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1.
Rev. colomb. anestesiol ; 48(3): 145-154, July-Sept. 2020. tab, graf
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1126296

RESUMO

Abstract Introduction: Anesthesiology requires procedure fulfillment, problem, and real-time crisis resolution, problem, and complications forecast, among others; therefore, the evaluation of its learning should center around how students achieve competence rather than solely focusing on knowledge acquisition. Literature shows that despite the existence of numerous evaluation strategies, these are still underrated in most cases due to unawareness. Objective: The present article aims to explain the process of competency-based anesthesiology assessment, in addition to suggesting a brief description of the learning domains evaluated, theories of knowledge, instruments, and assessment systems in the area; and finally, to show some of the most relevant results regarding assessment systems in Colombia. Methodology: The results obtained in "Characteristics of the evaluation systems used by anesthesiology residency programs in Colombia" showed a certain degree of unawareness by stakeholders in the educational process, a fact that motivated the publishing of this discussion around the topic of competency-based assessment in anesthesiology. Following a bibliography search with the keywords through PubMed, OVID, ERIC, DIALNET, and REDALYC, 110 articles were reviewed and 75 were established as relevant for the research's theoretical framework. Results and conclusion: Anesthesiology assessment should be conceived from the competency's multidimensionality; it must be longitudinal and focused on the learning objectives.


Resumen Introducción: La anestesiología requiere la realización de procedimientos, resolución de problemas y crisis en tiempo real, previsión de problemas y complicaciones, entre otros, por lo tanto, la evaluación de su aprendizaje debería centrarse en cómo el estudiante alcanza la competencia y no solo en la adquisición de conocimientos. La literatura muestra que, a pesar de existir numerosas estrategias de evaluación, estas continúan siendo subvaloradas en muchos casos por desconocimiento. Objetivo: Este artículo pretende dar a conocer el proceso de evaluación en la anestesiología desde la competencia, además de sugerir una breve descripción de los dominios y teorías de aprendizaje, instrumentos y sistemas de evaluación en esta área y, finalmente, mostrar algunos de los resultados más relevantes sobre los sistemas de evaluación en Colombia. Metodología: Tras una búsqueda bibliográfica en PubMed, OVID, ERIC, DIALNET, REDALYC, con las palabras clave, se revisaron 110 artículos de los cuales 75 fueron considerados relevantes para elaborar el marco teórico de la investigación. Resultados y conclusiones: La evaluación en anestesiología debe ser concebida desde la multidimensionalidad de la competencia, ser longitudinal y enfocada en los objetivos de aprendizaje.

2.
Arch. argent. pediatr ; 117(4): 425-432, ago. 2019. ilus, tab
Artigo em Espanhol | LILACS, BINACIS | ID: biblio-1054950

RESUMO

La evaluación del desempeño del docente clínico permite proporcionar feedback para motivarlo a mejorar sus habilidades docentes. Se realizó la validación transcultural del Cuestionario de Enseñanza Clínica de Maastricht, mediante la guía internacional para la adaptación de los cuestionarios. Se investigó validez de contenido, proceso de respuesta, constructo y confiabilidad. Luego de la adaptación, residentes de dos hospitales universitarios evaluaron a 187 docentes clínicos. La validación del contenido y del proceso de respuesta fue adecuada. En el análisis factorial confirmatorio, todos los índices y criterios se ajustaron bien con el modelo de 5 factores y 14 ítems. El alfa de Cronbach fue de 0,80. El coeficiente G fue > 0,70, con bajos valores de varianza del error absoluto. Fueron necesarias 6 evaluaciones por docente para una evaluación confiable en cada dominio y en el desempeño global. La versión en castellano del Cuestionario es válida y confiable para evaluar a los docentes.


The evaluation of the clinical teacher's performance provides feedback to motivate them to improve their teaching skills. To perform the cross-cultural adaptation of the Maastricht Clinical Teaching Questionnaire, the International Guide for the Adaptation of the Questionnaires was followed. The validity of content, response process, construct and reliability were investigated. After cross-cultural adaption, residents of two University hospitals evaluated 187 clinical teachers. Content and answering process were validated. In the confirmatory factor analysis, all indexes and criteria for a good fit suited the 5 factors and 14 items model. The Cronbach's alpha coefficient was 0.80. The G coefficient was > 0.70, with low variance of the absolute error. Every clinical teacher should receive at least 6 evaluations to achieve a reliable evaluation of every domain and of their global performance. The Spanish version of the questionnaire is a valid, reliable instrument for medical residents to evaluate teachers.


Assuntos
Humanos , Comparação Transcultural , Inquéritos e Questionários , Reprodutibilidade dos Testes , Adaptação , Educação Médica
3.
Arch Argent Pediatr ; 117(4): e425-e432, 2019 08 01.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-31339289

RESUMO

The evaluation of the clinical teacher's performance provides feedback to motivate them to improve their teaching skills. To perform the cross-cultural adaptation of the Maastricht Clinical Teaching Questionnaire, the International Guide for the Adaptation of the Questionnaires was followed. The validity of content, response process, construct and reliability were investigated. After cross-cultural adaption, residents of two University hospitals evaluated 187 clinical teachers. Content and answering process were validated. In the confirmatory factor analysis, all indexes and criteria for a good fit suited the 5 factors and 14 items model. The Cronbach's alpha coefficient was 0.80. The G coefficient was > 0.70, with low variance of the absolute error. Every clinical teacher should receive at least 6 evaluations to achieve a reliable evaluation of every domain and of their global performance. The Spanish version of the questionnaire is a valid, reliable instrument for medical residents to evaluate teachers.


Assuntos
Características Culturais , Educação de Pós-Graduação em Medicina/normas , Docentes de Medicina , Competência Profissional , Inquéritos e Questionários , Humanos , Reprodutibilidade dos Testes
4.
Medicina (B.Aires) ; 68(6): 437-441, nov.-dic. 2008. graf, tab
Artigo em Espanhol | LILACS | ID: lil-633584

RESUMO

El objetivo de este trabajo fue describir el proceso de limitación de los esfuerzos terapéuticos (LET) en los pacientes internados en una sala general. Para ello se realizó un estudio prospectivo descriptivo, desarrollado en la sala de internación general de un hospital universitario. Fueron evaluados pacientes que tuviesen alguna LET, asistidos por el servicio de clínica médica en un período de 60 días consecutivos. Durante el mismo se hospitalizaron 402 pacientes, 62 (15%) tuvieron algún tipo de LET. Este último grupo estaba compuesto por un 66% de mujeres, la mediana de edad fue de 86 años (78-90) y de la duración de hospitalización de 12 días (8-18). La mala calidad de vida fue la causa más frecuente de LET (69%). Se brindó información acerca de las limitaciones a 43 familias (69%) y 8 pacientes (13%). En la decisión participaron el médico de cabecera (50%), médicos de planta (50%), residentes (40%), la familia (42%) y los propios pacientes (11%). En 7 casos hubo constancia en la historia clínica (11%). Diecisiete pacientes (27%) con LET fallecieron durante la internación, mientras que 44 (71%) fueron dados de alta. En conclusión, la limitación de esfuerzos terapéuticos en nuestros pacientes constituyó un hecho frecuente. No se logró identificar un proceso uniforme o sistematizado para la toma de la decisión de LET. Resulta innegable la necesidad de normativas que guíen al equipo de salud en la toma de decisiones, tranquilicen a familiares y acompañen a los pacientes en sus reales necesidades.


The purpose of this study is to describe the limiting life-sustaining treatment process of patients admitted to a general ward. A prospective descriptive study was designed. The setting was the general ward of universitary hospital. Study participants were patients assisted by the internal medicine department during a 60- consecutive days period who had limitations of life sustaining treatments. During the study period, 402 patients were hospitalized, 62 (15%) of them had limitations of life support care. The median patient age of the last group was 86 years (78-90), 66% were women and the length of stay was 12 days (8-18). A low quality of life was the most frequent cause of limitation (69%). Information about the limitations was provided to 43 families (69%) and 8 patients (13%). The primary care physician participated in the decision in 50% of the cases, while the attending physician, the resident in charge, patient's family and patients themselves participated in 50%, 40%, 42% and 11% of the cases respectively. The decision of limiting life-sustaining treatments was recorded in seven patient's charts (11%). Seventeen (27%) patients with limitations died during the hospital stay while 44 (71%) were discharged. In conclusion, we found a frequent life sustaining treatment limitation in our patients. These decisions did not follow a uniform or systemized process. The need of guidelines to sort the medical and ethical challenges imposed to the medical team is undeniable.


Assuntos
Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Estado Terminal/terapia , Cuidados para Prolongar a Vida/normas , Assistência Terminal , Argentina , Estado Terminal/mortalidade , Tomada de Decisões , Família/psicologia , Guias de Prática Clínica como Assunto , Estudos Prospectivos , Qualidade de Vida , Suspensão de Tratamento
5.
Medicina (B Aires) ; 68(6): 437-41, 2008.
Artigo em Espanhol | MEDLINE | ID: mdl-19147425

RESUMO

The purpose of this study is to describe the limiting life-sustaining treatment process of patients admitted to a general ward. A prospective descriptive study was designed. The setting was the general ward of universitary hospital. Study participants were patients assisted by the internal medicine department during a 60-consecutive days period who had limitations of life sustaining treatments. During the study period, 402 patients were hospitalized, 62 (15%) of them had limitations of life support care. The median patient age of the last group was 86 years (78-90), 66% were women and the length of stay was 12 days (8-18). A low quality of life was the most frequent cause of limitation (69%). Information about the limitations was provided to 43 families (69%) and 8 patients (13%). The primary care physician participated in the decision in 50% of the cases, while the attending physician, the resident in charge, patient's family and patients themselves participated in 50%, 40%, 42% and 11% of the cases respectively. The decision of limiting life-sustaining treatments was recorded in seven patient's charts (11%). Seventeen (27%) patients with limitations died during the hospital stay while 44 (71%) were discharged. In conclusion, we found a frequent life sustaining treatment limitation in our patients. These decisions did not follow a uniform or systemized process. The need of guidelines to sort the medical and ethical challenges imposed to the medical team is undeniable.


Assuntos
Estado Terminal/terapia , Cuidados para Prolongar a Vida/normas , Assistência Terminal , Idoso , Idoso de 80 Anos ou mais , Argentina , Estado Terminal/mortalidade , Tomada de Decisões , Família/psicologia , Feminino , Humanos , Masculino , Guias de Prática Clínica como Assunto , Estudos Prospectivos , Qualidade de Vida , Suspensão de Tratamento
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