18 research outputs found
Aplicabilidad de formir como portafolio electr贸nico en la formaci贸n y evaluaci贸n de los m茅dicos internos residentes de otorrinolaringolog铆a en Espa帽a
Texto completo descargado desde TeseoEl sistema MIR espa帽ol atesora un elevado prestigio en la formaci贸n de los m茅dicos internos residentes, tanto a nivel nacional como internacional, haciendo que los residentes formados en Espa帽a resulten ampliamente valorados en la mayor铆a de los pa铆ses de nuestro entorno e, incluso, demandados. Sin embargo, esta consideraci贸n global se encuentra cuestionada al desagregar esta visi贸n global entre las distintas especialidades, centros formativos y unidades docentes. La calidad de la formaci贸n de los residentes de otorrinolaringolog铆a (ORL) es un asunto que ha interesado tradicionalmente tanto a los propios residentes como a las unidades docentes y a las instituciones que tutelan y gestionan su formaci贸n. Pero este inter茅s se ha llegado a transformar en preocupaci贸n cuando en esta especialidad han desaparecido los est铆mulos competitivos entre unidades docentes para ofrecer la mejor formaci贸n al acreditarse cada vez m谩s servicios de ORL, no desacreditarse ninguno (salvo circunstancias extremas) y pr谩cticamente hacer coincidir el n煤mero de las plazas ofertadas en cada convocatoria anual con el de las plazas acreditadas. La ausencia de obligatoriedad en la utilizaci贸n de instrumentos de evaluaci贸n y el desconocimiento sobre la incorporaci贸n de nuevas metodolog铆as y herramientas docentes, acrecientan las incertidumbres sobre si es equiparable la calidad de los especialistas en otorrinolaringolog铆a que se forman en las unidades docentes espa帽olas, si existen desequilibrios formativos que reflejen por un lado falta de equidad en la disponibilidad y utilizaci贸n de lo recursos docentes, y por otro lado una falta de utilizaci贸n de metodolog铆as, y si esta formaci贸n es equiparable a la que est谩n ofreciendo los pa铆ses punteros en la especialidad. El art铆culo publicado por Su谩rez et al , en el que se analizaba el estado de las unidades docentes de ORL acreditadas en Espa帽a en el a帽o 2008, desvel贸 la existencia de una amplia variabilidad de su capacidad formativa en cuanto a infraestructura, recursos humanos, dotaci贸n en aparataje y equipamiento, y actividad. En este exhaustivo estudio se pusieron de manifiesto relevantes carencias formativas en m煤ltiples 谩reas de la especialidad en muchas unidades, a las que se les propuso opciones de mejora, resultando un n煤mero menor el de unidades docentes plenamente aptas para ofrecer una formaci贸n especializada integral y completa. Las f贸rmulas evaluativas que se emplean actualmente en las unidades docentes de ORL espa帽olas se ajustan a la normativa vigente para la globalidad de las especialidades pero no profundizan en la evaluaci贸n del grado de cumplimiento de todos y cada uno de los objetivos docentes incluidos en el programa oficial de la especialidad de otorrinolaringolog铆a ni de los objetivos docentes del logbook propuesto por la European Union of Medical Specialists (UEMS). El sustrato contenedor de las evidencias que acreditan que un residente dispone de la competencia suficiente en cada uno de los objetivos docentes que el propio programa oficial considera necesarios para que un especialista en otorrinolaringolog铆a disponga de la calidad precisa para desarrollar su trabajo como titulado se reduce al Libro del M茅dico Especialista en Formaci贸n o Libro del Residente. El formato de este documento ha sido reiteradamente cuestionado por m煤ltiples motivos, como, por ejemplo, estar a煤n elaborado en formato papel en la era de los documentos digitales e Internet, constituir un simple registro de actuaciones no evaluadas met贸dicamente, no disponer de elementos indexadores de las aportaciones que registran los residentes, no permitir recoger pruebas y evidencias de las actuaciones de los residentes y, sobre todo, no ofrecer un m谩s que necesario feed-back que informe al residente sobre el grado de cumplimiento de sus objetivos formativos y el desempe帽o de sus competencias, as铆 como de los objetivos que a煤n le falta por adquirir. La extensa aplicaci贸n de modernas metodolog铆as docentes y de nuevas herramientas formativas en los pa铆ses de nuestro entorno, que superan ampliamente las limitaciones del Libro del Residente espa帽ol, incrementa a煤n m谩s la incertidumbre sobre la calidad de la formaci贸n de los residentes de otorrinolaringolog铆a en Espa帽a. En este escenario faltaba por conocer la visi贸n del residente de otorrinolaringolog铆a sobre su propia formaci贸n, sobre su conocimiento de los objetivos docentes que los distintos programas formativos establecen, sobre las f贸rmulas que los residentes aplican para suplir las deficiencias de sus unidades docentes cuando 茅stas tienen lugar y el propio residente la detecta, sobre su conocimiento de las nuevas metodolog铆as docentes y las herramientas formativas puestas a su disposici贸n. El conocimiento de c贸mo perciben los residentes de ORL de las unidades docentes espa帽olas la gesti贸n de su proceso formativo y de sus resultados a la luz de las nuevas metodolog铆as y herramientas docentes contribuir铆a a completar la informaci贸n puramente cuantitativa aportada por el conocimiento de las disponibilidades docentes basadas 煤nicamente en estructura y recursos, y permitir铆a el dise帽o de nuevos programas y planes formativos orientados a la obtenci贸n de la equidad en la formaci贸n de todos los residentes de ORL de Espa帽a con los m谩s altos est谩ndares de calidad. La complacencia que muestran los residentes de ORL de las unidades docentes espa帽olas con la calidad de su formaci贸n es coherente con un sistema MIR espa帽ol que no efect煤a evaluaciones formales y objetivas del grado de consecuci贸n de los objetivos docentes requeridos por el programa oficial de la especialidad, limitadas a las evaluaciones subjetivas muy generales recogidas en las Fichas de Evaluaci贸n del Ministerio de Sanidad. Esta complacencia contrasta con el elevado conocimiento que muestran sobre el n煤mero y complejidad de esos objetivos docentes y, sobre todo, con la cuestionada capacidad de sus unidades docentes para ofrecerles la posibilidad de que con sus recursos humanos, materiales y de actividad puedan llegar a alcanzarlos en su totalidad. Los residentes de otorrinolaringolog铆a se adaptan perfectamente a los nuevos requerimientos de la andragog铆a y se muestran activamente dispuestos a autoguiar su aprendizaje cuando las herramientas formativas y el respaldo de sus tutores lo permiten. Cuando mayor es la capacidad formativa que ofrece una unidad docente tambi茅n es mayor la disposici贸n de los residentes a utilizar las nuevas herramientas formativas, incluso si no son obligatorias, y a ser m谩s exigentes en la cumplimentaci贸n integral de su programa docente. La ventaja de FORMIR de aunar en una 煤nica herramienta formativa la capacidad de permitir evaluaciones formativas y sumativas a los residentes de ORL lo convierten en su opci贸n preferida para sustituir al actual y obsoleto Libro del Residente. Su formato de portafolio electr贸nico admite la evaluaci贸n de todos los niveles de la pir谩mide de Miller y su masiva aceptaci贸n se basa en que mejora las prestaciones de cualquier otra herramienta evaluativa actual por su interfaz sencilla e intuitiva, la facilidad y comodidad de registrar sus actividades, el feedback num茅rico y autom谩tico que les devuelve cuando registran sus actividades y que les muestra cu谩ntas competencias han adquirido y cu谩ntas y cu谩les les quedan por adquirir, su capacidad de almacenamiento de evidencias, el escaso tiempo que les consume el registro de las actividades, y su capacidad de visualizarse tanto bajo el formato del logbook de la UEMS, como bajo el formato de un curriculum vitae
COVID-19; SARS-Cov-2; COVID-19 Testing; Otolaryngology
The SARS CoV-2 (COVID-19) disease has caused millions of cases since the pandemic status was declared by the World Health Organization (WHO) in March 2020, changing the usual medical and surgical practices. Doctors and nurses represent a significant percentage of the general population infected. Among them, the special risk of infection in otorhinolaryngologists and head and neck surgeons (ENT) stands out, due to the proximity to the upper airway and the risk of generation of bioaerosols during procedures./nThe objective of this article is to prepare a document on safe otorhinolaryngological practice during the COVID19 pandemic, based on a compilation of the best evidence adapted to the risk of transmission, according to the combination of the results of the risk indicators established by the Ministry of Health, Consumption and Social Welfare (MSCBS). This document is the result of the collaboration of the scientific commissions and the COVID-19 committee of the SEORLCCC.La enfermedad por el SARS CoV-2 (COVID-19) ha provocado millones de casos desde que se declarase el estado de pandemia por la Organizaci贸n Mundial de la Salud (OMS) en marzo de 2020, cambiando las pr谩cticas m茅dicas y quir煤rgicas habituales. Los sanitarios representan un importante porcentaje de la poblaci贸n general contagiada. Entre ellos, destaca el especial riesgo de infecci贸n en otorrinolaring贸logos y cirujanos de cabeza y cuello (ORL), debido a la cercan铆a a la v铆a a茅rea superior y al riesgo de generaci贸n de bioaerosoles durante los procedimientos./nEl objetivo de este art铆culo es la elaboraci贸n de un documento de pr谩ctica otorrinolaringol贸gica segura durante la pandemia COVID19, basado en una recopilaci贸n de la mejor evidencia adaptada al riesgo de transmisi贸n, seg煤n la combinaci贸n de los resultados de los indicadores de riesgo establecidos por el Ministerio de Sanidad, Consumo y Bienestar Social (MSCBS). El presente documento es fruto de la colaboraci贸n de las comisiones cient铆ficas y del comit茅 COVID-19 de la SEORLCCC
ENT practice during the COVID19 pandemic
Introducci贸n: La enfermedad por el SARS CoV-2 (COVID-19) ha provocado millones
de casos desde que se declarase el estado de pandemia por la Organizaci贸n Mundial de la Salud (OMS) en
marzo de 2020, cambiando las pr谩cticas m茅dicas y quir煤rgicas habituales. Los sanitarios representan un
importante porcentaje de la poblaci贸n general contagiada. Entre ellos, destaca el especial riesgo de infecci贸n
en otorrinolaring贸logos y cirujanos de cabeza y cuello (ORL), debido a la cercan铆a a la v铆a a茅rea superior y al riesgo de generaci贸n de bioaerosoles durante los procedimientos. Objetivo: El objetivo de este art铆culo es
la elaboraci贸n de un documento de pr谩ctica otorrinolaringol贸gica segura durante la pandemia COVID19.
M茅todo: Revisi贸n bibliogr谩fica. Resultados: Recopilaci贸n de la mejor evidencia adaptada al riesgo de trans misi贸n, seg煤n la combinaci贸n de los resultados de los indicadores de riesgo establecidos por el Ministerio
de Sanidad, Consumo y Bienestar Social (MSCBS). El presente documento es fruto de la colaboraci贸n de
las comisiones cient铆ficas y del comit茅 COVID-19 de la SEORLCCC.Introduction: The SARS CoV-2 (COVID-19) disease has caused millions of cases since the
pandemic status was declared by the World Health Organization (WHO) in March 2020, changing the usual
medical and surgical practices. Doctors and nurses represent a significant percentage of the general population
infected. Among them, the special risk of infection in otorhinolaryngologists and head and neck surgeons
(ENT) stands out, due to the proximity to the upper airway and the risk of generation of bioaerosols during
procedures. Objective: The objective of this article is to prepare a document on safe otorhinolaryngological
practice during the COVID19 pandemic. Results: Compilation of the best evidence adapted to the risk of
transmission, according to the combination of the results of the risk indicators established by the Ministry
of Health, Consumption and Social Welfare (MSCBS). This document is the result of the collaboration of
the scientific commissions and the COVID-19 committee of the SEORLCCC
Strategies for the Practice of Otolaryngology and Head and Neck Surgery during COVID-19 Pandemic
The appearance of a new coronavirus disease called COVID-19 at the end of 2019 and its pandemic expansion in the world has changed the usual practice of medicine, and has had great impact in the field of Otorhinolaryngology and Head and Neck Surgery (OHNS). The aim of this document is to review the available evidence and propose strategies and recommendations for the medical-surgical practice of OHNS, which allow establishing the usual activity, adapting the safety and efficacy standards to the current pandemic situation. Therefore, it is required to identify and classify patients according to criteria of infectious-immunological status, and to establish recommendations for protection in consultations, hospitalization and the operating room, which avoid the transmission of the disease to other users and healthcare personnel, in the specific context of the development of our specialty. This document is the result of the collaboration of all the scientific commissions of Spanish OHNS society and therefore might help other OHNS to develop their work during COVID-19 pandemic
Loss of smell and taste can accurately predict COVID-19 infection: a machine-learning approach
The COVID-19 outbreak has spread extensively around the world. Loss of smell and
taste have emerged as main predictors for COVID-19. The objective of our study is to develop a
comprehensive machine learning (ML) modelling framework to assess the predictive value of smell
and taste disorders, along with other symptoms, in COVID-19 infection. A multicenter case-control
study was performed, in which suspected cases for COVID-19, who were tested by real-time reversetranscription
polymerase chain reaction (RT-PCR), informed about the presence and severity of their
symptoms using visual analog scales (VAS). ML algorithms were applied to the collected data to
predict a COVID-19 diagnosis using a 50-fold cross-validation scheme by randomly splitting the
patients in training (75%) and testing datasets (25%). A total of 777 patients were included. Loss of
smell and taste were found to be the symptoms with higher odds ratios of 6.21 and 2.42 for COVID-19
positivity. The ML algorithms applied reached an average accuracy of 80%, a sensitivity of 82%, and
a specificity of 78% when using VAS to predict a COVID-19 diagnosis. This study concludes that
smell and taste disorders are accurate predictors, with ML algorithms constituting helpful tools for
COVID-19 diagnostic prediction.Junta de Andaluc铆
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.
Journal Article; Research Support, Non-U.S. Gov't;BACKGROUND
We evaluated a newly designed electronic portfolio (e-Portfolio) that provided quantitative evaluation of surgical skills. Medical students at the University of Seville used the e-Portfolio on a voluntary basis for evaluation of their performance in undergraduate surgical subjects.
METHODS
Our new web-based e-Portfolio was designed to evaluate surgical practical knowledge and skills targets. Students recorded each activity on a form, attached evidence, and added their reflections. Students self-assessed their practical knowledge using qualitative criteria (yes/no), and graded their skills according to complexity (basic/advanced) and participation (observer/assistant/independent). A numerical value was assigned to each activity, and the values of all activities were summated to obtain the total score. The application automatically displayed quantitative feedback. We performed qualitative evaluation of the perceived usefulness of the e-Portfolio and quantitative evaluation of the targets achieved.
RESULTS
Thirty-seven of 112 students (33%) used the e-Portfolio, of which 87% reported that they understood the methodology of the portfolio. All students reported an improved understanding of their learning objectives resulting from the numerical visualization of progress, all students reported that the quantitative feedback encouraged their learning, and 79% of students felt that their teachers were more available because they were using the e-Portfolio. Only 51.3% of students reported that the reflective aspects of learning were useful. Individual students achieved a maximum of 65% of the total targets and 87% of the skills targets. The mean total score was 345 卤 38 points. For basic skills, 92% of students achieved the maximum score for participation as an independent operator, and all achieved the maximum scores for participation as an observer and assistant. For complex skills, 62% of students achieved the maximum score for participation as an independent operator, and 98% achieved the maximum scores for participation as an observer or assistant.
CONCLUSIONS
Medical students reported that use of an electronic portfolio that provided quantitative feedback on their progress was useful when the number and complexity of targets were appropriate, but not when the portfolio offered only formative evaluations based on reflection. Students felt that use of the e-Portfolio guided their learning process by indicating knowledge gaps to themselves and teachers.The Electronic Portfolio of the Faculty of Medicine was supported by a financial fund from the 2009 Innovation and Teaching Enhancing Programme, University of
Seville, Spain. The manuscript processing charges were financed by the Andalusian Association for Medical Education in OtorhinolaryngologyYe
Impact of mobilization of residents in otolaryngology-head鈥搉eck surgery in COVID-19 units on mental health status
International audienceBackground: To investigate mental health, sleep, and addiction features of young otolaryngologists (YO) according to the mobilization in COVID-19 units at the end of the third European wave of infections. Methods: A cross-sectional survey was sent to 220 YO of 6 European University hospitals. The following outcomes were evaluated: postgraduate year; age; management of COVID-19 patients; workload; nights on call; stress; Beck depression inventory; Insomnia severity index; sleep and mental health status evolutions throughout pandemic; consumption of alcohol, tobacco, and drugs before and during pandemic. Results: A total of 128 YO completed the evaluations (58.2%). Twenty responders (15.6%) did not manage COVID-19 patients, while 65 (50.8%), 20 (15.6%), and 23 (18%) managed rarely, frequently or daily COVID-19 patients during the pandemic, respectively. The management of COVID-19 patients was associated with increases of workload (p = 0.023) and number of nights on-call (p < 0.001). At the end of the third wave, the depression rates were 34% (N = 31/68) and 57% (N = 34/60) in YO who worked less and more than 50聽h weekly, respectively. Sleep disturbance concerned 39% (N = 26/66) and 55% (N = 27/60) of YO who worked less and more than 50聽h weekly, respectively. Mobilized YO reported a significant increase of alcohol consumption compared with control group (p = 0.002). Tobacco and drugs consumptions did not evolve. The consumption of alcohol was positively correlated with the number of nights on-call (p = 0.036) and the total hours of work (p = 0.009). Conclusions: Young otolaryngologists (YO) mobilized in COVID-19 units reported higher hours worked, nights on call, and alcohol consumption compared with others. Future large cohort-studies are needed to confirm our observations
Impacto de la pandemia COVID-19 en la formaci贸n de los residentes de otorrinolaringolog铆a
Background and objectives: Training in surgical specialties has declined during the COVID-19 pandemic. A study was carried out to further analyze the impact of the COVID-19 pandemic on specific aspects of clinical, training, and research activities performed by the otolaryngology residents in Spain.
Methods: A cross-sectional qualitative study was conducted during the last two weeks of February 2021. The study consisted of an online survey taken by otolaryngology residents who had undertaken one-year continuing training from February 15, 2020, to February 15, 2021, and consisted of 26 questions exploring the impact of the COVID-19 on the health of the ENT residents and training activities. Categorical variables were reported as frequency and percentage. When indicated, Pearso艅s Chi-square test (蠂2) with Yates's correction and Pearson's correlation coefficient (r) were used.
Results: 143 completed surveys were received from 264 residents (54.17%). 36 residents (25.2%) have suffered from the disease due to SARS-CoV-2. Most of them only developed mild symptoms (86.1%), with 3 requiring hospitalization (8.3%). The origin of infection was unknown in all reported cases and the need for confinement was principally due to either attending an asymptomatic patient in 9 cases (6.3%) or to being supposedly in close contact with an asymptomatic person in 22 (15.4%). 60.1% of the residents surveyed reported having lost more than 6 months of their training period, and in 18.8% of cases, it was as high as 10 and 12 months. There has been a reduction of more than 75% of what was planned in surgical training (P < .05) of tympanoplasty, mastoidectomy, stapedectomy, cochlear implants, endoscopic sinonasal and anterior skull base surgery, septoplasty and turbinoplasty.
Conclusions: The decline in ENT activity and residents having to assist in other COVID-19 units during the most critical moments of the pandemic, has caused the main reduction in their training capacity. Contagion mainly occurred through contact with asymptomatic carriers during patient care and through supposedly close contact with asymptomatic carriers. Virtual activities have been widely accepted, but they have not completely replaced all residents' training needs. Measures should be implemented to recover lost training, especially surgical practical learning in otology and rhinology.Antecedentes y objetivos: La pandemia COVID-19 ha alterado todas las actividades sanitarias, entre ellas la formaci贸n especializada de los residentes. Se llev贸 a cabo un estudio para analizar en profundidad el impacto de la pandemia COVID-19 en aspectos espec铆ficos de las actividades cl铆nicas, formativas e investigadoras que realizan los residentes de otorrinolaringolog铆a (ORL) en Espa帽a durante un a帽o completo de formaci贸n.
M茅todos: Se realiz贸 un estudio cualitativo transversal durante las 煤ltimas dos semanas de febrero de 2021. El estudio consisti贸 en una encuesta en l铆nea realizada por residentes de ORL que hab铆an realizado un a帽o continuado de formaci贸n desde el 15 de febrero de 2020 al 15 de febrero de 2021 y consisti贸 en 26 preguntas que exploraban el impacto del COVID-19 en la salud de los residentes de ORL, en su dedicaci贸n laboral y en las actividades de formaci贸n. Las variables categ贸ricas se informaron como frecuencia y porcentaje. Cuando se indic贸, se utiliz贸 la prueba chi-cuadrado de Pearson con la correcci贸n de Yates y el coeficiente de correlaci贸n de Pearson (r).
Resultados: Se recibieron 143 encuestas cumplimentadas de 264 residentes (54,17%). Treinta y seis residentes (25,2%) hab铆an padecido la enfermedad por SARS-CoV-2. La mayor铆a de ellos solo desarrollaron s铆ntomas leves (86,1%) y 3 requirieron hospitalizaci贸n (8,3%). Los residentes encuestados que resultaron positivos para SARS-CoV-2 no fueron capaces de identificar la fuente de su contagio y la necesidad de confinamiento se debi贸 principalmente a la atenci贸n de un paciente asintom谩tico en 9 casos (6,3%) o al contacto estrecho con un asintom谩tico en situaciones no identificadas distintas de la atenci贸n sanitaria en 22 (15,4%). El 60,1% de los residentes encuestados reportaron haber perdido m谩s de 6 meses de su per铆odo de formaci贸n, y en el 18,8% de los casos llegaron a 10 y 12 meses. Se ha producido una reducci贸n de m谩s del 75% de lo previsto en formaci贸n quir煤rgica (p < 0,05) de timpanoplastia, mastoidectom铆a, estapedectom铆a, implantes cocleares, cirug铆a endosc贸pica nasosinusal y de base de cr谩neo anterior, septoplastia y turbinoplastia.
Conclusiones: El descenso de la actividad ORL y la necesidad de prestar asistencia en otros servicios y unidades durante los momentos m谩s cr铆ticos de la pandemia han causado la principal reducci贸n de su capacidad de formaci贸n. El contagio fundamentalmente ocurri贸 por el contacto con portadores asintom谩ticos durante la atenci贸n a pacientes y por contacto estrecho con portadores asintom谩ticos. Las actividades virtuales han sido ampliamente aceptadas, pero no han reemplazado por completo las necesidades de formaci贸n de todos los residentes. Se deber谩n implementar medidas para recuperar la formaci贸n perdida, especialmente el aprendizaje pr谩ctico quir煤rgico en otolog铆a y rinolog铆a
Impacto de la pandemia COVID-19 en la formaci贸n de los residentes de otorrinolaringolog铆a.
Training in surgical specialties has declined during the COVID-19 pandemic. A study was carried out to further analyze the impact of the COVID-19 pandemic on specific aspects of clinical, training, and research activities performed by the otolaryngology residents in Spain. A cross-sectional qualitative study was conducted during the last two weeks of February 2021. The study consisted of an online survey taken by otolaryngology residents who had undertaken one-year continuing training from February 15, 2020, to February 15, 2021, and consisted of 26 questions exploring the impact of the COVID-19 on the health of the ENT residents and training activities. Categorical variables were reported as frequency and percentage. When indicated, Pearso艅s Chi-square test (蠂2) with Yates's correction and Pearson's correlation coefficient (r) were used. 143 completed surveys were received from 264 residents (54.17%). 36 residents (25.2%) have suffered from the disease due to SARS-CoV-2. Most of them only developed mild symptoms (86.1%), with 3 requiring hospitalization (8.3%). The origin of infection was unknown in all reported cases and the need for confinement was principally due to either attending an asymptomatic patient in 9 cases (6.3%) or to being supposedly in close contact with an asymptomatic person in 22 (15.4%). 60.1% of the residents surveyed reported having lost more than 6聽months of their training period, and in 18.8% of cases, it was as high as 10 and 12聽months. There has been a reduction of more than 75% of what was planned in surgical training (P聽 The decline in ENT activity and residents having to assist in other COVID-19 units during the most critical moments of the pandemic, has caused the main reduction in their training capacity. Contagion mainly occurred through contact with asymptomatic carriers during patient care and through supposedly close contact with asymptomatic carriers. Virtual activities have been widely accepted, but they have not completely replaced all residents' training needs. Measures should be implemented to recover lost training, especially surgical practical learning in otology and rhinology