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[PMID]:29506509
[Au] Autor:Zhang Z; Zhou M; Liu K; Zhu B; Liu H; Sun X; Xu X
[Ad] Endereço:Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, China.
[Ti] Título:Development of a new valid and reliable microsurgical skill assessment scale for ophthalmology residents.
[So] Source:BMC Ophthalmol;18(1):68, 2018 Mar 05.
[Is] ISSN:1471-2415
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: More and more concerns have been arisen about the ability of new medical graduates to meet the demands of today's practice environment. In this study, we wanted to develop a valid, reliable and standardized assessment tool for evaluating the basic microsurgical skills of residents in a microsurgery laboratory, to get them well prepared before entering the surgical realm of ophthalmology. METHODS: Twenty-three experts who have teaching experience reviewed the assessment scale. Constructive comments were incorporated to ensure face and content validity. Twenty-one attendings from different specialties then graded eight corneal rupture suturing videos with the scale to investigate interrater reliability. Fourteen of them graded the same videos 3 months later to investigate intrarater reliability (repeatability). RESULTS: A total of 280 assessment scales were completed. All the ICC values of interrater reliability were greater than 0.8 with 75% data greater than 0.9 (range 0.860-0.976). All the ICC values of intrarater reliability (repeatability) were also greater than 0.8 with 63% data greater than 0.9 (range 0.833-0.954). CONCLUSIONS: The assessment scale we developed is valid and reliable. This tool could be useful to ensure that junior residents achieve a certain level of microsurgical technique in a laboratory environment before training in the operation room. Hopefully, this tool will provide a structured template for other residency programs to assess their residents for basic microsurgical skills.
[Mh] Termos MeSH primário: Competência Clínica/normas
Avaliação Educacional/métodos
Internato e Residência
Microcirurgia/educação
Procedimentos Cirúrgicos Oftalmológicos/educação
Oftalmologia/educação
Técnicas de Sutura/educação
[Mh] Termos MeSH secundário: Lesões da Córnea/cirurgia
Seres Humanos
Reprodutibilidade dos Testes
Inquéritos e Questionários
[Pt] Tipo de publicação:JOURNAL ARTICLE; VALIDATION STUDIES
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180311
[Lr] Data última revisão:
180311
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180307
[St] Status:MEDLINE
[do] DOI:10.1186/s12886-018-0736-z


  2 / 41300 MEDLINE  
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[PMID]:28460596
[Au] Autor:Cerrone SA; Adelman P; Akbar S; Yacht AC; Fornari A
[Ad] Endereço:a Internal Medicine , Northwell Health , Manhasset , NY , USA.
[Ti] Título:Using Objective Structured Teaching Encounters (OSTEs) to prepare chief residents to be emotionally intelligent leaders.
[So] Source:Med Educ Online;22(1):1320186, 2017.
[Is] ISSN:1087-2981
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Chief Residents must lead, manage and mentor a diverse and often large group of residents, however there is a lack of formal leadership training throughout graduate medical education. OBJECTIVE: Development of a 3-part Chief Resident (CR) Program focused on leading, managing and mentoring. DESIGN: Each participant completes an Emotional Intelligence (EI) Inventory prior to the day-long event. Participants receive their EI scores at the beginning of the program, which features interactive sessions on leadership, management, and feedback skills. The program then reinforces the application of their new knowledge about EI through a four station OSTE (Observed Structured Teaching Encounter). CRs practice feedback and coaching skills in a simulated environment where they need to provide the context of formative feedback to a standardized resident. RESULTS: The aggregated mean pre-session EI score for all participants was 76.9 (an ideal score is >85). An independent-samples t-test compared the CRs' leadership and feedback performance on their first and second OSTE performance within a single afternoon session. There was a significant difference between the first OSTE performance (M = 47.92, SD = 7.8) and the second OSTE performance (M = 51.22, SD = 6.9); t (68) = 1.99, p = 0.006. These results suggest that participating in multiple OSTEs positively reinforces the core interpersonal and communication skills discussed in the didactic and practiced in the interactive portions of the program. CONCLUSION: The low mean pre-session EI score achieved by our participants supports the idea that CRs enter their new roles with a level of EI that can be enhanced. CRs had an overall positive reaction to EI and its application to the core skills addressed in the program, highlighting the fact that similar programs could be used to train early career physicians to be more skilled and comfortable with leading, managing and mentoring. ABBREVIATIONS: CR: Chief resident; EI: Emotional intelligence; GME: Graduate medical education; OSTE: Objective structured teaching encounter.
[Mh] Termos MeSH primário: Educação de Pós-Graduação em Medicina/métodos
Inteligência Emocional
Internato e Residência/métodos
Liderança
Médicos/psicologia
[Mh] Termos MeSH secundário: Competência Clínica
Currículo
Avaliação Educacional
Seres Humanos
Mentores
Ensino
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170503
[St] Status:MEDLINE
[do] DOI:10.1080/10872981.2017.1320186


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[PMID]:29231639
[Au] Autor:Hunnålvatn KH; Ivan D; Wisborg T
[Ti] Título:Emergency medicine in the general practice internship in Finnmark county.
[Ti] Título:Akuttmedisinsk turnusarbeid i Finnmark..
[So] Source:Tidsskr Nor Laegeforen;137(23-24), 2017 12 12.
[Is] ISSN:0807-7096
[Cp] País de publicação:Norway
[La] Idioma:eng; nor
[Ab] Resumo:BACKGROUND: It is preferred that duty doctors in municipal health services participate in call-outs in emergency situations. The frequency of participation has previously been shown to vary. We wanted to examine the newly qualified doctors' expectations and experiences ­ both before and after the general practice internship ­ of emergency medicine and ambulance call-outs. MATERIAL AND METHOD: All 23 of the interns who were to undertake their general practice internship in Finnmark county in the period 2015­16 answered a questionnaire and participated in a focus group interview before the start of the internship. Twenty-one of the interns participated in the focus group interview after completing the internship. Each doctor took part in two interviews. We analysed the transcripts from the focus group interviews using the grounded theory method. RESULTS: The responses from the questionnaire before the general practice internship showed that the interns felt they needed more training in intravenous cannulation and in teamwork. Their expectations in connection with the challenges of call-outs are best characterised by the core category 'Can I do anything useful?' from the focus groups before the internship. After the internship, however, the core category 'It all went well in the end', was the best fit. Due to short transport times and their knowledge of certain patients, some of the doctors chose not to take part in call-outs. INTERPRETATION: During the general practice internship, the interns were initially anxious about whether they might be superfluous in call-outs, but eventually found their footing in the call-out role. The study shows that there is a need for more practice in certain practical procedures, and that doctors' non-technical skills need to be improved. This can be done through training in team leader roles before the general practice internship.
[Mh] Termos MeSH primário: Serviços Médicos de Emergência
Medicina Geral/educação
Internato e Residência
Papel do Médico/psicologia
[Mh] Termos MeSH secundário: Ambulâncias
Atitude do Pessoal de Saúde
Competência Clínica
Grupos Focais
Seres Humanos
Noruega
Equipe de Assistência ao Paciente
Inquéritos e Questionários
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171213
[St] Status:MEDLINE
[do] DOI:10.4045/tidsskr.17.0160


  4 / 41300 MEDLINE  
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[PMID]:29466595
[Au] Autor:Rosenberg LB
[Ad] Endereço:Division of Geriatrics and Palliative Care, Massachusetts General Hospital, Boston, Massachusetts.
[Ti] Título:A Teaching Case.
[So] Source:JAMA;319(7):657-658, 2018 Feb 20.
[Is] ISSN:1538-3598
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Medicina Paliativa/educação
Relações Médico-Paciente
Doente Terminal
[Mh] Termos MeSH secundário: Seres Humanos
Medicina Interna/educação
Internato e Residência
Masculino
Cuidados Paliativos
[Pt] Tipo de publicação:JOURNAL ARTICLE; PERSONAL NARRATIVES
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180302
[Lr] Data última revisão:
180302
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180222
[St] Status:MEDLINE
[do] DOI:10.1001/jama.2018.0071


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[PMID]:28453424
[Au] Autor:Patel RR; Ravichandran S; Doering MM; Hardi AC
[Ad] Endereço:a Washington University School of Medicine , St. Louis , Missouri , USA.
[Ti] Título:A Multicomponent Library Resource Model to Enhance Academic Global Health Education Among Residency Programs.
[So] Source:Med Ref Serv Q;36(2):120-128, 2017 Apr-Jun.
[Is] ISSN:1540-9597
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Global health is becoming an increasingly important component of medical education. Medical libraries have an opportunity to assist global health residents with their information needs, but first it is important to identify what those needs are and how best they can be addressed. This article reports a collaboration between global health faculty and an academic medical librarian to assess the information needs of global health pathway residents and how assessment data are used to create a multicomponent program designed to enhance global health education.
[Mh] Termos MeSH primário: Saúde Global/educação
Internato e Residência
[Mh] Termos MeSH secundário: Comportamento Cooperativo
Educação Médica
Seres Humanos
Bibliotecários
Bibliotecas Médicas
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180302
[Lr] Data última revisão:
180302
[Sb] Subgrupo de revista:H
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.1080/02763869.2017.1293971


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[PMID]:29292904
[Au] Autor:Arthur K; Westbeck E
[Ti] Título:Väntetiderna på AT rekordlånga i Stockholm ­ oansvarigt tycker Sylf..
[So] Source:Lakartidningen;114, 2017 10 31.
[Is] ISSN:1652-7518
[Cp] País de publicação:Sweden
[La] Idioma:swe
[Mh] Termos MeSH primário: Internato e Residência/recursos humanos
Internato e Residência/organização & administração
[Mh] Termos MeSH secundário: Seres Humanos
Suécia
Fatores de Tempo
[Pt] Tipo de publicação:LETTER
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180103
[St] Status:MEDLINE


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[PMID]:28462597
[Au] Autor:Dias RD; Scalabrini Neto A
[Ad] Endereço:a STRATUS Center for Medical Simulation , Brigham and Women's Hospital, Harvard Medical School , Boston , MA , USA.
[Ti] Título:Acute stress in residents during emergency care: a study of personal and situational factors.
[So] Source:Stress;20(3):241-248, 2017 May.
[Is] ISSN:1607-8888
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Providing care for simulated emergency patients may induce considerable acute stress in physicians. However, the acute stress provoked in a real-life emergency room (ER) is not well known. Our aim was to assess acute stress responses in residents during real emergency care and investigate the related personal and situational factors. A cross-sectional observational study was carried out at an emergency department of a tertiary teaching hospital. All second-year internal medicine residents were invited to voluntarily participate in this study. Acute stress markers were assessed at baseline (T1), before residents started their ER shift, and immediately after an emergency situation (T2), using heart rate, systolic, and diastolic blood pressure, salivary α-amylase activity, salivary interleukin-1 ß, and the State-Trait Anxiety Inventory (STAI-s and STAI-t). Twenty-four residents were assessed during 40 emergency situations. All stress markers presented a statistically significant increase between T1 and T2. IL-1 ß presented the highest percent increase (141.0%, p < .001), followed by AA (99.0%, p = .002), HR (81.0%, p < .001), DBP (8.0%, p < .001), and SBP (3.0%, p < .001). In the multivariable analysis, time of residency had a negative correlation with HR during the emergency (adjusted R-square = .168; F = 8.69; p = .006), SBP response (adjusted R-square = .210; F = 6.19; p = .005) and DBP response (adjusted R-square = .293; F = 9.09; p = .001). Trait anxiety (STAI-t) was positively correlated with STAI-s (adjusted R-square = .326; F = 19.9; p < .001), and number of procedures performed during emergency care had a positive association with HR response (adjusted R-square = .241; F = 5.02; p = .005). In the present study, emergency care provoked substantial acute stress in residents. Resident experience, trait anxiety, and number of emergency procedures were independently associated with acute stress response.
[Mh] Termos MeSH primário: Ansiedade/fisiopatologia
Pressão Sanguínea
Serviço Hospitalar de Emergência
Frequência Cardíaca
Internato e Residência
Estresse Ocupacional/fisiopatologia
Médicos/psicologia
Estresse Psicológico/fisiopatologia
[Mh] Termos MeSH secundário: Adulto
Ansiedade/metabolismo
Ansiedade/psicologia
Estudos Transversais
Emergências
Feminino
Seres Humanos
Interleucina-1beta/metabolismo
Medicina Interna/educação
Masculino
Estresse Ocupacional/metabolismo
Estresse Ocupacional/psicologia
Saliva/química
alfa-Amilases Salivares/metabolismo
Estresse Psicológico/metabolismo
Estresse Psicológico/psicologia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Interleukin-1beta); EC 3.2.1.1 (Salivary alpha-Amylases)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180228
[Lr] Data última revisão:
180228
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170503
[St] Status:MEDLINE
[do] DOI:10.1080/10253890.2017.1325866


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[PMID]:28449612
[Au] Autor:Schattner A
[Ad] Endereço:a The Faculty of Medicine , Hadassah Medical School, Hebrew University , Jerusalem , Israel.
[Ti] Título:Residents' responsibilities: Adopting a wider view.
[So] Source:Med Teach;39(12):1286-1289, 2017 Dec.
[Is] ISSN:1466-187X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Current ACGME regulations have limited residents' weekly hours and continuous working hours, a marked change, despite its uncertain effects on physician well-being and quality of care. Although residency programs in internal medicine and family medicine have adapted schedules to conform to these regulations, increasing evidence is accumulating to suggest that these training experiences are not adequately preparing the next generation of practicing primary care and hospital-based physicians. Data from an array of sources continue to demonstrate significant deficiencies in six areas of residents' responsibilities towards their patients: diminished patient "face time" and direct patient care; focus on patients' "reason for hospitalization" or "reason for visit" at the expense of possible neglect of patients' "secondary" medical problems; limited attention to patients' emotional or contextual problems and limited empathy; deficient implementation of the essential constituents of patient-centered care; neglect of habitual "reflective practice"; and excessive distinction between inpatient and outpatient responsibilities, leading to missed opportunities for inpatient residents to be aware of and attend to patients' post-discharge course although new information and readmissions related to the index hospitalization are prevalent. Thus, redesigning residency programs to widen residents' outlook and cover these inseparable components of high-quality care, may infuse the often fatigued and burnt-out residents with purpose and fulfillment, finally incorporating the missing elements of patient-centered care as integral parts of patients' admissions and therefore, of physicians' future careers.
[Mh] Termos MeSH primário: Competência Clínica
Empatia
Internato e Residência/organização & administração
Assistência Centrada no Paciente/organização & administração
Estudantes de Medicina/psicologia
[Mh] Termos MeSH secundário: Emoções
Seres Humanos
Internato e Residência/normas
Alta do Paciente
Assistência Centrada no Paciente/normas
Admissão e Escalonamento de Pessoal
Qualidade da Assistência à Saúde/organização & administração
Fatores de Tempo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180228
[Lr] Data última revisão:
180228
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.1080/0142159X.2017.1319916


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[PMID]:29195003
[Au] Autor:Daily JA; Bolin E; Eble BK
[Ad] Endereço:Arkansas Children's Hospital, Little Rock, Arkansas, USA.
[Ti] Título:Teaching pediatric cardiology with meaning and sense.
[So] Source:Congenit Heart Dis;13(1):154-156, 2018 Jan.
[Is] ISSN:1747-0803
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Pediatric cardiologists teach complicated concepts to a diverse group of learners that include medical students, nurses, residents, fellows, patients, and parents. Unfortunately, much of what is taught is not retained. In order to increase the likelihood of long-term retention, a cardiologist should teach with both meaning and sense. The authors provide a review of these concepts and give specific examples of how to teach in ways that both make sense and are meaningful to a cardiologist's leaners.
[Mh] Termos MeSH primário: Cardiologia/educação
Competência Clínica
Currículo/normas
Internato e Residência
Pediatria/educação
Estudantes de Medicina
Ensino/normas
[Mh] Termos MeSH secundário: Criança
Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180219
[Lr] Data última revisão:
180219
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171202
[St] Status:MEDLINE
[do] DOI:10.1111/chd.12561


  10 / 41300 MEDLINE  
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[PMID]:29373781
[Au] Autor:Driver R; Grose B; Serafini M; Cottrell S; Sizemore D; Vallejo M
[Ti] Título:A Focused Observation Tool Using Dreyfus Stages of Skill Acquisition as an Evaluative Scale.
[So] Source:W V Med J;113(2):36-41, 2017 Mar-Apr.
[Is] ISSN:0043-3284
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Focused Observartion (FO) is associated with assessing complex skills and differs from generalized observations and evaluations. We've developed a FO assessing clinical procedural skills using Hubert Dreyfus Stages of Skill Acquisition as descriptive anchors. This study sought to analyze the effectiveness of this measure of skill progression. During week 1 and week 4 of training, FO was performed repetitively on 6 residents during endotracheal intubation. Skill stage ratings were converted to numerical scores. A dependent, paired samples t-test was calculated using total mean score (dependent variable) and an effect size. (Cohen's d) was performed to ascertain the standardized mean difference between observations. A significant improvement in mean scores occurred between Week 1 (AVG 1.2, STDV ± 0.1) and Week 4 (AVG 2.0, STDV ± 0.1) (t= -3.9, p<.05) Calculated Chohen's d indicates that this difference was meaningful. This study demonstrates success in adapting a Focused Observation technique and an innovative evaluative scale based upon Dreyfus stages of skill acquisition.
[Mh] Termos MeSH primário: Competência Clínica/normas
Educação Baseada em Competências/métodos
Internato e Residência/normas
Intubação Intratraqueal/métodos
[Mh] Termos MeSH secundário: Educação Baseada em Competências/normas
Seres Humanos
Intubação Intratraqueal/normas
West Virginia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180215
[Lr] Data última revisão:
180215
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180127
[St] Status:MEDLINE



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