Medical education

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Simulation, a teaching aid for medical education

Simulation, a teaching aid for medical education

Simulation is a technique used for formal medical education for more than 40 years. Its application has allowed a better training of medical and nursing students, as well as specialists in different clinical and surgical residences and the improvement of invasive and surgical techniques. In addition, by using simulation labs it has been possible to have a more objective education, given the fact that sometimes the access of the student to the patient is limited by ethical, social, administrative or legal parameters. Finally simulation together with the critical reasoning and education based on the resolution of problems has allowed improving and understanding the deep meaning of the competitions. As a technique, simulation offers an objective and a control way to understand the real importance of trial and error as an important pillar for the improvement of skills; besides it represents a method that allows a quality control over education and surgical techniques.
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17 Lee mas

An electronic portfolio for quantitative assessment of surgical skills in undergraduate medical education.

An electronic portfolio for quantitative assessment of surgical skills in undergraduate medical education.

Portfolio-based assessment tool is at the apex of Miller’s pyramid, because it provides performance-based assess- ment in real context by analysis of actions [1,2]. Portfolios are widely replacing logbooks in medical education. Logbooks are simple collections of tasks performed but do not include critical reflections, and recording of activities in a logbook may be viewed as a chore rather than a way to stimulate learning. Portfolios include critical reflection, and therefore encourage performance and learning as a challenge in a way that logbooks do not [3]. Undergraduate students usually complete logbooks that describe the diseases they should observe [4], but these do not usually include tasks to develop practical skills. Reflection is a metacognitive process that creates a greater understanding of both the self and the situation, so that future actions can be influenced by this understanding [5]. Although there is little research evidence to suggest that reflection improves quality of care, it may enhance the care process [6].
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9 Lee mas

Game-based Learning in medical education

Game-based Learning in medical education

Rules. The player has a limited time to each of the phases that must pass to cure the patient. To access the medical records has to select the photo of the patients. As an interactive puzzle type game, the user can solve every case and move on to other levels of major complications through different routes of action. In all, learning is assured. The steps are usually: having knowledge of patient’s symptoms, asking for lab tests and some extra patient’s anamnesis, making a diagnosis of the infectious disease and finally giving the patient an adequate treatment. All this against the clock, there is a time for each phase, the patient after a while without the correct answer gets worse, and decide to change doctor. Due to much of the first diagnoses in real life are not the most appropriate, this game allows the player to return to resolve cases more than once, whether is right to review concepts as it has successful to heal patient.
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8 Lee mas

A Latin American, Portuguese and Spanish consensus on a core communication curriculum for undergraduate medical education

A Latin American, Portuguese and Spanish consensus on a core communication curriculum for undergraduate medical education

this list, those they considered as most renowned in this field (in relation to specific aspects such as academic lead- ership, impact publications, research experience, etc.) and to classify each “ eligible expert ” into one of the following three categories: unquestionable expert, possible expert and without opinion on the candidate ’ s expertise. Focus- ing especially on those that received classification as un- questionable or possible expert from several different institutions/countries, the final panel was constituted, in- cluding 51 experts from Argentina, Brazil, Chile, Colombia, Spain, Mexico, Peru and Portugal: 37 physi- cians (4 planners and/or healthcare managers in public and private medical institutions and 1 representative of an organisation for patients ’ defence), 5 psychologists and 2 pharmacists, 1 philosopher and 1 PhD in Social Sciences.
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16 Lee mas

Guidelines for incorporating scientific knowledge and practice on rare diseases into higher education: neuronal ceroid lipofuscinoses as a model disorder  model disorder.

Guidelines for incorporating scientific knowledge and practice on rare diseases into higher education: neuronal ceroid lipofuscinoses as a model disorder model disorder.

The delegates agreed on the need for an innovative integration of RDs into the medicine curriculum as well as in Continuing Professional Development (CPD) and Continuing Medical Education (CME). The complexity of RDs requires a broad understanding of a variety of con- cepts including the implications of diagnostic delay, quality of life, re- spect for patient's family opinions, equity of access to treatments, all within a strong ethical framework. The literature retrieved from biblio- graphic databases, such as PubMed, was very limited on the topic of ed- ucational issues in RDs. Even when the numbers of citations on RDs was expanded to include the last 10 years (from 5754 in 2005 to 12,646 in 2014), the articles regarding medical education numbered 377 for the entire period. When these articles were manually analyzed their rele- vance was very low. Only one article from the 377 includes in the title both term “ Rare diseases ” and “ medical education ” [36]. In the Orphanet Journal of Rare Disease (OJRD) a search in the same period retrieved 64 citations and only 2 included both terms in the title [34,37]. Both cita- tions are abstracts of oral presentations from the 5th European Confer- ence on Rare Diseases (ECRD 2010). More relevant information can be accessed on web sites such as Orphanet, NORD, EURODIS and others.
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100 años después de Flexner

100 años después de Flexner

One hundred years ago, Flexner’s critique of medical education converted an evolutionary change already under way in North American medical education into a revolution. Medicine and the sciences underpinning it have made equally transformative advances since Flexner’s report, and once again, our approach to education is in- adequate to meet the needs of medicine. Ossified curricular structures, a persistent focus on the factual minutiae of today’s knowledge base, dis- tracted and overcommitted teaching faculty, ar- chaic assessment practices, and regulatory con- straints abound. These challenges threaten the integrated acquisition of technical knowledge and contextual understanding, the appropriately su- pervised mastery of practical skills, and the in- ternalization of essential values that together make for an informed, curious, compassionate, proficient, and moral physician.
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6 Lee mas

Development of an institutional curriculum in ethics and public health

Development of an institutional curriculum in ethics and public health

The inclusion of the humanities in medical edu- cation may offer significant potential benefits to individual professionals and to the medical com- munity as a whole. Debate remains, however, about the definition and precise role of the hu- manities in medical education, whether at the premedical, medical school, or postgraduate level. Recent trends have revealed an increasing pres- ence of the humanities in medical training(6). The first step in organizing our training pro- gramme was to decide on the intended partici- pants. Considering international tendencies two options were evaluated by the IRB: a. to have a programme designed solely for professionals with previous information about bioethics, such a pro- gramme could focus on general ethical principles, the roles and responsibilities and the process of protocol review, and b. to expand the audience to include other stakeholders like accredited re-
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7 Lee mas

Publications relating to the reactions of medical students to human cadavers and ethics

Publications relating to the reactions of medical students to human cadavers and ethics

Bob et al have addressed ethical issues within a ge- neral framework in their research. More physical and emotional problems came to the forefront. A small percentage of them may have feelings of horror, apprehension, guilt, wonder, gratitude, sadness and even overwhelming physical reacti- ons, nightmares, intrusive visual images, insom- nia, depression, and learning impairments(14). Shaikh wrote in a review the ethical concerns in the dissection of cadavers “Anatomical dissection is a time honoured part of medical education”. However, the use of human tissues for research purposes, the use of human cadavers for teaching and training purposes is surrounded by ethical uncertainties. The main ethical concern of cada- ver dissection lies in respect to human life(10). In Kennedy’s book; a particular act of an accep- table type of action involving the tissue removal may be wrong if the person from whom the tis- sue is removed does not consent since its removal without consent in these conditions would cons- titute impermissible injury. For example, use of some persons as organ banks for others without their knowledge or consent, or the removal of a person’s tissue for experimental purposes without his or her consent, or body snatching for medical research would all be seen as ethically impermis- sible. The ethical failing here is not that every use
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7 Lee mas

Preclinical Students’ Views on Medical Ethics Education: A Focus Group Study in Turkey

Preclinical Students’ Views on Medical Ethics Education: A Focus Group Study in Turkey

Association for Evaluation and Accreditation of Medical Education Programs (TEPDAD) that recognized by World Federation for Medical Edu- cation. Also, it is one of the first faculties to im- plement the active education (PBL, TBL) system. Undergraduate medical education in DEUFM lasts six years(17). PBL is applied in the first three years, while the Task Based Learning method is adopted in the fourth and fifth grades. The fi- nal year involves internship(18). Medical ethics education has been offered since the 1980s. It is included in the curriculum throughout six years, but is more intensive in the first three years. There are various activities used to teach the objectives of medical ethics to students such as interactive lectures, problem-based learning sessions, discus- sions on cases and current media news, discus- sions and writing assignments on books/ethical issues/movies. Theoretical exams are held in the form of Multiple Choice Questions (MCQs). Besides, assignments for writing book, ethical is- sue and movie reviews are given during the first three years, respectively. Students are required to attend the discussion session held for each assign- ment topic in company with an instructor at the end of the academic year. Students are assessed using an assessment form at the end of each clini- cal clerkship period in 4 th and 5 th grades in terms
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				¿Por qué la educación de pregrado en Ecuador se queda corta para capacitar habilidades para la salud rural? Un estudio cualitativo

← Volver a los detalles del artículo ¿Por qué la educación de pregrado en Ecuador se queda corta para capacitar habilidades para la salud rural? Un estudio cualitativo

PRÁCTICA FAMILIAR RURAL│Vol.3│No.3│Noviembre 2018 │www.saludrural.org 3 During the undergraduate medical curriculum, students have little contact with rural areas until their final year, when they have a two-month rotation known as the “pre-rural”. This is because medical education in Ecuador shows a predominant orientation towards hospital training.(10)(11)(12) A recent study by our team indicated that regarding obstetrical and gynecological skills a large gap exists between the skills that are important for a RD in the rural year and the former training in the undergraduate curriculum. Skills rated important for rural practice, like ‘episiotomy and repair’ or ‘speculum examination during pregnancy’, have not been seen nor practiced by up to 45% of respondents.(13)
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10 Lee mas

Dissection as a teaching tool: past, present, and future

Dissection as a teaching tool: past, present, and future

Cultural changes, scientific progress, and new trends in medical education have modified the role of dissection in teaching anatomy in today’s medical schools. We discuss in this article the role of dissection itself, the value of which has been under debate for the last 30 years. The importance of dissection is considered from different points of view: educational, bioethical, and human values. Included are different opinions from professors and students. Finally, the current practice of dissection is described for some universities in the United States and Europe, showing its use as a learning tool. Anat Rec (Part B: New Anat) 285B:11–15, 2005. © 2005 Wiley-Liss, Inc.
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5 Lee mas

Knowledge of medical abortion among Brazilian medical students

Knowledge of medical abortion among Brazilian medical students

The medical students' knowledge of MA was very poor at the 3 med- ical schools where the study was conducted. And yet, these schools are located in the region of Brazil considered to be the most developed. Even though all students in their fi nal year had heard about misoprostol to induce abortion, and nearly 90% said that they had heard how to use it, their answers to more speci fi c questions showed that only 1 in every 5 had satisfactory knowledge in these 2 matters. Indeed, nearly half of the 6th-year students gave incorrect answers to at least 6 of the 12 questionnaire items regarding knowledge of MA.
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5 Lee mas

Older drivers, medical condition, medical impairment and crash risk

Older drivers, medical condition, medical impairment and crash risk

New evidence has appeared to support the fact that the over-involvement of older drivers in traffic accidents disappears when the low mileage bias is taken into account. As a group, older drivers are as safe as or safer than other age groups, and only low mileage older drivers have a high crash rate. Furthermore, the role of the medical condition of older drivers in traffic accidents, as well as the fitness to drive evaluation, are objects of controversy. We examined all this with a cohort of 4316 drivers attending Medical Driving Test Centres for a mandatory fitness to drive evaluation. Our data shows that older drivers ( ≥ 75) have a lower crash rate. Medical conditions that impair fitness to drive, as a tendency, increased with advanced age and with lower mileage group. The multivariate analysis of variance showed that there is an effect (p < 0.0001) of age-range and mileage on the annual crash rate per million kilometres driven, while a medical restriction (“fit to drive with restriction”) has no effect (p > 0.05). Our data suggests that health status is not associated with increased crash risk for the low mileage group, although further studies are needed. © 2007 Elsevier Ltd. All rights reserved.
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6 Lee mas

Normative scores of the cambridge cognitive examination-revised in healthy spanish population

Normative scores of the cambridge cognitive examination-revised in healthy spanish population

As expected, the median values of CAMCOG-R total scores for all age groups and educational levels were higher than optimal cut-off points for discriminating healthy controls from patients with dementia and other psychiatric disorders (determined in other smaller Spanish samples) (Llinàs et al., 1995; Lozano-Gallego et al., 1999; Vilalta et al., 1990). A wide range of normative values was observed across percentiles and most of these, especially for younger participants and higher levels of education, were much higher than 59, which is the score established as the most reliable cut-off point for case identifi cation regardless of the age and educational level of participants (Lozano-Gallego et al., 1999). Some normative values below this cut-off point were observed, particularly those corresponding to participants aged 80 years or more and with less than 5 years of formal schooling and who obtained scores in the lowest percentile (5-10%ile).
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8 Lee mas

The incorporation of girls in the educational system in Hellenistic and Roman Greece

The incorporation of girls in the educational system in Hellenistic and Roman Greece

some women practiced medicine and many more, midwifery 41 . The story of Hagnodike, despite its apochryphal character, reveals that due to notions of modesty, even the patriarchal Athenians were obliged to allow freeborn women to practice medicine, (we cannot be sure if female doctors were restricted to an all female clientele). It was easier for midwives to be accepted, because their role was subordinate. Of course a female doctor had to be not only literate but well-educated. For the midwife, the level of education required to perform successively her duties depended on the category she aspired to belong. According to the Greek doctor Soranos (2 nd
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Automatic production and integration of knowledge to the support of the decision and planning activities in medical-clinical diagnosis, treatment and prognosis.

Automatic production and integration of knowledge to the support of the decision and planning activities in medical-clinical diagnosis, treatment and prognosis.

The preprocessing step in figure 5.1 uses a set of translation rules to adapt the data in a EOC database to the terminology that we want for the final SDA. This preprocessing is justified, firstly, by the fact that the database may contain numerical, multi-valued or Boolean values and we may not need such amount of variability in the final SDA. Secondly, from a medical point of view, it may be of some interest to reflect only part of the treatment or different perspectives of the same treatment, instead of the complete treatment registered in the EOC database. For example, if we are only interested in the nursing activities or in the treatment of critical cases. So, part of the data should be left out of the learning process or generalized in a different way. Finally, data preprocessing is useful to integrate data from different health care centres which may use different terminology. In these cases, preprocessing can be used to format, filter and discretize data from different sources and make these data homogeneous before the machine learning process is started. Translation rules perform operations on the domain terminology such as generalization, exten- sion, removal and replacement. Generalization allows a common term to represent different con- ditions. Formally expressed, generalization is when a unique term t represents several constraints p 1 , p 2 , ..., p n within the database (i.e., t ← p i with i = 1..n). For example if we consider the rules
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Infecciones de transmisin sexual asociadas a sntomas vulvovaginales en adolescentes que niegan vida sexual activa

Infecciones de transmisin sexual asociadas a sntomas vulvovaginales en adolescentes que niegan vida sexual activa

10-18 years requiring first-time medical care at the De- partment of Psychiatry and Adolescent Medicine bet- ween January 1995 and December 1999, were reviewed. A diagnosis of infectious vulvovaginitis was the main inclusion criterion. Thirty-one of 304 patients were excluded for physiological leukorrhea, as well as 15 whose laboratory evidence of infectious vulvovagini- tis was not available in the medical records. The rate of vulvovaginitis secondary to an STI was 20.5%, i.e., 53 cases of a total of 258 adolescents included in the study. The medical records were reviewed by one pe- diatrician (EER), one specialist in adolescent medicine (EVJ), and one pediatric urologist (ARR), who were standardized to identify eligibility criteria and to re- trieve information.
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COMMON COUNTRY ASSESSMENT FOR THE ISLAMIC REPUBLIC OF IRAN

COMMON COUNTRY ASSESSMENT FOR THE ISLAMIC REPUBLIC OF IRAN

For a higher growth rate to be achieved, it is necessary to raise the proportion of the national product invested annually in production activity and environmental protection. During the 1990s gross investment fluctuated between 22 percent and 35 percent of the GDP (See Figure 1.7). However, with depreciation estimated to be as much as 20 percent of GDP, net investment has been inadequate and remains lacklustre. Liberalisation of the economy and the expansion of activities to private investment can be expected to raise the overall level of investment. It is difficult to produce an exact target figure because investment of the right kind will produce output and employment more effectively (i.e. have a lower capital/output ratio or be more labour intensive). At present, it is clear that the target ought to be more investment of the right kind rather than any particular figure. Nor is it a matter of investing exclusively in the public or private sectors. Investment is needed in health and education, in improving social infrastructure, in the production of useful goods and services, in the expansion of non-oil exports, in projects that protect the environment and create employment. These aims require a careful selection of priorities on the part of the public sector as well as economic incentives that encourage private investors to invest in useful activities. Two major problems have been identified with present investment patterns:
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Egipto

Egipto

There are a number of challenges in the area of mental health and psychiatric services. In spite of the fact that mental health-related conditions constitute about 14% of the global burden of disease, the budget allocated for these diseases is far less, proportionally. The number of hours given for training in mental health in medical schools and other health training institutions is limited and does not reflect the importance of this field as a contributor to morbidity. Mental health needs to be integrated into primary health care on a nationwide basis; community awareness needs to be raised regarding the hazards of substance abuse. In addition there is an increasing need to develop services in mental health care subspecialties with child and adolescent, forensic and old age psychiatry developed as disciplines with decentralized services provided.
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Pre-hospital management of mass casualty civilian shootings: a systematic literature review

Pre-hospital management of mass casualty civilian shootings: a systematic literature review

At the Utoya Island shooting in 2011, limited inter- agency communication and a persisting threat by the shooter resulted in EMS staff unable to get onto the is- land and access casualties for two hours and seven mi- nutes [48] Similarly in the report on the Columbine Shootings of 1999, injured victims were still stranded in the school over two hours after the shooters had com- mitted suicide. Furthermore due to a breakdown in com- munication a medical team almost came under friendly fire by the Special Weapons And Tactics (SWAT) team [36]. In the UK after the Cumbria shootings in 2010, Chesterman’s report identified interoperability of the police and ambulance as a “highly significant issue leading to extensive delays of ambulances reaching patients and police being left to transport the injured” [57]. This report concluded that “it would be reason- able for the public to expect the ambulance service to attend scenes where there is a residual risk” even though the police service will not be able to guaran- tee the safety of the staff [16].
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