[What can we expect from continuing medical education? Myths and reality]

[Continuing training plan in a clinical management unit]

Continuing Care Unit (UCA) focused the attention of frail patients, polypathological patients and palliative care. UCA attend patients at home, consulting, day unit, telephone consulting and in two hospitals of the health area. From 2002 UCA began as a management unit, training has been a priority for development. Key elements include: providing education to the workplace, including key aspects of the most prevalent health care problems in daily work, directing training to all staff including organizational aspects of patient safety and the environment, improved working environment, development of new skills and knowledge supported by the evidence-based care for the development of different skills. The unit can be the ideal setting to undertake the reforms necessary conceptual training of professionals to improve the quality of care.

Medical education in Spain: current status and new challenges

As in other countries, medical education in Spain is structured across three distinct stages: undergraduate or basic medical education; postgraduate specialized training; and continuing medical education. The aim of this article is to give an overview of the current state of these three stages, discussing the strengths and weaknesses and the challenges facing each one in the coming years, and how Spain can look to the international community to support change. We suggest that the undergraduate medical education system should be adapted to Spain's new social requirements and requires to be increasingly aligned with postgraduate training. We suggest that continuing medical education should develop its Continuous Professional Development programmes to ensure the permanent competence of Spanish medical professionals. The European Higher Education arena, as defined by the Bologna Declaration, provides many opportunities as well as a challenging situation for improving any current weaknesses in the Spanish medical education system.

Continuing medical education and continuing medical education accreditation in Spain

Nearly all Spanish physicians are employed by public or private institutions, and employers are enabling the continuing medical education (CME) of physicians. In view of coexisting CME accreditation systems in Spain, we conclude that a common approach is needed. We recommend establishing formal relationships with American and European systems to ensure consistent accreditation and mutual recognition of CME credits and improvement in accreditation.

[Continuing education in primary care: the educational needs of its professionals]

OBJECTIVES

To find professionals' suggestions for training contents, the value they place on various options, the difficulties they detect for attending activities and their preferences for time-table and format of courses.

DESIGN

Cross-sectional, descriptive study.

SETTING

Primary Care Area 7 in Madrid.

PARTICIPANTS

Medical and office workers from the area (n=1,053).

MAIN MEASUREMENTS

An anonymous self-filled questionnaire.

RESULTS

39% replied (46% nurses; 42% administrative assistants, and 40% doctors). The subjects for courses most often requested by doctors were dermatology, minor surgery and radiology; by nurses, emergency, functional bandages and computer skills; and by administrative assistants, computers, management of health service delivery and Internet. The continuing education options valued most highly were courses/workshops in the area's continuing education programme, self-training sessions and rotations. The main difficulties for attending courses were the lack of budget for cover and time-tables outside working hours. 42% preferred mornings; and 35%, courses lasting more than 20 hours.

CONCLUSIONS

The training needs expressed by doctors and nurses are mainly clinical in content, whereas those of office staff are mainly computer-related. The most highly valued training options are the courses/workshops in the area's continuing education programme. The main difficulty for attending courses is the lack of cover for their job.

[What is the attitude of doctors to the current model of primary care?]

OBJECTIVES

To determine the attitude of doctors towards the current model of primary care and to calculate its relationship with social and demographic and/or work variables.

DESIGN

Multi-centre cross-sectional study.

SETTING

Health centres in Area II of the Murcia region. Participants. All general practitioners, family doctors and paediatricians in the health centres mentioned (54 in all).

MAIN MEASUREMENTS

The "Scale of attitudes towards the contents of primary health care" by Ballesteros et al. was used as the tool of evaluation. This scale provides both a total score and a specific score for each of its 7 dimensions.

RESULTS

In general, doctors' attitudes were favourable (4.1 points average out of 5). We found a less favourable attitude in the dimension "Inclusion of second-level professionals in primary care", with family doctors most in agreement. The professionals working in centres on the periphery and those without tenure had a more positive attitude towards the current model, for the remaining variables.

CONCLUSIONS

Understanding professionals' attitudes and the variables related to them may serve as a basis for designing intervention strategies aimed at improving the quality of primary care and for the positive evolution of professionals working in PC.