Percepción de residentes de medicina de urgencias en Colombia del ambiente educativo en los servicios de urgencias


Autoria(s): Erazo Guerrero, Lilia
Contribuinte(s)

Barragan, Ana M.

Isaza-Restrepo, Andres

Ibáñez-Pinilla, Milcíades

Data(s)

14/11/2014

31/12/1969

Resumo

Introducción: La atención de calidad en urgencias sólo es posible si los médicos han recibido una enseñanza de alta calidad. La escala PHEEM (Postgraduate Hospital Educational Environment Measure) es un instrumento válido y fiable, utilizado internacionalmente para medir el entorno educativo, en la formación médica de posgrado. Materiales y métodos: Estudio de corte trasversal que utilizó la escala PHEEM versión en español para conocer el entorno educativo de los programas de urgencias. El coeficiente alfa de Cronbach se calculó para determinar la consistencia interna. Se aplicó estadística descriptiva a nivel global, por categorías e ítems de la escala PHEEM y se compararon resultados por sexo, año de residencia y programa. Resultados: 94 (94%) residentes llenaron el cuestionario. La puntuación media de la escala PHEEM fue 93,91 ± 23,71 (58,1% de la puntuación máxima) que se considera un ambiente educativo más positivo que negativo, pero con margen de mejora. Hubo una diferencia estadísticamente significativa en la percepción del ambiente educativo entre los programas de residencia (p =0,01). El instrumento es altamente confiable (alfa de Cronbach = 0,952). La barrera más frecuente en la enseñanza fue el hacinamiento y la evaluación fue percibida con el propósito de cumplir normas. Discusión: Los resultados de este estudio aportaron evidencia sobre la validez interna de la escala PHEEM en el contexto colombiano. Este estudio demostró cómo la medición del ambiente educativo en una especialidad médico-quirúrgica, con el uso de una herramienta cuantitativa, puede proporcionar información en relación a las fortalezas y debilidades de los programas.

Introduction: Quality assistance in the emergency department is possible only if physicians have received a high quality education. The PHEEM (Postgraduate Hospital Educational Environment Measure) scale is a valid and reliable instrument used internationally to measure the educational environment in postgraduate medical education. Materials and methods: A cross-sectional study used the Spanish version of the scale PHEEM for meet educational environment of emergency programs. Cronbach's alpha coefficient was calculated to determine internal consistency. Descriptive statistics is applied globally, by category and items of the scale PHEEM. The results were compared by gender, year of residence and program. Results: 94 (94%) residents filled the questionnaire. The mean score of the PHEEM was 93, 91 ± 23,71 (58,1% of the maximal score) which is considered the educational environment more positive than negative, with capability of improvement. There was a statistically significant difference in the perception of educational environment among residency by programs (p=0.01). The instrument is highly reliable (Cronbach´s alpha = 0.952). The most common barrier was overcrowding teaching and assessment was perceived in order to meet standards. Discussion: The results of this study provided evidence of the internal validity of the scale PHEEM in the Colombian context. This study demonstrated how the measurement of the educational environment in a medical-surgical specialty, with the use of a quantitative tool, can provide information regarding the strengths and weaknesses of the program.

Formato

application/pdf

Identificador

http://repository.urosario.edu.co/handle/10336/9033

Idioma(s)

spa

Publicador

Facultad de Medicina

Direitos

info:eu-repo/semantics/openAccess

Fonte

instname:Universidad del Rosario

reponame:Repositorio Institucional EdocUR

Fluit C, Bolhuis S, Grol R, Laan R, Wensing M. Assessing the quality of clinical teachers: a systematic review of content and quality of questionnaires for assessing clinical teachers. J Gen Intern Med. 2010; 25(12):1337–45.

Donato A. Direct observation of residents: a model for an assessment system. Am J Med. 2014; 127(5):455–60.

Suter RE. Emergency medicine in the United States: a systemic review. World J Emerg Med. 2012; 3(1):5–10.

Roff S, McAleer S, Skinner a. Development and validation of an instrument to measure the postgraduate clinical learning and teaching educational environment for hospital-based junior doctors in the UK. Med Teach. 2005; 27(4):326–31.

Wall D, Clapham M, Riquelme A, Vieira J, Cartmill R, Aspegren K, et al. Is PHEEM a multi-dimensional instrument? An international perspective. Med Teach. 2009;31(11):e521–e527.

Clapham M, Wall D, Batchelor A. Educational environment in intensive care medicine--use of Postgraduate Hospital Educational Environment Measure (PHEEM). Med Teach. 2007;29(6):e184–e191.

Algaidi S. Assessment of Educational Environment for Interns Using Postgraduate Hospital Educational Environment Measure (PHEEM). J Taibah Univ Med Sci. 2010; 5(1):1–12.

Heng K. Teaching and evaluating multitasking ability in emergency medicine residents - what is the best practice? J of Emer Med. 2014, 7:41

Alagappan K, Holliman CJ. History of the development of international emergency medicine. Emerg Med Clin North Am. 2005;23(1):1–10.

Moineddin R, Meaney C, Agha M, Zagorski B, Glazier R. Modeling factors influencing the demand for emergency department services in Ontario: a comparison of methods. BMC Emerg Med. 2011; 11(1):13-24.

Scheepers R, Arah O, Heineman MJ, Lombarts K. In the eyes of residents good supervisors need to be more than engaged physicians: the relevance of teacher work engagement in residency training. Adv Health Sci Educ Theory Pract. 2014;45-60.

Metheny WP, Espey EL, Bienstock J, Cox SM, Erickson SS, Goepfert AR, et al. To the point: medical education reviews evaluation in context: assessing learners, teachers, and training programs. Am J Obstet Gynecol. 2005; 192(1):34–7.

De Araujo P, Khraiche M, Tukan A. Does overcrowding and health insurance type impact patient outcomes in emergency departments? Health Econ Rev. 2013; 3(1):25-34.

Scrofine S, Fitzsimons V. Emergency department throughput: strategies for success. J Nurs Adm. 2014;44(7/8):375–7.

Ross M a, Aurora T, Graff L, Suri P, O’Malley R, Ojo A, et al. State of the art: emergency department observation units. Crit Pathw Cardiol. 2012; 11(3):128–38.

Shayne P, Lin M, Ufberg JW, Ankel F, Barringer K, Morgan-Edwards S, et al. The effect of emergency department crowding on education: blessing or curse? Acad Emerg Med. 2009; 16(1):76–82

Colletti JE, Flottemesch TJ, O’Connell T a, Ankel FK, Asplin BR. Developing a standardized faculty evaluation in an emergency medicine residency. J Emerg Med. 2010; 39(5):662–8.

Srinivasan M, Li S-TT, Meyers FJ, Pratt DD, Collins JB, Braddock C, et al. “Teaching as a Competency”: competencies for medical educators. Acad Med. 2011; 86(10):1211–20.

Kulstad EB, Kelley KM. Overcrowding is associated with delays in percutaneous coronary intervention for acute myocardial infarction. Int J Emerg Med. 2009; 2(3):149–54.

Arnold JL, Dickinson G, Tsai M, Han D. A survey of emergency medicine in 36 countries. CJEM. 2001;3(2):109–18.

Duffy FD, Holmboe ES. Self-assessment in Lifelong Learning and Improving Performance in Practice Physician Know Thyself. JAMA. 2014;296(9):1137–9.

Ilgen JS, Takayesu JK, Bhatia K, Marsh RH, Shah S, Wilcox SR, et al. Back to the bedside: the 8-year evolution of a resident-as-teacher rotation. J Emerg Med. 2011;41(2):190–5.

Nichols BG, Nichols LM, Poetker DM, Stadler ME. Operationalizing professionalism: a meaningful and practical integration for resident education. Laryngoscop. 2014; 124(1):110–5.

Malling B, Mortensen LS, Scherpbier AJJ, Ringsted C. Educational climate seems unrelated to leadership skills of clinical consultants responsible of postgraduate medical education in clinical departments. BMC Med Educ. 2010; 10:62.

Wittich CM, Reed D a, McDonald FS, Varkey P, Beckman TJ. Perspective: Transformative learning: a framework using critical reflection to link the improvement competencies in graduate medical education. Acad Med. 2010;85(11):1790–3.

Garfield JM, Garfield FB, Hevelone ND, Bhattacharyya N, Dedrick DF, Ashley SW, et al. Doctors in acute and longitudinal care specialties emphasise different professional attributes: implications for training programmes. Med Educ. 2009; 43(8):749–56.

Fitzgibbons JP, Bordley DR, Berkowitz LR, Miller BW, Henderson MC. Redesigning Residency Education in Internal Medicine : A Position Paper from the Association of Program Directors in Internal Medicine. Ann Intern Med. 2006;144:920-926

Sutkin G, Wagner E, Harris I, Schiffer R. What makes a good clinical teacher in medicine? A review of the literature. Acad Med. 2008;83(5):452–66.

Bandiera G, Lendrum D. Dispatches from the front: emergency medicine teachers’ perceptions of competency-based education. CJEM. 2011; 13(3):155–61.

Wachtel JK, Greenberg MR, Smith AB, Weaver KR, Kane BG. Residents as teachers: residents’ perceptions before and after receiving instruction in clinical teaching. J Am Osteopath Assoc. 2013;113(1):23–33.

Hassan S, Mat Pa MN, Yusoff MSB. Discriminant and convergent validity of measurement tools in postgraduate medical education of a surgical-based discipline: Towards assessment program. Educ Med J. 2012; 4(1):22–43.

Marco C a, Kowalenko T. Competence and challenges of emergency medicine training as reported by emergency medicine residents. J Emerg Med. 2012; 43(6):1103–9.

Derlet R, Richards J. Frequent Overcrowding in U.S. Emergency Departments. Acad Emerg Med. 2001;8(2):151–5.

Velásquez J, Pinilla A, Pinzón A, Severiche D. Perfil de formación del posgrado en Medicina Interna en Colombia. Acta Med Col. 2008:45–57.

Shimizu T, Tsugawa Y, Tanoue Y, Konishi R, Nishizaki Y, Kishimoto M, et al. The hospital educational environment and performance of residents in the General Medicine In-Training Examination: a multicenter study in Japan. Int J Gen Med. 2011; 6:637–40.

Christian MS, Garza AS, Slaughter JE. Work Engagement: a Quantitative Review and Test of Its Relations With Task and Contextual Performance. Pers Psycho. 2011; 64(1):89–136.

Bandiera G, Lee S, Tiberius R. Creating effective learning in today’s emergency departments: how accomplished teachers get it done. Ann Emerg Med. 2005; 45(3):253–61.

Irby DM. Excellence in clinical teaching: knowledge transformation and development required. Med Educ. 2014;48(8):776–84.

Leach DC, Philibert I. High-quality learning for high-quality healthcare: Getting it right. JAMA. 2014; 296 (9): 1132-1134

Bowen JL. Educational strategies to promote clinical diagnostic reasoning. N Engl J Med. 2006, 23;355(21):2217–25.

Counselman FL, Borenstein M a, Chisholm CD, Epter ML, Khandelwal S, Kraus CK, et al. The 2013 Model of the Clinical Practice of Emergency Medicine. Acad Emerg Med. 2014; 21(5):574–98.

Mood A, Graybill FA, Boes D. Introduction to the Theory of Statistics, 3rd Edition. 1974: 300-312

Rothberg M, Kleppel R, Friderici J, Hinchey K. Implementing a Resident Research Program to Overcome Barriers to Resident Research. Acad Med. 2014; 89:1133–1139

Solanas A, Salafranca L, Fauquet J, Núñez M. Estadística descriptiva en Ciencias del Comportamiento. Thompson, editor. Madrid; 2005.

Shokoohi S, Emami AH, Mohammadi A. Psychometric properties of the Postgraduate Hospital Educational Environment Measure in an Iranian hospital setting. Medical Educ. 2014;1:4–6.

Llera J, Durante E. Correlation between the educational environment and burn-out syndrome in residency programs at a university hospital. Arch Argent Pediatr. 2014; 112(1):6–11.

Riquelme A, Herrera C, Aranis C, Oporto J, Padilla O. Psychometric analyses and internal consistency of the PHEEM questionnaire to measure the clinical learning environment in the clerkship of a Medical School in Chile. Med Teach. 2009;31(6):e221–e225.

Vieira JE. The postgraduate hospital educational environment measure (PHEEM) questionnaire identifies quality of instruction as a key factor predicting academic achievement. Clinics. 2008; 63(6):741–6.

Aspegren K, Bastholt L, Bested KM, Bonnesen T, Ejlersen E, Fog I, et al. Validation of the PHEEM instrument in a Danish hospital setting. Med Teach. 2007; 29(5):498–500.

TEME

Palavras-Chave #610.7 #Urgencias médicas #Medicina de emergencias #Educación médica #educational environment, emergency medicine, PHEEM, teaching
Tipo

info:eu-repo/semantics/bachelorThesis

info:eu-repo/semantics/submittedVersion