RESUMEN

BACKGROUND: Overconfidence is the tendency to overestimate the knowledge, capacity, or performance one really possesses. This cognitive bias could be potentially dangerous in medical decision-making, considering the impact it could have on patient health care. The aim of this study was to evaluate the incidence of overconfidence and underconfidence in medical student knowledge on general surgery by using traditional and new statistical approaches. METHODS: During the application of a multiple-choice examination, 251 next-to-graduate medical students were invited to express the accuracy of their responses by choosing their own perceived confidence level for a set of questions. Analysis was done by comparing the difference between percentage of right answers (student's actual knowledge or accuracy) and self-estimated confidence level (student's perceived knowledge or confidence). Overconfidence was defined as a positive difference between confidence and accuracy, and underconfidence as a negative difference. RESULTS: Nearly 12% of students showed significant overconfidence regarding their actual knowledge or accuracy levels. Better students showed a lower overconfidence effect than students with poorer performance. On the other hand, underconfidence was less likely than overconfidence (8.3% of students), and that effect was most frequently found in students who performed better in examinations. CONCLUSIONS: The small proportion of our students exhibiting overconfidence or underconfidence behaviors moderates the need for educational interventions. Nevertheless, promoting prudence in individualized students manifesting overconfidence, and trust in those reporting significant underconfidence could increase the reliability of medical judgment during their future professional life. Overconfidence in individuals with lower scores in examinations may depend on a ceiling-like effect, since worst ranked students have a wider upper margin to manifest their confidence perceptions. The most confident students showed higher scores in examinations than the less confident ones. From this point of view, confidence could be considered an essential ingredient of success in examination performance.

Asunto(s)

Asunto(s)

Asunto(s)

RESUMEN

No disponible

Asunto(s)

Asunto(s)

RESUMEN

Objetivo. Analizar las medidas implantadas en las unidades clínicas para garantizar la confidencialidad de la información sanitaria de los ciudadanos y que han sido validadas como adecuadas por un equipo de evaluadores de la Agencia de Calidad Sanitaria de Andalucía. Material y métodos. Estudio descriptivo retrospectivo de 272 unidades clínicas en proceso de acreditación por la Agencia de Calidad Sanitaria de Andalucía evaluadas entre enero de 2003 y diciembre de 2010. Se han analizado las medidas evaluadas adecuadas para garantizar la confidencialidad, estableciendo categorías tras análisis de los registros de la aplicación que da soporte a los procesos de certificación (ME_joraC). Resultados. Se identificaron espacios de mejora en cuanto a la custodia de los registros clínicos (64,1%) y al control interno de la aplicación de las medidas de seguridad de la información (19,6%). Principalmente, las soluciones implantadas en las unidades clínicas han sido de carácter tecnológico (28,5%). Se aportaron también con frecuencia soluciones relacionadas con la implantación (17,9%) y difusión (22,3%) de protocolos de uso de la historia clínica. Conclusiones. Los procesos de certificación facilitan la identificación de espacios de mejora y la implantación de medidas de garantía de la confidencialidad. Las soluciones tecnológicas que dan respuesta a las necesidades planteadas por la digitalización de los registros clínicos, así como la implantación efectiva de protocolos y la monitorización de la adherencia a estos protocolos mediante autoevaluaciones concentran la mayoría de los esfuerzos por garantizar la confidencialidad. Además, se fomenta la implicación y responsabilidad de los profesionales sobre este tema (AU)

Objective. To analyse the measures introduced by Health Care Units to ensure the confidentiality of health information on patients that been validated as adequate by an assessment team of the Agency for Healthcare Quality in Andalusia (Spain). Material and methods. A retrospective study was conducted on Health Care Units accredited by the Agency for Healthcare Quality in Andalusia. A total of 272 Health Care Units were evaluated between January 2003 and December 2010. We analysed the measures that were assessed as adequate to ensure the confidentiality of data by this team, establishing categories after analysing records of the application that supports the certification process (ME_joraC). Results. Using on- site surveys, areas of improvement were found in the safeguarding of medical records (64.1%) and the internal control of implementing the information security measure (19.6%). The measures introduced into the Health Care Services were mainly technological actions (28.5%), which were related to the increasing presence of electronic history. It also frequently provided solutions related to implementation (17.9%) and dissemination (22.3%) protocols for use of medical records. Conclusions. Accreditation processes help to identify areas for improvement and the introduction of procedures for ensure confidentiality of data in the healthcare system. Technological solutions that respond to the needs created by the computerisation of medical records, and the effective implementation of protocols and monitoring the adherence to these protocols using self-assessment, strengthen the efforts to ensure confidentiality. Furthermore, it promotes the involvement and responsibility of the professionals on this topic (AU)

Asunto(s)

Asunto(s)

RESUMEN

No disponible

Asunto(s)

RESUMEN

Objetivos. Conocer las características generales de las solicitudes de acreditación de actividades de formación continuada dirigidas a profesionales sanitarios en la Comunidad Autónoma de Madrid, dentro del sistema de acreditación de formación continuada del Sistema Nacional de Salud establecido en España. Proponer actuaciones futuras que contribuyan a mejorar la calidad de las actividades de formación continuada. Métodos. Estudio descriptivo retrospectivo transversal. Se incluyeron todas las solicitudes de acreditación de actividades docentes de formación continuada dirigidas a profesionales sanitarios, para las que se solicitó acreditación en la Comunidad de Madrid, desde 2002 a 2004, en una base de datos y se estudiaron 9 variables, que se analizaron con el programa informático SPSS 11.0. Resultados. Se han recibido 6.869 solicitudes, con un número total de horas programadas de 188.027 y un total de alumnos de 342.361. Existe un gran incremento de solicitudes en el período considerado. Las actividades más frecuentes son presenciales (93,9%), en forma de cursos (71,4%), de entre 21 y 40 alumnos (51,3%), contenido centrado en la práctica clínica (77,5%), de menos de 21 horas lectivas de duración (68,1%), dirigidas en exclusiva a una sola profesión (71,7%) que suele ser Medicina (60%) y solicitadas por entidades privadas (60,4%). Las organizaciones empresariales son las solicitantes más frecuentes (24,4%). Se acreditó el 91,6% de las actividades. Conclusiones. La acreditación de actividades de formación continuada está cobrando gran importancia. El análisis de las características de estas actividades puede permitir conocer y mejorar los diversos aspectos que ayuden a garantizar un incremento en la calidad de la formación continuada ofertada. En este sentido creemos necesario: a) desarrollar y consolidar un cuerpo de conocimientos comunes en todo el sistema de acreditación; b) aumentar la coordinación entre todas las estructuras implicadas en dicho sistema, y c) avanzar en la realización de auditorías y en la acreditación de centros de formación continuada

Objectives. To know the general characteristics of the applications for accreditation of continuing education activities for healthcare professionals in the "Madrid Community" within the Spanish continuing education accreditation system of the Spanish National Healthcare system. To propose future lines of work that contribute to the improvement in the quality of these activities. Methods. Cross-sectional retrospective descriptive study. All requests for accreditation of continuing education activities for healthcare professionals received in the "Madrid Community" (Madrid, Spain) between 2002 and 2004 have been included in a database where 9 different variables were analyzed with SPSS 11.0. Results. We received 6,869 applications with 188,027 programmed hours and 342,361 students. There is an increase in the number of applications during the period studied. The most frequent activities are those in which the student has to be present in the classroom (93.9%), courses (71.4%), those with 21 to 40 students (51.3%), focused on clinical practice (77.5%), with less than 21 hours (68.1%), aimed at a single profession (usually medicine -60%-) (71.7%) and requested by private organizations (60.4%). Companies are the most frequent organizations that request accreditation (24.4%). A total of 91.6% of activities were accredited. Conclusions. Accreditation of continuing education activities has become important for health professionals. The analysis of the characteristics of these activities makes it possible to know and improve the different aspects that guarantee an increase in the quality of continuing education offered. According to the above, we consider that the following is necessary: a) to develop and consolidate a common knowledge pool for the whole accreditation system; b) to increase coordination between all the different structures within the accreditation system, and c) to make progress in the auditing and accreditation of continuing education institutions

Asunto(s)

RESUMEN

No disponible

Asunto(s)

RESUMEN

Over the past decade in the United States, the number of private residential facilities for youth has grown exponentially, and many are neither licensed as mental health programs by states, nor accredited by respected national accrediting organizations. The Alliance for the Safe, Therapeutic and Appropriate use of Residential Treatment (A START) is a multi-disciplinary group of mental health professionals and advocates that formed in response to rising concerns about reports from youth, families and journalists describing mistreatment in a number of the unregulated programs. This article summarizes the information gathered by A START regarding unregulated facilities. It provides an overview of common program features, marketing strategies and transportation options. It describes the range of mistreatment and abuse experienced by youth and families, including harsh discipline, inappropriate seclusion and restraint, substandard psychotherapeutic interventions, medical and nutritional neglect, rights violations and death. It reviews the licensing, regulatory and accrediting mechanisms associated with the protection of youth in residential programs, or the lack thereof. Finally, it outlines policy implications and provides recommendations for the protection of youth and families who pursue residential treatment.

Asunto(s)

Asunto(s)

RESUMEN

La acreditación de la formación médica continuada (FMC) tiene como objetivo esencial la mejora de la oferta formativa, por encima de otros objetivos complementarios como servir de guía a los distintos agentes, atestiguar la participación en los programas formativos, orientar la oferta o reconocer la cualificación de los proveedores. De los tres ámbitos tradicionales de la acreditación, la acreditación individual debe separarse claramente, equiparándose a lo que se conoce como revalidación. Los otros dos ámbitos genuinos de acreditación de la FMC son la acreditación de actividades formativas la acreditación de instituciones proveedoras. Los créditos de FMC sirven para tres cometidos fundamentales: la carrera profesional, la revalidación el desarrollo profesional continuo. Adicionalmente, pueden utilizarse para otras finalidades relacionadas con la promoción profesional individual. La situación de la acreditación de la FMC en España esmuí esperanzadora, con dos sistemas de acreditación que disponen de una relativamente larga trayectoria y unas expectativas que lo sitúan en una posición avanzada a nivel europeo (AU)

The main objective of continuing medical education (CME) accreditation is to improve the CME offer, being other additional objectives to serve as orientation of the different agents, to certify the attendance of participants, to orient the CME offer and to recognise the quality of CME providers. Among the three traditional domains of the accreditation, the accreditation of the individuals must be clearly separated and should be identified to revalidation. The other two genuine domains of the CME accreditation are the CME activities accreditation and the CME providing institutions accreditation. The CME credits are useful for three particular professional developments: professional career, revalidation and continuing professional development. Additionally one can use them for other individual promotion purposes. The CME accreditation situation in Spain is currently encouraging, with two accreditation systems actively implemented into practice and with good expectations in the European context (AU)

Asunto(s)

RESUMEN

No disponible

Asunto(s)

RESUMEN

Accrediting bodies of nursing as well as other healthcare organizations require that nursing ethics content be incorporated in programs of study. How does nursing define the termnursing ethics? How is it distinguished or viewed in various levels of higher degree nursing education? What is the role of codes for nursing? These are but a few of the questions pondered in the following article that includes personal correspondence with two distinguished authors, educators, and consultants for biomedical ethics, Dr. Sara T. Fry and Dr. Nancy Berlinger of the Hastings Center.

Asunto(s)

RESUMEN

The importance of continuing medical education has been long recognized by the orthopaedic profession as vital in maintaining a current knowledge and skills base. There has been increasing concern over the expanding involvement of industry in sponsoring continuing medical education. Concomitant with rising costs of medical education is a decreasing source of funds from government and other sources; therefore industry has taken an active role in sponsoring continuing medical education, leading to a potential for serious conflict of interest. National and federal guidelines have been created to allow commercial sponsorship, yet leave the responsibility for the design, faculty, and content to the accredited provider. The guidelines are intended to prevent bias, keep commercial displays separate from educational presentations, and clearly state that industry-sponsored events should be primarily educational in nature and directly benefit the patient. Because of the potential conflict inherent within industry-sponsored continuing medical education, a cooperative relationship between educators, industry, and attendees of educational activities must be achieved to prevent bias and to keep the patient's best interest as paramount. Each orthopaedic surgeon has an ethical obligation to resolve any conflicts of interest in the best interest of the patient.

Asunto(s)

Asunto(s)