sábado, 25 de diciembre de 2010

El plan de estudios innovador en anestesiología. Un reto y la esperanza para el futuro-La transformación del profesionalismo médico para adaptarse a las cambiantes necesidades de salud-Impacto de una conferencia didáctica sobre profesionalismo en el conocimiento creciente entre facultativos y residentes en un departamento académico

El plan de estudios innovador en anestesiología. Un reto y la esperanza para el futuro
The Innovative Anesthesiology Curriculum. A Challenge and Hope for the Future
Catherine M. Kuhn, M.D., Department of Anesthesiology,
Duke University, Durham, North Carolina.
catherine.kuhn@duke.edu
Anesthesiology 2010; 112:267- 8
WHAT exactly is a curriculum? The traditional definition of an educational curriculum is a particular course of study.* The word curriculum originates from the Latin word currere, to run, as in a course or racetrack. Thought of this way, an anesthesiology residency curriculum could be envisioned as a series of actions, experiences, and programs through which newly graduated medical students become qualified anesthesiologists. This vision of curriculum acknowledges that residency graduates are not fully formed and incorporates the concept of life-long learning. Innovation means doing things in a new way to bring out changes in a product or organization. Therefore, an innovative curriculum should be forward-facing, nimble, and adept to change, particularly in a medical environment that is undergoing rapid transformation. It should prepare, direct, and push the individual trainee toward a minimal goal of excellent clinical practice as well as preparation for academic practice for those residents who plan such a career. The course can be set by the program, but the trainee might accomplish his or her goal in a variety of ways.

La transformación del profesionalismo médico para adaptarse a las cambiantes necesidades de salud
Transforming medical professionalism to fit changing health needs
Thomas Plochg, Niek S Klazinga, Barbara Starfield
BMC Medicine 2009, 7:64 doi:10.1186/1741-7015-7-64
Background: The professional organization of medical work no longer reflects the changing health needs caused by the growing number of complex and chronically ill patients. Key stakeholders enforce coordination and remove power from the medical professions in order allow for these changes. However, it may also be necessary to initiate basic changes to way in which the medical professionals work in order to adapt to the changing health needs. Discussion: Medical leaders, supported by health policy makers, can consciously activate the selfregulatory capacity of medical professionalism in order to transform the medical profession and the related professional processes of care so that it can adapt to the changing health needs. In doing
so, they would open up additional routes to the improvement of the health services system and to health improvement. This involves three consecutive steps: (1) defining and categorizing the health needs of the population; (2) reorganizing the specialty domains around the needs of population groups; (3) reorganizing the specialty domains by eliminating work that could be done by less educated personnel or by the patients themselves. We suggest seven strategies that are required in order to achieve this transformation. Summary: Changing medical professionalism to fit the changing health needs will not be easy. It will need strong leadership. But, if the medical world does not embark on this endeavour, good doctoring will become merely a bureaucratic and/or marketing exercise that obscures the ultimate goal of medicine which is to optimize the health of both individuals and the entire population.

Impacto de una conferencia didáctica sobre profesionalismo en el conocimiento creciente entre facultativos y residentes en un departamento académico

Impact of a Didactic Lecture on Professionalism in Increasing Knowledge Amongst Faculty and Residents in an Academic Department
Peregrina L. Arciaga, MD, Adejare Windokun, MD, Jonathan S. Jahr, MD, John Tetzlaff, MD, Stephen Steen, ScD, MD
JEPM Vol. 10, Issue I, Jan-June 2008

Abstract
Background: The ACGME require compliance with six core competencies - professionalism is one of them. Non-professional behavior is the most common reason for disciplinary action against physicians by the Medical Boards. Professionalism should be taught and measured at an early stage of the physician's career. Methods: IRB approval was obtained to carry out this study. The subjects were faculty and residents of the anesthesia department. The pretest was administered and followed by a lecture and discussion on professionalism by Anesthesia faculty. This was followed by the posttest. The test consisted of 22 questions related to professionalism. Results: Eighteen subjects completed the pretest while 14 completed the posttest. Age range was 39.72 +/- 10.58. The pretest scores were 59.6+/- 12.5, while the posttest scores were 57.8 +/- 12.8. Correct answers for each question ranged from 5.6 to 100% for the pretest and 0 to 100% for the post test. Correct answers for each subject ranged from 31.8 to 77.3% for both pre and post tests. No statistically significant difference was found in scores between the pre-test and post-test. Conclusion: Based on these initial findings, teaching professionalism is extremely difficult and feed back from the participants using tools like a pretest and post-test may help identify if knowledge transfer has actually occurred. Teaching and assessment of professionalism should take into consideration the students pre-existing knowledge-base, cultural background and environment.
Key Words: core competencies, faculty and residents, professionalism teaching and assessment, multiple choice questions, validity and reliability, cultural diversity

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Anestesiología y Medicina del Dolor

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