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1.
Plast Reconstr Surg ; 145(2): 576-584, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31985665

RESUMO

BACKGROUND: Prior studies demonstrate that social media are used by plastic surgeons to educate and engage. The hashtag #PlasticSurgery has been studied previously and is embraced by American plastic surgeons and journals; however, no studies have examined its use or adoption across Europe. METHODS: A retrospective analysis of 800 tweets containing the words "plastic surgery" or the hashtag #PlasticSurgery in four of the most spoken European languages worldwide excluding English (Spanish, #CirugiaPlastica; French, #ChirurgiePlastique; Portuguese, #CirurgiaPlastica; and German, #PlastischeChirurgie) was performed. The following were assessed: identity of author, subject matter, use of the hashtag #PlasticSurgery in each language, whether posts by surgeons and academic institutions were self-promotional or educational, and whether a link to a journal article or a reference in PubMed was provided. RESULTS: Seventeen percent and 3 percent of analyzed tweets came from plastic surgeons or academic institutions, respectively; only 17.5 percent of them were for educational purpose. None of them had any digital link to a peer-reviewed article or a scientific journal. CONCLUSIONS: This study demonstrates the low participation of plastic surgeons and academic institutions in social media (especially for education) in four of the major world languages. Social media should be considered in Europe as an opportunity to increase leadership, improve education, and spread knowledge of plastic surgery by board-certified plastic surgeons.


Assuntos
Educação Médica/estatística & dados numéricos , Liderança , Cirurgia Plástica/educação , Europa (Continente) , Humanos , Linguagem , Estudos Retrospectivos , Mídias Sociais/estatística & dados numéricos , Cirurgia Plástica/estatística & dados numéricos , Terminologia como Assunto
2.
Global Health ; 15(1): 60, 2019 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-31675976

RESUMO

BACKGROUND: Globalization has made it possible for global health professionals and trainees to participate in short-term training and professional experiences in a variety of clinical- and non-clinical activities across borders. Consequently, greater numbers of healthcare professionals and trainees from high-income countries (HICs) are working or volunteering abroad and participating in short-term experiences in low- and middle-income countries (LMICs). How effective these activities are in advancing global health and in addressing the crisis of human resources for health remains controversial. What is known, however, is that during these short-term experiences in global health (STEGH), health professionals and those in training often face substantive ethical challenges. A common dilemma described is that of acting outside of one's scope of training. However, the frequency, nature, circumstances, and consequences of performing outside scope of training (POST) have not been well-explored or quantified. METHODS: The authors conducted an online survey of HIC health professionals and trainees working or volunteering in LMICs about their experiences with POST, within the last 5 years. RESULTS: A total of 223 survey responses were included in the final analysis. Half (49%) of respondents reported having been asked to perform outside their scope of training; of these, 61% reported POST. Trainees were nearly twice as likely as licensed professionals to report POST. Common reasons cited for POST were a mismatch of skills with host expectations, suboptimal supervision at host sites, inadequate preparation to decline POST, a perceived lack of alternative options and emergency situations. Many of the respondents who reported POST expressed moral distress that persisted over time. CONCLUSIONS: Given that POST is ethically problematic and legally impermissible, the high rates of being asked, and deciding to do so, were notable. Based on these findings, the authors suggest that additional efforts are needed to reduce the incidence of POST during STEGH, including pre-departure training to navigate dilemmas concerning POST, clear communication regarding expectations, and greater attention to the moral distress experienced by those contending with POST.


Assuntos
Educação Médica/estatística & dados numéricos , Saúde Global/educação , Pessoal de Saúde/psicologia , Padrões de Prática Médica/estatística & dados numéricos , Países em Desenvolvimento , Pessoal de Saúde/estatística & dados numéricos , Humanos , Missões Médicas , Princípios Morais , Padrões de Prática Médica/ética , Inquéritos e Questionários
3.
Immun Inflamm Dis ; 7(3): 214-228, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31290265

RESUMO

BACKGROUND: Clinicians draw on instructional approaches when training patients with anaphylaxis to use adrenaline autoinjectors, but patient use is poor. Psychological barriers to these behaviours exist but are not considered routinely when training patients to use autoinjectors. Health Psychology principles suggest exploring these factors with patients could improve their autoinjector use. OBJECTIVE: To evaluate the impact of a 90-minute workshop training clinicians in strategies and techniques for exploring and responding to psychological barriers to autoinjector use with patients. Attendees' knowledge, confidence and likelihood of using the strategies were expected to improve. METHODS: Impact was evaluated using a longitudinal mixed-method design. Twenty-nine clinicians (general and specialist nurses, general practitioners, and pharmacists) supporting patients with anaphylaxis in UK hospitals and general practice attended. Self-rated knowledge, confidence, and likelihood of using the strategies taught were evaluated online 1 week before, 1 to 3, and 6 to 8 weeks after the workshop. Clinicians were invited for telephone interview after attending to explore qualitatively the workshop impact. RESULTS: χ2 analyses were significant in most cases (P < .05), with sustained (6-8 weeks) improvements in knowledge, confidence, and likelihood of using the strategies taught. Thematic analysis of interview data showed the workshop enhanced attendees' knowledge of the care pathway, understanding of patient's experience of anaphylaxis as psychological not purely physical, and altered their communication with this and other patient groups. However, interviewees perceived lack of time and organisational factors as barriers to using the strategies and techniques taught in clinical contexts. CONCLUSION: Training clinicians in psychologically informed strategies produce sustained improvements in their confidence and knowledge around patient autoinjector education, and their likelihood of using strategies in clinical practice. CLINICAL RELEVANCE: Exploring psychological barriers should be part of training patients with anaphylaxis in autoinjector use.


Assuntos
Anafilaxia/prevenção & controle , Educação Médica/métodos , Epinefrina/administração & dosagem , Pessoal de Saúde/psicologia , Pessoal de Saúde/estatística & dados numéricos , Autoadministração/métodos , Inquéritos e Questionários , Adulto , Anafilaxia/tratamento farmacológico , Educação Médica/estatística & dados numéricos , Feminino , Clínicos Gerais/psicologia , Clínicos Gerais/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Enfermeiras Clínicas/psicologia , Enfermeiras Clínicas/estatística & dados numéricos , Farmacêuticos/psicologia , Farmacêuticos/estatística & dados numéricos , Médicos/psicologia , Médicos/estatística & dados numéricos , Autoadministração/estatística & dados numéricos , Vasoconstritores/administração & dosagem
6.
Surgery ; 165(6): 1065-1068, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30898374

RESUMO

BACKGROUND: Expert performance is characterized by consistency. The degree of variability of performance from repetition to repetition during proficiency-based simulator training could potentially indicate acquisition of expertise. We hypothesized that learners with less variability in performance during simulator training would achieve greater performance at the end of training and improved transfer of skills to a live, anesthetized, porcine model. METHODS: The performance of 93 subjects (surgery residents and medical students) who had participated in 3 randomized controlled trials was analyzed for variability. All participants had trained in laparoscopic suturing on the Fundamentals of Laparoscopic Surgery (FLS) simulator. Their performance had been assessed on the simulator before (baseline) and after training (posttest) and on a live, anesthetized, porcine model (transfer test). We computed the coefficient of variations of suturing scores during training for each participant. Linear regression was used to assess whether variability in performance during training predicted posttest and transfer-test scores. RESULTS: Decreased practice variability in performance was associated with greater scores in posttests and transfer tests. For each percent decrease in variability performance, posttest scores increased by 3.8 points (P < .001) and transfer-test scores increased by 3.0 points (P < .001). Greater mean scores during practice were associated with greater scores on the transfer test (P < .001). CONCLUSION: Decreased variability in performance during practice on simulators is associated with improved performance at the end of training and during transfer to a live, anesthetized, porcine model. These findings suggest that variability in performance during simulator training may be used to track the progress and readiness of a trainee for the clinical environment. Further studies are needed to verify the robustness of this potentially new metric of performance.


Assuntos
Desempenho Acadêmico/estatística & dados numéricos , Internato e Residência/métodos , Laparoscopia/educação , Curva de Aprendizado , Treinamento por Simulação/métodos , Animais , Competência Clínica/estatística & dados numéricos , Educação Médica/métodos , Educação Médica/estatística & dados numéricos , Humanos , Internato e Residência/estatística & dados numéricos , Laparoscopia/estatística & dados numéricos , Modelos Animais , Ensaios Clínicos Controlados Aleatórios como Assunto , Treinamento por Simulação/estatística & dados numéricos , Estudantes de Medicina/psicologia , Estudantes de Medicina/estatística & dados numéricos , Técnicas de Sutura/educação , Técnicas de Sutura/estatística & dados numéricos , Suínos
7.
Rev Med Interne ; 40(5): 286-290, 2019 May.
Artigo em Francês | MEDLINE | ID: mdl-30902508

RESUMO

INTRODUCTION: The first computerised national ranking exam (cNRE) in Medicine was introduced in June 2016 for 8214 students. It was made of 18 progressive clinical cases (PCCs) with multiple choice questions (MCQs), 120 independent MCQs and 2 scientific articles to criticize. A lack of mark discrimination grounded the cNRE reform. We aimed to assess the discrimination of the final marks after this first cNRE. METHODS: A national Excel® file gathering overall statistics and marks were transmitted to the medical faculties after the cNRE. The mean points deviation between two papers and the percentage of points ranking 75% of students allowed us to analyse marks' discrimination. RESULTS: The national distribution sigmoid curve of the marks is superimposable with previous NRE in 2015. In PCCs, 72% of students were ranked in 1090 points out of 7560 (14%). In independents MCQs, 73% of students were ranked in 434 points out of 2160 (20%). In critical analysis of articles, 75% of students were ranked in 225 points out of 1080 (21%). The above percentages of students are on the plateau of each discrimination curve for PCCs, independent MCQs and critical analysis of scientific articles. CONCLUSION: The cNRE reduced equally-ranked students compared to 2015, with a mean deviation between two papers of 0.28 in 2016 vs 0.04 in 2015. Despite the new format introduced by the cNRE, 75% of students are still ranked in a low proportion of points that is equivalent to previous NRE in 2015 (between 15 et 20% of points).


Assuntos
Computadores , Educação Médica , Avaliação Educacional/métodos , Estudantes de Medicina/classificação , Coleta de Dados/instrumentação , Coleta de Dados/normas , Ciência de Dados/instrumentação , Ciência de Dados/métodos , Educação Médica/classificação , Educação Médica/métodos , Educação Médica/normas , Educação Médica/estatística & dados numéricos , França/epidemiologia , Humanos , Medicina/instrumentação , Medicina/métodos
8.
Rev Col Bras Cir ; 46(1): e2050, 2019 Mar 21.
Artigo em Português, Inglês | MEDLINE | ID: mdl-30916207

RESUMO

OBJECTIVE: to evaluate the perception of quality of life among residents in the first year of Medical Residency compared to the one among residents in other years of training, given the importance of this issue in health. METHODS: a comparative and cross-sectional analytical study performed from February to April 2016 in a reference tertiary trauma hospital in Brazil. Resident physicians were voluntarily submitted to an online questionnaire on quality of life (called WHOQOL-BREF), validated by World Health Organization (WHO). They were divided into two groups: first year of residency (R1) and other years of residency. RESULTS: ninety-seven residents of several medical specialties answered the questionnaire. Of these, 59 were men and 38 were women. The mean age was 27.7 years. First-year residents accounted for 49.5% of the interviewees. Overall, quality of life was considered regular in both groups. In relation to psychological domain, there was a significant difference between the R1 group (with worse scores in this domain) and the non-R1 group (p<0.0000001). CONCLUSION: first-year residents' quality of life is worse than the one of the residents from other years, having a significant variation of positive feelings, learning capacity, memory, thought and concentration, self-esteem, body image and appearance, and negative feelings.


Assuntos
Educação Médica/métodos , Internato e Residência , Qualidade de Vida , Estudantes de Medicina/psicologia , Adulto , Brasil , Estudos Transversais , Educação Médica/estatística & dados numéricos , Feminino , Humanos , Internato e Residência/classificação , Internato e Residência/estatística & dados numéricos , Masculino , Estudantes de Medicina/estatística & dados numéricos , Inquéritos e Questionários
9.
Int J Surg ; 67: 113-116, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30708061

RESUMO

INTRODUCTION: Surgical trainees are reporting barriers to training in gastrointestinal (GI) endoscopy. This snapshot survey aimed to gather data on variation in access to quality GI endoscopy training for Colorectal and Upper Gastrointestinal (GI) surgical trainees across the UK and Ireland. MATERIALS AND METHODS: An online 20-point survey was designed and distributed nationally to surgical trainee members of the Association of Surgeons in Training (ASiT), Dukes and The Roux Group (formerly Association of Upper Gastrointestinal Surgeons of Great Britain and Ireland Trainees). The survey was designed in collaboration with The Roux Group for Upper GI trainees and the Dukes' Club for Colorectal trainees. RESULTS: 218 responses were received, most with a Colorectal or Upper GI sub-specialty interest (colorectal 56.0%; upper GI surgery 25.7%). Only 28.6% of trainees attended a dedicated training endoscopy list at least once a week with 28.1% not attending any at all. Less than half of trainees reported having endoscopy formally timetabled on rotas (36.9%). Most trainees (88.0%) encountered difficulties in gaining endoscopy training including lack of available lists (77.2%), conflicting operative commitments (59.4%), preferential allocation of lists to gastroenterology trainees (57.9%) and resistance from endoscopy departmental leads (38.6%). Regarding JAG accreditation, 77.1% respondents felt it should be mandatory prior to CCT with 80.3% believing this would lead to better access to dedicated endoscopy training equivalent to gastroenterology trainees. 93.1% trainees felt that attaining JAG accreditation by surgical trainees was important to patient care. DISCUSSION: This study demonstrates significant barriers in accessing GI endoscopy training for general surgical trainees which urgently needs to be improved. In order to meet JAG training requirements for surgical trainees, a multifaceted collaborative approach from surgical and gastroenterology training bodies, local JAG trainers and the General Surgery SAC and JCST is required. This is to ensure that endoscopy is promoted and a robust model of training is successfully designed and delivered to general surgery trainees.


Assuntos
Educação Médica/estatística & dados numéricos , Endoscopia Gastrointestinal/educação , Cirurgia Geral/educação , Cirurgiões/educação , Adulto , Competência Clínica , Feminino , Humanos , Irlanda , Masculino , Estudos Prospectivos , Inquéritos e Questionários , Reino Unido
10.
Lancet ; 393(10171): 541-549, 2019 02 09.
Artigo em Inglês | MEDLINE | ID: mdl-30739689

RESUMO

BACKGROUND: Women are under-represented in surgery and leave training in higher proportions than men. Studies in this area are without a feminist lens and predominantly use quantitative methods not well suited to the complexity of the problem. METHODS: In this qualitative study, a researcher interviewed women who had chosen to leave surgical training. Women were recruited using a purposive snowball strategy through the routine communications of the Royal Australasian College of Surgeons and Royal Australasian College of Surgeons Trainee Association over a 3-week period, and were interviewed over the following 4 months in the past 4 years in person or by telephone. More specific details are available on request from the authors. Supported by male and female co-researchers, and in dialogue with study participants, she then coded the findings and defined themes. An explanatory model was developed by integrating findings with different theories and previous literature. The research team developed three aspects of the model into a visual analogue. FINDINGS: 12 women participated in the study, with all Australian states and territories, and New Zealand, as well as five medical specialty streams, represented. The time spent in training ranged from 6 months to 4 years, and all participants, except two, had trained in both metropolitan and rural locations. The findings confirmed factors identified in earlier reports as reasons women leave surgical training, and contributed six new factors: unavailability of leave, a distinction between valid and invalid reasons for leave, poor mental health, absence of interactions with the women in surgery section of their professional body and other supports, fear of repercussion, and lack of pathways for independent and specific support. The relationships between factors was complex and sometimes paradoxical. The visual analogue is a tower of blocks, with each block representing a factor that contributed to the decision to leave surgical training, and with the toppling of the tower representing the choice to leave. The visual analogue indicates that effective action requires attention to the contributory factors, the small actions that can topple the tower, and the contexts in which the blocks are stacked. INTERPRETATION: Women might be best helped by interventions that are alert to the possibility of unplanned negative effects, do not unduly focus on gender, and address multiple factors. This should inform interventions in surgical training, with attention to local social context, health-care setting, and training programme structure. FUNDING: Royal Australasian College of Surgeons Ian and Ruth Gough Surgical Education Scholarship.


Assuntos
Escolha da Profissão , Cirurgiões/educação , Cirurgiões/psicologia , Atitude do Pessoal de Saúde , Austrália , Esgotamento Profissional/psicologia , Educação Médica/estatística & dados numéricos , Feminino , Feminismo , Humanos , Nova Zelândia , Admissão e Escalonamento de Pessoal , Pesquisa Qualitativa , Fatores Sexuais
11.
Acad Med ; 94(5): 640-644, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30640267

RESUMO

The authors describe influences associated with the incorporation of modern technologies into medical school admissions processes. Their purpose is not to critique or support specific technologies but, rather, to prompt reflection on the evolution that is afoot. Technology is now integral to the administration of multiple admissions tools, including the Medical College Admission Test, situational judgment tests, and standardized video interviews. Consequently, today's admissions landscape is transforming into an online, globally interconnected marketplace for health professions admissions tools. Academic capitalism and distance-based technologies combine to enable global marketing and dissemination of admissions tests beyond the national jurisdictions in which they are designed. As predicted by disruptive business theory, they are becoming key drivers of transformative change. The seeds of technological disruption are present now rather than something to be wary of in the future. The authors reflect on this transformation and the need for tailoring test modifications to address issues of medical student diversity and social responsibility. They comment on the online assessment of applicants' personal competencies and the potential detriments if this method were to replace admissions methods involving human contact, thanks to the ease with which institutions can implement them without cost to themselves and without adequate consideration of measurement utility or contextual appropriateness. The authors advocate for socially responsible academic capitalism within this interconnected admissions marketplace: Attending to today's transformative challenges may inform how health professions education responds to tomorrow's admissions technologies and, in turn, how tomorrow's health professionals respond to their patients' needs.


Assuntos
Educação Médica/história , Invenções/história , Critérios de Admissão Escolar/estatística & dados numéricos , Faculdades de Medicina/história , Educação Médica/estatística & dados numéricos , História do Século XXI , Humanos , Invenções/estatística & dados numéricos , Faculdades de Medicina/estatística & dados numéricos
12.
Acta Neurochir (Wien) ; 161(2): 205-211, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30673844

RESUMO

BACKGROUND: Our previous studies suggest that the training history of an investigator, termed "medical academic genealogy", influences the outcomes of that investigator's research. Here, we use meta-analysis and quantitative statistical modeling to determine whether such effects contribute to systematic bias in published conclusions. METHODS: A total of 108 articles were identified through a comprehensive search of the high-grade glioma (HGG) surgical resection literature. Analysis was performed on the 70 articles with sufficient data for meta-analysis. Pooled estimates were generated for key academic genealogies. Monte Carlo simulations were performed to determine whether the effects attributed to genealogy alone can arise due to chance alone. RESULTS: Meta-analysis of the HGG literature without consideration for academic medical genealogy revealed that gross total resection (GTR) was associated with a significant decrease in the odds ratio (OR) for the hazard of death after surgery for both anaplastic astrocytoma (AA) and glioblastoma (AA: log [OR] = - 0.04, 95% CI [- 0.07 to - 0.01]; glioblastoma log [OR] = - 0.36, 95% CI [- 0.44 to - 0.29]). For the glioblastoma literature, meta-analysis of articles contributed by members of a genealogy consisting of mostly radiation oncologists revealed no reduction in the hazard of death after GTR [log [OR] = - 0.16, 95% CI [- 0.41 to 0.09]. In contrast, meta-analysis of published articles contributed by members of a genealogy consisting of mostly neurosurgeons revealed that GTR was associated with a significant reduction in the hazard of death [log [OR] = - 0.29, 95% CI [- 0.40 to 0.18]. Monte Carlo simulation revealed that the observed discrepancy between the articles contributed by the members of these two genealogies was unlikely to arise by chance alone (p < 0.006). CONCLUSIONS: Meta-analysis of articles contributed by authors belonging to the different medical academic genealogies yielded distinct and contradictory pooled point-estimates, suggesting that genealogy contributes to systematic bias in the published literature.


Assuntos
Educação Médica/estatística & dados numéricos , Neurocirurgiões/psicologia , Projetos de Pesquisa/estatística & dados numéricos , Viés , Glioblastoma/cirurgia , Humanos , Neurocirurgiões/educação , Procedimentos Neurocirúrgicos/normas , Procedimentos Neurocirúrgicos/estatística & dados numéricos , Publicações Periódicas como Assunto/estatística & dados numéricos , Projetos de Pesquisa/normas
13.
J Robot Surg ; 13(3): 385-389, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30088228

RESUMO

Robotic-assisted surgical procedures are being increasingly used in general surgery, including in the rural and community setting. Although there is no requirement, general surgery residency programs have begun to incorporate curriculums to train residents in this discipline. As a small rural community program, we recently instituted a voluntary and structured curriculum, and our initial experience is shared here. Our curriculum was voluntary for all general surgical residents for the academic years 2016-2017. The curriculum consisted of online training, bedside training, console simulation, bedside assisting, and operating at the console. During the fiscal year of 2016, 193 robot-assisted surgeries performed within the General Surgery Department. Fourteen of fifteen residents participated in the curriculum, with the exception being a resident new to our program. A survey was sent to the residents to evaluate their opinions towards robotic surgery and the curriculum, with 12/15 residents responding. Overall, residents' impressions were very favorable, with all reporting being either very or mostly satisfied with the curriculum and most, 58.4%, reporting there participating level on the robot to be appropriate. Importantly most, 91.7% did not think that the curriculum put an undue stress on their time or that it was detrimental to other aspects of their training. This study shows that a community rural general surgery program can incorporate a voluntary robotic curriculum effectively with high resident participation and satisfaction.


Assuntos
Currículo , Educação Médica/métodos , Cirurgia Geral/educação , Internato e Residência , Procedimentos Cirúrgicos Robóticos/educação , Cirurgiões/educação , Educação Médica/estatística & dados numéricos , Humanos , Internato e Residência/estatística & dados numéricos , Satisfação Pessoal , População Rural , Engajamento no Trabalho
14.
World Neurosurg ; 121: e113-e118, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30218804

RESUMO

BACKGROUND: An academic genealogy describes mentoring relationships in an academic discipline. In this study, we outline an academic genealogy of neurosurgery department chairs in the United States beginning with the founding members of the field. METHODS: The biographic information provided by the Society for Neurological Surgery provided the basis for our genealogy. We also performed a literature review with PubMed using the term neurosurgery department history. Our data was manually uploaded to an online database called Academic Tree. Within this platform, mentor and trainee relationships were indicated to produce an academic genealogy. RESULTS: Our search yielded a total of 377 chairs and 368 mentoring relationships across 98 neurosurgery departments. The largest family tree in our academic genealogy was that of Harvey Cushing, with 177 department chairs. Harvey Cushing was also the individual who trained the most number of department chairs (22). The institution that trained the most department chairs was Brigham and Women's Hospital (26). Only 23.6% of department chairs completed residency training at the same institution where they became chair. CONCLUSIONS: The academic genealogy in this study allows for any neurosurgeon trained in the United States to put his or her training into historical context. It also provides a reference for bibliographic research to quantitatively describe the influence of individuals and institutions on the field.


Assuntos
Centros Médicos Acadêmicos/estatística & dados numéricos , Docentes de Medicina/estatística & dados numéricos , Tutoria/estatística & dados numéricos , Neurocirurgia/estatística & dados numéricos , Educação Médica/estatística & dados numéricos , Mentores , Neurocirurgia/educação , Estados Unidos
15.
Acad Med ; 94(1): 76-84, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30113363

RESUMO

PURPOSE: To maintain scientific integrity and engender public confidence, research must be conducted responsibly. Whereas deliberate scientific misconduct such as data fabrication is clearly unethical, other behaviors-often referred to as questionable research practices (QRPs)-exploit the ethical shades of gray that color acceptable practice. This study aimed to measure the frequency of self-reported misconduct and QRPs in a diverse, international sample of health professions education (HPE) researchers. METHOD: In 2017, the authors conducted an anonymous, cross-sectional survey study. The web-based survey contained 43 items that asked respondents to rate how often they had engaged in a variety of irresponsible research behaviors. The items were adapted from previously published surveys. RESULTS: In total, 590 HPE researchers took the survey. The mean age was 46 years (SD = 11.6), and the majority of participants were from the United States (26.4%), Europe (23.2%), and Canada (15.3%). The three most frequently reported irresponsible research behaviors were adding authors who did not qualify for authorship (60.6%), citing articles that were not read (49.5%), and selectively citing papers to please editors or reviewers (49.4%). Additionally, respondents reported misrepresenting a participant's words (6.7%), plagiarizing (5.5%), inappropriately modifying results (5.3%), deleting data without disclosure (3.4%), and fabricating data (2.4%). Overall, 533 (90.3%) respondents reported at least one irresponsible behavior. CONCLUSIONS: Notwithstanding the methodological limitations of survey research, these findings indicate that a substantial proportion of HPE researchers report a range of misconduct and QRPs. Consequently, reforms may be needed to improve the conduct of HPE research.


Assuntos
Autoria/normas , Pesquisa Biomédica/normas , Educação Médica/normas , Ética em Pesquisa/educação , Editoração/normas , Má Conduta Científica/ética , Má Conduta Científica/estatística & dados numéricos , Adulto , Pesquisa Biomédica/estatística & dados numéricos , Estudos Transversais , Educação Médica/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Editoração/estatística & dados numéricos
16.
Acad Med ; 94(1): 17-19, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30157092

RESUMO

In this Invited Commentary, the authors use personal experiences to highlight how obstacles for qualified candidates with physical disabilities persist in medical education, especially at entry to and early stages of training. In an era when medical schools and residency programs advocate principles of diversity and inclusion, it is estimated that medical students with physical disabilities still comprise less than 1% of learners. The authors present four constructive actions to address the underrepresentation of individuals with physical disabilities in medical schools: (1) acknowledging biases, (2) building networks, (3) reassessing the undifferentiated model of medical education, and (4) advocating the advantages of physicians with disabilities. Supporting trainees and practicing physicians with physical disabilities requires pragmatic evaluation of the essential functions of contemporary medical education, as well as lateral thinking to approach clinical work in innovative ways.


Assuntos
Viés , Pessoas com Deficiência/estatística & dados numéricos , Educação Médica/estatística & dados numéricos , Médicos/estatística & dados numéricos , Faculdades de Medicina/estatística & dados numéricos , Adulto , Feminino , Humanos , Masculino , Adulto Jovem
17.
Acad Med ; 94(5): 708-714, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30520806

RESUMO

PURPOSE: This analysis examined the role of a National Institutes of Health (NIH) individual Mentored Career Development Award (K01, K08, K23) on launching and sustaining independent research careers for early-career scientists, and investigated the effects of these awards during and after the doubling of the NIH budget. METHOD: The authors used grants data from the NIH covering the period 1990 through 2016, and compared success in receipt of R01 equivalent awards (R01 Eq.) and Research Project Grants (RPGs) for K awardees and K applicants who did not receive funding. The analysis combined regression discontinuity design with coarsened exact matching, and regression. RESULTS: Overall, receipt of K award was associated with a 24.1% increase in likelihood of first independent NIH award (P < .01), and a larger number of R01 Eq. and RPG awards. After accounting for first major independent awards, K awards were uncorrelated with receiving second major independent research awards. Comparing different funding periods, K01 awards were predictive of subsequent R01 Eq. and RPG awards after but not during the NIH doubling, K08 awards were predictive only during the NIH doubling, and K23 awards were predictive during both periods. CONCLUSIONS: Receipt of Mentored Career Development Awards was linked to increased likelihood that early-career scientists successfully transitioned to an independent research career. These findings indicate that extending funding to additional K award applicants with meritorious scores could significantly strengthen the pipeline of biomedical researchers. In addition, enhancing K awards may be relevant to sustaining research careers for clinician scientists.


Assuntos
Pesquisa Biomédica/economia , Escolha da Profissão , Educação Médica/organização & administração , Organização do Financiamento/economia , National Institutes of Health (U.S.)/economia , Pesquisadores/economia , Apoio à Pesquisa como Assunto/economia , Adulto , Pesquisa Biomédica/estatística & dados numéricos , Educação Médica/estatística & dados numéricos , Feminino , Humanos , Masculino , Mentores/estatística & dados numéricos , National Institutes of Health (U.S.)/estatística & dados numéricos , Pesquisadores/estatística & dados numéricos , Estados Unidos
18.
Interface (Botucatu, Online) ; 23(supl.1): e170949, 2019. graf
Artigo em Inglês | LILACS, Repositório RHS | ID: biblio-984556

RESUMO

Abstract The More Doctors Program (PMM) was created in 2013. Guided by social needs, it set a new regulatory framework for medical education and residency in Brazil. This study is based on public policies and their actions aimed at implementing changes in medical education in PMM, as well as their results until 2015, by analyzing documents from official sources and the literature. The following results were identified: decrease in regional inequalities in the distribution of undergraduate course seats; education internalization; increase in medical residency seats specialized in Family and Community Medicine; expansion of preceptorship qualification; and creation of the National Registration of Specialists. The challenges faced by PMM to effectively achieve its goals, the need for State commitment and the current threats to this vital dimension of the program (ensure the right to health) are pointed out.(AU)


Resumo O Programa Mais Médicos (PMM), criado em 2013, estabeleceu novo marco regulatório para a graduação médica e a residência médica no Brasil, tendo a necessidade social como orientadora do processo. A presente reflexão pauta as políticas públicas e suas ações direcionadas à implementação de mudanças na formação médica no PMM e seus resultados até 2015, por meio de análise documental de fontes oficiais e literatura. Identificou-se: redução nas desigualdades regionais na distribuição de vagas de graduação; interiorização da formação; expansão de vagas de residência médica com enfoque na medicina de família e comunidade; expansão da qualificação da preceptoria; e criação do Cadastro Nacional de Especialistas. São apontados desafios enfrentados pelo PMM para alcançar efetivamente seus objetivos, a necessidade de comprometimento do Estado e as atuais ameaças a essa dimensão vital do programa, que busca a garantia do direito à saúde.(AU)


Resumen El Programa Más Médicos fue creado en 2013 y estableció un nuevo marco regulador para la formación y residencia médica en Brasil. En este artículo se han realizado análisis documentales, análisis de bases de datos oficiales y revisión de literatura, buscando estudiar los cambios en la formación médica y sus resultados hasta 2015. Se han identificado avances importantes en la distribución de plazas de graduación entre las diferentes regiones del país; en la interiorización de la formación; en la creación de cursos de medicina que sigan la regulación estatal; en la regulación de las plazas de residencia médica con enfoque en medicina de familia y comunidad; en la cualificación de la preceptoría; y en la creación del Catastro Nacional de Especialistas. En la conclusión se señalan los desafíos que ha enfrentado para alcanzar efectivamente sus objetivos.(AU)


Assuntos
Humanos , Atenção Primária à Saúde , Política Pública , Educação Médica/estatística & dados numéricos , Consórcios de Saúde , Médicos/provisão & distribução
19.
J Am Board Fam Med ; 31(6): 842-843, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30413540

RESUMO

Diversification of the physician workforce has been a goal of Association of American Medical Colleges for several years and could improve access to primary care for under-served populations and address health disparities. We found that family physicians' demographics have become more diverse over time, but still do not reflect the national demographic composition. Increased collaboration with undergraduate universities to expand pipeline programs may help increase the diversity of students accepted to medical schools, which in turn should help diversify the family medicine workforce.


Assuntos
Certificação/estatística & dados numéricos , Diversidade Cultural , Mão de Obra em Saúde/estatística & dados numéricos , Grupos Minoritários/estatística & dados numéricos , Médicos de Família/estatística & dados numéricos , Grupos de Populações Continentais/estatística & dados numéricos , Educação Médica/estatística & dados numéricos , Grupos Étnicos/estatística & dados numéricos , Medicina de Família e Comunidade/educação , Medicina de Família e Comunidade/legislação & jurisprudência , Medicina de Família e Comunidade/estatística & dados numéricos , Acesso aos Serviços de Saúde , Humanos , Grupos Minoritários/educação , Médicos de Família/educação , Médicos de Família/legislação & jurisprudência , Faculdades de Medicina/estatística & dados numéricos , Estados Unidos
20.
JNMA J Nepal Med Assoc ; 56(211): 666-669, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30381761

RESUMO

INTRODUCTION: Dementia is a public health concern as the prevalence is increasing worldwide with significant increase being in low-middle income countries. However these countries appear to be less prepared in handling this rise in terms of diagnosis and management. METHODS: This cross-sectional study was conducted in Kathmandu medical College, from June 2017 to July 2017. Purposive sampling was done and the medical students who were in their first and final year of study were included in the study after obtaining an informed consent. RESULTS: Total 185 students were included in the study, 80 (43.24%) from first year and 105 (56.75%) from final year of medical study. The mean score of knowledge among the students was 17.44±2.46; 15.32±1.22 among first year and 19.06±1.87 among the final year students. Majority of the students said they have heard about dementia however, only 3 (3.75%) of first year and 43 (41.9%) from final year students have either attended a class or continuing medical education on dementia Conclusions: The knowledge about dementia was found to be average among medical students but better among final year medical students in comparison to first year. The knowledge was found to be better statistically among those who had either attended a class or continuing medical education on dementia or had exposure through different medias.


Assuntos
Doença de Alzheimer , Educação Médica , Escolaridade , Estudantes de Medicina/estatística & dados numéricos , Doença de Alzheimer/diagnóstico , Doença de Alzheimer/terapia , Competência Clínica , Estudos Transversais , Educação Médica/métodos , Educação Médica/estatística & dados numéricos , Feminino , Humanos , Masculino , Nepal , Adulto Jovem
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