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Assessment of perceptions of clinical management in courses oriented by competency; Avaliação de percepções sobre gestão da clínica em cursos orientados por competência

Article Open Access
The study aims to assess perceptions of mastery of abilities in clinical management in participants of courses oriented by competency and based on active methodologies of teaching and learning, before and after the offered training process. Three conceptual frameworks were utilized: clinical management, expectation of auto-efficacy, and the holistic concept of competency. Methodologically, an electronic instrument was made available to students of the training courses, adapted to the Likert scale, in two stages: before the courses were undertaken and after their completion. The group of subjects that participated simultaneously in both stages was comprised of 825 trainees. Average, mean, standard deviation, and the Wilcoxon test were utilized in the analysis. Generally, in terms of findings, the perception of mastery of abilities in clinical management increased after the courses, proving a positive contribution of the training process of the students. Among other aspects of their results, it is concluded that the educational initiatives studied, oriented by competency and based in active methodologies of teaching and learning, can obtain the increase in perception of their participants regarding the mastery of abilities present in the competency profile, confirming the study’s hypothesis. © 2017, Associacao Brasileira de Pos - Graduacao em Saude Coletiva. All rights reserved.
The study aims to assess perceptions of mastery of abilities in clinical management in participants of courses oriented by competency and based on active methodologies of teaching and learning, before and after the offered training process. Three conceptual frameworks were utilized: clinical managem …

Procedural knowledge and skills of residents entering canadian family medicine programs in Alberta

Article Open Access
BACKGROUND AND OBJECTIVES: Incoming family medicine (FM) residents start residency with different levels of procedural training. Understanding their baseline skill level is necessary to plan the educational experiences and teaching methods that will provide the desired knowledge, skills, and attitudes related to performing medical procedures. METHODS: A survey of 69 procedures based on the core list issued by the College of Family Physicians of Canada was administered to incoming residents in Alberta (Calgary and Edmonton FM programs). The survey intended to identify the levels of training and confidence acquired for each listed procedure before residency, and plans to perform each of the procedures in future independent practice. RESULTS: A total of 146 residents from both programs responded to the survey (82% response rate). Of the 69 procedures evaluated, 15 (21.7%) had been previously performed at least five times by 50% or more residents. Only five procedures were rated by 80% or more of the residents as being able to perform independently or to teach to others: simple suture, infiltration of local anesthetic, intramuscular injection, cryotherapy of skin lesions and Pap smear. More male residents than female residents felt confident in performing 10 procedures, while female residents were more confident in performing Pap smears. Rural residents felt more confident to perform 22 procedures than their urban colleagues. CONCLUSIONS: This information demonstrates limited prior training in procedures among entering residents, and provides guidance to FM programs to develop teaching interventions to achieve competence in those procedural skills seen as necessary for family physicians. © 2018 Society of Teachers of Family Medicine. All Rights Reserved.
BACKGROUND AND OBJECTIVES: Incoming family medicine (FM) residents start residency with different levels of procedural training. Understanding their baseline skill level is necessary to plan the educational experiences and teaching methods that will provide the desired knowledge, skills, and attitud …

Facilitating pipeline progress from doctoral degree to first job

Article
The sequence of professional development within psychology from doctoral education to first job represents a period of remarkable professional and personal growth for each trainee. However, this sequence also contains a variety of barriers that hinder progress through the pipeline. The myriad individual-, program-, and system-level barriers encountered by trainees in health service/other applied service psychology and in research basic/applied psychology are identified. To actively and systematically facilitate improved passage through major transition points, individual trainee and trainer, program- and system-level action steps are recommended. In addition, emphasis is placed on ensuring that the psychology education and training culture prioritizes the progress, creativity, and flourishing of trainees and supports their movement through branching pipelines in their training and in their careers. © 2018 American Psychological Association.
The sequence of professional development within psychology from doctoral education to first job represents a period of remarkable professional and personal growth for each trainee. However, this sequence also contains a variety of barriers that hinder progress through the pipeline. The myriad indivi …

Maintaining capacity for in-practice teaching and supervision of students and general practice trainees: A cross-sectional study of early career general practitioners

Article
Objectives. Expanding learner cohorts of medical students and general practitioner (GP) vocational trainees and the impending retirement of the 'baby boomer' GP cohort threaten the teaching and supervisory capacity of the Australian GP workforce. Engaging newly qualified GPS is essential to sustaining this workforce training capacity. The aim of the present study was to establish the prevalence and associations of in-practice clinical teaching and supervision in early career GPS. Methods. The present study was a cross-sectional questionnaire-based study of recent (within 5 years) alumni of three of Australia's 17 regional general practice training programs. The outcome factor was whether the alumnus taught or supervised medical students, GP registrars or other learners in their current practice. Logistic regression analysis was used to establish associations of teaching and supervision with independent variables comprising alumnus demographics, current practice characteristics and vocational training experiences. Results. In all, 230 alumni returned questionnaires (response rate 37.4%). Of currently practising alumni, 52.4% (95% confidence interval (CI) 45.6-59.0%) reported current teaching or supervisory activities. Factors significantly (P < 0.05) associated with alumni currently undertaking in-practice clinical teaching and supervision were: Australian medical graduation (odds ratio (OR) for international graduates 0.36; 95% CI 0.14-0.92), working in a regional or remote area (OR 2.75; 95% CI 1.24-6.11) and currently undertaking nursing home visits, home visits or after-hours work (OR 2.01; CI 1.02-3.94). © AHHA 2018.
Objectives. Expanding learner cohorts of medical students and general practitioner (GP) vocational trainees and the impending retirement of the 'baby boomer' GP cohort threaten the teaching and supervisory capacity of the Australian GP workforce. Engaging newly qualified GPS is essential to sustaini …

Competency-Based, Time-Variable Education in the Health Professions: Crossroads

Article
Health care systems around the world are transforming to align with the needs of 21st-century patients and populations. Transformation must also occur in the educational systems that prepare the health professionals who deliver care, advance discovery, and educate the next generation of physicians in these evolving systems. Competency-based, time-variable education, a comprehensive educational strategy guided by the roles and responsibilities that health professionals must assume to meet the needs of contemporary patients and communities, has the potential to catalyze optimization of educational and health care delivery systems. By designing educational and assessment programs that require learners to meet specific competencies before transitioning between the stages of formal education and into practice, this framework assures the public that every physician is capable of providing high-quality care. By engaging learners as partners in assessment, competency-based, timevariable education prepares graduates for careers as lifelong learners. While the medical education community has embraced the notion of competencies as a guiding framework for educational institutions, the structure and conduct of formal educational programs remain more aligned with a time-based, competency-variable paradigm. The authors outline the rationale behind this recommended shift to a competency-based, time-variable education system. They then introduce the other articles included in this supplement to Academic Medicine, which summarize the history of, theories behind, examples demonstrating, and challenges associated with competencybased, time-variable education in the health professions. © 2018 by the Association of American.
Health care systems around the world are transforming to align with the needs of 21st-century patients and populations. Transformation must also occur in the educational systems that prepare the health professionals who deliver care, advance discovery, and educate the next generation of physicians i …

Science education: Development of environmental thinking

Article Open Access
The revealed feature of natural sciences school education today is related to the need for the systemic development of scientific environmental thinking in the structure of environmental competence for a sustainable development. Environmental thinking is viewed as a unity of scientific systems' thinking in the field of natural sciences and corresponding practical activities within sustainable humans' life environment development. Indicators of environmental thinking of teenagers, corresponding principles and pedagogical guidelines for the development of environmental thinking have been theoretically substantiated and experimentally approved. Educational, motivational and behavioral indicators of environmental thinking and four pedagogical guidelines were singled out. Systemic integration of educational, gaming, working and public environmental activities of pupils are proposed. A systemic activity approach strengthening the research orientation and the reflexive nature of the project environmental protection activities of pupils is studied. This approach takes into consideration the age features of pupils when developing a system of practical environmental protection, the organization of joint methodological and educational activities of teachers and the pedagogical characteristics of the education institutions. © 2018 International Strategic Management Association. All rights reserved.
The revealed feature of natural sciences school education today is related to the need for the systemic development of scientific environmental thinking in the structure of environmental competence for a sustainable development. Environmental thinking is viewed as a unity of scientific systems' thin …

The History of Medical Education in Europe and the United States, with Respect to Time and Proficiency

Article
In this article, the authors present a historic overview of the development of medical education in the United States and Europe (in particular the Netherlands), as it relates to the issues of time (duration of the course) and proficiency (performance requirements and examinations). This overview is necessarily limited and based largely on post hoc interpretation, as historic data on time frames are not well documented and the issue of competence has only recently been addressed. During times when there were few, if any, formal regulations, physicians were primarily "learned gentlemen"in command of few effective practical skills, and the duration of education and the competencies acquired by the end of a course simply did not appear to be issues of any interest to universities or state authorities. Though uniform criteria gradually developed for undergraduate medical education, postgraduate specialty training remained, before accreditation organizations set regulations, at the discretion of individual institutions and medical societies. This resulted in large variability in training time and acquired competencies between residency programs, which were often judged on the basis of opaque or questionable criteria. Considering the high costs of health care today and the increasing demand for patient safety and educational efficiency, continuing historic models of nonstandardized practices will no longer be feasible. Efforts to constrain, restructure, and individualize training time and licensing tracks to optimize training for safe care, both in the United States and Europe, are needed. © 2018 by the Association of American.
In this article, the authors present a historic overview of the development of medical education in the United States and Europe (in particular the Netherlands), as it relates to the issues of time (duration of the course) and proficiency (performance requirements and examinations). This overview is …

Training Primary Health Professionals in Breast Cancer Prevention: Evidence and Experience from Mexico

Article Open Access
To analyze the key successful factors of a national educational strategy for early breast cancer detection developed in Mexico for primary health care personnel from 2008 to 2014, an educational strategy to train physicians, nurses, health promoters, and medical students from local ministries of health with a competency-based approach was developed and implemented using diverse educational modalities, face-to-face, blended, and a massive open online course (MOOC). Formative and summative evaluations were used during the implementation of the course. A total of 19,563 health professionals were trained from 2008 to 2014. The graduation rate, an average of all educational modalities, was 91 %, much higher than those previously reported in the literature. The factors that might have influenced this success were (1) the training strategy, which was designed according to the characteristics and specific needs of the target groups; (2) the political will and commitment of the country’s health authorities; (3) the technological and educational models used; and (4) the punctual follow-up of participants. This study shows that carefully designed educational interventions can improve service professionals’ competencies and that regardless of the modality, face-to-face, blended learning, or MOOC, high graduation rates can be achieved. Further evaluation is required to demonstrate that the competencies remained in all target groups after 6 months of the intervention and that the women served by the trained personnel were provided accurate information and timely diagnoses of breast cancer. © 2016, The Author(s).
To analyze the key successful factors of a national educational strategy for early breast cancer detection developed in Mexico for primary health care personnel from 2008 to 2014, an educational strategy to train physicians, nurses, health promoters, and medical students from local ministries of hea …

The Magnitude and Determinants of Emotional-Behavioral Problems in Working Adolescents in Turkey

Article
OBJECTIVE: Working adolescents are at a greater risk of mental disorders than are non-working adolescents. The present study was aimed at determining the magnitude and determinants of emotional and behavioral problems in working adolescents. METHODS: This cross-sectional study was conducted with 343 adolescents attending two vocational training centers in the province of Balikesir between January 2016 and March 2016. The data were collected with the Personal Information Form, and the Strengths and Difficulties Questionnaire. In the analysis, descriptive statistics, the t-test, Mann Whitney U test and one way ANOVA were used. RESULTS: In the study of the adolescents, 16.9% were determined to have abnormal emotional and behavioral problems. Of the participating adolescents, girls, those with physical illnesses, living in fragmented families, perceiving their economic status as good, having fathers with primary school education and/or having mothers with high school or higher education had significantly higher emotional and behavioral problem scores (p < 0.05). CONCLUSION: In this study, approximately one-fifth working Turkish adolescents had abnormal mental status. Based on the aforementioned results, it can be suggested to develop intervention programs for the prevention, early diagnosis and treatment of emotional and behavioral problems in working adolescents. © 2017 Elsevier Inc.
OBJECTIVE: Working adolescents are at a greater risk of mental disorders than are non-working adolescents. The present study was aimed at determining the magnitude and determinants of emotional and behavioral problems in working adolescents. METHODS: This cross-sectional study was conducted with 343 …

Challenges for Training Translational Researchers in the Era of Ubiquitous Data

Article
Our ability to collect data at every stage of the translational pipeline creates great opportunities for formulating hypotheses both “upstream” (towards clinical implementation) and “downstream” (back to basic discovery). Translational researchers therefore must integrate information at multiple scales to both generate and test hypotheses—to some extent they must all be comfortable with the basics of “big data” analyses. This increased focus on data-driven science requires an understanding of basic experimental and clinical data collection—understanding that likely cannot efficiently be gathered through traditional apprenticeship models. Thus, new curricula are required to ensure that next-generation scientists have a new combination of skills required for integrating data to catalyze discovery. © 2017 American Society for Clinical Pharmacology and Therapeutics
Our ability to collect data at every stage of the translational pipeline creates great opportunities for formulating hypotheses both “upstream” (towards clinical implementation) and “downstream” (back to basic discovery). Translational researchers therefore must integrate information at multiple sca …