A implementação da Política Nacional de Educação Permanente em Saúde na visão de atores que a constroem / La implementación de la Política Nacional de Educación Permanente en Salud, en la visión de actores que la construyen / The implementation of the National Policy of Permanent Education in Health as seen by the actors that build it

Sob a égide do movimento de retomada da política de Educação Permanente em Saúde (EPS), este estudo deu voz a atores que a promovem, no intuito de compreender os fatores que favoreceram ou dificultaram a sua implementação. Por meio de um grupo focal com 14 informantes-chave, evidenciou-se que o repasse de recursos e os espaços colegiados são elementos que favorecem a implementação da política e precisam ser assegurados. Ao mesmo tempo, o desalinhamento conceitual acerca do que seja EPS e a fragmentação das ações e das áreas que compõem a política são desafios que precisam ser superados. Recolocar a política de Educação Permanente como prioritária na agenda da Educação em Saúde é o fator mais importante e ao mesmo tempo mais desafiador para a sua implementação.(AU)

Bajo la cúpula del movimiento de retomada de la política de Educación Permanente en Salud (EPS), este estudio dio voz a los actores que la promueven con el objetivo de comprender los factores que favorecieron o dificultaron su implementación. Por medio de un grupo focal con 14 informantes clave quedó claro que el traspaso de recursos y los espacios colegiados son elementos que favorecen la implementación de la política y que hay que asegurar. Al mismo tiempo, el desalineamiento conceptual sobre lo que sería la EPS y la fragmentación de las acciones y de las áreas que componen la política son retos por superar. Replantear la política de Educación Permanente como prioritaria en la agenda de la Educación en Salud es el factor más importante y al mismo tiempo más desafiador para su implementación.(AU)

Under the aegis of the restarting movement of the policy of Permanent Education in Health (CEH), this study gives voice to the actors that promote it, in order to understand the factors that favored or hindered its implementation. Through a focus group of 14 key informants, it was evidenced that the transfer of resources and collegiate spaces are elements that favor the implementation of the policy and need to be ensured. At the same time, challenges that need to be overcome are the conceptual misalignment of what CEH is and the fragmentation of policy actions and areas. Putting Permanent Education policy as a priority on the Health Education agenda is the most important and, at the same time, the most challenging factor for its implementation.(AU)

Efficacy of the multimodal strategy for Hand Hygiene compliance: an integrative review.

OBJECTIVE: Evaluate, from the literature, the effectiveness of the implementation of the multimodal strategy for health professionals compliance with Hand Hygiene and its sustainability over time. METHOD: Integrative review, with a view to answering the following question: "Is the implementation of the multimodal strategy effective in health professionals compliance with Hand Hygiene and can it be sustained over time?". The MEDLINE, SCOPUS, LILACS and CINAHL databases were used to retrieve the primary articles. RESULTS: Twenty-five studies were analyzed. Among the components of the multimodal strategy, three need to be better worked: health education, feedback from practices and management involvement. Although it needs to focus more on its five elements, interventions based on the multimodal strategy have favored HH compliance and its long-term sustainability. CONCLUSION: The strategy proved to be effective for HH compliance, especially when all integrating components are adequately addressed.

Efficacy of the multimodal strategy for Hand Hygiene compliance: an integrative review / Eficacia de la estrategia multimodal en la adhesión a la Higiene de las Manos: revisión integradora / Eficácia da estratégia multimodal para adesão à Higiene das Mãos: revisão integrativa

ABSTRACT Objective: Evaluate, from the literature, the effectiveness of the implementation of the multimodal strategy for health professionals compliance with Hand Hygiene and its sustainability over time. Method: Integrative review, with a view to answering the following question: "Is the implementation of the multimodal strategy effective in health professionals compliance with Hand Hygiene and can it be sustained over time?". The MEDLINE, SCOPUS, LILACS and CINAHL databases were used to retrieve the primary articles. Results: Twenty-five studies were analyzed. Among the components of the multimodal strategy, three need to be better worked: health education, feedback from practices and management involvement. Although it needs to focus more on its five elements, interventions based on the multimodal strategy have favored HH compliance and its long-term sustainability. Conclusion: The strategy proved to be effective for HH compliance, especially when all integrating components are adequately addressed.

RESUMEN Objetivo: Evaluar, a partir de la literatura, la eficacia de la implementación de la estrategia multimodal en la adhesión de los profesionales de salud a la Higiene de las Manos y su sostenibilidad a lo largo del tiempo. Método: Revisión integradora, para responder a la siguiente pregunta: "¿La implementación de la estrategia multimodal es eficaz en la adhesión de los profesionales de la salud a la Higiene de las Manos y puede ser sostenida a lo largo del tiempo?" Se utilizaron las bases de datos MEDLINE, SCOPUS, LILCAS y CINAHL para recuperar los artículos primarios. Resultados: Se analizaron 25 estudios. Entre los componentes de la estrategia multimodal, tres necesitan ser mejor trabajados: educación en salud, feedback de prácticas e involucramiento de la gestión. Aunque necesite un mayor enfoque de sus cinco elementos, las intervenciones basadas en la estrategia multimodal favorecieron la adhesión a la HM y su sostenibilidad a largo plazo. Conclusión: La estrategia se mostró eficaz en la adhesión a la HM, en particular cuando todos los componentes integradores están adecuadamente contemplados.

RESUMO Objetivo: Avaliar, a partir da literatura, a eficácia da implementação da estratégia multimodal para adesão dos profissionais de saúde à Higiene das Mãos e sua sustentabilidade ao longo do tempo. Método: Revisão integrativa, com vistas a responder a seguinte questão: "A implementação da estratégia multimodal é eficaz na adesão dos profissionais de saúde à Higiene das Mãos e pode ser sustentada ao longo do tempo?". Utilizaram-se as bases de dados MEDLINE, SCOPUS, LILACS e CINAHL para recuperar os artigos primários. Resultados: Foram analisados 25 estudos. Dentre os componentes da estratégia multimodal, três precisam ser melhor trabalhados: educação em saúde, feedback de práticas e envolvimento da gestão. Embora necessite maior enfoque dos seus cinco elementos, as intervenções baseadas na estratégia multimodal favoreceram a adesão à HM e sua sustentabilidade em longo prazo. Conclusão: A estratégia se mostrou eficaz para adesão à HM, em especial, quando todos componentes integradores são adequadamente contemplados.

Estrategias y técnicas didácticas de la relación numérica docente - estudiante en Anatomía Humana / Teaching strategies and techniques of the numerical relationship teacher-student in Human Anatomy

Introducción: las estrategias y técnicas didácticas se fundamentan en la misión institucional, como herramientas del proceso pedagógico. En la cátedra de Anatomía Humana, el docente, es responsable de seleccionarlas; considerando: estrategias y técnicas de enseñanza-aprendizaje. La asignatura, se divide en: componente teórico y práctico. Objetivo: identificar las estrategias y técnicas didácticas aplicadas en las tres escuelas de medicina A, B, C; dentro de la relación numérica docente /estudiante, durante el periodo 2005-2009. Materiales y Métodos: la información se recolectó mediante un cuestionario, administrado a 296 estudiantes activos, de la carrera de doctorado en medicina y 15 docentes laborando en el departamento de Ciencias Morfológicas (Anatomía) de las tres escuelas de medicina: A, B, C de El Salvador. Las estrategias de enseñanza identificadas: objetivos (72.89%) y manual guía (100%). La técnica de enseñanza que predominó en el componente teórico fue la clase magistral (59.98%). En el componente práctico, se aplica la técnica grupal con supervisión, (100%). Resultados: la estrategia de aprendizaje, en los componentes teórico y práctico: Recirculación de la información (48.47%). Técnica de aprendizaje, componente teórico: toma de apuntes (42.48%). Componente práctico: repaso con repetición (46.82%). Relación numérica docente/estudiante: Escuela A, 1/11; Escuela B, 1/44; Escuela C, 1/34. Conclusiones: dentro del entorno de la relación numérica, las estrategias y técnicas didácticas, aplicadas por los docentes, en las tres instituciones; son estáticas y responden a un modelo educativo tradicional, representativo de una educación masiva (AU).

Introduction: strategies and techniques are based by the institutional mission, as tools of pedagogic process. In the chair of Human Anatomy, the teacher is responsible for selecting them; considering strategies and technics teaching and learning. The subject is divided: theoretical and practical component. Objective: To identify strategies and teaching techniques applied in the three medical schools within the teacher / student numerical ratio during the period 2005-2009. Materials and Methods: The information was collected through a questionnaire administered to 296 active students, career doctorate in medicine and 15 teachers of the Department of Morphological Sciences (Anatomy) from three medical schools: A, B, C of El Salvador. Result: teaching strategies identified: objectives (72.89%) and manual guide (100%). Teaching technique that prevailed in the theoretical component was the master class (59.98%). In the practical component, group monitoring technique is applied (100%). The learning strategy, in the theoretical and practical components: Recirculation of information (48.47%). Learning technique, theoretical component: notetaking (42.48%). Practical component: review with repetition (46.82%). Numeric relationship teacher / student: school A, 1/11; School B, 1/44; School C, 1/34. Conclusions: within the environment of the numerical relationship, strategies and teaching-learning techniques applied by the teacher, are statics in the three institutions and respond to a representative of a mass education (AU).

Online continuing interprofessional education on hospital-acquired infections for Latin America

Abstract Introduction: Latin America is a large and diverse region, comprising more than 600 million inhabitants and one million physicians in over 20 countries. Resistance to antibacterial drugs is particularly important in the region. This paper describes the design, implementation and results of an international bi-lingual (Spanish and Portuguese) online continuing interprofessional interactive educational program on hospital-acquired infections and antimicrobial resistance for Latin America, supported by the American Society for Microbiology. Methods: Participation, satisfaction and knowledge gain (through pre and post tests) were used. Moreover, commitment to change statements were requested from participants at the end of the course and three months later. Results: There were 1169 participants from 19 Latin American countries who registered: 57% were physicians and 43% were other health care professionals. Of those, 1126 participated in the course, 46% received a certificate of completion and 54% a certificate of participation. There was a significant increase in knowledge between before and after the course. Of 535 participants who took both tests, the grade increased from 59 to 81%. Commitments to change were aligned with course objectives. Discussion: Implementation of this educational program showed the feasibility of a continent-wide interprofessional massive course on hospital acquired-infections in Latin America, in the two main languages spoken in the region. Next steps included a new edition of this course and a "New Challenges" course on hospital-acquired infections, which were successfully implemented in the second semester of 2015 by the same institutions.

Bilingual Language Assessment: Contemporary Versus Recommended Practice in American Schools.

PURPOSE: The purpose of this study was to identify current practices of school-based speech-language pathologists (SLPs) in the United States for bilingual language assessment and compare them to American Speech-Language-Hearing Association (ASHA) best practice guidelines and mandates of the Individuals with Disabilities Education Act (IDEA, 2004). METHOD: The study was modeled to replicate portions of Caesar and Kohler's (2007) study and expanded to include a nationally representative sample. A total of 166 respondents completed an electronic survey. RESULTS: Results indicated that the majority of respondents have performed bilingual language assessments. Furthermore, the most frequently used informal and standardized assessments were identified. SLPs identified supports, and barriers to assessment, as well as their perceptions of graduate preparation. CONCLUSION: The findings of this study demonstrated that although SLPs have become more compliant to ASHA and IDEA guidelines, there is room for improvement in terms of adequate training in bilingual language assessment.

Online continuing interprofessional education on hospital-acquired infections for Latin America.

INTRODUCTION: Latin America is a large and diverse region, comprising more than 600 million inhabitants and one million physicians in over 20 countries. Resistance to antibacterial drugs is particularly important in the region. This paper describes the design, implementation and results of an international bi-lingual (Spanish and Portuguese) online continuing interprofessional interactive educational program on hospital-acquired infections and antimicrobial resistance for Latin America, supported by the American Society for Microbiology. METHODS: Participation, satisfaction and knowledge gain (through pre and post tests) were used. Moreover, commitment to change statements were requested from participants at the end of the course and three months later. RESULTS: There were 1169 participants from 19 Latin American countries who registered: 57% were physicians and 43% were other health care professionals. Of those, 1126 participated in the course, 46% received a certificate of completion and 54% a certificate of participation. There was a significant increase in knowledge between before and after the course. Of 535 participants who took both tests, the grade increased from 59 to 81%. Commitments to change were aligned with course objectives. DISCUSSION: Implementation of this educational program showed the feasibility of a continent-wide interprofessional massive course on hospital acquired-infections in Latin America, in the two main languages spoken in the region. Next steps included a new edition of this course and a "New Challenges" course on hospital-acquired infections, which were successfully implemented in the second semester of 2015 by the same institutions.

Educação permanente: um projeto de extensão da instituição de ensino técnico de enfermagem no município de Lagoa de Itaenga/PE / Permanent education: an extension project for the technical nursing education institution in the municipality of Lagoa de Itaenga

A Política Nacional de Educação Permanente em Saúde (PNEPS) tem como fundamento os princípios do SUS a partir da realidade dos serviços de saúde, valorizando seu caráter continuado e multiprofissional. O presente projeto de intervenção tem por objetivo, desenvolver um projeto de extensão nas USFs, da Estratégia de saúde da família na perspectiva de suprir as lacunas de educação permanentes vivenciadas nesse cenário de prática da integração ensino serviço no município de Lagoa de Itaenga/PE. Como resultados, espera-se melhorar o processo de integração ensino serviço, com a contribuição da instituição de ensino técnico enquanto contrapartida na educação permanente dos técnicos de enfermagem atuantes na atenção Primária à saúde do município. De uma forma geral, enfatiza-se a importância de uma política de educação permanente, para melhor capacitação e melhoria da atuação deste segmento profissional na ESF do município.

Formative second opinion: qualifying health professionals for the unified health system through the Brazilian Telehealth Program.

BACKGROUND: The World Health Organization's World Health Assembly WHA58.28/2005 Resolution recommends the adoption of e-health by health systems of State Members. The Brazilian Telehealth Program integrates the national policy of education for health that combines many strategies with complementary foci, including technical-level workers, undergraduate students of the 14 health professions, residency, postgraduate courses, support, and continuing health education at work. The Brazilian Unified Health System has approximately 1.5 million workers. The objectives of this work areas are as follows: to define a new concept, the so-called "formative second opinion" (FSO); to describe the methodology for its construction; and to show its structure as well as the number of FSOs already available, classified according to the field of knowledge. MATERIALS AND METHODS: The Brazilian Telehealth Program was created in 2007 and has already offered around 41,000 teleconsultations. Based on their relevance and pertinence, 710 questions asked through teleconsulting by health professionals were selected. The questions were handled so that each question should not contain any specific information about patients, preserving professional confidentiality. For each question, a bibliographic review was performed and used to build a structured and standardized answer, based on the best available scientific and clinical evidence. RESULTS: This question-and-answer combination, originated thru teleconsulting, created by the Brazilian Telehealth Program, was termed the FSO and has been made available, with open access for all health professionals, at the Web site of the Program. Among the total number of 710 FSOs, diagnosis and treatment support corresponded to 238 questions (33.5%), followed by primary healthcare (90 questions) and then by subjects concerning oral health (68 questions) and nursery (39 questions). The structure and design of the FSO are also shown. CONCLUSIONS: The FSO helps professionals and health workers to use the already produced best evidence and scientific knowledge to solve their daily practice questions, improving, qualifying, and increasing the resolution of primary healthcare by the Unified Health System in Brazil. Oral health is frequently asked about by professionals, matching the high prevalence of oral disease in primary healthcare.

Continuing education on child development for primary healthcare professionals: a prospective before-and-after study.

CONTEXT AND OBJECTIVE: Children's developmental disorders are often identified late by healthcare professionals working in primary care. The aim of this study was to assess the impact of a continuing education program on child development, on the knowledge and practices of these professionals. DESIGN AND SETTING: Prospective single-cohort study (before-and-after study), conducted in the city of Belém, Pará , Brazil. METHODS: Two hundred and twenty-one professionals working in primary healthcare (82.2%) participated in a continuing education program on child development and were assessed before and after implementation of the program through tests on their knowledge of child development, consisting of 19 questions for physicians and 14 for nurses, and questionnaires on their professional practices. RESULTS: One to three years after the program, the mean number of correct answers in the tests had increased from 11.5 to 14.3 among physicians in the Healthy Family Program (Programa Família Saudável, PFS); 13.0 to 14.3 among physicians in Municipal Health Units (Unidades Municipais de Saúde, UMS); 8.3 to 10.0 among PFS nurses; and 7.8 to 9.4 among UMS nurses. In interviews with mothers attended by these professionals before the program, only 21.7% reported that they were asked about their children's development, 24.7% reported that the professional asked about or observed their children's development and 11.1% received advice on how to stimulate them. After the program, these percentages increased to 34.5%, 54.2% and 30.3%, respectively. CONCLUSIONS: Professionals who participated in the program showed improved performance regarding child development knowledge and practices.

Continuing education on child development for primary healthcare professionals: a prospective before-and-after study / Educação continuada em desenvolvimento infantil para profissionais da atenção primária em saúde: estudo prospectivo do tipo antes-e-depois

CONTEXT AND OBJECTIVE: Children's developmental disorders are often identified late by healthcare professionals working in primary care. The aim of this study was to assess the impact of a continuing education program on child development, on the knowledge and practices of these professionals. DESIGN AND SETTING: Prospective single-cohort study (before-and-after study), conducted in the city of Belém, Pará , Brazil. METHODS: Two hundred and twenty-one professionals working in primary healthcare (82.2%) participated in a continuing education program on child development and were assessed before and after implementation of the program through tests on their knowledge of child development, consisting of 19 questions for physicians and 14 for nurses, and questionnaires on their professional practices. RESULTS: One to three years after the program, the mean number of correct answers in the tests had increased from 11.5 to 14.3 among physicians in the Healthy Family Program (Programa Família Saudável, PFS); 13.0 to 14.3 among physicians in Municipal Health Units (Unidades Municipais de Saúde, UMS); 8.3 to 10.0 among PFS nurses; and 7.8 to 9.4 among UMS nurses. In interviews with mothers attended by these professionals before the program, only 21.7% reported that they were asked about their children's development, 24.7% reported that the professional asked about or observed their children's development and 11.1% received advice on how to stimulate them. After the program, these percentages increased to 34.5%, 54.2% and 30.3%, respectively. CONCLUSIONS: Professionals who participated in the program showed improved performance regarding child development knowledge and practices. .

CONTEXTO E OBJETIVO: Alterações do desenvolvimento em crianças frequentemente têm sido tardiamente identificadas por profissionais de saúde que atuam na atenção básica. O objetivo deste estudo foi avaliar o impacto de um programa de educação permanente sobre desenvolvimento infantil nos conhecimentos e práticas desses profissionais. TIPO DE ESTUDO E LOCAL: Estudo de coorte única prospectivo (antes-e-depois), realizado no município de Belém, Pará, Brasil. MÉTODOS: 221 (82,2%) profissionais da rede básica de saúde que participaram do programa de educação permanente sobre desenvolvimento infantil foram avaliados antes e após a implantação do programa, através de testes sobre seus conhecimentos em desenvolvimento infantil com 19 questões para médicos e 14 para enfermeiros, e questionários sobre sua prática profissional. RESULTADOS: Um a três anos após o programa, a média de perguntas certas dos testes aumentou de 11,5 para 14,3 entre os médicos do Programa da Família Saudável (PFS); 13,0 para 14,3 entre os médicos de Unidades Municipais de Saúde (UMS); 8,3 para 10,0 entre os enfermeiros de PFS e 7,8 para 9,4 entre os enfermeiros de UMS. Nas entrevistas com mães atendidas por esses profissionais, verificou-se que, antes do programa, apenas 21,7% informaram que foram indagadas sobre o desenvolvimento dos seus filhos, 24,7% relataram que o profissional perguntou ou observou o desenvolvimento da sua criança e 11,1% receberam orientação sobre como estimulá-las; após o programa, esses percentuais aumentaram para 34,5%, 54,2% e 30,3%, respectivamente. CONCLUSÃO: Profissionais que participaram do programa apresentaram melhor desempenho quanto aos conhecimentos e práticas sobre desenvolvimento infantil. .

Curso de Formação de Monitores para as Ações de Educação Permanente para o Controle Social” - Supervisão Técnica de Saúde Pirituba/Perus/Coordenadoria Regional de Saúde Norte / Monitors Training Course for Continuing Education Actions for Social Control - Health Technical Supervision Pirituba / Perus / Northern Regional Health Coordination

A Supervisão Técnica de Saúde Pirituba/Perus (STS–PP) comprometida com o fortalecimento da Gestão Pública, do Controle Social, vem realizando a capacitação de conselheiros de forma continua no território, sem que se observe intensificação nas ações de controle social. Pautado nessas preocupações passa a implementar a formação de conselheiros tendo como a base a educação permanente, com a capacitação de monitores para acompanhar os trabalhos, tendo como propósito a consolidação dos conhecimentos obtidos e a aquisição de uma visão critica, principalmente sobre a política de saúde e os dispositivos necessários para o controle social consciente. No 1º semestre de 2014 foi realizado o curso para 20 monitores, sendo 4 do segmento usuários e 16 servidores, que foram habilitados. Dessa forma se ampliou a formação de monitores na perspectiva da Educação Permanente, permitindo atuar efetivamente no território e no processo de trabalho da ação conselheira (AU)

[Evaluation of tutors and facilitators on the formation process of facilitators on Permanent Health Education of Londrina, Paraná]. / Avaliação de tutores e facilitadores sobre o processo de formação de facilitadores de Educação Permanente em Saúde no município de Londrina, Paraná

The Ministry of Health has instituted the Permanent Health Education (PHE) with the purpose to change both the practices and the education of health professionals. As a strengthening strategy of this policy, the formation of PHE tutors and facilitators has begun in the whole country. This project aims to analyze this individuals' perception on the PHE facilitator course in Londrina, PR. It is a qualitative study, carried out with PHE tutors and facilitators from December 2006 to January 2007. Data were collected through semi-structured interviews and submitted to the discourse analysis proposed by Martins and Bicudo. By analyzing two categories the study revealed: Contributions from the permanent health education course and Critics on the facilitators' formation process. The results showed that despite some limitations such as the course period, selection of facilitators and difficulties with the course methodology, the education of facilitators has brought contributions to the systematical knowledge on PHE and the opportunity to reflect upon the practices in health.

Avaliação de tutores e facilitadores sobre o processo de formação de facilitadores de Educação Permanente em Saúde no município de Londrina, Paraná / Evaluation of tutors and facilitators on the formation process of facilitators on Permanent Health Education of Londrina, Paraná

A formação de tutores e facilitadores iniciou-se como estratégia de fortalecimento da política de Educação Permanente em Saúde (EPS). O objetivo deste estudo foi analisar as percepções desses sujeitos sobre o curso de facilitadores de EPS em Londrina (PR). Trata-se de um estudo qualitativo, realizado com tutores e facilitadores de EPS, no período de dezembro de 2006 a janeiro de 2007. Os dados foram coletados por meio de entrevistas semiestruturadas e submetidos à análise de discurso proposta por Martins e Bicudo. Os resultados revelaram algumas críticas referentes ao processo de seleção de facilitadores, tempo de duração e término do curso, dificuldades com a metodologia, entre outras. Apesar disso, os participantes salientaram contribuições, tais como a sistematização do conhecimento sobre EPS e a oportunidade de refletir sobre as práticas de trabalho. As críticas voltaram-se mais para aspectos operacionais, ao passo que as contribuições levantadas referiram-se justamente aos objetivos centrais do processo de formação de facilitadores.

The Ministry of Health has instituted the Permanent Health Education (PHE) with the purpose to change both the practices and the education of health professionals. As a strengthening strategy of this policy, the formation of PHE tutors and facilitators has begun in the whole country. This project aims to analyze this individuals' perception on the PHE facilitator course in Londrina, PR. It is a qualitative study, carried out with PHE tutors and facilitators from December 2006 to January 2007. Data were collected through semi-structured interviews and submitted to the discourse analysis proposed by Martins and Bicudo. By analyzing two categories the study revealed: Contributions from the permanent health education course and Critics on the facilitators' formation process. The results showed that despite some limitations such as the course period, selection of facilitators and difficulties with the course methodology, the education of facilitators has brought contributions to the systematical knowledge on PHE and the opportunity to reflect upon the practices in health.

Práticas de formação continuada em Educação Física / Prácticas de la formación continua en Educacion Fisica / Practices of continuing formation in Physical Education

Trata de um estudo em que as práticas de formação são analisadas no momento em que uma professora de Educação Física de uma escola de ensino municipal tenta efetivar as propostas de formação previstas na política sugerida pela Secretaria de Educação. Discorre sobre ocultações que cercam esse campo, geradas por consensos que criam projetos ilusórios. Analisa a escola e a forma como sua organização favorece e/ou dificulta as práticas de formação construídas. Aproxima-se da professora colaboradora para revelar como se organiza esse espaço escolar que se apresenta como determinante na limitação ou constituição dessas práticas de formação.

It is a study in which its practices of formation are analyzed at the moment when a Physical Education teacher of a municipal school tries to make effective the formation proposals foreseen in the policy suggested by the Secretary of Education. It discusses about the occultation that surround that area, generated through consensus that create illusory projects. It analyzes the school and the way how its organization benefits and/or makes difficult the formation practices built. It approachs the collaborator teacher to show how that school space is organized and its presentation as determinant in the limitation or constitution of such formation practices.

Esto a partir de un estudio en que las prácticas de la formación se analizan en el momento en que una profesora de Educación Física de una escuela municipal de la educación trata de llevar a cabo el proyecto de formación previsto en la formulación de políticas sugeridas por el Departamento de Educación. Discute occultations que rodean a este campo, generados por proyectos de construcción que crean poco realista. Examina la escuela y la forma en que su organización promueve y/o dificulta la formación práctica de la construcción. Estrecho de la maestra colaborador para revelar cómo se organiza la escuela que se presenta como crucial en la limitación o la constitución de estas prácticas de formación.

Assessment of risks related to medicine dispensing by nonprofessionals in Colombia: clinical case simulations.

BACKGROUND: Appropriate dispensing is one of the steps for rational drug use, so it is generally advised that the dispenser should have relevant and updated knowledge, skills, and attitudes. OBJECTIVE: To assess pharmacies and nonprofessional employees' (NEs) skills and knowledge, as well as their response to several specific case simulations in Bogota, Colombia. METHODS: A descriptive cross-sectional study was performed on a random sample of 371 pharmacies in Bogota. Information from each pharmacy was obtained using 2 approaches: (1) direct interview to collect data on organizational aspects of the store and characteristics of NEs, and (2) simulation (both by direct interview and by telephone) to assess dispensing responses in 6 simulated clinical cases. RESULTS: More than half of the simulated clinical situations resulted in inappropriate dispensing (direct simulations 57%; telephone simulations 55%). The proportion of correct answers to theoretical questions regarding a specific therapeutic problem during interviews was higher than the response when a simulation presented that same case and a dispensing act was expected. The educational background of the NEs included in the study points to a specific problem: two-thirds of the individuals selling medicines had completed only secondary-level education and only 2% of the sample had a pharmacist as technical director. Continuing education courses were either directly organized by drug manufacturers (one-third of the courses attended by pharmacists) or sponsored by them (more than an additional one-third). CONCLUSIONS: NEs should be considered part of the therapeutic chain and, if appropriately updated or instructed, could play a very important role in the always difficult promotion of rational drug use. Public health institutions and universities should be more actively involved in the provision of independent, unbiased, and essential information on common therapeutic problems, safety concerns, and new drug prescription restrictions.