Training Cerebrovascular and Neuroendovascular Surgery Residents: A Systematic Literature Review and Recommendations.

Background: The rapid evolution of neuroendovascular intervention has resulted in the inclusion of endovascular techniques as a core competency in neurosurgical residency training. Methods: We conducted a literature review of studies involving the training of neurosurgical residents in cerebrovascular and endovascular neurosurgery. We reviewed the evolution of cerebrovascular neurosurgery and the effects of these changes on residency, and we propose interventions to supplement contemporary training. Results: A total of 48 studies were included for full review. Studies evaluated trainee education and competency (29.2%, 14/48), neuroendovascular training models (20.8%, 10/48), and open cerebrovascular training models (52.1%, 25/48), with some overlap. We used a qualitative analysis of reviewed reports to generate a series of suggested training supplements to optimize cerebrovascular education. Conclusion: Cerebrovascular neurosurgery is at a crossroads where trainees must develop disparate skill sets with inverse trends in volume. Continued longitudinal exposure to both endovascular and open cerebrovascular surgical fields should be mandated in general resident education, and blended learning tactics using adjunct simulation systems and models should be incorporated with didactics to both optimize learning and alleviate restraints placed by decreased volume and autonomy.

Palliative care in a Graduate Entry Medical Curriculum: exploring students' attitudes on the importance of receiving teaching in palliative care.

BACKGROUND: As people live longer with life-limiting illnesses, there is greater need for skills and knowledge in palliative care (PC). Medical students should acquire the knowledge, attitudes, and confidence during training for future decision-making. However, most graduates across Europe feel unprepared to provide PC. To develop PC training for medical students, we must gain perspective on their understanding of PC and their learning needs. OBJECTIVES: The aim was to investigate graduate entry medical students' views on the importance of education in PC and how well PC topics were covered within their curriculum. The objective was to highlight areas that could be reviewed for future PC curricula. METHODS: In this prospective quantitative study, penultimate and final-year students were recruited from a graduate entry medical school. Ethical approval was granted. Students completed an online questionnaire. RESULTS: From 281 recruited students, 82 responded. Ninety-five percent of respondents felt everyone should have a PC rotation. The aspects of education perceived to be most important were knowledge of symptom control, communication, ethical issues, self-care, and grief. The only aspect considered well covered within the curriculum was ethical issues. Ninety-six percent of penultimate and 75% of final years wanted more teaching in PC. CONCLUSION: Graduate entry medical students view PC as a vital subject within their medical school training. The study highlights challenges in providing education and sufficient placement in PC to correlate with the respondents' perceived needs. The findings contribute to the growing literature surrounding the importance of PC education within the medical school curriculum.

Pertinencia de la superación posgraduada en correspondencia con los problemas de salud en Villa Clara / Relevance of postgraduate improvement in correspondence with health problems in Villa Clara

Fundamento: en la Universidad de Ciencias Médicas de Villa Clara se ha diseñado e implementado una estrategia metodológica para lograr mayor relación de la superación profesional con el cuadro de salud. Objetivo: exponer los resultados de la superación profesional en correspondencia con los principales problemas de salud en Villa Clara. Métodos: se realizó un estudio descriptivo con diseño transversal de la superación profesional vinculada al posgrado en el periodo 2017-2021. Se aplicaron métodos teóricos, empíricos y matemático-estadísticos; la información obtenida se presentó en tablas con valores absolutos y relativos. Resultados: del total de actividades planificadas, el 83,01 % respondieron a los problemas de salud de la provincia. Relacionado con las enfermedades crónicas no transmisibles se efectuaron 542; tumores malignos, 179; Programa de Atención Materno Infantil, 1762; y Programa de Atención al Adulto Mayor, 198. Sobre otras enfermedades transmisibles, su mayor número estuvo en el 2019. En el 2020 predominaron las vinculadas a las arbovirosis y la pandemia de la COVID-19 cuando se capacitaron un total de 325 880 profesionales en el 2020 y 5839 en el 2021. Conclusiones: la superación posgraduada de los profesionales de la salud en Villa Clara se ha correspondido con los principales problemas de la salud del territorio en los años del 2017 al 2021 lo cual evidencia pertinencia y progreso en la continuidad de la formación académica del capital humano.

Background: at Villa Clara University of Medical Sciences, a methodological strategy has been designed and implemented to achieve a greater relationship between professional improvement and health status. Objective: to present the results of professional improvement in correspondence with the main health problems in Villa Clara. Methods: a descriptive study was carried out with a cross-sectional design of professional improvement linked to postgraduate studies from 2017 to 2021. Theoretical, empirical and mathematical-statistical methods were applied; the information obtained was presented in tables with absolute and relative values. Results: out of the whole activities, 83.01% responded to the health problems of the province. Related to chronic non-transmissible diseases, 542 were carried out; malignant tumors, 179; Maternal and Child Care Program, 1762; and the Elderly Care Program, 198. Regarding other transmissible diseases, the highest number was in 2019. In 2020, those linked to arboviruses and the COVID-19 pandemic predominated when a total of 325,880 professionals were trained in 2020 and 5839 in 2021. Conclusions: the postgraduate improvement of health professionals in Villa Clara has corresponded to the main health problems of the territory in the years from 2017 to 2021, which shows relevance and progress in the continuity of the academic training of human capital.

Material didáctico para el desarrollo de la competencia comunicativa audio-oral en la educación médica de posgrado

Fundamento: El conocimiento del inglés como el idioma empleado globalmente en diversos sectores, se ha convertido, junto a las tecnologías de la información y las comunicaciones, es una herramienta de formación, trabajo y entretenimiento indispensable; el dominio de este posibilita las relaciones de cooperación e intercambio de profesionales del sector de la salud en varios países. Objetivo: Diseñar un material didáctico para el desarrollo de la competencia comunicativa audio-oral en inglés en estudiantes de posgrado de la carrera de Medicina, mediante el empleo de tecnologías de la información y la comunicación. Metodología: Se realizó una investigación de desarrollo con enfoque mixto en la Universidad de Ciencias Médicas de Holguín durante el período marzo-julio de 2022. Se asumió el método dialéctico materialista como concepción general de la investigación y se emplearon otros del nivel teórico: histórico-lógico, análisis y síntesis e inducción deducción, sistémico-estructural-funcional y revisión documental; empíricos: encuesta, entrevista y observación participativa. Resultados: Las principales dificultades estuvieron relacionadas con el insuficiente tratamiento de la competencia comunicativa audio-oral en inglés, se constató la importancia de la misma dentro del proceso de enseñanza-aprendizaje del inglés, pues establece las pautas generales que se deben seguir para una comunicación efectiva y se instituye desde una mirada holística del acto comunicativo del profesional. Conclusiones: Los especialistas valoraron el material como adecuado por su estructura y factibilidad para su implementación. Después de su aplicación se evidenció su efectividad en la consolidación del aprendizaje en este nivel educacional a través de la preparación idiomática.

Background: Knowledge of English as the language used globally in various sectors, has increasingly become, together with information and communications technologies, an indispensable training, work and entertainment tool in the current era. Its domain enables cooperation relations and exchange of professionals in the health sector in various countries. Objective: To design a didactic material for the development of audio-oral communicative competence in English in postgraduate medical students, through the use of Information and Communication Technologies (ICT). Methods: A development research with a mixed approach was carried out at the Holguín University of Medical Sciences during the period March-July 2022. It was assumed the dialectical materialist method as the general conception of the research and others of the theoretical level: historical- logical, analysis and synthesis and induction deduction, systemic-structural-functional and documentary review; empirical: survey, interview and participatory observation. Results: The main difficulties were related to an insufficient treatment of audio-oral communicative competence in English, it was confirmed its importance within the teaching-learning process of English, since it establishes the general guidelines that must be followed for an effective communication. Moreover, it is instituted from a holistic view of the professional communicative act. Conclusions: The specialists assessed the material as adequate due to its structure and feasibility for its implementation. After its application, it was evidenced its effectiveness in consolidating learning in this educational level through language training.

'Low-value' clinical care in general practice: a cross-sectional analysis of low-value care in early-career GPs' practice.

Nonevidence-based and 'low-value' clinical care and medical services are 'questionable' clinical activities that are more likely to cause harm than good or whose benefit is disproportionately low compared with their cost. This study sought to establish general practitioner (GP), patient, practice, and in-consultation associations of an index of key nonevidence-based or low-value 'questionable' clinical practices. The study was nested in the Registrar Clinical Encounters in Training study-an ongoing (from 2010) cohort study in which Australian GP registrars (specialist GP trainees) record details of their in-consultation clinical and educational practice 6-monthly. The outcome factor in analyses, performed on Registrar Clinical Encounters in Training data from 2010 to 2020, was the score on the QUestionable In-Training Clinical Activities Index (QUIT-CAI), which incorporates recommendations of the Australian Choosing Wisely campaign. A cross-sectional analysis used negative binomial regression (with the model including an offset for the number of times the registrar was at risk of performing a questionable activity) to establish associations of QUIT-CAI scores. A total of 3206 individual registrars (response rate 89.9%) recorded 406 812 problems/diagnoses where they were at risk of performing a questionable activity. Of these problems/diagnoses, 15 560 (3.8%) involved questionable activities being performed. In multivariable analyses, higher QUIT-CAI scores (more questionable activities) were significantly associated with earlier registrar training terms: incidence rate ratios (IRRs) of 0.91 [95% confidence interval (CI) 0.87, 0.95] and 0.85 (95% CI 0.80, 0.90) for Term 2 and Term 3, respectively, compared to Term 1. Other significant associations of higher scores included the patient being new to the registrar (IRR 1.27; 95% CI 1.12, 1.45), the patient being of non-English-speaking background (IRR 1.24; 95% CI 1.04, 1.47), the practice being in a higher socioeconomic area decile (IRR 1.01; 95% CI 1.00, 1.02), small practice size (IRR 1.05; 95% CI 1.00, 1.10), shorter consultation duration (IRR 0.99 per minute; 95% CI 0.99, 1.00), and fewer problems addressed in the consultation (IRR 0.84; 95% CI 0.79, 0.89) for each additional problem]. Senior registrars' clinical practice entailed less 'questionable' clinical actions than junior registrars' practice. The association of lower QUIT-CAI scores with a measure of greater continuity of care (the patient not being new to the registrar) suggests that continuity should be supported and facilitated during GP training (and in established GPs' practice).

Training primary care staff in delivering the primary care consultation remotely: a systematic review.

BACKGROUND: Remote consultation is widely used in primary care, and its use has increased greatly since the onset of the COVID-19 pandemic. Despite this, primary care clinicians lack formal training in delivering remote consultation. There is a need to understand how training might best be delivered, and what evidence there is to support this. AIM: To summarise existing published literature about training primary care staff in conducting primary care consultation remotely, to outline which models of training may be effective, and to identify unanswered questions for future research. DESIGN & SETTING: Systematic review of English language studies in primary care included in Medline (Ovid), Cochrane Database, PubMed, Embase (Ovid), Web of Science, and CINAHL from 2010-2021; and in Google results from 2010-2022. METHOD: Databases were searched using a predefined search strategy. Title, abstract, and full-text screening was conducted to identify eligible studies for inclusion in the review. The quality of included studies was assessed, and findings were synthesised to answer the research questions. RESULTS: We included 10 studies. Seven examined training on remote consultation with trainee GPs or residents, and three examined training on remote consultation with qualified primary care clinicians. Training described led to positive change overall, including increased confidence and self-efficacy in delivering remote consultations. Furthermore, trainees reported increased use of remote consultation, increased efficiency, and increased engagement from patients. Studies where training involved workshops or didactic learning alongside experiential learning resulted in more positive feelings and more confidence about how technology could aid consultations. CONCLUSION: There is limited evidence on training primary care staff in conducting remote consultation. Available evidence indicates that training has a positive impact on the ability of clinicians and staff to deliver remote consultation.

The prevalence and associations of Australian early-career general practitioners' provision of after-hours care.

INTRODUCTION: Access to after-hours care (AHC) is an important aspect of general practice service provision. OBJECTIVE: To establish the prevalence and associations of early-career GPs' provision of AHC. DESIGN: An analysis of data from the New alumni Experiences of Training and independent Unsupervised Practice (NEXT-UP) cross-sectional questionnaire-based study. Participants were early-career GPs (6-month to 2-year post-Fellowship) following the completion of GP vocational training in NSW, the ACT, Victoria or Tasmania. The outcome factor was 'current provision of after-hours care'. Associations of the outcome were established using multivariable logistic regression. FINDINGS: Three hundred and fifty-four early-career GPs participated (response rate 28%). Of these, 322 had responses available for analysis of currently performing AHC. Of these observations, 128 (40%) reported current provision of AHC (55% of rural participants and 32% of urban participants). On multivariable analysis, participants who provided any AHC during training were more likely to be providing AHC (odds ratio (OR) 5.51, [95% confidence interval (CI) 2.80-10.80], p < 0.001). Current rural location and in-training rural experience were strongly associated with currently providing AHC in univariable but not multivariable analysis. DISCUSSION: Early-career GPs who provided AHC during training, compared with those who did not, were more than five times more likely to provide after-hours care in their first 2 years after gaining Fellowship, suggesting participation in AHC during training may have a role in preparing registrars to provide AHC as independent practitioners. CONCLUSION: These findings may inform future GP vocational training policy and practice concerning registrars' provision of AHC during training.

Cuidados paliativos: o ensino na graduação é suficiente para a atuação na atenção primária à saúde no Brasil / Palliative care: is undergraduate teaching sufficient for primary health care in Brazil? / Cuidados paliativos: ¿es suficiente la docencia de pregrado para la atención primaria de salud en Brasil?

Introdução: Espera-se que o aumento da carga de doenças crônicas e do envelhecimento populacional repercuta em crescente demanda por cuidados paliativos no país. Apesar disso, no Brasil ainda há um déficit no ensino da área, visto sobretudo na escassez de sua abordagem na graduação em Medicina, assim como em outras áreas da saúde. Esse cenário traduz-se em uma formação frágil dos profissionais da saúde, principalmente médicos, impactando o cuidado necessário a pacientes com condições clínicas potencialmente ameaçadoras da vida em todos os contextos, incluindo a atenção primária à saúde. Objetivos: Este estudo objetiva analisar o panorama de ensino de cuidados paliativos no Brasil e sua implicação na formação do médico generalista e na qualidade dos cuidados prestados na atenção primária à saúde. Também objetiva identificar competências necessárias para o ensino de cuidados paliativos na graduação de Medicina. Métodos: Trata-se de uma revisão integrativa da literatura nacional a respeito do ensino de cuidados paliativos nas escolas médicas do Brasil e suas implicações na adequação à prática na atenção primária à saúde. Resultados: Dos estudos analisados, todos ressaltam a importância da abordagem dos cuidados paliativos na formação de base profissional na graduação e revelam a existência de lacunas a serem supridas nessa área de ensino. Entre as lacunas foram identificadas baixa abordagem nas grades curriculares, metodologias de ensino não adequadas e pouca especialização dos docentes. Com base nisso, alguns estudos brasileiros construíram propostas curriculares baseadas em mapeamento de competências mínimas na tentativa de sanar essas lacunas, incluindo habilidades de comunicação e a atitude médica diante do processo de morte. Este artigo compila as principais competências para o ensino de cuidados paliativos na graduação encontradas para o contexto brasileiro. Conclusões: A fragilidade do ensino de cuidados paliativos na graduação médica resulta em médicos generalistas carentes de competências básicas para esse tipo de cuidado, o qual ocupa cada vez mais lugar de destaque no cotidiano da atenção primária à saúde. Essa fragilidade precisa ser urgentemente abordada a fim de se adequar às necessidades populacionais, particularmente no Sistema Único de Saúde (SUS), dado o quantitativo de médicos de família e comunidade aquém das necessidades da APS brasileira.

Introduction: It is expected that the increase in the burden of chronic diseases and population aging will result in a growing demand for palliative care in the country. Despite this, there is still a deficit in Brazil in the teaching of the area, seen above all in the scarcity of its approach in medical school, as well as in other areas of health. This scenario translates into a weak training of health professionals, especially physicians, impacting the necessary care of patients with potentially life-threatening clinical conditions in all contexts, including primary health care. Objectives: This study aimed to analyze the overview of palliative care teaching in Brazil and its implication in the training of general practitioners and in the quality of care provided in primary health care. It also aimed to identify the necessary skills for teaching palliative care in medical school. Methods: This is an integrative review of the national literature on the teaching of palliative care in medical schools in Brazil and its implications for adapting to practice in primary health care. Results: Of the analyzed studies, all of them emphasized the importance of approaching palliative care in professional basic training in medical school and reveal the existence of gaps to be filled in this teaching area. Among the gaps identified were low approach in curriculum grids, inappropriate teaching methodologies and little specialization of instructors. From this, some Brazilian studies built curricular proposals based on mapping minimum skills in an attempt to remedy these gaps, including communication skills and the medical attitude towards the death process. This article compiles the main skills for teaching palliative care in medical school found for the Brazilian context. Conclusions: The weakness of teaching palliative care in medical school results in general practitioners lacking basic skills for this type of care, which occupies an increasingly prominent place in everyday primary health care. This weakness needs to be urgently addressed to adapt to the population's needs, particularly in SUS, because of the number of family and community physicians falling short of the needs of primary health care in Brazil.

Introducción: Se espera que el aumento de la carga de enfermedades crónicas y el envejecimiento poblacional se traduzcan en una creciente demanda de cuidados paliativos en el país. A pesar de eso, en Brasil todavía hay un déficit en la enseñanza del área, visto sobre todo en la escasez de su abordaje en la graduación médica, así como en otras áreas de la salud. Este escenario se traduce en una frágil formación de los profesionales de la salud, especialmente de los médicos, impactando en la atención necesaria a los pacientes con condiciones clínicas potencialmente mortales en todos los contextos, incluida la atención primaria de salud. Objetivos: Este estudio tiene como objetivo analizar el panorama de la enseñanza de cuidados paliativos en Brasil y su implicación en la formación de médicos generales y en la calidad de la atención prestada en la atención primaria de salud. También tiene como objetivo identificar las habilidades necesarias para la enseñanza de los cuidados paliativos en la graduación médica. Métodos: Estudio basado en una revisión integradora de la literatura nacional sobre la enseñanza de cuidados paliativos en las facultades de medicina de Brasil y sus implicaciones para la adaptación a la práctica en la atención primaria de salud. Resultados: De los estudios analizados, todos destacan la importancia del abordaje de los cuidados paliativos en la formación profesional a nivel de pregrado y revelan la existencia de vacíos a ser llenados en esta área de enseñanza. Entre los vacíos se identificaron bajo enfoque en las mallas curriculares, metodologías de enseñanza inadecuadas y poca especialización de los docentes. A partir de eso, algunos estudios brasileños construyeron propuestas curriculares basadas en el mapeo de competencias mínimas en un intento de remediar estas brechas, incluyendo las habilidades de comunicación y la actitud médica frente al proceso de muerte. Este artículo recopila las principales competencias para la enseñanza de cuidados paliativos en la graduación encontradas para el contexto brasileño. Conclusiones: La fragilidad de la enseñanza de los cuidados paliativos en la carrera de medicina hace que los médicos generales carezcan de las competencias básicas para este tipo de atención, que ocupa un lugar cada vez más destacado en el cotidiano de la atención primaria de salud. Esa fragilidad necesita ser atendida con urgencia para adaptarse a las necesidades de la población, particularmente en el SUS, debido a la cantidad de médicos familiares y comunitarios que no alcanzan las necesidades de la APS brasileña.

Experiences of French medical students during their clerkship in adolescent psychiatry: a qualitative study.

The epidemiology of adolescent psychiatric disorders and the relational complexity of their management make exposure to adolescent psychiatry essential during medical school. However, some clinical particularities can complicate the students' learning experiences. Our work aimed to explore the experience of being a medical student during clerkships in adolescent psychiatry. Following the Interpretative Phenomenological Analysis qualitative approach, 20 semi-structured face-to-face interviews were conducted with medical students at the end of their clerkship in adolescent psychiatry. Three super-ordered themes emerged to describe their experience: in-depth self-exploration calling on emotions, thoughts and experiences; changes in the view of adolescent mental health; better understanding of the role and meaning of adolescent psychiatric care and how to approach it. Identification between students and patients could result from time-related factors (the end of adolescent brain remodeling, long, demanding studies, and financial and material dependence). In addition, the predominant use of non-analytical clinical reasoning processes-less valued in the rest of the graduate curriculum-poses a challenge for students. Indeed, for a student to find his or her place in adolescent psychiatry requires the student to reinvent him or herself, because the codes are different (no gown, less well-defined tasks, etc.). Finally, the excess prevalence of mental disorders among medical students requires increased vigilance on the part of tutors. For all these reasons, close, attentive tutoring seems essential to support students, while these clerkships afford a real opportunity for students to broaden their interpersonal skills.

Fundamentos que sustentan la estrategia de superación profesional para la atención médica integral al trabajador / Fundamentals that support the strategy of professional improvement for the comprehensive medical attention to workers

Fundamento: los resultados científicos son los aportes que constituyen productos de la actividad investigativa en la cual se han utilizado procedimientos y métodos científicos; que permiten dar solución a problemas de la práctica o de la teoría. Objetivo: expresar los fundamentos que sustentan de forma teórica y práctica la estrategia de superación profesional para la atención médica integral a la salud del trabajador, en los consultorios médicos de familia del municipio de Santa Clara. Métodos: se realizó un estudio con enfoque cualitativo a partir del diseño de una investigación, de tipo cuasiexperimento en el municipio de Santa Clara, provincia de Villa Clara, en el período comprendido enero-mayo 2019. La información se obtuvo mediante el uso de los siguientes métodos del nivel teórico: analítico-sintético, inductivo-deductivo, histórico-lógico y como empírico: guía para el análisis documental. Resultados: en la conformación de la estructura de la estrategia de superación profesional para la atención médica integral a la salud del trabajador se establecieron un grupo de fundamentos: filosóficos, sociológicos, psicológicos, pedagógicos y de las ciencias de la educación médica, los cuales les ofrecieron un carácter científico, coherencia y organización al producto diseñado. Conclusiones: los fundamentos que sustentan la mencionada estrategia como resultado científico se convirtieron en la base para su estructuración, y aportaron tanto en la teoría como en la práctica, un grupo de regularidades que enriquecen, de forma general, las ciencias de la educación médica.

Background: the scientific results are the contributions that constitute products of the researching activity in which scientific procedures and methods have been used; that allow to solve problems of practice or theory. Objective: to express the fundamentals that theoretically and practically support the professional improvement strategy for comprehensive medical care for worker's health, in family medical offices in the municipality of Santa Clara. Methods: a study with a qualitative approach was carried out based on the design of a quasi-experimental investigation in the municipality of Santa Clara, Villa Clara province, from January to May 2019. The information was obtained through the use of the following theoretical level methods: analytical-synthetic, inductive-deductive, historical-logical and empirical ones: guide for documentary analysis. Results: in the conformation of the structure of the strategy of professional improvement for the comprehensive medical attention to health workers, a group of foundations were established: philosophical, sociological, psychological, pedagogical and of the sciences of medical education, which they offered a scientific character, coherence and organization to the designed product. Conclusions: the foundations that support the aforementioned strategy as a scientific result became the basis for its structuring, and contributed, both in theory and in practice, a group of regularities that enrich, in a general way, the sciences of medical education.

Conocimientos de los residentes de Medicina General Integral sobre prevención y control de las arbovirosis / Comprehensive General Medicine residents: their knowledge about prevention and control of arboviruses

Fundamento: las arbovirosis son enfermedades víricas transmitidas por mosquitos, las que han propagado rápidamente en todas las regiones del mundo en los últimos años, con alta incidencia en la salud de las personas y en la economía de los países. Objetivo: identificar el nivel de conocimientos de los residentes de Medicina General Integral del municipio Abreus, sobre la prevención y control de las arbovirosis. Métodos: se realizó un estudio observacional, descriptivo, de corte transversal, en la Dirección Municipal de Salud Abreus, en octubre de 2021. Se utilizaron métodos teóricos y empíricos para fundamentar la investigación, y estadísticos para el análisis de los datos encontrados. Resultados: la mayoría de los residentes manifestaron que han tenido preparación sobre la prevención y control de las arbovirosis, fundamentalmente, durante la educación en el trabajo, todos han adquirido experiencia previa en la pesquisa activa, y algunos señalaron haber atendido a enfermos; sin embargo, la mayoría presentaron dificultades para identificar las formas clínicas y el cuadro clínico de las arbovirosis. Conclusiones: se identificó el nivel de conocimientos alcanzados por los residentes de Medicina General Integral del municipio Abreus, sobre la prevención y control de las arbovirosis, el diagnóstico realizado mostró la necesidad de asumir nuevas metodologías en la educación en el trabajo a fin de lograr correctos modos de actuación y actualización sobre su prevención y control.

Background: arboviruses are viral diseases transmitted by mosquitoes, which have spread rapidly in all regions of the world in recent years, with a high impact on people's health and the economies of countries. Objective: to identify the level of knowledge of Comprehensive General Medicine residents from the Abreus municipality, about the prevention and control of arboviruses. Methods: an observational, descriptive, cross-sectional study was carried out at the Abreus Municipal Health Directorate, in October 2021. Theoretical and empirical methods were used to support the research, and statistical methods were used to analyze the data found. Results: most residents stated that they have had training on the prevention and control of arboviruses, mainly, during on-the-job education, all have acquired previous experience in active search, and some of them indicated had taken care for sick people; however, most of them had difficulties in identifying the clinical forms and clinical profile of arboviruses. Conclusions: the level of knowledge achieved by Comprehensive General Medicine residents from Abreus municipality was identified, regarding the prevention and control of arboviruses, the diagnosis made by them showed the need to conceive new methodologies in education at work in order to achieve adequate modes of action and updating their knowledge about the prevention and control of it.

Integrating Problem-Based Learning Into an Internal Medicine Residency Curriculum.

Background: Problem-based learning (PBL) is a form of constructivist learning that allows learners to use higher order thinking by promoting learners to construct their own knowledge and understanding. PBL is prevalent in medical school education, but literature on PBL in graduate medical education (GME) is lacking. Because of the limited amount of data on PBL curricula in GME and the need for young physicians to develop critical thinking, lifelong self-directed learning, and problem-solving skills, we sought to incorporate PBL into the curriculum for our internal medicine residency program in a university-based community hospital setting. Methods: The PBL committee created 4 cases derived from actual patient encounters that address common chief complaints encountered in the hospital and served as a crash course curriculum for interns in internal medicine. The success of the PBL curriculum was measured using a 39-question survey created by PBL leadership to assess the learners' satisfaction with case content, likeability/design, feasibility, effectiveness, and motivation/self-learning. Additional questions asked for ways to improve PBL sessions in the future. Results: Overall, interns felt the content was clinically relevant, challenged them to think critically, and aided in the medical management of their patients. They also found PBL to be more effective and more enjoyable than the traditional lecture-style curriculum. Conclusion: Implementing a PBL curriculum in a residency program is possible. Although PBL has associated challenges such as scheduling, it is well received when supported by the program.

The Registrar Clinical Encounters in Training (ReCEnT) cohort study: updated protocol.

BACKGROUND: During vocational general practice training, the content of each trainee's (in Australia, registrars') in-consultation clinical experience is expected to entail a breadth of conditions that exemplify general practice, enabling registrars to gain competency in managing common clinical conditions and common clinical scenarios. Prior to the Registrar Clinical Encounters in Training (ReCEnT) project there was little research into the content of registrars' consultations despite its importance to quality of training. ReCEnT aims to document the consultation-based clinical and educational experiences of individual Australian registrars. METHODS: ReCEnT is an inception cohort study. It is comprised of closely interrelated research and educational components. Registrars are recruited by participating general practice regional training organisations. They provide demographic information about themselves, their skills, and their previous training. In each of three 6-month long general practice training terms they provide data about the practice where they work and collect data from 60 consecutive patient encounters using an online portal. Analysis of data uses standard techniques including linear and logistic regression modelling. The ReCEnT project has approval from the University of Newcastle Human Research Ethics Committee, Reference H-2009-0323. DISCUSSION: Strengths of the study are the granular detail of clinical practice relating to patient demographics, presenting problems/diagnoses, medication decisions, investigations requested, referrals made, procedures undertaken, follow-up arranged, learning goals generated, and in-consultation help sought; the linking of the above variables to the presenting problems/diagnoses to which they pertain; and a very high response rate. The study is limited by not having information regarding severity of illness, medical history of the patient, full medication regimens, or patient compliance to clinical decisions made at the consultation. Data is analysed using standard techniques to answer research questions that can be categorised as: mapping analyses of clinical exposure; exploratory analyses of associations of clinical exposure; mapping and exploratory analyses of educational actions; mapping and exploratory analyses of other outcomes; longitudinal 'within-registrar' analyses; longitudinal 'within-program' analyses; testing efficacy of educational interventions; and analyses of ReCEnT data together with data from other sources. The study enables identification of training needs and translation of subsequent evidence-based educational innovations into specialist training of general practitioners.

Efectividad de los Juegos educacionales en la formación del cirujano: una revisión de alcance

Introducción: La educación médica ha propiciado estrategias de enseñanza-aprendizaje que integran nuevas actividades pedagógicas y evaluativas acordes con el avance en el conocimiento. Los juegos educacionales (JE) surgen como una opción en pro del mejoramiento en los objetivos y resultados educacionales, con una utilidad potencial dentro del proceso formativo de los cirujanos. Hay investigaciones crecientes sobre el tema. Objetivo: evaluar de forma cualitativa el estado de la evidencia disponible sobre la efectividad de los JE como estrategia pedagógica en estudiantes de postgrado de cirugía general. Método: revisión de alcance de la literatura, según la metodología del Joanna Briggs Institute. Se evaluó el impacto educacional de los JE según la clasificación de Kirkpatrick. Resultados: la evidencia acerca de la utilidad los JE en la educación médica en cirugía es limitada. Existe una heterogeneidad de metodologías, procesos y resultados educativos producto de implementar JE como instrumento de evaluación o de instrucción. No obstante, es posible un impacto positivo de acuerdo con las investigaciones. No hay una evaluación de los alcances y el rol de los JE en la formación de los cirujanos. Conclusión: los JE se constituyen en una estrategia novedosa a considerar en la educación en cirugía general. Su implementación se condiciona a la construcción de una evidencia sólida, reproducible y basada en objetivos claros de enseñanza-aprendizaje. Sin embargo, la investigación en el tema es incipiente.

Summary Background: Medical education has fostered teaching-learning strategies that integrate new pedagogical and evaluative activities in accordance with the advancement in knowledge. Educational games (EG) emerge as an option for improving educational objectives and results, with potential utility within the training process of surgeons. There is growing research on the subject. Objective: To qualitatively evaluate the state of the available evidence on the efficacy of EG as a pedagogical strategy in general surgery postgraduate students. Method: Scoping review of the literature, according to the methodology of the Joanna Briggs Institute. The educational impact of the EG was evaluated according to the Kirkpatrick classification. Results: Evidence about the usefulness of EGs in medical education in surgery is limited. There is a heterogeneity of methodologies, processes and educational results resulting from implementing EG as an evaluation or instructional instrument. However, a positive impact is possible according to research. There is no evaluation of the scope and role of EBs in the training of surgeons. Conclusions: The EG constitute a novel strategy to consider in general surgery education. Its implementation is conditional on the construction of solid, reproducible evidence based on clear teaching-learning objectives. However, research on the subject is incipient.

Videoconferencias para residentes de Histología en la Universidad de Ciencias Médicas de Sancti Spíritus / Videoconferences to Histology residents at the Sancti Spíritus University of Medical Sciences

Fundamento: No se conoce cómo aceptan los residentes de Histología la inclusión de un sistema de videoconferencias sobre la estructura microscópica del cuerpo humano en su estrategia de autoaprendizaje. Objetivo: Explorar en profundidad la experiencia de los residentes de Histología de la Universidad de Ciencias Médicas de Sancti Spíritus que utilizaron un sistema de videoconferencias para su formación profesional. Metodología: Estudio cualitativo en el que se realizó una entrevista a profundidad con los especialistas y residentes de Histología que han utilizado el sistema de videoconferencias en la Universidad de Ciencias Médicas de Sancti Spíritus. Se transcribieron las entrevistas, se codificaron y se seleccionaron los principales temas abordados. Resultados: Se entrevistaron 5 usuarios del sistema de videoconferencias; de la entrevista surgieron 5 temas: 1) Como los residentes insertan las videoconferencias en su estrategia de autoaprendizaje, 2) Preferencia de las videoconferencias sobre los libros de texto, 3) Aciertos y desaciertos de las videoconferencias, 4) ¿Qué aportan las videoconferencias a la formación del residente, ventajas y desventajas? y 5) Sugerencias para mejorar las videoconferencias. Conclusiones: Un sistema de videoconferencias sobre la estructura microscópica del cuerpo humano puede ocupar un papel protagónico en la estrategia de aprendizaje de residentes de Histología. La preferencia que muestran los residentes por las videoconferencias sobre otros medios didácticos puede estar asociada a la capacidad de la multimedia para disminuir la carga cognitiva y facilitar el aprendizaje cuando se siguen los principios de Mayer al elaborar estos medios. La presencia de imágenes digitales en estas videoconferencias fue clave para su aceptación.

Background: It is not known how Histology residents accept the inclusion of a videoconferencing system on the microscopic structure of the human body in their self-learning strategy. Objective: To explore to depth the experience of Histology residents at the Sancti Spíritus University of Medical Sciences who used a videoconferencing system for their professional training. Methodology: Qualitative study with in-depth interview was conducted with Histology specialists and residents who have used the videoconferencing system at the Sancti Spíritus University of Medical Sciences. The interviews were transcribed, coded and the main topics addressed were selected. Results: 5 users of the videoconferencing system were interviewed; 5 themes emerged from the interview: 1) How residents insert videoconferences into their self-learning strategy, 2) Preference for videoconferences over textbooks, 3) Successes and failures of videoconferences, 4) What do videoconferences contribute to the training of the resident, advantages and disadvantages?, 5) Suggestions to improve videoconferences. Conclusions: A videoconferencing system on the microscopic structure of the human body can play a leading role in the learning strategy of Histology residents. The preference shown by residents for videoconferencing over other teaching media may be associated with the ability of multimedia to reduce cognitive load and facilitate learning when Mayer's principles are followed to developing these media. The presence of digital images in these videoconferences was essential to their acceptance.

Becas para la formación de médicos especialistas académicos del Hospital Clínico de la Universidad de Chile / Academic residents fellowship program at the University of Chile Clinical Hospital

The mission of the University of Chile Clinical Hospital is to be the main University Hospital in the country. Along with training of health professionals in clinical practice and research, the Hospital provides comprehensive health solutions to the community. Since its foundation, it played an important role in the training of health professionals and specialists. To fulfill this mission, it is important to have outstanding academics and a system that allows their renewal and replacement. From January 25, 2001, the University of Chile approved the regulations that rule the Residents Program Fellowship, aimed to train the new generations of clinical academics. These regulations allow the financing of training programs in basic or primary specialties (such as internal medicine, surgery, obstetrics and gynecology, among others) or in specialties derived from them (such as cardiology, gastroenterology and reproductive medicine, among others.) The different clinical departments and the Hospital Direction define each year how many places will be offered and in which specialties. The Faculty of Medicine Graduate School carries out the formal selection of the applicants. This article reviews the results of this program between 2013 and 2021, analyzing in detail the traceability of each graduate over the years.

Assessment of Postgraduate Online Medical Education During the COVID-19 Pandemic in Saudi Arabia: A Cross-Sectional Study.

Purpose: The COVID-19 pandemic has limited the traditional way of teaching due to contact restrictions and the trainees being the front-line providers of patient care in certain specialties. During the pandemic, many academic institutes have adopted various methods for utilizing online learning as an alternative to traditional teaching. Numerous studies reported the impact of these changes on medical education with varying results. As such, comprehensive assessments are necessary to evaluate the outcomes of this rapid transformation. The aim of this study was to provide qualitative and quantitative assessments of post-graduate online medical education during the COVID-19 pandemic in Saudi Arabia. Participants and Methods: In this cross-sectional study, an online questionnaire was distributed among postgraduate trainers and trainees in Riyadh second health cluster. The questionnaire was used to assess the experiences, perception, coping, satisfaction and preferences of medical trainers and trainees towards online education during the COVID-19 pandemic. Results: A total of 207 participants were involved in this study. While the sociodemographics differed between trainers and trainees, age was significantly associated with negative pre-pandemic online learning experiences. Stress was reported among both groups and was significantly correlated with the pre-pandemic computer and internet competency. Coping was reported to be easier by trainers compared to trainees. The overall perception of online learning was positive in 73% of the respondents. Perception significantly correlated with age, stress, coping and satisfaction (P < 0.0001). The majority of trainees were interested in a hybrid mode learning, combining traditional teaching with online education. Conclusion: There is a significant difference between trainers and trainees with regard to their experience of online education. Further studies are required to assess how to effectively implement online education in postgraduate training programs and identify strategies to overcome the reported deficiencies.