Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 19.379
Filtrar
1.
Medicine (Baltimore) ; 99(44): e22959, 2020 Oct 30.
Artigo em Inglês | MEDLINE | ID: mdl-33126364

RESUMO

INTRODUCTION: Type 2 diabetes mellitus is responsible for high mortality and morbidity globally and in India. India has high prevalence of the condition and the burden is set to increase exponentially in the next decade. Indians traditionally reside in rural or semi-urban areas with limited access to healthcare facilities. To overcome this, the government has introduced a cadre of health workers called Accredited Social Health Activists (ASHA) for such areas. These workers were initially trained to provide maternal & infant care but now need improved competence training to improve type 2 diabetes screening & management in these locations. The objective of the study is to assess the competence training provided to ASHA workers at the chosen study sites. METHODOLOGY: A cluster randomized control trial has been designed. It will be conducted across 8 centers in Hyderabad & Rangareddy districts of Telangana, India. The training will be provided to ASHA workers. The tool used for training will be developed from existing sources with an emphasis on topics which require training. The training will be delivered across 6 months at each center as a classroom training. Each participant's baseline competence will be recorded using a questionnaire tool and a practical evaluation by trained public health experts. The same experts will use the same tools to assess the training post the intervention. DISCUSSION: This trial will evaluate the use of health worker training as a tool for improving the clinical competence in relation to type 2 diabetes mellitus. We anticipate that the module will provide a greater understanding of type 2 diabetes mellitus, the importance of screening of both disease and complications and improved skills for the same. The study has received the ethical approval form the Institutional Ethics Committee of the Indian Institute of Public Health Hyderabad. The registration number is: IIPHH/TRCIEC/218/2020. The trial has also been registered under the Clinical trial registry of India (CTRI) on 27 July 2020. The registration number of the trial is: CTRI/2020/07/026828. The URL of the registry trial is: http://ctri.nic.in/Clinicaltrials/showallp.php?mid1=45342&EncHid=&userName=CTRI/2020/07/026828.


Assuntos
Competência Clínica , Agentes Comunitários de Saúde/educação , Diabetes Mellitus Tipo 2/terapia , Capacitação em Serviço/métodos , Competência Clínica/normas , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/prevenção & controle , Feminino , Humanos , Índia , Masculino , Ensaios Clínicos Controlados Aleatórios como Assunto
2.
J Postgrad Med ; 66(4): 200-205, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33037168

RESUMO

With the introduction of competency-based undergraduate curriculum in India, a paradigm shift in the assessment methods and tools will be the need of the hour. Competencies are complex combinations of various attributes, many of which being not assessable by objective methods. Assessment of affective and communication domains has always been neglected for want of objective methods. Areas like professionalism, ethics, altruism, and communication-so vital for being an Indian Medical Graduate, can be assessed longitudinally applying subjective means only. Though subjectivity has often been questioned as being biased, it has been proven time and again that a subjective assessment in expert hands gives comparable results as that of any objective assessment. By insisting on objectivity, we may compromise the validity of the assessment and deprive the students of enriched subjective feedback and judgement also. This review highlights the importance of subjective assessment in competency-based assessment and ways and means of improving the rigor of subjective assessment, with particular emphasis on the development and use of rubrics.


Assuntos
Competência Clínica/normas , Educação Baseada em Competências/organização & administração , Educação de Graduação em Medicina/métodos , Educação Médica/organização & administração , Avaliação Educacional/métodos , Adulto , Currículo , Feminino , Humanos , Índia , Masculino , Profissionalismo , Estudantes de Medicina
3.
East Mediterr Health J ; 26(9): 1011-1017, 2020 Sep 24.
Artigo em Inglês | MEDLINE | ID: mdl-33047791

RESUMO

Background: Health professionals are at the frontline of the COVID-19 pandemic and are directly exposed to infection hazards. Therefore, they should have the essential competencies for approaching patients. Aims: The study aimed to identify essential competencies required for approaching patients with COVID-19. Methods: All postgraduate health professionals at the Syrian Virtual University SVU (n=28) were invited to participate in the study during the Covid-19 lockdown in 2020, resulting in 20 postgraduates accepting. The Delphi technique was adopted for identifying competencies in medical education and a virtual meeting was undertaken through the University Management System in order to provide instruction and create a list of competencies. Competency domains were divided into 'knowledge', 'skills', and 'attitudes' and were classified into four categories: etiology, assessment and diagnosis, management, and prognosis. Results: Fifty-two essential competencies were identified; 7 competencies on etiology, 7 related to assessment and diagnosis, 34 related to management, and 4 related to prognosis. Conclusion: It is hoped that the identified competencies would help health professionals to deliver the best health care for COVI-19 patients, as well as help policy-makers to support comprehensive training programmes that can equip health professionals with the required competencies to fight the pandemic.


Assuntos
Competência Clínica/normas , Infecções por Coronavirus/epidemiologia , Conhecimentos, Atitudes e Prática em Saúde , Pessoal de Saúde/educação , Pneumonia Viral/epidemiologia , Betacoronavirus , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/terapia , Técnica Delfos , Humanos , Pandemias , Pneumonia Viral/diagnóstico , Pneumonia Viral/terapia
4.
PLoS One ; 15(9): e0238881, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32941490

RESUMO

BACKGROUND: Adherence to the best standards of nursing practice is the fundamental principle to improve patient outcome and prevent nursing procedure related-infections. A peripheral venous catheter (PVC) is the most common invasive procedure performed in nursing care. Its poor performance could expose patients to bloodstream-related infections. The present study aimed to assess post-basic nursing students' knowledge of evidence-based guidelines on the management of peripheral venous catheters. METHODS: A cross-sectional study design was conducted on May 01-03, 2019, using a convenient sample 239 among post-basic nursing students in Wollega University. RESULTS: The study result showed that nursing students' had a low mean (4.1±1.52) of knowledge about PVC procedure management. Only 41% of the respondents have adhered to recommendations of CDC guidelines. Among the provided options of the items, none achieved 100% correct answers. The majority of nursing students (77%) responded that antiseptic handwashing is always performed before insertion of PVCs. Meanwhile, few students (5%) correctly answered that the infusion set is recommended to be removed after 96 hours when neither lipids nor blood products are administered. In multivariable regression analysis, nursing students who had received training (AOR = 2.9, 95% CI (1.6, 5.1)) and who were younger (AOR = 2.4, 95% CI (1.3, 4.3)) significantly associated with a higher score of knowledge. CONCLUSIONS: This study finding shows that an overall level of knowledge of post-basic nursing students is inadequate. Measurements such as an increase in the provision of adequate training by nurses educators based on evidence-based guidelines could improve the post-basic nursing students' knowledge.


Assuntos
Cateterismo Periférico/enfermagem , Competência Clínica/normas , Adulto , Cateterismo Periférico/normas , Estudos Transversais , Educação de Pós-Graduação em Enfermagem , Enfermagem Baseada em Evidências , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Guias de Prática Clínica como Assunto , Estudantes de Enfermagem , Adulto Jovem
6.
J Am Board Fam Med ; 33(Supplement): S1-S9, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32928942

RESUMO

Family Medicine was a child of the 1960s. Triggered by compelling social need for care outside of large hospitals, Family Medicine emphasized access to personal physicians based in the community. As a protest movement, the ABFP required ongoing recertification for all Diplomates, with both independent examination and chart audit. Fifty years later, society and health care have changed dramatically, and it is time again to consider how Board Certification must respond to those change. We propose three interlocking arguments. First, even before COVID-19, health and health care have been in a time of fundamental transformation. Second, given the role Board Certification plays in supporting improvement of healthcare, Board Certification itself must respond to these changes. Third, to move forward, ABFM and the wider Board community must address a series of wicked problems - i.e., problems which are both complex-with many root causes-and complicated- in which interventions create new problems. The wicked problems confronting board certification include: 1) combining summative and formative assessment, 2) improving quality improvement and 3) reaffirming the social contract and professionalism and its assessment.


Assuntos
Certificação/normas , Competência Clínica/normas , Medicina de Família e Comunidade/normas , Melhoria de Qualidade , Certificação/métodos , Certificação/tendências , Medicina de Família e Comunidade/educação , Medicina de Família e Comunidade/tendências , Humanos , Estados Unidos
7.
Rural Remote Health ; 20(3): 6027, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32981326

RESUMO

CONTEXT: Physicians who migrate globally face a daunting series of time-consuming, labor- and resource-intensive procedures to prove their clinical competency before being allowed to practice medicine in a new country. ISSUES: In this commentary, we describe licensing barriers faced by physician-migrants based on the authors' experiences, and reflect also on rapidly implemented measures to address COVID-19 pandemic related workforce shortages. We offer recommendations for potential reductions in bureaucratic regulatory barriers that prohibit mobilization of international medical graduate talent. LESSONS LEARNED: Licensing boards and authorities should strive for standardized, competency-based basic professional recognition. Professional medical societies are well-positioned to guide such competency-based recognition as a more organized, international collaborative effort across specialties. The COVID-19 pandemic facilitated cross-state and international licensing in some regions, highlighting a key opportunity: streamlining professional recognition requirements is achievable.


Assuntos
Infecções por Coronavirus/epidemiologia , Credenciamento/organização & administração , Médicos Graduados Estrangeiros/normas , Pneumonia Viral/epidemiologia , Migrantes , Betacoronavirus , Competência Clínica/normas , Credenciamento/normas , Humanos , Internacionalidade , Pandemias , Fatores de Tempo
8.
Curr Opin Anaesthesiol ; 33(5): 674-684, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32826622

RESUMO

PURPOSE OF REVIEW: Effective and safe regional anaesthesia and pain medicine procedures require clinicians to learn and master complex theoretical knowledge and motor skills. This review aims to summarize articles relevant to education and training in these skill sets in the previous 2 years. RECENT FINDINGS: Twenty-two articles were identified, investigating nine out of the 13 top-ranked research topics in education and training in regional anaesthesia. Research topics addressed by these articles included prerotation simulation, deliberate practice combined with formative assessment tools, validation of assessment tools, three-dimensional-printed models, and knowledge translation from simulation to clinical practice. Emerging concepts investigated for their applications in regional anaesthesia included eye-tracking as a surrogate metric when evaluating proficiency, and elastography aiding visual salience to distinguish appropriate perineural and inappropriate intraneural injections. SUMMARY: Research into education and training in regional anaesthesia covered multiple and diverse topics. Methodological limitations were noted in several articles, reflecting the difficulties in designing and conducting medical education studies. Nonetheless, the evidence-base continues to mature and innovations provide exciting future possibilities.


Assuntos
Anestesia por Condução/normas , Anestesiologia/educação , Educação Médica , Ultrassonografia de Intervenção/normas , Anestesia por Condução/métodos , Anestesiologia/normas , Competência Clínica/normas , Humanos , Dor
10.
Curationis ; 43(1): e1-e8, 2020 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-32633991

RESUMO

BACKGROUND: Lesotho has been experiencing health challenges as indicated by its high maternal mortality ratio of 620 per 100 000 live births for the year 2010, which has been linked to its limited human resources. OBJECTIVES: The knowledge and skills of final-year student nurse-midwives related to the active management of the third stage of labour were determined. METHOD: A quantitative, descriptive survey design was used to conduct this study with 99 final-year midwifery students at four nursing schools in Lesotho using stratified sampling. The structured questionnaire collected data on the knowledge and self-reported competency. Subsequently, the controlled cord traction marks, extracted from the objective structured clinical examination (OSCE), were compared to the self-reported competency of these midwifery students using R software version 3.4.0. RESULTS: The mean score for knowledge and the OSCE was 73.8% (n = 99) and 77.2% (n = 99), respectively. The majority of respondents (95.2%, n = 99) rated themselves highly in terms of the active management of the third stage of labour competency. There was no correlation between the self-reported competency and knowledge (r = 0.08, p = 0.4402), and self-reported competency and OSCE scores (r = -0.004, p = 0.01). CONCLUSION: The high mean scores for the knowledge and the OSCE indicate that the theoretical component of the curriculum on the active management of the third stage of labour was effective in equipping final-year midwifery students with knowledge and skills to carry out this competency.


Assuntos
Competência Clínica/normas , Terceira Fase do Trabalho de Parto/fisiologia , Tocologia/educação , Estudantes de Enfermagem/estatística & dados numéricos , Adulto , Competência Clínica/estatística & dados numéricos , Currículo/tendências , Feminino , Humanos , Tocologia/estatística & dados numéricos , Gravidez , África do Sul , Inquéritos e Questionários
12.
J Am Assoc Nurse Pract ; 32(6): 416-418, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: covidwho-594928

RESUMO

Our health care landscape is rapidly changing. With the aging population and seemingly increasing outbreak of communicable diseases, it is expected that there will be a continued demand for inpatient/critical care providers. The current COVID-19 pandemic provides a glimpse of a health care system in severe provider shortage. Adult-gerontology acute nurse practitioners (GACNPs) can play a vital part in relieving that shortage. But with the increased role, there is an increased responsibility and need for expansion of AGACNP skill set. This includes the training and utilization of point-of-care ultrasound (POCUS). The case reports and data available from countries that have already combated COVID-19 outbreak show POCUS can play a key part in managing critically ill patients on isolation precautions. This article provides my perspective on POCUS training and competency achievement for AGACNPPs.


Assuntos
Competência Clínica/normas , Enfermagem Geriátrica/normas , Profissionais de Enfermagem/educação , Sistemas Automatizados de Assistência Junto ao Leito/normas , Ultrassonografia/normas , Idoso , Idoso de 80 Anos ou mais , Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Cuidados Críticos/normas , Avaliação Geriátrica/estatística & dados numéricos , Humanos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle
14.
Br J Oral Maxillofac Surg ; 58(7): 843-847, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32576468

RESUMO

The COVID-19 crisis has caused many issues across healthcare. In surgery, many operations have been cancelled with some surgeons losing their regular operating lists. During this time, technical expertise and decision making can deteriorate. In aviation after a prolonged period of absence from flying, this deficit in keeping skills and thinking up to date is known as being "out of currency" or "not current". Although aviation and healthcare cannot be compared, numerous human factors concepts are applicable to both. In this article, we explore the likely impact of potentially prolonged absences in operating on surgical skills and psyche, and introduce the concept of a Surgical Skills Currency Barometer. We also discuss a "task-o-meter" thought experiment, and suggest practices which could be adopted to help protect surgeon workload from exceeding surgical capability when returning to operating following a period of prolonged absence.


Assuntos
Competência Clínica/normas , Infecções por Coronavirus , Procedimentos Cirúrgicos Eletivos/normas , Pandemias , Segurança do Paciente , Equipamento de Proteção Individual , Pneumonia Viral , Aviação , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Humanos , Pneumonia Viral/epidemiologia , Cuidados Pós-Operatórios , Cuidados Pré-Operatórios , Retorno ao Trabalho
16.
Inquiry ; 57: 46958020927876, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32500772

RESUMO

This study aimed to describe the status and related factors of evidence-based practice (EBP) competency among nurses in China. A convenience sample of 1036 nurses were recruited from 13 public hospitals in Shanghai through an anonymous online survey. Nurses' demographic data, working data, and evidence-based nursing (EBN)-related conditions were collected by a structured questionnaire and EBP competency was assessed using the Chinese version of Evidence-based Nursing Competency Rating Scale (EBNCRS). The original score of EBNCRS among nurses was not good. The original score of evidence searching, critical appraisal, and synthesis subscale was lower than the original score of evidence transfer, situation assessment, and evidence implementation subscale. Nurses' age, hospital level, and perceived EBN knowledge were identified as significant related factors of EBP competency. There is an urgent need to upgrade the EBP competency of nurses in Shanghai, especially competency in evidence transfer, situation assessment, and evidence implementation.


Assuntos
Competência Clínica/normas , Enfermagem Baseada em Evidências/normas , Hospitais Públicos , Recursos Humanos de Enfermagem no Hospital/estatística & dados numéricos , Adulto , Atitude do Pessoal de Saúde , China , Estudos Transversais , Feminino , Humanos , Internet , Masculino , Inquéritos e Questionários
17.
Rev Assoc Med Bras (1992) ; 66(3): 328-333, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32520153

RESUMO

BACKGROUND: The aim of this study was to perform a cross-cultural adaptation of the Objective Structured Assessment of Technical Skill (OSATS) tool into Brazilian Portuguese and to determine its reproducibility and validity in Brasil. METHODS: A Brazilian Portuguese version of OSATS was created through a process of translation, back-translation, expert panel evaluation, pilot testing, and then its validation. For the construct and the concurrent validities, twelve participants were divided into a group of six experts and six novices, who had to perform tasks on a simulation model using human placentas. Each participant was filmed, and two blinded raters would then evaluate their performance using the traditional subjective method and then the Brazilian Portuguese version of OSATS. RESULTS: The Brazilian Portuguese version of OSATS had the face, content, construct, and concurrent validities achieved. The average experts' score and standard deviations were 34 and 0.894, respectively, for Judge 1 and 34.33 and 0.816 for Judge 2. In the case of novices, it was 13.33 and 2.388 for Judge 1 and 13.33 and 3.204 for Judge 2. The concordance between the judges was evident, with the Correlation Coefficient (Pearson) of 0.9944 with CI 95% between 0.9797 and 0.9985, with p < 10-10, evidencing the excellent reproducibility of the instrument. CONCLUSION: This preliminary study suggests that the Brazilian Portuguese version of OSATS can reliably and validly assess surgical skills in Brasil.


Assuntos
Competência Clínica/normas , Comparação Transcultural , Procedimentos Cirúrgicos Operatórios/normas , Inquéritos e Questionários , Traduções , Brasil , Educação de Pós-Graduação em Medicina/normas , Humanos , Internato e Residência , Procedimentos Cirúrgicos Operatórios/educação
19.
Am J Public Health ; 110(8): 1211-1213, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32552028

RESUMO

People who inject drugs (PWID) are at increased risk for developing wounds in addition to skin and soft tissue infections. The University of Illinois at Chicago College of Nursing, College of Medicine, and School of Public Health collaborated to establish a medical clinic serving PWID attending a Chicago syringe exchange program. A wound care program was implemented to improve clinicians' competence. During October 2018 to August 2019, 24% of all encounters were related to wound complaints.


Assuntos
Instituições de Assistência Ambulatorial , Competência Clínica/normas , Pessoal de Saúde/educação , Programas de Troca de Agulhas , Abuso de Substâncias por Via Intravenosa , Infecção dos Ferimentos/terapia , Adulto , Chicago , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Saúde Pública , Melhoria de Qualidade , Estudos Retrospectivos , Transtornos Relacionados ao Uso de Substâncias/reabilitação
20.
J Am Assoc Nurse Pract ; 32(6): 416-418, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32511190

RESUMO

Our health care landscape is rapidly changing. With the aging population and seemingly increasing outbreak of communicable diseases, it is expected that there will be a continued demand for inpatient/critical care providers. The current COVID-19 pandemic provides a glimpse of a health care system in severe provider shortage. Adult-gerontology acute nurse practitioners (GACNPs) can play a vital part in relieving that shortage. But with the increased role, there is an increased responsibility and need for expansion of AGACNP skill set. This includes the training and utilization of point-of-care ultrasound (POCUS). The case reports and data available from countries that have already combated COVID-19 outbreak show POCUS can play a key part in managing critically ill patients on isolation precautions. This article provides my perspective on POCUS training and competency achievement for AGACNPPs.


Assuntos
Competência Clínica/normas , Enfermagem Geriátrica/normas , Profissionais de Enfermagem/educação , Sistemas Automatizados de Assistência Junto ao Leito/normas , Ultrassonografia/normas , Idoso , Idoso de 80 Anos ou mais , Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Cuidados Críticos/normas , Avaliação Geriátrica/estatística & dados numéricos , Humanos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA