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1.
Acad Med ; 96(7S): S6-S8, 2021 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-34183595

RESUMO

The COVID-19 pandemic of 2020 exposed the reactive nature of the medical education community in response to a disruption that, at one time, may have seemed preposterous. In this article, the author reflected on the impact of an unpredictable plight on a system of medical education that (1) is continuous but doesn't function as a continuum and (2) requires adaptation but is steeped in a fixed mindset and structure that resists change. As a result, innovations which were previously considered impossible, such as time variable education and training, were forced into being. Inspired by the changes brought about by the pandemic, the ensuing decade is explored through a lens of possible futures to envision a path forward based on resilience rather than reactivity.


Assuntos
COVID-19 , Educação Baseada em Competências/organização & administração , Educação Médica/organização & administração , Modelos Educacionais , Inovação Organizacional , Educação Baseada em Competências/métodos , Criatividade , Educação Médica/métodos , Humanos , Resiliência Psicológica , Análise de Sistemas , Estados Unidos
2.
Rev. Fund. Educ. Méd. (Ed. impr.) ; 24(1): 51-54, ene.-feb. 2021.
Artigo em Espanhol | IBECS | ID: ibc-202424

RESUMO

INTRODUCCIÓN: En el contexto de la implantación del Plan Bolonia en nuestras universidades, la enseñanza tradicional va incorporando nuevas técnicas de formación, muchas de ellas sustentadas en las nuevas tecnologías. MATERIAL Y MÉTODOS: Se ha creado www.radiologiaparaestudiantes.com, página de acceso libre con casos clinicorradiológicos reales, dirigidos a estudiantes de medicina y escogidos por su interés docente. Cada caso consta de una pequeña historia clínica, una imagen problema y una respuesta comentada. Incorpora también una sección de anatomía. RESULTADOS: La página consta en la actualidad de 237 casos distribuidos en diferentes secciones. Ha recibido 240.000 visitas con 1.230.000 páginas visualizadas. España, México y Argentina son los países de donde proceden la mayoría de los usuarios. CONCLUSIÓN: Esta página, combinada con otras formas de docencia, permite el desarrollo de competencias en radiología y acerca a los estudiantes a su actividad médica posterior


INTRODUCTION: In the context of the 'Bolonia Plan' establishment in our universities, traditional education is incorporating new training techniques, many of them underpinned by new technologies. MATERIAL AND METHOD: For this purpose, www.radiologiaparaestudiantes.com has been created. A free access website with clinical-radiological real cases, aimed to medical students and chosen by its teaching interest. Each case consists of a brief medical history, a problem picture and a discussed answer. It also incorporates an anatomical section. RESULTS: The website currently consists of 237 cases divided in different sections. It has received 240.000 visits with 1.230.000 visualized pages. Spain, Mexico and Argentina are the countries where most users come from. CONCLUSION: This website, in combination with other teaching resources, allows the development of radiological skills bringing students closer to its later medical practice


Assuntos
Humanos , Radiologia/educação , Sistemas de Informação em Radiologia/organização & administração , Educação Médica/tendências , Webcasts como Assunto/organização & administração , Arquivos da Web como Assunto , Educação à Distância/métodos , Educação Baseada em Competências/métodos
3.
J Postgrad Med ; 67(1): 18-23, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33533748

RESUMO

The uncertainty in all spheres of higher education due to the COVID-19 pandemic has had an unprecedented impact on teaching-learning and assessments in medical colleges across the globe. The conventional ways of assessment are now neither possible nor practical for certifying medical graduates. This has necessitated thoughtful considerations in making adjustments to the assessment system, with most institutions transitioning to online assessments that so far have remained underutilized. Programmatic assessment encourages the deliberate and longitudinal use of diverse assessment methods to maximize learning and assessment and at present can be utilized optimally as it ensures the collection of multiple low-stake assessment data which can be aggregated for high-stake pass/fail decisions by making use of every opportunity for formative feedback to improve performance. Though efforts have been made to introduce programmatic assessment in the competency-based undergraduate curriculum, transitioning to online assessment can be a potential opportunity if the basic tenets of programmatic assessment, choice of online assessment tools, strategies, good practices of online assessments and challenges are understood and explored explicitly for designing and implementing online assessments. This paper explores the possibility of introducing online assessment with face-to-face assessment and structuring a blended programmatic assessment in competency-based medical education.


Assuntos
Educação Baseada em Competências/métodos , Currículo , Educação à Distância/métodos , Educação Médica/métodos , Avaliação Educacional/métodos , Humanos , Índia
5.
Neurosurgery ; 88(4): E345-E350, 2021 03 15.
Artigo em Inglês | MEDLINE | ID: mdl-33471893

RESUMO

Over the last decade, strict duty hour policies, pressure for increased work related value units from faculty, and the apprenticeship model of education have coalesced to make opportunities for intraoperative teaching more challenging. Evidence is emerging that graduating residents are not exhibiting competence by failing to recognize major complications, and perform routine operations independently. In this pilot study, we combine Vygotsky's social learning theory with a modified version of the competency-based scale called TAGS to study 1 single operation, anterior cervical discectomy and fusion, with 3 individual residents taught by a single faculty member. In order for the 3 residents to achieve "Solo and Observe" in all 4 zones of proximal development, the number of cases required was 10 cases for postgraduate year (PGY)-3a, 19 cases for PGY 3b, and 22 cases for the PGY 2. In this pilot study, the time required to complete an independent 2-level anterior cervical discectomy and fusion by the residents correlated with the number of cases to reach competence. We demonstrate the Surgical Autonomy Program's ability to track neurosurgical resident's educational progress and the feasibility of using the Surgical Autonomy Program (SAP) to teach residents in the operating room and provide immediate formative feedback. Ultimately, the SAP represents a paradigm shift towards a modern, scalable competency-focused subspecialty teaching, evaluation and assessment tool that provides increases in resident's autonomy and metacognitive skills, as well as immediate formative feedback.


Assuntos
Competência Clínica/normas , Educação Baseada em Competências/normas , Condicionamento Psicológico , Internato e Residência/normas , Neurocirurgia/educação , Neurocirurgia/normas , Educação Baseada em Competências/métodos , Educação de Pós-Graduação em Medicina/métodos , Educação de Pós-Graduação em Medicina/normas , Humanos , Internato e Residência/métodos , Salas Cirúrgicas/métodos , Salas Cirúrgicas/normas , Projetos Piloto
6.
Acad Med ; 96(2): 199-204, 2021 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-33060399

RESUMO

The iconic Miller's pyramid, proposed in 1989, characterizes 4 levels of assessment in medical education ("knows," "knows how," "shows how," "does"). The frame work has created a worldwide awareness of the need to have different assessment approaches for different expected outcomes of education and training. At the time, Miller stressed the innovative use of simulation techniques, geared at the third level ("shows how"); however, the "does" level, assessment in the workplace, remained a largely uncharted area. In the 30 years since Miller's conference address and seminal paper, much attention has been devoted to procedures and instrument development for workplace-based assessment. With the rise of competency-based medical education (CBME), the need for approaches to determine the competence of learners in the clinical workplace has intensified. The proposal to use entrustable professional activities as a framework of assessment and the related entrustment decision making for clinical responsibilities at designated levels of supervision of learners (e.g., direct, indirect, and no supervision) has become a recent critical innovation of CBME at the "does" level. Analysis of the entrustment concept reveals that trust in a learner to work without assistance or supervision encompasses more than the observation of "doing" in practice (the "does" level). It implies the readiness of educators to accept the inherent risks involved in health care tasks and the judgment that the learner has enough experience to act appropriately when facing unexpected challenges. Earning this qualification requires qualities beyond observed proficiency, which led the authors to propose adding the level "trusted" to the apex of Miller's pyramid.


Assuntos
Competência Clínica/normas , Educação Baseada em Competências/métodos , Tomada de Decisões/ética , Confiança/psicologia , Atitude do Pessoal de Saúde , Conscientização , Educação/normas , Educação Médica/normas , Educação de Pós-Graduação em Medicina/métodos , Avaliação Educacional/métodos , Humanos , Aprendizagem/fisiologia , Local de Trabalho/organização & administração
7.
Acad Med ; 96(3): 402-408, 2021 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-33239533

RESUMO

PURPOSE: As global health education and training shift toward competency-based approaches, academic institutions and organizations must define appropriate assessment strategies for use across health professions. The authors aim to develop entrustable professional activities (EPAs) for global health to apply across academic and workplace settings. METHOD: In 2019, the authors invited 55 global health experts from medicine, nursing, pharmacy, and public health to participate in a multiround, online Delphi process; 30 (55%) agreed. Experts averaged 17 years of global health experience, and 12 (40%) were from low- to middle-income countries. In round one, participants listed essential global health activities. The authors used in vivo coding for round one responses to develop initial EPA statements. In subsequent rounds, participants used 5-point Likert-type scales to evaluate EPA statements for importance and relevance to global health across health professions. The authors elevated statements that were rated 4 (important/relevant to most) or 5 (very important/relevant to all) by a minimum of 70% of participants (decided a priori) to the final round, during which participants evaluated whether each statement represented an observable unit of work that could be assigned to a trainee. Descriptive statistics were used for quantitative data analysis. The authors used participant comments to categorize EPA statements into role domains. RESULTS: Twenty-two EPA statements reached at least 70% consensus. The authors categorized these into 5 role domains: partnership developer, capacity builder, data analyzer, equity advocate, and health promoter. Statements in the equity advocate and partnership developer domains had the highest agreement for importance and relevance. Several statements achieved 100% agreement as a unit of work but achieved lower levels of agreement regarding their observability. CONCLUSIONS: EPAs for global health may be useful to academic institutions and other organizations to guide the assessment of trainees within education and training programs across health professions.


Assuntos
Competência Clínica/normas , Educação Baseada em Competências/métodos , Currículo/normas , Saúde Global/educação , Competência Clínica/estatística & dados numéricos , Consenso , Currículo/tendências , Técnica Delfos , Avaliação Educacional/métodos , Ocupações em Saúde/estatística & dados numéricos , Humanos , Inquéritos e Questionários , Local de Trabalho/normas
8.
J Surg Res ; 259: 399-406, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33109403

RESUMO

BACKGROUND: Competency-based education (CBE) seeks to determine resident proficiency in the knowledge, skills, and behaviors required for independent patient care. Multiple assessment instruments evaluate technical skills or direct patient care in the clinic setting, but there are few reports incorporating both within an orthopedic specialty rotation. This study reports a residency program's comprehensive CBE initiative using formative assessments in the clinic and operating room during a sports medicine rotation. MATERIALS AND METHODS: The sports medicine rotation used validated formative assessments to evaluate resident performance during clinic encounters and program-defined surgical entrustable professional activities (EPAs). Junior resident (postgraduate year [PGY] 1-2) EPAs included basic knee/shoulder arthroscopic procedures. Senior resident (PYG 5) EPAs comprised anterior cruciate ligament reconstruction, biceps tenodesis, shoulder stabilization, and rotator cuff repair. Assessment scores were compared between individuals and PGY groups. RESULTS: Sixty-six clinical skills (CS) and 106 surgical skills assessments were conducted for 22 residents in one academic year. Surgical skills assessments demonstrated significant differences between each PGY group (P < 0.01). All PGY2 and PGY5 residents achieved independence on the evaluated EPAs. PGY5s earned higher scores in CS assessments than the other classes (P < 0.01). PGY2 residents scored higher than PGY1s in 7 of 9 CS domains. CS independence was achieved by 21 of 22 residents by the end of the rotation. CONCLUSIONS: The CBE program effectively quantified expected differences in resident performance by PGY for clinic and surgical assessments on a sports medicine rotation. Assessments built an environment where feedback was more structured and standardized, creating a culture to improve resident education.


Assuntos
Artroscopia/educação , Competência Clínica/estatística & dados numéricos , Educação Baseada em Competências/métodos , Internato e Residência/métodos , Medicina Esportiva/educação , Educação Baseada em Competências/estatística & dados numéricos , Currículo , Humanos , Internato e Residência/estatística & dados numéricos , Avaliação de Programas e Projetos de Saúde
9.
Support Care Cancer ; 29(3): 1235-1244, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32613373

RESUMO

PURPOSE: Cancer navigation improves access to support and reduces barriers to care; however, appropriate training of navigators is essential. We developed the TrueNTH Peer Navigation Training Program (PNTP), a competency-based, blended online/in-person course. In this study, we evaluate the feasibility, acceptability, and effectiveness of the PNTP among prostate cancer (PC) survivors (patients, caregivers). METHODS: We employed an explanatory mixed method study design consisting of course usage data, pre-/post-questionnaires, and focus groups informed by the Kirkpatrick framework and self-efficacy theory. RESULTS: Three cohorts in two Canadian cities (n = 26) received the PNTP. Participants were motivated to support others like themselves (n = 20), fill a gap (n = 7), pay it forward (n = 6), and offer expertise (n = 4). Recruitment, retention, and questionnaire completion were 96.7%, 89.6%, and 92%. Participants contributed a total of 426 posts to the online forums (2 to 3 posts per participant/module). Satisfaction was 9.4/10 (SD = 0.7) and usability was 84.5/100 (SD = 10.1). All learning outcomes increased: understanding of learning objectives t(23) = - 6.12, p < 0.0001; self-efficacy to perform competencies t(23) = - 4.8, p < 0.0001; and eHealth literacy t(23) = - 4.4, p < 0.0001. Participants viewed the PTNP as intensive but manageable, improving knowledge and confidence and enhancing listening skills. Participants valued the flexibility of online learning, interactive online learning, in-person interactions for relationship building, and authentic role-playing for skill development. CONCLUSIONS: A facilitated online training program with in-person components is a highly acceptable and effective format to train PC survivors to become peer navigators. This competency-based peer navigator training program and delivery format may serve as a useful model for other cancer volunteer programs.


Assuntos
Cuidadores/psicologia , Educação Baseada em Competências/métodos , Educação à Distância/métodos , Neoplasias da Próstata/psicologia , Idoso , Sobreviventes de Câncer , Humanos , Masculino , Neoplasias da Próstata/mortalidade , Inquéritos e Questionários
10.
Acad Med ; 96(2): 236-240, 2021 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-32590468

RESUMO

PROBLEM: Primary care providers are responsible for the majority of pain care and opioid prescribing, but they are often inadequately trained. Training current providers to address the crisis of excessive opioid prescribing and inadequate pain management is a substantial workforce problem that requires urgent action. This educational need is vast and requires a staged solution to amplify its effect. APPROACH: The University of California, Davis Train-the-Trainer (T3) Primary Care Pain Management Fellowship targets the most pressing topics related to pain management, including prescription drug abuse, responsible opioid prescribing, and substance abuse, as well as broad coverage of comprehensive pain management. It offers an innovative, scalable solution to address the education gap in pain management that, in part, fuels the opioid epidemic in the United States. The T3 Fellowship incorporates a competency-based curriculum and a hybrid educational model of in-person and distance-based learning and direct faculty-fellow mentoring to comprehensively train primary care providers in pain care and prepare them to train others. Since it was established in 2017, 2 cohorts (of 17 and 26 fellows) have completed the 10-month fellowship and a third cohort of 38 fellows started the program in September 2019. OUTCOMES: Pre- and postprogram surveys for the first 2 cohorts, and a 6-month postprogram survey for the first cohort, demonstrated fellows' improvement and sustained performance in pain competencies as well as increased recognition and understanding of pain and related topics. NEXT STEPS: If adopted by other institutions and expanded across the country, the T3 Fellowship holds potential for developing an ever-growing legion of trained professionals who will locally fill the need for effective pain management, including appropriate opioid prescribing. Advancing this model will require further economic and feasibility studies to assess costs, resources, and other variables, as well as a robust comprehensive outcomes program.


Assuntos
Educação/estatística & dados numéricos , Manejo da Dor/normas , Atenção Primária à Saúde/estatística & dados numéricos , Capacitação de Professores/métodos , Analgésicos Opioides/uso terapêutico , California/epidemiologia , Educação Baseada em Competências/métodos , Bolsas de Estudo/estatística & dados numéricos , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Modelos Educacionais , Transtornos Relacionados ao Uso de Opioides/epidemiologia , Transtornos Relacionados ao Uso de Opioides/prevenção & controle , Padrões de Prática Médica/ética , Avaliação de Programas e Projetos de Saúde/estatística & dados numéricos , Inquéritos e Questionários , Estados Unidos/epidemiologia , Universidades/organização & administração
11.
Acad Med ; 96(2): 296-306, 2021 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-33031117

RESUMO

PURPOSE: As educators have implemented competency-based medical education (CBME) as a framework for training and assessment, they have made decisions based on available evidence and on the medical education community's assumptions about CBME. This critical narrative review aimed to collect, synthesize, and judge the existing evidence underpinning assumptions the community has made about CBME. METHOD: The authors searched Ovid MEDLINE to identify empirical studies published January 2000 to February 2019 reporting on competence, competency, and CBME. The knowledge synthesis focused on "core" assumptions about CBME, selected via a survey of stakeholders who judged 31 previously identified assumptions. The authors judged, independently and in pairs, whether evidence from included studies supported, did not support, or was mixed related to each of the core assumptions. Assumptions were also analyzed to categorize their shared or contrasting purposes and foci. RESULTS: From 8,086 unique articles, the authors reviewed 709 full-text articles and included 189 studies reporting evidence related to 15 core assumptions. Most studies (80%; n = 152) used a quantitative design. Many focused on procedural skills (48%; n = 90) and assessed behavior in clinical settings (37%; n = 69). On aggregate, the studies produced a mixed evidence base, reporting 362 data points related to the core assumptions (169 supportive, 138 not supportive, and 55 mixed). The 31 assumptions were organized into 3 categories: aspirations, conceptualizations, and assessment practices. CONCLUSIONS: The reviewed evidence base is significant but mixed, with limited diversity in research designs and the types of competencies studied. This review pinpoints tensions to resolve (where evidence is mixed) and research questions to ask (where evidence is absent). The findings will help the community make explicit its assumptions about CBME, consider the value of those assumptions, and generate timely research questions to produce evidence about how and why CBME functions (or not).


Assuntos
Competência Clínica/normas , Educação Baseada em Competências/métodos , Formação de Conceito/fisiologia , Educação Médica/métodos , Competência Clínica/estatística & dados numéricos , Currículo/normas , Educação Médica/estatística & dados numéricos , Educação Médica/tendências , Humanos , Conhecimento , Medicina/estatística & dados numéricos , Publicações/tendências , Projetos de Pesquisa/estatística & dados numéricos , Projetos de Pesquisa/tendências , Especialidades Cirúrgicas/estatística & dados numéricos , Participação dos Interessados/psicologia , Inquéritos e Questionários/estatística & dados numéricos
12.
Ann Surg ; 273(4): 701-708, 2021 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-33201114

RESUMO

OBJECTIVE: The aim of this study was to propose an evidence-based blueprint for training, assessment, and certification of operative performance for surgical trainees. SUMMARY BACKGROUND DATA: Operative skill is a critical aspect of surgical performance. High-quality assessment of operative skill therefore has profound implications for training, accreditation, certification, and the public trust of the profession. Current methods of operative skill assessment for surgeons rely heavily on global assessment strategies across a very broad domain of procedures. There is no mechanism to assure technical competence for individual procedures. The science and scalability of operative skill assessment has progressed significantly in recent decades, and can inform a much more meaningful strategy for competency-based assessment of operative skill than has been previously achieved. METHODS: The present article reviews the current status and science of operative skill assessment and proposes a template for competency-based assessment which could be used to update training, accreditation, and certification processes. The proposal is made in reference to general surgery but is more generally applicable to other procedural specialties. RESULTS: Streamlined, routine assessment of every procedure performed by surgical trainees is feasible and would enable a more competency-based educational paradigm. In light of the constraints imposed by both clinical volume and assessment bias, trainees should be expected to become proficient and be measured against a mastery learning standard only for the most important and highest-frequency procedures. For less frequently observed procedures, performance can be compared to a norm-referenced standard and, to provide an overall trajectory of performance, analyzed in aggregate. Key factors in implementing this approach are the number of evaluations, the number of raters, the timeliness of evaluation, and evaluation items. CONCLUSIONS: A competency-based operative skill assessment can be incorporated into surgical training, assessment, and certification. The time has come to develop a systematic approach to this issue as a means of demonstrating professional standards worthy of the public trust.


Assuntos
Certificação , Competência Clínica , Educação Baseada em Competências/métodos , Avaliação Educacional/métodos , Cirurgia Geral/educação , Internato e Residência/métodos , Procedimentos Cirúrgicos Operatórios/educação , Humanos
14.
J Surg Res ; 257: 221-226, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-32858323

RESUMO

BACKGROUND: The Accreditation Council for Graduate Medical Education has defined six core competencies (CCs) that every successful physician should possess. However, the assessment of CC achievement among trainees is difficult. This project was designed to prospectively evaluate the impact of resident identification of CC as a component of morbidity review on error identification and standard of care (SOC) assessments. The platform was assessed for its reliability as a measure of resident critical analysis of complication causality across postgraduate year (PGY). MATERIALS AND METHODS: A total of 1945 general surgery cases with complications were assessed for error identification and SOC management between January 1, 2016, and December 31, 2018. CC identification was additionally assessed between January 1, 2019, and December 31, 2019, and included 708 general surgery cases. Data were evaluated for error assessments and overall SOC management. PGY4 and 5 residents were compared for number of cases and complications reviewed, severity, error causation, and CC relevance. RESULTS: Study groups were equivalent by Clavien-Dindo scores. Error identification significantly increased in all categories: diagnostic (P < 0.001), technical (P < 0.05), judgment (P < 0.001), system (P < 0.001), and communication (P < 0.001). Overall SOC assessments validated by a supervising surgical quality officer were unchanged. An increased exposure to cases with severe complications, error causation, and CC relevance was noted across PGY. CONCLUSIONS: The addition of CC assessment into morbidity review appears to improve the critical thinking of evaluating residents by increasing the identification of management errors. Used as an element of prospective self-assessment, teaching residents to identify CC principles in cases with complications may assist in learner progression toward clinical competence and critical thinking.


Assuntos
Educação Baseada em Competências/métodos , Cirurgia Geral/educação , Complicações Pós-Operatórias/prevenção & controle , Autoavaliação (Psicologia) , Procedimentos Cirúrgicos Operatórios/efeitos adversos , Competência Clínica , Seguimentos , Humanos , Internato e Residência , Erros Médicos/efeitos adversos , Erros Médicos/prevenção & controle , Dano ao Paciente/prevenção & controle , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/etiologia , Avaliação de Programas e Projetos de Saúde , Estudos Prospectivos , Reprodutibilidade dos Testes , Índice de Gravidade de Doença , Cirurgiões/psicologia , Procedimentos Cirúrgicos Operatórios/educação
15.
Esc. Anna Nery Rev. Enferm ; 25(3): e20200293, 2021.
Artigo em Português | LILACS, BDENF - Enfermagem | ID: biblio-1279017

RESUMO

Resumo Objetivos Descrever a experiência da implementação de um programa de treinamento de assistente de pesquisa voluntário para graduandos canadenses de Enfermagem, objetivando o desenvolvimento de habilidades de comunicação verbal e escrita, métodos de pesquisa e análise de dados, pensamento crítico e resolução de problemas, assim como o planejamento de suas carreiras e o avanço de seus papéis relacionados à pesquisa e às oportunidades administrativas e de liderança. Método Estudo descritivo com relato de experiência sobre o processo de treinamento para um novo papel profissional relativo ao engajamento dos graduandos em 11 oficinas, cada uma com duração de uma hora e o processo de apoiá-los para assumir papéis profissionais e de liderança. Resultados Os graduandos demonstraram comprometimento em todas as fases do treinamento. Destaca-se, ainda, o interesse por assumirem a liderança em atividades práticas que redefinem seu perfil profissional. Essa experiência contribuiu para construir e nutrir relações intelectuais docentes-graduandos. Os graduandos expandiram suas redes profissionais e a relação com o mentor de carreira, estão desenvolvendo suas habilidades práticas e relataram confiança em se candidatar para cargos de assistentes de pesquisa. Conclusão e implicações para a prática O treinamento pode instrumentalizá-los para escolhas de planos de carreira, ingresso no mercado de trabalho e a construção de plano para desenvolvimento profissional. O desejo genuíno dos docentes de Enfermagem, apoiando uma nova geração de enfermeiros, culminou nessa experiência de empoderamento mútuo.


Resumen Objetivos Informar sobre la experiencia de un equipo de profesionales de enfermería y desarrollo profesional en la implementación de un programa de asistente voluntario de investigación para estudiantes universitarios canadienses de pregrado en enfermería con el objetivo de desarrollar la comunicación escrita y verbal, métodos de investigación, análisis de datos, pensamiento crítico y habilidades de resolución de problemas, así como en su planificación y avance profesional para funciones relacionadas con la investigación y oportunidades de empleo administrativo y de liderazgo. Método Un diseño descriptivo con el informe de la experiencia de los investigadores de enfermería y desarrollo profesional sobre el proceso de apoyo para la formación de los estudiantes para un nuevo rol profesional. La experiencia se refiere a 11 talleres que durarán una hora sobre los temas relacionados con la investigación. Resultados Los estudiantes demostraron compromiso con la capacitación. Relevante es su interés en liderar actividades prácticas para redefinir su perfil profesional. Esta experiencia contribuyó a construir y fomentar relaciones significativas e intelectuales entre los profesores y los estudiantes. Los estudiantes amplían sus redes profesionales y obtienen una relación con un mentor de carrera. Conclusión e implicaciones para la práctica La capacitación puede equipar mejor a los estudiantes para elegir trayectorias profesionales, entrar en el mercado laboral y elaborar un plan para el avance profesional. Fue el deseo genuino de los profesores de enfermería de apoyar a una nueva generación de enfermeras que culminó en esta experiencia de empoderamiento mutuo.


Abstract Objective To describe the experience of implementing a research assistant program for Canadian undergraduate nursing students, which aimed to develop written and verbal communication, critical thinking and problem-solving skills, as well as knowledge of various research methods. Engagement in this program was intended to support students' career planning and advancement in research related roles, including administrative and leadership employment opportunities. Method A descriptive design with the report of experience of nursing researchers and career advisers pertaining to: engagement in an 11 one-hour research focused workshop; and the process of supporting students to assume professional and leadership roles. Results Students demonstrated commitment to the training program throughout its phases. They expressed interest in leading practical activities to redefine their professional profile. This experience contributed to building and nurturing intellectual teacher-student relationships. Students are expanding their professional networks and a relationship with a career mentor, while demystifying the research assistant role. Students are developing practical skills and reporting confidence in applying for research assistant positions. Conclusion and Implications for practice Participating in the training program better equips students for choosing their career path, entering the job market, and building a plan for further career advancement. Nursing faculty's genuine desire for and purposeful actions to support a new generation of nurses informed this mutually empowering experience.


Assuntos
Humanos , Pesquisa/educação , Educação Baseada em Competências/métodos , Educação em Enfermagem/métodos , Escolas de Enfermagem , Estudantes de Enfermagem , Docentes de Enfermagem , Tutoria/métodos
16.
BMC Pregnancy Childbirth ; 20(1): 583, 2020 Oct 06.
Artigo em Inglês | MEDLINE | ID: mdl-33023484

RESUMO

BACKGROUND: Helping Babies Breathe (HBB) is a competency-based educational method for an evidence-based protocol to manage birth asphyxia in low resource settings. HBB has been shown to improve health worker skills and neonatal outcomes, but studies have documented problems with skills retention and little evidence of effectiveness at large scale in routine practice. This study examined the effect of complementing provider training with clinical mentorship and quality improvement as outlined in the second edition HBB materials. This "system-oriented" approach was implemented in all public health facilities (n = 172) in ten districts in Rwanda from 2015 to 2018. METHODS: A before-after mixed methods study assessed changes in provider skills and neonatal outcomes related to birth asphyxia. Mentee knowledge and skills were assessed with HBB objective structured clinical exam (OSCE) B pre and post training and during mentorship visits up to 1 year afterward. The study team extracted health outcome data across the entirety of intervention districts and conducted interviews to gather perspectives of providers and managers on the approach. RESULTS: Nearly 40 % (n = 772) of health workers in maternity units directly received mentorship. Of the mentees who received two or more visits (n = 456), 60 % demonstrated competence (received > 80% score on OSCE B) on the first mentorship visit, and 100% by the sixth. In a subset of 220 health workers followed for an average of 5 months after demonstrating competence, 98% maintained or improved their score. Three of the tracked neonatal health outcomes improved across the ten districts and the fourth just missed statistical significance: neonatal admissions due to asphyxia (37% reduction); fresh stillbirths (27% reduction); neonatal deaths due to asphyxia (13% reduction); and death within 30 min of birth (19% reduction, p = 0.06). Health workers expressed satisfaction with the clinical mentorship approach, noting improvements in confidence, patient flow within the maternity, and data use for decision-making. CONCLUSIONS: Framing management of birth asphyxia within a larger quality improvement approach appears to contribute to success at scale. Clinical mentorship emerged as a critical element. The specific effect of individual components of the approach on provider skills and health outcomes requires further investigation.


Assuntos
Asfixia Neonatal/terapia , Educação Baseada em Competências/organização & administração , Pessoal de Saúde/educação , Melhoria de Qualidade , Ressuscitação/educação , Asfixia Neonatal/mortalidade , Competência Clínica , Educação Baseada em Competências/métodos , Feminino , Hospitais Públicos/organização & administração , Humanos , Recém-Nascido , Mentores , Mortalidade Perinatal , Gravidez , Avaliação de Programas e Projetos de Saúde , Ruanda/epidemiologia
17.
Artigo em Inglês | MEDLINE | ID: mdl-33121028

RESUMO

Due to the coronavirus disease (COVID-19) pandemic, there are many restrictions in effect in clinical nursing practice. Since effective educational strategies are required to enhance nursing students' competency in clinical practice, this study sought to evaluate the effectiveness of simulation problem-based learning (S-PBL). A quasi-experimental control group pretest-post-test design was used. Nursing students were allocated randomly to the control group (n = 31) and the experimental group (n = 47). Students in the control group participated in a traditional maternity clinical practicum for a week, while students in the experimental group participated S-PBL for a week. The students in the experimental group were trained in small groups using a childbirth patient simulator (Gaumard® Noelle® S554.100, Miami, USA) based on a standardized scenario related to obstetric care. The students' learning attitude, metacognition, and critical thinking were then measured via a self-reported questionnaire. Compared with the control group, the pre-post difference in learning attitude and critical thinking increased significantly (p < 0.01) in the experimental group. S-PBL was found to be an effective strategy for improving nursing students' learning transfer. Thus, S-PBL that reflects various clinical situations is recommended to improve the training in maternal health nursing.


Assuntos
Educação Baseada em Competências/métodos , Metacognição , Aprendizagem Baseada em Problemas/métodos , Treinamento por Simulação/métodos , Estudantes de Enfermagem/psicologia , Pensamento , Betacoronavirus , COVID-19 , Competência Clínica , Infecções por Coronavirus/epidemiologia , Bacharelado em Enfermagem/métodos , Avaliação Educacional , Feminino , Humanos , Pandemias , Pneumonia Viral/epidemiologia , Preceptoria , Gravidez , SARS-CoV-2
18.
Biochem Mol Biol Educ ; 48(6): 670-674, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-33064370

RESUMO

The COVID-19 outbreak has shut down universities and prompted the teaching faculty to move to online resources. In view of upcoming of new Medical Council of India (MCI) curriculum and outbreak of COVID-19 pandemic, keeping pace with medical education became a challenge. To keep on par with learning activities of undergraduate students during this period, the teaching faculty adopted the use of online resources. E-learning tools were utilized to engage first-year undergraduate students and satisfy majority of aspects of Competency-Based Undergraduate Medical Curriculum/Education (CBMC/E) in Biochemistry.


Assuntos
Bioquímica/educação , COVID-19/epidemiologia , Educação Baseada em Competências/métodos , Currículo , Educação à Distância/métodos , Educação de Graduação em Medicina/métodos , Pandemias , Faculdades de Medicina/organização & administração , Competência Clínica , Educação Baseada em Competências/normas , Educação à Distância/normas , Educação de Graduação em Medicina/normas , Avaliação Educacional , Humanos , Índia/epidemiologia , SARS-CoV-2 , Materiais de Ensino
20.
J Grad Med Educ ; 12(4): 425-434, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32879682

RESUMO

Background: In 2018, Canadian postgraduate emergency medicine (EM) programs began implementing a competency-based medical education (CBME) assessment program. Studies evaluating these programs have focused on broad outcomes using data from national bodies and lack data to support program-specific improvement. Objective: We evaluated the implementation of a CBME assessment program within and across programs to identify successes and opportunities for improvement at the local and national levels. Methods: Program-level data from the 2018 resident cohort were amalgamated and analyzed. The number of entrustable professional activity (EPA) assessments (overall and for each EPA) and the timing of resident promotion through program stages were compared between programs and to the guidelines provided by the national EM specialty committee. Total EPA observations from each program were correlated with the number of EM and pediatric EM rotations. Results: Data from 15 of 17 (88%) programs containing 9842 EPA observations from 68 of 77 (88%) EM residents in the 2018 cohort were analyzed. Average numbers of EPAs observed per resident in each program varied from 92.5 to 229.6, correlating with the number of blocks spent on EM and pediatric EM (r = 0.83, P < .001). Relative to the specialty committee's guidelines, residents were promoted later than expected (eg, one-third of residents had a 2-month delay to promotion from the first to second stage) and with fewer EPA observations than suggested. Conclusions: There was demonstrable variation in EPA-based assessment numbers and promotion timelines between programs and with national guidelines.


Assuntos
Educação Baseada em Competências/métodos , Medicina de Emergência/educação , Internato e Residência/métodos , Canadá , Competência Clínica/normas , Medicina de Emergência/normas , Humanos , Avaliação de Programas e Projetos de Saúde
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