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1.
Diagnosis (Berl) ; 7(1): 21-25, 2020 01 28.
Artigo em Inglês | MEDLINE | ID: mdl-31352429

RESUMO

Background Diagnostic reasoning skills are essential to the practice of medicine, yet longitudinal curricula to teach residents and evaluate performance in this area is lacking. We describe a longitudinal diagnostic reasoning curriculum implemented in a university-based internal medicine residency program and self-evaluation assessment of the curriculum's effectiveness. Methods A longitudinal diagnostic reasoning curriculum (bolus/booster) was developed and implemented in the fall of 2015 at the University of Iowa. R1, R2, and R3 cohorts were taught the "bolus" curriculum at the beginning of each academic year followed by a "booster" component to maintain and build upon diagnostic reasoning skills taught during the "bolus" phase. Self-administered diagnostic thinking inventory (DTI) scores were collected in the spring of pre-curriculum (baseline, 2014-2015) and post-curriculum (2016-2017). Results The overall DTI scores improved in the R1 cohort, although statistically significant differences were not seen with R2s and R3s. In the original DTI categories, R1s improved in both flexibility of thinking and structure of thinking, the R2s improved in structure of thinking and the R3s did not improve in either category. R1s showed improvement in three of the four subcategories - data acquisition, problem representation, and hypothesis generation. The R2s improved in the subcategory of problem representation. R3s showed no improvement in any of the subcategories. The R3 cohort had higher mean scores in all categories but this did not reach statistical significance. Conclusions Our program created and successfully implemented a longitudinal diagnostic reasoning curriculum. DTI scores improved after implementation of a new diagnostic reasoning curriculum, particularly in R1 cohort.


Assuntos
Currículo/tendências , Educação de Pós-Graduação em Medicina/métodos , Resolução de Problemas/fisiologia , Competência Clínica/estatística & dados numéricos , Diagnóstico , Humanos , Internato e Residência/normas , Programas de Autoavaliação/métodos , Estados Unidos/epidemiologia
2.
Rev. Fund. Educ. Méd. (Ed. impr.) ; 22(6): 287-291, nov.-dic. 2019. mapas, tab
Artigo em Espanhol | IBECS | ID: ibc-187788

RESUMO

Introducción: La unidad curricular opcional proporciona al estudiante la oportunidad de profundizar en un área clínica de libre elección o en una realidad asistencial diferente, promoviendo un currículo personalizado. Sujetos y métodos: Estudio descriptivo de los intercambios clínicos en el período 2012-2017 del último año de licenciatura y comparativa entre nacionales e internacionales. Al finalizar el intercambio, el estudiante responde a un formulario onlineque incluye múltiples variables: demográficas, de proceso y de resultados, cuyo análisis es el objetivo de este estudio. Resultados: Un total de 253 intercambios realizados por 154 estudiantes, siendo un 55% mujeres, con una edad media de 28 años. Más de la mitad (59%) optaron por destinos internacionales, destacando Reino Unido (8,3%) y Brasil (7,5%), y apenas un 11% permaneció en la región. Los centros de destino fueron mayoritariamente hospitales terciarios, desarrollando actividades clínico-observacionales (66%), y hasta un 47% en áreas no abordadas en el currículo oficial. Las especialidades más solicitadas globalmente fueron salud internacional y medicina tropical (15%), anestesia (8,3%) y pediatría (8%). La planificación y los costes son asumidos por el estudiante, con apoyos externos prácticamente inexistentes. La autoevaluación final fue de 4,46 puntos (sobre 5) y el 99% lo recomendaba a sus colegas. Conclusiones: Individualmente, la unidad curricular opcionalpermite al estudiante probar sus competencias y su capacidad de adaptación a otras realidades asistenciales y sociales, confrontándolo con potenciales elecciones profesionales


Introduction: 'Elective' is an opportunity to deepen clinical competences and/or work in a different assistance reality and promotes personal curriculum. Subjects and methods: A descriptive analysis of the elective internships carried from 2012 to 2017 at the last year of course and compare international and national ones. The students complete an online survey regarding the activities which include demographic, development and outcomes variables. Results: 253 clinical internships carried out by 154 medical students with a mean age of 28 years and 55% were women. The majority (59%) chosen to carry out international internship, particularly United Kingdom (8.3%) and Brazil (7.5%), and only 11% stayed in Algarve region. Half of the internships were carried out in tertiary hospitals being observational-practical (66%). Until half of students (47%) chose medical specialties not included in official curriculum being preference areas: international health (15%) and anesthesiology (8.3%). The majority of internships (66%) were observational-practical. The students are responsible for all the necessary arrangements, being external financial support practically no existent). The final internship rank student was 4.46, on a scale of 0-5, and 99% would recommend the experience to their colleagues. Conclusions: The 'elective' aims to promote students ability to adapt a new professional and social realities, test their competences and sometimes confront themselves with their potential future professional choice


Assuntos
Humanos , Masculino , Feminino , Adulto , Currículo , Educação de Graduação em Medicina/normas , Autoavaliação , Programas de Autoavaliação , Educação de Graduação em Medicina/organização & administração , Intercâmbio Educacional Internacional , Inquéritos e Questionários , Estudantes de Ciências da Saúde/estatística & dados numéricos
5.
Adv Physiol Educ ; 43(3): 339-344, 2019 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-31305148

RESUMO

Physiology is one of the major foundational sciences for the medical curriculum. This discipline has proven challenging for students to master due to ineffective content acquisition and retention. Preliminary data obtained from a survey completed by "low-performance" students (those maintaining a grade average below the passing mark of 70%) at Morehouse School of Medicine reported that students lacked the ability to adequately recognize and extract important physiological concepts to successfully navigate multiple-choice assessments. It was hypothesized that a specially designed, small-group, active learning, physiology in-course enrichment program would minimize course assessment failure rates by enhancing the ability of low-performance students to effectively identify important course content, successfully perform on multiple-choice assessments, and, thereby, improve overall course performance. Using self-report surveys, study skills and test-taking deficiencies limiting successful comprehension of course material and examination performance were identified. Mini-quiz assessments and assignments in formulating multiple-choice examination questions were given to help students recognize and solidify core concepts and improve test-taking ability. Lastly, self-report surveys evaluated the effectiveness of the enrichment program on overall course performance. Results showed a marked improvement in student confidence levels with regards to approaching multiple-choice assessments, and a significant improvement in grades achieved in the physiology component of the first-year curriculum, as 100% of participants achieved a final passing grade average of ≥70%. It was concluded that students became more proficient in identifying, understanding, and applying core physiological concepts and more successful in mastering multiple-choice questions.


Assuntos
Desempenho Acadêmico/psicologia , Avaliação Educacional/métodos , Fisiologia/educação , Aprendizagem Baseada em Problemas/métodos , Programas de Autoavaliação/métodos , Estudantes de Medicina/psicologia , Currículo , Feminino , Humanos , Masculino , Inquéritos e Questionários
6.
Adv Physiol Educ ; 43(3): 345-349, 2019 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-31305152

RESUMO

A small private online course (SPOC) supports blended learning on a small scale, enabling students to have a more comprehensive and deeper learning experience. It also provides instructors with a flexible and feasible model to better understand the students' learning needs and to supervise students' learning behaviors. In this study, we adopted SPOC flipped classroom blended teaching in the physiology course for clinical undergraduate students of Kunming Medical University. Compared with the control group [lecture-based learning (LBL)], the SPOC flipped classroom method significantly increased the scores of students in the preclass test (65.13 ± 12.45 vs. 53.46 ± 8.09, SPOC vs. LBL) and postclass test (80.43 ± 14.29 vs. 69.01 ± 12.81, SPOC vs. LBL), which is induced by students' increased interest in self-learning. More importantly, the significant difference between the preclass scores of the two groups suggested that the video lecture-based preview is more effective than the textbook-based preview. The study indicated that the SPOC flipped classroom was effective in enhancing the examination scores of students, reflecting an improved learning efficiency and a deeper understanding of the knowledge. In summary, the flipped classroom based on SPOC improves learning outcomes compared with LBL and has a wide application in the learning of basic medical courses.


Assuntos
Currículo , Educação a Distância/métodos , Fisiologia/educação , Aprendizagem Baseada em Problemas/métodos , Estudantes de Medicina/psicologia , Avaliação Educacional/métodos , Humanos , Programas de Autoavaliação/métodos
7.
Postgrad Med J ; 95(1122): 235-236, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31109933
8.
Am J Audiol ; 28(2): 348-361, 2019 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-31095403

RESUMO

Purpose This study aimed to find out more about the effect of the use of the 1-3-6 early hearing detection and intervention (EHDI) timeline and interprofessional simulation training on audiology and speech-language pathology graduate students' confidence level of knowledge and skills. Method A 1-group pretest-posttest quasi-experimental study design was used to assess self-ratings of confidence in knowledge and skills. The mean age for 50 graduate students participating in this study was 25.32 years ( SD = ±3.77, range: 22-37 years). Participants completed a pre- and postevent questionnaire in which they rated their level of confidence for specific knowledge and skills. Three case scenarios represented by standardized parents were developed, and 8 students volunteered to participate in implementing the 1-3-6 EHDI timeline, whereas others participated as observers. All participants participated in the briefing and debriefing sessions immediately before and after each scenario. Participants were asked to rate their readiness for interprofessional education/practice and their satisfaction of the educational experience after the last case scenario. Results Overall, the pre- and postsimulation event questionnaire revealed a significant improvement in the participants' self-rated confidence levels in knowledge and skills. The mean difference between pre- and postevent scores was 0.78 ( p < .01). The mean interprofessional learning was 2.13 (range: 1.16-2.57, SD = ±0.24) based on a Likert scale, where 1 = strongly agree and 5 = strongly disagree. The mean satisfaction level was 4.37 (range: 3.94-4.72, SD = ±0.24) based on a Likert scale, where 1 = not satisfied and 5 = very satisfied. Conclusions The results demonstrated the value of using interprofessional simulation training among audiology and speech-language pathology students to improve their confidence in knowledge and skills. The curriculum developed in this study for the 1-3-6 EHDI timeline provides resources for educators in both professions and other related professions.


Assuntos
Audiologia/educação , Competência Clínica , Perda Auditiva Neurossensorial/reabilitação , Práticas Interdisciplinares/métodos , Treinamento por Simulação/métodos , Patologia da Fala e Linguagem/educação , Adulto , Currículo , Feminino , Auxiliares de Audição , Perda Auditiva Neurossensorial/diagnóstico , Humanos , Recém-Nascido , Masculino , Triagem Neonatal , Simulação de Paciente , Programas de Autoavaliação , Línguas de Sinais , Fatores de Tempo , Adulto Jovem
9.
Med. intensiva (Madr., Ed. impr.) ; 43(4): 207-216, mayo 2019. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-183125

RESUMO

Objetivo: Evaluar el efecto de un programa de entrenamiento en mindfulness sobre el burnout, el mindfulness, la empatía y la autocompasión en profesionales de la salud de un servicio de medicina intensiva de un hospital terciario. Diseño: Estudio longitudinal de diseño intrasujeto pre-post intervención. Ámbito: Servicio de medicina intensiva de un hospital de tercer nivel de referencia. Participantes: Treinta y dos participantes (médicos, enfermeras y técnicos auxiliares de enfermería). Intervención: Se presentó la intervención en forma de sesión clínica/taller acerca de la práctica de mindfulness y sus utilidades. Se ofreció la posibilidad de seguir un programa de entrenamiento de 8 semanas en prácticas breves guiadas diseñado específicamente y creando una comunidad virtual mediante un grupo de WhatsApp. Se envió una propuesta semanal en formato audio y texto y recordatorios diarios y mensajes estimulantes de la práctica. Variables principales: Se realizaron distintas mediciones psicométricas mediante autocuestionarios: Burnout (MBI), mindfulness (FFMQ), empatía (Jefferson) y autocompasión (SCS) antes y después del seguimiento del programa y variables sociodemográficas y laborales. Resultados: En los factores que inciden sobre el burnout disminuyó el nivel de cansancio emocional (−3,78 puntos, p=0,012). Los niveles de mindfulness mediante FFMQ no se modificaron globalmente, aunque aumentaron los factores «observación» y «ausencia de reactividad». La empatía no se vio modificada y se incrementaron los niveles de autocompasión (3,7 puntos, p=0,001). Los niveles de satisfacción y seguimiento del programa fueron muy altos. Conclusiones: Este programa, en la población descrita, mostró un descenso del cansancio emocional y un aumento de la autocompasión, factores que pueden producir bienestar e incidir en el burnout de este colectivo vulnerable


Objective: To evaluate the effect of a mindfulness training program on the levels of burnout, mindfulness, empathy and self-compassion among healthcare professionals in an Intensive Care Unit of a tertiary hospital. Design: A longitudinal study with an intrasubject pre-post intervention design was carried out. Setting: Intensive Care Unit of a tertiary hospital. Participants: A total of 32 subjects (physicians, nurses and nursing assistants) participated in the study. Intervention: A clinical session/workshop was held on the practice of mindfulness and its usefulness. The possibility of following an 8-week training program with specifically designed short guided practices supported by a virtual community based on a WhatsApp group was offered. A weekly proposal in audio and text format and daily reminders with stimulating messages of practice were sent. Main measurements: Various psychometric measures were self-reported: burnout (MBI), mindfulness (FFMQ), empathy (Jefferson) and self-compassion (SCS), before and after the training program. Demographic and workplace variables were also compiled. Results: Among the factors affecting burnout, the level of emotional exhaustion decreased (−3.78 points; P=.012), mindfulness levels measured by the FFMQ were not globally modified, though "observation" and "non-reacting" factors increased. Empathy was not modified, and self-compassion levels increased (3.7 points; P=.001). Satisfaction and program adherence levels were very high. Conclusions: In the population described, this program showed a decrease in emotional exhaustion and an increase in self-compassion -these being factors that can produce well-being and exert a positive impact upon burnout in this vulnerable group


Assuntos
Humanos , Masculino , Feminino , Pessoal de Saúde/psicologia , Unidades de Terapia Intensiva , Atenção Plena/instrumentação , Esgotamento Psicológico/psicologia , Fadiga por Compaixão/psicologia , Estudos Longitudinais , Atenção Plena/métodos , Psicometria/instrumentação , Programas de Autoavaliação , Esgotamento Profissional/terapia , Inquéritos e Questionários
10.
Educ. med. (Ed. impr.) ; 20(supl.1): 124-130, mar. 2019.
Artigo em Espanhol | IBECS | ID: ibc-192869

RESUMO

INTRODUCCIÓN: El Examen Nacional de Medicina (ENAM) es una prueba obligatoria que rinden los estudiantes al finalizar el internado médico; con los cambios de ley ahora sirve como requisito para realizar el Servicio Rural y Urbano-Marginal en Salud. OBJETIVO: Determinar las percepciones de utilidad y preparación para el ENAM en 10 facultades de medicina peruanas. METODOLOGÍA: Estudio transversal analítico que se basó en 11 preguntas de una encuesta autoaplicada, con un alfa de Cronbach de 0,65. Se cruzó dichas variables según el tipo de universidad, año de estudios y si ha repetido cursos; esto con los modelos lineales generalizados. RESULTADOS: El 92% sabía que es el ENAM, el 82% para qué servía, el 74% pensaba que lo aprobaría y el 27% percibía que los conocimientos que le daban en su universidad eran suficientes para rendirlo. El año de estudios fue la variable que más se relacionó con los conocimientos y percepciones acerca del ENAM, pero también se encontraron algunas diferencias según el tipo de universidad y el haber reprobado un curso anteriormente. DISCUSIÓN: El ENAM sigue siendo el más importante examen de medicina a nivel nacional, ya que compara el nivel de enseñanza entre universidades y ahora sirve para poder realizar el Servicio Rural y Urbano-Marginal en Salud. La mayoría sabía qué era y para qué servía, pero la minoría pensaba que lo podría aprobar o que los conocimientos que recibían eran suficientes; siendo ocasionalmente influido por el año de estudios y en menor medida por otras variables


INTRODUCTION: The National Medical Examination (ENAM) is a mandatory test that students are given to complete after their medical internship. With the changes in law, it now serves as a requirement for the Rural and Urban-Marginal Health Service (SERUMS). OBJECTIVE: To determine perceptions of usefulness and preparation for ENAM in ten Peruvian medical faculties. METHODOLOGY: An analytical cross-sectional study was based on 11 questions from a self-administered questionnaire, with a Cronbach Alpha of 0.65. The variables were crossed according to the type of university, year of studies, and if courses were repeated, with the generalised linear models. RESULTS: Almost all of them (92%) knew what the ENAM is, 82% for what it served, 74% thought they would pass it, and 27% perceived that the knowledge gained in their university was sufficient to pass it. The year of studies was the variable that was most related to the knowledge and perceptions about the ENAM, but some differences were also found according to the type of university and to have failed a previous course. DISCUSSION: The ENAM is still the most important national medical examination, as it compares the level of teaching between universities, and now serves to work in SERUMS. Most students knew what it was and what it was for, but the minority thought they could pass it or that the knowledge they received was sufficient, being occasionally influenced by the year of studies and to a lesser extent by other variables


Assuntos
Humanos , Avaliação Educacional , Percepção , Serviços de Saúde Rural/normas , Estudantes de Medicina/estatística & dados numéricos , Educação de Graduação em Medicina , Peru , Estudos Transversais , Programas de Autoavaliação , Inquéritos e Questionários , Universidades/estatística & dados numéricos
11.
BMC Med Educ ; 19(1): 42, 2019 Jan 31.
Artigo em Inglês | MEDLINE | ID: mdl-30704452

RESUMO

BACKGROUND: Writing multiple choice questions may be a valuable tool for medical education. We asked medical students to generate multiple choice questions and studied its effect on their exams. We hypothesized that students generating questions would improve their learning. METHODS: We randomized students in their second and third years at the School of Medicine to write four multiple choice questions on two different sections of General Pathology (Immunopathology and Electrolyte and acid-base status; second year) and Pathophysiology (Blood and Respiratory system; third year). We analyzed whether students writing questions on a section had better results in the exam test in that section than the rest of the students. RESULTS: Seventy-five (38.2%) students wrote questions for General Pathology and 109 (47.6%) for Pathophysiology. Students that wrote questions obtained significantly better results in the exam than those who did not. In General Pathology, students who wrote questions about Immunopathology obtained better results in that section than those who wrote questions about the other section (5.13 versus 3.86 over 10; P = 0.03). In Pathophysiology, the differences between both groups were not significant, but students who wrote good questions about Respiratory system obtained better results in that section than those who wrote good questions about Blood (6.07 versus 4.28 over 10; P = 0.015). Male students wrote good questions in Pathophysiology more frequently than female students (28.1% versus 10.4%; P = 0.02). CONCLUSIONS: The writing of multiple choice questions by medical students may improve their learning. A gender effect may also influence this intervention. Future investigations should refine its potential role in teaching.


Assuntos
Educação de Graduação em Medicina/métodos , Avaliação Educacional/métodos , Aprendizagem , Patologia/educação , Fisiologia/educação , Estudantes de Medicina , Feminino , Humanos , Masculino , Faculdades de Medicina , Programas de Autoavaliação , Fatores Sexuais , Espanha , Redação
12.
BMC Med Educ ; 19(1): 37, 2019 Jan 28.
Artigo em Inglês | MEDLINE | ID: mdl-30691472

RESUMO

BACKGROUND: Effective communication between patients and practitioners is fundamental to the delivery of high-quality care. This is particularly important in the complex and challenging nature of working in palliative and end of life care. Following specialist communication skills training, a group of healthcare professionals explored the impact of action learning (AL) on the perceptions of their knowledge, skills and confidence in communication skills. The research also aimed to establish an evidence base by exploring the nature and impact of the AL approach employed to facilitate improvements in professional practice. METHODS: The research employed a mixed methods approach. Learners (n = 57) scored their perceptions in key areas of communication skills through questionnaires as a baseline measure at time point T0. From this group, 12 participants were selected to undertake further follow-up, divided into Control (n = 6) and Intervention arms (n = 6). All repeated the same questionnaire at 3 subsequent time points (T1, T2, T3) scheduled monthly. Half also received additional telephone-coaching conversation intervention based on Weber's TLA® critical and reflexive approach (2014). To explore and assess perceptions, similarities and differences of their experience of undertaking the specific AL approach and processes, all completed participants (n = 4) and coaches (n = 2) were interviewed at time point T4 (33% response rate). Quantitative data from questionnaires was analysed for comparison of variables to provide a visual illustration of perceived learning journeys. Qualitative data from coaching conversations, interviews and questionnaire responses was analysed inductively to create final themes. RESULTS: Perceived improvements in knowledge, skills and confidence measured at 35% at time point T0, and improvement of 46% reported at time point T3. In the Control arm this was calculated at 25%, and at 67% from the Intervention arm. Findings indicate encouraging evidence for perceived improvements of knowledge, skills and confidence. CONCLUSIONS: The research demonstrates a positive appetite for, and experience of, the process and method. The value of such a solution-focused, critically reflexive AL practice suggests this may act as a facilitator for successful transfer of learning into practice for individuals and their organisations.


Assuntos
Competência Clínica , Comunicação , Pessoal de Saúde/educação , Aprendizagem Baseada em Problemas , Estudos de Viabilidade , Humanos , Cuidados Paliativos , Programas de Autoavaliação , Inquéritos e Questionários , Assistência Terminal
13.
Med Teach ; 41(1): 75-82, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-29533105

RESUMO

Computer-based testing (CBT) has made progress in health sciences education. In 2015, the authors led implementation of a CBT system (ExamSoft) at a dental school in the U.S. Guided by the Technology Acceptance Model (TAM), the purposes of this study were to (a) examine dental students' acceptance of ExamSoft; (b) understand factors impacting acceptance; and (c) evaluate the impact of ExamSoft on students' learning and exam performance. Survey and focus group data revealed that ExamSoft was well accepted by students as a testing tool and acknowledged by most for its potential to support learning. Regression analyses showed that perceived ease of use and perceived usefulness of ExamSoft significantly predicted student acceptance. Prior CBT experience and computer skills did not significantly predict acceptance of ExamSoft. Students reported that ExamSoft promoted learning in the first program year, primarily through timely and rich feedback on examination performance. t-Tests yielded mixed results on whether students performed better on computerized or paper examinations. The study contributes to the literature on CBT and the application of the TAM model in health sciences education. Findings also suggest ways in which health sciences institutions can implement CBT to maximize its potential as an assessment and learning tool.


Assuntos
Instrução por Computador/métodos , Educação em Odontologia/métodos , Avaliação Educacional/métodos , Odontologia Baseada em Evidências/educação , Estudantes de Odontologia/psicologia , Humanos , Avaliação de Resultados em Cuidados de Saúde , Programas de Autoavaliação , Software
14.
Rev. Fund. Educ. Méd. (Ed. impr.) ; 21(5): 247-254, sept.-oct. 2018. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-179841

RESUMO

Introducción: Las funciones esenciales de la salud pública se han definido como las condiciones que permiten un mejor desempeño de su práctica. Competencia profesional es un conjunto de conocimientos, habilidades y actitudes necesarias para que un profesional de la salud pública desarrolle adecuadamente las funciones y actividades que le son propias. Objetivo: Diseñar, validar y aplicar un instrumento para evaluar las competencias profesionales necesarias para realizar las funciones esenciales de la salud pública que poseen los graduados de los cursos de posgrado en salud pública de la Escuela Militar de Graduados de Sanidad. Sujetos y métodos: Se realizó un estudio observacional, analítico y transversal, y se analizó estadísticamente. Resultados: Se diseñó un instrumento con excelente validez de contenido (IVC = 0,94) y fiabilidad elevada (alfa de Cronbach = 0,94). El 81,59% de los graduados de la Maestría en Salud Pública tenía las 56 competencias profesionales necesarias para realizar las funciones esenciales de la salud pública. Por otro lado, el 53,21% de graduados del Curso Técnico Especializado en Salud Pública las tenía. Conclusiones: Se diseñó un instrumento válido y fiable para evaluar las competencias profesionales para realizar las funciones esenciales de la salud pública, y se evaluaron dichas competencias en los graduados de los cursos de posgrado en salud pública. Este instrumento, adaptado a circunstancias particulares, puede aplicarse a otros cursos de posgrado en salud pública


Introduction: The essential functions of public health have been defined as the conditions that allow a better performance of the practice of public health. Professional competence is a set of knowledge, skills and attitudes necessary for a public health professional to adequately develop the functions and activities that are his own. Aim: To design, validate and apply an instrument to evaluate the professional competences necessary to perform the essential functions of public health, possessed by graduates of postgraduate courses in public health of the Military School of Graduates of Health. Subjects and methods: An observational, analytical and transversal study was carried out. It was analyzed statistically. Results: An instrument with excellent content validity (IVC = 0.94) and high reliability (Cronbach’s alpha = 0.94) was designed. 81.59% of the graduates of the master’s degree in public health had the 56 professional competences necessary to carry out the essential functions of public health. On the other hand, 53.21% of graduates of the technical course specialized in public health had them. Conclusions: A valid and reliable instrument was designed to evaluate the professional competences to carry out the essential functions of public health and those competences were evaluated in the graduates of the postgraduate courses in public health. This instrument, adapted to particular circumstances, can be applied to other postgraduate courses in public health


Assuntos
Humanos , Masculino , Feminino , Adulto , Competência Clínica/estatística & dados numéricos , Saúde Pública/educação , Serviços de Saúde , Currículo , Estudos Transversais , Estudo Observacional , Programas de Autoavaliação
15.
BMC Med Educ ; 18(1): 211, 2018 Sep 17.
Artigo em Inglês | MEDLINE | ID: mdl-30223814

RESUMO

BACKGROUND: The relationship between confidence and competence in clinical skills development is complex but important. This study aims to determine undergraduate paediatric student confidence in performing three common paediatric clinical skills framed as Objective Structured Clinical Examination (OSCE) scenarios and to compare this with subsequent assessed performance. The study also aims to explore possible barriers to successful paediatric skills completion. METHODS: A mixed-methods study was conducted on medical students. Cross-sectional questionnaire data relating to confidence in performing a number of paediatric skills were compared with assessed paediatric skills competency. Focus groups were carried out to identify themes in paediatric skills completion to triangulate this data. RESULTS: Eighty-five medical students participated in the study. Students had high levels of pre-test confidence in their ability to perform paediatrics skills. However agreement between pre-test confidence and subsequent task performance was poor and students had significantly greater belief in their skills ability than was subsequently demonstrated. Focus groups identified paediatric skills complexity, conflicting teaching and having limited supervised skills opportunities and as being possible contributory factors to this discrepancy. CONCLUSIONS: Student paediatric skills confidence is not matched by performance. The reasons for this are diverse but mostly modifiable. A major factor is the lack of supervised skills experience with appropriate feedback to support students in learning to calibrate their confidence against their competence. A number of recommendations are made including the introduction of formative assessment opportunities.


Assuntos
Competência Clínica , Educação de Graduação em Medicina , Pediatria/educação , Programas de Autoavaliação , Estudantes de Medicina , Estudos Transversais , Avaliação Educacional , Grupos Focais , Humanos , Estudantes de Medicina/psicologia , Inquéritos e Questionários , Reino Unido
16.
Educ. med. super ; 32(3): 1-28, jul.-set. 2018. graf, tab
Artigo em Espanhol | LILACS, Repositório RHS | ID: biblio-989736

RESUMO

Introducción: Las instituciones de educación superior que forman recursos humanos para la salud, se esfuerzan por perfeccionar los perfiles de egreso en armonía con las necesidades de la población. Mientras, se incrementan los cuestionamientos a la calidad académica, como producto de las relaciones de poder entre el mercado y el estado. La Facultad de Enfermería es el único centro estatal responsable de la formación de grado y posgrado. Disponer de una tecnología para la autoevaluación de la calidad institucional, podría impactar en la mejora de las funciones universitarias y en la misión social. Objetivos: Diseñar una guía metodológica para implementar el proceso de autoevaluación de la calidad institucional y validar la misma, para desarrollar un proceso sistemático y confiable. Métodos: Consistió en un proyecto de desarrollo tecnológico. El diseño preliminar fue ajustado en función de la consulta a expertos y las mediciones de los coeficientes de Alfa de Cronbach y correlación de Pearson. Se implementó una prueba de autoevaluación mediante la técnica de informantes clave. Resultados: La opinión de los expertos fue favorable para la totalidad de los contenidos. Las pruebas estadísticas demostraron un alto índice de consistencia interna y confiabilidad. El diseño obtenido, integró las pautas universitarias establecidas y las particularidades del servicio. Las recomendaciones se orientaron a mejorar la información disponible y formalizar una metodología participativa. Conclusiones: El diseño de la guía fue validado y permitió un autoconocimiento de la calidad institucional con mayor rigurosidad científica. Se identificaron limitaciones en la fase de intercambio entre los evaluadores(AU)


Introduction: Higher education institutions that train human resources in health strive to improve graduation profiles in harmony with the population needs. Meanwhile, the questioning increases for academic quality, as a product of power relations between the market and the state. The School of Nursing is the only state-run center responsible for undergraduate and postgraduate training. Having a technology for the self-evaluation of institutional quality could have an impact on the improvement of the functions and social mission of the university. Objectives: To design methodological guidelines for implementing the process of self-assessment of institutional quality and to validate it, in order to develop a systematic and reliable process. Methods: This consisted in a technological development project. The preliminary design was adjusted based on expert consultation and measurements of the Cronbach's Alpha coefficients and Pearson's correlation. A self-assessment test was implemented using the key informant technique. Results: The opinion of the experts was favorable for all the contents. The statistical tests showed a high index of internal consistency and reliability. The design obtained integrated the established university guidelines and the service particularities. The recommendations were aimed at improving the available information and at formalizing a participatory methodology. Conclusions: The design of the guidelines was validated and allowed a self-knowledge about institutional quality with greater scientific rigor. Limitations were identified in the exchange phase between the evaluators(AU)


Assuntos
Humanos , Programas de Autoavaliação/métodos , Avaliação de Recursos Humanos em Saúde , Escolas de Enfermagem , Uruguai , Gestão da Qualidade Total
17.
BMC Med Educ ; 18(1): 201, 2018 Aug 22.
Artigo em Inglês | MEDLINE | ID: mdl-30134898

RESUMO

BACKGROUND: Medical students facing high-stakes exams want study resources that have a direct relationship with their assessments. At the same time, they need to develop the skills to think analytically about complex clinical problems. Multiple-choice questions (MCQs) are widely used in medical education and can promote surface learning strategies, but creating MCQs requires both in-depth content knowledge and sophisticated analytical thinking. Therefore, we piloted an MCQ-writing task in which students developed MCQs for their peers to answer. METHODS: Students in a fourth-year anatomic pathology course (N = 106) were required to write MCQs using the PeerWise platform. Students created two MCQs for each of four topic areas and the MCQs were answered, rated and commented on by their classmates. Questions were rated for cognitive complexity and a paper-based survey was administered to investigate whether this activity was acceptable, feasible, and whether it promoted desirable learning behaviours in students. RESULTS: Students were able to create cognitively challenging MCQs: 313/421 (74%) of the MCQs which we rated required the respondent to apply or analyse pathology knowledge. However, students who responded to the end-of-course questionnaire (N = 62) saw the task as having little educational value. Students found PeerWise easy to use, and indicated that they read widely to prepare questions and monitored the quality of their questions. They did not, however, engage in extensive peer feedback via PeerWise. CONCLUSIONS: Our study showed that the MCQ writing task was feasible and engaged students in self-evaluation and synthesising information from a range of sources, but it was not well accepted and did not strongly engage students in peer-learning. Although students were able to create complex MCQs, they found some aspects of the writing process burdensome and tended not to trust the quality of each other's MCQs. Because of the evidence this task did promote deep learning, it is worth continuing this mode of teaching if the task can be made more acceptable to students.


Assuntos
Educação de Graduação em Medicina , Avaliação Educacional/métodos , Patologia/educação , Estudantes de Medicina , Atitude , Humanos , Aprendizagem , Nova Zelândia , Projetos Piloto , Programas de Autoavaliação
18.
Belo Horizonte; s.n; s. n; 20180705. 220 p. ilus, tab.
Tese em Português | Coleciona SUS | ID: biblio-1005201

RESUMO

A avaliação é essencial para a análise da qualidade da formação médica e fundamental para o desenvolvimento e aprimoramento de atividades educacionais, e deve se basear tanto em competências quanto em conteúdo. Avaliações externas dos cursos de medicina, elaboradas por órgãos regulatórios, sinalizam os conteúdos considerados como essenciais ou mais relevantes do ponto de vista destes órgãos. Portanto, identificar objetivos de aprendizagem inferidos nessas avaliações poderia ajudar Instituições de ensino e alunos a compreender o que deles se espera. O presente estudo verifica a concordância entre o conteúdo avaliado pelos exames do ENADE 2013 e 2016 e REVALIDA 2015 e 2016 e o conteúdo da Matriz de Correspondência Curricular Revalida (Matriz Revalida). Analisou-se se os conteúdos da Matriz Revalida foram avaliados pelo ENADE e REVALIDA nos anos citados, e foram comparados os conteúdos abordados nas respectivas avaliações, determinando concordâncias e discrepâncias entre as mesmas. Metodologia: Verificou-se os conteúdos específicos abordados nos exames escritos do ENADE 2013 e 2016 (dois últimos anos de aplicação da prova e posteriores à publicação da Matriz Revalida) e do REVALIDA 2015 e 2016 (dois últimos anos de aplicação da prova e posterior a 2014 quando adquiriu nova formatação), tanto dos itens de múltipla escolha quanto discursivos. Os conteúdos explorados nessas avaliações foram comparados com os da Matriz Revalida, estabelecendo-se a relação de conteúdos entre estas. Resultados: A análise dos conteúdos da Matriz REVALIDA (n=749 temas) constantes nas avaliações estudadas revelou uma abrangência inferior de conteúdos no ENADE quando comparado ao REVALIDA. Quando associados os conteúdos abordados nas 4 avaliações, foi encontrado um grande número de temas da Matriz Revalida que não foram abordados em nenhuma das provas analisadas. Conclusão: As avaliações do ENADE e do REVALIDA possuem diferente abrangência quanto à utilização dos conteúdos constantes da Matriz Revalida. A terça parte dos temas da Matriz Revalida não foram abordados nas avaliações estudadas


Assessment is essential for analyzing the quality of medical formation and fundamental to the development and improvement of educational activities, and should be based on both competencies and content. External evaluations of medical courses, prepared by regulatory bodies, indicate the contents considered essential or more relevant from the point of view of these bodies. Therefore, identifying inferred learning objectives in these assessments could help teaching institutions and students to understand what is expected from them. The present study verifies the agreement between the content evaluated by the ENADE exams 2013 and 2016 and REVALIDA 2015 and 2016 and the content of the Matrix of Curricular Correspondence Revalida (Revalida Matrix). It was analyzed if the contents of the Revalida Matrix were evaluated by ENADE and REVALIDA in the mentioned years, and the contents were compared in the respective evaluations, determining concordances and discrepancies between them. Methodology: The specific contents addressed in the written exams of ENADE 2013 and 2016 (last two years of test application and after the publication of the Revalida Matrix) and REVALIDA 2015 and 2016 (last two years of test application and after 2014 when it acquired new formatting) were verified on both multiple choice and discursive items. The contents explored in these evaluations were compared with those of the Revalida Matrix, establishing the relation of contents between them. Results: The analysis of the contents of the REVALIDA Matrix (n = 749 subjects)contained in the evaluations studied revealed a lower content range in ENADE when compared to REVALIDA. When associated the contents discussed in the 4 evaluations, it was found a large number of Revalida Matrix themes that were not addressed in any of the tests analyzed. Conclusion: The evaluations of ENADE and REVALIDA have different scope regarding the use of the contents contained in the Revalida Matrix. The third part of the Revalida Matrix themes were not addressed in the evaluations studied


Assuntos
Humanos , Masculino , Feminino , Adulto , Adulto Jovem , Currículo , Educação Médica , Competência Profissional , Programas de Autoavaliação , Estudantes de Medicina , Questões de Prova , Avaliação Educacional
19.
Edumecentro ; 10(2): 171-187, abr.-jun. 2018. ilus
Artigo em Espanhol | LILACS | ID: biblio-891321

RESUMO

Se realizó una revisión bibliográfica con el objetivo de indagar sobre la autoeficacia docente y su influencia en la calidad de la docencia universitaria. Se describe la evolución histórica del concepto enunciado por Bandura (1999) a partir de la Teoría Social Cognitiva de Rotter, que constituye un aporte para la comprensión de la adaptación y cambio humano; su desarrollo teórico-metodológico la ha posicionado como válida y confiable para explicar cómo sus componentes (mecanismos, fuentes y procesos) se encuentran mediados por la autoeficacia. Niveles de autoeficacia positivos o negativos marcan profundas consecuencias en el desempeño personal y/o profesional; es un reto para la academia motivar al claustro de profesores para asumir este concepto como factor determinante en su accionar sistemático en aras de incrementar la calidad del proceso docente educativo.


A bibliographic review was carried out with the objective of researching about the teaching self-efficacy and its influence on the quality of university teaching. The historical evolution of the concept enunciated by Bandura (1999) is described from the Social Cognitive Theory of Rotter, which constitutes a contribution for the understanding of adaptation and human change; Its theoretical-methodological development has positioned it as valid and reliable to explain how its components (mechanisms, sources and processes) are mediated by self-efficacy. Levels of positive or negative self-efficacy have profound consequences on personal and / or professional performance; it is a challenge for the academy to motivate the teaching staff to assume this concept as a determining factor in their systematic action in order to increase the quality of the teaching-learning process.


Assuntos
Competência Profissional , Autoavaliação , Programas de Autoavaliação , Autoeficácia , Educação Médica
20.
Rev. medica electron ; 40(1): 221-223, ene.-feb. 2018. ilus
Artigo em Espanhol | LILACS, CUMED | ID: biblio-902285

RESUMO

Introducción: la artrosis de rodilla puede llegar a ser una patología muy invalidante por sus síntomas, caracterizados por dolor, inseguridad y pérdida funcional. Es una patología degenerativa que ha aumentado su prevalencia en las últimas décadas, muy ligada al envejecimiento poblacional. Objetivo: validar la técnica de la ostectomía del peroné en el genu varo doloroso como nueva opción de tratamiento. Materiales y Métodos: se realizó un estudio, prospectivo y lineal en el Hospital Militar "Dr. Mario Muñoz Monroy" de Matanzas, desde abril del 2016 hasta agosto del 2017. Se aplicó la nueva técnica del Dr. Ying­Ze Zhang, del Departamento de Cirugía Ortopédica del Tercer Hospital de la Universidad Médica de Hebei en Shijiazhuang, China. En la actualidad ya existe una casuística de 75 pacientes, con 84 rodillas operadas de los cuales se presentan los resultados de los primeros 11 pacientes, posterior al año de operado. Resultados: el promedio de edad fue de 64,3 años, (45 años el menor y 84 años el mayor); de los cuales 8 eran hombres y 3 mujeres. Se aplicó la escala visual analógica para el dolor pre y post-operatorio en cuanto a la marcha y al subir escalones; estando todos los pacientes al caminar, por encima de 6 y al subir escaleras por encima de 7. Después de un año de operados 10 pacientes se encontraban evaluados al caminar entre 0 y 3 puntos, y al subir escalones 9 en igual puntuación; 1 en 5, y solamente 1 paciente mantuvo igual puntuación antes de operarse. Valorando estas puntuaciones se evaluaron 9 pacientes de bien, 2 de regular, y se presentaron 3 complicaciones. Conclusiones: al año de seguimiento ocurre gran mejoría del dolor, mejorando la seguridad del paciente durante la marcha (AU).


Introduction: the fibular osteoarthritis could be a very invalidating disease due to its symptoms, characterized by pain, insecurity and functional loss. It is a degenerative disease whose prevalence has increased during the last decades, tightly linked to population ageing. Objective: to validate the technique of fibular ostectomy in the painful genu varum as a new treatment option. Materials and Methods: a prospective, lineal study was carried out in the Military Hospital "Dr. Mario Muñoz Monroy", of Matanzas, from April 2016 to August 2017. It was used the new technique of Dr. Ying-Ze Zhang, from the Department of Orthopedic Surgery of the Third Hospital of Hebei Medical University in Shijiazhuang, China. Currently there is a series of cases of 75 patients, with 84 operated knees; the results of the first 11 operated patients, are presented here after a year of the surgery. Results: the average age was 64.3 years, 45 years the youngest and 84 years the eldest; from them, 8 were men and 3 women. The analogical visual scale for the pre and post-surgical pain was applied during the gait and when going upstairs. During the gait all the patients were above 6, and when climbing upstairs above 7. After a year from the operation 10 patients got an evaluation between 0 and 3 points during the gait, and 9 got the same score when climbing steps; one got 5, and only 1 patient kept the same score than before the operation. Taking into account these scores, 9 patients were evaluated as good, 2 regular, and there were 3 complications. Conclusions: after a one-year follow-up, the pain greatly improves, improving patients' security during the gait (AU).


Assuntos
Humanos , Qualidade da Assistência à Saúde , Infecções por HIV/psicologia , Terapia Antirretroviral de Alta Atividade , Assistência à Saúde , Humanização da Assistência , Estigma Social , Programas de Autoavaliação , Sociedades/ética , Educação , Comunicação em Saúde
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