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1.
Harefuah ; 158(10): 643-647, 2019 Oct.
Artigo em Hebraico | MEDLINE | ID: mdl-31576709

RESUMO

INTRODUCTION: During the last decades the dominant paradigm, in which the duration of a rotation/course, the required content to be learnt (the material covered) and a test (usually a multiple choice one) evaluating the knowledge of the content, were paramount, is being replaced by a new paradigm: outcome/competency based medical education (CBME, OBME). In this paper the reasons for adopting this change in the developed world are presented, its nature and basic assumptions enumerated and national examples of its adoption from Scotland, Canada, UK and USA described. We will present in some detail the changes this approach entails, the new definitions it adopts, the learning outcomes it aspires to and how to evaluate them. Finally, we will present a draft outcomes proposal adapted to the Israeli reality. Since the Medicine Deans Forum and the Scientific Council of the Israeli Medical Association have adopted the new paradigm for the training of Israeli physicians, it is an opportune moment to expose the readership of Harefuah (i.e. Israel's physicians and medical students) to this relatively new paradigm.


Assuntos
Educação Médica , Médicos , Estudantes de Medicina , Educação Baseada em Competências , Humanos , Israel
2.
Harefuah ; 158(10): 674-679, 2019 10.
Artigo em Hebraico | MEDLINE | ID: mdl-31576716

RESUMO

INTRODUCTION: Competency Based Medical Education (CBME) is an educational approach that occupies a central place in medical education. Medical education is accountable for the graduates' professional level, ensuring they are skilled and competent in all key areas of their profession. Adopting CBME underscores the importance of simulation-based training. Experiential training provides, among other things: standardization of training, controlled exposure to extreme events and soft skills, such as patient-caregiver communication and teamwork training. Unlike the traditional apprentice approach, accountability reinforces the choice of a preliminary encounter with simulated patients prior to real-life care, as a complimentary tool for improving patient safety. Incorporating a practical exam is self-evident in CBME because of the need to ensure that the examinees are competent to provide unsupervised safe and quality care. Implementation of a national CBME program, likewise, incorporating simulation into national training programs, requires involvement and supervision on health system regulators. In this paper, we describe simulation-based national training programs that to date integrate competency-based training in the various medical sectors. As national programs, they are implemented under the guidance and in cooperation with the regulators. On the one hand, CBME is a new approach and its implementation will require time and the cooperation of many stakeholders. On the other hand, simulation is an existing, well-established training and assessment tool that can be used as an anchor around which you can start building the competency-based training programs.


Assuntos
Educação Baseada em Competências , Educação Médica , Humanos
3.
Rev Saude Publica ; 53: 74, 2019 Sep 09.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31508779

RESUMO

In their pedagogical projects, health management courses focus on multidisciplinarity, interdisciplinarity, comprehensiveness and transversality, whose main merit is to question health issues from different theoretical perspectives. Analyzing these issues under many perspectives does not necessarily mean the development of transversal competences. The development and application of these competences suppose going beyond integrating curricular contents and theory/practice. They depend on how the knowledge will be articulated to changes at organizational, sectorial and institutional levels and on the coevolution between these competences and changes. It is understood that health services manager role is effectively transversal when he/she: (i) acts at organizational boundaries, fostering interaction between organizations and other actors in the system; (ii) provides (and receives) feedback to (and from) these actors; and (iii) these feedbacks help decision makers to undertake organizational changes to respond to the environment and shape it.


Assuntos
Educação Baseada em Competências/métodos , Administradores de Instituições de Saúde/educação , Brasil , Administradores de Instituições de Saúde/organização & administração , Humanos , Competência Profissional
4.
J Vet Med Educ ; 46(3): 340-352, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31460844

RESUMO

BACKGROUND: Entrustable Professional Activities (EPAs) combine feedback and evaluation with a permission to act under a specified level of supervision and the possibility to schedule learners for clinical service. This literature review aims to identify workplace-based assessment tools that indicate progression toward unsupervised practice, suitable for entrustment decisions and feedback to learners. METHODS: A systematic search was performed in the PubMed, Embase, ERIC, and PsycINFO databases. Based on title/abstract and full text, articles were selected using predetermined inclusion and exclusion criteria. Information on workplace-based assessment tools was extracted using data coding sheets. The methodological quality of studies was assessed using the medical education research study quality instrument (MERSQI). RESULTS: The search yielded 6,371 articles (180 were evaluated in full text). In total, 80 articles were included, identifying 67 assessment tools. Only a few studies explicitly mentioned assessment tools used as a resource for entrustment decisions. Validity evidence was frequently reported, and the MERSQI score was 10.0 on average. CONCLUSIONS: Many workplace-based assessment tools were identified that potentially support learners with feedback on their development and support supervisors with providing feedback. As expected, only few articles referred to entrustment decisions. Nevertheless, the existing tools or the principals could be used for entrustment decisions, supervision level, or autonomy.


Assuntos
Tomada de Decisões , Educação em Veterinária , Local de Trabalho , Animais , Competência Clínica , Educação Baseada em Competências , Currículo , Retroalimentação , Humanos
6.
Pediatr Clin North Am ; 66(4): 839-854, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31230626

RESUMO

This article provides an overview of the role played by the clinical learning environment in providing opportunities for assessment of trainee performance and how those assessments can guide learning. It reviews the importance of competency models as frameworks to facilitate the creation of a shared mental model of what is to be learned between learners and supervisors. In addition, it discusses how assessment can be used to drive mastery learning as well as the components necessary for a program of assessment.


Assuntos
Competência Clínica , Educação Baseada em Competências , Educação de Pós-Graduação em Medicina , Avaliação Educacional/métodos , Aprendizagem , Pediatria/educação , Humanos , Motivação
8.
Lakartidningen ; 1162019 May 07.
Artigo em Sueco | MEDLINE | ID: mdl-31192435

RESUMO

Entrustable Professional Activities (EPAs) define observable key tasks that a doctor should be able to do independently after having completed a certain level of education. Progression is facilitated by frequent assessments of the defined activities, with increased degree of independence. The observations should be supported by constructive feed-forward. EPA is currently used in several countries both in undergraduate and post graduate education. In the context of pending changes in Swedish legislation regarding undergraduate education qualifications ordinance and medical licensing, a Swedish national work group has begun to define Swedish EPA for the future undergraduate education.


Assuntos
Competência Clínica/normas , Educação Baseada em Competências , Educação de Graduação em Medicina , Educação Baseada em Competências/métodos , Educação Baseada em Competências/organização & administração , Educação de Graduação em Medicina/métodos , Educação de Graduação em Medicina/organização & administração , Avaliação Educacional , Feedback Formativo , Humanos , Médicos/normas , Suécia , Confiança
9.
Rev. Univ. Ind. Santander, Salud ; 51(2): 129-134, abr.-jun. 2019. tab
Artigo em Espanhol | LILACS | ID: biblio-1003163

RESUMO

Resumen Introducción: El perfil profesional consiste en la descripción de las habilidades, conocimiento y destrezas que un profesional debe tener o tiene para ejercer eficientemente en un puesto de trabajo; son actividades que los jefes directivos esperan que asuma el trabajador como parte del desarrollo de su profesión. Objetivo: Describir la percepción del perfil profesional del egresado de fisioterapia en una Institución Universitaria Pública desde la perspectiva de los jefes directos. Metodología: Estudio descriptivo transversal, con una muestra de 25 jefes directos de los egresados de una universidad pública, seleccionados aleatoriamente de la base de datos de egresados de la institución; quienes diligenciaron un cuestionario en físico de 33 preguntas, elaborado por los investigadores. Resultados: Los cuestionarios fueron analizados con Microsoft Excel. De acuerdo con la valoración dada por los jefes directos del fisioterapeuta, se caracterizó por un alto grado de compromiso profesional y ético, conocimientos teóricos y prácticos, además de la calidad en el trabajo y cumplimiento. Sin embargo, la competencia menor calificada, fue el conocimiento de idiomas. Conclusiones: La percepción del perfil profesional para el jefe directo, tiene que ver con las competencias específicas y con la práctica basada en la evidencia, siendo las que obtuvieron un valor de 80%, por debajo del resultado obtenido en las competencias genéricas en el perfil observado en el profesional de la institución superior.


Abstract Introduction: Professional profile involves the description of abilities, knowledge and skills that every professional has or should have for an efficient work performance. This entails activities that executive heads expect that workers are in charge as part of their professional development. Objective: To describe the perception of the professional profile of the physiotherapy graduate in a public university institution from the perspective of the direct heads. Methodology: Cross-sectional descriptive study with a sample of 25 direct heads of graduates of a public university, randomly selected from the database of graduates of the institution. The participants answered a 33-question printed questionnaire designed by the researchers. Results: Every questionnaire was analyzed with Microsoft Excel. In accordance to the given assessment of the direct heads, the physiotherapists were characterized by having high professional and ethical commitment, theoretical and practical insights, and high quality in work performance and compliance at work. Nevertheless, the competence with the lowest score was the knowledge on foreign languages. Conclusions: The perception of the professional profile from the direct heads has to do with the specific competences and the evidence-based practice. These obtained a value of 80%, below the result obtained in the generic competences in the profile observed in the professional of the higher institution.


Assuntos
Humanos , Descrição de Cargo , Educação Baseada em Competências , Fisioterapia
10.
J Dent Educ ; 83(9): 1019-1029, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31133616

RESUMO

The aims of this study were to understand dental hygiene clinical instructors' teaching and learning perspectives regarding their described pedagogical beliefs, perceived roles in facilitating learning, and factors that influenced those perspectives and to assess how their espoused beliefs matched their instructional practice in relation to student-centered competency-based education. The Theory of Planned Behavior was used as a theoretical framework to guide the qualitative study design and analysis. Data were collected through semi-structured interviews with 15 dental hygiene clinical instructors at a Canadian university in 2014. Transcript data derived from the interviews were coded for thematic analysis. In the results, these dental hygiene clinical instructors reported a spectrum of pedagogical beliefs, with one end defined as student-centered and the other end teacher-centered. While the instructors tended to describe their teaching as student-centered, their responses in the simulated teaching scenarios of the interview were closer to teacher-centered practices. Interview-analysis results showed that the process by which the instructors developed their approaches to teaching was multifactorial. Factors included instructors' perceptions of their own learning experiences, experiences of inter-instructor collaboration, and methods of supporting students' self-efficacy in learning. Given the emergence of support for student-centered education ideology and the program's adoption of this ideology, this exploratory study suggests that uncovering the teaching and learning beliefs of instructors is crucial prior to designing faculty development programs.


Assuntos
Educação Baseada em Competências , Higienistas Dentários/educação , Educação em Odontologia , Higiene Bucal , Estudantes de Odontologia/psicologia , Atitude do Pessoal de Saúde , Canadá , Currículo , Tecnologia Educacional , Docentes de Odontologia , Humanos , Aprendizagem , Aprendizagem Baseada em Problemas , Pesquisa Qualitativa , Inquéritos e Questionários , Ensino
11.
J Dent Educ ; 83(9): 1076-1080, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31133620

RESUMO

With the extensive amount of learning required in dental schools, educators are constantly seeking more efficient learning models. The aim of this retrospective study was to evaluate a fixed prosthodontics course after its curriculum transitioned from a traditional lecture format to an active learning structure over the course of five years. In this retrospective, mono-centered study completed in 2018 at a U.S. dental school, data from the school's fixed prosthodontics course exams, National Board Dental Examination Part II (NBDE II), and the operative portion of the Western Regional Examining Board (WREB) licensure exam were collected for 381 students from the inaugural Class of 2015 to the Class of 2019. Data were evaluated for two groups based on method of instruction: the Classes of 2015 and 2016 were taught in a traditional model, and the Classes of 2017-19 were taught in the modified learning model. The data showed a 30% reduction in time students spent in the classroom and simulation clinic as compared to the previous model. The modified learning model reduced time spent in lecture, length of the course, and number of projects needed, while student performance remained consistent. Students in the active learning classes were able to pass all assessments including practical examinations at the same rate as previous classes using traditional learning methods. Students' performance on standardized national exams (NBDE II and WREB licensure exams) remained consistent among the graduating classes, and scores were comparable to the national average. Although limited in scope, this study suggests that it is possible to reduce contact time in fixed prosthodontics and maintain performance by increasing student engagement through active learning techniques.


Assuntos
Educação em Odontologia/métodos , Aprendizagem Baseada em Problemas/métodos , Prostodontia/educação , Estudantes de Odontologia/psicologia , Ensino , Educação Baseada em Competências , Currículo , Avaliação Educacional , Humanos , Estudos Retrospectivos , Faculdades de Odontologia , Estados Unidos
12.
Nurse Educ Today ; 79: 161-167, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31132728

RESUMO

BACKGROUND: Following major organizations' recommendations, healthcare professionals' education has been reformed in the last decade into competency-based education (CBE) to better prepare them with core competencies. This change was intended to prepare new graduates for the reality of health systems and future challenges. Few studies have focused on how new graduate nurses (NGNs) from these reformed programs use the competencies they have developed. OBJECTIVE: To describe the competencies of NGNs from a Canadian competency-based baccalaureate program, as perceived by various actors in acute-care settings. METHODS: A focused ethnography was conducted on three acute-care wards of an academic hospital. Participants (n = 19) from four subgroups (NGNs, preceptors, clinical nurse specialists, and nurse managers) participated in individual semi-structured interviews or focus groups. Data were also collected through observation and fieldnotes; an ethnographic analysis framework was used. RESULTS: Three themes were identified to describe the deployment of NGNs' competencies: NGNs' appropriation of their new role, fragmentation of practice into tasks, and development of practice; NGNs' collaboration within the interprofessional team, management of the dyad with licensed practical nurses, and ability to integrate patients and families into the team; and NGNs' scientific practice, increased scientific curiosity, and use of credible sources. Analysis of these themes' elements in light of the competency framework of the program showed that NGNs deploy seven of the eight competencies developed during their training. CONCLUSION: This study's results can be applied by nursing educators and hospital decision makers to ensure NGNs are able to use their competencies and to smoothen the transition period between the academic and clinical settings.


Assuntos
Antropologia Cultural , Competência Clínica/normas , Educação Baseada em Competências/normas , Enfermeiras e Enfermeiros , Adulto , Canadá , Cuidados Críticos , Bacharelado em Enfermagem , Humanos , Pessoa de Meia-Idade , Pesquisa em Educação de Enfermagem , Equipe de Assistência ao Paciente , Adulto Jovem
13.
Fam Med ; 51(4): 331-337, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30973621

RESUMO

BACKGROUND AND OBJECTIVES: In 2010, the College of Family Physicians of Canada (CFPC) launched its competency-based medical education (CBME) approach to residency curriculum and assessment. Named Triple C, this innovation was developed to ensure graduates of family medicine training programs are competent to begin unsupervised practice. Further, Triple C was intended to promote interest in practicing comprehensive family medicine. A program evaluation plan was launched by the CFPC alongside the implementation of Triple C to explore if intended outcomes were achieved. METHODS: We conducted retrospective secondary data analysis of survey findings from graduating family medicine residents from two sources: National Physician Survey (NPS 2007 and 2010); and the Family Medicine Longitudinal Survey (FMLS 2015). Demographics and practice intentions reported by residents in the NPS 2007, NPS 2010, and FMLS 2015 were included in the analyses and a comparison between years was undertaken using a series of Pearson χ2 test. RESULTS: Findings indicate that in comparison to pre-Triple C (NPS 2007 and NPS 2010), significantly more residents reported the intention to include palliative care, intrapartum care, in-patient hospital care, care in the home, and practicing in rural settings after the implementation of Triple C (FMLS 2015; P<0.01). CONCLUSIONS: Family medicine graduates report an increase in intention to include a broader range of clinical domains after implementation of Triple C. While a causal relationship cannot be determined, using a historical control in the form of survey data that predates Triple C implementation could support future approaches to evaluation of education reform.


Assuntos
Educação Baseada em Competências/normas , Currículo , Medicina de Família e Comunidade/educação , Internato e Residência , Médicos de Família/normas , Canadá , Feminino , Humanos , Estudos Longitudinais , Masculino , Avaliação de Programas e Projetos de Saúde , Estudos Retrospectivos , Inquéritos e Questionários
15.
BMC Med Educ ; 19(1): 100, 2019 Apr 05.
Artigo em Inglês | MEDLINE | ID: mdl-30953546

RESUMO

BACKGROUND: Simulation-based medical education (SBME) is a cornerstone for procedural skill training in residency education. Multiple studies have concluded that SBME is highly effective, superior to traditional clinical education, and translates to improved patient outcomes. Additionally it is widely accepted that mastery learning, which comprises deliberate practice, is essential for expert level performance for routine skills; however, given that highly structured practice is more time and resource-intensive, it is important to assess its value for the acquisition of rarely performed technical skills. The bougie-assisted cricothyroidotomy (BAC), a rarely performed, lifesaving procedure, is an ideal skill for evaluating the utility of highly structured practice as it is relevant across many acute care specialties and rare - making it unlikely for learners to have had significant previous training or clinical experience. The purpose of this study is to compare a modified mastery learning approach with deliberate practice versus self-guided practice on technical skill performance using a bougie-assisted cricothyroidotomy model. METHODS: A multi-centre, randomized study will be conducted at four Canadian and one American residency programs with 160 residents assigned to either mastery learning and deliberate practice (ML + DP), or self-guided practice for BAC. Skill performance, using a global rating scale, will be assessed before, immediately after practice, and 6 months later. The two groups will be compared to assess whether the type of practice impacts performance and skill retention. DISCUSSION: Mastery learning coupled with deliberate practice provides systematic and focused feedback during skill acquisition. However, it is resource-intensive and its efficacy is not fully defined. This multi-centre study will provide generalizable data about the utility of highly structured practice for technical skill acquisition of a rare, lifesaving procedure within postgraduate medical education. Study findings will guide educators in the selection of an optimal training strategy, addressing both short and long term performance.


Assuntos
Competência Clínica/normas , Cartilagem Cricoide/cirurgia , Medicina de Emergência/educação , Internato e Residência , Intubação Intratraqueal/métodos , Cartilagem Tireóidea/cirurgia , Traqueostomia/educação , Canadá , Educação Baseada em Competências , Simulação por Computador , Avaliação Educacional , Medicina de Emergência/normas , Humanos , Internato e Residência/normas , Intubação Intratraqueal/normas , Traqueostomia/normas , Estados Unidos
16.
J Laryngol Otol ; 133(4): 269-274, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30967161

RESUMO

BACKGROUND: ENT is highly under-represented in the saturated UK medical school curriculum, comprising less than 1 per cent of the curriculum. A 1-day course was implemented in order to raise awareness of ENT among medical students, educate them in the specialty and teach a basic skill. METHODS: The skills day comprised lectures by consultants followed by a consultant-led workshop teaching tracheostomy. Pre- and post-course questionnaires assessed perceptions of ENT, confidence performing tracheostomy and interest in ENT as a career. RESULTS: Perceptions of ENT as a specialty were improved by up to 80 per cent (p < 0.01). There was improved understanding of and confidence in performing tracheostomies. Interest in a career in ENT was increased by 77 per cent (p < 0.01). CONCLUSION: A 1-day course run by a student body can be a powerful adjunct to the medical school curriculum, in terms of educating undergraduates in ENT and inspiring the pursuit of ENT as a career.


Assuntos
Otolaringologia/educação , Estudantes de Medicina/psicologia , Traqueostomia/educação , Escolha da Profissão , Competência Clínica , Educação Baseada em Competências , Feminino , Humanos , Masculino , Faculdades de Medicina , Inquéritos e Questionários
18.
J Dent Educ ; 83(4): 464-473, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30936212

RESUMO

The Association of Canadian Faculties of Dentistry (ACFD) recently developed a proposal that reflects its evolving understanding of competency-based dental education. The ACFD proposal was developed into an Educational Framework for the Development of Competency in Dental Programs and has been adopted by all ten Canadian dental schools as the basis for their ongoing curriculum development and assessment. This framework identifies five global competencies that provide a big picture of the complex skills, knowledge, and behaviors that dental graduates must demonstrate. Detail for clarification and illustration is provided by more comprehensive "components" of each area that elaborate on the global statement and by a new dimension that assists with assessment: "indicators" of the specific knowledge, skills, and behaviors that can be measured as steps towards developing competence. In the information supporting understanding and assessment of the five key areas are both the existing national competency statements to facilitate the use of the framework by other stakeholders and a parallel set of knowledge, skills, and abilities statements developed by the National Dental Examining Board of Canada (NDEB) as the starting point for updating its examination blueprints. This article outlines the development, structure, and contents of the ACFD Educational Framework in the hope that it can serve as the foundation for a new Canadian national competencies document serving all national stakeholders.


Assuntos
Competência Clínica/normas , Educação em Odontologia/normas , Docentes de Odontologia , Sociedades Odontológicas/normas , Comitês Consultivos , Canadá , Educação Baseada em Competências/normas , Humanos
19.
Epileptic Disord ; 21(2): 129-140, 2019 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-30892268

RESUMO

Teaching competency in the diagnosis and clinical management of epilepsy is of utmost importance for the ILAE. To achieve this mission, the Task Force for Epilepsy Education (EpiEd) developed a competency-based curriculum for epileptology, covering the spectrum of skills and knowledge for best medical practice. The curriculum encompasses seven domains, 42 competencies, and 124 learning objectives, divided into three levels: entry (Level 1), proficiency (Level 2), and advanced proficiency (Level 3). A survey of the currently existing ILAE-endorsed teaching activities identified a significant gap in education of basic knowledge of epileptology (Level 1). To bridge this gap, a web-based educational tool is being developed. A virtual campus will be constructed around the curriculum, integrating the various educational activities of the ILAE. This paper describes the development of the curriculum and future tasks necessary to achieve the educational goal of the ILAE.


Assuntos
Comitês Consultivos , Educação Baseada em Competências , Currículo , Epilepsia , Neurologia/educação , Sociedades , Epilepsia/diagnóstico , Epilepsia/terapia , Humanos
20.
J Wound Ostomy Continence Nurs ; 46(2): 161-164, 2019 Mar/Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30844873

RESUMO

The purpose of this Quality Improvement project was to develop a multimedia hospital-acquired pressure injury (HAPI) prevention education program. The project setting was 3 adult critical care units plus a step-down unit located in the Mid-Atlantic region of the United States. A multimedia educational intervention was developed, which comprised 4 modules designed to improve nursing knowledge and competency in HAPI prevention. A posteducation program staff survey was also administered to evaluate nurse satisfaction with the program. Nurse knowledge of HAPI prevention was measured before and following implementation of the educational intervention. One hundred twenty-nine participants completed the education program, and 117 completed the satisfaction survey. Analysis revealed a statistically significant increase in knowledge after the education course (P < .05). Findings also indicated participants were satisfied that the program met stated aims.


Assuntos
Educação Continuada em Enfermagem/métodos , Lesão por Pressão/prevenção & controle , Adulto , Educação Baseada em Competências/métodos , Feminino , Humanos , Doença Iatrogênica/prevenção & controle , Masculino , Pessoa de Meia-Idade , Melhoria de Qualidade , Inquéritos e Questionários , Ensino/tendências
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