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)

Collaborative-guided spectral abundance learning with bilinear mixing model for hyperspectral subpixel target detection.

Detecting subpixel targets is a considerably challenging issue in hyperspectral image processing and interpretation. Most of the existing hyperspectral subpixel target detection methods construct detectors based on the linear mixing model which regards a pixel as a linear combination of different spectral signatures. However, due to the multiple scattering, the linear mixing model cannot​ illustrate the multiple materials interactions that are nonlinear and widespread in real-world hyperspectral images, which could result in unsatisfactory performance in detecting subpixel targets. To alleviate this problem, this work presents a novel collaborative-guided spectral abundance learning model (denoted as CGSAL) for subpixel target detection based on the bilinear mixing model in hyperspectral images. The proposed CGSAL detects subpixel targets by learning a spectral abundance of the target signature in each pixel. In CGSAL, virtual endmembers and their abundance help to achieve good accuracy for modeling nonlinear scattering accounts for multiple materials interactions according to the bilinear mixing model. Besides, we impose a collaborative term to the spectral abundance learning model to emphasize the collaborative relationships between different endmembers, which contributes to accurate spectral abundance learning and further help to detect subpixel targets. Plentiful experiments and analyses are conducted on three real-world and one synthetic hyperspectral datasets to evaluate the effectiveness of the CGSAL in subpixel target detection. The experiment results demonstrate that the CGSAL achieves competitive performance in detecting subpixel targets and outperforms other state-of-the-art hyperspectral subpixel target detectors.

Educação permanente no sistema único de saúde: concepções de profissionais da gestão e dos serviços / Continuing permanent education in the brazilian national health system: conceptions from management and care professionals / Educación continua en el sistema único de salud brasileño: concepciones de los profesionales de gestión y servicios

Este artigo pretende compreender as concepções de profissionais da gestão e dos serviços do Sistema Único de Saúde (SUS) sobre Educação Permanente em Saúde (EPS), bem como seus desafios e potencialidades. Utilizou-se de grupo focal para coleta, seguido de análise lexical do tipo classificação hierárquica descendente com auxílio do software Iramuteq. Os resultados delinearam quatro classes: a) EPS - entendimentos e expectativas; b) entraves à EPS; c) ETSUS e EPS por meio de cursos e capacitações; e d) dispositivos de EPS: potencialidades e desafios. Os participantes apontaram equívocos de entendimentos acerca da EPS ao equipará-la à Educação Continuada (EC) voltada à transferência de conteúdo, com repercussões negativas na prática de EPS. Discute-se o risco em centralizar o responsável pela concretização dessa proposta, que deveria ser coletiva e compartilhada entre diferentes atores. Reivindica-se, portanto, uma produção colaborativa, que possa circular entre os envolvidos, de modo que cada um experimente esse lugar e se aproprie da complexidade de interações propiciadas pela Educação Permanente em Saúde.(AU)

This article aims to understand the conceptions of professionals from the management and services of the Unified Health System (SUS) on Permanent Education in Health (EPS), as well as its challenges and potential. A focus group was used for data collection, followed by a lexical analysis of the descending hierarchical classification type using the Iramuteq software. The results delineated four classes: a) EPS - understandings and expectations; b) obstacles to EPS; c) ETSUS and EPS by courses and training; and d) EPS devices: potentialities and challenges. Participants pointed out misunderstandings about EPS, when equating it with Continuing Education (CE) focused on content transfer, with negative repercussions on EPS practice. The risk of centralizing the person responsible for implementing this proposal, which should be collective and shared among different actors, is discussed. Therefore, a collaborative production is claimed for, which can circulate among those involved, so that each one experiences this place and appropriates the complexity of interactions provided by Permanent Education in Health.(AU)

Este artículo tiene por objetivo comprender las concepciones de los profesionales de la gestión y servicios del Sistema Único de Salud (SUS) sobre Educación Continua en Salud (EPS), así como sus desafíos y potencialidades. Se utilizó un grupo focal para la recolección de datos, seguido por un análisis léxico del tipo clasificación jerárquica descendente con la ayuda del software Iramuteq. Los resultados delinearon cuatro clases: a) EPS: entendimientos y expectativas, b) Barreras para EPS, c) ETSUS y EPS a través de cursos y capacitación, y d) Dispositivos EPS: potencialidades y desafíos. Los participantes informaron que existen malentendidos sobre EPS al equipararla a Educación Continua, con repercusiones negativas en la práctica de EPS, orientada a la transferencia de contenidos. Se discute el riesgo de elegir a un solo organismo como responsable de implementar esta propuesta colectiva, que debería ser colectiva y compartida entre los diferentes actores. Se aboga por un liderazgo colaborativo, que pueda circular entre los involucrados, para que cada uno experimente este lugar y se apropie de la complejidad de interacciones que brinda la Educación Continua en Salud.(AU)

A relação com o saber nas atividades lúdicas escolares / The relationship with knowledge in school recreational activities / La relación con el saber en las actividades lúdicas escolares

O brincar é uma atividade importante para o desenvolvimento infantil, porque melhora aspectos cognitivos, emocionais e físicos. Além disso, jogos e brincadeiras podem ser explorados como recurso educacional. Partindo do entendimento da ludicidade enquanto um processo subjetivo, este trabalho investigou a relação com o saber estabelecida durante as brincadeiras, buscando compreendê-las em suas dimensões epistêmica, social e identitária. Dezesseis estudantes do 5º ano do ensino fundamental foram entrevistados a partir de um roteiro baseado no instrumento "balanço do saber", proposto por Bernard Charlot. As questões foram adaptadas para possibilitar apreender o que as crianças dizem aprender durante as brincadeiras em que participam, com ênfase naquelas realizadas em sala de aula. Os resultados da análise de conteúdo realizada mostraram que, apesar de existirem conflitos sobre como se estabelecem as funções lúdica e educativa, quando a brincadeira infantil é utilizada como recurso pedagógico, os sujeitos podem identificar benefícios no processo de aprendizagem por meio dela. Aponta-se, também, a necessidade de considerar a condição social da criança no ambiente escolar para o sucesso ao utilizar essas atividades como práticas pedagógicas.(AU)

Child's play is an important activity for child development since it improves cognition, emotional, and physical aspects. Games can also be explored as an educational resource. Starting from the understanding that playfulness is a subjective process, this work has investigated the relationship to the knowledge stablished during games, aiming to understand it in its epistemic, social, and identitary dimensions. A group of 16 5th grade students were interviewed from a script based on the instrument "balance of knowledge," as proposed by Bernard Charlot. The questions were adapted to enable the apprehension of what children say they learn on the games they play, emphasizing those which are played in classrooms. The results of the content analysis performed have showed that, despite the conflicts on how both playful and educative functions are stablished when child's play is used as a pedagogic resource, the subjects can identify benefits on the process of learning with it. The need to consider the child's social condition in the school environment to reach success when using these activities as pedagogical practices is also pointed out.(AU)

Jugar es una actividad importante para el desarrollo de los niños, porque mejora aspectos cognitivos, emocionales y físicos. Por tanto, los juegos son explorados como recurso educativo. Partiendo de la comprensión de que lo lúdico es un proceso subjetivo, este trabajo analizó la relación con el saber que se establece durante el juego, con el objetivo de comprenderlo en sus dimensiones epistémica, social e identitaria. Se entrevistó a dieciséis estudiantes de quinto grado a partir de un guion basado en el instrumento "balance del saber" propuesto por Bernard Charlot. Las preguntas fueron adaptadas para permitir la aprehensión de lo que los niños dicen que aprenden en sus juegos, enfatizando los que se juegan en las aulas. Los resultados del análisis de contenido realizado mostraron que, a pesar de que existen conflictos sobre cómo se establecen ambas funciones lúdica y educativa cuando se utiliza el juego infantil como recurso pedagógico, los niños pueden identificar beneficios en el proceso de aprendizaje a través del juego. Se señala la necesidad de considerar la condición social del niño en el entorno escolar para alcanzar el éxito al utilizar estas actividades como prácticas pedagógicas.(AU)

Collaborative Learning in Practice (CLiP) in a London maternity ward-a qualitative pilot study.

OBJECTIVES: Collaborative Learning in Practice (CLiP) is one way of addressing an increase in student placement capacity and potentially improving the student learning experience overall. The aim of this article is to report the findings of a CLiP pilot study undertaken in a London hospital maternity ante- and postnatal ward. DESIGN: A qualitative explorative study design employing a descriptive online survey and individual semi-structured interviews to evaluate the experiences. SETTING: A London based hospital maternity ante- and postnatal ward PARTICIPANTS: seven midwifery students from a mix of years (1-3) and six staff (all trained midwives) METHODS: The survey results and interview data were transcribed and thematically analysed to identify the barriers and enablers for CLiP RESULTS: Three themes emerged from the data: 1. Preparation for the CLiP pilot, 2. Peer-learning and collaboration as support and resource, 3. Independence and trust as drivers for learning. CONCLUSIONS: The results are in-line with previously conducted CLiP studies. This study contributes to the findings around the set-up of CLiP in a demanding London maternity ward. It demonstrates that adequate preparation is vital, including the role of the CLiP educator to raise awareness, provide training and to support CLiP midwives. The CLiP hour appears beneficial since it offers protected reflection time. CLiP appeared to increase the clinical confidence of students, particularly more experienced students, through peer learning and independence. Larger-scale research is needed.

Collaborative case-based learning with programmatic team-based assessment: a novel methodology for developing advanced skills in early-years medical students.

BACKGROUND: Imperial College London launched a new, spiral undergraduate medical curriculum in September 2019. Clinical & Scientific Integrative cases (CSI) is an innovative, flagship module, which uses pioneering methodology to provide early-years learning that [1] is patient-centred, [2] integrates clinical and scientific curriculum content, [3] develops advanced team-work skills and [4] provides engaging, student-driven learning. These aims are designed to produce medical graduates equipped to excel in a modern healthcare environment. METHODS: CSI has adopted a novel educational approach which utilises contemporary digital resources to deliver a collaborative case-based learning (CBL) component, paired with a team-based learning (TBL) component that incorporates both learning and programmatic assessment. This paper serves to explore how first-year students experienced CSI in relation to its key aims, drawing upon quantitative and qualitative data from feedback surveys from CSI's inaugural year. It provides a description and analysis of the module's design, delivery, successes and challenges. RESULTS: Our findings indicate that CSI has been extremely well-received and that the majority of students agree that it met its aims. Survey outputs indicate success in integrating multiple elements of the curriculum, developing an early holistic approach towards patients, expediting the development of important team-working skills, and delivering authentic and challenging clinical problems, which our students found highly relevant. Challenges have included supporting students to adapt to a student-driven, deep learning approach. CONCLUSIONS: First-year students appear to have adopted a patient-centred outlook, the ability to integrate knowledge from across the curriculum, an appreciation for other team members and the self-efficacy to collaboratively tackle challenging, authentic clinical problems. Ultimately, CSI's innovative design is attractive and pertinent to the needs of modern medical students and ultimately, future doctors.

Federated Learning via Augmented Knowledge Distillation for Heterogenous Deep Human Activity Recognition Systems.

Deep learning-based Human Activity Recognition (HAR) systems received a lot of interest for health monitoring and activity tracking on wearable devices. The availability of large and representative datasets is often a requirement for training accurate deep learning models. To keep private data on users' devices while utilizing them to train deep learning models on huge datasets, Federated Learning (FL) was introduced as an inherently private distributed training paradigm. However, standard FL (FedAvg) lacks the capability to train heterogeneous model architectures. In this paper, we propose Federated Learning via Augmented Knowledge Distillation (FedAKD) for distributed training of heterogeneous models. FedAKD is evaluated on two HAR datasets: A waist-mounted tabular HAR dataset and a wrist-mounted time-series HAR dataset. FedAKD is more flexible than standard federated learning (FedAvg) as it enables collaborative heterogeneous deep learning models with various learning capacities. In the considered FL experiments, the communication overhead under FedAKD is 200X less compared with FL methods that communicate models' gradients/weights. Relative to other model-agnostic FL methods, results show that FedAKD boosts performance gains of clients by up to 20 percent. Furthermore, FedAKD is shown to be relatively more robust under statistical heterogeneous scenarios.

A percepção dos idosos sobre a qualidade de vida e o impacto do grupo de convivência na sua saúde / La percepción de los ancianos sobre la calidad de vida y el impacto del grupo de convivencia en su salud / The perception of elderly people about quality of life and the impact of social interaction groups on their health

RESUMO Objetivo: identificar a percepção dos idosos sobre sua qualidade de vida e o impacto do grupo de convivência na sua saúde. Método: estudo descritivo e exploratório, com abordagem qualitativa, realizado com 12 idosos participantes do Grupo de Convivência de uma Unidade Básica de Saúde de um município do sudeste goiano. Os dados foram coletados no período de janeiro e fevereiro de 2019, mediante entrevista aberta, e submetidos à Análise Temática. Resultados: da análise das entrevistas emergiram três categorias: Aspectos positivos e negativos que interferem na qualidade de vida do idoso e os fatores subjetivos; O ageísmo como processo de dificuldade de inserção social do idoso; Contribuições do Grupo de Convivência para a qualidade de vida da pessoa idosa, as quais mostram que a qualidade de vida está relacionada com alimentação saudável, prática de exercícios físicos, a importância das relações familiares, da espiritualidade e religiosidade, e que a velhice ainda está permeada de preconceitos e exclusão social. Considerações finais: evidenciou-se que os participantes do Grupo de Convivência referiram a importância dessa ferramenta para a melhora da sua qualidade de vida e do convívio social.

RESUMEN Objetivo: identificar la percepción de los ancianos sobre su calidad de vida y el impacto del grupo de convivencia en su salud. Método: estudio descriptivo y exploratorio, con abordaje cualitativo, realizado con 12 ancianos participantes del Grupo de Convivencia de una Unidad Básica de Salud de un municipio del sudeste de Goiás/Brasil. Los datos fueron recogidos en el período de enero y febrero de 2019, mediante entrevista abierta, y sometidos al Análisis Temático. Resultados: del análisis de las entrevistas surgieron tres categorías: Aspectos positivos y negativos que interfieren en la calidad de vida del anciano y los factores subjetivos; El edadismo como proceso de dificultad de inserción social del anciano; Contribuciones del Grupo de Convivencia para la calidad de vida de la persona mayor, las cuales muestran que la calidad de vida está relacionada con alimentación saludable, práctica de ejercicios físicos, la importancia de las relaciones familiares, de la espiritualidad y religiosidad, y que la vejez todavía está impregnada de prejuicios y exclusión social. Consideraciones finales: se evidenció que los participantes del Grupo de Convivencia refirieron la importancia de esta herramienta para la mejora de su calidad de vida y de la convivencia social.

ABSTRACT Objective: to identify the perception of elderly people about their quality of life and the impact of a social interaction group on their health. Method: a descriptive and exploratory study with a qualitative approach, carried out with 12 elderly participants of the Social Interaction Group of a Basic Health Unit in a municipality in southeastern Goiás. Data were collected between January and February 2019, through an open interview and submitted to Thematic Analysis. Results: from the analysis of the interviews, three categories emerged: Positive and negative aspects that interfere in the elderly's quality of life and subjective factors; Ageism as a process of difficulty in the social insertion of the elderly; Contributions of the Social Interaction Group for the quality of life of the elderly, which show that quality of life is related to healthy eating, physical exercise, the importance of family relationships, spirituality and religiosity, and that old age is still permeated by prejudice and social exclusion. Final considerations: it was evident that the participants of the Social Interaction Group mentioned the importance of this tool for improving their quality of life and social interaction.

Gênero, ciência e Saúde Coletiva: desconstruindo paradigmas na formação interdisciplinar universitária / Gender, science and public health: deconstructing paradigms in interdisciplinary university education / Género, ciencia y salud colectiva: desconstrucción de paradigmas en la formación interdisciplinaria universitaria

Discute-se experiência docente na Saúde Coletiva com estudantes de pós-graduação das Ciências da Saúde, marcadas pelo paradigma biomédico, com contingente feminino. O encontro com novo modo de produzir ciência - situado, relacional, engajado do ponto de vista ético-político e autorreflexivo - promove uma desconstrução epistemológica e abertura para se posicionar como novo sujeito do conhecimento. Mirar o corpo e a saúde-doença como objeto de estudo pela abordagem interseccional conduzem ao deslocamento subjetivo e heurístico da pesquisadora, com suas marcas sociais de gênero, raça, geracionais, nesta empreitada teórica e empírica de (auto)investigação. Encontrar uma questão de pesquisa inclui também se autoencontrar como profissional de Saúde, em sua posição de gênero, classe e raça/etnia. Advoga-se que os estudos sociais da ciência e estudos feministas decoloniais contribuem para que a universidade pública devolva à sociedade profissionais de Saúde que se reconheçam no público que atendem.(AU)

This article discusses teaching experiences with female students on a post-graduate program in health sciences, an area marked by the biomedical paradigm. The encounter with a new mode of producing science - situated, relational, ethically and politically engaged, and self-reflective - promotes the deconstruction of epistemology and provides an opening for individuals to position themselves as new subjects of knowledge. In this theoretical and empirical undertaking of (self)investigation, looking at the body, health and disease from an intersectional perspective prompts a subjective heuristic shift in the researcher, with her social and gender, race, and generational labels. To encounter a research question is also to encounter with oneself as a health professional, within your gender, class and race/ethnicity. It is argued that social studies of science and decolonial feminist studies can help public universities provide society with health professionals who recognize themselves in the public they treat.(AU)

Se discute la experiencia docente en la salud colectiva con estudiantes de postgrado de las ciencias de la salud, marcadas por el paradigma biomédico, con contingente femenino. El encuentro con un nuevo modo de producir ciencia -situado, relacional, comprometido desde el punto de vista ético-político y autorreflexivo- promueve una desconstrucción epistemológica y una apertura para posicionarse como nuevo sujeto del conocimiento. Mirar el cuerpo, la salud-enfermedad como objeto de estudio por el abordaje interseccional conduce al desplazamiento subjetivo y heurístico de la investigadora, con sus marcas sociales de género, raza, generacionales, en este trabajo teórico y empírico de (auto)investigación. Encontrar una cuestión de investigación también incluye auto-encontrarse como profesional de salud en su posición de género, clase y raza/etnia. Se aboga que los estudios sociales de la ciencia, estudios feministas descoloniales, contribuyen para que la universidad pública devuelva a la sociedad profesionales de salud que se reconozcan en el público que atienden.(AU)

Reabilitação Respiratória para pacientes submetidos à cirurgia torácica e abdominal / Respiratory rehabilitation for patients submitted to thoracic and abdominal surgery

Objetivo: descrever a experiência relacionada a reabilitação respiratória para pacientes submetidos à cirurgia torácica e abdominal superior durante a execução de um programa de extensão universitária. Método: relato de experiência, com abordagem descritiva, sobre a criação de um programa interdisciplinar de reabilitação respiratória para pacientes submetidos à cirurgia torácica e abdominal superior com parceria entre universidade pública e hospital municipal de Imperatriz, Maranhão. Resultados: as atividades do programa universitário de reabilitação respiratória para pacientes em pós-operatório são desempenhadas em três eixos in locus: Educação em Exercícios Respiratórios, Capacitação sobre assistência de enfermagem no pós-operatório de cirurgias torácicas e abdominais e, Educação em saúde e intervenções de enfermagem na atenção ao paciente no período pós-operatório. Conclusão: a atuação em projeto respiratório interdisciplinar, focado em ações educativas, mostrou-se uma ferramenta inovadora de apoio ao cuidado clínico de pacientes submetidos à cirurgia torácica e abdominal superior. (AU)

Objective: To describe the experience related to respiratory rehabilitation for patients undergoing thoracic and upper abdominal surgery during the execution of a university extension program. Methods: Experience report, with a descriptive approach, on the creation of an interdisciplinary program of respiratory rehabilitation for patients undergoing thoracic and upper abdominal surgery in partnership with a public university and a municipal hospital in Imperatriz, Maranhão. Results: The activities of the university respiratory rehabilitation program for patients in the postoperative period are performed in three axes in locus: Education in Respiratory Exercises, Training in nursing care in the postoperative period of thoracic and abdominal surgeries, and Health education and interventions nursing in patient care in the postoperative period. Conclusion: Acting in an interdisciplinary respiratory project, focused on educational actions, proved to be an innovative tool to support the clinical care of patients undergoing thoracic and upper abdominal surgery. (AU)

Objetivo: Describir la experiencia relacionada con la rehabilitación respiratoria para pacientes sometidos a cirugía torácica y abdominal superior durante la ejecución de un programa de extensión universitaria. Métodos: Informe de experiencia, con un enfoque descriptivo, sobre la creación de un programa interdisciplinario de rehabilitación respiratoria para pacientes sometidos a cirugía torácica y abdominal superior en colaboración con una universidad pública y un hospital municipal en Imperatriz, Maranhão. Resultados: Las actividades del programa universitario de rehabilitación respiratoria para pacientes en el postoperatorio se realizan en tres ejes en el locus: educación en ejercicios respiratorios, capacitación en cuidados de enfermería en el postoperatorio de cirugías torácicas y abdominales, y educación e intervenciones de salud enfermería en atención al paciente en el postoperatorio. Conclusión: Actuar en un proyecto respiratorio interdisciplinario, centrado en acciones educativas, demostró ser una herramienta innovadora para apoyar la atención clínica de pacientes sometidos a cirugía torácica y abdominal superior. (AU)

Attitudes of dental and chiropractic students towards a shared learning programme-An interprofessional learning model.

INTRODUCTION: Interprofessional learning (IPL) is the first stage towards the goal of interprofessional collaborative care. To enhance IPL experience, the School of Dentistry, International Medical University developed an IPL model based on the core competencies and the learning outcomes for dental and chiropractic students in their second and fourth year, respectively. The model was based on experiential learning and adult learning theories in addition to Miller's framework for clinical competencies. METHODS: The programme was developed as a student-centred, collaborative approach to achieve the learning outcomes for dental and chiropractic students. Second-year dental students (n = 46) and chiropractic students (n = 23) in their fourth year participated in the programme. The focus of the programme was to address the prevention of work-related musculoskeletal disorders (WMSDs) amongst dental students and to provide the chiropractic students with the opportunity to assess and identify risk factors for WMSDs in the dental setting. The readiness for interprofessional learning scale (RIPLS) questionnaire was completed prior to the interprofessional education programme and once again afterwards to determine dental and chiropractic students' awareness of roles and responsibilities of the other profession, and their attitudes to interprofessional education and teamwork. RESULTS: Dental and chiropractic students showed similar levels of readiness for shared learning. The results of this study suggest that the IPL programme contributed to the development of the students' positive perceptions towards the positive professional identity and the roles of other healthcare professionals. CONCLUSION: This study provides initial support for the integrated interprofessional learning experiences within the school. The results of the study will shape future curricula changes to further strengthen interprofessional education and subsequent interprofessional collaborative care.

Shared learning on an international clinical placement: Promoting symbiotic midwifery practice knowledge.

AIM: The aim of this study was to explore the experiences of shared learning between Australian and Balinese midwifery students during a two-week clinical placement in Bali Indonesia. BACKGROUND: Cultural safety in midwifery is a key concept that is underpinned by the provision of holistic quality midwifery care to all women. Therefore, culturally safe midwifery care identifies, protects and promotes women's individual cultures and is a key concept that is fostered in midwifery education. To educate culturally safe midwives, international placements to resource limited countries have become more common within midwifery education programs. METHODS: This study used a qualitative research design with a convenience sampling design. The participants were enrolled in midwifery courses in a University in the Northern Territory of Australia (n=9), a Balinese private midwifery school (n=4) and a Balinese public midwifery school (n=4). Thematic analysis was used to analyse the data. FINDINGS: The findings were categorised into major themes under the headings of "Learning together despite differences"; "Cultural differences", "Communication, Resources", and "Recommendations for future placements". CONCLUSION: This study provides a valuable insight into how shared learning increases students' midwifery knowledge and is fundamental in understanding cultural differences that could be applied to students' clinical midwifery practice.

How Teachers Meet in Interdisciplinary Teams: Hangouts, Distribution Centers, and Melting Pots.

PURPOSE: To explore team learning processes among interdisciplinary teacher teams in the development of integrated health professions education and to investigate students' perspectives on the quality of the educational courses. METHOD: Using an exploratory, sequential mixed-methods design, the first author conducted 17 vignette-guided, semistructured interviews with teachers originating from diverse disciplines. These teachers worked in different courses of integrated, undergraduate health professions programs at the Faculty of Health, Medicine and Life Sciences, Maastricht University, the Netherlands. The interview guide and vignettes were based on team learning research. The interviews sought to establish how interdisciplinary teacher team members work together on integrated curricula. The vignettes reflected constructs of team learning processes: sharing, co-construction, and constructive conflict. Data were collected between November 2017 and March 2018 and analyzed using template analysis. Sequentially, course evaluation data were used to provide a descriptive analysis of students' perspectives on educational quality (course organization, structure, learning effect, and alignment). RESULTS: Three team approaches were identified. In fragmented teams or "hangouts," teachers individually worked on tasks that they were interested in, leaving their disciplinary mark. Framework-guided teams or "distribution centers" aimed to work within the given frameworks and organizational expectations, striving for disciplinary balance. Integrated teacher teams or "melting pots" used an interdisciplinary approach on all topics and put students at the center. Integrated teams reflected high-level team learning processes and were most satisfied with their (team)work. In contrast, fragmented and framework-guided teams mainly reflected low-level team learning processes. Students evaluated courses of integrated teacher teams highest on all investigated quality items (course organization, structure, learning effect, and alignment). CONCLUSIONS: Successful interdisciplinary teacher teams are represented by an integrated approach with high-level team learning behavior and the best course evaluations. Therefore, health professions education management should actively encourage and facilitate integrated teacher teamwork.

A experiência de psicólogos em um programa de residência multiprofissional em saúde / The experience of psychologists in a health multiprofessional internship program / Lexpérience des psychologues dans un programme de résidence médicale multidisciplinaire / La experiencia de psicólogos en un programa de residencia multiprofesional en la salud

Resumo Esta pesquisa objetivou compreender a experiência de psicólogos que vivenciaram a formação em residência multiprofissional em saúde. Consistiu em pesquisa qualitativa de caráter exploratório inspirada na fenomenologia husserliana. Realizaram-se encontros dialógicos, entre a pesquisadora e seis participantes provenientes de programas de residência de um município de São Paulo, analisados por meio de narrativas compreensivas e uma narrativa síntese. Evidenciaram-se quatro elementos experienciais significativos: (1) transformação pessoal e profissional desencadeada pela dedicação integral característica da aprendizagem em serviço; (2) apropriação do ser psicólogo privilegiando a construção de práticas interdisciplinares e integralidade no cuidado; (3) apropriação da atenção psicológica estrategicamente desenvolvida conforme a rede assistencial à saúde; e (4) tensão entre exigências e estratégias de ensino e serviço, que se revelou prejudicial ao processo de aprendizagem. Concluiu-se que as vivências intersubjetivas propiciaram aprendizagens significativas de cunho pessoal e profissional, sinalizando a importância de estratégias pedagógicas que considerem os processos afetivo-emocionais vividos pelos residentes.

Abstract This study analyzed the experience of psychologists who went through a multiprofessional internship in public health. It is a qualitative and exploratory investigation inspired by Husserl's phenomenology. The researcher held dialogical encounters with six participants who attended different Multiprofessional Internship Programs in a town in the state of São Paulo, which were then analyzed by composition of comprehensive narratives and a synthesis narrative. Four significant experiencial elements were observed: (1) personal and professional growth stemming from learning in full dedication to the internship; (2) a reassessment of the psychologists' role regarding integrated and interdisciplinary healthcare; (3) a reassessment of psychological attention following an integrated health system; (4) tension between academic and health service demands and strategies interfered negatively on the learning process. Conclusion: the intersubjective experiences provided significant personal and professional learning, implying the importance of pedagogical strategies that consider the affective-emotional processes experienced by residents.

Résumé Cette recherche visait à comprendre l'expérience de psychologues ayant fait l'expérience de formation en résidence dans des établissements de santé multidisciplinaires. Il s'agissait de recherches exploratoires qualitatives basées sur la phénoménologie husserlienne. Des réunions de dialogue ont eu lieu entre la chercheuse et six participants de programmes de résidence dans une ville de São Paulo, analysées par des récits détaillés et un récit de synthèse. Quatre éléments expérientiels significatifs sont évidents: (1) la transformation personnelle et professionnelle déclenchée par le dévouement total caractéristique de l'apprentissage en cours; (2) l'appropriation du psychologue privilégiant la construction de pratiques interdisciplinaires et l'intégralité des soins; (3) l'appropriation des soins psychologiques stratégiquement développés en fonction du réseau de santé; (4) la tension entre les exigences d'enseignement et de service et les stratégies préjudiciables au processus d'apprentissage. Conclusion : les expériences intersubjectives ont fourni un apprentissage personnelle et professionnelle significatif, signalant l'importance des stratégies pédagogiques qui tiennent compte des processus affectifs-émotionnels vécus.

Resumen Esta investigación objetivó comprender la experiencia de psicólogos que han experimentado la formación en residencia multiprofesional en la salud. Es una investigación cualitativa, de carácter exploratorio, basándose en la fenomenología husserliana. Hubo reuniones dialógicas entre la investigadora y seis participantes de programas de residencia en un municipio de São Paulo, que fueron analizadas utilizando narrativas comprensivas y una síntesis narrativa. Se presentaron cuatro elementos experienciales significativos: (1) transformación personal y profesional provocada por el servicio de aprendizaje que requiere dedicación completa; (2) apropiación de la forma de ser un psicólogo que se centra en la construcción de prácticas interdisciplinarias e integridad en el cuidado; (3) apropiación de estrategias de atención psicológica desarrolladas según la red de atención a la salud; y (4) tensión entre exigencias y estrategias de enseñanza y servicio, que resultó perjudicial para el proceso de aprendizaje. Se concluye que las experiencias intersubjetivas proporcionaron aprendizajes personal y profesional significativos, lo que apunta a la importancia de estrategias pedagógicas que consideren los procesos afectivo-emocionales experimentados por los residentes.

Data visualization literacy: Definitions, conceptual frameworks, exercises, and assessments.

In the information age, the ability to read and construct data visualizations becomes as important as the ability to read and write text. However, while standard definitions and theoretical frameworks to teach and assess textual, mathematical, and visual literacy exist, current data visualization literacy (DVL) definitions and frameworks are not comprehensive enough to guide the design of DVL teaching and assessment. This paper introduces a data visualization literacy framework (DVL-FW) that was specifically developed to define, teach, and assess DVL. The holistic DVL-FW promotes both the reading and construction of data visualizations, a pairing analogous to that of both reading and writing in textual literacy and understanding and applying in mathematical literacy. Specifically, the DVL-FW defines a hierarchical typology of core concepts and details the process steps that are required to extract insights from data. Advancing the state of the art, the DVL-FW interlinks theoretical and procedural knowledge and showcases how both can be combined to design curricula and assessment measures for DVL. Earlier versions of the DVL-FW have been used to teach DVL to more than 8,500 residential and online students, and results from this effort have helped revise and validate the DVL-FW presented here.

A qualitative analysis of interprofessional students' perceptions toward patients with opioid use disorder after a patient panel experience.

Background: Students from health professional schools participated in a half-day interprofessional education workshop centered on substance use disorder training. One component was a patient panel featuring individuals with a history of opioid use disorder who described the impact of addiction on their lives and their road to recovery using varied treatment options. We hypothesized that interacting with individuals with opioid use disorder early in training would elicit more humanistic perspectives and decrease bias and stigma in future health care professionals. Methods: After participating in the panel experience, health professional students (N = 580) from medicine, nursing, pharmacy, physical therapy, and social work were asked to complete short, 5-minute, rapid reflections. Prompts asked students whether the panel changed their perception of individuals with substance use disorder, to reflect on their attitudinal changes or lack thereof, and how working in interprofessional teams could impact the management and treatment of these patients. Conventional content analysis was performed. Results: Eighty-nine percent of students who attended the session completed the rapid reflections (n = 514). Overall, approximately 70% (n = 369) of students indicated that their perceptions of individuals with substance use disorder had changed as a result of the patient panel, with students from pharmacy more likely to indicate a change in attitudes. Themes across all professions included a change toward a more humanistic perspective, value of hearing real patient stories, and learning about treatment and recovery options. Student responses described how interprofessional health care teams can provide more holistic care with a broader range of therapeutic options that may improve long-term outcomes. Conclusions: A patient panel experience is influential on interprofessional students' attitudes toward patients who suffer from opioid use disorder. Students identified an interprofessional approach as being a valuable component of management and treatment of these patients.

Effect of Collaborative Group Testing on Dental Students' Performance and Perceived Learning in an Introductory Comprehensive Care Course.

The use of collaboration while in dental school can help prepare dental students for the team-oriented nature of the workforce. One way to do this is via collaborative group testing (CGT), a method of assessment allowing students to learn from one another. The aim of this study was to examine the CGT method in a predoctoral dental education setting to determine if student examination performance improved with the addition of collaboration and if collaborative testing was beneficial to students' learning process. In 2016, all first-year dental students (n=76) at one U.S. dental school were assessed in an introductory comprehensive care course using a two-stage CGT in which students were assessed individually, prior to taking the same test in collaboration with an assigned partner. Three quizzes and a final examination were given in which student participants served as both control (individual assessments) and treatment (collaborative assessment). At the conclusion of the course, a questionnaire was administered to ascertain student perspectives. All assessments yielded favorable results with an overall score improvement from a mean of 81.1% on individual assessments to 91% on collaborative assessments (p=0.001), indicating that collaboration improved assessment outcomes. Additionally, retention of material was suggested with individual scores on the cumulative final surpassing average individual scores of the preceding quizzes (p<0.001). Students' responses on the questionnaire indicated that they perceived implementation of CGT was beneficial to their learning process. With these results, this testing methodology shows promise to enhance dental student learning, material retention, and teamwork.

Team-based learning in Physical therapy undergraduate course: experiment report / Aprendizado baseado em equipe na graduação em fisioterapia: relato de experiência / Aprendizaje basado en equipo en el grado en fisioterapia: informe de experiencia

Abstract Introduction: Active learning methods have shown positive results, mainly in terms of content learning and the development of communication skills, critical thinking, and collaborative practice. However, they are still unknown by most professors teaching in Physical therapy courses. Objective: To present the report of an experiment based on the application of the Team-Based Learning (TBL) method, in the Physical therapy undergraduate course. Method: This is a report of an experiment comparing traditional teaching and TBL with 61 students in the Physical therapy course. A comparison was performed between means, medians, approval ratio and satisfaction of the students who experienced the active methodology. Results: The results showed that the final average of the summative evaluations of the TBL group (71.9 ± 10.5 points) was statistically different (p = 0.003) from that of the traditional teaching group (63.7 ± 9.92 points). The proportion of approved students was not statistically different between the groups, 92.0% and 88.6%, respectively (p = 0.478). Conclusion: The overall satisfaction was that the method, although tiresome, according to the students, favored a greater understanding of the content and motivation to study. The study presents innovative results regarding the application of the team-based teaching method to the Physical therapy course.

Resumo Introdução: Metodologias de aprendizagem ativas de ensino têm mostrado resultados positivos, principalmente no que diz respeito à aprendizagem de conteúdos e à construção de habilidades de comunicação, pensamento crítico e prática colaborativa. Contudo, ainda mostram-se pouco conhecidos por professores de ensino em Fisioterapia. Objetivo: Apresentar um relato de experiência com base na aplicação do método Aprendizado Baseado em Equipe (TBL) no ensino de graduação em Fisioterapia. Método: Trata-se de um relato de experiência a partir do ensino tradicional e TBL com 61 estudantes do curso de Fisioterapia. Foram comparadas as médias, medianas, proporção de aprovação e satisfação dos estudantes que experimentaram a metodologia ativa. Resultados: Os resultados mostraram que a média final das avaliações somativas da turma que experimentou o TBL (71,9 ± 10,5 pontos) foi estatisticamente diferente (p = 0,003) quando comparado ao ensino tradicional (63,7 ± 9,92 pontos). A proporção de aprovados não diferiu estatisticamente entre os grupos, 92,0% e 88,6%, respectivamente (p = 0,478). Conclusão: A satisfação geral foi que o método embora cansativo, segundo os estudantes, favoreceu a maior compreensão do conteúdo e estímulo para estudar. O estudo apresenta resultados inovadores em relação à aplicação do método de ensino baseado em equipe para o curso de Fisioterapia.

Resumen Introducción: Los métodos activos de enseñanza han dado resultados positivos, principalmente en términos de aprendizaje de contenidos y de la construcción de habilidades de comunicación, pensamiento crítico y práctica colaborativa. Sin embargo, todavía se muestran poco conocidos por los docentes en Fisioterapia. Objetivo: Presentar un informe de experiencia con base en la aplicación del método Aprendizaje Basado en el Equipo (TBL), en el grado en Fisioterapia. Método: Se trata de un informe de experiencia desde la enseñanza tradicional y la TBL con 61 alumnos del curso de Fisioterapia. Se compararon los promedios, medianas, ratio de aprobación y satisfacción de estudiantes que habían experimentado la metodología activa. Resultados: Los resultados mostraron que el promedio final de las evaluaciones sumativas del grupo TBL (71,9 ± 10,5 puntos) fue estadísticamente diferente (p = 0,003) en comparación con la enseñanza tradicional (63,7 ± 9,92 puntos). La proporción de aprobados no difirió estadísticamente entre los grupos, con un 92,0% y un 88,6%, respectivamente (p = 0,478). Conclusión: La satisfacción general fue que el método, aunque agotador, según los estudiantes, les favoreció una mayor comprensión de los contenidos y el estímulo para estudiar. El estudio presenta resultados innovadores por la aplicación del método de enseñanza basado en equipo para el curso de Fisioterapia.

Interdisciplinaridade na assistência ao parto: percepção dos enfermeiros obstetras / Interdisciplinarity in childbirth care: perception of obstetric nurses

Objetivo: avaliar a percepção dos enfermeiros obstetras sobre a atuação interdisciplinar na assistência ao parto natural. Método: trata-se de um estudo qualitativo, descritivo, exploratório, realizado com seis enfermeiros obstetras de uma maternidade escola. Coletaram-se os dados aplicando-se um formulário para a entrevista semiestruturada submetido à Análise de Conteúdo de Bardin. Resultados: identificaram-se as seguintes temáticas: a prática interdisciplinar na formação profissional; a assistência de Enfermagem no contexto da interdisciplinaridade e o atendimento interdisciplinar ao parto: uma experiência ao alcance. Conclusão: observou-se a deficiência da abordagem interdisciplinar na formação acadêmica de todos os entrevistados, o que tem causado prejuízos na relação interpessoal e no processo de humanização ao parto. Identificaram-se enfermeiros que encontram dificuldades diante da atuação em equipe, em particular, em relação à assistência ao recém-nascido na sala de parto.(AU)

Objective: to evaluate the perception of obstetric nurses about the interdisciplinary role in natural childbirth care. Method: this is a qualitative, descriptive, exploratory study conducted with six obstetric nurses from a maternity school. Data was collected by applying a form for the semi-structured interview submitted to Bardin Content Analysis. Results: the following themes were identified: interdisciplinary practice in vocational training; Nursing care in the context of interdisciplinarity and interdisciplinary delivery care: an experience within reach. Conclusion: the deficiency of the interdisciplinary approach in the academic formation of all interviewees was observed, which has caused damage to the interpersonal relationship and the process of humanization at childbirth. Nurses were identified who find it difficult to face teamwork, in particular in relation to newborn care in the delivery room.(AU)

Objetivo: evaluar la percepción de los enfermeros obstétricos sobre el papel interdisciplinario en la atención natural del parto. Método: este es un estudio cualitativo, descriptivo, exploratorio realizado con seis enfermeros obstétricos de una escuela de maternidad. Los datos se recopilaron mediante la aplicación de un formulario para la entrevista semiestructurada sometido al Análisis de Contenido de Bardin. Resultados: se identificaron los siguientes temas: la práctica interdisciplinaria en la formación profesional; la atención de Enfermería en el contexto de la interdisciplinariedad y la atención interdisciplinaria del parto: una experiencia al alcance. Conclusión: se observó la deficiencia del enfoque interdisciplinario en la formación académica de todos los entrevistados, lo que ha causado daños a la relación interpersonal y al proceso de humanización en el parto. Se identificaron enfermeros a quienes les resulta difícil enfrentar el trabajo en equipo, en particular en relación con el cuidado del recién nacido en la sala de partos.(AU)

Be good, communicate, and collaborate: a qualitative analysis of stakeholder perspectives on adding a chiropractor to the multidisciplinary rehabilitation team.

Background: While chiropractors are integrating into multidisciplinary settings with increasing frequency, the perceptions of medical providers and patients toward adding chiropractors to existing healthcare teams is not well-understood. This study explored the qualities preferred in a chiropractor by key stakeholders in a neurorehabilitation setting. Methods: This qualitative analysis was part of a multi-phase, organizational case study designed to evaluate the planned integration of a chiropractor into a multidisciplinary rehabilitation team. The setting was a 62-bed rehabilitation specialty hospital located in the northeastern United States. Participants included patients, families, community members, and professional staff of the administrative, medical, nursing, and therapy departments. Data collection consisted of audiotaped, individual interviews and profession-specific focus groups guided by a semi-structured interview schedule. Transcripts were imported into a qualitative data analysis program for data analysis. An iterative coding process using thematic content analysis categorized key themes and domains. Results: Sixty participants were interviewed in June 2015, including 48 staff members, 6 patients, 4 family members, and 2 community members. Our analysis generated a conceptual model of The Preferred Chiropractor for Multidisciplinary Rehabilitation Settings composed of 5 domains and 13 themes. The central domain, Patient-Centeredness, or the provision of healthcare that is respectful, responsive, and inclusive of the patient's values, preferences, and needs, was mentioned in all interviews and linked to all other themes. The Professional Qualities domain highlighted clinical acumen, efficacious treatment, and being a safe practitioner. Interpersonal Qualities encouraged chiropractors to offer patients their comforting patience, familiar connections, and emotional intelligence. Interprofessional Qualities emphasized teamwork, resourcefulness, and openness to feedback as characteristics to enhance the chiropractor's ability to work within an interdisciplinary setting. Organizational Qualities, including personality fit, institutional compliance, and mission alignment were important attributes for working in a specific healthcare organization. Conclusions: Our findings provide an expanded view of the qualities that chiropractors might bring to multidisciplinary healthcare settings. Rather than labeling stakeholder perceptions as good, bad or indifferent as in previous studies, these results highlight specific attributes chiropractors might cultivate to enhance the patient outcomes and the experience of healthcare, influence clinical decision-making and interprofessional teamwork, and impact healthcare organizations.