Conflictos éticos en los cuidados de Enfermería durante la pandemia por COVID-19 / Ethical conflicts in Nursing care during the COVID-19 pandemic

Objetivos: el objetivo principal fue identificar los conflictos éticos con los que se encontraron las/os enfermeras/os durante la pandemia por COVID-19 en España en el ámbito profesional.Método: se realizó un estudio cualitativo mediante etnografía para acercarse a la experiencia vivida por las/os enfermeras/os trabajando en España durante la primera ola de la pandemia COVID-19. Se empleó un muestreo intencional para seleccionar a 33 participantes, a quienes se contactó para llevar a cabo entrevistas no estructuradas por vía telemática. El análisis de los datos se efectuó mediante un enfoque temático que involucró la identificación de unidades de significado y la generación de códigos.Resultados: participaron 29 enfermeras/os, mayoritariamente mujeres trabajadoras en un hospital. Se identificaron tres conflictos éticos principales. El primero se relacionó con la “Priorización por edad: conflicto en el tratamiento equitativo”, que surgió debido a la limitación de recursos y la toma de decisiones difíciles. El segundo conflicto se denominó “Morir en soledad: conflicto con el trato humano del paciente”, ya que los familiares no podían acompañar a sus allegados al final de sus vidas por las restricciones de visita. El tercer conflicto fue “Cuidar con (in)seguridad: conflicto de poner al paciente, la enfermera y la familia en riesgo”, relacionado con la escasez de material de protección, lo que generó temor a posibles contagios tanto en el ámbito profesional como familiar.Conclusiones: la identificación de estos conflictos éticos subraya la necesidad de reorientar la ética del cuidado en salud para futuras pandemias por parte de los gestores de centros sanitarios. (AU)

Objective: the main objective was to identify the ethical conflicts faced by Nursing professionals during the COVID-19 pandemic in Spain in their professional setting.Method: a qualitative study was conducted through ethnography in order to approach the experience lived by Nursing professionals working in Spain during the first wave of the COVID-19 pandemic. Intentional sampling was used to select 33 participants, who were contacted to participate in non-structured online interviews. Data analysis was conducted with a thematic approach which involved the identification of units of meaning and the generation of codes.Results: the study included 29 Nursing professionals, mostly women, working at a hospital. Three main ethical conflicts were identified. The first was related to “Prioritization by age: conflict in equitable treatment”, which came up due to limited resources and difficult decision making. The second conflict was called “Dying alone: a conflict with the humane treatment of patients”, because relatives could not accompany patients at the end of their lives due to visiting restrictions. The third conflict was: “Care with (in)security: the conflict of putting patients, nurses and relatives at risk”, associated with the lack of protection materials, which generated fear of potential contagion both in the professional and the family setting.Conclusion: the identification of these ethical conflicts underlines the need to redirect the ethics of healthcare for future pandemics by health center managers. (AU)

Debriefing to improve interprofessional teamwork in the operating room: A systematic review.

PURPOSE: Debriefing has been pivotal in medical simulation training, but its application to the real-world operating room environment has been challenging. We reviewed the literature on routine surgical debriefing with special reference to its implementation, barriers, and effectiveness. DESIGN: Descriptive systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. METHODS: Inclusion criteria were papers pertaining to debriefing in routine surgical practice. Excluded were papers reporting simulation training. We searched Google Scholar, CINAHL, Web of Science Core Collection, PsychINFO, Medline, Embase, and ProQuest Theses & Dissertations Global. The last search was performed on March 14, 2022. Quality was assessed on a 21-point checklist adapted from a standard reporting guideline. Synthesis was descriptive. FINDINGS: The search process resulted in 19 papers. Publication dates ranged from 2007-2022. Study methods included surveys, interviews, and analysis of administrative data. Five papers involved a specific intervention. Quality scores ranged from 12-19 out of 21. On synthesis, we identified five topics: explanations of how debriefing had been implemented; the value of coaching and audit; the learning dimensions of debriefing, both team learning and quality improvement at the organizational level; the effect of debriefing on patient safety or the organization's culture; and barriers to debriefing. CONCLUSIONS: Successful implementation programs were characterized by strong commitment from management and support by frontline workers. Integration with administrative quality and safety processes, and information feedback to frontline workers are fundamental to successful debriefing programs. CLINICAL RELEVANCE: Debriefing can improve teamwork, learning, and psychological safety but is difficult to practice in the operating room environment. It is relevant to review the benefits and barriers to debriefing, and to learn from the experience of others, in order to run better debriefing models in our own hospitals.

Budgetary investment in evidence-based practice by chief nurses and stronger EBP cultures are associated with less turnover and better patient outcomes.

BACKGROUND: Hospitals and healthcare systems strive to meet benchmarks for the National Database of Nursing Quality Indicator (NDNQI) measures, Centers for Medicare & Medicaid Services (CMS) Core Measures, and Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) outcome indicators. Prior research indicates that Chief Nursing Officers and Executives (CNOs, CNEs) believe that evidence-based practice (EBP) is important for ensuring the quality of care, but they allocate little funding to its implementation and report it as a low priority in their healthcare system. It is not known how EBP budget investment by chief nurses affects NDNQI, CMS Core Measures, and HCAHPS indicators or key EBP attributes and nurse outcomes. AIMS: This study aimed to generate evidence on the relationships among the budget devoted to EBP by chief nurses and its impact on key patient and nurse outcomes along with EBP attributes. METHODS: A descriptive correlational design was used. An online survey was sent to CNO and CNE members (N = 5026) of various national and regional nurse leader professional organizations across the United States in two recruitment rounds. Data collected included CNO/CNE EBP Beliefs, EBP Implementation, and perceived organizational culture of EBP; organizational culture, structure, personnel, and resources for EBP; percent of budget dedicated to EBP; key performance measures (NDNQI, CMS Core Measures, HCAHPS); nurse satisfaction; nurse turnover; and demographic questions. Descriptive statistics were used to summarize sample characteristics. Kendall's Tau correlation coefficients were calculated among EBP budget, nursing outcome measures, and EBP measures. RESULTS: One hundred and fifteen CNEs/CNOs completed the survey (a 2.3% response rate). The majority (60.9%) allocated <5% of their budget to EBP, with a third investing none. An increase in EBP budget was associated with fewer patient falls and trauma, less nursing turnover, and stronger EBP culture and other positive EBP attributes. A greater number of EBP projects were also associated with better patient outcomes. LINKING EVIDENCE TO ACTION: Chief nurse executives and CNOs allocate very little of their budgets to EBP. When CNEs and CNOs invest more in EBP, patient, nursing, and EBP outcomes improve. System-wide implementation of EBP, which includes appropriate EBP budget allocation, is necessary for improvements in hospital quality indicators and nursing turnover.

Percepción de docentes sobre habilidades comunicativas de sus estudiantes para una adecuada relación médico-paciente / Perception of teachers about communication skills of their students for an adequate doctor-patient relationship

Fundamento: la existencia de insatisfacciones en la relación médico-paciente constituye una preocupación por la dirección del Estado y del sector de salud cubanos. Objetivo: valorar el desarrollo de las habilidades comunicativas de los educandos, según la percepción docente sobre el cumplimiento de las funciones de la comunicación para una adecuada relación médico-paciente. Métodos: se realizó una investigación cualitativa en la Facultad de Medicina de la Universidad de Ciencias Médicas de Villa Clara, Cuba, entre mayo-junio 2021. Se aplicaron métodos teóricos: análisis-síntesis, inducción-deducción e histórico-lógico; y empíricos: análisis documental y encuesta de opinión estructurada a los docentes sobre la base de las funciones comunicativas. Los resultados se expresaron en porcientos según los indicadores para la valoración, y se ilustraron en figuras. Resultados: la malla curricular de la carrera de Medicina ofrece posibilidades de desarrollo de habilidades comunicativas como basamento para una adecuada relación médico-paciente, constituyen fortalezas las asignaturas y disciplinas propias de la formación en pregrado y la educación en el trabajo. La función informativa de la comunicación resultó ser la más favorecida en los criterios expresados por lo docentes; obtuvieron más bajos porcientos la reguladora y la afectiva. Conclusiones: la percepción docente mostró insuficiencias en la relación médico-paciente en todas las funciones, por lo que se precisa elaborar estrategias para el desarrollo de las habilidades comunicativas, imprescindibles en la formación médica humanitaria que caracteriza la asistencia médica cubana.

Background: the existence of dissatisfies in the doctor-patient relationship constitutes a concern for the direction of the State and the Cuban health branch. Objective: to assess the development of students' communication skills, according to the teacher's perception of compliance with communication functions for an adequate doctor-patient relationship. Methods: a qualitative research was carried out at the Faculty of Medicine of Villa Clara University of Medical Sciences, Cuba, from May to June 2021. Theoretical methods were applied: analysis-synthesis, induction-deduction and historical-logical; and empirical ones: documentary analysis and structured opinion survey of teachers based on communicative functions. The results were expressed in percentages according to the indicators for the assessment and were illustrated in figures. Results: the curriculum of the Medicine career offers possibilities for the development of communication skills as a basis for an adequate doctor-patient relationship, the subjects and disciplines of undergraduate training and the in-service training are strengths. The informative function of communication turned out to be the most favored in the criteria expressed by the teachers; the regulatory and affective obtained lower percentages. Conclusions: the teacher's perception showed insufficiencies in the doctor-patient relationship in all functions, which is why it is necessary to develop strategies for the development of communication skills, essential in humanitarian medical training that characterizes Cuban medical assistance.

El trabajo educativo curricular desde el tema Medicamentos antiulcerosos en la asignatura Farmacología II / Curricular educational work on the topic of anti-ulcer medications in the subject Pharmacology II

El trabajo educativo consiste en transmitir un mensaje coherente desde la propia ciencia y estimula la motivación del aprendizaje de los estudiantes y su propia actividad cognoscitiva. El propósito de la educación médica superior es egresar un profesional integral; por tanto, se trata de instruir y educar a los estudiantes en los más altos valores patrióticos, morales y éticos en cada uno de los escenarios docentes, desde la propia ciencia. El objetivo de esta comunicación es ejemplificar algunos contenidos sobre la temática referente a medicamentos antiulcerosos en los que se puede intencionar el trabajo educativo desde la propia ciencia.

The educational work consists of transmitting a coherent educational message from science itself and stimulates the students' learning motivation and their own cognitive activity. The purpose of higher medical education is to graduate a comprehensive professional; therefore, it is about instructing and educating students in the highest patriotic, moral and ethical values in each of the teaching scenarios, from science itself. The objective of this research paper is to exemplify some content on the subject related to antiulcer drugs from which educational work can be intentioned from science itself.

Concepción de la labor educativa desde el consultorio médico en el enfrentamiento a la COVID-19 / Conception of educational work from the doctor´s office while facing COVID-19

Fundamento: es necesario profundizar en los contenidos, formas y métodos de la labor educativa desde el consultorio médico de familia con los estudiantes de las ciencias médicas. Objetivo: caracterizar la concepción de la labor educativa asumida desde el consultorio médico de familia en el enfrentamiento a la COVID-19. Métodos: se realizó una investigación acción participativa, de corte transversal, en el período de marzo de 2020 a septiembre del 2021. El trabajo de campo se hizo con estudiantes de las carreras de Medicina, Enfermería y Estomatología, vinculados a los consultorios 17-17 y 17-37 pertenecientes al policlínico universitario "Chiqui Gómez-Lubián. Los métodos teóricos empleados fueron: analítico-sintético, inductivo-deductivo, histórico-lógico y enfoque de sistema; empíricos: análisis de documentos, observación de tipo participante, entrevista en profundidad y semiestructurada y análisis del producto de la actividad. Resultados: la concepción de la labor educativa empleada facilitó el trabajo de enfrentamiento a la pandemia de la COVID-19 desde el consultorio médico, la formación integral de los estudiantes y contribuyó al trabajo comunitario integrado. Conclusiones: el enfrentamiento a la COVID-19 permitió desplegar un sistema de acciones en la formación de los estudiantes que permitieron conformar una concepción acerca de la labor educativa desde el consultorio médico de familia.

Background: it is necessary to deepen the contents, forms and methods of the educational work from the family doctor's office with the students of medical sciences. Objective: to characterize the conception of the educational work assumed from the family doctor's office while facing COVID-19. Methods: a participatory, cross-sectional action research was carried out from March 2020 to September 2021. The field work was carried out with students from the Medicine, Nursing and Dentistry degrees, linked to clinics 17-17 and 17-37 belonging to the "Chiqui Gómez-Lubián" university polyclinic. Theoretical methods used were: analytical-synthetic, inductive-deductive, historical-logical and system approach; Empirical ones: document analysis, participatory observation and semi-structured interview and analysis of the product of the activity. Results: the conception of the educational work used facilitated the work to face COVID-19 pandemic from the doctor's office, the comprehensive training of students and contributed to integrated community work. Conclusions: the confrontation with COVID-19 allowed us to deploy a system of actions in the training of students that allowed us to form a conception about the educational work from the family doctor's office.

La formación ética universitaria cubana como herramienta para la prevención social / Cuban university ethics training as a tool for social prevention

Introducción: es vital promover una concepción y estrategias de prevención social en las universidades cubanas adecuadas a problemáticas y contradicciones sociales que vivencian sus actores como sujetos socioéticos en diversos ámbitos de vida para erigirse en agentes de cambio desde una praxis humanista y emancipadora acordes al proyecto social cubano. Objetivo: analizar crítica y propositivamente, desde una perspectiva sociológica, el papel de la prevención social como herramienta de formación ético-profesional en las universidades cubanas. Métodos: revisión bibliográfica sistemática para la reflexión crítica de documentos, (trabajos de diplomas, tesis de maestría y doctorado 2008-2021), artículos originales y de revisión (2010-2021) localizados en SciELO, Google académico y en la biblioteca digital del Centro de Estudios Comunitarios (UCLV). Se centró en enfoques y discursos producidos desde las ciencias y la política sociales sobre la problemática. Desarrollo: la universidad cubana debe promover el protagonismo personal y social en la solución de los problemas de la vida cotidiana (resultado o manifestación de las contradicciones en la sociedad) en el ejercicio de los diferentes roles sociales y que desde una posición ético-crítica actúe en la prevención social. Conclusiones: el conocimiento sociológico es herramienta de autorreflexión y reflexión institucional para propiciar alternativas a las prácticas preventivas tradicionales formalizadas articulando críticamente con la formación ética. La prevención es proceso educativo y de intervención social con la finalidad de la transformación de comportamientos y actitudes de vulnerabilidad de profesionales en formación, desligada del formalismo y la burocratización.

Introduction: it is vital to promote a conception and strategies of social prevention in Cuban universities appropriate to social problems and contradictions that their actors experience as socioethical subjects in various spheres of life to establish themselves as agents of change from a humanist and emancipatory praxis in accordance with the social project Cuban. Objective: to analyze critically and purposefully, from a sociological perspective, the role of social prevention as a tool for ethical-professional training in Cuban universities. Methods: systematic bibliographic review for critical reflection of documents, (diploma works, master's theses and doctorate 2008-2021), original and review articles (2010-2021) located in SciELO, Google academic and in the digital library of the Center of Community Studies (UCLV). It focused on approaches and discourses produced from the social sciences and politics on the problem. Development: the Cuban university must promote personal and social leadership in solving the problems of daily life (result or manifestation of the contradictions in society) in the exercise of different social roles and that from an ethical-critical position it acts in social prevention. Conclusions: sociological knowledge is a tool for self-reflection and institutional reflection to promote alternatives to traditional formalized preventive practices, critically articulating with ethical training. Prevention is an educational process and social intervention with the purpose of transforming behaviors and attitudes of vulnerability of professionals in training, detached from formalism and bureaucratization.

Validez de la unidad nacional en el pensamiento de Fidel Castro para enfrentar la COVID-19 / Validity of national unity in the thought of Fidel Castro to face COVID-19

En el ideario de Fidel Castro se aprecian sus consideraciones acerca de la necesidad de la unidad para vencer cualquier obstáculo que pretenda detener el curso de la Revolución cubana, en lo fundamental dirigidas hacia las maniobras desestabilizadoras de los enemigos de la patria; sin embargo, esa convicción fidelista de que la unidad garantiza el triunfo está presente en la batalla que se ha librado, y aún se libra, contra la COVID-19, donde el pueblo, organizado en diversos sectores, continúa obteniendo resultados positivos en contra de esta pandemia. Es objetivo de estos autores compartir algunas de sus ideas que servirán de análisis e inspiración para su aplicación en el actual contexto epidemiológico.

In Fidel Castro's ideology, his considerations about the need for unity to overcome any obstacle that tries to stop the course of the Cuban Revolution are appreciated, fundamentally directed towards the destabilizing maneuvers of the enemies of the homeland; however, this Fidel´s conviction that unity guarantees victory is present in the battle that has been waged, and is still being waged, against COVID-19, where the people, organized in various sectors, continue to obtain positive results against this pandemic. It is the objective of these authors to share some of their ideas that will serve as analysis and inspiration for their application in the current epidemiological context.

Conflicts and Challenges of Truth-Telling in Dentistry: A Case-Based Ethical Analysis.

Objectives : The basis of truth-telling is respecting the autonomy of patients and developing an ability to make informed decisions with valid consent. The purpose of this study was to ethically analyze the conflicts about truth-telling in dentistry. Materials and Methods: This case analysis focused on the issues of truth-telling in medicine and dentistry. The challenges encountered by dentists with respect to ethical issues related to truth-telling were discussed and analyzed by the research team. Results: The literature review showed that the issue of truth-telling in dentistry has been addressed from three aspects: Truth-telling about other dentists' medical errors, truth-telling about dangerous, refractory, or incurable diseases, and truth-telling to children or incompetent individuals for decision-making. Conclusion: When the duty of the dentist in truth-telling is conflicted with some other moral obligations, the conflict between the prima facie duties arises. The principle-based ethical theories provide a suitable conceptual framework for moral judgement in such conflicts. In cases of conflicts related to truth-telling, a balance should be maintained between principles and rules such as fidelity, respect for autonomy, maintaining trust in dentist-patient relation, and best interest of patients. The decision in truth-telling should be made individually for each patient based on the specific contextual conditions.

Perspectiva del cuidado en la ciberpsicología: reflexiones éticas / Care Approach to Cyberpsychology: Ethical Considerations / Perspectiva do cuidado em ciberpsicologia: reflexões éticas

Introducción. El despliegue de nuevas tecnologías de la información y la comunicación lleva a plantear la ciberpsicología como la integración de los medios digitales a la vida y las relaciones humanas, así como la inmersión tecnológica en la práctica profesional; esto implica retos en la comprensión de los cambios que ha producido la tecnología en el desarrollo individual y social. El objetivo del presente artículo fue plantear una reflexión sobre los aspectos éticos en la ciberpsicología y las implicaciones prácticas, a la luz de una perspectiva del cuidado que integra el principio del bienestar en un entorno virtual. Temas de reflexión. En primer lugar, se analizan las principales normativas en el marco de los principios éticos y bioéticos, con énfasis en el contexto colombiano. En segundo lugar, se reflexiona sobre la perspectiva del cuidado y algunas consideraciones en los medios digitales. Finalmente, se revisan algunas implicaciones prácticas de la ciberpsicología. Conclusiones. La perspectiva del cuidado y su aplicación en la ciberpsicología es uno de los anclajes éticos orientados a la promoción de relaciones basadas en el bienestar. Las discusiones éticas desde la perspectiva del cuidado en medios digitales integra la competencia técnico-profesional a la competencia ética. Esto implica un constante análisis de la apropiación de las tecnologías como espacio de encuentro y también como parte del compromiso con el cuidado propio y de los usuarios

Introduction. The spread of new information and communication technologies results in cyberpsychology being proposed as the integration of new digital media into human relationships and life, also, as technological immersion in professional practices. This implies challenges in understanding the changes that technology has produced in individual and social development. The objective of this article was to propose a reflection on the ethical aspects of cyberpsychology and its practical implications, according to a care approach which integrates the wellbeing principle in a virtual environment. Topics of reflection. Firstly, the main regulations for cyberpsychology are analyzed in the framework of the ethical and bioethical principles, with emphasis on the Colombian context. Secondly, we reflect on the care approach and some considerations for digital media. Finally, some practical implications of cyberpsychology are reviewed. Conclusions. The care approach and its application to cyberpsychology is one of the ethical anchors aimed at the promotion of wellbeing-based relationships. Ethical discussions from the care approach to digital media integrate technical-professional competency with ethical competency. This implies a constant analysis of the appropriation of technologies as a meeting space and as part of the commitment to self and user care.

Introdução. A implantação de novas tecnologias de informação e comunicação leva a postular a ciberpsicologia como a integração das mídias digitais na vida e nas relações humanas, bem como a imersão tecnológica na prática profissional. Isso implica desafios na compreensão das mudanças que a tecnología tem produzido no desenvolvimento individual e social. O objetivo deste artigo foi propor uma reflexão sobre os aspectos éticos na ciberpsicologia e as implicações práticas, à luz de uma perspectiva assistencial que integre o princípio do bem-estar no ambiente virtual. Tópicos de reflexão. Em primeiro lugar, analisamse as principais regulamentações no marco dos princípios éticos e bioéticos, com ênfase no contexto colombiano. Em segundo lugar, reflete-se sobre a perspectiva do cuidado e algumas considerações nos meios digitais. Finalmente, são revisadas algumas implicações práticas da ciberpsicologia. Conclusões. A perspectiva do cuidado e sua aplicação na ciberpsicologia é uma das âncoras éticas voltadas à promoção de relações baseadas no bem-estar. As discussões éticas na perspectiva do cuidado em mídia digital integram competência técnico-profissional com a competência ética. Isso implica uma análise constante da apropriação das tecnologias como espaço de encontro, assim como parte do compromisso com o autocuidado e dos usuários

Contingency Analysis of Ethics Training in Psychology Programs in Colombia / Análisis contingencial de la formación ética en programas de psicología en Colombia / Análise de contingência da formação ética em programas de psicologia na Colômbia

Introduction. The topic of ethics training in psychology has been constant in Colombia, especially since the Colombian Association of Psychology Faculties was created. However, reports of deficiencies in ethics training and research reviews, centered on identifying the ethical knowledge of students and professional actions in psychology, justify more complex studies. In this framework, relationships between contextual factors, which are necessary to understand the dynamics of psychological education, and factors related to ethically practicing the profession, must be included in the analysis. The objective of the study was, therefore, to demonstrate interdependent relations between the different actors that participate in ethics training, the interlocking of individual reinforcement contingencies and cultural consequences through a contingency analysis of psychology program curricula in Colombia. Methodology. A qualitative documentary análisis study with the methodology proposed by Todorov in terms of contingency analyses. Results. Interlocking practices were demonstrated in terms of metacontingencies in educational institutions, more focused on professional development than on ethics training. On an inter-institutional level, practices do not demonstrate a metacontingency in the strict sense, which was analyzed in light of the university autonomy and academic freedom policy. Malpractice can be considered a macrocontingency from the point of view of normalizing practices without an ethical reflection. Discussion. Psychological education is understood as a cultural practice that depends on relatively effectively interlocking contingencies, which prepares professionals who can adjust to the needs of society. This posture is coherent with the authors' proposals. Conclusions. It is necessary to effectively integrate training in disciplinary skills with ethics, in order to attain a cultural practice in the terms of the analyzed metacontingency.

Introducción. El tema de la formación ética en psicología ha sido una constante en Colombia, especialmente desde la constitución de la Asociación Colombiana de Facultades de Psicología. Sin embargo, los reportes de deficiencias en la formación ética y la revisión de investigaciones, centradas en identificar el conocimiento ético de los estudiantes y el actuar profesional en psicología, justifican un estudio más complejo. En este marco, las relaciones entre los factores contextuales, que son necesarios para comprender las dinámicas en la formación psicológica, y los factores relacionados con el ejercicio ético de la profesión deben incluirse en el análisis. El objetivo del estudio fue, entonces, evidenciar, a través de un análisis contingencial de los planes de estudio de los programas de psicología en Colombia, las relaciones de interdependencia entre los diferentes actores que intervienen en la formación ética, el entrelazamiento de las contingencias de refuerzo individual y las consecuencias culturales. Metodología. Estudio cualitativo de análisis documental con la metodología propuesta por Todorov en cuanto al análisis contingencial. Resultados. Se muestran prácticas entrelazadas en términos de metacontingencias en las instituciones formativas, más enfocadas al desarrollo profesional que a la formación ética. A nivel interinstitucional, las prácticas no evidencian una metacontingencia en sentido estricto, lo cual se analiza a la luz de la política de autonomía universitaria y de libertad de cátedra. La mala praxis puede considerarse como una macrocontingencia, desde el punto de vista de la normalización de prácticas sin una reflexión ética. Discusión. La formación en psicología se comprende como una práctica cultural, en función de contingencias entrelazadas de forma relativamente efectiva, que forma profesionales que se ajustan a las necesidades de la sociedad, postura que es coherente con lo propuesto por otros autores. Conclusiones. Es necesaria una integración efectiva del entrenamiento en competencias disciplinares con el de competencias éticas, con el fin de lograr una práctica cultural en los términos metacontingenciales analizados.

Introdução. A questão da formação ética em psicologia tem sido uma constante na Colômbia, especialmente desde a constituição da Associação Colombiana de Faculdades de Psicologia. No entanto, os relatos de deficiências na formação ética e a revisão de pesquisas, voltadas para identificar o conhecimento ético dos alunos e o comportamento profissional em psicologia, justificam um estudo mais complexo. Nesse quadro, as relações entre os fatores contextuais, necessários para compreender a dinâmica da formação psicológica, e os fatores relacionados ao exercício ético da profissão devem ser incluídos na análise. O objetivo do estudo foi, portanto, mostrar, através de uma análise contingencial dos planos de estudo dos programas de psicologia na Colômbia, as relações de interdependência entre os diferentes atores envolvidos na formação ética, o entrelaçamento das contingências de reforço individual e consequências culturais. Metodologia. Estudo qualitativo de análise documental com a metodologia proposta por Todorov em termos de análise de contingência. Resultados. Práticas entrelaçadas se mostram em termos de meta-contingências nas instituições formadoras, mais voltadas para o desenvolvimento profissional do que para a formação ética. No plano interinstitucional, as práticas não apresentam uma meta-contingência em sentido estrito, o que é analisado à luz da política de autonomia universitária e liberdade acadêmica. A práxis errada pode ser considerada uma macro-contingência, do ponto de vista da normalização de práticas sem reflexão ética. Discussão. A formação em psicologia é entendida como uma prática cultural, baseada em contingencias relativamente efetivamente entrelaçadas, que forma profissionais que se ajustam às necessidades da sociedade, posição condizente com a proposta por outros autores. Conclusões. É necessária uma integração efetiva da formação em competências disciplinares com a de competências éticas, a fim de alcançar uma prática cultural nos termos meta-contingenciais analisados.

Adherence by orthopaedic surgeons to AHPRA and Australian Orthopaedic Association advertising guidelines.

OBJECTIVES: To examine adherence to Australian Health Practitioner Regulation Agency (AHPRA) and Australian Orthopaedic Association (AOA) advertising guidelines by AOA members. DESIGN, SETTING: Cross-sectional survey, Australia. PARTICIPANTS: Two samples of AOA member orthopaedic surgeons: 81 randomly selected from a list of AOA members with publicly available contact details (AOA random sample); and a sample obtained by searching with Google for "orthopaedic surgeon" and the name of the major city in each of the eight Australian states and territories in turn; the top eight results for each search were considered for inclusion (AOA Google sample). MAIN OUTCOME MEASURES: Non-compliance of advertising material, by surgeon sample, with the AHPRA and AOA guidelines; associations between non-compliance and sample, state, location (metropolitan, regional), and subspecialty. RESULTS: Of the 81 surgeons in the AOA random sample, 52 (64%) were non-compliant with at least one aspect of the AHPRA guidelines, and 53 (65%) were non-compliant with at least one aspect of the AOA guidelines. Of the 59 surgeons in the AOA Google sample, 48 were non-compliant with the AHPRA guidelines (81%) and 46 with the AOA guidelines (78%). Incidence of non-compliance with the AHPRA guidelines was influenced by sample source (AOA Google v AOA random: incidence rate ratio [IRR], 1.37; 95% CI, 1.01-1.87), but not non-compliance with the AOA guidelines (IRR, 1.09; 95% CI, 0.77-1.55). CONCLUSION: A large proportion of AOA members who advertise online do not comply with AHPRA and AOA advertising guidelines.

The combined effect of psychological and social capital in registered nurses experiencing second victimization: A structural equation model.

PURPOSE: This study examined the combined role psychological capital and social capital play in the severity of second victim syndrome experienced by registered nurses. DESIGN: This research study was an ex post facto, cross-sectional, non-experimental survey design. Data were collected from October to December 2018. The study sample was composed of 1167 nurses recruited through 12 professional nursing associations in the United States. METHODS: Self-report questionnaires were administered to measure psychological capital (Psychological Capital Questionnaire), social capital (Social Capital Outcomes for Nurses) and second victim syndrome (Second Victim Experience and Support Tool). Data cleaning and analysis of 1167 cases were conducted via SPSS v25 and structural equation modeling of 999 cases was conducted with AMOS v25. FINDINGS: The SEM analysis demonstrated that psychological capital, on its own, had no effect on the severity of the second victim experience. Social capital, on its own, had a statistically significant relationship with second victim severity. The combined impact of social capital and psychological capital had a statistically significant effect on second victim severity. CONCLUSIONS: The results of this study have practical implications that include unit-based peer support programs and an increased focus on supportive workplace cultures. Programmatic efforts should also focus on social capital at the team level as well as the importance of building self-efficacy through increasing mastery experiences, modeling of behavior, social persuasion and monitoring one's physiological responses. CLINICAL RELEVANCE: These findings demonstrate the importance of social capital to mitigation of second victim experiences, while also demonstrating that psychological capital has no effect on second victim severity. Building social capital and collective efficacy are critical to mitigation of second victim syndrome.