Avaliação em ambientes virtuais de aprendizagem

The demand for evaluations of projects of virtual distance learning has required the use of concepts and methods that go beyond the strictly educational field, with emphasis on the multiplicity of theoretical frameworks and technical approaches employed in the assessment strategies of online learning. Despite the hegemony of quantitative methods in the evaluation of the technologies of information and communication, the use of qualitative methods in the assessment of virtual environments has increased throughout the last decades. The combination of qualitative-quantitative methods allows a better understanding of the phenomena underlying the use of technologies for online learning. Given that education in virtual environments relates to learning experiences that make use of hypermediatic resources within environments supported by an online communication technology, we have opted in the present article for focusing on topics associated to the evaluation of information and learning technologies in these environments, furthering the discussion concerning the methods relevant to the assessment both of the virtual learning environments and of the learning within this medium. This choice is due to the recognition of the specificities of the practices of distance learning, which stress the relationship between education and communication, made possible through the new information and communication technologies. It also recognizes the various roles, positive and negative, attributed to the information and communication technologies in education.A demanda por avaliações de projetos de aprendizagem virtual a distância tem requerido o emprego de conceitos e métodos que transcendem o campo exclusivo da Educação, destacando-se a multiplicidade de marcos teóricos e abordagens técnicas empregados nas estratégias avaliativas de aprendizagem online. A despeito da hegemonia dos métodos quantitativos na avaliação das tecnologias de informação e comunicação, o emprego de métodos qualitativos nas avaliações de ambientes virtuais tem crescido ao longo das duas últimas décadas. A combinação de métodos quali-quantitativos possibilita uma melhor compreensão dos fenômenos subjacentes ao uso das tecnologias para a aprendizagem online. Dado que a educação em ambientes virtuais refere-se a experiências de aprendizagem que utilizam recursos hipermidiáticos em ambientes apoiados por uma tecnologia de comunicação online, optou-se neste artigo enfocar alguns tópicos relativos à avaliação de tecnologias de informação e de aprendizagem nesses ambientes, aprofundando a discussão no que tange aos métodos relevantes à avaliação tanto dos ambientes virtuais de aprendizagem quanto da aprendizagem nesse meio. Essa opção se deve tanto ao reconhecimento das especificidades das práticas pedagógicas da EaD que colocam em evidência a relação entre educação e comunicação, viabilizadas por meio das tecnologias de informação e comunicação, quanto aos diversos papéis, negativos e positivos, atribuídos às tecnologias de comunicação e informação na Educação

Information and Communication Technologies in Postgraduate Courses at Healthcare Institutions: Evidence and Stereotypes

Objectiu. L'escenari contemporani de la salut pública exigeix innovacions en els programes de postgrau de salut. L'èmfasi en la formació continuada, l'actuació en xarxa i els vincles més flexibles entre la docència i els serveis desafien les institucions d'educació. Es reformulen els mètodes d'ensenyament i es revisa l'estructura curricular. D'altra banda, sobren testimonis de la capacitat de les tecnologies d'informació i comunicació per a produir innovació i col·laboració. Aquest estudi presenta l'aplicació pilot d'un instrument en adaptació, que permet avaluar els usos quotidians d'aquestes tecnologies en la docència de postgraus de salut. Mètodes. A través de la Xarxa es va passar una enquesta a 350 de docents d'un centre de postgrau a Barcelona (Espanya). En l'escala de Likert, es van avaluar les necessitats, les creences i la comoditat amb les tecnologies. També se'n van investigar els usos i la participació en xarxes. Resultats. La taxa de resposta va ser del 25% (89), el temps mitjà per a emplenar va ser de 10 minuts. L'ús de les tecnologies es va revelar instrumental, amb poc èmfasi en recursos associats a la innovació i a les xarxes. Conclusions. Els resultats són discutits sota dues perspectives. En primer lloc, respecte al procés de validació de l'instrument, i en segon, es discuteix de forma preliminar l'aparent dissonància entre les dades aportades i la forta aposta pel potencial de les tecnologies d'informació i comunicació.Objetivos. El escenario contemporáneo de la salud pública exige innovaciones en los programas de posgrado de salud. El énfasis en la formación continuada, la actuación en red y los vínculos más flexibles entre la docencia y los servicios desafían a las instituciones de educación. Se reformulan los métodos de enseñanza y se revisa la estructura curricular. Por otra parte, sobran testimonios de la capacidad de las tecnologías de información y comunicación para producir innovación y colaboración. Ese estudio presenta la aplicación piloto de un instrumento en adaptación, que permite evaluar los usos cotidianos de esas tecnologías en la docencia de posgrados de salud. Métodos. A través de la red se pasó una encuesta a 350 docentes de un centro de posgrado en Barcelona (España).  En la escala Likert, se evaluaron las necesidades, las creencias y la comodidad con las tecnologías. Se indagó por sus usos y por la participación en redes. Resultados. La tasa de respuesta fue del 25% (89), el tiempo medio para cumplimentar fue de 10 minutos. El uso de las tecnologías se reveló instrumental, con poco énfasis en recursos asociados a la innovación y a las redes. Conclusiones. Los resultados son discutidos bajo dos perspectivas. En primer lugar, respecto al proceso de validación del instrumento, y en segundo, se discute de forma preliminar la aparente disonancia entre los datos aportados y la fuerte apuesta en el potencial de las tecnologías de información y comunicación.Objective. The current state of public healthcare calls for innovations in postgraduate courses. Emphasis on lifelong education, networking performance and more flexible links between the area of teaching and actual healthcare services all pose a major challenge to education institutions. Teaching methods are being redefined and syllabus structures revised. But while ther has been much discussion in the literature on the capacity of ICTs to bring about innovation and collaboration, there is very little real evidence to back this idea. This study presents a pilot test of an instrument which is being developed to allow the assessment of everyday uses of ICTs in teaching postgraduate healthcare courses. Methods. Through the Internet, a Likert-scale survey was conducted on 350 teachers of a postgraduate education centre in Barcelona, Spain, evaluating needs, beliefs and comfort with technology as well as teacher participation in networks. Results. The 89 respondents (25%) took, on average, ten minutes to fill out the questionnaire. The use of technology was instrumental, with little emphasis on resources related to innovation and networks. Conclusions. The results are discussed from the points of view of the validation of the instrument and the apparent dissonance between the presented data and the strong bet on the potential of information and communication technologies

Registros em saúde: avaliação da qualidade do prontuário do paciente na atenção básica, Rio de Janeiro, Brasil

Com o objetivo de contribuir para a avaliação da Atenção Básica, desenvolveu-se estudo que tem por referência a qualidade de prontuários dos pacientes, considerando os registros dos atendimentos realizados em quatro municípios acima de 100 mil habitantes no Estado do Rio de Janeiro, Brasil, em 2004, esta pesquisa se trata de estudo transversal com base em dados primários, levantados por verificação direta no prontuário. Os atendimentos foram sorteados em amostra probabilística por conglomerado em dois estágios: estabelecimentos de atenção básica e atendimentos/prontuários. Verificou-se a completitude de atributos relativos à identificação dos usuários atendidos, em todos os prontuários, e a características do processo de atendimento (como peso, pressão arterial, colpocitologia e glicemia) nos prontuários de mulheres acima de 19 anos, hipertensas e diabéticas. Na identificação dos usuários, encontrou-se baixa presença dos atributos sociais e somente metade dos prontuários possuía registro da data de abertura. Os registros de características do processo de atendimento em mulheres, hipertensas e diabéticas, ficaram longe das proposições do Ministério da Saúde. A análise da completitude sugere discutível qualidade na continuidade do cuidado oferecido, dificuldades para a prática gerencial na Atenção Básica e para implementação da Estratégia Saúde da Família.With the purpose of contributing to the evaluation of primary care, a study was conducted based on the quality of patients' health charts, considering the records for care provided in 4 municipalities with more than 100 thousand inhabitants each in the State of Rio de Janeiro, Brazil, in 2004. This was a cross-sectional study based on primary data collected from direct consultation of patient charts. A two-stage, probabilistic cluster sample was selected from primary care facilities and consultations/patient charts. We checked the completeness of attributes pertaining to the identification of users receiving care and the characteristics of the care itself (weight, blood pressure, Pap tests, and blood glucose) on the charts of women over 19 years of age with hypertension and/or diabetes. User identification showed a low presence of social attributes, and only half of the charts had recorded the opening date. Records of process characteristics in care provided to women with hypertension and diabetes failed to conform to Brazilian Ministry of Health guidelines. Analysis of completeness suggests dubious quality in the continuity of the care provided and difficulties in management practice for primary care and implementation of the Family Health Strategy

Tecnologías de la información y comunicación en instituciones de posgrados de salud : evidencias y estereotipos

Objetivo: El escenario contemporáneo de la salud pública exige innovaciones en los programas de posgrado de salud. El énfasis en la formación continuada, la actuación en red y los vínculos más flexibles entre la docencia y los servicios desafían a las instituciones de educación. Se reformulan los métodos de enseñanza y se revisa la estructura curri­cular. Por otra parte, sobran testimonios de la capacidad de las tecnologías de información y comunicación para producir innovación y colaboración. Ese estudio presenta la aplicación piloto de un instrumento en adaptación, que permite evaluar los usos cotidianos de esas tecnologías en la docencia de posgrados de salud. Métodos: A través de la red se pasó una encuesta a 350 docentes de un centro de posgrado en Barcelona (España). En la escala Likert, se evaluaron las necesidades, las creencias y la comodidad con las tecnologías. Se indagó por sus usos y por la participación en redes. Resultados: La tasa de respuesta fue del 25% (89), el tiempo medio para cumplimentar fue de 10 minutos. El uso de las tecno­logías se reveló instrumental, con poco énfasis en recursos asociados a la innovación y a las redes. Conclusiones: Los resultados son discutidos bajo dos perspectivas. En primer lugar, respecto al proceso de validación del instrumento, y en segundo, se discute de forma preliminar la aparente disonancia entre los datos aportados y la fuerte apuesta en el potencial de las tecnologías de información y comunicación.Objective: The current state of public healthcare calls for innovations in postgraduate courses. Emphasis on lifelong education, networking performance and more flexible links between the area of teaching and actual healthcare services all pose a major challenge to edu-cation institutions. Teaching methods are being redefined and syllabus structures revised. But while there has been much discussion in the literature on the capacity of ICTs to bring about innovation and collaboration, there is very little real evidence to back this idea. This study presents a pilot test of an instrument which is being developed to allow the assessment of everyday uses of ICTs in teaching postgraduate healthcare courses. Methods: Through the Internet, a Likert-scale survey was conducted on 350 teachers of a postgraduate education centre in Barcelona, Spain, evaluating needs, beliefs and comfort with technology as well as teacher participation in networks. Results: The 89 respondents (25%) took, on average, ten minutes to fill out the questionnaire. The use of technology was instrumental, with little emphasis on resources related to innovation and networks. Conclusions: The results are discussed from the points of view of the validation of the instrument and the apparent dissonance between the presented data and the strong bet on the potential of information and communication technologies

Hospitais filantrópicos e a operação de planos de saúde próprios no Brasil

OBJECTIVE: To describe the management performance of philanthropic hospitals that operate their own health plans, in comparison with philanthropic hospitals as a whole in Brazil. METHODS: The managerial structures of philanthropic hospitals that operated their own health plans were compared with those seen in a representative group from the philanthropic hospital sector, in six dimensions: management and planning, economics and finance, human resources, technical services, logistics services and information technology. Data from a random sample of 69 hospitals within the philanthropic hospital sector and 94 philanthropic hospitals that operate their own health plans were evaluated. In both cases, only the hospitals with less than 599 beds were included. RESULTS: The results identified for the hospitals that operate their own health plans were more positive in all the managerial dimensions compared. In particular, the economics and finance and information technology dimensions were highlighted, for which more than 50% of the hospitals that operated their own health plans presented almost all the conditions considered. CONCLUSIONS: The philanthropic hospital sector is important in providing services to the Brazilian Health System (SUS). The challenges in maintaining and developing these hospitals impose the need to find alternatives. Stimulation of a public-private partnership in this segment, by means of operating provider-owned health plans or providing services to other health plans that work together with SUS, is a field that deserves more in-depth analysis.OBJETIVO: Descrever o desempenho gerencial de hospitais filantrópicos com operadoras de planos de saúde em comparação com o conjunto de hospitais filantrópicos no Brasil. MÉTODOS: Foram comparadas as estruturas gerenciais presentes nos hospitais filantrópicos com operadoras próprias de planos de saúde com aquelas observadas num conjunto representativo do setor hospitalar filantrópico, em seis dimensões: direção e planejamento, econômico-financeira, recursos humanos, serviços técnicos, serviços logísticos e tecnologia de informações. Consideraram-se os dados de uma amostra aleatória de 69 hospitais, extraída do setor hospitalar filantrópico, e 94 hospitais filantrópicos com operadoras próprias de planos de saúde. Nos dois casos incluíram-se apenas os hospitais com menos de 599 leitos. RESULTADOS: Foram identificados resultados mais positivos para o conjunto de hospitais com operadoras próprias de planos de saúde em todas as dimensões gerenciais comparadas. Em particular, destacaram-se as dimensões econômico-financeira e de tecnologia de informações, nas quais mais de 50% dos hospitais com operadoras apresentaram quase todas as condições consideradas. CONCLUSÕES: O setor hospitalar filantrópico é importante na prestação de serviços ao Sistema Único de Saúde. Os desafios para a sua manutenção e desenvolvimento impõem encontrar alternativas. O fomento de uma parceria público-privado neste segmento, por meio da operação de planos próprios ou prestação de serviços a outros planos de saúde convivendo com o SUS, constitui um campo que merece uma análise mais aprofundada

Design and baseline characteristics of the finerenone in reducing cardiovascular mortality and morbidity in diabetic kidney disease trial

Background: Among people with diabetes, those with kidney disease have exceptionally high rates of cardiovascular (CV) morbidity and mortality and progression of their underlying kidney disease. Finerenone is a novel, nonsteroidal, selective mineralocorticoid receptor antagonist that has shown to reduce albuminuria in type 2 diabetes (T2D) patients with chronic kidney disease (CKD) while revealing only a low risk of hyperkalemia. However, the effect of finerenone on CV and renal outcomes has not yet been investigated in long-term trials. Patients and Methods: The Finerenone in Reducing CV Mortality and Morbidity in Diabetic Kidney Disease (FIGARO-DKD) trial aims to assess the efficacy and safety of finerenone compared to placebo at reducing clinically important CV and renal outcomes in T2D patients with CKD. FIGARO-DKD is a randomized, double-blind, placebo-controlled, parallel-group, event-driven trial running in 47 countries with an expected duration of approximately 6 years. FIGARO-DKD randomized 7,437 patients with an estimated glomerular filtration rate >= 25 mL/min/1.73 m(2) and albuminuria (urinary albumin-to-creatinine ratio >= 30 to <= 5,000 mg/g). The study has at least 90% power to detect a 20% reduction in the risk of the primary outcome (overall two-sided significance level alpha = 0.05), the composite of time to first occurrence of CV death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for heart failure. Conclusions: FIGARO-DKD will determine whether an optimally treated cohort of T2D patients with CKD at high risk of CV and renal events will experience cardiorenal benefits with the addition of finerenone to their treatment regimen. Trial Registration: EudraCT number: 2015-000950-39; ClinicalTrials.gov identifier: NCT02545049