[Patient safety training and a safe teaching in primary care]. / La formación en seguridad del paciente y una docencia segura en atención primaria.

This narrative review manuscript aims to raise the difficulties and opportunities for patient safety in specialised healthcare training considering undergraduate, postgraduate, specialist and continuing education, even during the COVID-19 pandemic. It also suggests some proposals for carrying it out. It very briefly discusses this specific training and its current situation in primary care. Highlighting that patient safety is a need, an area of competence and a training opportunity for residents. It establishes the general framework of patient safety in primary care in the document "7 steps for Patient Safety in Primary Care", stating the need for a systemic approach. It highlights the elaboration and presentation of cases on clinical errors as the most frequent training strategy. The real-life clinical scenarios relate to difficult patients, critical incidents and bioethics issues in professional practice. These scenarios have as common characteristics, the fact to produce difficulties and suffering for all the actors involved. Several instruments for training in patient safety are also included. The medium-term goal is to consolidate clinical safety in specialised healthcare training. Finally, an analysis is made of the impact of the pandemic on patient safety training, particularly on specialised healthcare training and some proposals are recommended on how to carry out safe teaching in the times of the COVID-19 pandemic.

[Training evaluation using the four courses portfolio in primary care residents of a Teaching Unit in Murcia]. / Evaluación formativa mediante el portafolio de 4 promociones de residentes de medicina de familia y comunitaria de la Unidad Docente de Murcia.

OBJECTIVE: To evaluate the performance and quality of the 10 groups of training tasks envisaged in the portfolio training model undertaken by all residents of the Primary Care Teaching Unit in Murcia. DESIGN: A cross-sectional study was conducted on the portfolios provided and completed by all residents in May 2011. PARTICIPANTS: All residents who were in training at that time (131). METHOD: Ten groups of training tasks were established from those recommended by the National Commission for the specialty. The performance of each one in each of the portfolios was evaluated, and the compliance for each training task was calculated. The quality of the performance of each of the tasks was given a score, 0 points (very poor) to 10 points (excellent). RESULTS: As regards compliance, the tasks that were most performed were: filling in the Resident book correctly and using the resident skills guide, both with 99.24%, followed by reflection reports on the training visits. All tasks had a compliance rate higher than 67%. The mean percentage of compliance was 86.49%. All tasks obtained an average score greater than 7 (outstanding). The overall mean score was 7,8 points. CONCLUSIONS: The level of perfomance of the tasks set out in the portfolio by the residents was very satisfying. It is necessary to continue working on improving the performance of the portfolio.

New regulations regarding Postgraduate Medical Training in Spain: perception of the tutor's role in the Murcia Region.

BACKGROUND: Recently introduced regulatory changes have expanded the Tutor role to include their primary responsibility for Postgraduate Medical Training (PMT). However, accreditation and recognition of that role has been devolved to the autonomic regions. The opinions of the RT may be relevant to future decisions; METHODS: A comprehensive questionnaire, including demographic characteristics, academic and research achievement and personal views about their role, was sent to 201 RTs in the Murcia Region of Spain. The responses are described using median and interquartile ranges (IQR); RESULTS: There were 147 replies (response rate 73%), 69% male, mean age 45 +/- 7 yrs. RTs perception of the residents' initial knowledge and commitment throughout the program was 5 (IQR 4-6) and 7 (IQR 5-8), respectively. As regards their impact on the PMT program, RTs considered that their own contribution was similar to that of senior residents. RTs perception of how their role was recognised was 5 (IQR 3-6). Only 16% did not encounter difficulties in accessing specific RT training programs. Regarding the RTs view of their various duties, supervision of patient care was accorded the greatest importance (64%) while the satisfactory completion of the PMT program and supervision of day-to-day activities were also considered important (61% and 59% respectively). The main RT requirements were: a greater professional recognition (97%), protected time (95%), specific RT training programs (95%) and financial recognition (86%); CONCLUSIONS: This comprehensive study, reflecting the feelings of our RTs, provides a useful insight into the reality of their work and the findings ought to be taken into consideration in the imminent definitive regulatory document on PMT.

Perfil y competnncias del tutor de residentes d las especialidades hospitalariias de murcia (España)

Objetivo: Conocer las competencias y cualidades que debe tener un Tutor de formación sanitaria especializada, y describir su perfil profesional según los tutores hospitalarios. Material y Métodos: Estudio cualitativo, descriptivo, utilizando la técnica de los informadores clave. Sujetos: 10 tutores de especialidades hospitalarias de un hospital general universitario. Se realizó una encuesta autoaplicable, repartida y recogida personalmente, y de respuestas abiertas, con siete preguntas: 1. ¿Que competencias o cualidades debe tener un Tutor? 2. ¿Que pueden aprender los Residentes de ti? 3. ¿Que es lo que los Residentes no pueden aprender de ti? 4. Lo que no aprendan de ti, ¿de quién lo van a aprender? 5. ¿Que Métodos y Técnicas Docentes utilizas en la formación de los Residentes? 6. ¿Que Métodos y Técnicas Docentes vas a utilizar a partir de ahora? (tras la sesión teórica del curso). 7. ¿Que actividades formativas pluripotenciales has utilizado con tus residentes?. Las respuestas se agruparon por su número por las características que según el RD 183/2008, y las grandes áreas de competencias que debe tener un tutor (conocimientos, habilidades y actitudes). Los datos se presentan en cifras absolutas y frecuencias sobre el total de respuestas. Resultados: La tasa de respuesta de los tutores fue del 100%, con una media de 9 cualidades identificadas por cada tutor (total 90 respuestas). Las cualidades deseables se refieren primero a la competencia docente (44,4%), después a la competencia clínica (27%), seguida de la capacidad de comunicarse y relacionarse con el residente (24,4%); y otras cualidades (3,3%). Lo que pueden aprender los residentes de sus tutores son sobre todo habilidades y actitudes. Y mucho menos conocimientos. También algunas habilidades y actitudes, aunque distintas a las anteriores, es lo que los residentes no van a aprender de estos tutores. Lo que no aprendan de sus tutores lo van a aprender de otros colaboradores docentes, de otros tutores, y de otros compañeros. El método docente más utilizado por estos tutores es el de la Observación Directa del Residente mientras realiza sus tareas habituales. Y el método más mencionado para utilizar en el futuro es el de la Revisión por pares. Las actividades formativas pluripotenciales más utilizadas por los tutores son: los casos clínicos, la elaboración de protocolos o guías de práctica clínica y los trabajos de investigación Conclusiones: las competencias más importantes que debe tener un tutor son: ser un buen docente, tener cualidades como formador y ser un buen clínico. Las competencias identificadas permiten identificar un perfil ideal del tutor.

Adaptación de las unidades docentes hospitalarias a la nueva normativa española / Adapting hospital teaching units in Spain to new guidelines

El Real Decreto 183/2008 sobre formación médica especializada en España, publicado en 2008, ha supuesto un cambio sustancial de esta formación.