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1.
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1051214

RESUMO

Objetivo: avaliar o impacto da sensibilização no setor e adesão ao protocolo de sepse em unidade de tocoginecologia. Método: Trata-se de uma pesquisa-ação no período de janeiro a março/2016, com 63 profissionais que trabalham em unidade de tocoginecologia de um hospital de alta complexidade. Resultados: 51% dos profissionais receberam o treinamento sobre o protocolo de sepse e após, 50% dos pacientes que tinham critérios de SIRS foram incluídos no protocolo de sepse, sendo que o desfecho de 03 destas, foi alta hospitalar e 02 foram transferidas para UTI devido sepse grave. O tempo médio de administração do antibiótico foi 50 minutos, da solicitação do hemograma foi 46,25 minutos e do resultado do lactato foi acima de 30 minutos. Conclusão: Ainda há necessidade de melhoria em relação à adesão pela equipe de Enfermagem para implantação de medidas de combate à sepse


Objective: to evaluate the impact of the sensitization in the sector and adherence to the protocol of sepsis in a unit of tocoginecology. Method: This is an action research from January to March/2016, with 63 professionals working in a tocoginecology unit of a highly complex hospital. Results: 51% of the professionals received training on the sepsis protocol and after that, 50% of the patients who had SIRS criteria were included in the sepsis protocol, and the outcome of 03 of these was hospital discharge and 02 were transferred to the ICU Due to severe sepsis. The mean time of administration of the antibiotic was 50 minutes, the request of the blood count was 46.25 minutes and the result of the lactate was over 30 minutes. Conclusion: There is still a need for improvement regarding adherence by the Nursing team to implement measures to combat sepsis


Objetivo: evaluar el impacto de la sensibilización en el sector y la adhesión al protocolo de sepsis en unidad de tocoginecología. Método: Se trata de una investigación-acción en el período de enero a marzo/2016, con 63 profesionales que trabajan en unidad de tocoginecología de un hospital de alta complejidad. Resultados: 51% de los profesionales recibieron el entrenamiento sobre el protocolo de sepsis y después, 50% de los pacientes que tenían criterios de SIRS fueron incluidos en el protocolo de sepsis, siendo el desenlace de 03 de ellas, fue alta hospitalaria y 02 fueron transferidas a UTI Debido a la sepse grave. El tiempo promedio de administración del antibiótico fue de 50 minutos, de la solicitud del hemograma fue 46,25 minutos y el resultado del lactato fue de más de 30 minutos. Conclusión: Aún hay necesidad de mejora en relación a la adhesión por el equipo de Enfermería para implantación de medidas de combate a la sepsis


Assuntos
Humanos , Masculino , Feminino , Gravidez , Adulto , Pessoa de Meia-Idade , Sepse/diagnóstico , Sepse/prevenção & controle , Tecnologia Educacional , Obstetrícia/educação , Equipe de Assistência ao Paciente , Protocolos/métodos
4.
Int J Gynaecol Obstet ; 147(2): 140-146, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31571230

RESUMO

OBJECTIVE: To explore the knowledge of Developmental Origins of Health and Disease (DOHaD) concepts among midwives and obstetricians and to identify barriers and facilitators for clinicians to engage women and their partners before or early in pregnancy on risk factors associated with DOHaD, and thus to embed the concept of DOHaD in routine clinical practice. METHODS: A qualitative study using semi-structured interviews will be conducted in Ghana, India, Pakistan, Brazil, the UK, and USA in collaboration with the International Confederation of Midwives and the International Federation of Obstetricians and Gynecologists. Participants will be contacted via email and telephone interviews will be conducted until data saturation followed by inductive thematic analysis. RESULTS: Findings from this exploratory study will provide new knowledge about the perspectives of midwives and obstetricians on DOHaD and their role in preventing the intergenerational passage of non-communicable disease (NCD) risk and improving preconception care. CONCLUSION: This study will help us understand the current use of DOHaD principles in international maternity care and how this can be improved. Bringing DOHaD to clinical practice will help healthcare practitioners adopt a long-term approach in the prevention of NCDs and childhood obesity and will help women to enter pregnancy in optimum health.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Tocologia/métodos , Obstetrícia/métodos , Cuidado Pré-Concepcional/métodos , Brasil , Feminino , Gana , Humanos , Índia , Tocologia/educação , Obstetrícia/educação , Paquistão , Gravidez , Pesquisa Qualitativa , Melhoria de Qualidade
7.
Eur J Obstet Gynecol Reprod Biol ; 241: 13-18, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31437620

RESUMO

OBJECTIVES: To evaluate the learning climate (LC) and quality of training in postgraduate training courses in gynecology and obstetrics in Italy, as essential element to improve the training quality of future medical specialists. STUDY DESIGN: Web-based anonymous survey sent to all Italian trainees in gynecology and obstetrics to assess LC and quality of postgraduate training courses. This included sociodemographic information, details regarding training positions, and a 50-item validated Dutch Residency Educational Climate Test (D-RECT) questionnaire with 11 subscales (1-5 Likert scale). At the same time, the 24-items Fifth Year Training Questionnaire (FYT-Q) was submitted to all trainees at the fifth year of training to assess quality of life (burnout and depression), quality of training and final achieved competency level. Descriptive statistics were used to describe the main characteristics of the study population and for the D-RECT and the FYT-Q results. RESULTS: One hundred seventy-eight trainees' responses were included from 13 departments, yielding a department response rate of 33%. The mean composite score of the D-RECT was 3.185 (SD 0.305). The subscales "Formal education" and "Role of specialty tutor" scored a mean of 2.751 (SD 0.123) and 2.757 (SD 0.130), respectively. Sixty-four FYT-Q evaluations were completed. The 33% of trainees reported more than 56 weekly working hours. At least one burnout episode during the training was reported by 61% of the trainees, and the 45% of them reported one or more episode of depression. More than 50% of trainees reported adequate autonomy for gynecologic ultrasound, obstetrics first level ultrasound, hysteroscopy, and cesarean section. In FYT-Q adequacy of training, teaching, surgical teaching, and tutoring values resulted equal to or less than 3 in a 1-5 Likert scale. CONCLUSIONS: D-RECT and FYT-Q questionnaires show a training that requires improvement, although the results do not seem to be completely consistent. D-RECT emphasizes the need for a better formal teaching and specialty tutors to ensure training with better LC. Interventions are needed to improve LC and quality of training in postgraduate training courses in gynecology and obstetrics in Italy.


Assuntos
Ginecologia/educação , Obstetrícia/educação , Estudantes de Medicina/psicologia , Adulto , Feminino , Humanos , Masculino , Inquéritos e Questionários
9.
J Grad Med Educ ; 11(4 Suppl): 100-103, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31428265

RESUMO

Background: The quality of the learning environment in the operating room (OR) is vital for the training of surgical residents. Tools with validity evidence exist to measure resident perceptions of the operative learning environment, yet to date no studies have assessed this environment for obstetrics and gynecology residency programs in the United Arab Emirates (UAE). Objective: We explored perceptions of obstetrics and gynecology residents regarding their operative learning environment in 2 hospitals in Abu Dhabi, UAE. Methods: Our cross-sectional study was conducted in 2018 using the validated Surgical Theater Educational Environmental Measure (STEEM) questionnaire for trainee assessments in the OR learning environment. The 4 STEEM subscales measure teaching and training, learning opportunities, overall atmosphere, and supervision, workload, and support, respectively. Cronbach's alpha and intraclass correlation were used to establish the internal consistence and reliability of the questionnaire. We calculated an overall score and compared scores between the 2 institutions using Student's t test. Results: Thirty-one residents completed the questionnaire (18 at Corniche Hospital and 13 at Al Ain Hospital). The overall average STEEM score was 142.1. The score for residents at Corniche Hospital was 134.9 and that for Al Ain Hospital was 152.2, with better overall scores on 3 STEEM domains at Al Ain Hospital. Conclusions: Our study showed that obstetrics and gynecology residents in the UAE have a positive perception of their operative learning environment. We also identified areas for improvement.


Assuntos
Ginecologia/educação , Internato e Residência/organização & administração , Aprendizagem , Obstetrícia/educação , Salas Cirúrgicas , Estudos Transversais , Humanos , Reprodutibilidade dos Testes , Procedimentos Cirúrgicos Operatórios , Inquéritos e Questionários , Emirados Árabes Unidos
10.
Rev. Fund. Educ. Méd. (Ed. impr.) ; 22(4): 165-168, jul.-ago. 2019.
Artigo em Espanhol | IBECS | ID: ibc-183076

RESUMO

Objetivo: Se presenta la experiencia piloto de un seminario de toma de decisiones obstétricas, cuyos objetivos son fomentar el trabajo en equipo, entrenar la toma de decisiones en obstetricia e incrementar el interés de los alumnos y su aprendizaje. El fin del estudio es evaluar la satisfacción del alumno sobre el seminario. Sujetos y métodos: El seminario se diseñó con un formato de concurso por equipos y se realizó con estudiantes de sexto curso de medicina de la Universidad Europea (Madrid, España). Los participantes en el seminario cumplimentaron una encuesta de satisfacción. Los alumnos fueron distribuidos en dos grupos: participantes y no participantes en el seminario. Se analizó la diferencia en la nota media del examen final entre ambos grupos. Resultados: Nueve de 23 estudiantes participaron en el seminario. Los alumnos participantes tuvieron un alto grado de satisfacción y se sintieron más motivados y preparados tanto para el estudio de la asignatura como para afrontar su examen final. Se objetivó un mayor rendimiento estadísticamente significativo en el examen final de la asignatura por parte de los participantes en el seminario, de manera que obtuvieron una media 1,03 puntos (sobre 10) superior que los alumnos que no asistieron al seminario, aunque tanto por el número de participantes como por un más que probable sesgo de selección no pueden extraerse conclusiones válidas al respecto. Conclusión: El seminario aumentó la motivación de los alumnos y fue satisfactorio para ellos


Aim: The present study shows the pilot experience of a seminar on obstetric decision making, whose objectives are to promote teamwork, train decision making in Obstetrics and increase the interest of the students and their learning. The purpose of the study is to evaluate the student's satisfaction with the seminar. Subjects and methods: The seminar was designed with a team contest format and was carried out with students of the sixth course of Medicine of the European University (Madrid, Spain). Participants in the seminar filled out a satisfaction survey. The students were divided into two groups: participants and non-participants in the seminar. The difference in the average qualification of the final exam between the two groups was analyzed. Results: Nine students of 23 participated in the seminar. The participating students had a high degree of satisfaction and felt more motivated and prepared both for the study of the subject and to face the final exam. Higher statistically significant performance was observed in the final exam by the participants in the seminar, so that they obtained 1.03 points on average (over 10) more than the students who did not attend the seminar, although for the number of participants and a probable selection bias, no valid conclusions can be drawn at this level. Conclusion: The seminar increased the motivation of the students and was very satisfactory for them


Assuntos
Humanos , Congressos como Assunto , Tomada de Decisão Clínica , Estudantes de Medicina , Projetos Piloto , Obstetrícia/educação , Desempenho Acadêmico , Satisfação Pessoal , Análise de Dados
11.
JSLS ; 23(2)2019.
Artigo em Inglês | MEDLINE | ID: mdl-31285653

RESUMO

Background and Objectives: Skills-lab training is crucial for the development of advanced laparoscopic skills. In this study, we examined whether a systematic deconstructive and comprehensive tutoring approach improves training results in laparoscopic suturing and intracorporeal knot tying. Methods: Sixteen residents in obstetrics and gynecology participating in structured skills-lab laparoscopy training were randomized in 2 equal-sized groups receiving 1-on-1 tutoring either in the traditional method or according to the Peyton's 4-step approach, involving an additional training step, with the trainees instructing the tutor to perform the exercises. A validated assessment tool (revised Objective Structured Assessment of Technical Skills) and the number of completed square knots per training session and the mean time per knot were used to assess the efficacy of training in both groups. Results: Trainees in Peyton's group achieved significantly higher revised Objective Structured Assessment of Technical Skills scores (28.6 vs 23.9 points; P = .05) and were able to improve their scores during autonomous training repetitions, in contrast to the trainees not in Peyton's group (difference +4.75 vs -4.29 points, P = .02). Additionally, they seemed to be able to perform a greater number of successful knots during the exercise and to complete each knot quicker with the later observations failing to reach the threshold of statistical significance. Conclusion: Peyton's 4-step approach seemed to be superior for teaching laparoscopic skills to obstetrics and gynecology residents in the skills-lab setting and can be therefore proposed for training curricula.


Assuntos
Currículo , Ginecologia/educação , Internato e Residência , Laparoscopia/educação , Obstetrícia/educação , Técnicas de Sutura/educação , Adulto , Competência Clínica , Feminino , Humanos , Masculino
12.
Int J Gynaecol Obstet ; 147(1): 73-77, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31265126

RESUMO

OBJECTIVE: To evaluate the impact of a training program using a systematic protocol on ultrasound signs of placenta accreta spectrum (PAS). METHODS: Intra- and inter-observer variability rates and sensitivity were tested, before and after additional training, by two research fellows with a prior basic training in obstetric ultrasound using digitally recorded second-trimester ultrasound images from cases of anterior placenta previa with and without PAS. RESULTS: Fifty-two cases of anterior placenta previa with PAS (n=26) and without PAS (n=26) were included in the study. The highest level of inter-observer agreement for ultrasound signs was found for the absence of placental bulge and/or focal exophytic mass on gray-scale imaging and the absence of subplacental hypervascularity, bridging vessels and lacunar feeder vessels on color Doppler imaging. The level of inter-observer agreement increased from 39% before training to 40% after training; the numbers agreed as PAS by both trainees increased from four to 20. No cases were classified as inconclusive after training. There was a significant (P<0.001) change in sensitivity for both trainees after training. CONCLUSION: Additional training in detecting the ultrasound signs associated with PAS using a standardized protocol improves the diagnostic accuracy of operators with only a basic obstetric ultrasound training.


Assuntos
Obstetrícia/educação , Placenta Acreta/diagnóstico por imagem , Placenta Prévia/diagnóstico por imagem , Ultrassonografia Pré-Natal/métodos , Adulto , Feminino , Humanos , Programas de Rastreamento/métodos , Variações Dependentes do Observador , Gravidez , Segundo Trimestre da Gravidez , Avaliação de Programas e Projetos de Saúde
13.
J Obstet Gynaecol ; 39(8): 1123-1129, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31328599

RESUMO

The importance of incorporating non-technical skills in surgical training cannot be understated, however, these remain non-core components of training. The aim of our study was to evaluate the effectiveness of a training course in improving residents' non-technical skills performance in the operating room. Twenty-eight eligible Obstetrics and Gynaecology residents were divided into conventional and experimental groups by using blocked randomisation. The experimental group received a training course comprising of 20 h over 5 weeks as an educational intervention. A blinded assessor assessed non-technical skill performance by using non-technical skill for surgeons rating system while performing two procedures evacuation and curettage and elective caesarean section in pretest and post-test phase. The post-test results of experimental training group improved significantly in all four categories: situational awareness, decision-making, communication and leadership than the conventional training group demonstrating the effectiveness of a training course. Participants found the course useful and relevant to their practices and strongly recommended the incorporation of similar courses in early years of training. Impact Statement What is already known on this subject? Operating room is the mainstay of surgeons and the majority of the studies done in the operating room relate to structured courses to teach residents about non-technical skills, with training and evaluation done on the same day. These either explores the perception of trainees, expansion of the cognitive component and/or feasibility of training for non-technical skills. To date, there is a lack of evidence in the literature to address questions regarding the appropriate time to incorporate non-technical skills in the curriculum, due to study designs. This highlights the need for more randomised control trials with different curricular designs to evaluate effectiveness. What do the results of this study add? The results of our study enable a comparative analysis between learning curves of conventional training, with the experimental group demonstrating the effectiveness of a training course. This strongly supports implementation of non-technical training in postgraduate competency-based curricula. What are the implications of these findings for clinical practice and/or further research? This study shall be used as an evidence-based source to design curricula for teaching non-technical skills to residents.


Assuntos
Procedimentos Cirúrgicos em Ginecologia/educação , Ginecologia/educação , Internato e Residência , Procedimentos Cirúrgicos Obstétricos/educação , Obstetrícia/educação , Salas Cirúrgicas , Adulto , Conscientização , Competência Clínica , Comunicação , Currículo , Tomada de Decisões , Feminino , Humanos , Liderança , Masculino
14.
BMC Res Notes ; 12(1): 411, 2019 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-31307518

RESUMO

OBJECTIVE: From 2012 to 2015, two Departments of Obstetrics and Gynecology and two Departments of Pediatrics at the University of Copenhagen implemented an English medium international project. The project allowed international students to work in pairs with local Danish speaking students in a clinical setting. The student cohort was supported by Danish doctors who were responsible for student-pair supervision in English and, ultimately, patient care. Drawing on survey responses of 113 Danish doctors, this study considers the doctors' overall evaluation of the program and their perception of the international students' knowledge, skills and attitudes compared with local students. RESULTS: The Danish doctors rated the international and local students comparable in respect to professional commitment (p = 0.347), academic level (p = 0.134), and English proficiency (p = 0.080). The Danish doctors rated the international students significantly lower than the local students regarding communication with Danish doctors, other hospital staff, and patients (p < 0.001 in all cases). Ninety percent of the doctors involved in the project supported continuing working with internationalization if it included mixed pairs of students and a Danish doctor assigned each day to be exclusively responsible for student supervision. Language barriers for international medical students could be overcome but required substantial faculty support.


Assuntos
Educação Médica/normas , Hospitais Públicos , Hospitais Universitários , Médicos/estatística & dados numéricos , Estudantes de Medicina/estatística & dados numéricos , Adulto , Competência Clínica/normas , Comunicação , Dinamarca , Feminino , Ginecologia/educação , Humanos , Internacionalidade , Masculino , Obstetrícia/educação , Pediatria/educação , Inquéritos e Questionários
15.
Gynecol Obstet Fertil Senol ; 47(7-8): 562-567, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31280032

RESUMO

OBJECTIVES: Evaluate an educational program based on "CLEAR" (Cervical Length Education and Review) in the teaching of measuring sonographic cervical length to residents in gynecology and obstetrics. METHODS: This is a prospective cohort study in a tertiary care center between May and November 2017. The residents were asked to collect 5 cervical length images from patients suspected with threatened preterm labor. A theoretical session on cervix measurement image criteria based on "CLEAR" program was taught to all residents. Then, they had to collect 5 new cervical length images. All the images were reviewed by two experienced reviewers, blinded to the resident and whether the image was obtained before or after the theoretical session and based on 8 criteria. RESULTS: Ten residents participated to the study. The mean total score CLEAR was significantly higher post-intervention: 6.6±0.9 vs. 4.3±2.1, positive difference of 2.3±2.3 (P<0.001). Improvement was most significant with the junior residents: 3.6 pre vs. 6.5 post-intervention. CONCLUSION: Educational program based on CLEAR criteria allowed to improve the competence of residents in measuring sonographic cervical length, although this can also be correlated with the progression of residents during the semester. It could be implemented systematically with the aim of CLEAR certification to standardize the teaching of residents in gynecology and obstetrics.


Assuntos
Colo do Útero/diagnóstico por imagem , Ginecologia/educação , Internato e Residência , Trabalho de Parto Prematuro/diagnóstico por imagem , Obstetrícia/educação , Ultrassonografia Pré-Natal , Estudos de Coortes , Feminino , França , Idade Gestacional , Humanos , Gravidez , Estudos Prospectivos
16.
J Assist Reprod Genet ; 36(9): 1779-1780, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31346918

RESUMO

In this unique time of technological advancement in medicine and the culture of public discourse that surrounds it, trainees in obstetrics and gynecology require more intensive education in medical ethics to appropriately guide patient decision-making and to become more responsible voices in such an ethically complex field.


Assuntos
Ginecologia , Obstetrícia , Médicos/ética , Medicina Reprodutiva/educação , Medicina Reprodutiva/ética , Currículo , Tomada de Decisões , Educação Médica , Feminino , Ginecologia/educação , Ginecologia/ética , Humanos , Obstetrícia/educação , Obstetrícia/ética , Gravidez
17.
J Obstet Gynaecol ; 39(7): 981-985, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31303078

RESUMO

We aimed to determine the effectiveness of a one-day course on laparoscopic suturing skills development by performing a prospective study with obstetrics and gynaecology specialists. The course consisted of a theoretical portion describing the suturing technique basics and a practical portion consisting of box trainer suturing. Before and after the course, each trainee was given 10 min to introduce the suture material into the abdomen, properly position the needle using a needle holder, pass the suture through premarked points on the silicone pads and tie an intracorporeal knot. The procedures were video recorded and evaluated after the course. The results showed that there were statistically significant reductions in the needle holding, suture passing and knot tying times after completing the course. Overall, the one-day course was an effective training programme for improving a surgeon's laparoscopic suturing skills. IMPACT STATEMENT What is already known on this subject? Currently, many countries have centres that provide laparoscopic training as part of the medical residency education. However, a standardised training programme has not been implemented worldwide. What do the results of this study add? In this study, we pointed out the effectiveness of a one-day laparoscopic suturing course. A one-day suturing course is easy to implement, cheap and effective. What are the implications of these findings for clinical practice and/or further research? A one-day suturing course should be implemented worldwide, especially in those countries lacking sufficient financial resources to provide laparoscopic training as part of the medical residency programme.


Assuntos
Ginecologia/educação , Laparoscopia/educação , Obstetrícia/educação , Técnicas de Sutura/educação , Procedimentos Cirúrgicos em Ginecologia/educação , Humanos , Estudos Prospectivos
20.
Sultan Qaboos Univ Med J ; 19(1): e58-e62, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31198597

RESUMO

Objectives: Obstetrics and gynaecology (OBGYN) is a major speciality in the medical field that is often demanding yet rewarding; however, OBGYN receives the least number of applicants in Oman. This study aimed to determine the factors that influence graduates in choosing OBGYN as their speciality. Methods: This cross-sectional questionnaire-based study was conducted from February to March 2017 at Sultan Qaboos University Hospital, Royal Hospital, Khoula Hospital and Al Nahdha Hospital, Muscat, Oman. The questionnaire was distributed to 150 Omani medical graduates (interns and post-intern doctors). Results: A total of 145 Omani graduates took part in the study (response rate: 96.7%) and the participants' average age was 26 years. Family medicine ranked as the first choice followed by paediatrics and emergency medicine. OBGYN was the first choice for eight female graduates. The top factors attracting male graduates to the OBGYN speciality were its surgical opportunities (80.6%), intellectual content (77.4%), faculty interactions and the opportunity to care for a healthy population (54.8% each); however, the top factors attracting females were the intellectual content (88.6%), patients' desire for female physicians (85.1%), the opportunity to care for a healthy population (76.3%) and cultural expectations (69.5%). The most discouraging factors for male graduates were cultural expectations (100%), the patients' desire for a female physician (93.5%) and the level of stress (71%), while the discouraging factors for female graduates were the level of stress (82.5%), time demands (78.1%), night duties and the length of the residency (71.9% each). Conclusion: Most of the factors that discourage female graduates from choosing OBGYN are to some extent modifiable. These changes should be considered to encourage the selection of OBGYN as a career by medical students.


Assuntos
Escolha da Profissão , Obstetrícia/educação , Estudantes de Medicina/estatística & dados numéricos , Adulto , Atitude do Pessoal de Saúde , Estudos Transversais , Feminino , Humanos , Masculino , Omã , Inquéritos e Questionários
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