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2.
J Leg Med ; 39(3): 229-233, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31626576

RESUMO

Lapses in professionalism are a common cause of disciplinary action against physicians by U.S. medical boards. However, the exact definition of "professionalism" is unclear, making it likely that a physician will not train or practice under the same framing of professionalism and so may fail to develop certain skills. The goal of this study was to identify and compare the professionalism framings of medical boards. The medical board web pages for all 50 states, the District of Columbia, and four territories were examined in June 2017 for use of the word "professionalism" or "professional" in their application, rules, or laws, which was then coded as a best fit to one of six core framings of professionalism. Of the 55 states and territories, integrity was the most common professionalism framing (40.0%), followed by excellence (23.6%), behavior (12.7%), mixed (9.1%), unclear (9.1%), and absent (5.5%). Although integrity was the most common framing, diversity exists among medical boards, which could lead to board misunderstandings of incidents labeled as professionalism violations and ineffective remediation of offenses. In order to best communicate the nature of the offense and thus best facilitate remediation, the incident should be called by its true name rather than the all-encompassing term "professionalism."


Assuntos
Papel do Médico , Médicos/normas , Prática Profissional/normas , Profissionalismo/normas , Conselho Diretor/legislação & jurisprudência , Conselho Diretor/normas , Humanos , Má Conduta Profissional , Profissionalismo/tendências , Conselhos de Especialidade Profissional/legislação & jurisprudência , Conselhos de Especialidade Profissional/normas , Estados Unidos
3.
Semin Vasc Surg ; 32(1-2): 14-17, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31540649

RESUMO

The recognition of vascular surgery as an independent surgical specialty is inevitable, but the pathway to full autonomy remains uncertain. Vascular surgery emerged from general surgery in the mid-1950s with the advent of synthetic grafts and microvascular techniques. By the early 1980s, Accreditation Council for Graduate Medical Education-approved fellowships were established in most large academic medical centers. The American Board of Surgery recognized this additional specialty training by awarding vascular graduates a Certificate of Special Qualifications distinguishing them from general surgeons. The emergence of endovascular surgery radically changed the face of vascular surgery from a general surgery subspecialty to a unique surgical specialty with a growing array of minimally invasive tools. With the establishment of a primary Certificate in Vascular Surgery and the subsequent development of integrated residencies, vascular surgery moved ever closer to recognition as an independent surgical specialty. Despite the remarkable progress that has been observed over the past 50 years, there is a desire in the vascular community for formal recognition of the unique body of knowledge and surgical skills that serve as the foundation of contemporary vascular care.


Assuntos
Educação de Pós-Graduação em Medicina/métodos , Autonomia Profissional , Conselhos de Especialidade Profissional , Cirurgiões/educação , Procedimentos Cirúrgicos Vasculares/educação , Competência Clínica , Currículo , Educação de Pós-Graduação em Medicina/história , Educação de Pós-Graduação em Medicina/normas , Educação de Pós-Graduação em Medicina/tendências , Previsões , História do Século XX , História do Século XXI , Humanos , Conselhos de Especialidade Profissional/história , Conselhos de Especialidade Profissional/normas , Conselhos de Especialidade Profissional/tendências , Cirurgiões/história , Cirurgiões/normas , Cirurgiões/tendências , Estados Unidos , Procedimentos Cirúrgicos Vasculares/história , Procedimentos Cirúrgicos Vasculares/normas , Procedimentos Cirúrgicos Vasculares/tendências
4.
Semin Vasc Surg ; 32(1-2): 5-10, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31540658

RESUMO

The American Board of Surgery (ABS) has more than 80 years of both direct and indirect involvement in US surgical education, with its primary role being certification of graduates of Accreditation Council for Graduate Medical Education-approved surgical training programs. The ABS's impact on education has been at multiple levels, including the development of the content and administration of qualifying and certifying examinations; original education research based on the Board's unique data sets; and surgical training and education-related initiatives in partnership with multiple regulatory bodies and surgical societies. Within these efforts, by incremental steps, the specialty of vascular surgery attained recognition as a primary specialty of the ABS, and the Vascular Surgery Board of the ABS was established 20 years ago, in 1998. The 2 decades that followed have witnessed significant transformations in the evaluation and treatment of vascular disease, the paradigms for training vascular and endovascular surgeons, and the Vascular Surgery Board has partnered with stakeholder organizations to continually ensure quality education for the evolving vascular surgical workforce. Looking forward, while surgical education remains outside of its primary mission, the ABS and Vascular Surgery Board will continue as key stakeholders and leaders in the complex network of professional societies and training institutions that will guide the evolution of vascular surgery training.


Assuntos
Educação de Pós-Graduação em Medicina/métodos , Conselhos de Especialidade Profissional , Cirurgiões/educação , Procedimentos Cirúrgicos Vasculares/educação , Competência Clínica , Currículo , Educação de Pós-Graduação em Medicina/história , Educação de Pós-Graduação em Medicina/normas , História do Século XX , História do Século XXI , Humanos , Conselhos de Especialidade Profissional/história , Conselhos de Especialidade Profissional/normas , Cirurgiões/história , Cirurgiões/normas , Estados Unidos , Procedimentos Cirúrgicos Vasculares/história , Procedimentos Cirúrgicos Vasculares/normas
6.
Pap. psicol ; 40(1): 21-30, ene.-abr. 2019. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-181995

RESUMO

El cuestionario para la Evaluación de los Tests (CET; Prieto y Muñiz, 2000) y su revisión (CET-R; Hernández et al., 2016) se han venido aplicando sistemáticamente desde 2010, impulsado por la Comisión de tests del Consejo General de la Psicología del Colegio Oficial de Psicólogos. El objetivo es proporcionar información contrastada sobre la calidad de las pruebas a los profesionales, con el fin de mejorar el uso de los tests. El presente trabajo tiene un doble objetivo. El primero, presentar los resultados de la sexta evaluación de tests psicológicos y educativos, en la que se han revisado un total de 10 tests. El segundo, evaluar el impacto que la aplicación del CET/CET-R ha tenido durante estos años en dos agentes cruciales: las editoriales de tests, y los profesores universitarios encargados de formar a los futuros profesionales usuarios de tests. Los resultados de la sexta evaluación, así como los resultados de la encuesta para evaluar el impacto del CET/CET-R, se pueden considerar en general satisfactorios. Sin embargo, se identifican varios aspectos que son susceptibles de mejora


The Questionnaire for the Assessment of Tests (CET; Prieto & Muñiz, 2000) and the revised version of this questionnaire (CET-R; Hernández et al., 2016) have been applied systematically since 2010 by the Test Commission of the Spanish Psychological Association. The main goal is to provide practitioners with reliable information on the quality of the tests in order to improve test use. The aim of this paper is twofold. First, to present the results of the sixth review of psychological and educational tests, in which a total of 10 tests have been evaluated. Second, to assess the impact that the application of CET/CET-R has had over these years on two key agents: test publishers and university lecturers who are responsible for training future test users. Both the results of the sixth review and the results of the survey to assess the impact of CET/CET-R are satisfactory in general terms. However, some issues where there is room for improvement have been identified


Assuntos
Humanos , Testes Psicológicos , Psicometria/educação , Psicologia Educacional/métodos , Psicologia Educacional/organização & administração , Docentes/estatística & dados numéricos , Inquéritos e Questionários , Conselhos de Especialidade Profissional/organização & administração , Conselhos de Especialidade Profissional/normas , Editoração/estatística & dados numéricos , Psicologia Educacional/estatística & dados numéricos
7.
Plast Reconstr Surg ; 143(5): 1099e-1105e, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30807492

RESUMO

BACKGROUND: Originally developed for resident self-assessment, the Plastic Surgery In-Service Examination has been administered for over 45 years. The Accreditation Council for Graduate Medical Education requires that at least 70 percent of graduates pass the American Board of Plastic Surgery Written Examination on their first attempt. This study evaluates the role of In-Service Exam scores in predicting Written Exam success. METHODS: In-Service Exam scores from 2009 to 2015 were collected from the National Board of Medical Examiners. Data included residency training track, training year, and examination year. Written Exam data were gathered from the American Board of Plastic Surgery. Multivariate analysis was performed and receiver operating characteristic curves were used to identify optimal In-Service Exam score cut-points for Written Exam success. RESULTS: Data from 1364 residents were included. Residents who failed the Written Exam had significantly lower In-Service Exam scores than those who passed (p < 0.001). Independent residents were 7.0 times more likely to fail compared with integrated/combined residents (p < 0.001). Residents who scored above the optimal cut-points were significantly more likely to pass the Written Exam. The optimal cut-point score for independent residents was the thirty-sixth percentile and the twenty-second percentile for integrated/combined residents. CONCLUSIONS: Plastic Surgery In-Service Exam scores can predict success on the American Board of Plastic Surgery Written Exam. Residents who score below the cut-points are at an increased risk of failing. These data can help identify residents at risk for early intervention.


Assuntos
Sucesso Acadêmico , Educação de Pós-Graduação em Medicina/estatística & dados numéricos , Internato e Residência/estatística & dados numéricos , Conselhos de Especialidade Profissional/estatística & dados numéricos , Cirurgia Plástica/educação , Competência Clínica , Educação de Pós-Graduação em Medicina/normas , Escrita Manual , Humanos , Autoavaliação , Conselhos de Especialidade Profissional/normas , Estados Unidos
8.
Turk Neurosurg ; 29(1): 121-126, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30614509

RESUMO

AIM: To provide information on the process and the results of the Turkish Board of Neurological Surgery and increase the relevant awareness. MATERIAL AND METHODS: The number of applications to the written and oral board exams organized by the Turkish Neurosurgical Society Proficiency Board since 2006, the number of successful and unsuccessful participants, and the number of the neurosurgery residents and specialists who applied to the exam were evaluated. RESULTS: A total of 554 candidates took the exam since 2006 when the first TBNS was applied. Two hundred and sixty of the candidates were successful (46.9%), and 294 (53.1%) were unsuccessful. Two hundred and forty six (44.4%) of those who took the test were neurosurgeons, 308 (55.6%) were neurosurgery residents who had completed their 3rd year in their training. The highest score in the written exams was 93/100, and the lowest score was 33/100. In verbal exams, a total of 73 candidates participated, and 66 (90.4 %) of them were successful while 7 of them (9.6%) were unsuccessful. CONCLUSION: Board exams are inevitable to provide a certain level of education and standardization in the training of neurosurgery. Our duty as neurosurgeons is to participate in these exams and work to increase participation for continuing education.


Assuntos
Neurocirurgiões/educação , Neurocirurgiões/normas , Neurocirurgia/educação , Neurocirurgia/normas , Feminino , Humanos , Internato e Residência , Masculino , Conselhos de Especialidade Profissional/normas
9.
Arthritis Care Res (Hoboken) ; 71(3): 337-342, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30570838

RESUMO

OBJECTIVE: There continues to be a debate about the value and purpose of maintenance of certification (MOC) programs in the US. The goal of this study is to assess the impact, value, and purpose of MOC programs in rheumatology. METHODS: A survey was sent to 3,107 rheumatologists in the US. The survey addressed how rheumatologists perceive the value and impact of MOC programs on rheumatology practice and patient care. RESULTS: A total of 515 rheumatologists completed this survey. The majority (74.8%) believed there was no significant value in MOC, beyond what is already achieved from continuing medical education. Most rheumatologists did not believe MOC was valuable in improving patient care (63.5%), and the majority felt that the primary reason for creating MOC was either the financial well-being of board-certifying organizations (43.4%) or to satisfy administrative requirements in health systems (30%). Although 65.6% perceived that staying current with new medical knowledge was a positive impact of MOC programs, the MOC was perceived to result in time away from providing patient care (74.6%) and time away from family (74%). When asked about potential effects of requiring MOC, 77.7% reported physician burnout, 67.4% early physician retirement, and 63.9% anticipated an effect on reducing the overall number of practicing rheumatologists. CONCLUSION: The majority of rheumatologists do not believe there is significant value for MOC programs. There is evidence for lack of trust in board-certifying organizations, and rheumatologists believe MOC programs contribute to physician burnout, early retirement, and loss in the rheumatology workforce.


Assuntos
Atitude do Pessoal de Saúde , Certificação/normas , Competência Clínica/normas , Percepção , Reumatologistas/normas , Conselhos de Especialidade Profissional/normas , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Percepção/fisiologia , Reumatologistas/psicologia , Inquéritos e Questionários/normas , Estados Unidos/epidemiologia
11.
Clin J Oncol Nurs ; 22(6): 656-662, 2018 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-30452006

RESUMO

BACKGROUND: Lung cancer traditionally has a high morbidity and mortality rate because of late diagnosis. Use of a tumor board has been noted as one way to improve patient care and quality of life. OBJECTIVES: This article aimed to determine the contributions of an oncology nurse navigator (ONN) related to physician adherence to guidelines and streamlined patient care in an interprofessional lung cancer tumor board. METHODS: Retrospective chart review was performed for 18 months prior to and following implementation of the lung cancer tumor board. FINDINGS: After implementation of the lung cancer tumor board and the creation of clinical pathways by the ONN, diagnosis of early-stage non-small cell lung cancer and the use of diagnostic workups increased.


Assuntos
Carcinoma Pulmonar de Células não Pequenas/terapia , Neoplasias Pulmonares/terapia , Enfermagem Oncológica/normas , Navegação de Pacientes/normas , Guias de Prática Clínica como Assunto , Conselhos de Especialidade Profissional/normas , Carcinoma Pulmonar de Células não Pequenas/diagnóstico , Detecção Precoce de Câncer/normas , Feminino , Fidelidade a Diretrizes/estatística & dados numéricos , Humanos , Relações Interprofissionais , Neoplasias Pulmonares/diagnóstico , Masculino , Papel do Profissional de Enfermagem , Avaliação em Enfermagem/normas , Equipe de Assistência ao Paciente/organização & administração , Melhoria de Qualidade , Sistema de Registros , Estudos Retrospectivos , Resultado do Tratamento , Estados Unidos
14.
Int J Health Policy Manag ; 7(9): 782-790, 2018 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-30316226

RESUMO

BACKGROUND: National licensing examinations (NLEs) are large-scale examinations usually taken by medical doctors close to the point of graduation from medical school. Where NLEs are used, success is usually required to obtain a license for full practice. Approaches to national licensing, and the evidence that supports their use, varies significantly across the globe. This paper aims to develop a typology of NLEs, based on candidacy, to explore the implications of different examination types for workforce planning. METHODS: A systematic review of the published literature and medical licensing body websites, an electronic survey of all medical licensing bodies in highly developed nations, and a survey of medical regulators. RESULTS: The evidence gleaned through this systematic review highlights four approaches to NLEs: where graduating medical students wishing to practice in their national jurisdiction must pass a national licensing exam before they are granted a license to practice; where all prospective doctors, whether from the national jurisdiction or international medical graduates, are required to pass a national licensing exam in order to practice within that jurisdiction; where international medical graduates are required to pass a licensing exam if their qualifications are not acknowledged to be comparable with those students from the national jurisdiction; and where there are no NLEs in operation. This typology facilitates comparison across systems and highlights the implications of different licensing systems for workforce planning. CONCLUSION: The issue of national licensing cannot be viewed in isolation from workforce planning; future research on the efficacy of national licensing systems to drive up standards should be integrated with research on the implications of such systems for the mobility of doctors to cross borders.


Assuntos
Competência Clínica/normas , Países Desenvolvidos , Educação Médica/normas , Licenciamento em Medicina/normas , Faculdades de Medicina/normas , Educação Médica/classificação , Avaliação Educacional/normas , Humanos , Internacionalidade , Licenciamento em Medicina/classificação , Médicos/normas , Faculdades de Medicina/classificação , Conselhos de Especialidade Profissional/normas
16.
Circ Cardiovasc Interv ; 11(9): e006094, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-30354589

RESUMO

BACKGROUND: Patients and other providers have access to few publicly available physician attributes that identify interventional cardiologists with better postprocedural outcomes, particularly in states without public reporting of outcomes. Interventional cardiology board certification, maintenance of certification, graduation from a US medical school, medical school ranking, and length of practice represent such publicly available attributes. Previous studies on these measures have shown mixed results. METHODS AND RESULTS: We included interventional cardiologists practicing in New York State in the years 2011 to 2013. The primary outcome was 30-day risk-standardized mortality rate (RSMR) after percutaneous coronary intervention. Hierarchical regression modeling was used to analyze the physician attributes and was adjusted for provider caseload. A total of 356 providers were studied. The average 30-day RSMR was 1.1 (SD=0.1) deaths per 100 cases for all percutaneous coronary interventions and 0.7 (SD=0.1) deaths per 100 cases for nonemergent procedures. The primary outcome was slightly lower among providers with interventional cardiology board certification compared with noncertified providers (1.06 [SD=0.14] versus 1.14 [SD=0.14] deaths per 100 cases; P<0.001). In multivariable hierarchical regression modeling, after adjusting for provider caseload, none of the physician attributes were associated with the primary outcome. Provider caseload was significantly associated with 30-day RSMR independent of the other attributes. CONCLUSIONS: Interventional cardiology board-certified providers had a modestly lower 30-day RSMR before accounting for caseload. However, after adjusting for provider caseload, none of the examined publicly available physician attributes, including interventional cardiology board certification, were independently associated with 30-day RSMR.


Assuntos
Cardiologistas/educação , Competência Clínica , Educação de Pós-Graduação em Medicina , Intervenção Coronária Percutânea/mortalidade , Indicadores de Qualidade em Assistência à Saúde , Conselhos de Especialidade Profissional , Cardiologistas/normas , Competência Clínica/normas , Bases de Dados Factuais , Educação de Pós-Graduação em Medicina/normas , Humanos , New York , Intervenção Coronária Percutânea/efeitos adversos , Intervenção Coronária Percutânea/normas , Indicadores de Qualidade em Assistência à Saúde/normas , Medição de Risco , Fatores de Risco , Conselhos de Especialidade Profissional/normas , Fatores de Tempo , Resultado do Tratamento , Carga de Trabalho
18.
Fam Med ; 50(8): 597-604, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-30215819

RESUMO

BACKGROUND AND OBJECTIVES: The American Board of Family Medicine (ABFM) is the first medical specialty board to require all residents participate in the maintenance of certification (MOC) process prior to sitting for board certification. This study used surveys and focus groups of family medicine residents in four university-affiliated residency programs to explore participants' perceived benefits and barriers to common methods of completing the performance improvement in practice (Part IV) MOC requirement, and the perceived impact on practice. METHODS: Residents independently selected into one of three ABFM-approved methods of meeting the Part IV requirement. Following completion of the activity, participants completed a survey and then participated in a focus group. RESULTS: Residents cited time constraints as a major barrier to all Part IV methods. They also reported lack of relevance to practice, deficiencies in performance improvement skills, and access to clinical data. Ease of use was a benefit of online modules, but residents did not perceive them as relevant to practice or leading practice change. Portfolio and self-directed activities were perceived as most relevant to practice and improved patient care, and involved more team-based experiences. Most participants would not participate in Part IV if not required. CONCLUSIONS: Group quality improvement projects through the portfolio-approved and self-directed activities seemed to be the most positively reported way to complete the ABFM requirement. Regardless of method, time constraints and quality improvement expertise are significant barriers to completion of the requirement. Residency programs will need to grapple with these barriers to maximize benefits to residents as they prepare to become board certified.


Assuntos
Competência Clínica/normas , Medicina de Família e Comunidade/educação , Internato e Residência , Conselhos de Especialidade Profissional/normas , Grupos Focais , Humanos , Masculino , Melhoria de Qualidade , Inquéritos e Questionários
19.
J Surg Educ ; 75(6): e47-e53, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30122641

RESUMO

OBJECTIVE: There has been a significant increase in the number of regulatory requirements for general surgery graduate medical education (GME) programs over the last 20 years from the governing bodies of the American Board of Surgery (ABS) and the Accreditation Council of Graduate Medical Education (ACGME). We endeavored to calculate the cost to general surgery GME programs of regulatory requirements. DESIGN: We examined the requirements for General Surgery ABS Certification as well as the 2017 ACGME Program Requirements in General Surgery for all mandates that require funding by the surgery program to achieve. The requirements requiring funding include certification in Advanced Cardiac Life Support, Advanced Trauma Life Support, Fundamentals of Laparoscopic Surgery, Fundamentals of Endoscopic Surgery; access to medical references; simulation capability, program director protected time (30%); program coordinator salary (Association for Hospital Medical Education reported mean); and faculty time devoted to morbidity and mortality conference, journal club, Clinical Competency Committee, and Program Evaluation Committee. We then identified the cost of each mandate based on the average program in the United States of 5 residents per year in 5 clinical years. RESULTS: Total cost for the average program per year as the result of ABS or ACGME mandate equaled a minimum of $227,043. The ABS associated costs are $8900 per year. The ACGME associated costs are $218,143. The cost of program director and faculty time to meet the minimum ACGME requirements equaled $159,600. CONCLUSIONS: The most significant cost associated with mandates set forth by the ABS and ACGME are program director and faculty time devoted to resident education and evaluation. Recognition of this cost burden by institutions and policymakers for the allocation of funds is important to maintain strong general surgery GME programs.


Assuntos
Acreditação/normas , Educação de Pós-Graduação em Medicina/normas , Cirurgia Geral/educação , Conselhos de Especialidade Profissional/normas , Estados Unidos
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