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1.
BMC Med ; 17(1): 139, 2019 07 18.
Artículo en Inglés | MEDLINE | ID: mdl-31315642

RESUMEN

BACKGROUND: Clinical practice guidelines are an important source of information, designed to help clinicians integrate research evidence into their clinical practice. Digital education is increasingly used for clinical practice guideline dissemination and adoption. Our aim was to evaluate the effectiveness of digital education in improving the adoption of clinical practice guidelines. METHODS: We performed a systematic review and searched seven electronic databases from January 1990 to September 2018. Two reviewers independently screened studies, extracted data and assessed risk of bias. We included studies in any language evaluating the effectiveness of digital education on clinical practice guidelines compared to other forms of education or no intervention in healthcare professionals. We used the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach to assess the quality of the body of evidence. RESULTS: Seventeen trials involving 2382 participants were included. The included studies were diverse with a largely unclear or high risk of bias. They mostly focused on physicians, evaluated computer-based interventions with limited interactivity and measured participants' knowledge and behaviour. With regard to knowledge, studies comparing the effect of digital education with no intervention showed a moderate, statistically significant difference in favour of digital education intervention (SMD = 0.85, 95% CI 0.16, 1.54; I2 = 83%, n = 3, moderate quality of evidence). Studies comparing the effect of digital education with traditional learning on knowledge showed a small, statistically non-significant difference in favour of digital education (SMD = 0.23, 95% CI - 0.12, 0.59; I2 = 34%, n = 3, moderate quality of evidence). Three studies measured participants' skills and reported mixed results. Of four studies measuring satisfaction, three studies favoured digital education over traditional learning. Of nine studies evaluating healthcare professionals' behaviour change, only one study comparing email-delivered, spaced education intervention to no intervention reported improvement in the intervention group. Of three studies reporting patient outcomes, only one study comparing email-delivered, spaced education games to non-interactive online resources reported modest improvement in the intervention group. The quality of evidence for outcomes other than knowledge was mostly judged as low due to risk of bias, imprecision and/or inconsistency. CONCLUSIONS: Health professions digital education on clinical practice guidelines is at least as effective as traditional learning and more effective than no intervention in terms of knowledge. Most studies report little or no difference in healthcare professionals' behaviours and patient outcomes. The only intervention shown to improve healthcare professionals' behaviour and modestly patient outcomes was email-delivered, spaced education. Future research should evaluate interactive, simulation-based and spaced forms of digital education and report on outcomes such as skills, behaviour, patient outcomes and cost.


Asunto(s)
Instrucción por Computador , Educación en Salud/métodos , Empleos en Salud/educación , Empleos en Salud/normas , Personal de Salud/educación , Guías de Práctica Clínica como Asunto , Competencia Clínica , Conducta Cooperativa , Humanos , Internet , Conocimiento , Aprendizaje , Entrenamiento Simulado , Realidad Virtual
2.
Stud Health Technol Inform ; 262: 272-275, 2019 Jul 04.
Artículo en Inglés | MEDLINE | ID: mdl-31349320

RESUMEN

This cross-sectional research aimed to explore the associated factors with participation in the quality improvement processes in Kalasin hospital, Kalasin province, Thailand. The 412 samples were randomized selection and the created questionnaire was applied to collect their opinion. The results showed that level of participation in quality improvement, which called HA of hospital health professionals at high level (average = 3.52, S.D. = 0.86). In aspect of internal factors of samples, positions and role of responsibility were significantly related with quality improvement. Job motivation and support from the organization were positively correlated with participation of HA activities with statistical significance level. Finding can be suggest that the hospital need to support their staff in aspect of focus on patient, human resources development and patient care process. Including to support and staff encouragement to high level of participant all quality improvement quality.


Asunto(s)
Acreditación , Empleos en Salud , Mejoramiento de la Calidad , Estudios Transversales , Empleos en Salud/normas , Humanos , Tailandia
4.
J Med Internet Res ; 21(4): e12968, 2019 04 24.
Artículo en Inglés | MEDLINE | ID: mdl-31017584

RESUMEN

BACKGROUND: The shortage and disproportionate distribution of health care workers worldwide is further aggravated by the inadequacy of training programs, difficulties in implementing conventional curricula, deficiencies in learning infrastructure, or a lack of essential equipment. Offline digital education has the potential to improve the quality of health professions education. OBJECTIVE: The primary objective of this systematic review was to evaluate the effectiveness of offline digital education compared with various controls in improving learners' knowledge, skills, attitudes, satisfaction, and patient-related outcomes. The secondary objectives were (1) to assess the cost-effectiveness of the interventions and (2) to assess adverse effects of the interventions on patients and learners. METHODS: We searched 7 electronic databases and 2 trial registries for randomized controlled trials published between January 1990 and August 2017. We used Cochrane systematic review methods. RESULTS: A total of 27 trials involving 4618 individuals were included in this systematic review. Meta-analyses found that compared with no intervention, offline digital education (CD-ROM) may increase knowledge in nurses (standardized mean difference [SMD]=1.88; 95% CI 1.14 to 2.62; participants=300; studies=3; I2=80%; low certainty evidence). A meta-analysis of 2 studies found that compared with no intervention, the effects of offline digital education (computer-assisted training [CAT]) on nurses and physical therapists' knowledge were uncertain (SMD 0.55; 95% CI -0.39 to 1.50; participants=64; I2=71%; very low certainty evidence). A meta-analysis of 2 studies found that compared with traditional learning, a PowerPoint presentation may improve the knowledge of patient care personnel and pharmacists (SMD 0.76; 95% CI 0.29 to 1.23; participants=167; I2=54%; low certainty evidence). A meta-analysis of 4 studies found that compared with traditional training, the effects of computer-assisted training on skills in community (mental health) therapists, nurses, and pharmacists were uncertain (SMD 0.45; 95% CI -0.35 to 1.25; participants=229; I2=88%; very low certainty evidence). A meta-analysis of 4 studies found that compared with traditional training, offline digital education may have little effect or no difference on satisfaction scores in nurses and mental health therapists (SMD -0.07; 95% CI -0.42 to 0.28, participants=232; I2=41%; low certainty evidence). A total of 2 studies found that offline digital education may have little or no effect on patient-centered outcomes when compared with blended learning. For skills and attitudes, the results were mixed and inconclusive. None of the studies reported adverse or unintended effects of the interventions. Only 1 study reported costs of interventions. The risk of bias was predominantly unclear and the certainty of the evidence ranged from low to very low. CONCLUSIONS: There is some evidence to support the effectiveness of offline digital education in improving learners' knowledge and insufficient quality and quantity evidence for the other outcomes. Future high-quality studies are needed to increase generalizability and inform use of this modality of education.


Asunto(s)
Educación en Salud/métodos , Empleos en Salud/normas , Personal de Salud/educación , Humanos , Ensayos Clínicos Controlados Aleatorios como Asunto
5.
J Med Internet Res ; 21(1): e12959, 2019 01 22.
Artículo en Inglés | MEDLINE | ID: mdl-30668519

RESUMEN

BACKGROUND: Virtual reality (VR) is a technology that allows the user to explore and manipulate computer-generated real or artificial three-dimensional multimedia sensory environments in real time to gain practical knowledge that can be used in clinical practice. OBJECTIVE: The aim of this systematic review was to evaluate the effectiveness of VR for educating health professionals and improving their knowledge, cognitive skills, attitudes, and satisfaction. METHODS: We performed a systematic review of the effectiveness of VR in pre- and postregistration health professions education following the gold standard Cochrane methodology. We searched 7 databases from the year 1990 to August 2017. No language restrictions were applied. We included randomized controlled trials and cluster-randomized trials. We independently selected studies, extracted data, and assessed risk of bias, and then, we compared the information in pairs. We contacted authors of the studies for additional information if necessary. All pooled analyses were based on random-effects models. We used the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach to rate the quality of the body of evidence. RESULTS: A total of 31 studies (2407 participants) were included. Meta-analysis of 8 studies found that VR slightly improves postintervention knowledge scores when compared with traditional learning (standardized mean difference [SMD]=0.44; 95% CI 0.18-0.69; I2=49%; 603 participants; moderate certainty evidence) or other types of digital education such as online or offline digital education (SMD=0.43; 95% CI 0.07-0.79; I2=78%; 608 participants [8 studies]; low certainty evidence). Another meta-analysis of 4 studies found that VR improves health professionals' cognitive skills when compared with traditional learning (SMD=1.12; 95% CI 0.81-1.43; I2=0%; 235 participants; large effect size; moderate certainty evidence). Two studies compared the effect of VR with other forms of digital education on skills, favoring the VR group (SMD=0.5; 95% CI 0.32-0.69; I2=0%; 467 participants; moderate effect size; low certainty evidence). The findings for attitudes and satisfaction were mixed and inconclusive. None of the studies reported any patient-related outcomes, behavior change, as well as unintended or adverse effects of VR. Overall, the certainty of evidence according to the GRADE criteria ranged from low to moderate. We downgraded our certainty of evidence primarily because of the risk of bias and/or inconsistency. CONCLUSIONS: We found evidence suggesting that VR improves postintervention knowledge and skills outcomes of health professionals when compared with traditional education or other types of digital education such as online or offline digital education. The findings on other outcomes are limited. Future research should evaluate the effectiveness of immersive and interactive forms of VR and evaluate other outcomes such as attitude, satisfaction, cost-effectiveness, and clinical practice or behavior change.


Asunto(s)
Educación en Salud/métodos , Empleos en Salud/normas , Personal de Salud/educación , Realidad Virtual , Humanos
6.
Adv Health Sci Educ Theory Pract ; 24(2): 413-421, 2019 05.
Artículo en Inglés | MEDLINE | ID: mdl-29777463

RESUMEN

Educational assessment for the health professions has seen a major attempt to introduce competency based frameworks. As high level policy developments, the changes were intended to improve outcomes by supporting learning and skills development. However, we argue that previous experiences with major innovations in assessment offer an important road map for developing and refining assessment innovations, including careful piloting and analyses of their measurement qualities and impacts. Based on the literature, numerous assessment workshops, personal interactions with potential users, and our 40 years of experience in implementing assessment change, we lament the lack of a coordinated approach to clarify and improve measurement qualities and functionality of competency based assessment (CBA). To address this worrisome situation, we offer two roadmaps to guide CBA's further development. Initially, reframe and address CBA as a measurement development opportunity. Secondly, using a roadmap adapted from the management literature on sustainable innovation, the medical assessment community needs to initiate an integrated plan to implement CBA as a sustainable innovation within existing educational programs and self-regulatory enterprises. Further examples of down-stream opportunities to refocus CBA at the implementation level within faculties and within the regulatory framework of the profession are offered. In closing, we challenge the broader assessment community in medicine to step forward and own the challenge and opportunities to reframe CBA as an innovation to improve the quality of the clinical educational experience. The goal is to optimize assessment in health education and ultimately improve the public's health.


Asunto(s)
Educación Basada en Competencias/métodos , Evaluación Educacional/métodos , Empleos en Salud/educación , Competencia Clínica , Educación Basada en Competencias/normas , Empleos en Salud/normas , Humanos , Aprendizaje , Reproducibilidad de los Resultados
7.
BMC Med Educ ; 18(1): 309, 2018 Dec 18.
Artículo en Inglés | MEDLINE | ID: mdl-30563502

RESUMEN

BACKGROUND: Interprofessional collaboration (IPC) primarily aims to enhance collaborative skills and to improve the awareness of teamwork and collaborative competencies of health care students. The Readiness for Interprofessional Learning Scale (RIPLS) was used to assess such skills. The aim of this study was to adapt a Chinese version of the RIPLS among Chinese health care students and to test the psychometric properties of the modified instrument. METHODS: The questionnaire was translated following a two-step process, comprising forward and backward translations and a pilot test. The Chinese version was tested on a group of students from various health care professions. Cronbach's α coefficients were calculated for each of the four factors and also for the entire questionnaire in order to evaluate the internal consistency of the Chinese version of the RIPLS. RESULTS: Of the 295 health care students surveyed, 282 (96.5%) completed the questionnaire. Cronbach's α coefficient for the overall scale was 0.842. Internal consistencies within each factor were good (α > 0.70) except for the factor "Roles and Responsibilities", where α = 0.216. Confirmatory factor analysis showed that the data fit the four-factor structure. CONCLUSION: The Chinese version of the RIPLS was an acceptable instrument for evaluating the attitudes of the health care students in China. The factor "Roles and Responsibilities" requires further scrutiny and development, at least in the Chinese context.


Asunto(s)
Empleos en Salud/educación , Relaciones Interprofesionales , Estudiantes del Área de la Salud , Adaptación Psicológica , Actitud del Personal de Salud , China , Conducta Cooperativa , Estudios Transversales , Femenino , Empleos en Salud/normas , Humanos , Aprendizaje , Masculino , Psicometría , Reproducibilidad de los Resultados , Estudiantes del Área de la Salud/psicología , Encuestas y Cuestionarios , Adulto Joven
8.
Int J Med Educ ; 9: 271-285, 2018 Oct 25.
Artículo en Inglés | MEDLINE | ID: mdl-30368488

RESUMEN

Objectives: To review the research literature on cultural safety education within post-secondary health science programs. Methods: We conducted health and social science database searches from 1996-2016, using combined keywords: cultural competence or safety; teaching or curriculum; universities, polytechnics or professional programs; and Aboriginal or Indigenous. In dyads, authors selected, and reviewed studies independently followed by discussion and consensus to identify thematic linkages of major findings. Results: A total of 1583 abstracts and 122 full-text articles were reviewed with 40 selected for final inclusion. Publications from Australia, Canada, New Zealand and the United States described curriculum development and delivery. A variety of evaluation approaches were used including anecdotal reports, focus groups, interviews, course evaluations, reflective journals, pre-post surveys, critical reflective papers, and exam questions. Duration and depth of curricular exposure ranged from one day to integration across a six-year program.  Changes in student knowledge, attitude, self-confidence, and behaviour when working with Indigenous populations were reported. Cultural safety education and application to practice were shown to be linked to improved relationships, healthier outcomes, and increased number of Indigenous people entering health education programs and graduates interested in working in diverse communities. Conclusions: This review provides a summary of multidisciplinary didactic and experiential instructional approaches to cultural safety education and the impact on students, educators and Indigenous people.  Institutional support, strategic planning and cultural safety curriculum policy within post-secondary settings and community engagement are imperative for positive student experiences, advocacy, and actions toward health equity and improved health for Indigenous people and communities.


Asunto(s)
Competencia Cultural/educación , Curriculum , Empleos en Salud/educación , Ciencias Sociales/educación , Australia/epidemiología , Canadá/epidemiología , Competencia Clínica/normas , Competencia Clínica/estadística & datos numéricos , Competencia Cultural/psicología , Curriculum/normas , Curriculum/estadística & datos numéricos , Empleos en Salud/normas , Empleos en Salud/estadística & datos numéricos , Humanos , Nueva Zelanda/epidemiología , Seguridad del Paciente/normas , Ciencias Sociales/normas , Ciencias Sociales/estadística & datos numéricos , Estados Unidos/epidemiología
9.
PLoS One ; 13(10): e0206096, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-30359391

RESUMEN

BACKGROUND: High quality primary care is fundamental to achieving health for all. Research priority setting is a key facilitator of improving how research activity responds to concrete needs. There has never before been an attempt to identify international primary care research priorities, in order to guide resource allocation and to enhance global primary care. This study aimed to identify a list of top 10 primary care research priorities, as identified by members of the public, health professionals working in primary care, researchers, and policymakers. METHODS: We adapted the James Lind Alliance Priority Setting Partnership process, to conduct multiple rounds of stakeholder recruitment and prioritization. The study included an online survey conducted in three languages, followed by an in-person priority setting exercise involving primary care stakeholders from 13 countries. FINDINGS: Participants identified a list of top 10 international primary care research priorities. These were focused on diverse topics such as enhancing use of information and communication technology, and improving integration of indigenous communities' knowledge in the design of primary care services. The main limitations of the study related to challenges in engaging an adequate diversity and number of appropriate stakeholders, particularly members of the public, in aggregating the diverse set of responses into coherent categories representative of the participants' perspectives and in adequately representing the diversity of submitted responses while ensuring research priorities on the final list are sufficiently actionable to guide resource allocation. CONCLUSIONS: The top 10 identified research priorities have the potential to guide research resource allocation, supporting funding agencies and initiatives to promote global primary care research and practice.


Asunto(s)
Investigación Biomédica , Técnica Delfos , Prioridades en Salud , Atención Primaria de Salud , Investigación Biomédica/métodos , Investigación Biomédica/organización & administración , Investigación Biomédica/normas , Consenso , Empleos en Salud/normas , Prioridades en Salud/organización & administración , Prioridades en Salud/normas , Prioridades en Salud/estadística & datos numéricos , Humanos , Internacionalidad , Lenguaje , Médicos de Familia/estadística & datos numéricos , Atención Primaria de Salud/métodos , Atención Primaria de Salud/organización & administración , Atención Primaria de Salud/normas , Atención Primaria de Salud/estadística & datos numéricos , Práctica Profesional/organización & administración , Práctica Profesional/normas , Práctica Profesional/estadística & datos numéricos , Investigación/organización & administración , Investigación/estadística & datos numéricos , Encuestas y Cuestionarios
10.
Nurse Educ Today ; 70: 77-86, 2018 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-30170152

RESUMEN

BACKGROUND: In the face of rapid digitalisation and ever-higher educational requirements for healthcare professionals, it is important that health science teachers possess the relevant core competences. The education of health science teachers varies internationally and there is no consensus about the minimum qualifications and experience they require. OBJECTIVE: The aim of this systematic review was to describe the health science teachers' competences and the factors related to it. DESIGN: Systematic review of original quantitative studies. DATA SOURCES: Four databases were selected from which to retrieve original studies: Cinahl (Ebsco), PubMed, Medic, Eri (ProQuest). REVIEW METHODS: The systematic review used PICOS inclusion criteria. Original peer-reviewed quantitative studies published between 1/2007 and 1/2018 were identified. Screening was conducted by two researchers separately reading the 1885 titles, 600 abstracts, and 63 full-texts that were identified, and then agreed between them. Critical appraisal was performed using the JBI MAStARI evaluation tool. The data was extracted and then analysed narratively. RESULTS: The core competences of health science teachers include areas of knowledge, skills and attitudes. Health science teachers evaluate their own competence as high. Only in relation to entrepreneurship and leadership knowledge was evaluated to be average. The most common factors influencing competence were teachers' title/position, healthcare experience, research activities, age, academic degree and for which type of organisation they work. CONCLUSION: It is important to identify the core competencies required by health science teachers in order to train highly competent healthcare professionals. Based on the findings of this systematic review we suggest that teachers should be encouraged to gain university education and actively participate in research, and that younger teachers should have opportunities to practice the relevant teaching skills to build competence.


Asunto(s)
Competencia Clínica , Conocimientos, Actitudes y Práctica en Salud , Empleos en Salud/normas , Enseñanza , Prestación de Atención de Salud , Educación de Postgrado , Humanos , Liderazgo
11.
Adv Physiol Educ ; 42(3): 417-423, 2018 Sep 01.
Artículo en Inglés | MEDLINE | ID: mdl-29972063

RESUMEN

This review article includes our analysis of the literature and our own experiences in using various types of active learning as best practices for evidence-based teaching in physiology. We have evaluated what physiology students should be expected to learn and what are specific challenges to enhancing their learning of physiology principles. We also consider how the instructor should design his or her teaching to improve buy-in from both students and other faculty members. We include a discussion of how the readers can evaluate their teaching approaches for their successes in enhancing student learning of physiology. Thus we have addressed pedagogical improvements specific to student learning of physiology, with additional suggestions from cognitive psychology approaches that can improve physiology teaching and learning.


Asunto(s)
Fisiología/educación , Fisiología/normas , Guías de Práctica Clínica como Asunto/normas , Aprendizaje Basado en Problemas/normas , Empleos en Salud/educación , Empleos en Salud/normas , Humanos , Aprendizaje Basado en Problemas/métodos , Estudiantes del Área de la Salud
13.
BMC Med Educ ; 18(1): 92, 2018 May 03.
Artículo en Inglés | MEDLINE | ID: mdl-29724211

RESUMEN

BACKGROUND: The multiple mini-interview (MMI) is a common assessment strategy used in student selection. The MMI as an assessment strategy within a health professions curriculum, however, has not been previously studied. This study describes the integration of a 5-station MMI as part of an end-of-year capstone following the first year of a health professions curriculum. The goal of the capstone MMI was to assess professional competencies of students and to offer formative feedback to prepare students for their upcoming clinical practice experiences. The purpose of this study was to evaluate the psychometric properties of an MMI integrated into a health professions curriculum. METHODS: Five capstone MMI stations were designed to each evaluate a single construct assessed by one rater. A principal component analysis (PCA) was used to evaluate the structure of the model and its ability to distinguish 5 separate constructs. A Multifaceted Rasch Measurement (MFRM) model assessed student performance and estimated the sources of measurement error attributed to 3 facets: student ability, rater stringency, and station difficulty. At the conclusion, students were surveyed about the capstone MMI experience. RESULTS: The PCA confirmed the MMI reliably assessed 5 unique constructs and performance on each station was not strongly correlated with one another. The 3-facet MFRM analysis explained 58.79% of the total variance in student scores. Specifically, 29.98% of the variance reflected student ability, 20.25% reflected rater stringency, and 8.56% reflected station difficulty. Overall, the data demonstrated an acceptable fit to the MFRM model. The majority of students agreed the MMI allowed them to effectively demonstrate their communication (80.82%), critical thinking (78.77%), and collaboration skills (70.55%). CONCLUSIONS: The MMI can be a valuable assessment strategy of professional competence within a health professions curriculum. These findings suggest the MMI is well-received by students and can produce reliable results. Future research should explore the impact of using the MMI as a strategy to monitor longitudinal competency development and inform feedback approaches.


Asunto(s)
Curriculum , Empleos en Salud/educación , Entrevistas como Asunto/métodos , Competencia Profesional , Criterios de Admisión Escolar , Rendimiento Académico , Competencia Clínica , Comunicación , Conducta Cooperativa , Femenino , Empleos en Salud/normas , Humanos , Masculino , Análisis de Componente Principal , Psicometría , Pensamiento
14.
J Clin Pharmacol ; 58(7): 843-848, 2018 07.
Artículo en Inglés | MEDLINE | ID: mdl-29723424

RESUMEN

In recent years, health care has been increasingly delivered by interprofessional teams in the inpatient, outpatient, and transition-of-care arenas. For many reasons, effective communication between patient-centered care teams and patients is critically important in order to optimize care, ensure patient safety, and prevent medical and medication misadventures. In rapid-paced, high-stress medical environments, it is especially important to carefully evaluate the causes of all misadventures in a manner that avoids assigning blame and identifies the root causes and, through team activity, leads to development of remedies that reduce the likelihood of future misadventures. Using a series of illustrative cases, this paper seeks to bring attention to these issues and provide insights regarding some tools developed to assist in improving patient safety and effective team communication.


Asunto(s)
Empleos en Salud/educación , Seguridad del Paciente/normas , Farmacología Clínica/educación , Competencia Clínica , Comprensión , Conducta Cooperativa , Prescripciones de Medicamentos/normas , Empleos en Salud/normas , Humanos , Comunicación Interdisciplinaria , Internado y Residencia , Relaciones Interprofesionales , Relaciones Médico-Paciente
18.
Support Care Cancer ; 26(6): 1943-1952, 2018 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-29305720

RESUMEN

BACKGROUND: In 2015, an evidence- and consensus-based palliative care guideline in adults with incurable cancer was published by the German Guideline Program. Barriers and enablers for the guideline implementation of members of the German Association for Palliative Medicine (DGP) were unknown. Therefore, the aims of this study were (1) to evaluate professionals' knowledge, motivation, and outcome expectancy towards already existing recommendations for palliative care and (2) to evaluate the self-experienced competence in five medical key topics presented in the new guideline. METHODS: A web-based online survey with all DGP members in 2014 using a specifically designed questionnaire including 62 questions was used. Independent predictors for identified barriers were analysed using multivariable logistic regression analyses. RESULTS: All 4786 members with known email address were invited, 1181 followed the link, 1138 began to answer, and 1031 completed the questionnaire. Fifty-four percent know already existing recommendations concerning palliative care, 8.4% know and use these recommendations; of the latter group, 44.2% do not notice any improvement of their treatment when applying them. Of key symptoms addressed in the guideline, depression was the symptom with lowest perceived competence (63.7 vs. > 90% for other symptoms). Non-physicians and those working in settings with little contact to seriously ill or dying patients feel less competent in almost all symptoms. CONCLUSION: Emphasis on the high-quality and evidence- and consensus-based character of the guideline should be underlined in future implementation processes. Implementation strategies should focus on depression and non-physicians and those professionals working in settings with little contact to seriously ill patients.


Asunto(s)
Barreras de Comunicación , Adhesión a Directriz , Neoplasias/terapia , Cuidados Paliativos/normas , Adulto , Actitud del Personal de Salud , Femenino , Alemania/epidemiología , Adhesión a Directriz/estadística & datos numéricos , Conocimientos, Actitudes y Práctica en Salud , Empleos en Salud/normas , Empleos en Salud/estadística & datos numéricos , Humanos , Masculino , Persona de Mediana Edad , Regionalización , Encuestas y Cuestionarios
20.
Ann Glob Health ; 84(1): 47-57, 2018 04 30.
Artículo en Inglés | MEDLINE | ID: mdl-30873790

RESUMEN

BACKGROUND: Mozambique is an emerging lower income country (LIC) on the southeast coast of Africa. There are significant workforce shortages in medical and health professions in the country. Mozambique was one of 12 countries in Africa that was awarded a grant through the Medical Education Partnership Initiative (MEPI) in 2010. The overarching goal of MEPI Mozambique was to enhance the capacity of medical schools to train the medical and scientific leadership corps that the country required to facilitate the training of doctors and other health professionals, and thus to strengthen the national health system. OBJECTIVE: The aim of this article is to provide an overview of MEPI Mozambique activities, its outcomes and successes, lessons learned, and how these have sustainably strengthened the health sector in the country.What Was Done: The Eduardo Mondlane University (UEM) formed a partnership with the University of California, San Diego (UCSD) to implement MEPI Mozambique. A range of activities in medical education, research capacity development, electronic connectivity and information technology, and developing relationships among medical education stakeholders, were performed.Outcomes and Effects: The activities and innovations introduced under MEPI became part of the daily routine in medical education in Mozambique, dramatically influencing attitudes and perceptions. Joint research with partners leveraged research capabilities. The creation of a research support center offered a mechanism to sustainably build on MEPI achievements. Scientific knowledge generated through research has been translated into practice and policy, and has improved the working environment for health professionals. The use of interactive communication technologies enabled the scaling up of training and research in sustainable ways, and created communities of practice. CONCLUSION: MEPI Mozambique developed transformational long-term partnerships between UEM, UCSD and other partners. These are changing the trajectory of medical and health professions education in Mozambique and creating sustainable capacity for research.


Asunto(s)
Investigación Biomédica , Educación Médica , Empleos en Salud , Personal de Salud/educación , Facultades de Medicina , Investigación Biomédica/métodos , Investigación Biomédica/organización & administración , Investigación Biomédica/normas , Creación de Capacidad/estadística & datos numéricos , Educación Médica/organización & administración , Educación Médica/normas , Empleos en Salud/educación , Empleos en Salud/normas , Humanos , Colaboración Intersectorial , Mozambique , Facultades de Medicina/organización & administración , Facultades de Medicina/normas
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