicio de los antibióticos en el servicio de urgencias y la prevalencia de Escherichia coli productora de betalactamasa de espectro extendido. Resultados: el número de retroalimentaciones descendió de 10,9 a 2 %. Se redujo el consumo de ceftriaxona (p = 0,04), piperacilina tazobactam (p = 0,01), cefepime (p = 0,04) y ciprofloxacina (p = 0,01). Se evidenció una tendencia a la reducción en la prevalencia de E. coli BLEE (p = 0,3). La intervención no produjo un retraso en el inicio de antibióticos en el servicio de urgencias. Conclusión: una estrategia de auditoría y retroalimentación a los médicos generales, referente a la calidad de la prescripción antibiótica, reduce el consumo de antibióticos sin afectar la oportunidad del diagnóstico de sepsis o el inicio de su tratamiento y puede impactar favorablemente en el perfil de resistencia de la flora microbiana institucional.
SUMMARY Objectives: To measure the impact on the quality of the empirical antibiotic prescription in general practitioners, after the implementation of an evaluation and feedback system. Methods: Quasi-experimental study with pre- and post-intervention in a tertiary care center in Medellín. The prescriptions of a group of antibiotics were reviewed by an internist, an epidemiologist and an infectologist. When failures were found, prescribing doctors were informed. Subsequently, antibiotic consumption, feedbacks, sepsis diagnosis, start time of antibiotics in the emergency department and monthly incidence of Escherichia coli producing extended spectrum betalactamase were measured. Results: The numbers of feedbacks decreased from 10.9% to 2%. Consumption of ceftriaxone (p = 0.04), piperacillin tazobactam (p = 0.01), cefepime (p = 0.04) and ciprofloxacin (p = 0.01) was reduced. There was a tendency to reduce the prevalence of E. coli ESBL. The intervention did not cause a delay in the start of antibiotics in the emergency department. Conclusions: A strategy of continuous feedback to general practitioners regarding the quality of antibiotic prescription reduces consumption of antibiotics without causing changes in diagnosis opportunity or the beginning of antibiotics in sepsis and can impact favorably the resistance profile of the institutional microbial flora.
Subject(s)
Humans , Prescriptions , Anti-Bacterial Agents , Feedback , General PractitionersABSTRACT
ABSTRACT: Interprofessional education has become widely recognised as fundamental to educate new generations of dentists able to successfully join the dental public and private sectors and provide appropriate dental treatment to complex patients in a complex health system. This article presents the innovated curriculum of the dentistry course at Universidad de La Frontera describing its interprofessional education components. The description of IPE in the dental curriculum was done using Institutional documents. The university vocational training policy provides the framework in which IPE is implemented in undergraduate courses. Six out of eight dental curriculum components included IPE in their educational methodologies: 'Integrated units', 'Culture, society and mankind', 'Prevention', 'Professional Projections', 'Integrated clinics', and 'Profes sional Practice'. IPE is present thorough the dental course from first to final year and it takes different forms within each componen t. IPE is one of the methodologies used to achieve the learning outcomes stated in the curriculum. Passing through all modu- les of the dental curriculum leads to the development of generic and professional skills that allow students to obtain their professional title.
RESUMEN: La educación interdisciplinaria ha sido ampliamente reconocida como fundamental en la educación de nuevas generaciones de odontólogos capaces de unirse exitosamente a los sectores público y privado de salud y de otorgar tratamiento odontológico a pacientes con condiciones complejas en un sistema de salud complejo. Este artículo presenta el curriculum innovado de la carrera de odontología de la Universidad de La Frontera, describiendo sus componentes de educación interdisciplinaria (EID). Para la de EID en el plan de estudios se usaron una serie de documentos institucionales. La política de formación profesional da un marco en el cual EID es implementado en los planes de estudio de pregrado. Seis de ocho componentes del plan de estudios de la carrera de odontología incluyen EID en sus metodologías educativas: "Unidades de integración", "Cultura, hombre y sociedad", "Prevención", "Proyecciones profesionales", "Clínicas Integrales" y "Prácticas Profesionales. EID está presente a lo largo de toda la carrera de odontología del primer al último año y toma diferentes formas de acuerdo a cada componente. EID es una de las metodologías usadas para lograr los objetivos de aprendizaje establecidos en el plan de estudios. Cumplir con todas las asignaturas del plan lleva al desarrollo de habilidades genéricas y profesionales que permiten a los estudiantes obtener su título profesional.