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Abramovich I, Crisan I, Sobreira Fernandes D, De Hert S, Lukic A, Norte G, Matias B, Majić M, Berger-Estilita J. Anaesthesia training designs across Europe: A survey-based study from the trainees committee of the European Society of Anaesthesiology and Intensive Care. Rev Esp Anestesiol Reanim (Engl Ed) 2024:S2341-1929(24)00074-X. [PMID: 38636795 DOI: 10.1016/j.redare.2024.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 08/13/2023] [Indexed: 04/20/2024]
Abstract
BACKGROUND Anaesthesiology training programs in Europe vary in duration, content, and requirements for completion. This survey-based study conducted by the Trainees Committee of the European Society of Anaesthesiology and Intensive Care explores current anaesthesia training designs across Europe. METHODS Between May and July 2018, we sent a 41-item online questionnaire to all National Trainee Representatives, members of the National Anaesthesiologists Societies Committee, and Council Representatives of the European Society of Anaesthesiology and Intensive Care (ESAIC) of all member countries. We cross-validated inconsistent data with different country representatives. RESULTS Forty-three anaesthesiologists from all 39 associated ESAIC countries completed the questionnaire. Results showed considerable variability in teaching formats, frequency of teaching sessions during training, and differences in assessments made during and at the end of training. The reported duration of training was 60 months in 59% (n = 23) of participating countries, ranging from 24 months in Russia and Ukraine to 84 months in the UK. CONCLUSION This study shows the significant differences in anaesthesiology training formats across Europe, and highlights the importance of developing standardised training programs to ensure a consistent level of training and to improve patient safety. This study provides valuable insights into European anaesthesia training, and underlines the need for further research and collaboration to improve requirements.
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Affiliation(s)
- I Abramovich
- Charité - Universitätsmedizin Berlin, Department of Anaesthesiology and Intensive Care Medicine (CCM/CVK), Berlin, Germany.
| | - I Crisan
- Universitätsspital Zürich, Department of Emergency Medicine, Zürich, Switzerland
| | - D Sobreira Fernandes
- Centro Hospitalario de Póvoa de Varzim y Vila de Conde, Póvoa de Varzim, Portugal
| | - S De Hert
- Department of Anaesthsiology and Peri-operative Medicine, Ghent University, Ghent, Belgium
| | - A Lukic
- Department of Anaesthesiology, Reanimateology and Intensive Care, General Hospital Varaždin, Varaždin, Croatia
| | - G Norte
- Department of Anaesthesiology, Centro Hospitalar Trás-os-Montes y Alto Douro, Vila Real, Portugal
| | - B Matias
- Department of Anaesthesiology, Centro Hospitalar de Setúbal, Setúbal, Portugal
| | - M Majić
- Department of Anaesthesiology and ICU, University Hospital Centre Zagreb, Zagreb, Croatia
| | - J Berger-Estilita
- Institute for Medical Education, University of Bern, Bern, Switzerland; Institute of Anaesthsiology and Intensive Care, Salemspital, Hirslanden Medical Group, Bern, Switzerland; CINTESIS - Center for Health Technology and Services Research, Faculty of Medicine, Porto, Portugal
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Garin N, Zarate-Tamames B, Jornet S, García EM, López-Gil MDM, Romero G, Del Estal J. Pharmaceutical care in respiratory diseases: Current situation and opportunities for Hospital Pharmacy in Spain. Farm Hosp 2024:S1130-6343(24)00026-6. [PMID: 38580504 DOI: 10.1016/j.farma.2024.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 01/10/2024] [Accepted: 02/13/2024] [Indexed: 04/07/2024] Open
Abstract
OBJECTIVE Respiratory diseases present a challenge for the healthcare system due to their prevalence and clinical impact. The aim of this study was to explore the current situation of hospital pharmacy in the field of respiratory diseases. METHOD Observational, cross-sectional study, with a national scope, divided into 2 parts. In an initial phase, the activity and level of pharmaceutical care in respiratory diseases was evaluated through an online questionnaire using REDCap. The survey was addressed to department chiefs and consisted of 17 items, divided into 2 modules: general data and general activity. The second phase was open to hospital pharmacists, with the aim of exploring their opinion on care, training, and improvement needs. The number of items in this phase was 19, divided into 5 modules: general data, pharmaceutical care, competencies, training and degree of satisfaction. RESULTS In the first phase, 23 hospitals were included. Most of them (n=20) had a pharmacist in charge of respiratory diseases. However, a large proportion of them dedicated less than 40% of their working day to this activity. The pharmacist's activity occurred at the level of external patients (n=20), hospitalized patients (n=16), and secondarily in management (n=8). Integration is greater in pathologies such as asthma, IPF, pulmonary hypertension, and bronchiectasis. Participation in committees was present in 15 hospitals, with variability in pathologies and degree of involvement. In the second phase, 164 pharmacists participated, who considered pharmaceutical care in cystic fibrosis, asthma and lung transplant as a priority. Fifty-one percent considered integration to be adequate and 91% considered it necessary to implement prioritization criteria. Professional competencies ranged from 6.5-6.9 out of 10 points. Only 45% of participants had received specific training in the last four years, indicating greater priority for asthma, pulmonary hypertension and IPF. CONCLUSIONS Most centers have pharmacists specialized in respiratory diseases. However, there is room for improvement in terms of sub specialization, participation in multidisciplinary committees, implementation of prioritization criteria, diversification in pathologies treated, as well as greater specific training in this area.
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Affiliation(s)
- Noé Garin
- Servicio de Farmacia, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, 08025, España.
| | - Borja Zarate-Tamames
- Servicio de Farmacia, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, 08025, España
| | - Sonia Jornet
- Servicio de Farmacia, Hospital Universitari Joan XXIII, Tarragona, España
| | - Eva María García
- Servicio de Farmacia, Hospital Universitario de Fuenlabrada, Fuenlabrada, España
| | | | - Gregorio Romero
- Servicio de Farmacia, Hospital de Hellin, Gerencia de Atención Integrada Hellín, Hellín, España
| | - Jorge Del Estal
- Servicio de Farmacia, Consorci Sanitari Parc Taulí, Sabadell, España
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Egea-Gámez RM, Galán-Olleros M, González-Menocal A, González-Díaz R. [Translated article] How do I plan adolescent idiopathic scoliosis surgery? Systematization of a preoperative planning method. Rev Esp Cir Ortop Traumatol (Engl Ed) 2024; 68:T73-T85. [PMID: 37981198 DOI: 10.1016/j.recot.2023.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 11/23/2022] [Indexed: 11/21/2023] Open
Abstract
Preoperative planning is essential in adolescent idiopathic scoliosis (AIS) surgery to determine the fusion levels and to perform the procedure with greater precision and diligence. However, the protocolized performance of such planning is not as widespread among specialists in training. The aim of this article is to describe in detail the preoperative planning method for AIS used in a specialised paediatric and adolescent spine unit of a referral centre, as well as the logistics and the tactics, supported a free semi-automatic digital measurement and planning software. Three representative cases of different vertebral deformities, treated by posterior spinal fusion after preoperative planning according to the method, are shown. This method is highly suitable for the trainee surgeon as it combines the advantages of traditional and modern methods, and is simple, low-cost, accessible, reproducible and with an educational character.
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Affiliation(s)
- R M Egea-Gámez
- Unidad de Raquis, Servicio de Cirugía Ortopédica y Traumatología, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - M Galán-Olleros
- Ortopedia Infantil, Servicio de Cirugía Ortopédica y Traumatología, Hospital Infantil Universitario Niño Jesús, Madrid, Spain.
| | - A González-Menocal
- Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario Infanta Elena, Madrid, Spain
| | - R González-Díaz
- Unidad de Raquis, Servicio de Cirugía Ortopédica y Traumatología, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
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Duque P, Varela JA, Garrido P, Valencia O, Terradillos E. Impact of prebriefing on emotions in a high-fidelity simulation session: A randomized controlled study. Rev Esp Anestesiol Reanim (Engl Ed) 2023; 70:447-457. [PMID: 37673209 DOI: 10.1016/j.redare.2022.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 05/06/2022] [Indexed: 09/08/2023]
Abstract
INTRODUCTION Medical simulation is associated with intense emotions which influence human behavior. We aim to investigate how prebriefing impacts on learners' emotions during a high-fidelity simulation (HFS) session. METHODS This is a prospective randomized controlled study. Participants were randomly allocated to receive a standardized prebriefing (SP group) versus not receiving it (NSP group). Debriefing following the «good judgment» approach, structured in reactions, understanding and summary phases, was used in both groups. In order to assess emotions, we used the circumplex model of affect applying the Affect Grid scale, which was performed prior to prebriefing, following case performance and following debriefing. Debriefing times were also assessed. RESULTS A total of 128 physicians participate in the study (64 vs. 64). Following case performance, this HFS session was experienced with significantly more pleasant emotions compared to baseline, that were maintained during debriefing (p < 0.01) while alertness increased after case performance diminishing after debriefing (p < 0.01). There were no statistical significant differences between groups. In the NSP group, total debriefing (p = 0.003) and understanding phase (p = 0.002) times were significantly longer. CONCLUSIONS This HFS session was experienced as pleasant with high alertness with no specific emotional impact attributable to prebriefing. Prebriefing leads to a freer flowing debriefing.
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Affiliation(s)
- P Duque
- Anesthesiology Department, Gregorio Marañon Hospital, Madrid, Spain.
| | - J A Varela
- Anesthesiology Department, Gregorio Marañon Hospital, Madrid, Spain
| | - P Garrido
- Anesthesiology Department, La Paz Hospital, Madrid, Spain
| | - O Valencia
- Anesthesiology Department, 12 de Octubre Hospital, Madrid, Spain
| | - E Terradillos
- Anesthesiology Department, Gregorio Marañon Hospital, Madrid, Spain
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Roldán Arcelus E, Teixeira Taborda A, Cutillas Ruiz R. [Survey on the state of investigation in rehabilitation in Spain: Results]. Rehabilitacion (Madr) 2023; 57:100812. [PMID: 37406425 DOI: 10.1016/j.rh.2023.100812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Revised: 01/04/2023] [Accepted: 01/15/2023] [Indexed: 07/07/2023]
Abstract
The research, training and innovation committee of the Spanish Society of Physical Medicine and Rehabilitation (SERMEF) wanted to know the state of research in our speciality. To this end, an online survey was developed and distributed among rehabilitation doctors in Spain, which obtained 253 responses. Of these, 65% stated that research activity in rehabilitation does take place in their work centre; the number of active projects in their centres as stated by them was: none in 35.7%; one in 17.7%, two in 23.3%, three in 8.4% and four or more in 14.9%. Among the main difficulties encountered, 89% highlight that there is no staff hired for research and 95% that in their centres part of the working day is not allocated to research. In terms of personal research activity, 56% reported that they were involved in research, with the most common role being that of principal investigator (58%). Ninety-five percent of respondents report that the main obstacle to developing a research project is the pressure of care and lack of time, and correspondingly, a large majority (83%) claim that having stipulated time for research in their working day would be a motivation.
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Affiliation(s)
- E Roldán Arcelus
- Servicio de Medicina Física y Rehabilitación, Complejo Hospitalario de Navarra, Pamplona, Navarra, España.
| | - A Teixeira Taborda
- Servicio de Medicina Física y Rehabilitación, Hospital Universitario Fundación Jiménez Diaz, Madrid, España
| | - R Cutillas Ruiz
- Servicio de Medicina Física y Rehabilitación, Hospital Universitario Fundación Jiménez Diaz, Madrid, España
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Pinés-Corrales PJ, Hanzu FA, Casañ Fernández R, Fernández Martínez A, Tejera Pérez C, Escalada San Martín FJ, Bretón Lesmes I. Survey on Endocrinology and Nutrition undergraduate teaching in Spain-2021. ENDOCRINOL DIAB NUTR 2023; 70 Suppl 3:36-49. [PMID: 37604746 DOI: 10.1016/j.endien.2023.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 05/10/2022] [Indexed: 08/23/2023]
Abstract
OBJECTIVES Advances in endocrinology and nutrition (E&N) and the importance of its associated disorders require that its teaching within the medical degree meets adequate standards of quality and homogeneity Our objective was to expand the data on E&N undergraduate teaching in Spain. METHODS We designed an observational, cross-sectional web-based study addressed to the coordinators of E&N teaching at the 42 faculties of medicine that had taught the subject during the 2020-2021 academic year. RESULTS One in three faculties had a professor who was an E&N specialist, but less than half had a full professor of E&N. There is great variability in teaching programmes, although most of them dedicate 6 ECTS credits to the subject. Over two-thirds of the faculties maintain theoretical lessons with over 50 students per class. Most programmes dedicate between four and six hours to hypothalamic pituitary disorders, thyroid diseases and adrenal gland disorders. However, there is great variability in the time dedicated to diabetes and nutrition. In one-third of the faculties, students are not required to do a rotation in the E&N department. Teachers at the universities widely participate in undergraduate/master's students' final projects and master's degree studies. CONCLUSIONS The E&N specialty maintains a good position within universities, but there is still great heterogeneity in the teaching structure of the subject.
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Affiliation(s)
| | | | | | | | | | - F Javier Escalada San Martín
- Clínica Universidad de Navarra, CIBER Pathophysiology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; Grupo de Obesidad y Adipobiología, Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
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González-Campo L, Vicente-Bártulos A, Gaetano-Gil A, Estelles-Lerga P, Pecharromán-de Las Heras I, Zamora J. Coronary computed tomography in emergencies: The importance of the radiologist's experience. Radiologia (Engl Ed) 2023; 65:298-306. [PMID: 37516483 DOI: 10.1016/j.rxeng.2023.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 07/19/2021] [Indexed: 07/31/2023]
Abstract
INTRODUCTION Incorporating coronary computed tomography angiography (CTA) in the hospital workup for suspected acute coronary syndrome requires appropriate skills for interpreting this imaging test. Radiologists' skills can affect the interobserver agreement in evaluating these studies. OBJECTIVE To determine the interobserver agreement according to radiologists' experience in the interpretation of coronary CTA studies done in patients who present at the emergency department with acute chest pain and low-to-intermediate probability of acute coronary syndrome. MATERIALS AND METHODS We studied the interobserver agreement in the urgent evaluation of coronary CTA studies in which CAD-RADS was used to register the findings. We created pairs of observers among a total of 8 assessors (4 attending radiologists and 4 radiology residents). We used the kappa coefficient to estimate the overall concordance and the concordance between subgroups according to their experience. RESULTS The agreement was substantial between experienced radiologists and residents (k=0.627; 95%CI: 0.436-0.826) as well as between all the pairs of observers (k=0.661; 95%CI: 0.506-0.823) for all the CAD-RADS together. The degree of agreement within the group of experienced radiologists was greater than that within the group of residents in all the analyses. The agreement was excellent for the overall CAD-RADS (k=0.950; 95% CI: 0.896-1) and for CAD-RADS ≥ 4 (k=1); the agreement was lower for CAD-RADS ≥ 3 (k=0.754; 95% CI: 0.246-1.255). The agreement for the residents for these categories was k=0.623, k=0.596, and k=0.473, respectively. CONCLUSION The agreement among attending radiologists regarding the assessment of urgent coronary CTA studies is excellent. The agreement is lower when residents are paired with attending radiologists. These findings should be taken into consideration when implementing coronary CTA in emergency departments and in the organisation of radiological staff for interpreting and reporting this imaging test.
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Affiliation(s)
- L González-Campo
- Servicio de Radiodiagnóstico, Hospital Universitario Ramón y Cajal, Madrid, Spain.
| | - A Vicente-Bártulos
- Servicio de Radiodiagnóstico, Hospital Universitario Ramón y Cajal, Madrid, Spain; CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - A Gaetano-Gil
- Unidad de Bioestadística Clínica, Hospital Ramón y Cajal (IRYCIS), Madrid, Spain
| | | | | | - J Zamora
- Unidad de Bioestadística Clínica, Hospital Ramón y Cajal (IRYCIS), Madrid, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; Institute of Applied Research, University of Birmingham, United Kingdom
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Benavides FG, Borrell C. [The need for university links for public health professionals]. Gac Sanit 2023; 37:102308. [PMID: 37285740 DOI: 10.1016/j.gaceta.2023.102308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 04/01/2023] [Indexed: 06/09/2023]
Abstract
There needs to be a bidirectional relationship between the public health profession and academia. This will enhance their professional practice and the academy will be able to carry out practice-based teaching and research. This field note explains a legislative advance in this direction. So that professionals from public health institutions can access permanent positions as university professors, as well as the professionals in the clinical field, we ask several deputies from some parliamentary groups of the Universities Commission to include a reform that modifies article 70 of the project of Organic Law of the University System (LOSU in Spanish acronym) with this possibility. Ultimately, LOSU was approved in March 2023 with the requested amendment, providing a great opportunity for both public health institutions and academia to advance a bidirectional relationship.
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Affiliation(s)
- Fernando G Benavides
- Máster y Diploma de Salud Pública, Departamento de Medicina y Ciencias de la Vida, Universitat Pompeu Fabra, Barcelona, España; CIBER de Epidemiología y Salud Pública (CIBERESP), España.
| | - Carme Borrell
- CIBER de Epidemiología y Salud Pública (CIBERESP), España; Agència de Salut Pública de Barcelona, Barcelona, España; Institut de Recerca Biomèdica Sant Pau (IIB Sant Pau), Barcelona, España
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García Blasco L, Pinés Corrales PJ, Hanzu F, Fernández Martínez A, Bretón Lesmes I, Escalada San Martín J. A survey on the perception of the specialty of Endocrinology and Nutrition among students preparing for the entrance exam for medical specialty training in Spain. ENDOCRINOL DIAB NUTR 2023; 70:240-244. [PMID: 37116969 DOI: 10.1016/j.endien.2023.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 01/08/2023] [Indexed: 04/30/2023]
Abstract
INTRODUCTION AND AIMS Previous studies have shown that there is decreasing interest in E&N among medical students. The aim of our study was to evaluate the perception of E&N among a sample of medical students. MATERIAL AND METHODS We surveyed 2252 students prior to taking the exam that allows access to specialised training in Spain. RESULTS Overall, 9.9% (222 participants) would probably choose E&N. The most positive aspects in includes of the specialty are its logical pathophysiological basis (54%) and that the work is dynamic and varied (27%), while the least attractive aspects are the few interventional techniques. The parts of the specialty that most attract students are hypothalamic-pituitary disease and diabetes mellitus. CONCLUSIONS The proportion of candidates who want to study E&N as their first choice is adequate in relation to the number of places available.
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Affiliation(s)
- Lourdes García Blasco
- Complejo Hospitalario Universitario de Albacete [University Hospital Complex of Albacete], Spain.
| | - Pedro J Pinés Corrales
- Complejo Hospitalario Universitario de Albacete [University Hospital Complex of Albacete], Spain
| | - Felicia Hanzu
- Hospital Universitari Clínic de Barcelona [Clinical University Hospital of Barcelona], Spain
| | | | - Irene Bretón Lesmes
- Hospital General Universitario Gregorio Marañón [Gregorio Marañón General University Hospital], Spain
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Llorente-Ortega M, Polo R, Chiva S, Martín-Calvo N, Sáenz-Santa-María E, Diez-Caballero F, Fernandez S. The development and validation of a new simulator for endourology. Actas Urol Esp 2023; 47:236-243. [PMID: 36731822 DOI: 10.1016/j.acuroe.2023.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 12/22/2022] [Accepted: 12/23/2022] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Simulation in medicine has developed a lot in the last few decades. There is a broad range of simulators available, above all for training in surgical procedures. Endourology can benefit much from simulation because the minimally-invasive procedures of endourology frequently have long learning curves, which can be reduced by training with simulators. MATERIALS AND METHODS A low-fidelity simulator was designed for practicing endourology techniques that use cystoscopy. The process of validation involved 5 experts and 19 non-experts. Experts comprised medical professionals working in a department of urology who had performed at least 100 flexible cystoscopy procedures. Non-experts were residents in internal medicine without experience in any type of endoscopy. Information about face and content validity was collected by means of Likert scales from 1 to 5. To evaluate construct validity, we measured the time to complete two tasks, for which the procedure was evaluated by means of the OSATS global evaluation scale. RESULTS New simulator was successfully built according to its design. For all evaluated aspects of construct validity, there was a significant difference (p<0.05) between the group of experts and the group of non-experts. Content validity was scored 4.66 (standard deviation ±0.56) by the experts and 4.41 (±0.71) by the non-experts. In the face validity questionnaire, the average score was 4.14 (±0.94), the question receiving the highest score: 4.6 (±0.84) concerned immersion in the procedure. CONCLUSION The simulator presented is valid both for training up new urologists in endourology technique and for experts seeking to perfect their skills.
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Affiliation(s)
- M Llorente-Ortega
- Medical Engineering Laboratory, School of Medicine, Universidad de Navarra, Pamplona, Spain
| | - R Polo
- Faculty of Medicine, Universidad de Navarra, Pamplona, Spain
| | - S Chiva
- Department of Urology, Clínica Universidad de Navarra, Pamplona, Spain
| | - N Martín-Calvo
- Faculty of Medicine, Department of Preventive Medicine and Public Health, Universidad de Navarra, Pamplona, Spain, CIBER-obn, Instituto Salud Carlos III, IdiSNA, Institute of Health Research of Navarra, Madrid, Spain
| | - E Sáenz-Santa-María
- Medical Engineering Laboratory, School of Medicine, Universidad de Navarra, Pamplona, Spain
| | - F Diez-Caballero
- Department of Urology, Clínica Universidad de Navarra, Pamplona, Spain
| | - S Fernandez
- Medical Engineering Laboratory, School of Medicine, Universidad de Navarra, Pamplona, Spain.
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11
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Díez JJ, Iglesias P, Gómez-Mateos MÁ. Educational and research needs in hypothyroidism of primary care physicians in the Community of Madrid. ENDOCRINOL DIAB NUTR 2022; 69:828-836. [PMID: 36470819 DOI: 10.1016/j.endien.2022.11.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 10/24/2021] [Indexed: 06/17/2023]
Abstract
AIM To document the opinion of primary care physicians on hypothyroidism and explore their educational and research needs. METHODS A web-based survey was released through Healthcare Management offices in Madrid to be answered anonymously by the doctors at the health centers. RESULTS Five hundred and forty-six out of 3897 (14%) physicians completed the survey. More than 90% of respondents agreed that hypothyroidism is a common and easily managed health problem and that its poor control increases healthcare costs. This percentage was higher in older doctors and those with longer professional experience. 88.1% of respondents showed interest in educational activities (86.6% in receiving and 20.9% in providing education). The preference for clinical sessions in the health center (71.5%) exceeded that of sessions in the hospital (20.2%), while the preference for online courses (67.8%) exceeded that of face-to-face courses (50.9%). 53.5% of interviewees expressed interest in research on hypothyroidism. Women and professionals with a higher number of hypothyroid patients under their care were more likely to be interested in educational and research activities. CONCLUSION Primary care physicians in the Community of Madrid are aware of the health problem posed by thyroid hormone deficiency and are clearly in favour of participating in educational and research activities in this area of knowledge.
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Affiliation(s)
- Juan J Díez
- Servicio de Endocrinología y Nutrición, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain; Instituto de Investigación Sanitaria Puerta de Hierro Segovia de Arana, Majadahonda, Madrid, Spain; Departamento de Medicina, Universidad Autónoma de Madrid, Madrid, Spain.
| | - Pedro Iglesias
- Servicio de Endocrinología y Nutrición, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain; Instituto de Investigación Sanitaria Puerta de Hierro Segovia de Arana, Majadahonda, Madrid, Spain
| | - María Ángeles Gómez-Mateos
- Instituto de Investigación Sanitaria Puerta de Hierro Segovia de Arana, Majadahonda, Madrid, Spain; Dirección Médica, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
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Vara-Ortiz MÁ, Fabrellas Padrés N. [Impact of training and legal aspects on the application of nurse demand management by primary care nurses in Catalonia]. Aten Primaria 2022; 54:102491. [PMID: 36272398 PMCID: PMC9586855 DOI: 10.1016/j.aprim.2022.102491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 09/16/2022] [Accepted: 09/28/2022] [Indexed: 12/02/2022] Open
Abstract
Objetivo Conocer la experiencia de las enfermeras de atención primaria en la aplicación de la gestión enfermera de la demanda (GED). Diseño Estudio observacional, descriptivo y transversal. Emplazamiento Atención primaria de Cataluña. Participantes Enfermeras de atención primaria de Cataluña. Se estimó una muestra de 394 participantes alcanzando 405. La obtención de datos fue desde octubre de 2021 hasta enero de 2022. Mediciones principales Se realizó un cuestionario ad hoc, el cual exploraba aspectos referentes a la experiencia de aplicación de la GED: definición y manejo del programa, formación y aspectos legales del programa. Resultados Las enfermeras entienden la GED como un triaje. Además, consideran que la implantación de la prescripción enfermera no mejora la aplicación de la GED. Manifiestan una falta de formación especialmente las enfermeras más noveles. La formación ideal en GED, consideran, debería incluir fisiopatología y supuestos prácticos. Siete de cada 10 enfermeras desconocen el marco legal que ampara la GED y les provoca inseguridad no conocerlo. Seis de cada 10 han dejado de ser resolutivas por miedo a las repercusiones legales. Las enfermeras que sí conocen el marco legal son las que han dejado de resolver en menor proporción. Conclusiones Se constata la necesidad de formación general en la GED y en los aspectos legales que dan cobertura al programa especialmente en las enfermeras más jóvenes y con menos experiencia en atención primaria. De esta manera se mejorará la aplicación y aceptación del rol autónomo enfermero en la gestión de enfermedades agudas leves.
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Affiliation(s)
- María Ángeles Vara-Ortiz
- Escola d'Infermeria, Universitat de Barcelona, Hospitalet de Llobregat, Barcelona, España; Centro de Atención Primaria Barri Llatí, Santa Coloma de Gramenet, Barcelona, España.
| | - Núria Fabrellas Padrés
- Escola d'Infermeria, Universitat de Barcelona, Hospitalet de Llobregat, Barcelona, España
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Hernández López M, Puentes Gutiérrez AB, García Bascones M, Fernández García L, Pérez Novales D, Marquina Valero MA. [Strength training education for physicians increases its prescription]. Rehabilitacion (Madr) 2022; 56:274-278. [PMID: 35469644 DOI: 10.1016/j.rh.2021.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Revised: 08/16/2021] [Accepted: 10/23/2021] [Indexed: 06/14/2023]
Abstract
INTRODUCTION Medical prescriptions have traditionally been focused on aerobic exercise. However, an increasing number of authors are pointing towards strength training as the healthiest exercise modality. The purpose of this study is to assess whether physicians increase their knowledge as well as their confidence to prescribe strength training after attending a physical training course. MATERIALS AND METHODS A prospective cohort study of 160 physicians was conducted, 80 physicians out of the 160 attended a physical training course, whereas the remaining 80 physicians did not. Personal and professional data was collected, as well as data regarding the type of exercise they were practising or prescribing and the confidence and knowledge for their prescription. Finally, differences between the two groups and the impact of attending the course where analysed. RESULTS Both groups were homogeneous in gender, age, medical speciality and practice of physical exercise, with very low rates of strength training and prescription for both groups. It was established that the group attending the course acquired knowledge and confidence for prescribing strength training. Moreover, this group considered that strength training was the exercise modality which should be encouraged (P<.001). CONCLUSIONS Education in strength training for physicians by means of a theoretical-practical course increases knowledge and confidence for its prescription.
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Affiliation(s)
- M Hernández López
- Servicio de Medicina Física y Rehabilitación, Complejo Hospitalario Universitario de Toledo, Toledo, España.
| | - A B Puentes Gutiérrez
- Servicio de Medicina Física y Rehabilitación, Complejo Hospitalario Universitario de Toledo, Toledo, España
| | - M García Bascones
- Servicio de Medicina Física y Rehabilitación, Complejo Hospitalario Universitario de Toledo, Toledo, España
| | - L Fernández García
- Servicio de Medicina Física y Rehabilitación, Complejo Hospitalario Universitario de Toledo, Toledo, España
| | - D Pérez Novales
- Servicio de Medicina Física y Rehabilitación, Complejo Hospitalario Universitario de Toledo, Toledo, España
| | - M A Marquina Valero
- Servicio de Medicina Física y Rehabilitación, Complejo Hospitalario Universitario de Toledo, Toledo, España
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Castellanos-Ortega Á, Broch MJ, Palacios-Castañeda D, Gómez-Tello V, Valdivia M, Vicent C, Madrid I, Martinez N, Párraga MJ, Sancho E, Fuentes-Dura MDC, Sancerni-Beitia MD, García-Ros R. Competency assessment of residents of Intensive Care Medicine through a simulation-based objective structured clinical evaluation (OSCE). A multicenter observational study. Med Intensiva 2022; 46:491-500. [PMID: 36057440 DOI: 10.1016/j.medine.2022.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 01/22/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVES The current official model of training in Intensive Care Medicine (ICM) in Spain is based on exposure to experiences through clinical rotations. The main objective was to determine the level of competency (I novice to V independent practitioner) achieved by the residents at the end of the 3rd year of training (R3) in ICM through a simulation-based OSCE. Secondary objectives were: (1) To identify gaps in performance, and (2) To investigate the reliability and feasibility of conducting simulation-based assessment at multiple sites. DESIGN Observational multicenter study. SETTING Thirteen Spanish ICU Departments. PARTICIPANTS Thirty six R3. INTERVENTION The participants performed on five, 15-min, high-fidelity crisis scenarios in four simulation centers. The performances were video recorded for later scoring by trained raters. MAIN VARIABLES OF INTEREST Via a Delphi technique, an independent panel of expert intensivists identified critical essential performance elements (CEPE) for each scenario to define the levels of competency. RESULTS A total of 176 performances were analyzed. The internal consistency of the check-lists were adequate (KR-20 range 0.64-0.79). Inter-rater reliability was strong [median Intraclass Correlation Coefficient across scenarios: 0.89 (0.65-0.97)]. Competency levels achieved by R3 were: Level I (18.8%), II (35.2%), III (42.6%), IV/V (3.4%). Overall, a great heterogeneity in performance was observed. CONCLUSION The expected level of competency after one year in the ICU was achieved only in half of the performances. A more evidence-based educational approach is needed. Multiple center simulation-based assessment showed feasibility and reliability as an evaluation method of competency. TRIAL REGISTRATION COBALIDATION. NCT04278976. (https://register. CLINICALTRIALS gov).
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Affiliation(s)
- Á Castellanos-Ortega
- Intensive Care Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - M J Broch
- Intensive Care Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | | | - V Gómez-Tello
- Intensive Care Department, University Hospital Moncloa, Madrid, Spain
| | - M Valdivia
- Intensive Care Department, Hospital Puerta de Hierro-Majadahonda, Spain
| | - C Vicent
- Intensive Care Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - I Madrid
- Intensive Care Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - N Martinez
- Intensive Care Department, Hospital Puerta de Hierro-Majadahonda, Spain
| | - M J Párraga
- Intensive Care Department, Hospital Universitario Morales Meseguer, Murcia, Spain
| | - E Sancho
- Intensive Care Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - M D C Fuentes-Dura
- Department of Methodology of the Behavioral Sciences, University of Valencia, Spain
| | - M D Sancerni-Beitia
- Department of Methodology of the Behavioral Sciences, University of Valencia, Spain
| | - R García-Ros
- Department of Developmental and Educational Psychology, University of Valencia, Spain.
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Sánchez-Gómez S, Maza-Solano JM, López Flórez L, Parente Arias P, Lobo Duro D, Palacios-García JM. Impact of the COVID-19 pandemic on the training of otorhinolaryngology residents. Acta Otorrinolaringol Esp (Engl Ed) 2022; 73:235-245. [PMID: 35868611 PMCID: PMC9295374 DOI: 10.1016/j.otoeng.2021.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 09/25/2021] [Indexed: 11/27/2022]
Abstract
Background and objectives Training in surgical specialties has declined during the COVID-19 pandemic. A study was carried out to further analyze the impact of the COVID-19 pandemic on specific aspects of clinical, training, and research activities performed by the otolaryngology residents in Spain. Methods A cross-sectional qualitative study was conducted during the last two weeks of February 2021. The study consisted of an online survey taken by otolaryngology residents who had undertaken one-year continuing training from February 15, 2020, to February 15, 2021, and consisted of 26 questions exploring the impact of the COVID-19 on the health of the ENT residents and training activities. Categorical variables were reported as frequency and percentage. When indicated, Pearson’s Chi-square test (χ2) with Yates’s correction and Pearson's correlation coefficient (r) were used. Results 143 completed surveys were received from 264 Residents (54.17%). 36 residents (25.2%) have suffered from the disease due to SARS-CoV-2. Most of them only developed mild symptoms (86.1%), with 3 requiring hospitalisation (8.3%). The origin of infection was unknown in all reported cases and the need for confinement was principally due to either attending an asymptomatic patient in 9 cases (6.3%) or to being supposedly in close contact with an asymptomatic person in 22 (15.4%). 60.1% of the residents surveyed reported having lost more than 6 months of their training period, and in 18.8% of cases, it was as high as 10 and 12 months. There has been a reduction of more than 75% of what was planned in surgical training (p < 0.05) of tympanoplasty, mastoidectomy, stapedectomy, cochlear implants, endoscopic sinonasal and anterior skull base surgery, septoplasty and turbinoplasty. Conclusions The decline in ENT activity and residents having to assist in other COVID-19 units during the most critical moments of the pandemic, has caused the main reduction in their training capacity. Contagion mainly occurred through contact with asymptomatic carriers during patient care and through supposedly close contact with asymptomatic carriers. Virtual activities have been widely accepted, but they have not completely replaced all residents’ training needs. Measures should be implemented to recover lost training, especially surgical practical learning in otology and rhinology.
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Affiliation(s)
| | | | | | | | - David Lobo Duro
- Hospital Universitario Marqués de Valdecilla, Santander, Spain
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Bağriaçik E, Bayraktar N. Effectiveness of training in disease management for patients with type 2 diabetes mellitus: A systematic review. ENDOCRINOL DIAB NUTR 2022; 69:362-378. [PMID: 35697468 DOI: 10.1016/j.endien.2022.05.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 06/14/2021] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Diabetes mellitus (DM) is included in the disease group described as the pandemic of the century. Although disease management is possible, it can significantly reduce the quality of life when glycaemic control is poor. The objective of this systematic review was to examine the effectiveness of different educational programmes on the management of the disease among type 2 DM patients. METHODS In the literature review, the flow chart of PRISMA-P (Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols) was used. A literature search was conducted from 2010 to 2020 using the Ulakbim National Database, Google Scholar, Scopus, PubMed, Library, Science Direct, Web of Science, Medline, Ebscohost and Cochrane Library, and 18 English randomised controlled studies were included. RESULTS Within the scope of these studies, it was found that individualised and face-to-face training and long-term follow-up after the training were effective on metabolic control. Peer support was also determined as an important factor in the efficacy of the training. In line with the training, the self-management and quality-of-life scores of the individuals with diabetes were positively affected. CONCLUSIONS It can be suggested that planned and regular training has a positive effect on metabolic control variables, self-management behaviours and quality of life of individuals with diabetes. Regular training for individuals with diabetes and follow-up for more than 6 months are recommended since they have a positive effect on the disease. It is also recommended to integrate peer support into training programmes.
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García-Salvador I, Chisbert-Alapont E, Antonaya Campos A, Casaña Mohedo J, Hurtado Navarro C, Fernández Peris S, Bonías López J, de la Rica Escuín ML. [Assessment of basic training needs in palliative care in primary healthcare nurses in Spain]. Aten Primaria 2022; 54:102344. [PMID: 35489161 PMCID: PMC9062674 DOI: 10.1016/j.aprim.2022.102344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 02/11/2022] [Accepted: 02/18/2022] [Indexed: 11/25/2022] Open
Abstract
AIM Asses training, perception of readiness and training needs in palliative care (PC) theoretical and practical of primary care nurses in Spain, through descriptive cross-sectional study. DESIGN Descriptive cross-sectional study. SETTING Primary care nurses in Spain with online access. PARTICIPANTS Primary care nurses in Spain, January and February 2021. 344 responses, 339 met the inclusion criteria. MAIN NEASUREMENTS Sociodemographic variables, PC training, training needs were analyzed. Through Google Forms online questionnaire and INCUE Instrument. Descriptive analyses were performed and the results were compared using the exact symmetry test and the Mann-Whitney test. RESULTS 82,6% women, with an average age of 45.5years. 86.1% of the nurses had training in PC, been basic in the 45.4%. Only 40.5% feel quite or very prepared to take care for palliative patients. Nurses demanded more training in psycho-emotional and grief and coping with losses. 83.76% passed the theoretical block compared to 43.36% of the practical, detecting higher training needs in the last (P<.001). The passed rates varied depending on the educational level. CONCLUSIONS Nursing training in PC in primary care continues to be deficient, especially in practical application. Targeted training is necessary to have an impact on the care of people with palliative needs and their families.
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Affiliation(s)
- Isidro García-Salvador
- Enfermería, Servicio de Oncología, Departamento de Salud Dr. Peset, Valencia, España; Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (Fisabio), Valencia, España; Grupo de Investigación INCUE, Departamento de Salud Dr. Peset, Valencia, España
| | - Encarna Chisbert-Alapont
- Enfermería, Servicio de Hematología, Departamento de Salud La Fe, Valencia, España; Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (Fisabio), Valencia, España; Grupo de Investigación INCUE, Departamento de Salud Dr. Peset, Valencia, España.
| | - Amparo Antonaya Campos
- Dirección de Atención Primaria, Departamento de Salud Dr. Peset, Valencia, España; Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (Fisabio), Valencia, España; Grupo de Investigación INCUE, Departamento de Salud Dr. Peset, Valencia, España
| | - Jorge Casaña Mohedo
- Departamento de Enfermería, Facultad de Medicina y Ciencias de la Salud, Universidad Católica San Vicente Mártir, Valencia, España; Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (Fisabio), Valencia, España; Grupo de Investigación INCUE, Departamento de Salud Dr. Peset, Valencia, España
| | - Clara Hurtado Navarro
- Adjunta de Docencia, Departamento de Salud Dr. Peset, Valencia, España; Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (Fisabio), Valencia, España; Grupo de Investigación INCUE, Departamento de Salud Dr. Peset, Valencia, España
| | - Silvia Fernández Peris
- Asociación de Psicooncología Carena, Departamento de Salud Dr. Peset, Valencia, España; Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (Fisabio), Valencia, España; Grupo de Investigación INCUE, Departamento de Salud Dr. Peset, Valencia, España
| | - José Bonías López
- Enfermería, Centro de Salud de San Marcelino, Departamento de Salud Dr. Peset, Valencia, España; Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (Fisabio), Valencia, España; Grupo de Investigación INCUE, Departamento de Salud Dr. Peset, Valencia, España
| | - María Luisa de la Rica Escuín
- Enfermería, Grupo de Investigación del Cuidado en el proceso de final de vida, Instituto para la Investigación en Salud de Aragón, Zaragoza, España; Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (Fisabio), Valencia, España
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18
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Llimós M, Vives-Cases C, Davó-Blanes MC, Carrasco-Garrido P, Garin O, Ronda E, Benavides FG. [Characteristics and contents of the Master's programs in public health in Spain]. Gac Sanit 2022; 36:127-138. [PMID: 32493582 DOI: 10.1016/j.gaceta.2020.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 03/04/2020] [Accepted: 03/04/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To compare the main academic characteristics and contents of the different master's programs in public health currently offered in Spain. METHOD A systematic search has been carried out in the Register of Universities, Centers and Degrees of the Ministry of Education, Culture and Sports. The main academic characteristics and the contents (mandatory and optional) of the programs of 11 official master's degrees with the renewed accreditation in 2018 were analyzed based on the data published on the universities' web pages. RESULTS Most programs are 60 ECTS (European Credit Transfer and Accumulation System), face-to-face, taught in Spanish, include in their curriculum the completion of a master's thesis but not professional practices. Only contents related to statistics and basic epidemiology, and the training activity of master's thesis, are offers by all programs. CONCLUSIONS The majority of public health master's programs in Spain shows a certain homogeneity regarding their academic characteristics, but a great heterogeneity in relation to their contents. There is also a great heterogeneity in the credits granted to the different subjects, especially optional subjects. It would be advisable to standardize a common core, especially in the mandatory contents.
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Affiliation(s)
- Mireia Llimós
- Departamento de Ciencias Experimentales y de la Salud, Universidad Pompeu Fabra, Barcelona, España.
| | - Carmen Vives-Cases
- Departamento de Enfermería Comunitaria, Medicina Preventiva y Salud Pública e Historia de la Ciencia, Universidad de Alicante, Alicante, España; CIBER de Epidemiología y Salud Pública (CIBERESP), España
| | - M Carmen Davó-Blanes
- Departamento de Enfermería Comunitaria, Medicina Preventiva y Salud Pública e Historia de la Ciencia, Universidad de Alicante, Alicante, España; CIBER de Epidemiología y Salud Pública (CIBERESP), España
| | - Pilar Carrasco-Garrido
- Área de Medicina Preventiva y Salud Pública, Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos, Madrid, España
| | - Olatz Garin
- Departamento de Ciencias Experimentales y de la Salud, Universidad Pompeu Fabra, Barcelona, España; CIBER de Epidemiología y Salud Pública (CIBERESP), España; Instituto Hospital del Mar de Investigaciones Médicas (IMIM), Barcelona, España
| | - Elena Ronda
- Departamento de Enfermería Comunitaria, Medicina Preventiva y Salud Pública e Historia de la Ciencia, Universidad de Alicante, Alicante, España; CIBER de Epidemiología y Salud Pública (CIBERESP), España; Centro de Investigación en Salud Laboral (CiSAL), Universidad Pompeu Fabra, Barcelona, España
| | - Fernando G Benavides
- Departamento de Ciencias Experimentales y de la Salud, Universidad Pompeu Fabra, Barcelona, España; CIBER de Epidemiología y Salud Pública (CIBERESP), España; Instituto Hospital del Mar de Investigaciones Médicas (IMIM), Barcelona, España; Centro de Investigación en Salud Laboral (CiSAL), Universidad Pompeu Fabra, Barcelona, España
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Romero-Bueno F, Rodríguez-Nieto MJ, Naredo E. Education and Use of Lung Ultrasound in Rheumatology and Pneumology in Spain: A SER-SEPAR Survey. Reumatol Clin (Engl Ed) 2022; 18:94-99. [PMID: 35074285 DOI: 10.1016/j.reumae.2020.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 10/01/2020] [Indexed: 06/14/2023]
Abstract
INTRODUCTION Lung ultrasound (LUS) is a clinical and research tool with great potential in the diagnosis and monitoring of diffuse interstitial lung disease (ILD) present in systemic autoimmune diseases (SAD). Appropriate training in LUS is essential for the correct and safe use of this technique. OBJECTIVE To document the current state of LUS education and use among Spanish rheumatologists and pneumologists. MATERIAL AND METHODS A national online survey was designed for members of the Spanish Society of Rheumatology and the ILD Area of the Spanish Society of Pneumology and Thoracic Surgery. The survey consisted of 22 questions on demographics, professional activity, performance and training in LUS. RESULTS One hundred and thirty-five (56.72% rheumatologists, 41.79% pneumologists) responded to the survey. Of these, 56.30% were part of an ILD Unit in their centre. LUS in clinical practice was performed by 35.82% but only 14.93% performed it in ILD, mainly for diagnostic purposes. Training in LUS of responders had been diverse in format, content and sponsors. The vast majority (87.79%) considered that the optimal model of education in LUS should be standardized and structured and consist of a combination of theoretical-practical courses and the conduct of a minimum number of supervised LUS examinations, with competency assessment. CONCLUSIONS The current lack of formal structured education in LUS is an opportunity to develop quality educational programmes in this emerging field.
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Affiliation(s)
| | | | - Esperanza Naredo
- Servicio de Reumatología, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain.
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20
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Persia-Paulino YR, Pascual I, Fernández-Asensio R, Cuevas-Pérez J, Adeba A, Martín M, García-Pérez L, Avanzas P, Reyes-Cortina M, Moris C, Rozado J. Impact of COVID-19 pandemic on cardiology fellows academic training: beyond the clinical impact. Arch Cardiol Mex 2021; 91:18-24. [PMID: 34968379 PMCID: PMC10161867 DOI: 10.24875/acm.20000518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJETIVO Determinar la percepción de los médicos internos residentes (MIR) de cardiología de España sobre el efecto de la pandemia por COVID-19 en su formación y la adaptación realizada por sus servicios. MÉTODOS Estudio de corte transversal a través de una plataforma de encuesta digital con el objetivo de conocer la opinión individual de los MIR de cardiología sobre la influencia de la pandemia en su formación. Se realiza un análisis estadístico para determinar los factores que influyeron en la percepción de la formación afectada. RESULTADOS Participó un total de 180 MIR de las 17 comunidades autónomas (CA). Los MIR de tercer año fueron los más afectados, junto con los que rotaban en imagen cardíaca. Los residentes de las CA con una prevalencia >5 casos/1,000 habitantes fueron los que mayor probabilidad tuvieron de ser desplazados de sus servicios. CONCLUSIONES Según la opinión de los participantes, el efecto de la pandemia por COVID-19 en su formación fue más negativa en los residentes de tercer año y los que rotaban en imagen cardíaca. OBJECTIVE The objectives were to analyze the perception of the Cardiology Fellows in Training (FIT) of Spain about the impact of the COVID-19 pandemic on their academic training and to know the adaptative changes performed by their department. METHODS A cross-sectional study performed through a digital survey platform for Cardiology FIT. Chi2 analysis and logistic regression were performed to determine the factors that influenced on the perception of an affected training. RESULTS A total of 180 FIT from the 17 regions of Spain participated. Third year FIT and those rotating in cardiac imaging were the most affected with statistically significant difference. The residents of the regions with a prevalence of >5 cases/1,000 inhabitants were the most likely to be displaced from their departments. CONCLUSIONS According to the opinion of the participants, the impact of the COVID-19 pandemic on their academic training was more negative in third year FITs and those rotating in cardiac imaging.
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Affiliation(s)
- Yván R Persia-Paulino
- Departamento de Cardiología, Área del Corazón, Hospital Universitario Central de Asturias, Oviedo
| | - Isaac Pascual
- Departamento de Cardiología, Área del Corazón, Hospital Universitario Central de Asturias, Oviedo.,Departamento de Medicina, Universidad de Oviedo, Oviedo
| | | | - Javier Cuevas-Pérez
- Departamento de Cardiología, Área del Corazón, Hospital Universitario Central de Asturias, Oviedo
| | - Antonio Adeba
- Departamento de Cardiología, Área del Corazón, Hospital Universitario Central de Asturias, Oviedo
| | - María Martín
- Departamento de Cardiología, Área del Corazón, Hospital Universitario Central de Asturias, Oviedo
| | - Laura García-Pérez
- Departamento de Cardiología, Área del Corazón, Hospital Universitario Central de Asturias, Oviedo
| | - Pablo Avanzas
- Departamento de Cardiología, Área del Corazón, Hospital Universitario Central de Asturias, Oviedo.,Departamento de Medicina, Universidad de Oviedo, Oviedo
| | | | - César Moris
- Departamento de Cardiología, Área del Corazón, Hospital Universitario Central de Asturias, Oviedo.,Departamento de Medicina, Universidad de Oviedo, Oviedo
| | - José Rozado
- Departamento de Cardiología, Área del Corazón, Hospital Universitario Central de Asturias, Oviedo
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Añel Rodríguez RM, Aibar Remón C, Martín Rodríguez MD. [Patient participation in its own safety]. Aten Primaria 2021; 53 Suppl 1:102215. [PMID: 34961579 PMCID: PMC8721344 DOI: 10.1016/j.aprim.2021.102215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Accepted: 09/08/2021] [Indexed: 11/23/2022] Open
Abstract
El enfoque de atención centrada en el paciente y los avances normativos desarrollados en los últimos años han promovido la implicación del paciente en la toma de decisiones sobre pruebas diagnósticas y tratamientos. En otros aspectos, como la participación en su seguridad, aún queda mucho por hacer. Hasta hace poco tiempo se ha considerado al paciente como mero receptor de los servicios sanitarios, no como parte activa del sistema, ni mucho menos como barrera de seguridad frente a los fallos y errores que acontecen durante la asistencia. Algunos pacientes se han activado con base en sus experiencias. Pero muchos otros no. Por eso es necesario sensibilizar, informar y formar al paciente de forma proactiva para que participe en su seguridad. No se trata de traspasarle la responsabilidad, sino de facilitar y promover su participación reforzando su seguridad durante el proceso asistencial. El sistema sanitario debe estar comprometido, y el paciente informado y formado. Aportamos herramientas y recursos online para su aplicación en atención primaria.
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Affiliation(s)
- Rosa María Añel Rodríguez
- Especialista en Medicina Familiar y Comunitaria, Máster en Participación y Desarrollo Comunitario, Médica de familia, Centro de Salud Landako, Durango, País Vasco, España; Grupo de trabajo de Seguridad del Paciente de semFYC.
| | - Carlos Aibar Remón
- Especialista en Medicina Preventiva y Salud Pública, Profesor titular de Medicina Preventiva y Salud Pública, Universidad de Zaragoza, Aragón, España; Grupo de trabajo de Seguridad del Paciente de semFYC
| | - María Dolores Martín Rodríguez
- Especialista en Medicina Familiar y Comunitaria, Maestría Universitaria en Seguridad del Paciente y Calidad Asistencial, Médico Coordinador, Central de Coordinación de Urgencias y Emergencias, Fundación Pública Urxencias Sanitarias de Galicia-061, Galicia, España; Grupo de trabajo de Seguridad del Paciente de semFYC
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López-Bravo A, Bellosta-Diago E, Viloria-Alebesque A, Marín-Gracia M, Laguna-Sarriá J, Santos-Lasaosa S. Headache as a reason for consultation: the primary care perspective. Neurologia (Engl Ed) 2021; 36:597-602. [PMID: 34654534 DOI: 10.1016/j.nrleng.2020.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Accepted: 06/16/2018] [Indexed: 10/23/2022] Open
Abstract
INTRODUCTION Headache is a frequent reason for consultation with primary care (PC) physicians. However, the condition is underdiagnosed and undertreated. One reason for this may be the lack of specific training on headache in PC. METHODS We conducted a descriptive cross-sectional study of data gathered with a self-administered survey that was completed by PC physicians from our health district. We collected sociodemographic data and information on previous training in neurology and headache, and training needs. RESULTS The survey was completed by 104 PC physicians, 53% of whom were women; mean age was 49 years. Most respondents worked in urban settings (42.3%) and had been trained via residency (77.9%). Although 65.4% spent more time with patients with headache than with other patients, only 32.7% used the International Classification of Headache Disorders. In our sample, 68.3% of respondents reported a high or very high interest in headache, and 75.9% wished to receive further training on the condition; theoretical and practical courses and update lectures were regarded as the most useful tools. In clinical practice, 90% used triptans and 78% used preventive treatments. The most frequently used drug was amitriptyline; only 22.1% choose topiramate. CONCLUSIONS PC physicians are in frequent contact with patients with headache and show interest in receiving training on this condition. This could be helpful in designing training programmes aimed at improving quality of care in this area.
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Affiliation(s)
- A López-Bravo
- Servicio de Neurología, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain.
| | - E Bellosta-Diago
- Servicio de Neurología, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
| | - A Viloria-Alebesque
- Servicio de Neurología, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
| | - M Marín-Gracia
- Servicio de Neurología, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
| | - J Laguna-Sarriá
- Servicio de Medicina Familiar y Comunitaria, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
| | - S Santos-Lasaosa
- Servicio de Neurología, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
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Vázquez Gómez M, Galipienso Eri M, Hernández Martínez A. Has 2020 been a lost year in orthopedic surgery and trauma training? Residents' perceptions. Rev Esp Cir Ortop Traumatol (Engl Ed) 2021; 66:397-402. [PMID: 34419383 PMCID: PMC8373591 DOI: 10.1016/j.recot.2021.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 06/13/2021] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE The COVID-19 pandemic has affected specialized healthcare training at all levels. Surgical learning has been severely affected, and the impact on orthopedic surgery residency training has so far not been assessed. MATERIAL AND METHODS An online survey of 17 questions was sent via web link to orthopedic surgery residents throughout Spain between February 10, 2021 and February 28, 2021. The effects of the COVID-19 pandemic on the care and training activities of residents were analyzed. RESULTS A total of 307 orthopedic surgery residents from all over Spain responded to the online survey. A total of 77.2% of the respondents had to suspend their rotations. Of these, 67.5% would like to resume the rotations they missed during the pandemic. A total of 69.7% of scheduled surgeries were suspended. Surgical activity was completely stopped for an average of 8 weeks. 66.8% of the residents consider that their surgical training has been affected and this will have repercussions on their future work. 49.5% considered the online training offered to be insufficient. Of the total number of respondents, 52.1% considered that the impact of the pandemic situation on their training situation was bad or very bad. CONCLUSIONS The data collection shows a negative impact on both theoretical and clinical training. This study highlights the need to continue offering quality training by maximizing learning opportunities.
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Bağriaçik E, Bayraktar N. Effectiveness of training in disease management for patients with type 2 diabetes mellitus: A systematic review. ENDOCRINOL DIAB NUTR 2021; 69:S2530-0164(21)00181-6. [PMID: 34400106 DOI: 10.1016/j.endinu.2021.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 06/08/2021] [Accepted: 06/14/2021] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Diabetes mellitus (DM) is included in the disease group described as the pandemic of the century. Although disease management is possible, it can significantly reduce the quality of life when glycaemic control is poor. The objective of this systematic review was to examine the effectiveness of different educational programmes on the management of the disease among type 2 DM patients. METHODS In the literature review, the flow chart of PRISMA-P (Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols) was used. A literature search was conducted from 2010 to 2020 using the Ulakbim National Database, Google Scholar, Scopus, PubMed, Library, Science Direct, Web of Science, Medline, Ebscohost and Cochrane Library, and 18 English randomised controlled studies were included. RESULTS Within the scope of these studies, it was found that individualised and face-to-face training and long-term follow-up after the training were effective on metabolic control. Peer support was also determined as an important factor in the efficacy of the training. In line with the training, the self-management and quality-of-life scores of the individuals with diabetes were positively affected. CONCLUSIONS It can be suggested that planned and regular training has a positive effect on metabolic control variables, self-management behaviours and quality of life of individuals with diabetes. Regular training for individuals with diabetes and follow-up for more than 6 months are recommended since they have a positive effect on the disease. It is also recommended to integrate peer support into training programmes.
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Molina Collada J, Mayordomo L; Grupo de Trabajo de Ecografía de la Sociedad Española de Reumatología (ECOSER). Perceived quality of training in musculoskeletal ultrasound in Spanish rheumatology services. ACTA ACUST UNITED AC 2021:S2173-5743(21)00155-6. [PMID: 34373233 DOI: 10.1016/j.reumae.2021.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Accepted: 01/28/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND OBJECTIVE Ultrasound has been included in the training of residents in rheumatology in recent years, as a result of its increased use in daily clinical practice. Our objective is to evaluate the perceived quality of ultrasound training of residents in rheumatology services in Spain. MATERIAL AND METHODS Online survey aimed at rheumatologists who began their training in rheumatology between 2009 and 2019. RESULTS One hundred thirty-nine rheumatologists participated in the survey, of which 97.1% had at least one ultrasound machine in their training centre. Up to 51.1% performed a rotation in ultrasound and 56% had an ultrasound consultation. Access to SER courses was high (87.8%) while access to EULAR courses was limited (17.3%) and up to 69.1% of residents did not complete the competency accreditation. Training in evaluation of inflammatory joint activity, entheses and microcrystalline diseases received the highest scores. Evaluation of ultrasound training during the residency was good in 36% of cases, fair in 28.1%, poor in 18% and excellent in 12.9%. Of those surveyed, 88% consider their clinical practice as a rheumatologist to have improved. CONCLUSIONS Most residents have performed ultrasound rotations. Participation in SER ultrasound courses is high and moderate in EULAR courses, while only a minority completed the competency accreditation. The overall degree of satisfaction with training in ultrasound during residency is good and, in the opinion of residents, contributes to the improvement of their skills as rheumatologists.
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Galán-Olleros M, García-Coiradas J, Llanos S, Valle-Cruz JA, Marco F. Fracture planning is easy: Development of a basic method of digital planning based on the traditional pencil and paper technique. Rev Esp Cir Ortop Traumatol (Engl Ed) 2021; 66:328-340. [PMID: 34366259 DOI: 10.1016/j.recot.2021.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 03/30/2021] [Accepted: 05/17/2021] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION Preoperative planning constitutes a fundamental tool in the management of fractures; however, its practical application is far from the desired, perhaps due to the absence of a basic and simple method, adapted to the current times. We describe a digital planning method, halfway between the traditional and the technological, which preserves its educational essence, allows the understanding of the fracture and the individualization of the osteosynthesis. MATERIAL AND METHODS After the initial analysis of the fracture and the patient's characteristics, different measurements are made on X-ray and CT images with a digital medical imaging software. These images are then copied into a presentation program (Microsoft® PowerPoint or Keynote ©Apple Inc.), in which the main fragments and fracture lines are traced with the computer pointer. These are subsequently moved into a reduced position and the implants for internal fixation are graphically represented together with a guide of the surgical strategy. RESULTS We show 4 cases of different types of fractures operated through reduction and osteosynthesis after preoperative planning according to the described method. The basic points for the surgical planning, logistics, tactics and postoperative radiological results of each case are detailed. CONCLUSIONS Despite rise of advanced planning software, traditional paper and pencil methods are still fundamental, even more so for the trauma surgeon in training. The digital planning method described is very appropriate for this purpose, as it combines the advantages of both methods: simplicity, accessibility, quickness, low-cost, reproducibility, educational character, efficiency and possibility of simulation, corrections and reuse of cases.
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Affiliation(s)
- M Galán-Olleros
- Unidad de Traumatología y Politraumatizados, Servicio de Traumatología y Cirugía Ortopédica, Hospital Clínico Universitario San Carlos, Madrid, España.
| | - J García-Coiradas
- Unidad de Traumatología y Politraumatizados, Servicio de Traumatología y Cirugía Ortopédica, Hospital Clínico Universitario San Carlos, Madrid, España
| | - S Llanos
- Unidad de Traumatología y Politraumatizados, Servicio de Traumatología y Cirugía Ortopédica, Hospital Clínico Universitario San Carlos, Madrid, España
| | - J A Valle-Cruz
- Unidad de Traumatología y Politraumatizados, Servicio de Traumatología y Cirugía Ortopédica, Hospital Clínico Universitario San Carlos, Madrid, España
| | - F Marco
- Unidad de Traumatología y Politraumatizados, Servicio de Traumatología y Cirugía Ortopédica, Hospital Clínico Universitario San Carlos, Madrid, España; Departamento de Cirugía, Facultad de Medicina de la Universidad Complutense de Madrid, Madrid, España
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Ramos Hernández C, Núñez Delgado M, Botana Rial M, Mouronte Roibás C, Leiro Fernández V, Vilariño Pombo C, Tubío Pérez R, Nuñez Fernández M, Fernández Villar A. Validity of lung ultrasound to rule out iatrogenic pneumothorax performed by pulmonologists without experience in this procedure. Rev Clin Esp 2021; 221:258-263. [PMID: 32943217 DOI: 10.1016/j.rce.2020.01.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 01/04/2020] [Accepted: 01/10/2020] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Ultrasonography has been shown to be a useful tool for diagnosing pneumothorax in the hands of experts. After performing bronchopleural procedures, the recommendation is to perform chest radiography to rule out complications. Our objective was to determine the validity of lung ultrasound, conducted by pulmonologists without experience in this procedure, to rule out pneumothorax after invasive procedures. MATERIAL AND METHODS Our prospective observational study consecutively included patients who underwent transbronchial lung biopsy (TBLB), therapeutic thoracentesis (TT) and/or transparietal pleural biopsies (PB) for whom subsequent chest radiography to rule out complications was indicated. In all cases, the same pulmonologist who performed the technique performed an ultrasound immediately after the procedure. A diagnosis of pneumothorax was considered in the presence of a lung point or the combination of the following signs: absence of pleural sliding, absence of B-lines and presence of the "barcode" sign. RESULTS We included 275 procedures (149 TBLBs, 36 BPs, 90 TTs), which resulted in 14 (5.1%) iatrogenic pneumothoraxes. Ultrasonography presented a sensitivity of 78.5%, a specificity of 85% and positive and negative predictive value of 22% and 98.6%, respectively. Ultrasonography did not help detect the presence of 3 pneumothoraxes, one of which required chest drainage, but adequately diagnosed 2 pneumothoraxes that were not identified in the initial radiography. CONCLUSIONS Lung ultrasound performed by pulmonologists at the start of their training helps rule out pneumothorax with a negative predictive value of 98.6%, thereby avoiding unnecessary radiographic control studies in a considerable number of cases.
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Affiliation(s)
- C Ramos Hernández
- Servicio de Neumología. Hospital Álvaro Cunqueiro. EOXI de Vigo PneumoVigo I+i. Instituto de Investigación Sanitaria Galicia Sur (IISGS), Vigo, España.
| | - M Núñez Delgado
- Servicio de Neumología. Hospital Álvaro Cunqueiro. EOXI de Vigo PneumoVigo I+i. Instituto de Investigación Sanitaria Galicia Sur (IISGS), Vigo, España
| | - M Botana Rial
- Servicio de Neumología. Hospital Álvaro Cunqueiro. EOXI de Vigo PneumoVigo I+i. Instituto de Investigación Sanitaria Galicia Sur (IISGS), Vigo, España
| | - C Mouronte Roibás
- Servicio de Neumología. Hospital Álvaro Cunqueiro. EOXI de Vigo PneumoVigo I+i. Instituto de Investigación Sanitaria Galicia Sur (IISGS), Vigo, España
| | - V Leiro Fernández
- Servicio de Neumología. Hospital Álvaro Cunqueiro. EOXI de Vigo PneumoVigo I+i. Instituto de Investigación Sanitaria Galicia Sur (IISGS), Vigo, España
| | - C Vilariño Pombo
- Servicio de Neumología. Hospital Álvaro Cunqueiro. EOXI de Vigo PneumoVigo I+i. Instituto de Investigación Sanitaria Galicia Sur (IISGS), Vigo, España
| | - R Tubío Pérez
- Servicio de Neumología. Hospital Álvaro Cunqueiro. EOXI de Vigo PneumoVigo I+i. Instituto de Investigación Sanitaria Galicia Sur (IISGS), Vigo, España
| | - M Nuñez Fernández
- Servicio de Neumología. Hospital Álvaro Cunqueiro. EOXI de Vigo PneumoVigo I+i. Instituto de Investigación Sanitaria Galicia Sur (IISGS), Vigo, España
| | - A Fernández Villar
- Servicio de Neumología. Hospital Álvaro Cunqueiro. EOXI de Vigo PneumoVigo I+i. Instituto de Investigación Sanitaria Galicia Sur (IISGS), Vigo, España
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Molina Collada J, Mayordomo L. Perceived Quality of Training in Musculoskeletal Ultrasound in Spanish Rheumatology Services. Reumatol Clin (Engl Ed) 2021; 18:S1699-258X(21)00062-0. [PMID: 33931334 DOI: 10.1016/j.reuma.2021.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Revised: 01/18/2021] [Accepted: 01/28/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND AND OBJECTIVE Ultrasound has been included in the training of residents in rheumatology in recent years, as a result of its increased use in daily clinical practice. Our objective is to evaluate the perceived quality of ultrasound training of residents in rheumatology services in Spain. MATERIAL AND METHODS Online survey aimed at rheumatologists who began their training in rheumatology between 2009 and 2019. RESULTS One hundred thirty-nine rheumatologists participated in the survey, of which 97.1% had at least one ultrasound machine in their training centre. Up to 51.1% performed a rotation in ultrasound and 56% had an ultrasound consultation. Access to SER courses was high (87.8%) while access to EULAR courses was limited (17.3%) and up to 69.1% of residents did not complete the competency accreditation. Training in evaluation of inflammatory joint activity, entheses and microcrystalline diseases received the highest scores. Evaluation of ultrasound training during the residency was good in 36% of cases, fair in 28.1%, poor in 18% and excellent in 12.9%. Of those surveyed, 88% consider their clinical practice as a rheumatologist to have improved. CONCLUSIONS Most residents have performed ultrasound rotations. Participation in SER ultrasound courses is high and moderate in EULAR courses, while only a minority completed the competency accreditation. The overall degree of satisfaction with training in ultrasound during residency is good and, in the opinion of residents, contributes to the improvement of their skills as rheumatologists.
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Affiliation(s)
- Juan Molina Collada
- Servicio de Reumatología, Hospital General Universitario Gregorio Marañón, Madrid, España.
| | - Lucía Mayordomo
- Servicio de Reumatología, Hospital Universitario Valme, Sevilla, España
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Ramos Hernández C, Núñez Delgado M, Botana Rial M, Mouronte Roibás C, Leiro Fernández V, Vilariño Pombo C, Tubío Pérez R, Nuñez Fernández M, Fernández Villar A. Validity of lung ultrasound to rule out iatrogenic pneumothorax performed by pulmonologists without experience in this procedure. Rev Clin Esp 2021; 221:258-63. [PMID: 33998511 DOI: 10.1016/j.rceng.2020.01.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Accepted: 01/10/2020] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Ultrasonography has been shown to be a useful tool for diagnosing pneumothorax in the hands of experts. After performing bronchopleural procedures, the recommendation is to perform chest radiography to rule out complications. Our objective was to determine the validity of lung ultrasound, conducted by pulmonologists without experience in this procedure, to tule out pneumothorax after invasive procedures. MATERIAL AND METHODS Our prospective observational study consecutively included patients who underwent transbronchial lung biopsy (TBLB), therapeutic thoracentesis (TT) and/or transparietal pleural biopsies (PB) for whom subsequent chest radiography to rule out complications was indicated. In all cases, the same pulmonologist who performed the technique performed an ultrasound immediately after the procedure. A diagnosis of pneumothorax was considered in the presence of a lung point or the combination of the following signs: absence of pleural sliding, absence of B-lines and presence of the "barcode" sign. RESULTS We included 275 procedures (149 TBLBs, 36 BPs, 90 TTs), which resulted in 14 (5.1%) iatrogenic pneumothoraxes. Ultrasonography presented a sensitivity of 78.5%, a specificity of 85% and positive and negative predictive value of 22% and 98.6%, respectively. Ultrasonography did not help detect the presence of 3 pneumothoraxes, one of which required chest drainage, but adequately diagnosed 2 pneumothoraxes that were not identified in the initial radiography. CONCLUSIONS Lung ultrasound performed by pulmonologists at the start of their training helps rule out pneumothorax with a negative predictive value of 98.6%, thereby avoiding unnecessary radiographic control studies in a considerable number of cases.
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Luque-Luna M, Morgado-Carrasco D. RF-Surgical Simulation and Digital Tools for Surgical Training During the COVID-19 Pandemic. Actas Dermosifiliogr (Engl Ed) 2021; 112:S0001-7310(21)00099-5. [PMID: 33652008 PMCID: PMC7910661 DOI: 10.1016/j.ad.2021.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 02/14/2021] [Indexed: 11/26/2022] Open
Affiliation(s)
- M Luque-Luna
- Servicio de Dermatología, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, España
| | - D Morgado-Carrasco
- Servicio de Dermatología, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, España.
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Romero-Bueno F, Rodríguez-Nieto MJ, Naredo E. Education and Use of Lung Ultrasound in Rheumatology and Pneumology in Spain: A SER-SEPAR Survey. Reumatol Clin (Engl Ed) 2021; 18:S1699-258X(20)30239-4. [PMID: 33495104 DOI: 10.1016/j.reuma.2020.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 09/27/2020] [Accepted: 10/01/2020] [Indexed: 12/09/2022]
Abstract
INTRODUCTION Lung ultrasound (LUS) is a clinical and research tool with great potential in the diagnosis and monitoring of diffuse interstitial lung disease (ILD) present in systemic autoimmune diseases (SAD). Appropriate training in LUS is essential for the correct and safe use of this technique. OBJECTIVE To document the current state of LUS education and use among Spanish rheumatologists and pneumologists. MATERIAL AND METHODS A national online survey was designed for members of the Spanish Society of Rheumatology and the ILD Area of the Spanish Society of Pneumology and Thoracic Surgery. The survey consisted of 22 questions on demographics, professional activity, performance and training in LUS. RESULTS One hundred and thirty-five (56.72% rheumatologists, 41.79% pneumologists) responded to the survey. Of these, 56.30% were part of an ILD Unit in their centre. LUS in clinical practice was performed by 35.82% but only 14.93% performed it in ILD, mainly for diagnostic purposes. Training in LUS of responders had been diverse in format, content and sponsors. The vast majority (87.79%) considered that the optimal model of education in LUS should be standardized and structured and consist of a combination of theoretical-practical courses and the conduct of a minimum number of supervised LUS examinations, with competency assessment. CONCLUSIONS The current lack of formal structured education in LUS is an opportunity to develop quality educational programmes in this emerging field.
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Affiliation(s)
| | | | - Esperanza Naredo
- Servicio de Reumatología. Hospital Universitario Fundación Jiménez Díaz, Madrid, España.
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Pescador Chamorro MI, Zeballos Sarrato SE, Marsinyach Ros MI, Zeballos Sarrato G, Márquez Isidro EM, Sánchez Luna M. [Training, experience and need of booster courses in neonatal cardiopulmonary resuscitation. Survey to pediatricians]. An Pediatr (Barc) 2020; 96:S1695-4033(20)30497-5. [PMID: 33390358 DOI: 10.1016/j.anpedi.2020.11.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 11/10/2020] [Accepted: 11/13/2020] [Indexed: 01/13/2023] Open
Abstract
INTRODUCTION the resuscitation of the newborn in the delivery room requires high capacities and occurs frequently in an unexpected way. Many professionals trained in pediatrics as pediatric residents will work posteriorly in pediatric units with delivery rooms and will perform neonatal resuscitation only occasionally. Skills acquired in practice or resuscitation courses deteriorate over time. MATERIAL AND METHODS descriptive observational study through a survey to pediatricians trained in neonatology at a tertiary hospital in Madrid, and who completed their residency period between 2009 and 2016. Questions about their training in resuscitation and their usual work in the delivery room. RESULTS Out of 179 surveys sent 140 pediatricians (78,2%) answered it. 73.6% took a training course in neonatal resuscitation during the residency. There was a progressive increase in the number of residents who did the course during the study period. 74.3% have worked after residency in assistance at birth. 40.7% have taken a refresher course in neonatal resuscitation. CONCLUSIONS training in neonatal resuscitation has increased and been consolidated during the training process for pediatric residents. A high percentage of pediatricians work after the residency in pediatric units with delivery rooms, less than half of these professionals having been recycled in neonatal resuscitation. Recycling and periodic training seem interesting options to improve the performance of these professionals in the delivery room.
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Affiliation(s)
| | | | | | | | | | - Manuel Sánchez Luna
- Servicio de Neonatología, Hospital General Universitario Gregorio Marañón, Madrid, España
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Castilla Guerra L, Suárez Fernández C, Mostaza JM, Valdivielso Felices P, Torres do Rego A, Gómez Cerezo JF. Consensus document for the training of residents in cardiovascular risk. Rev Clin Esp 2020; 220:587-591. [PMID: 32111440 DOI: 10.1016/j.rce.2019.11.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Accepted: 11/13/2019] [Indexed: 11/19/2022]
Abstract
Vascular disease is currently a major health problem, not only for its high prevalence but also for the considerable morbidity, mortality and disability that it entails. Medical internists play a central role in diagnosing and treating vascular disease and controlling the cardiovascular risk factors (CRFs) that cause it. In fact, the clinical care of patients in cardiovascular risk units is a specific characteristic of an internist's field of action. This article contains the consensus document for the training of residents in CRFs. This proposal by the Cardiovascular Risk Workgroup of the Spanish Society of Internal Medicine emerged as a response by our Society to the specific need for training in CRFs. Implementing this proposal would provide an important benefit, not only for medical internists in training but also for society as a whole.
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Affiliation(s)
- L Castilla Guerra
- Servicio de Medicina Interna, Hospital Universitario Virgen Macarena, Sevilla, España.
| | - C Suárez Fernández
- Servicio de Medicina Interna, Hospital Universitario de La Princesa, Madrid, España
| | - J M Mostaza
- Servicio de Medicina Interna, Hospital Universitario Carlos III. Madrid, España
| | - P Valdivielso Felices
- Servicio de Medicina Interna, Hospital Clínico Universitario Virgen de la Victoria. Málaga, España
| | - A Torres do Rego
- Servicio de Medicina Interna, Hospital General Universitario Gregorio Marañón. Madrid, España
| | - J F Gómez Cerezo
- Servicio de Medicina Interna, Hospital Universitario Infanta Sofía, Madrid, España
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Carmona García P, Zarragoikoetxea Jauregui I, Mateo E, García Fuster R, Vicente R, Argente Navarro P. Multicentric survey on the use of intraoperative echocardiography in cardiovascular surgery in Spain. Rev Esp Anestesiol Reanim (Engl Ed) 2020; 67:551-555. [PMID: 33162120 DOI: 10.1016/j.redar.2020.07.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 07/04/2020] [Accepted: 07/13/2020] [Indexed: 06/11/2023]
Abstract
Transesophageal echocardiography (TEE) is an essential tool in the intraoperative and postoperative period of cardiac surgery with recently wide diffusion. We aimed to know the current situation of TEE in the field of cardiovascular anesthesiology in Spain through a national survey that explores the availability of equipment, indication and use of this technique as well as the training and accreditation of professionals involved. The findings show that in Spain intraoperative TEE is an integral part of cardiovascular procedures today and in most centers it is performed by anesthesiologists highly involved in this type of surgery. Despite the absence of structured training in the curriculum of our specialty, anesthesiologists acquire the skills through specific short-term rotations and a high percentage of them have obtained official accreditation.
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Affiliation(s)
- P Carmona García
- Servicio de Anestesiología y Reanimación, Hospital Universitario La Fe, Valencia, miembro del grupo de trabajo en Ecografía de la Sección de Cuidados Críticos de la SEDAR, coordinadora del grupo de trabajo en Ecocardiografía transesofágica intraoperatoria de la SEDAR, España.
| | | | - E Mateo
- Servicio de Anestesiología y Reanimación, Consorcio Hospital General Universitario de Valencia, España
| | - R García Fuster
- Servicio de Cirugía Cardiaca, Consorcio Hospital General Universitario de Valencia, coordinador del grupo de trabajo en Ecocardiografía transesofágica intraoperatoria de la SECCE, España
| | - R Vicente
- Servicio de Anestesiología y Reanimación, Hospital Universitario La Fe, Valencia, España
| | - P Argente Navarro
- Servicio de Anestesiología y Reanimación, Hospital Universitario La Fe, Valencia, España
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Martínez Ruiz J, Carrión López P, Giménez Bachs JM, Pastor Navarro H, Martínez Sanchiz C, Fernández Anguita PJ, Moreillo Vicente L, Salinas Sánchez AS. [Urology clinics referral Patterns after initiation of a Primary Care BPH-LUTS protocol.]. ARCH ESP UROL 2020; 73:573-581. [PMID: 32886072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
OBJECTIVE In the Spanish health system, General Practitioners (GPs) play a key role in regulating the flow of patients to hospital care. Most of patients with BPH can be managed through out the evolution of the disease exclusively by the GPs. METHODS: A pre-experimental study was carried outin two periods, before (pre-test) and after (post-test) of the dissemination of a management protocol for patients with BPH. The protocol was trialled in the health area of Villarrobledo and included all referrals to the urology clinic for BPH from Primary Care. We analyzed the appropriate referrals according with the criteria set for thin the protocol and compared the complementary tests through statistical study (descriptive, a bivariate, multivariate analysis and rate calculation) using version 21of the SPSS. RESULTS Referral rate decreased after the application of the protocol but did not increase the rate of appropriated referrals. Patients referred after setting forth protocol by GPs that assisted to the education program were younger. There were referred less patients with elevated PSA and more patients with clinical progression. These GPs used less test to achieve diagnosis. The GPs whodid not attend were significantly younger, mainly women, with no previous specific training in BPH and without a full time GP position. CONCLUSIONS The implementation of a protocol has reduced the referral rate, but it has not improved the appropriate referrals. More research is required to understand the determinants of inequalities in referral from primary care.
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Sebastián-Tomás JC, Navarro-Martínez S, Peris-Tomás N, Díez-Ares JÁ, Gonzálvez-Guardiola P, Periañez-Gómez D, Martínez-Mas E, Trullenque-Juan R. Surgical resident training program to perform laparoscopic bariatric procedures: Are safety and postoperative outcomes compromised? Cir Esp 2021; 99:200-7. [PMID: 32693919 DOI: 10.1016/j.ciresp.2020.05.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 05/23/2020] [Accepted: 05/30/2020] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Laparoscopic bariatric procedures such as laparoscopic Roux-en-Y gastric bypass (LRYGB) are technically demanding and require a long learning curve. Little is known about whether surgical resident (SR) training programs to perform these procedures are safe and feasible. This study aims to evaluate the results of our SR training program to perform LRYGB. METHODS We designed a retrospective study including patients with LRYGB between January 2014 and December 2018, comparing SR results to experienced bariatric surgeons (EBS). In our country, SR have a five-year surgical formative period, and in the fourth year they are trained for 6 months in our bariatric surgery unit, from January to June. In the beginning, they perform different steps of this procedure, to finally complete an LRYGB. We collected demographic data, comorbidities, intraoperative outcomes, and postoperative complications and outcomes after a one-year follow-up. RESULTS Two hundred and eight patients were eligible for inclusion: 67 in group I (SR), and 141 in group II (EBS). Both groups were comparable. There was no statistically significant difference in operating time (166.45min in group I vs. 156.69min in group II; P=0.156). Conversion to open surgery, hospital stay, postoperative complications, and short-term outcomes had no significant differences between the two groups. There was no mortality registered during this period. CONCLUSION Implementation of LRYGB stepwise learning as part of an SR training program is safe, and results are comparable to EBS, without loss of efficiency. Therefore, it is feasible to train SR in bariatric surgery under EBS supervision.
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Seguí-Moya E, González-Padilla DA, Ortega-Polledo LE, Sánchez-García M, López-González JA, Antón-Juanilla M, Mercader-Barrull C, Carrión DM, Gómez Rivas J, Álvarez-Ossorio JL. [Impact of COVID-19 in spanish urology residents: Recommendations and perspective]. ARCH ESP UROL 2020; 73:471-478. [PMID: 32538819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The COVID-19 pandemic has seriously disrupted the day-to-day running of hospitals, affecting the activity of all medical and surgical departments. It has also affected urology residents, depriving them of training at their usual workplaces and forcing them to support COVID units. This has implied not only the loss of daily activities, but also the uncertainty of job opportunities for the final year residents. In addition, the cancellation of numerous events such as congresses, exams,or courses has affected the annual planning of the specialty. A review of the current literature on the impact of the COVID-19 pandemic, as well as the de-escalation process, on resident training has been carried out using web search and PubMed. The situation of the residents has been analyzed, both through the information generated by recent literature and by the personal experience of the authors, from different areas: evaluation systems, educational and surgical aspects, as well as healthcare work. As a result of this review, the negative impact of the crisison urology resident training can be observed, especially in the surgical field, but new learning opportunities or new forms of communication with the patient can also be observed. These educational and healthcare resources invite the urology resident in particular, and the medical society in general, to reinvent themselves. The aim of this article is to analyse the training of the urology resident in the de-escalation phase. Similarly, the emerging educational resources during the pandemic are synthesized, inviting the reader, and especially the urology resident, to continue their training and learningin these times of uncertainty.
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Affiliation(s)
- Elena Seguí-Moya
- Servicio de Urología. Hospital General Universitario de Elche. Alicante. España
| | | | | | | | | | | | | | - Diego M Carrión
- Servicio de Urología. Hospital Universitario La Paz. Madrid. España
| | - Juan Gómez Rivas
- Servicio de Urología. Hospital Universitario La Paz. Madrid. España
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Cruz Navarro N. The value of andrology medical-surgical training programs for Urology residents. Actas Urol Esp 2020; 44:340-344. [PMID: 32245595 DOI: 10.1016/j.acuro.2020.01.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Accepted: 01/24/2020] [Indexed: 11/27/2022]
Abstract
Nowadays, sub-specialty expertise in andrology is required within the Urology training program. These practices -during the MIR (Medical Intern Residency) program and once the specialty studies are over- should be performed under supervision and have a multidisciplinary nature. In fact, the urologist's andrology training program does not finish with his residency period. The unceasingly increasing knowledge related to infertility, reproduction, sexual medicine and reconstructive surgery require a high level of dedication and engagement with continuing education. The field of Andrology has evolved significantly in Europe and in the United States in the past 30 years. Although the andrology training programs in these 2regions share some common aspects, there are also substantial differences between them. This chapter includes a review of the Spanish training programs and those in our international environment, with the objective to comprehend the importance of andrology medical-surgical training for Urology residents.
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Viejo Casas A, Gómez Molleda F, Astruga Tejerina C, Rodríguez Porres M, de Las Cuevas Allende R, Conde Diez S. [Quality of spirometry in Primary Care in Cantabria 10 years later. EspiroCan Study]. Semergen 2020; 46:161-166. [PMID: 32088158 DOI: 10.1016/j.semerg.2019.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 12/12/2019] [Accepted: 12/29/2019] [Indexed: 11/18/2022]
Abstract
INTRODUCTION To study the quality of spirometry performed in Primary Care in Cantabria (Spain) and the level of compliance with the regulations of this technique of the Spanish Society of Chest Diseases and Thoracic Surgery (SEPAR). MATERIAL AND METHODS Cross-sectional descriptive study in the Community of Cantabria using an original questionnaire based on the latest SEPAR regulations. The questionnaire was distributed in 2018 by internal mail to the 42 Primary Care Centres of the Cantabrian Health Service, with the coordinators of the PCC and the nurses responsible having been personally contacted by the researchers or by telephone. This is an original survey, based on the regulations of the SEPAR, which evaluates the quality of the material used (model, years of operation, calibration, cleanliness), as well as the training of personnel who perform spirometry. RESULTS The health personnel responsible for performing spirometry were surveyed in the 42 Primary Care Centres of the Cantabrian Health Service throughout the Cantabrian area. A mean of 564 spirometries are performed per month. A significant number (13%) of spirometers are never calibrated, and only 10.5% of the spirometers are calibrated by the personnel who perform the test in the centre itself. More than half (54, 53.7%) of these professionals have never received specific training to perform spirometry, and only 3.8% of them have experience in performing the test as recommended by SEPAR. As for the cleaning of the devices, 30% of the technicians do not clean the spirometer or the adapter. CONCLUSIONS 10 years after our initial study lack of training is still being observed in the professionals, and probably translates into invalid spirometry.
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Affiliation(s)
- A Viejo Casas
- Médicina de Familia, Servicio Cántabro de Salud, Asociación Cántabra de Investigación en Aparato Respiratorio ACINAR , Santander (Cantabria), España; Instituto de Investigación Sanitaria Valdecilla (IDIVAL), Santander (Cantabria), España; Grupo de Trabajo Respiratorio SEMERGEN, España.
| | - F Gómez Molleda
- Médicina de Familia, Servicio Cántabro de Salud, Asociación Cántabra de Investigación en Aparato Respiratorio ACINAR , Santander (Cantabria), España
| | - C Astruga Tejerina
- Médicina de Familia, Servicio Cántabro de Salud, Asociación Cántabra de Investigación en Aparato Respiratorio ACINAR , Santander (Cantabria), España
| | - M Rodríguez Porres
- Médicina de Familia, Servicio Cántabro de Salud, Asociación Cántabra de Investigación en Aparato Respiratorio ACINAR , Santander (Cantabria), España; Grupo de Trabajo Respiratorio SEMERGEN, España
| | - R de Las Cuevas Allende
- Médicina de Familia, Servicio Cántabro de Salud, Asociación Cántabra de Investigación en Aparato Respiratorio ACINAR , Santander (Cantabria), España
| | - S Conde Diez
- Médicina de Familia, Servicio Cántabro de Salud, Asociación Cántabra de Investigación en Aparato Respiratorio ACINAR , Santander (Cantabria), España
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Martínez-Ciarpaglini C, Expósito-Afonso I, Iglesias M, Perez-Mies B. [Pathology training in Spain: What is the status quo and how should we improve?]. Rev Esp Patol 2019; 53:3-9. [PMID: 31932007 DOI: 10.1016/j.patol.2019.06.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2019] [Revised: 05/06/2019] [Accepted: 06/13/2019] [Indexed: 11/17/2022]
Abstract
The unpopularity of Pathology among medical students is of concern worldwide, as is the high drop-out rate during the speciality training programme. Spain is no exception, with an estimated annual drop-out rate greater than 20%. In the present study, we aimed to analyse factors related to motivation, teaching and satisfaction with post-graduate training. Postgraduates in their 3rd and 4th year of speciality training programmes and pathologists during their first three years as specialists were asked to fill in a questionnaire; 155 participants from different parts of Spain took part in the study. Our results revealed a high level of satisfaction among those who had chosen pathology as their specialty and that their satisfaction correlated significantly with two factors: a previous knowledge of the speciality when choosing it and the quality of the training received. We detected certain differences amongst different training centres. The weakest points and thus those that need to be improved were training in molecular techniques, research methods and fine needle aspiration. Improving speciality training is certainly possible and should be the concern of all those who are responsible for postgraduate education in teaching hospitals.
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Affiliation(s)
- Carolina Martínez-Ciarpaglini
- Servicio de Anatomía Patológica, Hospital Clínico Universitario de Valencia. Fundación de investigación INCLIVA, Valencia, España.
| | - Idaira Expósito-Afonso
- Servicio de Anatomía Patológica, Universidad de La Laguna. Hospital Universitario de Canarias, Tenerife, España
| | - Mar Iglesias
- Servicio de Anatomía Patológica, Universidad Autónoma de Barcelona. Instituto Municipal de Investigaciones Médicas, Hospital del Mar, Barcelona, España
| | - Belen Perez-Mies
- Servicio de Anatomía Patológica, Hospital Ramón y Cajal, Madrid, España
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Villanueva Ordóñez MJ, Rey Galán C, Crespo Ruiz F, Díaz González L, Martínez Bastida G. Analysis of a sustained educational intervention to teach cardiopulmonaryresuscitation to schoolchildren. Emergencias 2019; 31:189-194. [PMID: 31210452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
This project analyzed the feasibility, effectiveness, and sustainability of an educational project to teach cardiopulmonary resuscitation (CPR). This project has been carried out in a publicly subsidized school in a town in Asturias, Spain (population, over 80 000 inhabitants). The enrollment included students in preschool and both primary and secondary education classes. The project had 3 phases: 1) health care experts trained the teachers in CPR and they designed the educational project together; 2) health care experts taught CPR to schoolchildren, and 3) teachers taught CPR to the children. All the children enrolled in preschool and primary school (aged 3 to 12 years) initially participated in the study. Training followed the 2005 guidelines of the International Liaison Committee on Resuscitation (ILCOR) in effect at the time of the study. In the first phase (2006), 19 teachers (79.2% of the faculty) were trained in basic CPR and collaborated with the health care professionals in designing the course, including setting its objectives and developing materials. In the second phase (2006-2011), the health care professionals trained 646 preschool and primary school children and accredited 13 teachers (54.2% of the faculty) in the use of an automated external defibrillator (AED) and to serve as CPR instructional monitors. In the third phase (2012-2014), 7 teachers trained 703 preschool and primary and secondary school students, and 17 teachers (70.8% of the faculty) received training to become CPR monitors and/or to update their knowledge of AED use. A total of 1349 students between the ages of 3 and 15 years received instruction in CPR. The school has had an AED on its premises since 2011. The teachers have made further improvements in the courses, incorporating new teaching materials, updating the objectives, and extending instruction to secondary school students. The implementation of an educational program to teach CPR in a school that enrolls preschool through secondary school students was feasible and sustainable. Teachers have improved the program, extended it to secondary school students, and made the project known in the local media and on the school's web site, thus contributing to the creation of a CPR culture that reached out to the community.
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Affiliation(s)
| | - Corsino Rey Galán
- Sección Cuidados Intensivos Pediátricos, Hospital Universitario Central de Asturias, Universidad de Oviedo, Oviedo, España
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Rodríguez Socarrás M, Ciappara M, García Sanz M, Pesquera L, Carrión DM, Tortolero L, Palou Redorta J, Cózar-Olmo JM, Esteban Fuertes M, Gómez Rivas J. Current status of young urologists and residents' activity and academic training in Spain. National survey results. Actas Urol Esp 2019; 43:169-175. [PMID: 30846289 DOI: 10.1016/j.acuro.2018.11.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2018] [Revised: 11/03/2018] [Accepted: 11/11/2018] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To study the current status of the activity and academic training of residents and young urologists in Spain. MATERIAL AND METHODS From the working group of residents and young urologists of the Spanish Association of Urology (AEU), an anonymous survey of 32 questions was designed. Its aim was to evaluate the academic activity of residents, defined by: number of communications to congresses, publications in national and international journals, clinical rotations within Spain and abroad, master's degree, Doctorate (PhD), applications to the European Board of Urology exam and language competences. The survey was sent via email and disseminated through social networks. RESULTS Ninety-one respondents were obtained; 66% affirmed not having publications in scientific journals, 67% did not perform rotations abroad. Only 21% claimed to have taken the EBU exam. Only 2% of the respondents had completed a Fellowship. Although most of them (82%) had not done so, they would be interested. However, 67% of respondents believed that the relevance of academic/research activity is from high to very high. CONCLUSIONS Our results indicate that academic activity, scientific production and publication of articles of the residents and young urologists in Spain is low. Moreover, participation in the EBU exam, the completion of a master's degree, PhD, rotations and fellowship is low. In contrast, the assessment of scientific activity is considered to be very relevant.
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Affiliation(s)
- M Rodríguez Socarrás
- Grupo de Residentes y Jóvenes Urólogos de la Asociación Española de Urología; Fellowship Servicio de Urología, Ospedale San Raffaele Turro, Milán, Italia; European Training Center in Endourology (ETCE); Young Academic Urologist Urotechnology group (YAU-ESUT).
| | - M Ciappara
- Grupo de Residentes y Jóvenes Urólogos de la Asociación Española de Urología; Servicio de Urología, Hospital Clínico San Carlos, Madrid, España
| | - M García Sanz
- Grupo de Residentes y Jóvenes Urólogos de la Asociación Española de Urología; Servicio de Urología, Complejo Universitario Hospitalario de León, León, España
| | - L Pesquera
- Grupo de Residentes y Jóvenes Urólogos de la Asociación Española de Urología; Servicio de Urología, Hospital Clínico Universitario de Valladolid, Valladolid, España
| | - D M Carrión
- Grupo de Residentes y Jóvenes Urólogos de la Asociación Española de Urología; Servicio de Urología, Hospital Universitario La Paz, Madrid, España
| | - L Tortolero
- Grupo de Residentes y Jóvenes Urólogos de la Asociación Española de Urología; Servicio de Urología, IMED Hospitales, Levante, España
| | | | - J M Cózar-Olmo
- Servicio de Urología, Complejo Hospitalario Universitario de Granada, Granada, España
| | - M Esteban Fuertes
- Servicio de Urología, Hospital de Parapléjicos de Toledo, Toledo, España
| | - J Gómez Rivas
- Grupo de Residentes y Jóvenes Urólogos de la Asociación Española de Urología; Servicio de Urología, Hospital Universitario La Paz, Madrid, España; Young Academic Urologist Urotechnology group (YAU-ESUT)
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González-Salvado V, Rodríguez-Ruiz E, Abelairas-Gómez C, Ruano-Raviña A, Peña-Gil C, González-Juanatey JR, Rodríguez-Núñez A. Training adult laypeople in basic life support. A systematic review. ACTA ACUST UNITED AC 2019; 73:53-68. [PMID: 30808611 DOI: 10.1016/j.rec.2018.11.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2018] [Accepted: 11/07/2018] [Indexed: 02/03/2023]
Abstract
INTRODUCTION AND OBJECTIVES Bystander assistance is decisive to enhance the outcomes of out-of-hospital cardiac arrest. Despite an increasing number of basic life support (BLS) training methods, the most effective formula remains undefined. To identify a gold standard, we performed a systematic review describing reported BLS training methods for laypeople and analyzed their effectiveness. METHODS We reviewed the MEDLINE database from January 2006 to July 2018 using predefined inclusion and exclusion criteria, considering all studies training adult laypeople in BLS and performing practical skill assessment. Two reviewers independently extracted data and evaluated the quality of the studies using the MERSQI (Medical Education Research Study Quality Instrument) scale. RESULTS Of the 1263 studies identified, 27 were included. Most of them were nonrandomized controlled trials and the mean quality score was 13 out of 18, with substantial agreement between reviewers. The wide heterogeneity of contents, methods and assessment tools precluded pooling of data. Nevertheless, there was an apparent advantage of instructor-led methods, with feedback-supported hands-on practice, and retraining seemed to enhance retention. Training also improved attitudinal aspects. CONCLUSIONS While there were insufficiently consistent data to establish a gold standard, instructor-led formulas, hands-on training with feedback devices and frequent retraining seemed to yield better results. Further research on adult BLS training may need to seek standardized quality criteria and validated evaluation instruments to ensure consistency.
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Affiliation(s)
- Violeta González-Salvado
- Servicio de Cardiología, Hospital Clínico Universitario de Santiago de Compostela, Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Santiago de Compostela, A Coruña, Spain; Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), A Coruña, Spain; Grupo CLINURSID, Universidade de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain.
| | - Emilio Rodríguez-Ruiz
- Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), A Coruña, Spain; Servicio de Medicina Intensiva, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain
| | - Cristian Abelairas-Gómez
- Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), A Coruña, Spain; Grupo CLINURSID, Universidade de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain; Facultad de Ciencias de la Educación, Universidade de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain
| | - Alberto Ruano-Raviña
- Departamento de Medicina Preventiva y Salud Pública, Universidad de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Spain
| | - Carlos Peña-Gil
- Servicio de Cardiología, Hospital Clínico Universitario de Santiago de Compostela, Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Santiago de Compostela, A Coruña, Spain; Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), A Coruña, Spain
| | - José Ramón González-Juanatey
- Servicio de Cardiología, Hospital Clínico Universitario de Santiago de Compostela, Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Santiago de Compostela, A Coruña, Spain; Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), A Coruña, Spain
| | - Antonio Rodríguez-Núñez
- Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), A Coruña, Spain; Grupo CLINURSID, Universidade de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain; Unidad de Cuidados Intensivos Pediátricos, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain; Escuela de Enfermería, Universidade de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain
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Cerezo Espinosa C, Segura Melgarejo F, Melendreras Ruiz R, García-Collado ÁJ, Nieto Caballero S, Juguera Rodríguez L, Pardo Ríos S, García Torrano S, Linares Stutz E, Pardo Ríos M. Virtual reality in cardiopulmonary resuscitation training: a randomized trial. Emergencias 2019; 31:43-46. [PMID: 30656873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
OBJECTIVES To assess the efficacy of virtual reality (VR) in cardiopulmonary resuscitation (CPR) training. MATERIAL AND METHODS Experimental, analytic, cross-sectional study of a CPR training method using VR. Participants were randomly assigned to train in a control group or a VR group. RESULTS The mean (SD) scores on a scale of 10 after training were 9.28 (0.91) in the VR group and 7.78 (1.63) in the control group, for a mean difference of 1.49 (95% CI, 0.96-2.02; P<.001). The VR group achieved a mean of 97.5 (9.7) compressions/min, versus 80.9 (7.7) compressions/min in the control group, for a mean difference of 16.6 compressions/min (95% CI, 15.0-18.2; P=.003). The mean compression depth in the VR group was 34.0 (6.5) mm, versus 27.9 (4.9) mm in the control group, for a mean difference of 6.7 (95% CI, 5.7-7.8; P<.001). CONCLUSION Training with VR can improve CPR theoretical knowledge and practical skills.
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Affiliation(s)
- Cristina Cerezo Espinosa
- Programa Doctorado en Ciencias de la Salud, Universidad Católica de Murcia (UCAM), España. Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, España
| | | | | | | | - Sergio Nieto Caballero
- Programa Doctorado en Ciencias de la Salud, Universidad Católica de Murcia (UCAM), España. Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, España. Gerencia de Urgencias y Emergencias Sanitarias 061 de la Región de Murcia, España
| | | | - Sergio Pardo Ríos
- Conserjería de Educación y Universidades de la Región de Murcia, España
| | | | | | - Manuel Pardo Ríos
- Gerencia de Urgencias y Emergencias Sanitarias 061 de la Región de Murcia, España
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Brogly N, Engelhardt W, Hill S, Ringvold EM, Varosyan A, Varvinskiy A, Zerafa M. European Diploma in Anaesthesiology and Intensive Care in Spain: Results for the part 1 and part 2 exams in the last five years. Are we going in the right direction? ACTA ACUST UNITED AC 2019; 66:206-212. [PMID: 30678812 DOI: 10.1016/j.redar.2018.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Revised: 11/27/2018] [Accepted: 12/13/2018] [Indexed: 10/27/2022]
Abstract
BACKGROUND The European Diploma in Anaesthesiology and Intensive Care (EDAIC) has become a standard of quality among Spanish anaesthesiologists. The aim of this retrospective observational study was to assess the results of Spanish participants for the Part1 and Part2 exams over a recent five years period from 2012 to 2016 and 2013 to 2017, respectively. MATERIAL AND METHODS After obtaining the authorization from the European Society of Anaesthesiology, the results of both parts of the EDAIC exams were anonymously analysed for five years. We analysed the number of registrations, the pass rates, the cause for failure and the mean scores for basic sciences (paperA of part1 exam and the two first vivas of part2 exam) and clinical anaesthesia and intensive care (paperB of part1 exam and the two last vivas of part2 exam). Quantitative variables were analysed using the one-way analysis of variance, and qualitative variables using the chi-square test for trends. The level of statistical significance was set at P<.05. RESULTS For the written part1 exam, 1,189 of a total of 10,954 candidates (10.85%) were registered in Spanish centres, reflecting the global growth of the exam (P=.29). The pass rate was 62.1%, with no significant differences from other countries (P=.38). Basic sciences were involved in 84.1% of failing candidates. Mean scores were 71.74±5.98% for basic science (paperA) and 74.48±4.29% for clinical anaesthesiology (paperB). Regarding the part2 exam, 72.4% of the candidates who had passed the part1 exam registered for the oral part2, with a pass rate of 62.7% versus 62.2% in the rest of the world (P=.91). Failing in the basic sciences sections of the part2 resulted in 93.8% of candidates failing the part2 exam. Bad fails were registered in 56 (31.5%) of failing candidates, of which 71.3% occurred in the basic sciences vivas. Isolated bad fails only occurred in 7 (3.9%) cases. CONCLUSIONS The evolution of the EDAIC in Spain has been very similar to evolution of the EDAIC in the rest of the world. Further efforts to improve knowledge in basic sciences and better preparation in the technique of oral examination should improve the pass rate of the EDAIC examinations from an ever-increasing cohort of candidates.
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Affiliation(s)
- N Brogly
- Examinations Committee of the European Diploma in Anaesthesiology and Intensive Care (EDAIC); Departamento de Anestesia y Reanimación, Hospital Universitario La Paz, Madrid, España.
| | - W Engelhardt
- Examinations Committee of the European Diploma in Anaesthesiology and Intensive Care (EDAIC); Department of Anaesthesiology and Intensive Care Medicine, Offenburg Hospital, Offenburg, Alemania
| | - S Hill
- Examinations Committee of the European Diploma in Anaesthesiology and Intensive Care (EDAIC)
| | - E-M Ringvold
- Examinations Committee of the European Diploma in Anaesthesiology and Intensive Care (EDAIC); Department of Anaesthesiology and Intensive Care, Vestfold Hospital Trust, Tønsberg, Noruega
| | - A Varosyan
- Examinations Committee of the European Diploma in Anaesthesiology and Intensive Care (EDAIC); Department of Anaesthesiology and Intensive Care, Yerevan State Medical University, Erebouni Medical Centre, Yerevan, Armenia
| | - A Varvinskiy
- Examinations Committee of the European Diploma in Anaesthesiology and Intensive Care (EDAIC); Department of Anaesthesia, Torbay Hospital, Torquay, Reino Unido
| | - M Zerafa
- Examinations Committee of the European Diploma in Anaesthesiology and Intensive Care (EDAIC); Department of Anaesthesia and Intensive Care Medicine, Mater Dei Hospital, Msida, Malta
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Abstract
The diagnoses and prognoses that medical professionals have to communicate in cases of cancer come with special problems. Of all fatal diseases, cancer possibly causes most psychological impact on the patient. Although, by nature, medical professionals are aware of this negative impact and take care to be as prudent and human as possible, recent studies have shown that the "psychological factors of the patient" are of direct relevance to the medical factors in cancer, over and above their importance on quality of life during the course of the disease. This direct relevance needs replies that go beyond purely medical knowledge, as well as a specific training as to their application. Interdisciplinary medical-psychological cooperation is probably required. Studies indicate that compliance with both requisites may bring an improvement to clinical results. In Europe, although less than in the United States of America, the necessary inclusion has been the recognition of psychological training in academic pre- and postgraduate training in communicating these cases.
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Affiliation(s)
- D M Campagne
- Departamento de Personalidad, Evaluación y Tratamientos Psicológicos, Facultad de Psicología, Universidad Nacional de Educación a Distancia, Madrid, España.
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García-Rodríguez A, Fernández-Esparrach G, Sendino O, Ginès A. State of endoscopic ultrasonography in Spain in 2017. Gastroenterol Hepatol 2018; 41:672-678. [PMID: 30060962 DOI: 10.1016/j.gastrohep.2018.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 05/31/2018] [Accepted: 06/04/2018] [Indexed: 02/07/2023]
Abstract
AIM To understand the current state of endoscopic ultrasonography (EUS) in Spain. METHODS Descriptive analysis from a national survey with 11 questions: 10 related to technique and 1 to the training and experience of the endoscopists. RESULTS Sixty endoscopists from 48 of the 97 (49.5%) hospitals that perform EUS in Spain responded to the survey. A total of 28,678 procedures (20,311 diagnostic, 7,446 with puncture and 921 therapeutic) were recorded over the course of one year. Approximately 64% of the hospitals perform between 300 and 999 tests per year. All have radial and sectorial echoendoscopes, with a median of 2 (2-8) scopes. For cytological diagnosis, the 22-gauge needle is the most commonly used (98%) and, for histological diagnosis, the Procore (72%). The study of the pancreas and bile duct is the most common indication for diagnostic EUS (60%), followed by the staging of digestive tract neoplasms (20%). Approximately 72% of the hospitals perform on-site cytopathology evaluations and sedation is administered in equal parts by both endoscopists and anaesthetists. In terms of experience, 45% of echoendoscopists perform fewer than 300 annual exams and the median training duration is 6months (0.5-36). CONCLUSIONS EUS is adequately implemented in Spain and good equipment is available. However, it is necessary to establish a standardised EUS training program since the one undertaken by many echoendoscopists could prove insufficient according to the standards established by Scientific Societies.
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Affiliation(s)
- Ana García-Rodríguez
- Unidad de Endoscopia, Servicio de Gastroenterología, ICMDiM, Hospital Clínic, CIBERehd, IDIBAPS, Universitat de Barcelona, Barcelona, España
| | - Gloria Fernández-Esparrach
- Unidad de Endoscopia, Servicio de Gastroenterología, ICMDiM, Hospital Clínic, CIBERehd, IDIBAPS, Universitat de Barcelona, Barcelona, España.
| | - Oriol Sendino
- Unidad de Endoscopia, Servicio de Gastroenterología, ICMDiM, Hospital Clínic, CIBERehd, IDIBAPS, Universitat de Barcelona, Barcelona, España
| | - Angels Ginès
- Unidad de Endoscopia, Servicio de Gastroenterología, ICMDiM, Hospital Clínic, CIBERehd, IDIBAPS, Universitat de Barcelona, Barcelona, España
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- Unidad de Endoscopia, Servicio de Gastroenterología, ICMDiM, Hospital Clínic, CIBERehd, IDIBAPS, Universitat de Barcelona, Barcelona, España
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López-Bravo A, Bellosta-Diago E, Viloria-Alebesque A, Marín-Gracia M, Laguna-Sarriá J, Santos-Lasaosa S. Headache as a reason for consultation: the primary care perspective. Neurologia 2018; 36:S0213-4853(18)30183-X. [PMID: 30072273 DOI: 10.1016/j.nrl.2018.06.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Revised: 06/14/2018] [Accepted: 06/16/2018] [Indexed: 01/09/2023] Open
Abstract
INTRODUCTION Headache is a frequent reason for consultation with primary care (PC) physicians. However, the condition is underdiagnosed and undertreated. One reason for this may be the lack of specific training on headache in PC. METHODS We conducted a descriptive cross-sectional study of data gathered with a self-administered survey that was completed by PC physicians from our health district. We collected sociodemographic data and information on previous training in neurology and headache, and training needs. RESULTS The survey was completed by 104 PC physicians, 53% of whom were women; mean age was 49 years. Most respondents worked in urban settings (42.3%) and had been trained via residency (77.9%). Although 65.4% spent more time with patients with headache than with other patients, only 32.7% used the International Classification of Headache Disorders. In our sample, 68.3% of respondents reported a high or very high interest in headache, and 75.9% wished to receive further training on the condition; theoretical and practical courses and update lectures were regarded as the most useful tools. In clinical practice, 90% used triptans and 78% used preventive treatments. The most frequently used drug was amitriptyline; only 22.1% choose topiramate. CONCLUSIONS PC physicians are in frequent contact with patients with headache and show interest in receiving training on this condition. This could be helpful in designing training programmes aimed at improving quality of care in this area.
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Affiliation(s)
- A López-Bravo
- Servicio de Neurología, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España.
| | - E Bellosta-Diago
- Servicio de Neurología, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España
| | - A Viloria-Alebesque
- Servicio de Neurología, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España
| | - M Marín-Gracia
- Servicio de Neurología, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España
| | - J Laguna-Sarriá
- Servicio de Medicina Familiar y Comunitaria, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España
| | - S Santos-Lasaosa
- Servicio de Neurología, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España
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Lovegrove C, Bruce E, Raison N, Khan S, Brown C, Rane A, Sheriff M, Dasgupta P, Ahmed K. Development and validation of a training and assessment tool for laparoscopic radical nephrectomy. Actas Urol Esp 2018; 42:396-405. [PMID: 29609827 DOI: 10.1016/j.acuro.2017.10.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Revised: 10/29/2017] [Accepted: 10/30/2017] [Indexed: 10/17/2022]
Abstract
INTRODUCTION Laparoscopic radical nephrectomy(LRN) is a cornerstone in managing renal cancer and small renal masses. Twenty-first century surgical training faces challenges, thus must be efficient and safe so surgeons attain relevant skills, protecting patients and operative outcomes. This study aimed to systematically develop a tool for training and assessment in LRN and validate the developed tool for use by trainee urologists. METHODS This prospective, longitudinal, multi-institutional study was undertaken from September 2014 - June 2015. Healthcare Failure Mode and Effect Analysis was utilised for development and followed by validation where the assessment tool was distributed to five specialists to increase content validity. Four experts were observed as a multi-institutional approach. Hand-assisted, transperitoneal and retroperitoneal approaches were considered. RESULTS The LRN Assessment Tool comprised four phases, 17 processes, 41 sub-processes. Four surgeons and operating teams were observed across four hospitals for 19.5hours (5.75h hand-assisted, 8.75h trans-peritoneal, 5h retro-peritoneal). After hazard analysis, three checklists were constructed. Those for hand-assisted LRN and transperitoneal LRN contained four phases, 20 processes, 33 sub-processes and that for retroperitoneal LRN contained four phases, 20 processes, 30 sub-processes. These were merged to form one assessment tool. The final result was a four phase LRN Assessment Tool with 17 processes, 41 sub-processes. All participants agreed the final LRN Assessment Tool included pertinent steps. CONCLUSIONS The LRN Assessment Tool was developed using Healthcare Failure Mode and Effect Analysis risk analysis to ensure hazardous procedural sub-steps were included. Validation ascertained important processes were not overlooked. Full application through a pilot study must be undertaken.
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50
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Torres Macho J, García Sánchez FJ, Garmilla Ezquerra P, Beltrán Romero L, Canora Lebrato J, Casas Rojo JM, Arribas Arribas P, López Palmero S, Pintos Martínez S, Cepeda Rodrigo JM, Luordo D, Beltrán López M, Méndez Bailón M, Rodilla Sala E, Manzano Espinosa L, Zapatero Gaviria A, García de Casasola G. Positioning document on incorporating point-of-care ultrasound in Internal Medicine departments. Rev Clin Esp 2018. [PMID: 29519537 DOI: 10.1016/j.rce.2018.02.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
This positioning document describes the most important aspects of clinical ultrasonography in the internal medicine setting, from its fundamental indications to the recommended training period. There is no question as to the considerable usefulness of this tool in the standard clinical practice of internists in numerous clinical scenarios and settings (emergencies, hospital ward, general and specific consultations and home care). Ultrasonography has a relevant impact on the practitioner's ability to resolve issues, increasing diagnostic reliability and safety and providing important information on the prognosis and progression. In recent years, ultrasonography has been incorporated as a tool in undergraduate teaching, with excellent results. The use of ultrasonography needs to be widespread. To accomplish this, we must encourage structured training and the acquisition of equipment. This document was developed by the Clinical Ultrasonography Workgroup and endorsed by the Spanish Society of Internal Medicine.
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Affiliation(s)
- J Torres Macho
- Servicio de Medicina Interna-Urgencias, Hospital Universitario Infanta Cristina, Parla (Madrid), España.
| | - F J García Sánchez
- Servicio de Medicina Interna-Urgencias, Hospital Universitario Infanta Cristina, Parla (Madrid), España
| | - P Garmilla Ezquerra
- Servicio de Urgencias, Hospital Universitario Marqués de Valdecilla, Santander, España
| | - L Beltrán Romero
- Servicio de Medicina Interna, Hospital Universitario Virgen del Rocío, Sevilla, España
| | - J Canora Lebrato
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, Madrid, España
| | - J M Casas Rojo
- Servicio de Medicina Interna-Urgencias, Hospital Universitario Infanta Cristina, Parla (Madrid), España
| | - P Arribas Arribas
- Servicio de Medicina Interna, Hospital de Santa Bárbara, Soria, España
| | - S López Palmero
- Unidad de Gestión Clínica de Medicina Interna, Hospital de Torrecárdenas, Almería, España
| | | | - J M Cepeda Rodrigo
- Servicio de Medicina Interna, Hospital Vega Baja, Orihuela (Valencia), España
| | - D Luordo
- Servicio de Medicina Interna-Urgencias, Hospital Universitario Infanta Cristina, Parla (Madrid), España
| | - M Beltrán López
- Servicio de Medicina Interna, Hospital Virgen del Camino, Sanlúcar de Barrameda (Cádiz), España
| | - M Méndez Bailón
- Servicio de Medicina Interna, Hospital Universitario Clínico San Carlos, Madrid, España
| | - E Rodilla Sala
- Servicio de Medicina Interna, Hospital de Sagunto, Valencia, España
| | - L Manzano Espinosa
- Servicio de Medicina Interna, Hospital Universitario Ramón y Cajal, Madrid, España
| | - A Zapatero Gaviria
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, Madrid, España
| | - G García de Casasola
- Servicio de Medicina Interna-Urgencias, Hospital Universitario Infanta Cristina, Parla (Madrid), España
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