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2.
Can J Cardiol ; 37(3): 519-522, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33476752

RESUMO

The COVID-19 pandemic has had an unprecedented impact on cardiology training. Novel opportunities have been identified in several domains: patient exposure, procedural experience, didactic education, research and development, advocacy and well-being, and career advancement. Lessons learned from COVID-19 should be used to further improve fellowship training such as, for example, through the development of a competency-based training and evaluation system. Multimodality teaching that incorporates telelearning provides creative solutions for trainee and continuing medical education. Fellow-initiated research should be supported and nurtured. Enhanced attention to trainee well-being and burnout is particularly important. The emerging cardiologists of the future and the way they are trained will be shaped by the COVID-19 challenge of our generation.


Assuntos
Cardiologia/educação , Educação de Pós-Graduação em Medicina/métodos , Educação de Pós-Graduação em Medicina/normas , Qualidade da Assistência à Saúde , Educação de Pós-Graduação em Medicina/organização & administração , Previsões
4.
Emergencias (Sant Vicenç dels Horts) ; 32(6): 403-408, dic. 2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-197992

RESUMO

OBJETIVO: Investigar la presencia del cuerpo doctrinal de la Medicina de Urgencias y Emergencias (MUE) en el examen de acceso a médico interno residente (MIR) en España y su evolución en el tiempo. MÉTODO: Estudio longitudinal retrospectivo. Tres investigadores revisaron independientemente las preguntas de los exámenes MIR de los últimos 10 años (2010-2019) y las clasificaron por acuerdo mayoritario como directamente, indirectamente o no relacionadas con la MUE. La temática de las preguntas directamente relacionadas con la MUE se clasificó según el índice del libro de texto de MUE de Tintinalli y según la clasificación de las áreas de la base Science Citation Index Expanded (SCIE) de la Web of Science. La evolución temporal de la presencia y la temática de la MUE se analizó mediante regresión lineal simple. RESULTADOS: Se revisaron 2.300 preguntas: 487 (22%) estaban directamente relacionadas con la MUE (313 citaban específicamente el escenario de urgencias o emergencias). La presencia de preguntas directamente relacionadas con la MUE se mantuvo constante entre 2010-2019 (p = 0,172). Siguiendo la clasificación de Tintinalli, las temáticas más frecuentes de estas preguntas fueron urgencias cardiovasculares (12,2%), infecciosas (11,1%) y gastrointestinales (10,9%), sin cambios significativos entre 2010-2019, mientras que siguiendo la clasificación del SCIE, estas temáticas fueron urgencias (11,9%, que aumentó significativamente durante el periodo, p = 0,005), cardiovascular (11,3%, que descendió, p = 0,037) y enfermedades infecciosas (10,7%, sin cambios durante el periodo). CONCLUSIÓN: La MUE, a pesar de no estar reconocida como una especialidad formativa por la vía MIR, tiene una elevada relevancia para la administración sanitaria a la hora de seleccionar a los MIR, que inician su formación especializada en el sistema público de salud, a juzgar por su elevada presencia en el examen anual al que se somete a los candidatos


OBJETIVE: To investigate the presence of fundamental concepts in emergency medicine on the entrance examination taken by candidates for medical internships and residency training in Spain, and to identify changes over time. METHODS: Longitudinal retrospective study. Three independent researchers reviewed questions on the entrance examinations of the past 10 years (2010-2019) and classified them as directly, indirectly, or not related to emergency medicine. The topics of directly related questions were also classified according to the categories listed in Tintinalli's Emergency Medicine and subject areas in the Citation Index Expanded (SCIE) of the Web of Science. Changes in the number of questions and range of topics were analyzed with simple linear regression models. RESULTS: A total of 2300 questions were reviewed; 487 (22%) were directly related to emergency medicine, and 313 of them specifically referred to an emergency or urgent care setting. The proportion of directly related questions held steady over the 10-year period (P=.172). The most frequently mentioned categories listed by Tintinalli were cardiovascular (12.2%), infectious (11.1%), and gastrointestinal (10.9%) emergencies, and no significant differences were noted over time. However, proportions assigned to the SCIE categories did change over time, as follows. Questions about emergency care in general (11.9% during the period overall) increased significantly with time(P=.005) whereas cardiovascular questions (11.3%) decreased (P=.037). The proportion of infectious disease topics remained the same (10.7%). CONCLUSION: Even though emergency medicine is not a recognized specialty for medical residency training in the public health system, questions on emergencies are considered important for evaluating candidates, judging by the high percentage of questions on the examinations


Assuntos
Humanos , Desempenho Acadêmico/normas , Medicina de Emergência/educação , Internato e Residência/estatística & dados numéricos , Avaliação Educacional/métodos , Educação de Pós-Graduação em Medicina/normas , Critérios de Admissão Escolar , Medicina de Emergência/normas , Estudos Retrospectivos , Estudos Longitudinais , Modelos Lineares , Competência Clínica
5.
PLoS One ; 15(12): e0244147, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33338062

RESUMO

BACKGROUND: Dual degrees combining and MD with another professional degree (MPH, MBA, or PhD) are becoming more common in an attempt to increase an applicant's competitivity for a residency. OBJECTIVE: This study was designed to assess differences in MD-only and dual degree MD applicants with respect to applicant characteristics and match outcomes. METHODS: Utilizing the voluntarily-reported publicly available 2017-2019 Texas STAR database, we assessed applicants from 115 medical schools. Texas STAR indicates that over this time period, there were 18,224 responses for a response rate of 43.8%. Comparisons were made between groups using student's t-test and chi-squared analysis. RESULTS: Compared to MD only students, MD/MPH applicants had a higher propensity towards primary care specialties. MD/PhD applicants did not differ versus MD only applicants in their selection of primary care specialties, or of competitive specialties. MD/MBA applicants chose more competitive specialties and less primary care specialties. Despite all these differences, match rates were not different comparing MD only and dual-degree students. CONCLUSIONS: Despite the growing popularity of combined MD programs, such programs do not appear to increase applicant match competitivity.


Assuntos
Mobilidade Ocupacional , Educação de Pós-Graduação em Medicina/normas , Humanos , Educação Interprofissional , Estudantes de Medicina/estatística & dados numéricos
6.
Methodist Debakey Cardiovasc J ; 16(3): 199-204, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33133355

RESUMO

Americans expect their doctors to have the competence to deliver high-quality care and expect safeguards to be in place that assure their doctors are competent. However, competence requires knowledge, and people have trouble assessing their own knowledge and level of competence. Because external assessment is required, several organizations have taken on the roles of defining and assuring medical competence. For example, professional organizations such as the American College of Cardiology (ACC) have developed consensus documents that define core competencies for cardiologists. External organizations such as the Accreditation Council for Graduate Medical Education and the American Board of Internal Medicine (ABIM) have defined training requirements for cardiologists, and the ABIM has developed a process to certify that physicians maintain their competence, although the process has generated considerable criticism from the profession. Recently, the ACC and ABIM have worked together to make the certification process less onerous and more meaningful. This paper provides a brief summary of the history and ongoing efforts to assure the competence of cardiologists.


Assuntos
Acreditação , Cardiologistas/educação , Cardiologia/educação , Certificação , Competência Clínica , Educação de Pós-Graduação em Medicina , Acreditação/normas , Cardiologistas/normas , Cardiologia/normas , Certificação/normas , Competência Clínica/normas , Currículo , Educação de Pós-Graduação em Medicina/normas , Humanos
8.
Educ. med. (Ed. impr.) ; 21(5): 328-337, sept.-oct. 2020. tab
Artigo em Espanhol | IBECS | ID: ibc-196877

RESUMO

El aprendizaje del residente se realiza a través del trabajo que desarrolla en diferentes contextos laborales como: la planta del hospital, el quirófano, el centro de salud, la participación en congresos o en comisiones, etc. Aun así, este desempeño tiene que complementarse con metodologías que conlleven actividades específicas para desarrollar aquellas competencias que no se pueden trabajar de forma planificada y explícita en el día a día como el pensamiento crítico, el trabajo cooperativo, la gestión de las emociones, etc. Más allá de las clásicas sesiones clínicas de casos o bibliográficas, existen otras metodologías activas dirigidas a favorecer estos aprendizajes para alcanzar una formación integral, como el aprendizaje basado en problemas, el método de caso y de proyectos, los incidentes críticos, la gamificación, los juegos de rol o el libro del residente. Destacamos las competencias que cada una de ellas ayudan a adquirir. Dedicamos un apartado a las actividades profesionales confiables (APROC) o entrustable professional activities (EPAs), por tratarse de un enfoque metodológico operativo que facilita la puesta en práctica de la formación y evaluación basada en competencias a través de tareas o actividades complejas. La combinación de metodologías complementarias con las actividades clínicas completa el mapa para adquirir las competencias requeridas en los programas de formación especializada. De este modo, se pretende ayudar al formador a planificar la formación del residente de acuerdo a su perfil competencial


The resident's learning is developed through the work in different settings such as: the hospital ward, the primary health center, the operating room, the participation in congresses or in committees, etc. Even so, this performance has to be complemented with methodologies that involve specific activities to develop those competencies that cannot be worked on a day-to-day basis (critical thinking, cooperative work, emotion management, etc.). We present other methodologies aimed to achieve those competencies, such as problem-based learning, the projects method, the case method, and the critical incidents, gamification, role-playing games or the resident's logbook, highlighting the competencies that each of them help to acquire. We dedicate a section to entrustable professional activities (EPAs), an operational methodological approach that facilitates the implementation of competency-based medical education and evaluation through clinical activities. The combination of complementary methodologies with clinical activities completes the map to acquire the competencies required in specialized training and guide the tutor in order to plan the training of the specialist


Assuntos
Humanos , Educação Continuada , Aprendizagem , Educação de Pós-Graduação em Medicina/normas , Competência Profissional/normas , Internato e Residência , Aprendizagem Baseada em Problemas/métodos , Autoaprendizagem como Assunto , Profissionalismo
9.
Clin Med (Lond) ; 20(6): e248-e252, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32912965

RESUMO

COVID-19 has proven to be a potent disruptor of postgraduate training, assessment and learning. In so doing, it has equally proved to be a potent catalyst and has driven innovation. Here we discuss the response of the Federation of the three UK Royal Colleges of Physicians to the challenges presented in these areas by the COVID-19 pandemic.


Assuntos
Infecções por Coronavirus , Educação de Pós-Graduação em Medicina , Avaliação Educacional/métodos , Pandemias , Pneumonia Viral , Competência Clínica , Educação de Pós-Graduação em Medicina/métodos , Educação de Pós-Graduação em Medicina/normas , Humanos , Internet , Médicos , Reino Unido
11.
Am Surg ; 86(9): 1119-1123, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32804539

RESUMO

BACKGROUND: The Accreditation Council for Graduate Medical Education (ACGME) provides no specific guidelines for surgical critical care (SCC) training during general surgery residency. Growing emphasis is placed on this experience with increasing case requirements and dedicated SCC content on board certification exams. METHODS: A digital survey was distributed to ACGME-accredited general surgery residencies via email. Respondents reported number and setting of critical care months during residency and rated comfort level within 5 critical care principles and overall satisfaction with their SCC experience. Study cohorts were formed to compare experiences and competencies between respondents based on setting, months, postgraduate year (PGY) level, and formal surgical intensive care unit (SICU) experience. Differences between cohorts were compared using the Mantel-Haenszel test (P < .05). RESULTS: Seventy-three residents responded with 45% training at academic centers versus 46% in community hospitals. Approximately 50% completed a formal SICU rotation, while 9% reported no dedicated critical care rotation during residency. Overall, 78% felt satisfied with their SCC experience. Residents training at academic centers were more satisfied overall and felt more comfortable with ventilator management. Those who completed 5 or more months of critical care training reported greater confidence with intravenous sedation and ventilator management, while residents having a formal SICU rotation felt more confident with vasopressor and ventilator management. DISCUSSION: Variability remains within SCC training among general surgery residents with perceived benefits seen in training at academic centers and completing a formal SICU rotation. Although limited, these findings offer a foundation for developing an effective SCC curriculum.


Assuntos
Competência Clínica , Cuidados Críticos , Currículo/normas , Educação de Pós-Graduação em Medicina/normas , Cirurgia Geral/educação , Internato e Residência/métodos , Humanos , Estudos Retrospectivos
14.
Rev. Fund. Educ. Méd. (Ed. impr.) ; 23(4): 205-209, ago. 2020. tab
Artigo em Espanhol | IBECS | ID: ibc-195082

RESUMO

INTRODUCCIÓN: La prueba de acceso para la formación de médicos internos residentes (MIR) ha sido reconocida por su equidad, pero no ha estado exenta de críticas, especialmente por centrarse mayoritariamente en aspectos cognitivos. Además, dicha prueba se aprecia como un distorsionador en los estudios de medicina. OBJETIVO: Conocer la relación entre el expediente académico y el resultado en la prueba MIR de los graduados en medicina de los estudios conjuntos de la Universitat Pompeu Fabra (UPF) y la Universitat Autònoma de Barcelona (UAB). Sujetos y métodos: El estudio se realizó con todos los graduados de las primeras cuatro promociones de los estudios cita-dos. Para ello se registraron las calificaciones de los expedientes finales de los graduados y el número de orden obtenido en la prueba MIR. RESULTADOS: En ambos sexos y en todas las promociones se encontró una relación positiva y significativa entre expediente académico y resultado en el examen MIR. CONCLUSIONES: El mejor predictor de éxito en la prueba MIR es el éxito en los estudios realizados durante la carrera. Se recomienda informar a los estudiantes de este hecho para reducir la distorsión que produce el examen MIR en su comporta-miento académico


INTRODUCTION: The exam to access for the selection of a medical specialty in Spain (MIR test) has been recognized for its equity, but has not been without criticism especially for focusing mainly on cognitive aspects. In addition, this test is seen as a distorter in medicine studies. AIM: To know the relationship between the final academic record and the result in the MIR test of graduates in medicine from the joint studies of the Universitat Pompeu Fabra (UPF) and the Universitat Autònoma de Barcelona (UAB). Subjects and methods: The study was conducted with all graduates of the first four promotions of the studies cited. For this, the qualifications of the final files of the graduates were registered, as well as the order number obtained in the MIR test. RESULTS: In both sexes and in all the promotions a positive and significant relationship between academic record and result in the MIR exam was found. CONCLUSIONS: It is concluded that the best predictor of success in the MIR test is the success in studies conducted during the career. It is recommended to inform students of this fact to reduce the distortion produced by the MIR exam in their academic behaviour


Assuntos
Humanos , Masculino , Feminino , Educação de Pós-Graduação em Medicina/métodos , Internato e Residência/normas , Critérios de Admissão Escolar , Desempenho Acadêmico/normas , Educação de Pós-Graduação em Medicina/normas , Competência Clínica/normas , Estudantes de Medicina/psicologia , Escolha da Profissão
20.
Rev Assoc Med Bras (1992) ; 66(3): 328-333, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32520153

RESUMO

BACKGROUND: The aim of this study was to perform a cross-cultural adaptation of the Objective Structured Assessment of Technical Skill (OSATS) tool into Brazilian Portuguese and to determine its reproducibility and validity in Brasil. METHODS: A Brazilian Portuguese version of OSATS was created through a process of translation, back-translation, expert panel evaluation, pilot testing, and then its validation. For the construct and the concurrent validities, twelve participants were divided into a group of six experts and six novices, who had to perform tasks on a simulation model using human placentas. Each participant was filmed, and two blinded raters would then evaluate their performance using the traditional subjective method and then the Brazilian Portuguese version of OSATS. RESULTS: The Brazilian Portuguese version of OSATS had the face, content, construct, and concurrent validities achieved. The average experts' score and standard deviations were 34 and 0.894, respectively, for Judge 1 and 34.33 and 0.816 for Judge 2. In the case of novices, it was 13.33 and 2.388 for Judge 1 and 13.33 and 3.204 for Judge 2. The concordance between the judges was evident, with the Correlation Coefficient (Pearson) of 0.9944 with CI 95% between 0.9797 and 0.9985, with p < 10-10, evidencing the excellent reproducibility of the instrument. CONCLUSION: This preliminary study suggests that the Brazilian Portuguese version of OSATS can reliably and validly assess surgical skills in Brasil.


Assuntos
Competência Clínica/normas , Comparação Transcultural , Procedimentos Cirúrgicos Operatórios/normas , Inquéritos e Questionários , Traduções , Brasil , Educação de Pós-Graduação em Medicina/normas , Humanos , Internato e Residência , Procedimentos Cirúrgicos Operatórios/educação
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