Expectations, abilities and difficulties that presented the students in the Practicum Hospital

Objetivos: Conocer las expectativas, habilidades y dificultades que presentan los alumnos durante el practicum hospitalario, con el propósito de mejorar el proceso de aprendizaje. Material y método: Estudio exploratorio, método mixto secuencial, cualitativo - cuantitativo. Muestra de 112 estudiantes. La recogida se realizó en tres fases a través de preguntas abiertas entregadas antes del inicio de las prácticas, en la mitad y al finalizar. La información recogida se categorizó entre las cinco competencias a desarrollar por el estudiante a lo largo de su formación en el Practicum. Resultados: En relación a la mayor expectativa que los alumnos presentaron al inicio, fue la de la primera competencia, un 64 % opinaba que mediante la experiencia, autonomía y conocimientos prácticos se conseguiría la seguridad necesaria para desarrollar la práctica profesional. El mejor conocimiento y habilidad adquirida durante el primer periodo fueron los procedimientos en un 95%, seguido de la dinámica organizativa de la unidad en un 61%. En el segundo periodo también fue el principal conocimiento y habilidad mejor adquirida la de procedimientos con un 88%, seguida de la comunicación paciente/familia /equipo con un 57%. La mayor dificultad que presentaron en el primer periodo fue un 73% con los procedimientos, medicación y técnicas y un 41% las relacionadas con la organización y equipo. Conclusiones: Este estudio nos ha aportado una visión de las expectativas, habilidades adquiridas y dificultades de los alumnos durante las prácticas clínicas, de las cinco competencias a desarrollar. Esta información nos ayudará a adecuar actuaciones e iniciativas de mejora.Objectives: know expectations, abilities and difficulties that presented the students during the practicum hospital during the practicum hospital in order to improve the learning process. Materials and methods: Exploratory, mixed method sequential study, qualitative - quantitative. Sample of 112 students. The collection was conducted through three surveys given before the start of the internship, middle and end. The information collected was categorized among the five competencies to be developed by the student throughout his training at the practicum. Results: In relation to the increased expectation that students had at the beginning, was the first competition, 64% felt that through experience, autonomy and expertise will get the confidence to develop professional practice. Improved knowledge and skills gained during the first period were the procedures by 95%, followed by the organizational dynamics of the unit by 61%. In the second period was also the main skill best acquired knowledge and the procedures with 88%, followed by communication patient / family / team with 57%. The greatest difficulty presented in the first period was 73% with the procedures, techniques and medication and 41% related to the organization and team. Conclusions: This study has provided an overview of the expectations, skills acquired and difficulties of students during clinical practice, the five powers to develop. This information will help us adapt actions and improvement initiatives

Expectativas, habilidades y dificultades que presentan los alumnos durante el Practicum Hospitalario

Objectives: know expectations, abilities and difficulties that presented the students during the practicum hospital during the practicum hospital in order to improve the learning process. Materials and methods: Exploratory, mixed method sequential study, qualitative - quantitative. Sample of 112 students. The collection was conducted through three surveys given before the start of the internship, middle and end. The information collected was categorized among the five competencies to be developed by the student throughout his training at the practicum. Results: In relation to the increased expectation that students had at the beginning, was the first competition, 64% felt that through experience, autonomy and expertise will get the confidence to develop professional practice. Improved knowledge and skills gained during the first period were the procedures by 95%, followed by the organizational dynamics of the unit by 61%. In the second period was also the main skill best acquired knowledge and the procedures with 88%, followed by communication patient / family / team with 57%. The greatest difficulty presented in the first period was 73% with the procedures, techniques and medication and 41% related to the organization and team. Conclusions: This study has provided an overview of the expectations, skills acquired and difficulties of students during clinical practice, the five powers to develop. This information will help us adapt actions and improvement initiatives.Objetivos: Conocer las expectativas, habilidades y dificultades que presentan los alumnos durante el practicum hospitalario, con el propósito de mejorar el proceso de aprendizaje. Material y método: Estudio exploratorio, método mixto secuencial, cualitativo - cuantitativo. Muestra de 112 estudiantes. La recogida se realizó en tres fases a través de preguntas abiertas entregadas antes del inicio de las prácticas, en la mitad y al finalizar. La información recogida se categorizó entre las cinco competencias a desarrollar por el estudiante a lo largo de su formación en el Practicum. Resultados: En relación a la mayor expectativa que los alumnos presentaron al inicio, fue la de la primera competencia, un 64 % opinaba que mediante la experiencia, autonomía y conocimientos prácticos se conseguiría la seguridad necesaria para desarrollar la práctica profesional. El mejor conocimiento y habilidad adquirida durante el primer periodo fueron los procedimientos en un 95%, seguido de la dinámica organizativa de la unidad en un 61%. En el segundo periodo también fue el principal conocimiento y habilidad mejor adquirida la de procedimientos con un 88%, seguida de la comunicación paciente/familia /equipo con un 57%. La mayor dificultad que presentaron en el primer periodo fue un 73% con los procedimientos, medicación y técnicas y un 41% las relacionadas con la organización y equipo. Conclusiones: Este estudio nos ha aportado una visión de las expectativas, habilidades adquiridas y dificultades de los alumnos durante las prácticas clínicas, de las cinco competencias a desarrollar. Esta información nos ayudará a adecuar actuaciones e iniciativas de mejora

Dolutegravir monotherapy in HIV-infected patients with sustained viral suppression.

We reviewed the 24 week outcomes of HIV-infected patients from our hospital who had their ART switched to dolutegravir monotherapy on an individual clinical basis. Retrospective hospital database assessment of virally suppressed patients in whom the treating physician had switched to 50 mg of dolutegravir once daily due to one or more of the following reasons: antiretroviral-related adverse effects; comorbidities; risk of interactions; or archived resistance. Patients had ≥24 weeks of follow-up. Population, virological and immunological responses and safety and tolerability are described. Thirty-three (22 on PIs, of whom 18 had ritonavir-boosted PI monotherapy) patients were identified: median (IQR) age of 56 (50-62) years, 55% women, median (IQR) of 19 (17-23) years of known HIV infection, 39% prior AIDS events, median (IQR) of 8 (4-13) years with undetectable plasma HIV-1 RNA and median (IQR) CD4 cell count of 596 (420-843) cells/mm(3). Twenty-five (76%) patients had antiretroviral-related adverse effects, 32 (97%) patients had comorbidities, 28 (85%) patients had risk of interactions and 16 (48%) patients had archived resistance. One patient with suboptimal adherence had low-level virological failure through weeks 4-24. HIV RNA genotypic resistance tests detected no integrase mutations at weeks 4 and 24, but 118R was detected in 7% of the integrated HIV DNA at 24 weeks. Patients had significant median decreases in triglycerides (-117 mg/dL), total cholesterol (-36 mg/dL), the total cholesterol/HDL cholesterol ratio (-0.7) and high-sensitivity C-reactive protein (-0.05 mg/dL) (P ≤ 0.007), although the Chronic Kidney Disease Epidemiology Collaboration equation also decreased (-7.1 mL/min) (P  These data suggest the efficacy of dolutegravir monotherapy as a maintenance strategy to be further confirmed in randomized clinical trials