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1.
J Surg Res ; 246: 499-505, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31679798

RESUMO

BACKGROUND: Surgical coaching is an emerging concept of education and collaboration to improve surgical performance. Surgical education in low-resource settings remains a challenge because of confounding barriers of access, resources, and sustainability. No formal assessments of coaching as a means to improve surgical quality in low- or middle-income countries (LMICs) exist. The purpose of this review is to explore if surgical coaching could serve as an effective method of fostering continued education and advancement of surgical skills in low-resource settings. METHODS: We conducted a systematic literature search in July 2018. Included studies were peer-reviewed and met preestablished study criteria. Studies must have assessed surgical coaching, specifically defined as a means to establish continuous professional growth of trainees and practicing surgeons. RESULTS: Of 2189 articles, 175 were selected for full-text analysis, 23 met inclusion criteria for analysis, 13 of these 23 articles evaluated coaching of trainees, 10 articles assessed coaching surgeons in established careers. 18 of the 23 articles discussed skill acquisition, 4 of which assessed nontechnical skills alone, and 14 assessed technical skills or both technical and nontechnical skills. Remote or cross-institutional coaching was explored in 8 of the 23 studies. None of the studies discussed or evaluated coaching in LMICs. CONCLUSIONS: Coaching is a method of teaching surgeons at multiple stages of a career. The explored advantages of surgical coaching may be applied to continuous performance improvement and collaboration with surgeons in LMICs. Furthermore, coaching may aid in advancement of the well-established Lancet Global Surgery Indicators, improving surgical capacity and quality in LMICs.


Assuntos
Educação Médica Continuada/métodos , Cooperação Internacional , Tutoria , Especialidades Cirúrgicas/educação , Cirurgiões/educação , Competência Clínica , Estudos de Viabilidade , Saúde Global , Humanos
2.
Rev Med Chil ; 147(8): 1059-1066, 2019 Aug.
Artigo em Espanhol | MEDLINE | ID: mdl-31859972

RESUMO

BACKGROUND: Continuing education is essential for health professions and online courses can be a good way for professional development. AIM: To describe the experience with online courses for continuing education in hepatology and gastroenterology and to analyze their educational impact. MATERIAL AND METHODS: A three years' experience in courses on liver diseases and digestive tract is described. Their curricular design, methodology, and the educational impact was analyzed using the four levels of the Kirkpatrick's model. RESULTS: On average, there were 321 students per course (2015-2017). 94% were Chilean and 6% from abroad (20 countries). In the educational impact analysis, in level 1 "reaction": 93% said that the course fulfilled their expectations and 92% would recommend it. In level 2 "learning": 42% approved the courses. Level 3 "behavior" was not evaluated and level 4 "organizational change" highlighted that the traditional face-to-face continuing education model of Chilean Gastroenterology Society (SChG) changed to full distance model in these three courses, with 1284 students from South America, Asia and Europe, in a 3-years-period. Additionally, these programs were included in the Medical Society of Santiago (SMS) continuing education agenda. CONCLUSIONS: The alliance between the SMS and the SChG generated on line courses that meet the educational needs of physicians and medical students, with excellent results and student perception.


Assuntos
Educação a Distância/métodos , Educação Médica Continuada/métodos , Gastroenterologia/educação , Chile , Avaliação Educacional , Feminino , Geografia , Humanos , Masculino , Avaliação de Programas e Projetos de Saúde , Reprodutibilidade dos Testes , Sociedades Médicas , Fatores de Tempo
3.
Pediatrics ; 144(6)2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31690712

RESUMO

BACKGROUND AND OBJECTIVES: This article is the second of a 2-part series examining results regarding self-reported learning and practice change from the American Board of Pediatrics 2017 pilot of an alternative to the proctored, continuing certification examination, termed the Maintenance of Certification Assessment for Pediatrics (MOCA-Peds). Because of its design, MOCA-Peds has several learning advantages compared with the proctored examination. METHODS: Quantitative and qualitative analyses with 5081 eligible pediatricians who registered to participate in the 2017 pilot; 81.4% (n = 4016) completed a quarter 4 survey and/or the end-of-year survey (January 2018) and compose the analytic sample. RESULTS: Nearly all (97.6%) participating pediatricians said they had learned, refreshed, or enhanced their medical knowledge, and of those, 62.0% had made a practice change related to pilot participation. Differences were noted on the basis of subspecialty status, with 68.9% of general pediatricians having made a practice change compared with 41.4% of subspecialists. Within the 1456 open-ended responses about participants' most significant practice change, responses ranged widely, including both medical care content (eg, "care for corneal abrasions altered," "better inform patients about. . .flu vaccine") and nonspecific content (eg, providing better patient education, using evidence-based medicine, increased use of resources in regular practice). CONCLUSIONS: As a proctored examination alternative, MOCA-Peds positively influenced self-reported learning and practice change. In future evaluation of MOCA-Peds and other medical longitudinal assessments, researchers should study ways to further encourage learning and practice change and sustainability.


Assuntos
Atitude do Pessoal de Saúde , Certificação/normas , Competência Clínica/normas , Educação Médica Continuada/normas , Aprendizagem , Pediatras/normas , Adulto , Certificação/métodos , Educação Médica Continuada/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pediatras/psicologia , Projetos Piloto , Padrões de Prática Médica/normas , Inquéritos e Questionários
4.
J Stroke Cerebrovasc Dis ; 28(12): 104323, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31562040

RESUMO

BACKGROUND AND PURPOSE: In the existing model of community health service in China, community general practitioners play important roles in health promotion as well as prehospital stroke recognition and management. We recently engineered Stroke 120 based on FAST for China. This investigation aimed to investigate its acceptance in community physicians and promote their stroke related knowledge. METHODS: We conducted an stroke education session to community physicians or family doctors (total of 435 participants), teaching both FAST and Stroke 120. Online survey was distributed to the participants before and after the education session to evaluate the awareness of stroke and the acceptance of the stroke recognition tool. RESULTS: Significant stroke knowledge deficiencies were found in community physicians. After the education session, percent of the participants knew that the thrombolytic therapeutic window (<4.5 hours) was improved from 54.0% to 91.6% (P < .001). A total of 88.5% of them would send their patients who had stroke to the nearest hospital with stroke center by emergency medical service, compared to baseline (64.4%, P < .001). In total, 95.2% of them would recommend thrombolytic therapy in the treatment of acute ischemic stroke compared to 82.7% (baseline P < .001). Although majority mastered both FAST (95.5%) and Stroke 120 (98.0%) through our education session, 96.3% of them believe that Stroke 120 is the most suitable for Chinese in stroke education. CONCLUSIONS: Stroke 120 strategy was well accepted by the community physicians in China and in the meantime improved knowledge regarding stroke was observed.


Assuntos
Serviços de Saúde Comunitária , Educação Médica Continuada/métodos , Conhecimentos, Atitudes e Prática em Saúde , Capacitação em Serviço/métodos , Médicos de Família/economia , Médicos de Atenção Primária/educação , Acidente Vascular Cerebral , Adulto , Atitude do Pessoal de Saúde , Conscientização , China , Competência Clínica , Serviço Hospitalar de Emergência , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Médicos de Família/psicologia , Médicos de Atenção Primária/psicologia , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/etiologia , Acidente Vascular Cerebral/fisiopatologia , Acidente Vascular Cerebral/terapia , Terapia Trombolítica , Tempo para o Tratamento , Adulto Jovem
5.
Hand Surg Rehabil ; 38(6): 348-352, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31473335

RESUMO

Our hypothesis was that immediate repetition of a microsurgery-suturing task will improve its execution and outcome. This was an experimental animal study. Ten surgeons were divided into two groups of five surgeons. Each performed two end-to-end carotid anastomoses on the same rat, one after the other. The anastomosis was evaluated by the surgeon and an instructor. The primary endpoint was permeability. The outcome was evaluated using an objective and subjective assessment grid yielding 1 to 3 points per item. The total scores for each of the 10 surgeons were used to compare the anastomosis of carotid 1 versus 2, using the ratings given by the surgeon and the instructor. Twenty anastomoses were performed, but 1 rat died intraoperatively, leaving 18 anastomoses for evaluation. No significant differences were found on the main endpoint of permeability, with all anastomoses being permeable. The surgeon's self-assessment was significantly better for the second carotid artery (P=0.05), but this was not confirmed by the proxy assessment (instructor). The analysis by subgroups-morning versus afternoon-found the second carotid anastomosis was significant better in the self-assessment and proxy assessment for the morning group (P<0.001, P=0.024). There was no significant difference in clamping times. The immediate repetition of a microsurgical procedure seems to favor its execution, which leads us to propose that the more difficult or important anastomosis should be done after an easier or less important one during complex surgeries. LEVEL OF EVIDENCE: 2B.


Assuntos
Anastomose Cirúrgica/educação , Competência Clínica , Educação Médica Continuada/métodos , Microcirurgia/educação , Cirurgiões , Suturas , Animais , Artérias Carótidas/cirurgia , Humanos , Ratos Sprague-Dawley , Grau de Desobstrução Vascular
6.
Gastrointest Endosc Clin N Am ; 29(4): 647-657, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31445688

RESUMO

Pioneered in Japan to address the limitations of endoscopic mucosal resection in the stomach, endoscopic submucosal dissection (ESD) has been applied throughout the gastrointestinal tract, including the colorectum. ESD is technically challenging and has been slowly gaining traction in the West. However, for the committed and resourceful endoscopist, proficiency in ESD can still be achieved. Moreover, improvement in techniques and devices are likely to ease the learning curve while improving procedural duration, safety, and efficacy of colorectal ESD. This article reviews challenges and methods in learning ESD in the United States and provides a primer on performing ESD and full-thickness resection in the colorectum.


Assuntos
Competência Clínica , Colonoscopia/educação , Neoplasias Colorretais/cirurgia , Ressecção Endoscópica de Mucosa/educação , Ressecção Endoscópica de Mucosa/métodos , Idoso , Neoplasias Colorretais/patologia , Educação Médica Continuada/métodos , Feminino , Gastroenterologia/educação , Humanos , Masculino , Pessoa de Meia-Idade , Estados Unidos
7.
Lakartidningen ; 1162019 Aug 27.
Artigo em Sueco | MEDLINE | ID: mdl-31454059

RESUMO

The Swedish Association of General Practice has published a set of guidelines for general practitioner's (GPs') learning in general practice/family medicine. This article is a summary of principles, guidelines and applications regarding Swedish GPs' continuing professional development (CPD). We argue that reflection on own practice, reflection with colleagues in small groups and use of written learning plans and portfolios for courses and lectures are important parts of CPD and should be increasingly used and supported by employers. Collection of CME credits for certification purposes does not ensure that educational measures have been effective. Statements of recurring CPD should be incorporated in contracts between health care authorities and health care units.


Assuntos
Educação Médica Continuada/métodos , Medicina Geral/educação , Guias como Assunto , Humanos , Aprendizagem , Sociedades Médicas , Suécia
8.
J Surg Res ; 244: 579-586, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31446322

RESUMO

BACKGROUND: Introducing new surgical devices into the operating room (OR) can serve as a critical opportunity to address patient safety. The effectiveness of OR briefings to improve communication, teamwork, and safety has not been evaluated in this setting. METHODS: Ariadne Labs and Johnson and Johnson (J&J) collaborated to develop and assess an intervention including a Device Briefing Tool (DBT) and novel multidisciplinary team training for clinicians (surgeons and nurses) around the introduction of a new device in the OR. J&J sales representatives trained clinicians to use the DBT, a communication tool to improve patient safety when a new device is used for the first time. Surveys were administered to representatives (n = 10), surgeons (n = 15), and nurses (n = 30) at the baseline, after trainings, and after using the DBT in an operation at six different Thai hospitals. RESULTS: Familiarity with the Surgical Safety Checklist (SURGICAL SAFETY CHECKLIST) varied but increased post-training. Regarding trainings, 90% of representatives felt they very much or completely met all learning objectives but 50% felt only slightly prepared to train clinicians on using DBT. Post-training, clinician confidence in using a new device rose from 47 to 85%. Regarding the DBT, 90% of clinicians felt confident using it and reported they were very likely to use it in the future. Overall, over 90% of all clinicians and representatives felt safe having surgery in their hospitals. CONCLUSIONS: There is high acceptability and feasibility of the multidisciplinary trainings and the DBT among representatives and clinicians, albeit in a limited number of participants from a small number of institutions.


Assuntos
Competência Clínica/normas , Educação Médica Continuada/métodos , Educação Continuada em Enfermagem/métodos , Salas Cirúrgicas/normas , Equipe de Assistência ao Paciente , Segurança do Paciente/normas , Instrumentos Cirúrgicos , Atitude do Pessoal de Saúde , Lista de Checagem , Estudos de Viabilidade , Humanos , Enfermagem de Centro Cirúrgico/educação , Projetos Piloto , Desenvolvimento de Programas , Melhoria de Qualidade , Cirurgiões/educação , Tailândia
9.
Emerg Med J ; 36(8): 453-455, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31292205

RESUMO

BACKGROUND: Clinicians in the emergency care specialties often access information via social media (SM) to supplement their learning. The rapid and user-centred dissemination of information via SM speeds knowledge translation and means unnoticed errors may propagate quickly. East Midlands Emergency Medicine Educational Media is a UK web-based resource that produces emergency medicine-related learning materials. In October 2018, we inadvertently shared two sets of incorrect learning materials via SM because of a non-intentional mistake. We highlight how these errors were perpetuated and then corrected. METHOD: In October 2018, two separate posts were published on Facebook, Instagram, Twitter and Reddit. One was an incorrect ECG where a paced rhythm was published instead of an ECG of hypocalcaemia; the other was incorrect information contained within an infographic. We reviewed the analytics of the posts, on each of the SM platforms. RESULTS: The ECG mistake was picked up on Facebook 40 hours after posting by a follower. The infographic mistake was picked up on Reddit, within 3 hours. Despite these mistakes, and their correction, they continued to be shared on both Twitter and Facebook. The posts reached over 15 000 people. CONCLUSION: Highlighting errors in educational content shared on SM is rarely reported in academic literature. We feel disclosure, and adding an update to the post is the best methodology to amend errors. We invite debate on a strategy to elucidate the number of errors in medical educational resources shared via SM and strategies on how to correct and improve them.


Assuntos
Aprendizagem , Mídias Sociais/normas , Educação Médica Continuada/métodos , Educação Médica Continuada/normas , Humanos , Mídias Sociais/tendências , Reino Unido
10.
J Health Organ Manag ; 33(4): 443-459, 2019 Jun 28.
Artigo em Inglês | MEDLINE | ID: mdl-31282819

RESUMO

PURPOSE: The purpose of this paper is to ascertain primary care advanced clinical practitioners' (ACP) perceptions and experiences of what factors influence the development and identity of ACP roles, and how development of ACP roles that align with Health Education England's capability framework for advanced clinical practice can be facilitated in primary care. DESIGN/METHODOLOGY/APPROACH: The study was located in the North of England. A qualitative approach was used in which 22 staff working in primary care who perceived themselves to be working as ACPs were interviewed. Data analysis was guided by Braun and Clarke's (2006) six phase method. FINDINGS: Five themes emerged from the data - the need for: a standardised role definition and inclusive localised registration; access to/availability of quality accredited educational programmes relevant to primary care and professional development opportunities at the appropriate level; access to/availability of support and supervision for ACPs and trainee ACPs; a supportive organisational infrastructure and culture; and a clear career pathway. ORIGINALITY/VALUE: Findings have led to the generation of the Whole System Workforce Framework of INfluencing FACTors (IN FACT), which lays out the issues that need to be addressed if ACP capability is to be maximised in primary care. This paper offers suggestions about how IN FACT can be addressed.


Assuntos
Educação Médica Continuada , Atenção Primária à Saúde/organização & administração , Análise de Sistemas , Educação Médica Continuada/métodos , Educação Médica Continuada/organização & administração , Humanos , Entrevistas como Assunto , Médicos de Atenção Primária/organização & administração
11.
Australas Psychiatry ; 27(4): 404-408, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31264890

RESUMO

OBJECTIVE: This paper attempts to address whether the Royal Australian and New Zealand College of Psychiatrists (RANZCP) have implemented a competency-based continuing professional development (CPD) programme. CONCLUSION: The RANZCP have implemented a competency-based CPD programme, but a number of areas, especially assessment, can strengthen the competency-based approach.


Assuntos
Educação Baseada em Competências/métodos , Avaliação de Programas e Projetos de Saúde , Psiquiatria/educação , Desenvolvimento de Pessoal , Austrália , Educação Médica Continuada/métodos , Avaliação Educacional , Humanos , Nova Zelândia , Sociedades Médicas
14.
BMC Med Educ ; 19(1): 238, 2019 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-31262281

RESUMO

BACKGROUND: Procurement of bone allograft must be performed by trained personnel. Improper handling and lack of knowledge during bone procurement will lead to contamination hence jeopardizing quality of the procured bones and expose bone recipients to risks of infection in post-operative phase. Bone procurement workshop is the fundamental training programme to enhance skill among personnel who has been or will be involved in bone procurement. This study evaluated the effectiveness of the workshop contents including teaching materials by assessing the knowledge on bone procurement among the participants before and after the workshop. METHODS: Bone procurement workshop was held for 2 days for doctors and paramedics. The knowledge on bone procurement was evaluated in pre- and post-assessments by answering self administration questionnaire before and after the workshop, respectively. RESULTS: A total of 50 participants comprised of doctors and paramedics attended the workshop however only 15 (55.6%) doctors and 12 (44.4%) paramedics completed the assessments. Overall, the mean total score for the post-assessment (61.4%) was significantly higher (p < 0.05) than that of the pre-assessment score (32.2%). The mean values of correct responses for the post-assessment was significantly higher (p < 0.05) than that of the pre-assessment in all five topics given during the workshop. The correct responses for the pre- and the post- assessments in the respective group of the doctors and paramedics were also statistically significant (p < 0.05). In the pre-assessment, the doctors had the highest score in Surgical Approach & Reconstruction (50%) while the paramedics had the highest score in Donor Screening & Selection Criteria (33.3%). In the post-assessment, the doctors had the highest score in Donor Screening & Selection Criteria (70%) while the paramedics in Packaging & Transportation (65.8%). CONCLUSIONS: The assessment managed to show that the workshop contents and teaching materials were effective in improving the cognitive knowledge of the personnel who would get involved in bone procurement under the National Donation Programme.


Assuntos
Pessoal Técnico de Saúde/educação , Transplante Ósseo/educação , Competência Clínica , Educação Médica Continuada , Adulto , Aloenxertos , Cognição , Educação Médica Continuada/métodos , Feminino , Humanos , Capacitação em Serviço/métodos , Malásia , Masculino , Pessoa de Meia-Idade , Médicos , Cirurgiões/educação , Bancos de Tecidos
15.
Presse Med ; 48(7-8 Pt 1): 767-779, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31303371

RESUMO

OBJECTIVES: In France, too few general practitioners (GP) follow the training about suicide prevention and risk. This study aimed at reviewing international publications regarding GP's training on suicide risk, in order to inform us about the training practices in the world and potentially discover new methodologies. METHODS: We performed bibliographic databases searches on GPs training about suicide prevention and risk, for practicing GPs, excluding studies about particular population groups, following the PRISMA statement guidelines. Training duration, educational program, content, time of assessment, tools, and information about train the trainers or kirkpatrick's level were identified for each selected study. RESULTS: This review revealed that there is no consensus on the training program or on the assessment tools in GP's training about suicide prevention and risk. Nevertheless, it reveals a similar framework including a theoretical part, with a fundamental knowledge content, and an interactive part. CONCLUSION: If reaching standardized training practices seems difficult to achieve, standardizing assessment tools might be a relevant purpose. Indeed, using the same tools would allow proper training comparison. Practically speaking, this review inspired us in the implementation of in situ training and convincing us to undertake a French translation of an assessment scale.


Assuntos
Medicina Geral/educação , Clínicos Gerais/educação , Suicídio/prevenção & controle , Estudos de Casos e Controles , Educação Médica Continuada/métodos , Educação Médica Continuada/normas , Educação Médica Continuada/estatística & dados numéricos , Avaliação Educacional , França/epidemiologia , Medicina Geral/métodos , Medicina Geral/normas , Medicina Geral/estatística & dados numéricos , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Padrões de Prática Médica/normas , Padrões de Prática Médica/estatística & dados numéricos , Aprendizagem Baseada em Problemas/métodos , Aprendizagem Baseada em Problemas/normas , Suicídio/estatística & dados numéricos , Tentativa de Suicídio/prevenção & controle , Tentativa de Suicídio/estatística & dados numéricos
17.
GMS J Med Educ ; 36(3): Doc25, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31211220

RESUMO

Aim: In Germany there is an increasing shortage of physicians, especially in rural areas. Strategies that make use of medical doctors from non-EU member states could effectively counteract this problem more rapidly than other strategies, including those that focus on education. Physicians from third countries must first demonstrate evidence of their professional qualifications on an exam. The failure rate in Schleswig-Holstein is approximately 50%. The specific aim of the 80-hour training course is to prepare third-country physicians for the practice of medicine in Germany and to provide exposure to the rural setting, regardless of whether or not these physicians have already taken an exam to receive formal recognition of their professional qualifications. Method: The need for post-licensure training courses was discerned in interviews with third-country physicians and examiners. The course was also evaluated using different instruments and then revised accordingly. Results: The training program has been held four times with a total of 52 third-country physicians; the program was given the very good rating of 1.4 on the traditional German academic grading scale. In addition to the 10-day training course, the participants had access to an online medical learning platform. Moreover, information on working in rural setting and a field trip to a variety of medical institutions in a rural region was integrated into the course. The majority of the participants used the course as additional preparation for the exam. Their willingness to later practice medicine in a rural setting was high with 89% of participants. Conclusion: The evaluation results suggest that such an intensive training program is suitable to prepare third-country physicians for medical practice in Germany and in particular in rural regions.


Assuntos
Países em Desenvolvimento , Educação Médica Continuada/normas , Médicos/psicologia , População Rural , Adulto , Idoso , Atitude do Pessoal de Saúde , Escolha da Profissão , Currículo/normas , Educação Médica Continuada/métodos , Educação Médica Continuada/tendências , Alemanha , Humanos , Entrevistas como Assunto/métodos , Acontecimentos que Mudam a Vida , Pessoa de Meia-Idade , Médicos/estatística & dados numéricos , Pesquisa Qualitativa
18.
Int. j. cardiovasc. sci. (Impr.) ; 32(3): 227-237, May-June 2019. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1002219

RESUMO

The knowledge on the management of patients with acute coronary syndrome (ACS) is essential to reduce the gap between evidence and practice. Objective: To describe a simulation training strategy for emergency healthcare professionals and provide preliminary data on knowledge acquisition, learners' confidence and prescription of medications after training. Methods: The training was part of the implementation of two myocardial infarction systems of care. It comprehended lectures and simulation-based learning using high and low-fidelity mannequins and actors. It was tested in two phases: the first one in Belo Horizonte and the second one in Montes Claros, both in the state of Minas Gerais. A test was applied before and after training to assess knowledge acquisition. Confidence to perform thrombolysis in ST-elevation myocardial infarction (STEMI) patients was assessed using a questionnaire, and the impact on medication prescription analyzed STEMI patients admitted to hospitals in Montes Claros. Results: In the first phase, 156 professionals answered both tests: 70% of them improved their results and the median number of right answers increased (6, interquartile range [IQR] 5-7; vs 7 ([IQR] 6-9; p < 0.05). In the second phase, 242 professionals answered both tests: 58% of the physicians and 83% of the nurses obtained better test scores. Participants referred a positive impact on their clinical practice, 95% reported feeling very secure when perform fibrinolysis after the training, and there was also an impact on medication prescription. Conclusions: There was an impact on the learners' knowledge acquisition and confidence using our two-phase training model, with evidence of impact on performance


Assuntos
Humanos , Masculino , Feminino , Indicadores de Qualidade em Assistência à Saúde , Serviço Hospitalar de Emergência/tendências , Síndrome Coronariana Aguda/mortalidade , Prescrições de Medicamentos , Heparina/uso terapêutico , Reperfusão Miocárdica/métodos , Análise Estatística , Telemedicina/métodos , Assistência Centrada no Paciente/métodos , Educação Médica Continuada/métodos , Eletrocardiografia/métodos , Serviços Médicos de Emergência , Infarto do Miocárdio
20.
Indian Pediatr ; 56(5): 369-373, 2019 05 15.
Artigo em Inglês | MEDLINE | ID: mdl-31102378

RESUMO

OBJECTIVE: To document the impact of neonatal resuscitation capacity building of birth attendants at district and sub-district level on fresh stillbirth within the public health system in India. DESIGN: An implementation research using pre-post study design. SETTING: 3 high-infant and neonatal mortality districts (Gonda, Aligarh and Raebareli) of Uttar Pradesh, India. PARTICIPANTS: Pregnant women who delivered at the health facilities and their newborns. INTERVENTIONS: An intervention package with (i) training on essential newborn care resuscitation; (ii) skill laboratories establishment for peer-interactive learning; (iii) better documentation; and (iv) supportive supervision was implemented at all health facilities in the districts. MAIN OUTCOME MEASURES: Impact on fresh stillbirth rates and resuscitation practices were documented at 42 health facilities (Gonda-17, Aligarh-8 and Raebareli-17) over 12-18 months. RESULTS: Out of the 3.3% (4431/133627) newborns requiring resuscitation, 58.5% (n=2599) were completely revived, 19% (n=842) had some features of hypoxic insult after birth and 1.4% (n=62) were stillbirths. There was 15.6% reduction in still birth rate in the three districts with the intervention package. CONCLUSIONS: The reduction in still birth rate and improvement in newborn resuscitation efforts in the three districts indicated feasibility of implementation and scalability of the intervention package. However sustenance of the impact over longer period needs documentation.


Assuntos
Fortalecimento Institucional , Educação Médica Continuada/métodos , Educação Continuada em Enfermagem/métodos , Hospitais de Distrito , Tocologia/educação , Ressuscitação/educação , Natimorto/epidemiologia , Educação Médica Continuada/organização & administração , Educação Continuada em Enfermagem/organização & administração , Estudos de Viabilidade , Feminino , Humanos , Índia/epidemiologia , Lactente , Mortalidade Infantil , Recém-Nascido , Gravidez
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