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Passoni Lopes LC, Ferrazini RVS, Costa K, de Albuquerque WL, Carvalho C, Kwan J, David TKP, Chu S, Tempski PZ, de Arruda Martins M, Alencar JCG. Entrustable professional activities, emergency medicine and medical education: a systematic review. Int J Emerg Med 2024; 17:112. [PMID: 39237864 PMCID: PMC11375971 DOI: 10.1186/s12245-024-00699-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 08/26/2024] [Indexed: 09/07/2024] Open
Abstract
INTRODUCTION Entrustable professional activities (EPAs) are one way to assess competencies, and are designed to bridge the gap between theoretical competencies and real world clinical practice. AIMS This was a systematic review which aims to answer the question: "Which EPAs related to Emergency Medicine are described for medical schools?". METHODS We included original qualitative, interventional and observational studies (cross-sectional, case-control, and cohort studies) that described EPAs relevant to Emergency Medicine for Medical School. The search strategy was created using a combination of keywords and standardized index terms related to EPAs and Emergency Medicine. RESULTS The search strategy identified 991 citations. After screening the titles and abstracts, we identified 85 potentially relevant studies. After the full-text review, a total of 11 reports met the criteria for inclusion. CONCLUSION Recognizing a patient requiring urgent or emergent care and initiating evaluation and management is the most common EPA related to Emergency Medicine described at Medical Schools. Use of EPAs is associated with increased student satisfaction and improved competences. However, there is a lack of undergraduate EM specific EPAs being systematically developed and published, and this should be an area to be explored in future studies.
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Affiliation(s)
- Lucas Casagrande Passoni Lopes
- Faculdade de Medicina de Bauru, Universidade de São Paulo, 9-75, Doutor Octávio Pinheiro Brisolla, st, Bauru - São Paulo, 17012-901, Brazil.
| | - Rafael Vasconcelos Silva Ferrazini
- Faculdade de Medicina de Bauru, Universidade de São Paulo, 9-75, Doutor Octávio Pinheiro Brisolla, st, Bauru - São Paulo, 17012-901, Brazil
| | - Kessy Costa
- Faculdade de Medicina de Bauru, Universidade de São Paulo, 9-75, Doutor Octávio Pinheiro Brisolla, st, Bauru - São Paulo, 17012-901, Brazil
| | - Winicius Loureiro de Albuquerque
- Faculdade de Medicina de Bauru, Universidade de São Paulo, 9-75, Doutor Octávio Pinheiro Brisolla, st, Bauru - São Paulo, 17012-901, Brazil
| | - Clara Carvalho
- Emergency Medicine Department, Salvador University (UNIFACS), Salvador, Bahia, Brasil
| | - James Kwan
- Department of Emergency Medicine, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, 21 Lower Kent Ridge Road, Singapore, 119077, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, 11 Mandalay Road, Singapore, 308232, Singapore
| | - Teng Kuan Peng David
- Department of Emergency Medicine, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore
| | - Simon Chu
- Lyell McEwin Hospital Emergency Department, Elizabeth Vale, SA, Australia
- Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia
| | - Patricia Zen Tempski
- School of Medicine of University of São Paulo, São Paulo, Brazil
- Center for Development of Medical Education, São Paulo, Brazil
- Executive Secretary of Same (System of Accreditation of Medical School), São Paulo, Brazil
| | | | - Julio Cesar Garcia Alencar
- Faculdade de Medicina de Bauru, Universidade de São Paulo, 9-75, Doutor Octávio Pinheiro Brisolla, st, Bauru - São Paulo, 17012-901, Brazil
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Boğa E. The relationship between regional inequalities in the provision of emergency health services and other health services. Medicine (Baltimore) 2023; 102:e35930. [PMID: 37960727 PMCID: PMC10637487 DOI: 10.1097/md.0000000000035930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 10/12/2023] [Indexed: 11/15/2023] Open
Abstract
In this research, it was aimed to examine relationship between regional inequalities in the provision of emergency health services and other health services in Turkey. The values of the number of emergency services and the population per emergency service for the years 2002-2021 were taken from the most up-to-date database published by the Ministry of Health in 2022 and were chosen as the dependent variables of the study. The "regional price level indices for consumption expenditures (PLI)" and "gross domestic product per capita, Statistical Regions Level 2 (PcGDP)" data compiled by TURKSTAT were used as independent variables. Number of emergency stations were significantly correlated with TR31 (İzmir) (r = 0.903; P < .01), TR32 (Aydin, Denizli, Muğla) (r = 0.771; P < .01), TR42 (Kocaeli, Sakarya, Düzce, Bolu, Yalova) (r = -0.798; P < .01), TR62 (Adana, Mersin) (r = 0.837; P < .01), TR63 (Hatay, K.Maraş, Osmaniye) (r = -0.749; P < .01), TR72 (Kayseri, Sivas, Yozgat) (r = -0.719; P < .01), TR83 (Samsun, Tokat, Çorum, Amasya) (r = 0.873; P < .01), TRA2 (Ağri, Kars, Iğdir, Ardahan) (r = -0.873; P < .01), TRB2 (Van, Muş, Bitlis, Hakkari) (r = -0.736; P < .01), TRC2 (Şanliurfa, Diyarbakir) (r = 0.697; P < .01), and TRC3 (Mardin, Batman, Şirnak, Siirt) (r = 0.574; P < .01). In total, 11 of 26 were significantly correlated with inequalities. Although the number of emergency services has increased since 2002 and the population density per emergency room has tended to decrease, regional inequalities also have an impact on the delivery of emergency services today.
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Affiliation(s)
- Erkan Boğa
- Republic of Türkiye Ministry of Health Esenyurt Necmettin Kadioğlu Hospital, Istanbul, Türkiye
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Bierrenbach AL, Quintino ND, Moreira CHV, Damasceno RF, Nunes MDCP, Baldoni NR, de Oliveira da Silva LC, Ferreira AM, Cardoso CS, Haikal DS, Sabino EC, Ribeiro ALP, Oliveira CDL. Hospitalizations due to gastrointestinal Chagas disease: National registry. PLoS Negl Trop Dis 2022; 16:e0010796. [PMID: 36121897 PMCID: PMC9522308 DOI: 10.1371/journal.pntd.0010796] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 09/29/2022] [Accepted: 09/06/2022] [Indexed: 02/01/2023] Open
Abstract
OBJECTIVES Analyze the hospitalizations of patients admitted for Chagas disease with gastro-intestinal involvement (CD-GI) in the Brazilian Unified Health System, describe the epidemiological profile, mortality and costs. METHODS This is an observational study that uses secondary data from the National Hospital Information System (SIH-SUS) for the years 2017-2019. CD-GI admissions were defined by specific ICD-10 codes that identify the main diagnosis. RESULTS From 2017 to 2019, there were 4,407 hospitalizations for CD-GI in Brazil, considering only public hospitals and those associated with the SUS. This corresponds to an average of 1,470 hospitalizations per year, or 0.6 per 100,000 inhabitants, with significant regional variation. Hospitalizations increased with age and were slightly higher in men. More than 60% were emergencies and in 50% the procedure performed was surgical. The most used code was the one for megaesophagus followed by megacolon. In-hospital mortality was 5.8% and 17.2% went to intensive care units. The median cost was USD$ 553.15 per hospitalization, and an overall cost of USD$ 812,579.98 per year to the SUS budget. CONCLUSION The numbers, rates and costs presented here are possibly underestimated but they give us an idea of the overall profile of hospitalizations due to CD-GI, which are not rare and are related to significant in-hospital mortality. CD-GI is a neglected manifestation of a neglected disease.
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Oliveira IS, Tomazoni SS, Vanin AA, Araujo AC, de Medeiros FC, Oshima RKA, Costa LOP, Costa LDCM. Management of acute low back pain in emergency departments in São Paulo, Brazil: a descriptive, cross-sectional analysis of baseline data from a prospective cohort study. BMJ Open 2022; 12:e059605. [PMID: 35365544 PMCID: PMC8977796 DOI: 10.1136/bmjopen-2021-059605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To describe management strategies used in public emergency departments in a middle-income country for patients with acute non-specific low back pain. DESIGN A descriptive, cross-sectional analysis of baseline data from a prospective cohort study. SETTING AND PARTICIPANTS A study with 600 patients with low back pain presenting in four public emergency departments from São Paulo, Brazil was conducted. OUTCOME MEASURES Diagnostic tests, pharmacological interventions, and/or referral to other healthcare professionals were collected. Descriptive analyses were used to report all outcomes. RESULTS Of all patients, 12.5% (n=75) underwent some diagnostic imaging tests. Medication was administered to 94.7% (n=568) of patients. The most common medications were non-steroidal anti-inflammatory drugs (71.3%; n=428), opioids (29%; n=174) and corticosteroids (22.5%; n=135). Only 7.5% (n=45) of patients were referred to another type of care. CONCLUSION There is a need for research data on low back pain from middle-income countries. There was an acceptable rate of prescription for diagnostic imaging tests. However, there were high medication prescriptions and small rates of referrals to other healthcare services. Our findings indicate that there is still a need to implement best practices in the management of acute low back pain at public emergency departments in Brazil.
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Affiliation(s)
- Indiara Soares Oliveira
- Masters and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, Brazil
| | - Shaiane Silva Tomazoni
- Masters and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, Brazil
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Adriane Aver Vanin
- Masters and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, Brazil
| | - Amanda Costa Araujo
- Masters and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, Brazil
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