Intensive medical student involvement in short-term surgical trips provides safe and effective patient care: a case review

<p>Abstract</p> <p>Background</p> <p>The hierarchical nature of medical education has been thought necessary for the safe care of patients. In this setting, medical students in particular have limited opportunities for experiential learning. We report on a student-faculty collaboration that has successfully operated an annual, short-term surgical intervention in Haiti for the last three years. Medical students were responsible for logistics and were overseen by faculty members for patient care. Substantial planning with local partners ensured that trip activities supplemented existing surgical services. A case review was performed hypothesizing that such trips could provide effective surgical care while also providing a suitable educational experience.</p> <p>Findings</p> <p>Over three week-long trips, 64 cases were performed without any reported complications, and no immediate perioperative morbidity or mortality. A plurality of cases were complex urological procedures that required surgical skills that were locally unavailable (43%). Surgical productivity was twice that of comparable peer institutions in the region. Student roles in patient care were greatly expanded in comparison to those at U.S. academic medical centers and appropriate supervision was maintained.</p> <p>Discussion</p> <p>This demonstration project suggests that a properly designed surgical trip model can effectively balance the surgical needs of the community with an opportunity to expose young trainees to a clinical and cross-cultural experience rarely provided at this early stage of medical education. Few formalized programs currently exist although the experience above suggests the rewarding potential for broad-based adoption.</p

Written information about individual medicines for consumers.

Medicines are the most common intervention in most health services. As with all treatments, those taking medicines need sufficient information: to enable them to take and use the medicines effectively, to understand the potential harms and benefits, and to allow them to make an informed decision about taking them. Written medicines information, such as a leaflet or provided via the Internet, is an intervention that may meet these purposes

Características da oferta de contracepção de emergência na rede básica de saúde do Recife, Nordeste do Brasil

The aim of the study was to describe the use of emergency contraception (EC) in Family Health Units in Recife between March and September, 2011. The questionnaire was answered by 234 professionals, 154 nurses and 80 physicians selected by random sampling in 117 USF. Almost all professionals (90.6%) reported availability of EC in Family Health Unit; physicians and/or nurse were the main prescribers (73.9%); 27.4% knew the distribution strategy by “women’s health kit”. Although 85.0% of professionals have already prescribed the EC, only 8.5% considered the EC as a woman’s right. The majority (80.7%) understand the Family Planning manual of the Ministry of Health and about half (51.2%) understand the Reproductive Rights manual of the municipality’s manual. 51.3% knew the EC action mechanism and 77.4% usually inform women about EC. Among those who do not explain about EC, the main reasons were: “lack of opportunity” (10.0%) for physicians and “to avoid becoming routine” (6.5%) for nurses. Half of the professionals (50.0%) reported prescribing in three recommended situations (unprotected intercourse, rape and failure of contraceptive methodin use) and 65.8% agree that religion interfere in the decision of the prescription/advice. Health professionals have demonstrated sufficient technical knowledge to prescribe EC, but do not recognize it as a right of women. Also, they consider that the influence of religion may interfere with the decision of prescribing and with the use of EC by women.O objetivo do estudo foi descrever as características da utilização da contracepção de emergência (CE) em unidades de saúde da família (USF) da cidade do Recife entre março e setembro de 2011. O questionário foi respondido por 234 profissionais, 154 enfermeiros e 80 médicos selecionados por amostragem aleatória em 117 USF. Quase todos os profissionais (90,6%) informaram disponibilidade da CE na USF; médico e/ou enfermeiro foram os principais dispensadores (73,9%) e 27,4% conheciam a estratégia de distribuição através do “kit saúde da mulher”. Apesar de 85,0% dos profissionais já terem prescrito a CE, apenas 8,5% a consideram como direito da mulher. A maioria (80,7%) conhecia o manual de Planejamento Familiar do Ministério da Saúde e cerca de metade (51,2%) conhecia o manual de Direitos Reprodutivos do município. Entre os entrevistados, 51,3% conheciam o correto mecanismo de ação e 77,4% costumam informar às mulheres sobre CE. Os principais motivos para não informar foram: “falta de oportunidade” (10,0%) para os médicos e “para evitar que se tornem rotina” (6,5%) para os enfermeiros. Metade dos profissionais (50,0%) informaram prescrever nas três situações preconizadas (relação desprotegida, estupro e falha do método contraceptivo em uso) e 65,8% concordam que a religião interfere na decisão da prescrição/orientação. Os profissionais de saúde demonstraram ter conhecimento técnico suficiente para prescrever a CE, porém não a reconhecem como um direito das mulheres. Além disso, consideram que a influência religiosa pode interferir na decisão da prescrição e no uso da CE pelas mulheres