PROTOCOLLO: MESSA A PUNTO E VALIDAZIONE DI UNO STRUMENTO VALUTATIVO DEL TIROCINIO PROFESSIONALIZZANTE PER LA SCUOLA DI SPECIALIZZAZIONE IN IGIENE E MEDICINA PREVENTIVA

L'Unione Europea (UE), nel 2005, ha riconosciuto l'equipollenza tra i Paesi membri della specializzazione in Sanit\ue0 Pubblica, obbligando al confronto e all'analisi dei percorsi di formazione. Il D.M. n\ub0 176 dell'1 agosto 2005 individua gli obiettivi formativi e i relativi percorsi didattici articolati in Attivit\ue0 Formative, preordinate al raggiungimento degli obiettivi formativi utili a conseguire il titolo. Pertanto le Scuole di Specializzazione devono garantire percorsi di formazione all'interno delle strutture sanitarie, siano esse territoriali od ospedaliere. Questo studio si propone di mettere a punto uno strumento di valutazione del tirocinio professionalizzante, finalizzato a individuarne e valutarne gli aspetti qualificanti, utile a favorire un confronto tra le Scuole di Specializzazione in Igiene e Medicina Preventiva

Survey on professional training in three Italian Post-Graduate Schools of Public Health

Background: In 2005 the European Union (EU) recognized the equivalence within its member states of qualifications conferred by post-graduate schools (PGS) in public health. In Italy, ministerial decree no. 176 of 1st August 2005 defined the training goals and the related training programmes (Training Activities) leading to conferral of the qualification of specialist in Public Health and Preventive Medicine (PHPM). This study aimed to develop and validate an assessment tool for professional training programmes. The purpose has been to identify and evaluate their typical features and, at the same time, to enable comparison between Italian PGSs in PHPMs. Methods: In the first phase, a multiple-choice questionnaire was created, using a Likert scale with scores from 1 to 6. This was prepared by post-graduates attending the Milan PGS. This tool was validated by applying it to a pilot sample of post-graduates attending the Milan PGS in PHPM. Following this, a second round of discussion and validation of the model took place, involving 61 post-graduates attending PGSs in PHPM at the Universities of Palermo, Pisa and Turin. A web platform was used that enabled the survey to be created and managed by defining and managing pre-set interview templates. Results: The questionnaire consisted of three sections: Section A - Twenty-eight percent of post-graduates attended their training programme in a university or research centre, 29.8% in a hospital and 35.1% in a Local Health Unit. This training program lasted more than 12 months in 37% of the cases. Section B - The answers were all above pass-level (3 to 4 = satisfactory) except as regards the level of empowerment and the workload, which was judged to be unsatisfactory overall.The skills of the staff present in the facility attended were judged favourably (3.5). Section C - Section C investigates the duration and autonomy of the activities performed during the training programmes aimed at meeting the training requirements set out in ministerial decree no. 176/2005. Among respondents, 87% had taken part in ongoing statistical public health analyses, 81% had given presentations and contributed posters in public health congresses and 79% had planned or implemented an epidemiological survey. Conclusions: A pre-set form for the assessment of training programmes by the post-graduates themselves is a useful tool with which to obtain their feedback

Spread of hyperplastic pulmonary neuroendocrine cells into air spaces (S.H.I.P.M.E.N.T.S) : a proof for artifact

Objectives: Spread through air spaces (STAS) is a recently proposed invasion way of lung cancer, including neuroendocrine (NE) neoplasms. However, if this phenomenon is a real one or an artifact while manipulating lung specimens, it is still matter of debate. Material and methods: Three consecutive patients with newly diagnosed diffuse idiopathic pulmonary NE cell hyperplasia (DIPNECH) were reviewed for STAS. Results: In well-fixed lung specimens, DIPNECH was seen to coexist with atypical carcinoid, bifocal typical carcinoid and adenocarcinoma in the three patients, respectively. While STAS was not observed at the growing edges of tumors, a few freely-floating aggregates of hyperplastic NE cells within air spaces were noticed to emanate from foci of NE hyperplasia and tumorlets and in intimate association with normal bronchiolar cells and erythrocytes to denote artifactual derivation upon tissue manipulation. Conclusions: Traveling of hyperplastic NE cells through air spaces is likely to artifactually occur via knife, surgeon or other way, thus challenging invasion by STAS