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2.
N Z Med J ; 133(1508): 12-28, 2020 01 17.
Artigo em Inglês | MEDLINE | ID: mdl-31945040

RESUMO

AIM: To investigate GP knowledge of the use of cannabis as a medicine and its regulation in New Zealand. METHOD: A convenience sample of GPs completed a questionnaire during continuing medical education sessions. Key domains investigated were: patient interactions around use of cannabis as a medicine; prescription facilitation and impediments; knowledge of evidence for and against the use of cannabis as a medicine; knowledge of the New Zealand regulatory processes and knowledge of pharmaceutical grade products. Questionnaires were administered between June and October 2018. RESULTS: There were 42/76 (55%) GPs who stated at least one patient had asked for a cannabis prescription for medical use in the last 12 months and 43/76 (57%) were aware of pharmaceutical grade preparations, the majority Sativex. There were 59/75 (79%) who expressed concerns about future prescribing; however, 63/75 (84%) indicated they would be 'somewhat' or 'very' likely to prescribe a PHARMAC-funded product with good evidence in specific conditions. CONCLUSION: Some GPs have concerns about prescribing medicinal cannabis. Due to regulatory restrictions, including no currently funded products, and uncertain scientific evidence of efficacy and safety, education programmes will be required to inform the medico-legal, evidential and practical elements of prescribing cannabis as a medicine.


Assuntos
Clínicos Gerais/ética , Clínicos Gerais/estatística & dados numéricos , Maconha Medicinal/uso terapêutico , Adulto , Idoso , Idoso de 80 Anos ou mais , Cannabis/efeitos adversos , Educação Médica Continuada/normas , Feminino , Humanos , Conhecimento , Masculino , Pessoa de Meia-Idade , Motivação/fisiologia , Nova Zelândia/epidemiologia , Segurança do Paciente , Inquéritos e Questionários , Resultado do Tratamento
3.
Med Educ Online ; 25(1): 1710330, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31891330

RESUMO

Background: Continuing Medical Education (CME) is a cornerstone of improving competencies and ensuring high-quality patient care by nurses and physicians. The Ministry of Health (MOH) Malaysia collaborated with Steno Diabetes Centre to improve diabetes-related competencies of general physicians and nurses working in primary care through a six-month training programme called the Steno REACH Certificate Course in Clinical Diabetes Care (SRCC).Objective: This impact evaluation aimed to assess the effect of participation of general physicians and nurses in the SRCC in selected public primary healthcare clinics in Kuala Lumpur and Selangor, Malaysia.Design: The quasi-experimental, embedded, mixed-methods study used concurrent data collection and the Solomon four-group design. Participants in an intervention group (Arm 1) and control group (Arm 3) were assessed by pre-and post-test, and participants in separate intervention (Arm 2) and control (Arm 4) groups were assessed by post-test only. Quantitative and qualitative methods were used to assess the effect of the programme.Results: Thirty-four of the 39 participants in the intervention groups (Arms 1 and 2) completed the SRCC and were included in the analysis. All 35 participants in the control groups (Arms 3 and 4) remained at the end of the study period. Significant improvements in diabetes-related knowledge, skills and clinical practise were found among general physicians and nurses in the intervention group after the six-month SRCC, after controlling the pretest effects. No clear changes could be traced regarding attitudes.Conclusion: SRCC participants had significant improvements in knowledge, skills and clinical practice that meet the current needs of general physicians and nurses working in primary care in Malaysia. Thus, SRCC is an effective CME approach to improving clinical diabetes care that can be scaled up to the rest of the country and, with some modification, beyond Malaysia.


Assuntos
Diabetes Mellitus/epidemiologia , Educação Médica Continuada/organização & administração , Educação Continuada em Enfermagem/organização & administração , Clínicos Gerais/educação , Conhecimentos, Atitudes e Prática em Saúde , Adulto , Competência Clínica/normas , Diabetes Mellitus/fisiopatologia , Educação Médica Continuada/normas , Educação Continuada em Enfermagem/normas , Feminino , Humanos , Malásia , Masculino , Pessoa de Meia-Idade , Atenção Primária à Saúde/organização & administração
4.
Rev. Asoc. Méd. Argent ; 132(4): 34-36, dic. 2019.
Artigo em Espanhol | LILACS | ID: biblio-1087229

RESUMO

La educación médica continua (EMC) es el proceso de adquisición de nuevos conocimientos y habilidades a lo largo de toda la vida activa de los médicos. Es responsabilidad de cada médico para poder ofrecer la mejor atención a sus enfermos. La EMC no se limita a la educación formal, sino que dispone de distintas estrategias de aprendizaje, entre las que se mencionan los cursos y ateneos, la concurrencia a congresos, jornadas y simposios, el entrenamiento en servicio, la educación a distancia y el autoaprendizaje. La EMC debe ser considerada como la etapa final y más larga en la formación de un médico. (AU)


Continuing medical education (CME) is the process of acquiring new knowledge and skills throughout active life of doctors. It is the responsibility of each doctor to be able to offer the best care of their patients. The CME is not limited to formal education, but different learning are available, including courses, athenaeums, congress attendance, conferences and symposia, in-service training, distance education and self-learning. The CME should be considered as the final and longest stage in the doctor´s training. (AU)


Assuntos
Certificação , Educação Médica/métodos , Educação Médica/normas , Educação Médica Continuada/métodos , Educação Médica Continuada/normas , Argentina , Instituições Acadêmicas , Academias e Institutos , Legislação Médica , Medicina
6.
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
8.
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
9.
Urologe A ; 58(8): 877-880, 2019 Aug.
Artigo em Alemão | MEDLINE | ID: mdl-31267141

RESUMO

Currently, continuing medical evaluation takes place in Germany-but not nationally or regularly, and without national standards. Therefore, comparisons between different clinics and trainers can currently not be drawn. Survey modes, such as those that have existed in Switzerland for decades, could provide a constructive basis in the assessment of the current continuing medical education of urology residents and subsequently facilitate the discussion on improvements. This requires constructive cooperation of all involved, without attributing the responsibility only to the educators. Models of rewarding good continuing education should also be found.


Assuntos
Educação Médica Continuada/normas , Urologia/educação , Alemanha , Humanos , Garantia da Qualidade dos Cuidados de Saúde , Inquéritos e Questionários , Suíça , Urologia/normas
10.
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
11.
BMC Med Educ ; 19(1): 177, 2019 May 30.
Artigo em Inglês | MEDLINE | ID: mdl-31146715

RESUMO

BACKGROUND: In osteopathic medicine, palpation is considered to be the key skill to be acquired during training. Whether palpation skills are adequately acquired during undergraduate or postgraduate training is difficult to assess. The aim of our study was to test a palpation assessment tool developed for undergraduate medical education in a postgraduate medical education (PME) setting. METHODS: We modified and standardized an assessment tool, where a coin has to be palpated under different layers of copy paper. For every layer depth we randomized the hiding positions with a random generator. The task was to palpate the coin or to determine that no coin was hidden in the stack. We recruited three groups of participants: 22 physicians with no training in osteopathic medicine, 25 participants in a PME course of osteopathic techniques before and after a palpation training program, 31 physicians from an osteopathic expert group with at least 700 h of osteopathic skills training. These experts ran the test twice to check for test-retest-reliability. Inferential statistical analyzes were performed using generalized linear mixed models with the dichotomous variable "coin detected / not detected" as the dependent variable. RESULTS: We measured a test-retest reliability of the assessment tool as a whole with 56 stations in the expert group of 0.67 (p <  0.001). For different paper layers, we found good retest reliabilities up to 300 sheets. The control group detected a coin significantly better in a depth of 150 sheets (p = 0.01) than the pre-training group. The osteopathic training group showed significantly more correct coin localizations after the training in layer depths of 200 (p = 0.03) and 300 sheets (p = 0.05). This group also had significantly better palpation results than the expert group in the depth of 300 sheets (p = 0.001). When there was no coin hidden, the expert group showed significantly better results than the post-training group (p = 0.01). CONCLUSIONS: Our tool can be used with reliable results to test palpation course achievements with 200 and 300 sheets of paper. Further refinements of this tool will be needed to use it in complex assessment designs for the evaluation of more sophisticated palpatory skills in postgraduate medical settings.


Assuntos
Competência Clínica , Educação Médica Continuada/normas , Palpação , Adulto , Competência Clínica/normas , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Palpação/métodos , Palpação/normas , Reprodutibilidade dos Testes
12.
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
15.
Mil Med ; 184(Suppl 1): 386-391, 2019 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-30901403

RESUMO

BACKGROUND: We developed simulator-based tools for assessing provider competence in transthoracic echocardiography (TTE) and vascular duplex scanning. METHODS: Psychomotor (technical) skill in TTE image acquisition was calculated from the deviation angle of an acquired image from the anatomically correct view. We applied this metric for formative assessment to give feedback to learners and evaluate curricula.Psychomotor skill in vascular ultrasound was measured in terms of dexterity and image plane location; cognitive skill was assessed from measurements of blood flow velocity, parameter settings, and diagnosis. The validity of the vascular simulator was assessed from the accuracy with which experts can measure peak systolic blood flow velocity (PSV). RESULTS: In the TTE simulator, the skill metric enabled immediate feedback, formative assessment of curriculum efficacy, and comparison of curriculum outcomes. The vascular duplex ultrasound simulator also provided feedback, and experts' measurements of PSV deviated from actual PSV in the model by <10%. CONCLUSIONS: Skill in acquiring diagnostic ultrasound images of organs and vessels can be measured using simulation in an objective, quantitative, and standardized manner. Current applications are provision of feedback to learners to enable training without direct faculty oversight and formative assessment of curricula. Simulator-based metrics could also be applied for summative assessment.


Assuntos
Competência Clínica/normas , Ultrassonografia/normas , Currículo/normas , Ecocardiografia/métodos , Ecocardiografia/normas , Educação Médica Continuada/métodos , Educação Médica Continuada/normas , Avaliação Educacional/métodos , Humanos , Reprodutibilidade dos Testes , Treinamento por Simulação/métodos , Ultrassonografia/métodos
16.
Am J Med ; 132(8): 921-925, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-30853472

RESUMO

Provision and participation in formal external continuing medical education (CME) is costly. Employer or state support of CME is the exception rather than the rule. The medical industry has supported both providers and consumers of educational activities, leading to concerns of commercial bias. Recent medical industry initiatives in Europe to improve the transparency of the relationship between industry and the profession, including the field of medical education, have had the paradoxical effect of the industry playing an increasingly direct role in the provision of physician education. Funding of medical professional society annual congresses has been directly and indirectly jeopardized. Acknowledging that there are areas of cooperation in the field of education between the medical profession and the medical industry from which both can benefit, we argue that medical education requires an objective approach that the primary fiduciary duty of medical industry companies precludes. Medical professional societies, as not-for-profit organizations whose core mission is the development and promotion of best practice, are best placed to guide and deliver medical education to their members.


Assuntos
Educação Médica Continuada/métodos , Educação Médica Continuada/normas , Médicos/normas , Educação Médica Continuada/tendências , Previsões/métodos , Humanos , Médicos/estatística & dados numéricos , Sociedades Médicas/organização & administração , Sociedades Médicas/tendências
18.
Crit Care Med ; 47(3): e256-e262, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30640220

RESUMO

OBJECTIVES: Critical care ultrasonography has become established within ICUs as a diagnostic tool and to guide management strategies and practical procedures. Following an international consensus statement in 2011, various national professional societies and organizations have sought to develop and deliver training program. The aim of this review was to assess the similarities and differences among these postgraduate intensive care/critical care training program. DATA SOURCES: A systematic review was performed in two steps. First, we searched medical databases and national societies' websites for documents meeting predefined inclusion criteria. If not found, professionals related to critical care ultrasonography were contacted. DATA EXTRACTION: Data were extracted independently by two authors. Analyses were conducted on general training requirements as well as specific competencies defined in the documents. DATA SYNTHESIS: Eight national program from seven countries were identified from a total of 25 countries; all identified program have defined competencies for core critical care ultrasonography. Although there were common themes across these program, significant variations in training requirements and assessments existed, for example, number of scans required for echocardiography training ranged from 10 to 100. Furthermore, the specifics of each ultrasound module varied between program. CONCLUSIONS: Despite widespread and increasing use of ultrasound in ICUs, the majority of countries lacked a formal training program and clearly defined competencies. Even among the countries where these are available, there remains variability. There is a need to better define the competencies required in core critical care ultrasonography and standardize the assessment process.


Assuntos
Competência Clínica/normas , Cuidados Críticos , Educação Médica Continuada/métodos , Ultrassonografia , Cuidados Críticos/métodos , Cuidados Críticos/normas , Currículo/normas , Educação Médica Continuada/normas , Humanos , Unidades de Terapia Intensiva/normas , Ultrassonografia/normas
19.
Pediatr Surg Int ; 35(4): 495-499, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30661099

RESUMO

PURPOSE: A career in pediatric surgery has historically required extensive research experience, but the optimal research training is not well defined. The purpose of this study was to explore the formative research experiences among pediatric surgeons. METHODS: A 1-h focus group was held with 14 pediatric surgeons at the 2017 Pediatric Trauma Society annual meeting. A 17-item survey was also administered. Questions were intended to elicit discussion of prior research experiences. A qualitative analysis of the dialogue was performed. RESULTS: Seventy-seven percent of respondents completed a research fellowship. Most (77%) currently conduct clinical research. Participants most frequently desired additional training in study design (50%), NIH funding (43%), and grant preparation (43%). Seven themes were identified from the focus group: (1) Early research exposure is rudimentary; (2) Resume-building was a motivation; (3) Mentorship is important; (4) Institutional resources are vital; (5) Independent learning is necessary; (6) Protected time is limited; and (7) Basic science research is not always practical. CONCLUSIONS: Many pediatric surgeons feel that their research training can be improved upon. Formal mentorship, dedicated research time, and institutional resources were perceived to be important factors. Education in research study design, grant writing, and NIH funding may be beneficial. LEVEL OF EVIDENCE: V, expert opinion.


Assuntos
Pesquisa Biomédica , Competência Clínica , Educação Médica Continuada/normas , Cirurgia Geral/educação , Sociedades Médicas , Cirurgiões/educação , Traumatologia/educação , Criança , Feminino , Humanos , Internato e Residência/métodos , Masculino , Inquéritos e Questionários , Estados Unidos
20.
Trials ; 20(1): 62, 2019 Jan 18.
Artigo em Inglês | MEDLINE | ID: mdl-30658657

RESUMO

BACKGROUND: Variations in care models contribute to cancer pain being under-recognised and under-treated in half of all patients with cancer. International and national cancer pain management guidelines are achievable with minimal investment but require practice changes. While much of the cancer pain research over the preceding decades has focused on management interventions, little attention has been given to achieving better adherence to recommended cancer pain guideline screening and assessment practices. This trial aims to reduce unrelieved cancer pain by improving cancer and palliative doctors' and nurses' ('clinicians') pain assessment capabilities through a targeted inter-professional clinical education intervention delivered to participants' mobile devices ('mHealth'). METHODS: A wait-listed, randomised control trial design. Cancer and/or palliative care physicians and nurses employed at one of the six participating sites across Australia will be eligible to participate in this trial and, on enrolment, will be allocated to the active or wait-listed arm. Participants allocated to the active arm will be invited to complete the mHealth cancer pain assessment intervention. In this trial, mHealth is defined as medical or public health practice supported by mobile devices (i.e. phones, patient monitoring devices, personal digital assistants and other wireless devices). This mHealth intervention integrates three evidence-based elements, namely: the COM-B theoretical framework; spaced learning pedagogy; and audit and feedback. This intervention will be delivered via the QStream online platform to participants' mobile devices over four weeks. The trial will determine if a tailored mHealth intervention, targeting clinicians' cancer pain assessment capabilities, is effective in reducing self-reported cancer pain scores, as measured by a Numerical Rating Scale (NRS). DISCUSSION: If this mHealth intervention is found to be effective, in addition to improving cancer pain assessment practices, it will provide a readily transferable evidence-based framework that could readily be applied to other evidence practice gaps and a scalable intervention that could be administered simultaneously to multiple clinicians across diverse geographical locations. Moreover, if found to be cost-effective, it will help transform clinical continuing professional development. In summary, this mHealth intervention will provide health services with an opportunity to offer an evidence-based, pedagogically robust, cost-effective, scalable training alternative. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry (ANZCTR), ACTRN12618001103257 . Registered on 3 July 2018.


Assuntos
Dor do Câncer/terapia , Educação Médica Continuada/métodos , Educação Continuada em Enfermagem/métodos , Manejo da Dor/métodos , Equipe de Assistência ao Paciente , Telemedicina/métodos , Atitude do Pessoal de Saúde , Dor do Câncer/diagnóstico , Dor do Câncer/fisiopatologia , Dor do Câncer/psicologia , Telefone Celular , Ensaios Clínicos Fase III como Assunto , Educação Médica Continuada/normas , Educação Continuada em Enfermagem/normas , Fidelidade a Diretrizes , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Aplicativos Móveis , Estudos Multicêntricos como Assunto , New South Wales , Manejo da Dor/normas , Medição da Dor , Equipe de Assistência ao Paciente/normas , Guias de Prática Clínica como Assunto , Padrões de Prática em Enfermagem , Padrões de Prática Médica , Ensaios Clínicos Controlados Aleatórios como Assunto , Telemedicina/normas , Fatores de Tempo , Resultado do Tratamento
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