La integración de la inteligencia artificial en la educación médica y su impacto en la práctica clínica / The integration of artificial intelligence in medical education and its impact on clinical practice

Introducción: La integración de la inteligencia artificial (IA) en la educación médica redefine paradigmas, optimiza méto-dos y forja una simbiosis tecnológica. Desarrollo: La IA potencia simulaciones clínicas, mejora evaluaciones y desarrolla habilidades blandas, redefiniendo lainteracción médico-paciente. Conclusiones: Aunque persisten desafíos éticos, la colaboración interdisciplinaria y la adaptabilidad son cruciales. La IA marca un hito en la evolución médica al elevar la calidad asistencial y establecer estándares para una colaboración armoniosa entre tecnología y compasión.(AU)

Introduction: The incorporation of artificial intelligence (AI) into medical education redefines paradigms, optimisesmethods and forges a technological symbiosis. Development: AI enhances clinical simulations, improves assessments and develops soft skills, thereby redefining doctor-patient interaction. Conclusions: Although ethical challenges remain, interdisciplinary collaboration and adaptability are crucial. AI marks a milestone in the evolution of medicine by raising the quality of care and setting standards for harmonious collaboration between technology and compassion.(AU)

Do we know where we are heading?

Sam Foster, Executive Director of Professional Practice, Nursing and Midwifery Council, considers the issue of long-term workforce planning, focusing on England.

Still a long way to go on patient safety.

Sam Foster, Executive Director of Professional Practice, Nursing and Midwifery Council, looks at the findings of a parliamentary review into progress on safety proposals and encourages nurses to be part of the culture change.

The needs of newly qualified nurses.

Sam Foster, Executive Director of Professional Practice, Nursing and Midwifery Council, considers the importance of providing the right support to nurses who are new to the register.

What do we mean by accountability?

Sam Foster, Executive Director of Professional Practice, Nursing and Midwifery Council, considers the concepts and principles of professional accountability.

Why we all need to speak up.

Sam Foster, Executive Director of Professional Practice, Nursing and Midwifery Council, considers the Freedom to Speak Up report and its importance in ensuring patient and staff safety.

Embedding Physical Activity Guidance During Pregnancy and in Postpartum Care: 'This Mum Moves' Enhances Professional Practice of Midwives and Health Visitors.

INTRODUCTION: The benefits of physical activity during pregnancy and after childbirth are well established, yet many health care professionals do not feel well equipped to provide physical activity guidance to these populations. As such, the objectives of this study were to explore the immediate and longer term effects of training on health care professionals' ability to provide physical activity guidance to pregnant women and new mothers (mums). METHODS: Midwives and health visitors from 5 locations in the United Kingdom were provided with training on the Chief Medical Officers' physical activity guidelines for pregnancy and after childbirth (n = 393). Midwives and health visitors attended training to become This Mum Moves Ambassadors, then disseminated education to colleagues through a cascade training model. Changes in knowledge, confidence, and professional practice were assessed by survey before and immediately after training (n = 247), and follow-up surveys were completed 3 (n = 35) and 6 (n = 34) months posttraining. RESULTS: At all posttraining time points, health care professionals reported a significant increase in their confidence to communicate about physical activity (P < .001). The reported frequency of having conversations about physical activity increased significantly 3 and 6 months following training compared with baseline (pregnant women, P = .017; new mums, P = .005). There were changes in the types of advice and resources offered by health care professionals and an overall increase in health care professionals' own reported physical activity levels. DISCUSSION: The This Mum Moves cascade approach to delivering training in physical activity guidelines improved reported knowledge, confidence and professional practice of midwives and health visitors, both immediately following and 3 and 6 months after training.

Homeopathy is not placebo effect: proof of scientific evidence for homeopathy

Homeopathy has been a medical practice recognized worldwide for more than two centuries, performing care, teaching and research activities in several health institutions and medical schools. It employs a clinical approach based on heterodox and complementary scientific principles (principle of therapeutic similitude, homeopathic pathogenetic experimentation, use of individualized medicines and dynamized or potentiated doses), with the aim of awakening a curative response in the body against its own disorders and/or diseases. Based on different premises from those used by conventional medical practice, homeopathy is often the target of unfounded and widespread criticism from individuals who systematically deny homeopathic assumptions and any scientific evidence that proves them due to their pseudoskeptical and pseudoscientific stance, which prevents a correct and bias-free analysis. In order to enlighten doctors, researchers, health professionals and the general public, demystifying culturally rooted dogmatic positions and the pseudoskeptical fallacies that "there is no scientific evidence for homeopathy" and "homeopathy is placebo effect", the Technical Chamber of Homeopathy of the Regional Council of Medicine of the State of São Paulo (TC-Homeopathy, Cremesp) prepared the "Special Dossier: Scientific Evidence for Homeopathy" in 2017, made available in three independent editions (online in Portuguese and English; printed in Portuguese) in the Revista de Homeopatia (São Paulo). Then, the dossier was published in Spanish in the La Homeopatía de México journal in 2023 in an edition commemorating the journal's 90th anniversary. Encompassing nine narrative reviews on the various lines of homeopathy research and containing hundreds of scientific articles describing experimental and clinical studies, the Dossier highlighted the state of the art of homeopathic science. Proving and expanding this scientific evidence in 13 chapters, the current work aims to update and clarify knowledge in the area. In addition to elucidating the epistemological premises of the homeopathic model in detail, the work describes the various aspects of basic and clinical research which endorse homeopathic practice and treatment in a continuum of information, data and bibliographic references. The work discusses various topics related to research in homeopathy, covering everything from "homeopathic clinical epidemiology" to "pseudoskeptic and pseudoscientific strategies used in attacks on homeopathy", including "pharmacological basis of the principle of similitude", "experimental studies in biological models", "randomized controlled clinical trials", "systematic reviews, meta-analyses and global reports" and "observational studies", among others. In view of the fact that it becomes fruitless and tiring to describe and analyze all the studies and experiments from the different research lines, we suggest and systematize in the different chapters for those who want to delve deeper into the areas of interest, bibliographical surveys of existing literature through the different databases. As we reiterate throughout the work, despite the difficulties and limitations that exist in developing research in homeopathy due to both methodological aspects and the lack of institutional and financial support, the set of experimental and clinical studies described is indisputable proof that "there is scientific evidence for homeopathy" and "homeopathy is not placebo effect", contrary to falsely disseminated prejudice. However, new studies must continue to be developed to improve clinical practice and elucidate peculiar aspects of the homeopathic paradigm. Acting as an integrative and complementary therapy to other specialties, homeopathy can add efficacy, effectiveness, efficiency and safety to medical practice, acting in a curative and preventive manner, reducing symptomatic manifestations and the predisposition to falling ill, with low cost and minimal adverse events, helping doctors to fulfill their "highest and only mission, which is to make sick people healthy, which is called healing" (Samuel Hahnemann, Organon of Medicine, § 1).

La homeopatía no es efecto placebo: comprobación de las evidencias científicas en homeopatía / Homeopathy is not Placebo Effect: Proof of Scientific Evidence for Homeopathy

La Homeopatía ha sido una práctica médica de renombre mundial durante más de dos siglos, desarrollando actividades asistenciales, docentes y de investigación en varias instituciones de salud y escuelas de medicina. Emplea un enfoque clínico basado en principios científicos heterodoxos y complementarios (principio de similitud terapéutica, experimentación patogénica homeopática, uso de medicamentos individualizados y dosis dinamizadas), con el objetivo de despertar una respuesta curativa del organismo frente a sus propios trastornos o enfermedades. Partiendo de premisas diferentes a las empleadas por la práctica médica convencional, la Homeopatía suele ser objeto de críticas infundadas y generalizadas por parte de individuos que niegan sistemáticamente los supuestos homeopáticos y cualquier evidencia científica que los demuestre porque tienen una postura pseudoescéptica y pseudocientífica que impide un análisis correcto y desprejuiciado. Son "pseudoescépticos" disfrazados de "pseudocientíficos". Ilustrar a médicos, investigadores, profesionales de la salud y al público en general, desmitificando las posturas dogmáticas culturalmente arraigadas y las falacias pseudoescépticas de que "no hay evidencia científica en la Homeopatía" y "la Homeopatía es un efecto placebo", en 2017, la Cámara Técnica de Homeopatía del Consejo Regional de Medicina del Estado de São Paulo (CT-Homeopatía, Cremesp) elaboró el "Dossier Especial: Evidencia Científica en Homeopatía", disponible en tres ediciones independientes (en línea en portugués e inglés; impresa en portugués) en la Revista de Homeopatía (São Paulo). En 2023, el dossier fue publicado en español en la revista La Homeopatía de México, en una edición conmemorativa del 90 aniversario de la revista. Abarcando nueve revisiones narrativas sobre las diversas líneas de investigación en Homeopatía, que contienen cientos de artículos científicos que describen estudios experimentales y clínicos, el dossier destacó el estado del arte de la ciencia homeopática. Demostrando y ampliando esta evidencia científica, el presente trabajo ("La Homeopatía no es Efecto Placebo": Comprobación de las Evidencias Científicas en Homeopatía) pretende esclarecer los conocimientos en el área en trece capítulos. Además de dilucidar en detalle las premisas epistemológicas del modelo homeopático, el trabajo describe, en un continuo de información, datos y referencias bibliográficas, los diversos aspectos de la investigación básica y clínica que avalan la práctica y el tratamiento homeopático. Discutiendo diversos temas relacionados con la investigación en Homeopatía, el libro aborda desde la "epidemiología clínica homeopática" hasta las "estrategias pseudoescépticas y pseudocientíficas utilizadas en los ataques a la Homeopatía", pasando por el "fundamento farmacológico del principio de similitud", "estudios experimentales en modelos biológicos", "ensayos clínicos controlados aleatorizados", "revisiones sistemáticas, metaanálisis e informes globales" y "estudios observacionales", entre otros. Como hemos reiterado a lo largo del libro, a pesar de las dificultades y limitaciones en el desarrollo de la investigación en Homeopatía, tanto por aspectos metodológicos como por la ausencia de apoyo institucional y financiero, el conjunto de estudios experimentales y clínicos descritos es una prueba irrefutable de que "existen evidencias científicas en Homeopatía" y "la Homeopatía no es efecto placebo", contrariamente al prejuicio falsamente difundido. Actuando como terapia integradora y complementaria a otras especialidades, la Homeopatía puede agregar eficacia, efectividad, eficiencia y seguridad a la práctica médica, reduciendo las manifestaciones sintomáticas y la predisposición a la enfermedad, con bajo costo y mínimos eventos adversos.

Practice hours: examining the evidence.

Sam Foster, Executive Director of Professional Practice, Nursing and Midwifery Council, considers the challenges the NHS Long Term Workforce Plan brings to the question of the number of student practice learning hours.

Striking the right balance.

Sam Foster, Executive Director of Professional Practice, Nursing and Midwifery Council, reflects on the need to consider the impact on the wellbeing of professionals of fitness-to-practise processes.

Defining the scope of advanced practice.

Sam Foster, Executive Director of Professional Practice, Nursing and Midwifery Council, considers the issue of defining and regulating the scope of advanced nursing practice.

We need to support those who speak up, for everyone's safety.

Sam Foster, Executive Director of Professional Practice, Nursing and Midwifery Council, reflects on the need to support those who speak up.

Raising the profile of nurse leadership.

Sam Foster, Executive Director of Professional Practice, Nursing and Midwifery Council, reflects on the findings of a study that examined the attributes required of, and the challenges faced by, nurse directors.

A global approach to workforce issues.

Sam Foster, Executive Director of Professional Practice, Nursing and Midwifery Council, considers how World Health Organization documents can point the way to improving nursing and midwifery education.

Contribuitions for teaching religiosity/spirituality in undergraduate nursing programs: a qualitative study with Brazilian nurses / Contribuições para o ensino de religiosidade/espiritualidade na graduação em enfermagem: estudo qualitativo com enfermeiros brasileiros / Contribuciones para enseñanza de religiosidad/espiritualidad en la graduación en enfermería: estudio cualitativo con enfermeros brasileños

Objective:to identify and collect recommendations for teaching religiosity/spirituality in undergraduate Nursing courses of nurses working in a Hospital. Method:this is a qualitative study, with 34 nurses interviewed. The research corpus was fully transcribed and submitted to content analysis. Results:the religiosity/spirituality theme was absent in the graduation of most of professionals. They mentioned the restricted preparation to deal with human issues and for being a dimension that offers a resource to face thechallenges of the daily life of the profession. What mitigated this gap was that some professionals have their own religious/spiritual beliefs, which have often guided how this religious/spiritual support is provided in health care.Conclusions:participants suggest the presence of religiosity/spirituality teaching in nursing graduation effectively and practically, not only theoretically reinforce its importance. Taking religiosity/spirituality content to undergraduate courses can be sensitive to the holistic needs of patients/users and even the professionals themselves.

Objetivo: identificar e coletar recomendações para o ensino da religiosidade/espiritualidade na graduação em Enfermagem a partir de enfermeiros de um Hospital. Método: estudo qualitativo, com 34 enfermeiros(as) entrevistados(as). O corpus de pesquisa foi transcrito na íntegra e submetido à análise conteúdo. Resultados:areligiosidade/espiritualidade esteve ausente na graduação da maioria dos profissionais e é referida em termos da restrita preparação para lidar com questões humanas e por ser uma dimensão que oferece enfrentamento para os desafios do cotidiano da profissão. O que atenuou essa lacuna foi a presença da própria crença religiosa/espiritual, o que tem balizado, muitas vezes, como o apoio religioso/espiritual é oferecido no cuidado. Conclusões:os participantes sugerem o ensino da religiosidade/espiritualidade na graduação em enfermagem de maneira efetiva e prática, não apenas reforçar sua importância. Levar esse conteúdo para a graduação pode se mostrar sensível às necessidades holísticas dos pacientes/usuários e até mesmo dos próprios profissionais.

Objetivo:identificar y recoger recomendaciones para la enseñanza de la religiosidad/espiritualidad en la graduación de enfermería de enfermeros de un hospital. Método: estudio cualitativo, con 34 enfermeros entrevistados. El corpus de investigación fue transcrito en su totalidad y sometido a análisis de contenido. Resultados:la religiosidad/espiritualidad estuvo ausente en la formación de la mayoría de estos profesionales y es señalada por su falta de preparación para enfrentar los problemas humanos y porque es una dimensión que ofrece recursos para enfrentar del día a día. Las creencias religiosas/espirituales de los profesionales paliaron esta brecha, que muchas veces ha marcado cómo se ofrece el apoyo religioso/espiritual en el cuidado. Conclusiones:la religiosidad/espiritualidad en la graduación de enfermería se sugiere de manera práctica, no solo reforzando su importancia. Contenidos de religiosidad/espiritualidad a los cursos de pregrado puede ser sensible a las necesidades holísticas de los pacientes/usuarios e incluso de los propios profesionales.

Spirituality in Australian Health Professional Practice: A Scoping Review and Qualitative Synthesis of Findings.

This study explores how spirituality is integrated into practice across the different Australian health professions. Utilising the Joanna Briggs Institute's (JBI) protocol, six databases were searched, and sixty-seven articles were finally included. To present the findings, a qualitative synthesis was used. 'Meaning' and 'purpose in life' were found to be key to many spirituality definitions. The most frequently reported approach for Australian health professionals (HPs) in asking about client spirituality was using one or two questions within a comprehensive assessment. Major facilitators included a holistic care approach and prior training, whereas a key barrier was a lack of time.

The status of nurses in social care.

Sam Foster, Executive Director of Professional Practice, Nursing and Midwifery Council, considers strategies for reforming social care and recognising and rewarding the work of nurses in the sector.

Supporting international recruits.

Sam Foster, Executive Director of Professional Practice, Nursing and Midwifery Council, considers the issues faced by internationally recruited nurses and areas where retention strategies could be focused.

Professional practices in situations of child abuse: an integrative review. / As práticas profissionais realizadas em situações de maus-tratos infantis: uma revisão integrativa.

Child abuse is a problem that affects children all over the world. The present study therefore aimed to identify and analyze the main findings relating to professional practices for dealing with situations of child maltreatment in articles published in Brazil. To this end, we conducted an integrative literature review of articles published between 2017 and 2022 based on searches of the following databases: Google Scholar, SciELO Brasil, the periodicals database of the Agency for the Improvement of Higher Education Personnel (CAPES), MEDLINE, the Virtual Health Library, and Electronic Journals in Psychology (PePSIC). A total of 24 publications were selected for the review after screening the titles and abstracts. The findings reveal several challenges to ensuring the protection of children caused by shortcomings in professional training, which have a negative influence on the identification and reporting of child maltreatment. The present study reveals the lack of priority given to the issue of child maltreatment in professional training and provides important inputs to inform future research on professional practices for dealing with child violence.

A violência infantil é um problema que afeta crianças no mundo todo. O presente estudo objetiva identificar e analisar os principais resultados apresentados em artigos publicados no Brasil sobre as práticas profissionais desenvolvidas em situações de maus-tratos infantis. Para tanto, realizou-se uma revisão integrativa da literatura, com buscas nas bases de dados Google Acadêmico, no SciELO Brasil, nos Periódicos da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior do Ministério da Educação (CAPES/MEC), no MEDLARS ONLINE (Medline), na Biblioteca Virtual em Saúde (BVS Saúde) e nos Periódicos Eletrônicos em Psicologia (Pepsic), abrangendo publicações de 2017 a 2022. Após a leitura dos títulos e resumos, 24 artigos foram selecionados para a análise. Os resultados apontam a dificuldade na proteção integral da criança devido à deficiência na formação do profissional, que influencia na identificação e notificação do abuso infantil. O presente estudo revela o lugar que os maus-tratos infantis ocupam na formação dos profissionais e subsidia pesquisas futuras sobre práticas profissionais para o enfrentamento da violência infantil.