Background: Quality of the educational environment affects trainee performance and well-being in postgraduate healthcare education. In pharmacy practice the quality of the educational environment has not been extensively studied. Self-determination Theory can assist in understanding the underlying mechanisms. Objectives: In this study, the quality of the educational environment and its relationship with satisfaction and frustration of trainees’ basic psychological needs and motivation were investigated in a Dutch community pharmacy postgraduate education programme. Methods: In a cross-sectional study, pharmacists specializing to become community pharmacists completed the Scan of Postgraduate Educational Environment Domains (SPEED), the Basic Psychological Need Satisfaction and Frustration Scale for the Work Domain, and the Academic Motivation Scale. Confirmatory factor analysis followed by path analysis was used to analyse the relationships between the variables. Results: Out of 232 trainees, 205 responded (88%). Most trainees (82%) were positive about the quality of the educational environment. The resulting path model displayed a moderate to good fit. The perceived quality of the educational environment had a moderate positive association with basic psychological needs satisfaction (Factor loading = 0.40) and a similar negative association with basic psychological needs frustration (Factor loading = -0.47). Basic psychological needs frustration had a moderate association with an increased sense of internal and external pressures also known as controlled motivation (Factor loading = 0.31). Intrinsic motivation was not affected by the perceived quality of the educational environment. Conclusions: The educational environment was perceived as positive in most community pharmacies. However, having a less positive or a negative perception was associated with reduced satisfaction and increased frustration of trainees’ basic needs for autonomy, compentence and relatedness. Moreover, basic psychological needs frustration was associated with an increased perception of controlled motivation. We recommend supporting supervisors in creating a positive educational environment in pharmacy practice, thereby reducing the risk of basic psychological needs frustration and increased controlled motivation amongst trainees.

Quality of the educational environment in postgraduate community pharmacy education and the relationship with trainees’ basic psychological needs

https://www.rmo.com.mx/files/rmo_22_96_2_047-056.pdf

Cambios en el espesor coroideo central medidos por EDI-OCT en pacientes hemodializados de primera vez

Natural semantic networks (NSNs) provide an approach to understanding concepts in terms of their density and strength. The objective of this study was to conceptualize mistreatment and good treatment among health science students in Chile, according to gender and training cycle. Methods: A mixed-methods study with a relational scope was conducted, involving 994 health science students. The present study is exploratory and combines both qualitative and quantitative analysis. We utilized the NSN technique, applying a questionnaire via SurveyMonkey after obtaining informed consent. Results: A total of 4386 defining words for mistreatment were identified, with the most relevant being ‘aggression’, ‘abuse’, and ‘violence’. In the case of good treatment, a total of 4146 defining words were obtained, with ‘respect’, ‘empathy’, and ‘kindness’ standing out. For good treatment, a statistically significant relationship was observed between the defining words and the variables of gender (χ2 = 41.158; p &lt; 0.05) and training cycle (χ2 = 28.698; p &lt; 0.05). For mistreatment, a statistically significant relationship was found only with training cycle (χ2 = 35.858; p &lt; 0.05). Conclusions: Exploring the meanings associated with mistreatment and good treatment has a theoretical implication in the way in which two highly polysemic aspects of the educational environment can be understood. 

Natural Semantic Networks: The Concept of Mistreatment and Good Treatment in Students of Health Careers

Abstract Introduction: The PHEEM (postgraduate hospital educational environment measure) is a validated and reliable instrument to assess the educational environment in medical residency programs. Objective: To map the application of the PHEEM questionnaire in medical residency, evaluate the results found, positive and negative aspects and points for improvement. Method: We performed a scoping review according to the Joanna Briggs institution’s methodology. Studies that followed the PCC structure were included, as follows: P (participants) = resident physicians of any specialty; C (concept) = The PHEEM is an instrument used to assess the educational environment in medical residency, through a 40-item questionnaire divided into 3 subscales that include perception of autonomy, teaching and social support. C (context)= studies on PHEEM in medical residency of any specialty. PubMed, EMBASE and the Virtual Health Library databases were the data sources. Results: We identified 1588 references, and after reading the title and abstract, 50 references were selected for full reading, and 36 studies were included. The studies were carried out in 22 countries, and most revealed a more positive than negative educational environment, albeit with room for improvement. In the subscales, the perception of autonomy was more positive than negative, and the perception of teaching revealed that most programs are moving in the right direction. However, when evaluating social support, the results were divided between an unpleasant environment and an environment with more pros than cons. The main highlighted positive points were low racial and sexual discrimination, possibility of working in a team, adequate level of responsibilities, accessible teachers with good teaching skills, learning opportunities and participation in educational events. The main negative points were lack of adequate food and accommodation during the shifts, excessive workload, lack of feedback from preceptors and lack of protected time for study and the culture of blaming the resident. Conclusion: The application of PHEEM revealed that in most medical residency programs the educational environment was more positive than negative, albeit with room for improvement. Efforts are needed to improve the educational environment, especially social support, in medical residency programs.

Scoping review of the application of the Postgraduate Hospital Educational Environment Measure (PHEEM) in medical residency

Resumo Introdução: O Postgraduate Hospital Educational Environment Measure (PHEEM) é um instrumento validado e confiável para avaliar o ambiente educacional nos programas de residência médica. Objetivo: Este estudo teve como objetivos mapear a aplicação do questionário PHEEM na residência médica e avaliar os resultados, os aspectos positivos e negativos e os pontos passíveis de melhoria. Método: Trata-se de uma revisão de escopo de acordo com a metodologia do Instituto Joanna Briggs de revisões de escopo. Foram incluídos estudos seguindo a estrutura PCC: P (participantes) = médicos residentes de qualquer especialidade; C (conceito) = o PHEEM é um instrumento utilizado para avaliar o ambiente educacional na residência médica, por meio de um questionário de 40 itens divididos em três subescalas que incluem percepção de autonomia, ensino e suporte social; C (cenário) = pesquisas sobre o PHEEM na residência médica de qualquer especialidade. As bases eletrônicas pesquisadas foram: PubMed, Embase e Biblioteca Virtual em Saúde (BVS). Resultado: As estratégias de busca rodadas resultaram em 1.588 estudos, 50 foram lidos na íntegra, e incluíram-se 36. Os estudos foram realizados em 22 países, e a maioria revelou um ambiente educacional mais positivo que negativo, entretanto com espaço para melhorias. Nas subescalas, a percepção de autonomia se mostrou mais positiva que negativa, e a percepção de ensino revelou que a maioria dos programas está caminhando na direção certa. Entretanto, na avaliação do suporte social, os resultados foram divididos entre um ambiente não agradável e um ambiente com mais prós do que contras. Os principais pontos positivos destacados foram baixa discriminação racial e sexual, possibilidade de trabalhar em equipe, nível adequado de responsabilidades, professores acessíveis e com boas habilidades de ensino, oportunidades de aprendizado e participação em eventos educacionais. Os principais pontos negativos foram falta de alimentação e acomodação adequadas durante o plantão, carga horária excessiva, falta de feedback por parte dos preceptores, falta de tempo protegido para estudo e cultura de culpar o residente. Conclusão: A aplicação do PHEEM revelou que, na maioria dos programas de residência médica, o ambiente educacional se mostrou mais positivo que negativo, entretanto com espaço para melhorias. São necessários esforços para a melhoria do ambiente educacional, especialmente do suporte social, nos programas de residência médica.

Revisão de escopo da aplicação do Postgraduate Hospital Educational Environment Measure (PHEEM) na residência médica

Educational environment and mental wellbeing of medical and surgical postgraduate residents in Medellin, Colombia.

/pdf/marcadores-de-imagen-como-predictores-de-respuesta-en-la-2b9uasfeiw.pdf

Marcadores de imagen como predictores de respuesta en la degeneración macular neovascular asociada a la edad tratada con ranibizumab

Objective: To identify features in enhanced depth imaging spectral-domain optical coherence tomography (SD-OCT), fluorescein angiography (FA), and fundus auto fluorescence (FAF) of patients with neovascular age-related macular degeneration (nAMD), as image markers of poor response to intravitreal Ranibizumab therapy. Methods: Descriptive, comparative, cross sectional study. We evaluated the clinical charts of patients with nAMD on intravitreal Ranibizumab therapy. Subjects were divided into 2 groups: those with good response to Ranibizumab (G1) and those with poor response to therapy (G2). All patients underwent wide field fundus FA, wide field FAF and SD-OCT. Absolute and relative frequencies, strength of association (chi2) and prevalence ratio, with a 95% significance level were calculated. Results: The analysis included 30 eyes, 15 eyes in G1 and 15 eyes in G2. We found a statistically significant correlation between poor responders and the presence of external tubulations (p = 0.03). In the good responder group there was significant correlation with the presence of sub retinal fluid (p = 0.04), absence of sub retinal thickening (p < 0.01), absence of fibrosis at the FA (p = 0.02) and presence of hyper-auto fluorescent findings on the FAF (p ≤ 0.01). Conclusion: The identification of image markers prior to treatment could help predict the response to ranibizumab therapy in nAMD patients. The presence of sub retinal fluid, absence of sub retinal thickening, absence of fibrosis and presence of hyper-auto fluorescent were associated with good responder. These markers, plus initial visual acuity can be used as a guide for categorization of patients according to response expectation, and therefore tailor the follow up scheme.

/pdf/image-markers-as-predictors-of-response-in-neovascular-18zye6q8yh.pdf

Image markers as predictors of response in neovascular agerelated macular degeneration treated with ranibizumab.

La dermatitis de contacto es una enfermedad altamente prevalente en el area de la salud, siendo la segunda causa de consulta mas frecuente en la especialidad de dermatologia.  En este articulo se hace una revision completa del tema, comenzando con su definicion y los diferentes tipos descritos de dermatitis junto con sus principales caracteristicas; se describe su etiologia y patogenia, los principales factores de riesgo relacionados con el area de la salud que influyen en el desarrollo de la enfermedad; se mencionan las principales manifestaciones clinicas y como evolucionan en el tiempo. Se concluye que el medico debe realizar una historia clinica completa, haciendo enfasis en la anamnesis y el examen fisico de la piel y las lesiones, para realizar una adecuada correlacion medica, orientar su diagnostico y definir que ayuda diagnostica seria la mas adecuada, para asi escoger el tratamiento ideal.  Al ser la dermatitis de contacto una enfermedad recurrente, es importante educar al paciente para que sea consciente de su patologia, y asi prevenir futuras recaidas; es labor del medico realizar un seguimiento adecuado para evitar la progresion de la enfermedad y obtener un buen pronostico. Abstract Contact dermatitis is a highly prevalent disease in the health care area, being the second most frequent consult in dermatology. This article will make a complete review of the subject, starting with its definition and the different types of dermatitis described with their main characteristics; it will describe the etiology and pathogenesis, the main risk factors related with the health care workers that influence in the evolution of the disease. It also will mention the principal clinical manifestations and how they evolve during time. Concluding, the physician should perform a complete medical history with emphasis on the anamnesis and physical examination of the skin and lesions, for an appropriate medical correlation to guide the diagnosis and define which one is the most appropriate laboratory test, in order to choose the ideal treatment. As contact dermatitis is a recurrent disease, education is fundamental to create conscious in the patient about his condition, and prevent future relapses. It is physician’s responsibility to make a strict follow-up, in order to avoid disease progression and improve its outcome. Resumo A dermatite de contato e uma doenca altamente prevalente na area da saude, a segunda causa mais frequente de consultas na especialidade de dermatologia. Neste trabalho, uma revisao abrangente do tema, comecando com a sua definicao e diferentes tipos de dermatite descritos juntamente com as suas principais caracteristicas, descreve sua etiologia e patogenia, os principais fatores de risco associados com a area da saude que a influencia o desenvolvimento da doenca referida principais manifestacoes clinicas e evoluem com o tempo. Conclui-se que o medico deve realizar uma historia medica completa, com enfase no exame historia e fisica da pele e lesoes, para correlacao medico apropriado, guia de diagnostico e de ajuda de diagnostico definir o que seria o mais adequado, a fim de escolher o tratamento ideal. Quando em contato com a doenca dermatite recorrente, e importante educar o paciente estar ciente de sua condicao, e prevenir recaidas futuras e medico trabalho caminho certo para evitar a progressao da doenca e obter um bom resultado.

https://dialnet.unirioja.es/descarga/articulo/4164082.pdf

Dermatitis de contacto en el personal del área de la salud. Revisión de tema Contact dermatitis in personal health area. Topic review A dermatite de contato na área de saúde pessoal. Revisão do tópico

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Educational environment and mental wellbeing of medical and surgical postgraduate residents in Medellin, Colombia.

Marcadores de imagen como predictores de respuesta en la degeneración macular neovascular asociada a la edad tratada con ranibizumab

Image markers as predictors of response in neovascular agerelated macular degeneration treated with ranibizumab.

Dermatitis de contacto en el personal del área de la salud. Revisión de tema Contact dermatitis in personal health area. Topic review A dermatite de contato na área de saúde pessoal. Revisão do tópico