Analysis of factors affecting medical personnel seeking employment at primary health care institutions: developing human resources for primary health care.

BACKGROUND: The serious shortage of human resources for primary health care (PHC) is a common issue in health reforms worldwide. China has proposed that it is an effective way to encourage and guide qualified medical personnel to work in primary health care institutions (PHCIs). However, few studies have been conducted on the willingness and influencing factors of medical personnel to seek employment at PHCIs. METHODS: Based on implicit theory and lexical approach, pre-investigation was conducted to collect the items that influence the medical personnel to seek employment at PHCIs from the perspective of guided objects. Through a three-phase investigation of 1160 doctors in 29 public hospitals in 9 cities, the items were categorized, and a structural equation model was established and verified to explore the interrelationship of influencing factors. RESULTS: A total of 6 factors were rotated, including Sense of Gain (SG), Internal Organization Development (IOD), Remuneration and Development (RD), Condition of the City Where the PHCI Is Located (CCPL), Job Responsibilities (JR) and Family Support (FS). The results of the model showed that IOD, RD, JR and FS had a significantly positive effect on the SG. In addition, the FS, RD and JR significantly mediated the relationship between the internal and external environment of PHCIs and SG. The values of the fit index indicated an acceptable-fitting model. CONCLUSION: Family, remuneration, individual development, and job responsibility are closely related to the willingness of medical personnel to seek employment at PHCIs, and the internal and external environment of PHCIs is also an important factor. Therefore, the development of PHC providers can be promoted by paying attention to the family members of medical personnel, establishing a reasonable remuneration system, providing suitable development opportunities, arranging work rationally and improving the internal construction of PHCIs.

Physiotherapy services in patient care in Bhutan.

Physiotherapy and rehabilitative services are an integral part of patient care, but in many developing countries they are not considered a priority and are either not available or not easily accessible to those who need them. Bhutan is one such country where healthcare is provided free of cost to all, but as of 2021 physiotherapy services were available only in 26 of 48 hospitals and 19 of 20 districts. The number of physiotherapy professionals per 10,000 population is 1.4 with significant rates of attrition. There is lack of awareness among patients and other health professionals about physiotherapy and rehabilitation services. The country needs to integrate physiotherapy and rehabilitation services into the overall health policy framework and develop proper planning of human resources and infrastructure to meet the current and future demands.

A human resources for health analysis of registered family medicine specialists in South Africa: 2002-19.

BACKGROUND: In South Africa, there is a need to clarify the human resources for health policy on family physicians (FPs) and to ensure that the educational and health systems are well aligned in terms of the production and employment of FPs. OBJECTIVE: To analyse the human resource situation with regard to family medicine in South Africa and evaluate the requirements for the future. METHODS: A retrospective review of the Health Professions Council of South Africa's (HPCSA) database on registered family medicine practitioners from 2002 until 2019. Additional data were obtained from the South African Academy of Family Physicians and published research. RESULTS: A total of 1247 family medicine practitioners were registered with the HPCSA in 2019, including 969 specialist FPs and 278 medical practitioners on a discontinued register. Of the 969, 194 were new graduates and 775 from older programmes. The number of FPs increased from 0.04/10 000 population in 2009 to 0.16/10 000 in 2019, with only 29% in the public sector. On average, seven registrars entered each of nine training programmes per year and three graduated. New graduates and registrars reflect a growing diversity and more female FPs. The number of FPs differed significantly in terms of age, gender, provincial location and population groups. CONCLUSIONS: South Africa has an inadequate supply of FPs with substantial inequalities. Training programmes need to triple their output over the next 10 years. Human resources for health policy should substantially increase opportunities for training and employment of FPs.

Indian government E-learning initiatives in response to COVID-19 crisis: A case study on online learning in Indian higher education system.

Recently, the whole world has faced the deadliest and dangerous consequences due to the transmission of infectious novel coronavirus (nCov). With the outbreak of COVID-19, the education learners, practitioners, and other stakeholders were at the sake of a loss, as it causes the suspension of physical classes and physical interaction of the learners. In these circumstances, Electronic learning (E-learning), Online learning, and the use of Information and Communications Technology (ICT) tools came in handy. It helped the learners in the dissemination of ideas, conducting online classes, making online discussion forums, and taking online examinations. Like the government of each country, the Indian government was also caught off-guard but the existing E-learning infrastructure was able to leverage on while devising plans to tailor them to new situations and launching new ones. The initiatives at the forefront of this noble battle launched by the Department of School Education and Literacy, Ministry of Human Resources Development (MHRD) includes Diksha, Swayam Prabha Channel, Shiksha Van, E-Pathshala, and National Repository of Open Educational Resources (NROER). It worth noting that apart from the Indian central government efforts, each state has various online education initiatives that are tailored to their needs. This research evaluated each of these initiatives commenced by central and state governments and present a detailed analysis of most of the relevant initiatives. Additionally, a survey is conducted to get insights of learners in concern to online learning. Despite the issues raised in this learning, the outcomes come to be satisfactorily favoring online learning.

[PROBLEMS OF HUMAN RESOURCES DEVELOPMENT IN HEALTHCARE].

This article is devoted to current issues of human resources development in healthcare. The article emphasizes that the effectiveness of the healthcare system and the quality of medical care delivery deeply depend on the results of the work of medical workers, which are determined by their knowledge, skills and motivation. Considering the necessity of providing the healthcare sector with highly qualified personnel, as well as replenishing the staff with young specialists, we can say that public health is directly dependent on their competence. In addition, the problem of reducing staff turnover and retaining young specialists in the workplace is important, this problem can be solved by the mentoring system in a medical organization. In the article documents of international organizations and the Russian regulatory framework are analyzed, the data from the author's studies conducted in 2019-2020 are presented. The results of the expert interviews and questionnaires indicate a positive attitude of the respondents to the mentoring system as an instrument for developing human resources in medical organizations. Analyzing the data obtained, the author comes to the conclusion about the need for a competent organization of the mentoring process. This article focuses on the legislative regulation of mentoring, as well as incentive measures for mentors.

Training opportunities and the increase in the number of nurses in home-visit nursing agencies in Japan: a panel data analysis.

BACKGROUND: A training opportunity in which ongoing education is encouraged is one of the determinants in recruiting and retaining nurses in home-visit nursing care agencies. We investigated the association between ensuring training opportunities through scheduled training programs and the change in the number of nurses in home-visit nursing agencies using nationwide panel data at the agency level. METHODS: We used nationwide registry panel data of home-visit nursing agencies from 2012 to 2015 in Japan. To investigate the association between planning training programs and the change in the number of nurses in the following year, we conducted fixed-effect panel data regression analysis. RESULTS: We identified 4760, 5160 and 5025 agencies in 2012, 2013, and 2014, respectively. Approximately 60-80% of the agencies planned training programs for all staff, both new and former, during the study period. The means and standard deviations of the percentage change in the number of full time equivalent (FTE) nurses in the following year were 4.2 (19.8), 5.7 (23.5), and 5.8 (25.1), respectively. Overall, we found no statistically significant association between scheduled training programs and the change in the number of FTE nurses in the following year. However, the associations varied by agency size. Results of analysis stratified by agency size suggested that the first and second quartile sized agencies (2.5-4.0 FTE nurses) with scheduled training programs for all employees were more likely to see a 9.0% (95% confidence interval [CI]: 4.5, 13.5) and 8.5% (95% CI: 2.4, 14.5) increase in the number of FTE nurses in the following year, respectively. Similarly, the first and second quartile sized agencies with scheduled training programs for new employees were more likely to see a 4.7% (95% CI: 2.1, 7.2) and 3.3% (95% CI: 0.4, 6.2) increase in the number of FTE nurses in the following year, respectively. CONCLUSIONS: Ensuring training opportunities through scheduled training programs for all staff, both new and former, in relatively small-sized home-visit nursing agencies might contribute to an increase in the number of nurses at each agency.

[Personnel marketing in anesthesiology. Perception, use and evaluation by the target group]. / Personalmarketing in der Anästhesiologie. Wahrnehmung, Nutzung und Bewertung durch die Zielgruppe.

BACKGROUND: The human resources situation in the healthcare system is characterized by a manpower shortage. Recruiting medical staff is of great importance for hospitals and particularly in anesthesiology. Approaching and recruiting staff usually happens through external personnel marketing (PM); however, up until now the efficacy of these PM measures has barely been empirically investigated. AIM: The goal of this empirical study was to examine how familiar hospital physicians at varying career levels are with the different tools employed by external PM and how frequently they used as well as rated these tools in terms of benefits. Based on this information, the preferences of medical staff with respect to detailing the workplace of "hospital physician" as well as factors of the hospital's attractiveness as an employer were evaluated. Another aim was to derive recommendations on how to optimize the marketing instruments used for external PM in the healthcare system. MATERIAL AND METHODS: In an internet-based survey, 154 female and male physicians were questioned about their knowledge, use and benefit assessment of a total of 43 PM tools. RESULTS: Conventional methods of addressing applicants were commonly used but ranked behind the more personal and direct targeting tools in terms of benefit assessments. Internet-based tools with a conceptual affinity to conventional methods were also highly rated in terms of benefits. In contrast, unconventional methods of addressing applicants were hardly known and were not viewed as being useful. The PM tools from the field of "overall conditions for cooperation in the company" mainly received high to very high benefit assessments. These referred primarily to non-monetary factors, human resource development measures and also to aspects of remuneration. Image-promoting PM tools were rarely assessed as being useful, with the exception of measures aimed at creating personal contact between the hospital or unit/department and applicants or those allowing personal insight into the department's range of activities. The correlation between familiarity with PM tools and positive benefit assessments was low. CONCLUSION: The results of this PM study can contribute to the development of an effective and efficient conception of PM measures by hospitals. Addressing applicants through traditional job and internet-based advertisements should be supplemented by personalized targeting of potential applicants and innovative targeting instruments must be systematically developed and promoted in order to become effective. It remains questionable whether the target group of external PM can be reached with exclusively or even predominantly image-cultivating measures on behalf of the healthcare company, such as image campaigns. The most effective PM tools create good working conditions and develop factors contributing to the employer's attractiveness. These two tools should be given priority in human resource development also taking material incentives into consideration, all of which support the effective set-up of an employer branding.

SIGEPS: A System for Managing the Health Internship Program.

The healthcare sector's demand for a skilled workforce necessitates effective management of internship and residency programs. This study introduces the System for Managing the Health Internship Program (SIGEPS), aimed at addressing internship and residency management challenges in Joinville's municipal health network. The method of this study focused on developing a computational solution with applied and exploratory objectives. The research adopted a User-Centered Development approach, involving seven stages from scope determination to system implementation. Key stages included selecting Google's free technological tools, developing forms for information input, integrating these into a Google Sheets spreadsheet, and creating a website for schedule display. The primary result was the successful development of SIGEPS, which automated the process from initial requests to scheduling and analysis of healthcare institutions and displayed schedules online. The system offers several advantages over previous models, such as concurrent scheduling by multiple employees, process automation, enhanced information transparency, and improved efficiency with significant time savings. Future enhancements include integrating decision support systems and enabling data analysis reports through dashboards to further reduce scheduling efforts and enhance professional efficiency. This study demonstrates the feasibility of developing and implementing a free computational solution using the Google platform for managing internships and residencies in the healthcare sector.

Realist approach to community-based participatory research on a community health break-down in Japan: mechanism reasoning, knowledge and a trust partnership.

BACKGROUND: Our 10-year programme of community health regeneration and community-based participatory research (CBPR) was initially unknown. However, we succeeded in creating a collaboration between residents, medical staff, and administrative staff. We adopted a realist approach as an evaluation method. METHODS: The realist approach evaluates a programme using a Context-Mechanism-Outcome configuration (CMOc), which is a relatively new methodology. First, the programme manager summarised the entire programme, conducted questionnaires and interviews with seven core members, and summarised each into a CMOc. The programme was evaluated with particular focus on mechanistic reasoning. RESULTS: The number of doctors and nurses increased and residents became more active. The success factors were the acquisition of participants' knowledge and trust partnerships. In addition, it was important that the timing of the activity was good and that the participants were highly conscious. CONCLUSIONS: The 10-year CBPR was examined using a realist evaluation method. Knowledge acquisition and trust partnerships are important for reasoning mechanism.

Evaluating the Effects of Training to Improve Teaching Skills of Health Sciences Educators in Sudan.

Purpose: This evaluation draws evidence on the outcome of learning and teaching courses that were offered to a number of teaching staff (referred to as trainers) of the Academies of Health Sciences, Midwifery Schools and Centre for Continuous Professional Development in Sudan. Methods: The evaluation was a cross-sectional, institution-based study conducted from October 2017 to January 2018 involving qualitative design. It consisted of direct observations of teaching, focus group discussions with students and semi-structured interviews with managers of teaching institutions. Results: The findings of direct observations revealed that the learning and teaching course has positive effects on the trainers' ability to have clear, well-stated learning objectives; their presentation skills; and their use of different teaching methods. Moreover, the observations showed that trainers who attended the learning and teaching course now encourage the students to ask questions and are providing them with timely feedback about their learning. As students were the main beneficiaries for improved teaching, focus group discussions have shown that students were generally satisfied with trainers' performance regarding the stated learning outcomes, curricula design, use of a range of teaching methods and assessment methods. During in-depth interviews, managers of training institutions expressed satisfaction with the trainers' performance regarding the development of training materials, learners' assessment, supervision, and evaluation of training. Conclusion: Short courses on teaching and learning were a valuable investment for trainers, students, and the overall performance of health sciences training institutions. The evaluation revealed that trainers were able to apply what they have learnt. Moreover, students and managers noticed improvement in the performance of trainers in teaching, course delivery and assessment. It is recommended to expand, cascade and institutionalize the short courses on learning and teaching to all states to improve the capabilities of trainers, which would eventually contribute to the production of competent allied health professions in Sudan.

[Attending physicians in urology working at university centers or non-university centers-what are the differences? : Results of a web-based cross-sectional study at German hospitals]. / Urologische Oberärztinnen und Oberärzte an universitären oder nicht-universitären Kliniken ­ welche Unterschiede gibt es? : Ergebnisse einer webbasierten Querschnittstudie an deutschen Kliniken.

BACKGROUND: Attending physicians (AP) in urology represent a very heterogeneous group covering various clinical priorities and career objectives. To date, there are no reliable data on professional, personal and position-linked aspects of AP in urology working in university centers (univ-AP) opposed to those working in non-university centers (n-univ-AP). MATERIALS AND METHODS: The objective of this study was to analyze individual professional perspectives, professional and personal settings, specific job-related activities and individual professional goals of univ-AP opposed to n­univ-AP. Thus, a web-based survey containing 55 items was designed to perform a cross-sectional study that was then forwarded using a link which was sent via a mailing list of the German Society of Urology. The survey was available for completion by AP at German urological centers from February to April 2019. Group-specific differences were evaluated using bootstrap-adjusted multivariate logistic regression models. RESULTS: Of the 192 evaluable surveys, 61 (31.8%) and 131 (68.2%) were part of the univ-AP and n­univ-AP study group, respectively. Participating n­univ-AP compared to univ-AP held the position of AP (p = 0.022) significantly longer and were on call significantly more frequently (p < 0.001). AP in urology (self)-assessed themselves as autonomously confident in performing robotic, laparoscopic, open, endo-urologic, and plastic-reconstructive surgery in 12.4%, 25%, 59.6%, 92.1%, and 25.7%, respectively, with no significant differences between the two groups among all above mentioned surgical subdomains based on multivariate analysis. AP in urology were (very) content in 92% concerning the choice of their discipline, in 73.9% concerning their actual working circumstances, and in 60.2% concerning their level of surgical expertise. Only 27.1% and 19.9% were (very) content with the amount of available time for their personal professional development and for private affairs, respectively. As opposed to n­univ-AP, univ-AP would choose a career in clinical centers once again significantly more frequently (OR 2.87; p(BS) = 0.041), but assess the position of AP as their definitive career goal significantly less frequently (OR 0.42; p(BS) = 0.40). Univ-AP state significantly more frequently that they were running for the position of head of department or full professor (OR 5.64; p(BS) = 0.001). CONCLUSION: In this first survey study world-wide on AP in urology divided according to their academic background, similarities and variances were analyzed, baring the potential to further improve identification of AP for a career in clinical centers.

Assessment correlation of the organizational agility of human resources with the performance staff of Tehran Emergency Center.

BACKGROUND: Human resources are the most important tool in agility of organization and is considered to be the most valuable asset of any organization. Agile emergency system can reduce production costs, increase market share, fulfill the needs of patients, and most importantly, it reduced the mortality and morbidity from diseases and crashes. OBJECTIVE: The purpose of this study was to determine the correlation of human resource agility with performance of the staff of Tehran Emergency Center (TEC). MATERIALS AND METHODS: This research is a descriptive-correlational study and 285 operatives from TEC, with a population of 1100 were selected according to Morgan table and simple random sampling. The data of this research were collected using human resource agility capabilities questionnaire and Patterson job performance questionnaire. SPSS/18 software and descriptive-inferential tests were used to analyze the data. RESULTS: The results show that the correlation between organizational agility and employee performance is 0.754 and is significant (P = 0.01). The correlation between the employee performance and intelligence and knowledge (0.512), multiple competencies (0.61), knowledge management (0.57), empowerment culture (0.524), and information system (0.63) in significant level (P = 0.05). CONCLUSIONS: The agility of the staff of the TEC is correlated with their performance. Due to the sensitivity of the work of TEC staff, it is recommended that they are planning in such a way that they acquire the agility of themselves and their organizations by acquiring the necessary skills at all levels, especially the operational level.

Transferência tecnológica durante a pandemia de covid-19: relato do primeiro treinamento prático presencial no Brasil / Technology transfer during the COVID-19 pandemic: report on the first face-to-face practical training course in Brazil / Transferencia de tecnología durante la epidemia de COVID-19 en Brasil: informe de la primera formación práctica presencial

O relato descreveu o primeiro curso presencial visando capacitar profissionais de saúde pública na realização de vigilância genômica em tempo real, durante períodos pandêmicos. Relato de experiência sobre um curso teórico-prático com foco em pesquisa e vigilância genômica, incluindo tecnologias de sequenciamento móvel, bioinformática, filogenética e modelagem epidemiológica. O evento contou com 162 participantes e foi o primeiro grande treinamento presencial realizado durante a epidemia de covid-19 no Brasil. Não foi detectada infecção pelo SARS-CoV-2 ao final do evento em nenhum participante, sugerindo a segurança e efetividade de todas as medidas de segurança adotadas. Os resultados do evento sugerem que é possível executar capacitação profissional com segurança durante pandemias, desde que seguidos todos os protocolos de segurança.

The objective of this report was to describe the first face-to-face course aimed at training public health professionals in performing real-time genomic surveillance during the pandemic period. Experience report on a theoretical-practical course focusing on genomic research and surveillance, including mobile sequencing technologies, bioinformatics, phylogenetics and epidemiological modeling. There were 162 participants in the event and it was the first major face-to-face training course conducted during the COVID-19 epidemic in Brazil. No cases of SARS-CoV-2 infection was detected among the participants at the end of the event, suggesting the safety and effectiveness of all safety measures adopted. The results of this experience suggest that it is possible to conduct professional training safely during pandemics, as long as all safety protocols are followed.

Este estudio tuvo como objetivo describir el primer curso presencial para capacitar a los profesionales de la salud pública para llevar a cabo la vigilancia genómica en tiempo real durante los períodos de pandemia. Este es un informe de experiencia en un curso teórico-práctico centrado en la investigación y vigilancia genómica, que incluye secuenciación móvil, bioinformática, filogenética y tecnologías de modelado epidemiológico. Este evento contó con la asistencia de 162 participantes y fue la primera gran capacitación presencial realizada durante la epidemia de COVID-19 en Brasil. No se detectó infección por SARS-CoV-2 al final del evento en ningún participante, lo que sugiere la seguridad y efectividad de todas las medidas de seguridad adoptadas. Por lo tanto, los resultados del evento sugieren que es posible realizar entrenamientos profesionales de manera segura durante pandemias, siempre y cuando se sigan todos los protocolos de seguridad.

Job satisfaction and intention to stay within community and residential aged care employees.

OBJECTIVE: This study investigated the different facets of job satisfaction that influence community care and residential care employees' intention to stay in the aged care workforce. METHODS: A survey of four organisations in Australia was undertaken. t-Tests were conducted to analyse differences between groups. Regression analyses were performed to examine the factors influencing intentions to stay in the workforce. RESULTS: Community care workers were more satisfied with various facets of job satisfaction including work on their present job, supervision, people in their present job and the job in general. There was a difference between how the various facets of job satisfaction influenced intentions to stay for residential care compared to community care workers. CONCLUSIONS: Both workers were satisfied with their work conditions and work to different extents. There is an opportunity for residential care to look to the practices within the community care sector to improve employees' intentions to stay.

Dificultades para la participación en actividades académicas de la Escuela Nacional de Salud Pública - Perú, 2018 - 2020

Introducción. Las tasas de abandono de cursos obstaculizan el logro de metas de capacitación del personal afectando el servicio que brindan a la población. Objetivo. Identificar las principales dificultades y obstáculos que los trabajadores de salud reportan para participar en las actividades académicas de ENSAP, 2018-2020, con fines de mejorar el alcance de su oferta académica. Métodos. Investigación transversal descriptiva de nivel nacional aplicando un cuestionario virtual anónimo tipo Likert de 44 preguntas, validado (α de Cronbach de 0,888). Resultados. Recibimos 3299 respuestas de personal con características generales similares y representativas del público objetivo y beneficiario de ENSAP. Las respuestas fueron de una muestra mayoritariamente femenina, con formación enfermería y/o técnico en enfermería, entre los 30 y 49 años de edad. 41% tuvo un trabajo adicional; dedica a la capacitación un máximo 5 horas/semana después de las 18:00 hs. La carga laboral (82%), carga familiar (51%), mala conexión a red (57%), la falta de reconocimiento o compensación por capacitación de los jefes (49%), olvidar haberse inscrito (47%) y olvidar la contraseña de acceso (41%) fueron los obstáculos más mencionados. Conclusiones. La formación continua a distancia ofrece una oportunidad para llegar al personal de salud nivel nacional. El alto número de inscritos en las actividades de ENSAP refleja una gran demanda e interés por capacitarse a distancia, pero es necesario plantear alternativas frente a los obstáculos que enfrentan para culminar la capacitación sin reforzar las desigualdades existentes.

Introduction. Dropout rates hinder the achievement of staff training goals, affecting the service they provide to the population. Objective. Identify the main difficulties and obstacles to participate in the academic activities of ENSAP, 2018-2020, that health workers report in order to improve the scope of its academic offer. Methods. Descriptive cross-sectional research at the national level applying an anonymous online Likert-type questionnaire with 44 questions, validated (Cronbach's α of 0.888). Results. We received 3299 responses from personnel with similar general characteristics and representative of the target audience and beneficiary of ENSAP. The answers come from a mostly female sample, with nursing and / or nursing technical training, between 30 and 49 years of age. 41% have an additional job; dedicates a maximum of 5 hours / week to training and after 6:00 p.m. Excessive workload (82%), family burden (51%), poor network connection (57%), lack of recognition or compensation for training hours (49%), forgetting registration (47%) and forgetting platform´s password (41%) were the most mentioned obstacles. Conclusions. Continuous training through online modalities offers a great opportunity to reach more people at the national level. The high number of people enrolled in ENSAP activities reflects a great demand and interest in distance training, but it is necessary to propose alternatives to the obstacles they face to complete training without reinforcing existing inequalities.

Health Workforce Planning: An overview and suggested approach in Oman.

In most countries, the lack of explicit health workforce planning has resulted in imbalances that threaten the capacity of healthcare systems to attain their objectives. This has directed attention towards the prospect of developing healthcare systems that are more responsive to the needs and expectations of the population by providing health planners with a systematic method to effectively manage human resources in this sector. This review analyses various approaches to health workforce planning and presents the Six-Step Methodology to Integrated Workforce Planning which highlights essential elements in workforce planning to ensure the quality of services. The purpose, scope and ownership of the approach is defined. Furthermore, developing an action plan for managing a health workforce is emphasised and a reviewing and monitoring process to guide corrective actions is suggested.

Internacionalización en el desarrollo de Recursos Humanos a Nivel de Posgrado en Salud Pública en Meso América / Internacionalization of Human Resources development at Posdegree level on Public Health in Meso American Region

Desde 1982 hasta 2017, el CIESUNAN Managua ha entregado a la Región Meso Americana um aproximado de 1532 Profesionales Graduados de Posgrado, donde el 64% son mujeres, y el resto varones. 930 son nicaragüenses (60.7%), y el resto son graduados de otros países de la Región Mesoamericana. Estos Graduados han aprobado uno o más de los cinco programas de Maestrías (Administración de la Salud y Epidemiología desde 1982, Salud Pública desde 1990, Economía de la Salud desde 2005 y Salud Ocupacional desde 2010). En el 2015 es abierto el Programa de Doctorado en Ciencias de la Salud. La Gestión Institucional basada en la Extensión Universitaria y la Internacionalización se constituyen en las bases imprescindibles de la Formación de Recursos Humanos en ambientes complejos y a veces hasta conflictivos. Es posible identificar diferentes momentos o kayros en los 35 años del CIES, y deducir las lecciones aprendidas en este proceso, condición necesaria para comprender y emprender los retos del futuro de la Educación de Posgrado en Salud Pública en función del impacto tecnológico y epistemológico que caracteriza a la determinación social de la Salud y la necesaria Intersectorialidad a construir en el marco de la Iniciativa Salud en Todas las Políticas y de los Objetivos de Desarrollo Sostenibles. Se exploran los diferentes períodos (kayros) de desarrollo y las lecciones aprendidas en cada uno de ellos, especialmente en los aspectos relacionados con la internacionalización de estos procesos, las relaciones establecidas con los actores surgidos y los espacios abiertos en estos processos.

From 1982 to 2017, CIESUNAN Managua has delivered to the Mesoamerican Region approximately 1532 Graduate Graduates, where 64% are women. Among those graduates, 930 are Nicaraguans (60.7%), and the rest are graduates coming from other countries of the Mesoamerican Region. These Graduates have approved one or more of the five Master's programs (Health Administration and Epidemiology since 1982, Public Health since 1990, Health Economics since 2005 and Occupational Health since 2010). In 2015 the Doctorate Program in Health Sciences is opened. Institutional Management based on University Extensionand Internationalization constitute the essential bases of Human Resource Training in complex and sometimes even conflicting environments. It is possible to identify different moments or kayros in the 35 years of the CIES, and to deduce the lessons learned in this process, a necessary condition to understand and undertake the future challenges of Postgraduate Education in Public Health according to the technological and epistemological impact that characterizes to the social determination of Health and the necessary intersectorality to be built within the framework of the Health Initiative in All Policies and the Sustainable Development Goals. It explores the different development periods and lessons learned in each one of them, especially in the aspects related to the internationalization of these processes, the established relationships with the actors that have emerged and the open spaces in these processes

Professional training in physiotherapy: primary care practices / Formação profissional em fisioterapia: práticas realizadas na atenção básica

Abstract Introduction: Professional training in physiotherapy still focuses primarily on rehabilitation; however, there is a need to ensure that these professionals are also equipped to work in primary care (PC), since it is the gateway to the healthcare system. Objective: Identify practices carried out in PC by undergraduate physiotherapy courses in Santa Catarina state, Brazil, from the perspective of professors. Method: Qualitative study with a multiple-case design. All eight undergraduate physiotherapy courses available in the state were included as cases in this study. Five physiotherapy professors also took part as key informants (KIs) Data were collected by document analysis of course pedagogical projects (CPPs) and a semi-structured interview regarding training practices conducted in primary care (PC) settings. Data were analyzed using thematic analysis. Results: Based on content analysis of the interviews, practices carried out in PC by the different courses include territorialization; specific group activities; home health care/home visits; postural education in school settings; interdisciplinary and multiprofessional experiences; interviews; waiting room activities; combined consultations and singular therapeutic projects. Conclusion: practices performed in primary care facilities by undergraduate physiotherapy courses in Santa Catarina state (SC), Brazil, are aimed at meeting primary care needs; however, teaching-service-community integration is essential in order to diversify these PC experiences throughout the training process and expand interdisciplinary and multiprofessional activities.

Resumo Introdução: A formação profissional em Fisioterapia ainda se dá muito centrada em práticas reabilitadoras, contudo, observa-se a necessidade de garantir no processo formativo práticas desenvolvidas na Atenção Básica (AB), visto que esta é a principal porta de entrada para o sistema de saúde. Objetivo: Desvelar as práticas realizadas na AB pelos cursos de graduação em Fisioterapia no estado de SC, segundo o olhar dos docentes. Método: Estudo de abordagem qualitativa, tendo como método o estudo de casos múltiplos. Oito cursos de graduação em Fisioterapia presentes no estado catarinense, constituíram-se nos casos desta pesquisa. Participaram do estudo cinco docentes fisioterapeutas como Informantes-Chave (IC). A coleta de dados se deu por meio de análise documental dos Projetos Pedagógicos dos Cursos (PPCs) e de entrevista semiestruturada quanto as práticas realizadas no contexto da AB. A análise de dados se deu mediante análise de conteúdo temática. Resultados: A partir da análise de conteúdo das entrevistas, entre as práticas realizadas na AB pelos cursos, estão a territorialização; ações em grupos específicos; atenção domiciliar/visita domiciliar; educação postural no contexto escolar; vivências interdisciplinares e multiprofissionais; entrevista; ações em sala de espera; consultas compartilhadas e projeto terapêutico singular. Conclusão: As práticas realizadas pelos cursos de graduação em Fisioterapia no estado de SC buscam atender as demandas da atenção básica, no entanto, há que se estabelecer a integração ensino-serviço-comunidade, a fim de potencializar a diversificação dessas vivências na AB ao longo do processo formativo, ainda ampliar as atividades interdisciplinares e multiprofissionais.

Design and application of intelligent surgical operation scheduling system / 中华护理杂志

Objective To develop an intelligent scheduling system for surgery by setting up constraints in an intelligent working environment to achieve automatic scheduling of surgery and personnel,and to precisely match the sub-professional nurses for surgeries.Methods Scheduling constraints were set up,and finally efficient scheduling was developed.Results During the process of clinical application,the rates of error and omission for surgical schedule fell to 4.78％,the rate of surgery re-adjustment fell to 17.74％,the number of average daily operation increased,the matching degree of sub-professional surgery nurse post reached 94.71％.Conclusion The intelligent surgical scheduling system can improve the scheduling efficiency and quality,improve the utilization of the operation rooms,and improve the collaboration quality and efficiency of the sub-professional nurses.

Residências Multiprofissionais em Saúde como cenários de implementação da educação interprofissional / Multiprofessional Residencies in Health as scenarios for the implementation of interprofessional education

Este trabalho analisa as Residências Multiprofissionais em Saúde, com o objetivo de identificar de que maneira os programas financiados pelo Ministério da Saúde, a partir da Portaria Interministerial 1.077 de 2009, encontram-se distribuídos pelo país. Realizou-se uma pesquisa documental exploratória utilizando editais e portarias publicados pelo Ministério da Saúde, através da Secretaria de Gestão do Trabalho e da Educação em Saúde em conjunto com o Ministério da Educação, através da Secretaria de Educação Superior. A análise foi dividida em três momentos: distribuição dos programas de Residência Multiprofissional em Saúde de acordo com as regiões brasileiras, com as áreas de concentração consideradas pelo Ministério da Saúde como prioritárias para o Sistema Único de Saúde e com as instituições proponentes. Ao longo da escrita, os aspectos históricos das Residências Multiprofissionais em Saúde são revisitados desde a década de 70, até sua configuração como parte integrante da Política Nacional de Gestão da Educação na Saúde. São discutidos os elementos que permeiam a implementação das Residências Multiprofissionais em Saúde, como a concepção de atenção integral à saúde, o trabalho em equipe multiprofissional e a formação em serviço, além de questões relativas ao seu financiamento, à sua institucionalização e à sua inserção na Política Nacional de Educação Permanente em Saúde. As Residências Multiprofissionais em Saúde são consideradas como potenciais indutoras de transformação dos processos de educação e de trabalho vigentes na saúde, trazendo à discussão a importância de sua legitimação e consolidação como peça fundamental de uma política de formação voltada para o Sistema Único de Saúde. (AU)

The complex health demands of contemporary society require the construction of a professional profile and a more integrated health workforce. Interprofessional Education (IPE) for patient-centered collaborative practice has been globally recognized as a strategy capable of fostering changes in training and improving health outcomes. Guided by the teaching-service-community integration and training for teamwork, seeking to overcome the trend of isolated and fragmented professional performance, the Multiprofessional Residency in Health (RMS) constitutes a modality of in-service education that favors the development of interprofessionals collaborative skills. This thesis aimed to analyze the educational context of RMS programs from the perspective of EIP and collaborative practices in health. For this, a multi-method, exploratory and descriptive study of multiple cases was carried out between March and November 2020, with 86 actors from three RMS programs in the city of Rio de Janeiro. Data were collected through bibliographic research on the theme of EIP in the RMS; documentary analysis of the political-pedagogical projects (PPP) of the programs; online survey and application of the Jefferson Scale of Attitudes Related to Interprofessional Collaboration (EJARCI) to residents and tutors; and semi-structured online interviews with course coordinators. The analysis and combination of data were guided by the theoretical-methodological framework of the EIP. The publications found in the bibliographic research are mostly experience reports that evaluated the impacts of adopting EIP strategies, studies on the perception of residents about interprofessional performance, and PPP analyses. From the documental analysis, it was verified that the PPP of the three RMS programs are close to the EIP precepts, but they do not present a standardized structure oriented to the development of interprofessional competences. The EJARCI analysis showed a favorable attitude towards the interprofessional collaboration of all actors, with no statistical differences between the studied variables. The survey and interviews indicated that the RMS are configured as powerful educational scenarios for the acquisition of collaborative skills, as they promote communication and knowledge exchange between different professionals from integrative activities and contextual teaching methodologies that aim care integrality. The barriers that limit the success of EIP in the RMS could be mitigated through the qualification of teachers and tutors, reorganization of the workload of residents, deepening the use of interactive methodologies, greater interaction with medical residency, and diversification of scenarios and activities that promote interprofessional integration. (AU)