COVID-19 pandemic modified learning conditions in health professions' residences. The objecti... more COVID-19 pandemic modified learning conditions in health professions' residences. The objective of the research was to explore Argentinian residents' perceptions regarding training conditions during the first year of pandemic. A descriptive, quali-quantitative study was developed through an online, anonymous questionnaire, with 42 items: 17 closed options and 25 Likert scale from 1 to 5; and 2 open questions. Sampling was intentional and non-probabilistic. The questionnaire was answered by 1595 residents, 74% were physicians, 47.1% belonged to clinical specialties and 21.8% worked on the front line of care. A 77.2% worked in the public sector and 89.4% in hospital practice, 42.1% assumed tasks not typical of their specialty. They agreed on the availability of personal protection and supplies (mean 3.8 ± 1.3), reduction of lectures (mean 3.5 ± 1.6), procedures (mean 3.8 ± 1.4) and rotations (mean 3.7 ± 1.2). They concurred on the need to extend training to recover learning (mean 3 ± 1.6). The decrease in practices was associated with surgical specialties (p = 0.0001) and not practicing in the front line of care (p = 0.007). They perceived as positive aspects the chance to strengthen bonds between residents and closeness with relatives, and negative aspects the effects on health due to stress and social distancing. In conclusion, the general conditions of training were affected. This leads to rethink the teaching and assessment curricular alternatives, as well as interventions related to the well-being of the residents.
El objetivo de este trabajo fue describir el proceso de limitación de los esfuerzos terapéuticos ... more El objetivo de este trabajo fue describir el proceso de limitación de los esfuerzos terapéuticos (LET) en los pacientes internados en una sala general. Para ello se realizó un estudio prospectivo descriptivo, desarrollado en la sala de internación general de un hospital universitario. Fueron evaluados pacientes que tuviesen alguna LET, asistidos por el servicio de clínica médica en un período de 60 días consecutivos. Durante el mismo se hospitalizaron 402 pacientes, 62 (15%) tuvieron algún tipo de LET. Este último grupo estaba compuesto por un 66% de mujeres, la mediana de edad fue de 86 años (78-90) y de la duración de hospitalización de 12 días (8-18). La mala calidad de vida fue la causa más frecuente de LET (69%). Se brindó información acerca de las limitaciones a 43 familias (69%) y 8 pacientes (13%). En la decisión participaron el médico de cabecera (50%), médicos de planta (50%), residentes (40%), la familia (42%) y los propios pacientes (11%). En 7 casos hubo constancia en l...
The purpose of this study is to describe the limiting life-sustaining treatment process of patien... more The purpose of this study is to describe the limiting life-sustaining treatment process of patients admitted to a general ward. A prospective descriptive study was designed. The setting was the general ward of universitary hospital. Study participants were patients assisted by the internal medicine department during a 60-consecutive days period who had limitations of life sustaining treatments. During the study period, 402 patients were hospitalized, 62 (15%) of them had limitations of life support care. The median patient age of the last group was 86 years (78-90), 66% were women and the length of stay was 12 days (8-18). A low quality of life was the most frequent cause of limitation (69%). Information about the limitations was provided to 43 families (69%) and 8 patients (13%). The primary care physician participated in the decision in 50% of the cases, while the attending physician, the resident in charge, patient's family and patients themselves participated in 50%, 40%, 42% and 11% of the cases respectively. The decision of limiting life-sustaining treatments was recorded in seven patient's charts (11%). Seventeen (27%) patients with limitations died during the hospital stay while 44 (71%) were discharged. In conclusion, we found a frequent life sustaining treatment limitation in our patients. These decisions did not follow a uniform or systemized process. The need of guidelines to sort the medical and ethical challenges imposed to the medical team is undeniable.
Revista de la Facultad de Ciencias Médicas de Córdoba
Introducción: La pandemia por COVID-19 limitó la presentación de trabajos finales y tesis para la... more Introducción: La pandemia por COVID-19 limitó la presentación de trabajos finales y tesis para la finalización de especializaciones, maestrías y doctorado en forma presencial. Objetivo: Describir la experiencia en presentaciones a distancia de trabajos finales integradores y tesis. Materiales y métodos: Estudio cuali-cuantitativo de corte transversal. Se exploraron las percepciones de los graduados y jurados mediante un cuestionario. Resultados: Se incluyeron 54 presentaciones: 53,7% especializaciones, 40,7% maestrías y 5,6% doctorados. El promedio de audiencia fue de 34 personas y la distancia a la universidad fue 273,6 km. Respondieron 116 profesionales: graduados 28,4% y jurados 71,6%. Entre ellos 51,5% y 36,1% eran de género femenino, respectivamente. El 100% de los graduados y el 96,3% de los jurados opinaron que pudieron exponer los resultados de la investigación y solo el 3% y 7,3% respectivamente expresó que existieron dificultades técnicas. Los aspectos positivos identifi...
de cabecera (50%), medicos de planta (50%), residentes (40%), la familia (42%) y los propios paci... more de cabecera (50%), medicos de planta (50%), residentes (40%), la familia (42%) y los propios pacientes (11%). En 7 casos hubo constancia en la historia clinica (11%). Diecisiete pacientes (27%) con LET fallecieron durante la internacion, mientras que 44 (71%) fueron dados de alta. En conclusion, la limitacion de esfuerzos terapeuticos en nuestros pacientes constituyo un hecho frecuente. No se logro identificar un proceso uniforme o sistematizado para la toma de la decision de LET. Resulta innegable la necesidad de normativas que guien al equipo de salud en la toma de decisiones, tranquilicen a familiares y acompanen a los pacientes en sus reales necesidades. Palabras clave: suspension de tratamiento, tratamiento de soporte, calidad de vida, sala de internacion general Abstract Limitation of life-sustaining treatment. A prospective study developed in a clinical ward. The purpose of this study is to describe the limiting life-sustaining treatment process of patients admit- ted to a ge...
Los profesionales de la salud nos comunicamos sobre nuestros pacientes de diferentes formas, una... more Los profesionales de la salud nos comunicamos sobre nuestros pacientes de diferentes formas, una de las cuales es a traves de lo que escribimos en nuestras historias clinicas.
The purpose of this study is to describe the limiting life-sustaining treatment process of patien... more The purpose of this study is to describe the limiting life-sustaining treatment process of patients admitted to a general ward. A prospective descriptive study was designed. The setting was the general ward of universitary hospital. Study participants were patients assisted by the internal medicine department during a 60-consecutive days period who had limitations of life sustaining treatments. During the study period, 402 patients were hospitalized, 62 (15%) of them had limitations of life support care. The median patient age of the last group was 86 years (78-90), 66% were women and the length of stay was 12 days (8-18). A low quality of life was the most frequent cause of limitation (69%). Information about the limitations was provided to 43 families (69%) and 8 patients (13%). The primary care physician participated in the decision in 50% of the cases, while the attending physician, the resident in charge, patient's family and patients themselves participated in 50%, 40%, 42...
The purpose of this study is to describe the limiting life-sustaining treatment process of patien... more The purpose of this study is to describe the limiting life-sustaining treatment process of patients admitted to a general ward. A prospective descriptive study was designed. The setting was the general ward of universitary hospital. Study participants were patients assisted by the internal medicine department during a 60-consecutive days period who had limitations of life sustaining treatments. During the study period, 402 patients were hospitalized, 62 (15%) of them had limitations of life support care. The median patient age of the last group was 86 years (78-90), 66% were women and the length of stay was 12 days (8-18). A low quality of life was the most frequent cause of limitation (69%). Information about the limitations was provided to 43 families (69%) and 8 patients (13%). The primary care physician participated in the decision in 50% of the cases, while the attending physician, the resident in charge, patient's family and patients themselves participated in 50%, 40%, 42% and 11% of the cases respectively. The decision of limiting life-sustaining treatments was recorded in seven patient's charts (11%). Seventeen (27%) patients with limitations died during the hospital stay while 44 (71%) were discharged. In conclusion, we found a frequent life sustaining treatment limitation in our patients. These decisions did not follow a uniform or systemized process. The need of guidelines to sort the medical and ethical challenges imposed to the medical team is undeniable.
Introducción: La docencia clínica en las residencias se realiza en forma simultánea por médicos d... more Introducción: La docencia clínica en las residencias se realiza en forma simultánea por médicos de planta y residentes de años superiores. A pesar de su relevancia como docentes, la mayoría de las veces los residentes no poseen formación específica para este rol. La manera en que los residentes se desempeñan como docentes clínicos no está extensamente estudiada. Objetivo: Describir las características de los residentes como docentes clínicos de otros residentes y alumnos de grado en medicina Interna en un hospital Universitario. Método: Se realizó un estudio descriptivo de corte transversal utilizando el Maastricht Clinical Teaching Questionnaire (MCTQ) para describir a los residentes como docentes de otros residentes y alumnos. Se comparó a los residentes como docentes con los médicos de planta y a los residentes de los primeros años con los que se encontraban avanzados en sus programas. Resultados: 36 residentes fueron evaluados. El desempeño fue satisfactorio en el modelo de rol ...
Introducción: La docencia clínica en las residencias se realiza en forma simultánea por médicos d... more Introducción: La docencia clínica en las residencias se realiza en forma simultánea por médicos de planta y residentes de años superiores. A pesar de su relevancia como docentes, la mayoría de las veces los residentes no poseen formación específica para este rol. La manera en que los residentes se desempeñan como docentes clínicos no está extensamente estudiada. Objetivo: Describir las características de los residentes como docentes clínicos de otros residentes y alumnos de grado en medicina Interna en un hospital Universitario. Método: Se realizó un estudio descriptivo de corte transversal utilizando el Maastricht Clinical Teaching Questionnaire (MCTQ) para describir a los residentes como docentes de otros residentes y alumnos. Se comparó a los residentes como docentes con los médicos de planta y a los residentes de los primeros años con los que se encontraban avanzados en sus programas. Resultados: 36 residentes fueron evaluados. El desempeño fue satisfactorio en el modelo de rol ...
Introduction: Anesthesiology requires procedure fulfillment, problem, and real-time crisis resolu... more Introduction: Anesthesiology requires procedure fulfillment, problem, and real-time crisis resolution, problem, and complications forecast, among others; therefore, the evaluation of its learning should center around how students achieve competence rather than solely focusing on knowledge acquisition. Literature shows that despite the existence of numerous evaluation strategies, these are still underrated in most cases due to unawareness. Objective: The present article aims to explain the process of competency-based anesthesiology assessment, in addition to suggesting a brief description of the learning domains evaluated, theories of knowledge, instruments, and assessment systems in the area; and finally, to show some of the most relevant results regarding assessment systems in Colombia. Methodology: The results obtained in “Characteristics of the evaluation systems used by anesthesiology residency programs stakeholders in the educational process, a fact that motivated the publishi...
Introduction: Anesthesiology requires procedure fulfillment, problem, and real-time crisis resolu... more Introduction: Anesthesiology requires procedure fulfillment, problem, and real-time crisis resolution, problem, and complications forecast, among others; therefore, the evaluation of its learning should center around how students achieve competence rather than solely focusing on knowledge acquisition. Literature shows that despite the existence of numerous evaluation strategies, these are still underrated in most cases due to unawareness. Objective: The present article aims to explain the process of competency-based anesthesiology assessment, in addition to suggesting a brief description of the learning domains evaluated, theories of knowledge, instruments, and assessment systems in the area; and finally, to show some of the most relevant results regarding assessment systems in Colombia. Methodology: The results obtained in “Characteristics of the evaluation systems used by anesthesiology residency programs stakeholders in the educational process, a fact that motivated the publishi...
COVID-19 pandemic modified learning conditions in health professions' residences. The objecti... more COVID-19 pandemic modified learning conditions in health professions' residences. The objective of the research was to explore Argentinian residents' perceptions regarding training conditions during the first year of pandemic. A descriptive, quali-quantitative study was developed through an online, anonymous questionnaire, with 42 items: 17 closed options and 25 Likert scale from 1 to 5; and 2 open questions. Sampling was intentional and non-probabilistic. The questionnaire was answered by 1595 residents, 74% were physicians, 47.1% belonged to clinical specialties and 21.8% worked on the front line of care. A 77.2% worked in the public sector and 89.4% in hospital practice, 42.1% assumed tasks not typical of their specialty. They agreed on the availability of personal protection and supplies (mean 3.8 ± 1.3), reduction of lectures (mean 3.5 ± 1.6), procedures (mean 3.8 ± 1.4) and rotations (mean 3.7 ± 1.2). They concurred on the need to extend training to recover learning (mean 3 ± 1.6). The decrease in practices was associated with surgical specialties (p = 0.0001) and not practicing in the front line of care (p = 0.007). They perceived as positive aspects the chance to strengthen bonds between residents and closeness with relatives, and negative aspects the effects on health due to stress and social distancing. In conclusion, the general conditions of training were affected. This leads to rethink the teaching and assessment curricular alternatives, as well as interventions related to the well-being of the residents.
El objetivo de este trabajo fue describir el proceso de limitación de los esfuerzos terapéuticos ... more El objetivo de este trabajo fue describir el proceso de limitación de los esfuerzos terapéuticos (LET) en los pacientes internados en una sala general. Para ello se realizó un estudio prospectivo descriptivo, desarrollado en la sala de internación general de un hospital universitario. Fueron evaluados pacientes que tuviesen alguna LET, asistidos por el servicio de clínica médica en un período de 60 días consecutivos. Durante el mismo se hospitalizaron 402 pacientes, 62 (15%) tuvieron algún tipo de LET. Este último grupo estaba compuesto por un 66% de mujeres, la mediana de edad fue de 86 años (78-90) y de la duración de hospitalización de 12 días (8-18). La mala calidad de vida fue la causa más frecuente de LET (69%). Se brindó información acerca de las limitaciones a 43 familias (69%) y 8 pacientes (13%). En la decisión participaron el médico de cabecera (50%), médicos de planta (50%), residentes (40%), la familia (42%) y los propios pacientes (11%). En 7 casos hubo constancia en l...
The purpose of this study is to describe the limiting life-sustaining treatment process of patien... more The purpose of this study is to describe the limiting life-sustaining treatment process of patients admitted to a general ward. A prospective descriptive study was designed. The setting was the general ward of universitary hospital. Study participants were patients assisted by the internal medicine department during a 60-consecutive days period who had limitations of life sustaining treatments. During the study period, 402 patients were hospitalized, 62 (15%) of them had limitations of life support care. The median patient age of the last group was 86 years (78-90), 66% were women and the length of stay was 12 days (8-18). A low quality of life was the most frequent cause of limitation (69%). Information about the limitations was provided to 43 families (69%) and 8 patients (13%). The primary care physician participated in the decision in 50% of the cases, while the attending physician, the resident in charge, patient's family and patients themselves participated in 50%, 40%, 42% and 11% of the cases respectively. The decision of limiting life-sustaining treatments was recorded in seven patient's charts (11%). Seventeen (27%) patients with limitations died during the hospital stay while 44 (71%) were discharged. In conclusion, we found a frequent life sustaining treatment limitation in our patients. These decisions did not follow a uniform or systemized process. The need of guidelines to sort the medical and ethical challenges imposed to the medical team is undeniable.
Revista de la Facultad de Ciencias Médicas de Córdoba
Introducción: La pandemia por COVID-19 limitó la presentación de trabajos finales y tesis para la... more Introducción: La pandemia por COVID-19 limitó la presentación de trabajos finales y tesis para la finalización de especializaciones, maestrías y doctorado en forma presencial. Objetivo: Describir la experiencia en presentaciones a distancia de trabajos finales integradores y tesis. Materiales y métodos: Estudio cuali-cuantitativo de corte transversal. Se exploraron las percepciones de los graduados y jurados mediante un cuestionario. Resultados: Se incluyeron 54 presentaciones: 53,7% especializaciones, 40,7% maestrías y 5,6% doctorados. El promedio de audiencia fue de 34 personas y la distancia a la universidad fue 273,6 km. Respondieron 116 profesionales: graduados 28,4% y jurados 71,6%. Entre ellos 51,5% y 36,1% eran de género femenino, respectivamente. El 100% de los graduados y el 96,3% de los jurados opinaron que pudieron exponer los resultados de la investigación y solo el 3% y 7,3% respectivamente expresó que existieron dificultades técnicas. Los aspectos positivos identifi...
de cabecera (50%), medicos de planta (50%), residentes (40%), la familia (42%) y los propios paci... more de cabecera (50%), medicos de planta (50%), residentes (40%), la familia (42%) y los propios pacientes (11%). En 7 casos hubo constancia en la historia clinica (11%). Diecisiete pacientes (27%) con LET fallecieron durante la internacion, mientras que 44 (71%) fueron dados de alta. En conclusion, la limitacion de esfuerzos terapeuticos en nuestros pacientes constituyo un hecho frecuente. No se logro identificar un proceso uniforme o sistematizado para la toma de la decision de LET. Resulta innegable la necesidad de normativas que guien al equipo de salud en la toma de decisiones, tranquilicen a familiares y acompanen a los pacientes en sus reales necesidades. Palabras clave: suspension de tratamiento, tratamiento de soporte, calidad de vida, sala de internacion general Abstract Limitation of life-sustaining treatment. A prospective study developed in a clinical ward. The purpose of this study is to describe the limiting life-sustaining treatment process of patients admit- ted to a ge...
Los profesionales de la salud nos comunicamos sobre nuestros pacientes de diferentes formas, una... more Los profesionales de la salud nos comunicamos sobre nuestros pacientes de diferentes formas, una de las cuales es a traves de lo que escribimos en nuestras historias clinicas.
The purpose of this study is to describe the limiting life-sustaining treatment process of patien... more The purpose of this study is to describe the limiting life-sustaining treatment process of patients admitted to a general ward. A prospective descriptive study was designed. The setting was the general ward of universitary hospital. Study participants were patients assisted by the internal medicine department during a 60-consecutive days period who had limitations of life sustaining treatments. During the study period, 402 patients were hospitalized, 62 (15%) of them had limitations of life support care. The median patient age of the last group was 86 years (78-90), 66% were women and the length of stay was 12 days (8-18). A low quality of life was the most frequent cause of limitation (69%). Information about the limitations was provided to 43 families (69%) and 8 patients (13%). The primary care physician participated in the decision in 50% of the cases, while the attending physician, the resident in charge, patient's family and patients themselves participated in 50%, 40%, 42...
The purpose of this study is to describe the limiting life-sustaining treatment process of patien... more The purpose of this study is to describe the limiting life-sustaining treatment process of patients admitted to a general ward. A prospective descriptive study was designed. The setting was the general ward of universitary hospital. Study participants were patients assisted by the internal medicine department during a 60-consecutive days period who had limitations of life sustaining treatments. During the study period, 402 patients were hospitalized, 62 (15%) of them had limitations of life support care. The median patient age of the last group was 86 years (78-90), 66% were women and the length of stay was 12 days (8-18). A low quality of life was the most frequent cause of limitation (69%). Information about the limitations was provided to 43 families (69%) and 8 patients (13%). The primary care physician participated in the decision in 50% of the cases, while the attending physician, the resident in charge, patient's family and patients themselves participated in 50%, 40%, 42% and 11% of the cases respectively. The decision of limiting life-sustaining treatments was recorded in seven patient's charts (11%). Seventeen (27%) patients with limitations died during the hospital stay while 44 (71%) were discharged. In conclusion, we found a frequent life sustaining treatment limitation in our patients. These decisions did not follow a uniform or systemized process. The need of guidelines to sort the medical and ethical challenges imposed to the medical team is undeniable.
Introducción: La docencia clínica en las residencias se realiza en forma simultánea por médicos d... more Introducción: La docencia clínica en las residencias se realiza en forma simultánea por médicos de planta y residentes de años superiores. A pesar de su relevancia como docentes, la mayoría de las veces los residentes no poseen formación específica para este rol. La manera en que los residentes se desempeñan como docentes clínicos no está extensamente estudiada. Objetivo: Describir las características de los residentes como docentes clínicos de otros residentes y alumnos de grado en medicina Interna en un hospital Universitario. Método: Se realizó un estudio descriptivo de corte transversal utilizando el Maastricht Clinical Teaching Questionnaire (MCTQ) para describir a los residentes como docentes de otros residentes y alumnos. Se comparó a los residentes como docentes con los médicos de planta y a los residentes de los primeros años con los que se encontraban avanzados en sus programas. Resultados: 36 residentes fueron evaluados. El desempeño fue satisfactorio en el modelo de rol ...
Introducción: La docencia clínica en las residencias se realiza en forma simultánea por médicos d... more Introducción: La docencia clínica en las residencias se realiza en forma simultánea por médicos de planta y residentes de años superiores. A pesar de su relevancia como docentes, la mayoría de las veces los residentes no poseen formación específica para este rol. La manera en que los residentes se desempeñan como docentes clínicos no está extensamente estudiada. Objetivo: Describir las características de los residentes como docentes clínicos de otros residentes y alumnos de grado en medicina Interna en un hospital Universitario. Método: Se realizó un estudio descriptivo de corte transversal utilizando el Maastricht Clinical Teaching Questionnaire (MCTQ) para describir a los residentes como docentes de otros residentes y alumnos. Se comparó a los residentes como docentes con los médicos de planta y a los residentes de los primeros años con los que se encontraban avanzados en sus programas. Resultados: 36 residentes fueron evaluados. El desempeño fue satisfactorio en el modelo de rol ...
Introduction: Anesthesiology requires procedure fulfillment, problem, and real-time crisis resolu... more Introduction: Anesthesiology requires procedure fulfillment, problem, and real-time crisis resolution, problem, and complications forecast, among others; therefore, the evaluation of its learning should center around how students achieve competence rather than solely focusing on knowledge acquisition. Literature shows that despite the existence of numerous evaluation strategies, these are still underrated in most cases due to unawareness. Objective: The present article aims to explain the process of competency-based anesthesiology assessment, in addition to suggesting a brief description of the learning domains evaluated, theories of knowledge, instruments, and assessment systems in the area; and finally, to show some of the most relevant results regarding assessment systems in Colombia. Methodology: The results obtained in “Characteristics of the evaluation systems used by anesthesiology residency programs stakeholders in the educational process, a fact that motivated the publishi...
Introduction: Anesthesiology requires procedure fulfillment, problem, and real-time crisis resolu... more Introduction: Anesthesiology requires procedure fulfillment, problem, and real-time crisis resolution, problem, and complications forecast, among others; therefore, the evaluation of its learning should center around how students achieve competence rather than solely focusing on knowledge acquisition. Literature shows that despite the existence of numerous evaluation strategies, these are still underrated in most cases due to unawareness. Objective: The present article aims to explain the process of competency-based anesthesiology assessment, in addition to suggesting a brief description of the learning domains evaluated, theories of knowledge, instruments, and assessment systems in the area; and finally, to show some of the most relevant results regarding assessment systems in Colombia. Methodology: The results obtained in “Characteristics of the evaluation systems used by anesthesiology residency programs stakeholders in the educational process, a fact that motivated the publishi...
El aborto es un evento reproductivo que puede ocurrirle a cualquier mujer durante su vida fértil... more El aborto es un evento reproductivo que puede ocurrirle a cualquier mujer durante su vida fértil. Los cuidados asociados al aborto deben formar parte de los servicios de salud, más aún hoy luego de la reforma que legaliza la interrupción voluntaria del embarazo y refuerza la atención posaborto. Bajo este contexto es que este documento propone un programa de formación en atención posaborto, ILE e IVE, para residentes en ginecología y obstetricia, aunque esperamos que sirva de insumo para los currículos y programas de formación de otras especialidades de la medicina y carreras de ciencias de la salud.
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Papers by Roberta Ladenheim
atención posaborto, ILE e IVE, para residentes en ginecología y obstetricia, aunque esperamos que sirva de insumo para los currículos y programas de formación de otras especialidades de la medicina y carreras de ciencias de la salud.