Two sides of the same coin: educational and professional pathway for surgical residents.

AIM: To provide a review of medical malpractice cases ruled by the Italian Supreme Court with the aims at identifying lawsuits targeting involved with surgical residents. MATERIAL AND METHODS: Legal cases ruled by the Italian Supreme Court, from September 2020 to October 2020, pertaining to medical claims involving surgical residents were examined, using the main online databases. RESULTS: Of a total of eleven (n=11; 100%) cases identified, four (n= 4; 36,4%) cases addressed the standard of care pertaining to the surgical residents' medical activity. The legal reasoning of the Italian Supreme Court does not focus on the manual skill in the resident's medical performance, but rather on the choice to accept to treat the patient, regardless of the participation of the tutor. CONCLUSIONS: The performance of the surgical residents is made more difficult due to their peculiar nature, characterized by the complex interactions between the directives given by the tutor and the need to guarantee patients' needs. KEY WORDS: Surgical Residents, Tutor, Educational Pathway, Medical Malpractice, Standard of Care.

Exploring narratives and advocating support and peer mentorship to improve HIV-positive adolescent mothers' lives in South Africa.

Research on adolescent sexuality, health and parenting has gained much attention in recent years. This growing body of research, however, has arguably limited qualitative outputs on HIV-positive adolescent mothers' sexual and reproductive health choices, needs, and rights in South Africa that could lead to informed policymaking. Through in-depth interviews conducted with a select group of ten HIV-positive adolescents and three key informants, the article explores the sexual, motherhood, risk discourses and reproductive health issues and rights of HIV-positive adolescent mothers as they come to terms with choices they have made and the challenges ahead. The findings highlight the dominant narratives on what are deemed to be the forces that shape these adolescent mothers' new social realities. With existing policies in place for adolescents, it is argued that a "one-size-fits-all" policy approach does not work, especially for HIV-positive adolescent mothers. Drawing on this identified gap and the tensions between individual needs, and the public welfare provision, the article highlights the need for tailored policy that will accommodate and promote the overall well-being of HIV-positive adolescent mothers and their children.

Conclusiones del I Foro Nacional de jefes de Estudio, técnicos docentes y responsables autonómicos de Formación Sanitaria Especializada y del II Congreso Nacional de Formación Sanitaria Especializada (XIV Encuentro Nacional de tutores y jefes de Estudio). SEFSE-AREDA 2017, Madrid 28-29 de septiembre / Conclusions of I National Forum of heads, technicians and regional responsibles of Specialized Training and of the 2th National Congress of the Spanish Society for Postgraduate Medical Education (14th National Meeting of Heads and Tutors of Specialized Training). SEFSE-AREDA 2017, Madrid, September 28-29

Una buena gestión y calidad de la Formación Sanitaria Especializada (FSE) exige el compromiso explícito de los responsables de las CCAA y de los centros sanitarios. Esto implica la acreditación y reconocimiento de tutores, desarrollar el marco normativo que establece el RD 183/2008 (a los nueve años de su publicación sólo Cataluña, Canarias, Castilla y León, Extremadura, La Rioja y el País Vasco, lo han hecho), una mención explícita de la FSE en los planes estratégicos de las organizaciones sanitarias y en los contratos-programa con las unidades docentes y una participación activa de los jefes de estudio en los consejos de dirección de los centros. Por parte del Ministerio de Sanidad, es preciso agilizar la acreditación de las nuevas unidades docentes y abordar, junto con las CCAA, los problemas de financiación del proyecto de troncalidad y la organización de las unidades docentes troncales. Respecto al sentido de la formación, esta se ha de centrar en la seguridad del paciente, aquí la simulación es una metodología formativa idónea, y en la humanización, con una práctica de la medicina bajo un modelo deliberativo, siendo los formadores ejemplo para los que aprenden

The commitment of the heads of the Autonomous Communities and the health centers is key to a good management and the quality of the Specialized Healthcare Training (SHT). This implies the accreditation and recognition of tutors, developing the regulatory framework established by Royal Decree 183/2008 (nine years after its publication, only Catalonia, the Canary Islands, Castilla y León, Extremadura, La Rioja and the Basque Country have done so), an explicit mention of the SHT in the strategic plans of the health organizations and an active participation of the heads of SHT in the boards of directors. On the part of the Ministry of Health, it is necessary to speed up the accreditation process of new teaching units and, together with the Autonomous Communities, and address the financing problems of the core curriculum project and the organization of the core teaching units. Regarding the sense of training, this has to focus on safety patient, here the simulation is a suitable training methodology, and in the humanization, with a practice of medicine under a deliberative model, being the trainers an example for those who learn

An international survey of medical licensing requirements for immigrating physicians, focusing on communication evaluation.

OBJECTIVE: To identify current entry requirements set by international medical licensing bodies for immigrating physicians, focusing on postgraduate level communication skills, clinical and technical skill assessments. METHODS: A standardised, author developed survey was administered to a selection of national, state and provincial licensing institutions across 6 continents. Representative institutions were selected from the most populated regions of each continent. Surveys were administered by email and telephone. The information was also searched by website review. Website information alone was used if no response was received by the targeted institution after 2 phone/2 email attempts. Statistical analysis of the non-parametric data was conducted using SPSS (v.21). RESULTS: Thirty-seven licensing bodies were contacted from 30 countries; verifiable information was available for 29; twenty-six responded to the communication inquiry. Sixty five 65.4% (n=17) surveyed communication skills, 100% involved language proficiency testing; 11.5% tested other forms of communication skills. For clinical and technical skills, 86.2% (n=25) assessed candidates by credential review, 72.4% (n=21) required both credential review and exam and 62.1% (n=18) used country-specific examination. A mentorship period were required by 37.9% (n=11), ranging from 3 months to 1 year. Only 2 countries identified examinations for recertification. No technical/clinical skills nor communication skill evaluation (beyond language proficiency) are routinely assessed at the postgraduate level. CONCLUSIONS: International assessments of migrating physicians are heterogeneous. Communication skills, beyond language proficiency, are not routinely assessed in foreign trained physicians seeking entry. The majority of clinical and technical skills are assessed by credential review only. This study highlights the lack of standardisation of assessment internationally and the need for steps toward a global agreement on training schemes and summative assessment.

Clinical supervision: the state of the art.

Since the recognition of clinical supervision as a distinct professional competence and a core competence, attention has turned to ensuring supervisor competence and effective supervision practice. In this article, we highlight recent developments and the state of the art in supervision, with particular emphasis on the competency-based approach. We present effective clinical supervision strategies, providing an integrated snapshot of the current status. We close with consideration of current training practices in supervision and challenges.

Experiences in reconciling risk management and restorative justice: how circles of support and accountability work restoratively in the risk society.

Circles of Support and Accountability (COSA) is a restorative justice-based model that originated in Canada in the mid-1990s for the postincarceration reintegration of those who have offended sexually. Although the roots of COSA are in restorative justice philosophy, the program has also found favour, to some degree, with organisations such as police services and corrections that are traditionally concerned more with protecting community safety than with the ideals of restorative justice. Informed by the author's research and personal experience as a COSA volunteer, and analysis of recent and historical representations of COSA, this article explores theoretically how the development of the COSA initiative has been influenced by the seemingly disparate concerns of both the restorative justice and community protection movements, and examines the importance of balancing these paradigms in the everyday practices of circles.

Parent representation model in child safety conferences.

Child welfare-involved parents are often isolated and lack support and skills to navigate complex systems. Programs using a parent representation service model in child protection can offer an exceptional and critical form of support and empowerment to birthparents, promote parental engagement and cooperation, and teach system navigation skills. While there is a notable emphasis on an overall family-centered and strength-based approach in child welfare, much progress is still needed in giving voice to parents, empowering them, including them in decisionmaking about the case, and seeking their cooperation. Funding should be directed to recruiting more parent representatives to assist birthparents in their communities as well to educating and training child protective services workers by transferring values and strategies implemented by parent representatives. Although additional research is certainly necessary, it appears that programs such as the Child Welfare Organizing Project in New York City may be an important step toward building partnerships with families impacted by the child welfare system in promoting child safety, well-being, and permanency.

Supporting students with disabilities--promoting understanding amongst mentors in practice.

INTRODUCTION: Good practice demands a clinical practice culture positively disposed to students with disabilities. Equality legislation seeks to protect those with a disability from either direct or indirect discrimination. The balance between providing "reasonable adjustments" for the student, whilst ensuring "Fitness to Practice", and ultimate employability, requires a close partnership between higher education and practice mentors. METHODS: This paper reports on the development and evaluation of a range of interactive resources, used in the preparation of mentors to help them address the specific learning needs of disabled students. RESULTS: The evaluation revealed the benefit of student 'stories' in helping mentors to understand the support needs of disabled students and ensure reasonable adjustments are implemented in compliance with disability legislation. The interactive resources have been helpful in promoting positive action towards disabled students' learning, empathic understanding of mental health issues and knowledge and skills acquisition in support of dyslexic students. CONCLUSION: Implementing reasonable adjustments in practice requires a close working partnership between HEI's and mentors who appreciate support in understanding the development and application of coping strategies to overcome disabilities. Effective preparation of mentors is essential to ensure that opportunities for disabled students to succeed are maximised.

[Definition of the core area of medical services in the psychiatric-psychotherapeutic field--the prerequisite for any delegation]. / Definition des Kernbereichs ärztlicher Tätigkeit im psychiatrisch-psychotherapeutischen Fachgebiet--Voraussetzung für jede Delegation.

Based on legal jurisdiction, knowledge of the psychiatric-psychotherapeutic field and insight into the necessity of a new allocation of responsibilities in the overall therapeutic service of a clinic, the core areas of medical activities are defined for the first time, innovative organisational approaches to the reorganisation of therapeutic service are presented and discussed against the background of qualified staff deficit, introduction of an OPS coding for inpatient psychiatry and economic constraints.

Estado actual de la formación PIR: actividad clínica y docente de residentes y tutores / No disponible

Esta investigación proporciona nuevos datos sobre la actividad clínica y docente que desarrollan en el Sistema Público de Salud los Psicólogos Internos Residentes y los psicólogos clínicos con competencias docentes sobre el proceso de formación de especialistas PIR. Se construyó un cuestionario, el C-PIR, en el que se integraron variables asociadas a las siguientes áreas temáticas: 1) características del proceso de acceso a la formación especializada; 2) actividad clínica de los especialistas en formación; 3) recepción de docencia y actividad investigadora de los especialistas en formación; 4) actividad clínica de los supervisores de los especialistas en formación; 5) presencia relativa de modelos psicoterapéuticos y actividad clínica característica; y 6) dificultades percibidas asociadas al proceso de formación especializada. Se obtuvo colaboración del 20,19% de residentes (incorporados entre 1999-2001). Las áreas temáticas antedichas fueron evaluadas en 165 dispositivos de Salud Mental diferentes, lo cual corresponde al 61,76% de áreas docentes acreditadas. Se discuten los resultados en el contexto de los recientes avances de la Psicología Clínica en el ámbito sanitario (AU)

Current situation of clinical psychology residence in spain: data for a comprehensive evaluation. this study pretends to offer new data on psychologist’s clinical and teaching activity in the public health system. equal emphasis is paid to psychology residents as clinical psychology supervisors. the c-pir questionnaire was developed to accomplish variables related with the following topics: 1) process of access to the specialized teaching period; 2) clinical activity carried out by clinical psychology residents; 3) training and research activities received by clinical psychology residents; 4) clinical activity showed by supervisors; 5) relative presence of psychotherapeutic models and kind of clinical activity associated; and 6) troubles perceived by the residents regarding the specialized teaching process. 20,19% of residents (incorporation: 1999-2001) participated. the mentioned topics were assessed in 165 different mental health units concerning 61,76% of teaching areas accredited. results are discussed in the context of recent clinical psychology advances in public health settings (AU)