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5.
Ann R Coll Surg Engl ; 102(1): 49-53, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31755741

RESUMO

INTRODUCTION: Testicular torsion treatment rests on the horns of a dilemma, with widespread national variation in whether the responsible surgical specialty is general surgery or urology, even in hospitals with both general surgery and urology emergency service assets. This study aimed to quantify higher surgical trainee operative experience and confidence in managing suspected testicular torsion in a single UK deanery (Wales). MATERIALS AND METHODS: Anonymised logbook data were obtained via the Intercollegiate Surgical Curriculum Programme version 10 using the head of school report function for all general surgery (n=53) and urology (n=15) higher surgical trainees, which were combined with the distribution of an electronic self-administered questionnaire. RESULTS: Median operative scrotal explorations recorded for all general surgery higher surgical trainees and senior general surgery higher surgical trainees (ST7+) was 7 (range 1-22) and 10 (range 1-22), compared with 21 (range 9-64, p=0.00104) and 24 (19-64, p<0.001) for urology higher surgical trainees. The questionnaire response rate was 64.6% (general surgery 31/50, urology 11/15). Confidence levels in assessing adult and paediatric patients were lower in general surgery when compared with urology higher surgical trainees: median adult confidence rate 7/10 compared with 9/10, and paediatric confidence rate 7/10 compared with 8/10 (p<0.001 and p=0.053, respectively). All higher surgical trainees preferred urology as the accountable hospital specialty when both assets were available. DISCUSSION AND CONCLUSION: General surgery higher surgical trainees receive less than 50% of the operative exposure of urology higher surgical trainees in emergency scrotal surgery, which has important implications for curriculum competence development and patient safety.


Assuntos
Cirurgia Geral/educação , Torção do Cordão Espermático/cirurgia , Urologia/educação , Adulto , Atitude do Pessoal de Saúde , Criança , Competência Clínica/normas , Educação de Pós-Graduação em Medicina/estatística & dados numéricos , Cirurgia Geral/estatística & dados numéricos , Hospitais de Ensino/estatística & dados numéricos , Humanos , Masculino , Pediatria/educação , Pediatria/estatística & dados numéricos , Inquéritos e Questionários , Urologistas/educação , Urologistas/normas , Urologia/estatística & dados numéricos , País de Gales
6.
J Surg Res ; 246: 342-378, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31690531

RESUMO

BACKGROUND: Tools for assessment of technical skills are a crucial part of surgical education. They provide trainees with quantitative feedback highlighting both proficiency and areas for improvement. For this to be relevant to day-to-day practice, the tools used have to be validated and relevant to each surgical situation. This study aims to evaluate the validity of assessment tools used within surgery. MATERIALS AND METHODS: Following Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, a systematic review was conducted searching the MEDLINE and Embase databases (International Prospective Register of Systematic Reviews: CRD42018104674). Studies utilizing any assessment tool in any surgical specialty were included. Messick's criteria were used for literature evaluation, and the Modified Educational Oxford Centre for Evidence-Based Medicine was used to assess levels of recommendation. RESULTS: A total of 303 studies and 76 tools were included. The most commonly used tool was Objective Structured Assessment Tool Skills (OSATS; n = 137, 45.2%). OSATS was used in conjunction with another tool or tools in an additional 55 studies (18.2%). Seven further tools were used in at least 3 studies. A total of five studies evaluated contained all five aspects of Messick's validity. CONCLUSIONS: There are several widely validated tools for assessing technical skills, the most common of which is OSATS. There is an emerging trend for crowdsourcing as a quick, cheap method for assessment of technical skills. This technique has been validated using both GEARS and GOALS. Numerous tools were found to be used only once and demonstrate a tendency for units to create their own tools for a specific task or specialty.


Assuntos
Competência Clínica/normas , Internato e Residência/normas , Especialidades Cirúrgicas/educação , Humanos , Especialidades Cirúrgicas/normas
7.
Int J Radiat Oncol Biol Phys ; 106(1): 32-36, 2020 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-31647968

RESUMO

PURPOSE: Radiation treatment planning (RTP) is a unique skill that requires interdisciplinary collaboration among radiation oncologists (ROs), dosimetrists, and medical physicists (MP) to train and assess residents. With the adoption of competency-based medical education (CBME) in Canada, it is essential residency program curricula focuses on developing competencies in RTP to facilitate entrustment. Our study investigates how radiation oncology team members' perspectives on RTP education align with requirements of the CBME approach, and its implications for improving residency training. METHODS AND MATERIALS: This qualitative research study took place in the Department of Oncology at a midsize academic institution. Through convenience sampling, focus groups were conducted with radiation oncologists (n = 11), dosimetrists (n = 7), medical physicists (n = 7), and residents (n = 7). Thematic design was adopted to analyze the transcripts through open coding resulting in 3 overarching themes. RESULTS: The results identified existing strengths and weaknesses of the residency program and future opportunities to redesign the curriculum and assessment process within a CBME model. Three overarching themes emerged from the analysis: (1) the strengths of RTP in the CBME environment; (2) challenges of RTP in CBME; and (3) opportunities for change. Stakeholders were optimistic CBME will help enrich resident learning with the increased frequency and quality of competency-based assessments. Participants suggested building a library of cases and developing computer-based learning resources to provide a safe environment to develop skills in contouring, dosimetry, and plan evaluation, in accordance with CBME training. CONCLUSIONS: This study identified future opportunities to redesign the RTP curriculum and assessment process within a CBME model. The need for innovative teaching and learning strategies, including case libraries, computer-based learning, and quality assessments, were highlighted in designing an innovative RTP planning curriculum.


Assuntos
Competência Clínica , Educação Baseada em Competências , Internato e Residência , Radioterapia (Especialidade)/educação , Planejamento da Radioterapia Assistida por Computador , Canadá , Competência Clínica/normas , Educação Baseada em Competências/normas , Grupos Focais , Previsões , Humanos , Internato e Residência/normas , Cultura Organizacional , Pesquisa Qualitativa , Radio-Oncologistas , Radioterapia (Especialidade)/normas , Ensino/organização & administração , Carga de Trabalho
8.
Presse Med ; 48(12): e382-e388, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31757737

RESUMO

BACKGROUND: Rare diseases are defined by a prevalence of less than one out of 2000 persons. In clinical practice, their management is difficult, due to their diversity, their complexity and a lack of adapted physician training. OBJECTIVE: The aims of this study were to identify rare skin diseases in a reference center, to describe the difficulties encountered by general practitioners (GPs) in management of these uncommon cases, and to pinpoint the characteristics of the GPs having the most problems. METHODS: A survey conducted from March to June 2017 involving GPs at least one of whose rare skin disease patients was being monitored in a reference center. RESULTS: All in all, 96/195 (49.2%) of the GPs contacted completed the questionnaire, and virtually all of them (95%) reported five main categories of difficulties: giving a diagnosis, monitoring treatment, coordinating care, providing support, and ensuring management of intercurrent pathologies. The most widely reported difficulties were related to diagnosis (88.5%) and care coordination (76%). The GPs most in need of assistance were those practicing in rural areas (11 times more likely to experience difficulties), those with over 10 years of experience (up to 9.8 times more risk) and those not considering their role in the management of patients with rare diseases as instrumental (2.28 times more risk). CONCLUSIONS: This study brought to light the difficulties encountered by GPs in management of patients with rare skin diseases. We identified those the most in need of assistance, who are to be targeted for actions aimed at improving the care and treatment of patients suffering from rare skin diseases.


Assuntos
Competência Clínica , Clínicos Gerais , Padrões de Prática Médica , Doenças Raras/terapia , Dermatopatias/terapia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Atitude do Pessoal de Saúde , Criança , Pré-Escolar , Competência Clínica/normas , Competência Clínica/estatística & dados numéricos , Feminino , França/epidemiologia , Medicina Geral/educação , Clínicos Gerais/normas , Clínicos Gerais/estatística & dados numéricos , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Padrões de Prática Médica/normas , Padrões de Prática Médica/estatística & dados numéricos , Doenças Raras/epidemiologia , Dermatopatias/epidemiologia , Inquéritos e Questionários , Adulto Jovem
9.
J Nurs Adm ; 49(12): 583-585, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31725517

RESUMO

Developing a professional practice model (PPM) is essential for hospitals seeking Magnet designation. The article describes the development and implementation of a PPM in a tertiary hospital that was the 1st hospital in mainland China applying for Magnet recognition. This article provides a framework for hospital administrators who wish to reference a successful process when creating their own Magnet PPMs.


Assuntos
Competência Clínica/normas , Guias como Assunto , Recursos Humanos de Enfermagem no Hospital/normas , Papel Profissional , Qualidade da Assistência à Saúde/normas , Centros de Atenção Terciária/normas , Adulto , China , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Modelos de Enfermagem
10.
Niger J Clin Pract ; 22(10): 1365-1371, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31607725

RESUMO

Objective: Orofacial pain (OFP) is a unique group of dental conditions with focus on chronic nonodontogenic pain affecting mouth, jaws, and face. The aim of this study is to investigate the knowledge of dentists in Saudi Arabia toward OFP assessment. Materials and Methods: An English language questionnaire containing 20 close-ended questions was used to capture data. The questionnaire included diagnostic criteria and clinical symptoms and signs of various OFP conditions. It was distributed to general dental practitioners (GDP) and dental specialists in four major provinces in Saudi Arabia. Results: A total of 318 questionnaires were completed by 163 males and 155 females. Most participants were GDPs (193/318) and the remaining were specialists from different dental specialties. A majority of participants were not able to diagnose neuropathic OFP or neurovascular/vascular OFP conditions (33% and 28.6%, respectively). On the other hand, only 40.3% were confident enough to diagnose different types of temporomandibular disorders. The results also showed that graduates from non-Saudi programs had significantly higher self and knowledge assessment score (59.8% and 43.4%, respectively) compared with graduates from Saudi programs (39.9% and 22.6%, respectively). The dental specialists had higher self-assessment scores compared with GDPs (48% vs. 43.7%). Overall, there was a weak positive correlation between self-assessment and knowledge assessment (20.2%). Conclusion: This study demonstrates a higher OFP knowledge and confidence for dental specialists compared with GDPs. However, this difference does not necessarily translate into more competencies in clinical practice. Therefore, the implementation of OFP courses in dental schools' curricula may benefit future dentists and improve patients' care.


Assuntos
Competência Clínica/normas , Odontólogos/psicologia , Educação em Odontologia , Dor Facial/diagnóstico , Odontologia Geral/educação , Conhecimentos, Atitudes e Prática em Saúde , Adulto , Currículo , Avaliação Educacional/métodos , Dor Facial/etiologia , Dor Facial/fisiopatologia , Feminino , Humanos , Masculino , Neuralgia/diagnóstico , Medição da Dor , Arábia Saudita , Faculdades de Odontologia , Inquéritos e Questionários , Transtornos da Articulação Temporomandibular/complicações , Transtornos da Articulação Temporomandibular/diagnóstico
11.
J Nurs Adm ; 49(10): 455-456, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31517751

RESUMO

In this month's Magnet Perspectives column, the director of the Magnet Recognition Program highlights the program staff and leadership at ANCC responsible for the Magnet Program.


Assuntos
Competência Clínica/normas , Enfermeiras Administradoras/normas , Cuidados de Enfermagem/normas , Recursos Humanos de Enfermagem no Hospital/normas , Adulto , Feminino , Humanos , Liderança , Masculino , Pessoa de Meia-Idade , Estados Unidos
12.
J Nurs Adm ; 49(10): 503-508, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31517758

RESUMO

OBJECTIVE: To examine changes in new nurses' competencies across the 1st year of practice. BACKGROUND: Competency assessment is a challenge for nurse residency programs and often focuses on skills checklists and confidence self-reports. The Appraisal of Nursing Practice, an observational rating based on Quality and Safety in Nursing Education standards, was developed to help evaluate an RN residency program. METHODS: Preceptors, nurse educators, and/or unit managers from various units rated new nurse residents. Ratings were compared for 353 nurses at 3 points: within the 1st month in the program (T1), at 5 months (T2), and at month 11 (T3). RESULTS: Competency ratings increased significantly for all subscales from T1 to T2. Ratings continued to increase significantly from T2 to T3, although at a slightly slower rate. Teamwork and evidence-based practice increased the most. CONCLUSIONS: Future studies should explore factors affecting the trajectory in developing nursing competencies within various settings.


Assuntos
Competência Clínica/normas , Avaliação de Desempenho Profissional/normas , Guias como Assunto , Cuidados de Enfermagem/normas , Recursos Humanos de Enfermagem/normas , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Tempo , Estados Unidos
14.
J Nurses Prof Dev ; 35(5): 297-299, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31490905

RESUMO

Since its publication in 2016, the third edition of Nursing Professional Development: Scope and Standards of Practice has generated excitement for the specialty. The scope and standards has promoted uniformity of title, stimulated changes in position descriptions, fostered adherence to scope of practice, and served as a unifying framework for system-wide nursing professional development departments. However, continued action is required in the areas of advocacy, research, and engagement with the specialty organization.


Assuntos
Competência Clínica/normas , Enfermeiras e Enfermeiros/estatística & dados numéricos , Especialidades de Enfermagem , Desenvolvimento de Pessoal , Humanos
15.
Lakartidningen ; 1162019 Sep 10.
Artigo em Sueco | MEDLINE | ID: mdl-31503322

RESUMO

According to the Swedish National Board of Health and Welfare, about 3200 people a year die due to accidents. Around 900 of these are classified as "Accidental exposure to other and unspecified factors". A more precise classification with the board has not been recorded in these cases due to incomplete death certificates. This study examined the death certificates for this group in 2016 and compared it to patient records. This study showed that most cases of incomplete classification are in instances of elderly persons who sustained a fall and subsequently died due to complications of the resulting injury. The doctor has in most cases not perceived the death as accidental.This study showed that there is a lack of knowledge among doctors in how to accurately complete a death certificate.


Assuntos
Acidentes por Quedas/mortalidade , Causas de Morte , Coleta de Dados/normas , Atestado de Óbito , Documentação/normas , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Competência Clínica/normas , Feminino , Humanos , Masculino , Registros Médicos/normas , Pessoa de Meia-Idade , Médicos/normas , Distribuição por Sexo , Suécia/epidemiologia , Fatores de Tempo
16.
BMC Health Serv Res ; 19(1): 642, 2019 Sep 06.
Artigo em Inglês | MEDLINE | ID: mdl-31492130

RESUMO

BACKGROUND: Malnutrition is a comprehensive challenge for the nursing home, home care- and home nursing sector. Nutritional care and the subsequent documentation are a common and multifaceted healthcare practice that requires that the healthcare professionals possess complex combinations of competencies in order to deliver high-quality care and treatment. The purpose of this study was to investigate how a varied group of healthcare professionals' perceive their own competencies within nutrition and documentation and how organizational structures influence their daily work and the quality of care provided. METHODS: Two focus groups consisting of 14 healthcare professionals were conducted. The transcribed focus group interviews was analyzed using the qualitative content analysis approach. RESULTS: Six categories were identified: 1) Lack of uniform and systematic communication affect nutritional care practices 2) Experience-based knowledge among the primary workforce influences daily clinical decisions, 3) Different attitudes towards nutritional care lead to differences in the quality of care 4) Differences in organizational culture affect quality of care, 5) Lack of clear nutritional care responsibilities affect how daily care is performed and 6) Lack of clinical leadership and priorities makes nutritional care invisible. CONCLUSIONS: The six categories revealed two explanatory themes: 1) Absent inter- and intra-professional collaboration and communication obstructs optimal clinical decision-making and 2) quality deterioration due to poorly-established nutritional care structure. Overall, the two themes explain that from the healthcare professionals' point of view, a visible organization that allocates resources as well as prioritizing and articulating the need for daily nutritional care and documentation is a prerequisite for high-quality care and treatment. Furthermore, optimal clinical decision making among the healthcare professionals are compromised by imprecise and unclear language and terminology in the patients' healthcare records and also a lack of clinical guidelines and standards for collaboration between different healthcare professionals working in nursing homes, home care or home nursing. The findings of this study are beneficial to support organizations within these settings with strategies focusing on increasing nutritional care and documentation competencies among the healthcare professionals. Furthermore, the results advocate for the daily involvement and support of leaders and managers in articulating and structuring the importance of nutritional care and treatment and the subsequent documentation.


Assuntos
Atitude do Pessoal de Saúde , Conhecimentos, Atitudes e Prática em Saúde , Desnutrição/enfermagem , Casas de Saúde/normas , Competência Clínica/normas , Tomada de Decisão Clínica , Comunicação , Estudos Transversais , Assistência à Saúde/normas , Documentação , Feminino , Grupos Focais , Recursos em Saúde/estatística & dados numéricos , Serviços de Assistência Domiciliar/normas , Assistência Domiciliar/normas , Humanos , Liderança , Desnutrição/prevenção & controle , Estado Nutricional , Cultura Organizacional , Atenção Primária à Saúde/normas , Autoimagem
17.
BMC Health Serv Res ; 19(1): 612, 2019 Aug 30.
Artigo em Inglês | MEDLINE | ID: mdl-31470856

RESUMO

BACKGROUND: Shared decision-making (SDM) is a key principle in asthma management, but continues to be poorly implemented in routine care. This study aimed to evaluate the impact of a SDM communication skills training for physicians treating patients with asthma on the SDM behaviors of physicians, and to analyze physician views on the training. METHODS: A mixed methods study with a partially mixed sequential equal status design was conducted to evaluate a 12 h SDM communication skills training for physicians treating patients with asthma. It included a short introductory talk, videotaped consultations with simulated asthma patients, video analysis in small group sessions, individual feedback, short presentations, group discussions, and practical exercises. The quantitative evaluation phase consisted of a before (t0) after (t1) comparison of SDM performance using the observer-rated OPTION5, the physician questionnaire SDM-Q-Doc, and the patient questionnaire SDM-Q-9, using dependent t-tests. The qualitative evaluation phase (t2) consisted of a content analysis of audiotaped and transcribed interviews. RESULTS: Initially, 29 physicians participated in the study, 27 physicians provided quantitative data, and 22 physicians provided qualitative data for analysis. Quantitative results showed significantly improved performance in SDM following the training (t1) when compared with performance in SDM before the training (t0) (OPTION5: t (26) = - 5.16; p < 0.001) (SDM-Q-Doc: t (26) = - 4.39; p < 0.001) (SDM-Q-9: t (26) = - 5.86; p < 0.001). The qualitative evaluation showed that most physicians experienced a change in attitude and behavior after the training, and positively appraised the training program. Physicians considered simulated patient consultations, including feedback and video analysis, beneficial and suggested the future use of real patient consultations. CONCLUSION: The SDM communication skills training for physicians treating patients with asthma has potential to improve SDM performance, but would benefit from using real patient consultations.


Assuntos
Asma/terapia , Competência Clínica/normas , Médicos/normas , Idoso , Comunicação , Retroalimentação , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Participação do Paciente , Simulação de Paciente , Relações Médico-Paciente , Inquéritos e Questionários , Gravação de Fita , Gravação em Vídeo
18.
J Grad Med Educ ; 11(4 Suppl): 91-99, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31428264

RESUMO

Background: While resident participation in global health (GH) rotations has grown, little is known about trainee perceptions of the personal value of these international clinical experiences and their importance to the objectives of GH training. Objective: We sought to better understand the clinical scenarios experienced during international rotations that residents perceived as most meaningful and the frequency of these experiences across scenarios and participating residents. Methods: Using the conceptual framework of Schön's reflection on action, we asked University of Minnesota GH track pediatric and internal medicine-pediatric residents to describe 10 clinical scenarios they found interesting or impactful during their 2016-2017 GH elective. We conducted a qualitative analysis of the deidentified resident narratives and mapped themes to the Accreditation Council for Graduate Medical Education (ACGME) competencies. Results: All eligible residents (n = 13) participated, yielding 129 unique clinical scenarios from 7 countries. We identified 5 thematic groups: (1) addressing challenges in making diagnoses in resource-limited settings; (2) dealing with patient outcomes different from those expected in the United States; (3) encountering and managing diseases in a different clinical context; (4) encountering and managing diseases in a different cultural context; and (5) reflecting on learning and self-growth. Of the 129 unique clinical scenarios, 30% (n = 39) had not been previously experienced by participants. Across the 5 themes, all ACGME core competencies were addressed. Conclusions: Residents identified meaningful scenarios of their GH experiences that are relevant to the educational and clinical objectives of GH training.


Assuntos
Competência Clínica/normas , Saúde Global , Medicina Interna/educação , Internacionalidade , Internato e Residência , Aprendizagem , Pediatria/educação , Acreditação/normas , Adulto , Competência Cultural , Feminino , Recursos em Saúde/provisão & distribução , Humanos , Masculino , Narração , Estados Unidos
19.
J Grad Med Educ ; 11(4 Suppl): 118-124, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31428268

RESUMO

Background: Group discussion of resident performance is an emerging assessment approach in postgraduate medical education. However, groups do not necessarily make better decisions than individuals. Objective: This study examined how group meetings concerning the assessment of residents take place, what information is shared during the meetings, and how this influences program directors' judgment of resident performance. Methods: In 2017, the researchers observed 10 faculty group meetings where resident performance was discussed and interviewed the program directors within a month after the meetings. We used a thematic framework analysis to identify themes from the transcribed meetings and interviews. Results: The information shared by group members during the meetings had 2 aims: (1) forming a judgment about the residents, and (2) faculty development. Most group members shared information without written notes, most discussions were not structured by the program director, the major focus of discussions was on residents with performance concerns, and there was a lack of a shared mental model of resident performance. The program directors who benefited most from the meetings were those who thought group members were engaged and summarized the information after every discussion. Conclusions: Unstructured discussions and a lack of a shared mental model among group members impede effective information sharing about resident performance with a developmental approach. Structured discussions with an equal amount of discussion time for every resident and creating a shared mental model about the purpose of the discussions and the assessment approach could enhance use of a developmental approach to assessing resident performance.


Assuntos
Competência Clínica/normas , Avaliação Educacional/normas , Docentes de Medicina , Internato e Residência , Desenvolvimento de Pessoal , Educação de Pós-Graduação em Medicina , Humanos , Julgamento
20.
J Grad Med Educ ; 11(4 Suppl): 169-176, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31428276

RESUMO

Background: ACGME-I requires sponsoring institutions (SIs) to have systematic oversight of program performance. This was initially carried out through annual review, however, maintaining compliance became a challenge for a large SI like Singapore Health Services (SingHealth) as the number of residency programs grew from 5 to 34 in 3 years. Objective: We assessed the impact of quarterly monitoring using a dashboard on graduate medical education (GME) program performance and institutional oversight. Methods: In 2014, the SingHealth GME Committee (GMEC) approved the dashboard covering 13 indicators with implication on program performance, resident/faculty performance, and finance. Indicators were given color-coded scoring for compliance, borderline compliance, or concern. From annual reporting, periodicity was increased quarterly with reports distributed to program directors, head of department, and academic clinical programs. Results: Since implementation, programs consistently met or exceeded compliance standards in 11 of 13 indicators (84%), with 7 indicators (63%) showing upward trends. Programs with borderline scores in particular quarters showed improvement in subsequent quarters. By 2015, percentage compliance for the 3 dimensions of residents' perspectives were 1 to 2 points higher than the national compliance average. Of 19 programs undergoing ACGME-I accreditation in 2014, only 4 had citations in the foundational requirement. Institutional citations were resolved, with 0 citations in the reaccreditation site visit in 2015. Conclusions: For a large SI, increased periodicity of program performance reporting from annual to quarterly effectively addressed the gaps in a timely fashion. Institutional performance also improved through the use of quantitative data aligned with institution and national performance indicators.


Assuntos
Benchmarking , Competência Clínica/normas , Internato e Residência , Acreditação/normas , Educação de Pós-Graduação em Medicina , Humanos , Avaliação de Programas e Projetos de Saúde , Indicadores de Qualidade em Assistência à Saúde , Singapura
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