BackgroundMost patients with diabetes mellitus (DM) are followed by primary care physicians, who often lack knowledge or confidence to prescribe insulin properly. This contributes to clinical inertia and poor glycemic control. Effectiveness of traditional continuing medical education (CME) to solve that is limited, so new approaches are required. Electronic games are a good option, as they can be very effective and easily disseminated.ObjectiveThe objective of our study was to assess applicability, user acceptance, and educational effectiveness of InsuOnline, an electronic serious game for medical education on insulin therapy for DM, compared with a traditional CME activity.MethodsPrimary care physicians (PCPs) from South of Brazil were invited by phone or email to participate in an unblinded randomized controlled trial and randomly allocated to play the game InsuOnline, installed as an app in their own computers, at the time of their choice, with minimal or no external guidance, or to participate in a traditional CME session, composed by onsite lectures and cases discussion. Both interventions had the same content and duration (~4 h). Applicability was assessed by the number of subjects who completed the assigned intervention in each group. Insulin-prescribing competence (factual knowledge, problem-solving skills, and attitudes) was self-assessed through a questionnaire applied before, immediately after, and 3 months after the interventions. Acceptance of the intervention (satisfaction and perceived importance for clinical practice) was also assessed immediately after and 3 months after the interventions, respectively.ResultsSubjects’ characteristics were similar between groups (mean age 38, 51.4% [69/134] male). In the game group, 69 of 88 (78%) completed the intervention, compared with 65 of 73 (89%) in the control group, with no difference in applicability. Percentage of right answers in the competence subscale, which was 52% at the baseline in both groups, significantly improved immediately after both interventions to 92% in the game group and to 85% in control (P<.001). After 3 months, it remained significantly higher than that at the baseline in both groups (80% in game, and 76% in control; P<.001). Absolute increase in competence score was better with the game (40%) than with traditional CME (34%; P=.01). Insulin-related attitudes were improved both after the game (significant improvement in 4 of 9 items) and after control activity (3 of 9). Both interventions were very well accepted, with most subjects rating them as “fun or pleasant,” “useful,” and “practice-changing.”ConclusionsThe game InsuOnline was applicable, very well accepted, and highly effective for medical education on insulin therapy. In view of its flexibility and easy dissemination, it is a valid option for large-scale CME, potentially helping to reduce clinical inertia and to improve quality of care for DM patients.Trial RegistrationClinicaltrials.gov NCT001759953; https://clinicaltrials.gov/ct2/show/NCT01759953 (Archived by WebCite at htt...
BackgroundPhysicians´ lack of knowledge contributes to underuse of insulin and poor glycemic control in adults with diabetes mellitus (DM). Traditional continuing medical education have limited efficacy, and new approaches are required.ObjectiveWe report the design of a trial to assess the educational efficacy of InsuOnline, a game for education of primary care physicians (PCPs). The goal of InsuOnline was to improve appropriate initiation and adjustment of insulin for the treatment of DM. InsuOnline was designed to be educationally adequate, self-motivating, and attractive.MethodsA multidisciplinary team of endocrinologists, experts in medical education, and programmers, was assembled for the design and development of InsuOnline. Currently, we are conducting usability and playability tests, with PCPs and medical students playing the game on a desktop computer. Adjustments will be made based on these results. An unblinded randomized controlled trial with PCPs who work in the city of Londrina, Brazil, will be conducted to assess the educational validity of InsuOnline on the Web. In this trial, 64 PCPs will play InsuOnline, and 64 PCPs will undergo traditional instructional activities (lecture and group discussion). Knowledge on how to initiate and adjust insulin will be assessed by a Web-based multiple choice questionnaire, and attitudes regarding diabetes/insulin will be assessed by Diabetes Attitude Scale 3 at 3 time points—before, immediately after, and 6 months after the intervention. Subjects´ general impressions on the interventions will be assessed by a questionnaire. Software logs will be reviewed.ResultsTo our knowledge, this is the first research with the aim of assessing the educational efficacy of a computer game for teaching PCPs about insulin therapy in DM. We describe the development criteria used for creating InsuOnline. Evaluation of the game using a randomized controlled trial design will be done in future studies.ConclusionsWe demonstrated that the design and development of a game for PCPs education on insulin is possible with a multidisciplinary team. InsuOnline can be an attractive option for large-scale continuous medical education to help improving PCPs´ knowledge on insulin therapy and potentially improving DM patients´ care.Trial RegistrationClinicaltrials.gov: NCT01759953; http://clinicaltrials.gov/show/NCT01759953 (Archived by WebCite at http://www.webcitation.org/6Dq8Vc7a6).
"InsuOnLine" was rated by users as easy to play, fun, and useful for learning. Further studies will assess its educational effectiveness. "InsuOnLine" is a promising tool for large-scale continuing medical education on insulin, helping to fight clinical inertia in diabetes.
Objective: We report the preliminary assessment of InsuOnline © , a serious game designed for medical education on insulin therapy. Materials and methods: We conducted a pilot study with 41 undergraduate medical students and Internal Medicine residents to assess the educational effectiveness of InsuOnline © , as compared to a traditional educational activity (lecture, cases discussion). Knowledge, skills and beliefs on insulin therapy were evaluated by a questionnaire applied before, immediately after, and 3 months after both interventions. Results: Mean knowledge/skills score was improved from 68% to 89% in traditional education group (n = 23; p < 0.001), and from 61% to 90% in game group (n = 18; p < 0.001). After 3 months, mean score decreased (to 80% in traditional education group, and to 78% in game group; p < 0.001 for both) but remained significantly higher than at baseline in both groups (p < 0.001 for both). Although mean score was lower in game group than in traditional education group at baseline (p = 0.04), no difference remained between groups either immediately or 3 months post-intervention. Score increment was better with the game (29%) than with traditional education (21%; p = 0.04). Beliefs improved in the game group only. Conclusions: InsuOnline © is at least as effective as a traditional educational activity for medical education on insulin therapy, and it can a good option for large-scale continuing medical education on diabetes. Arch Endocrinol Metab. 2015;59(5):470-3
RESUMO A escolha da especialidade médica é de suma importância para o estudante de Medicina, uma vez que representa a escolha da sua prática diária. Embora a realização acadêmica, considerações financeiras e preferências de estilo de vida influenciem a escolha, os aspectos intrapessoais têm impacto na decisão do médico. Objetivos Avaliar os principais fatores que influenciam o acadêmico de Medicina na escolha da especialidade médica e identificar as áreas de atuação preferidas pelos estudantes dos quatro primeiros anos de uma instituição de ensino superior de Curitiba (PR). Resultados Dos 397 estudantes, 307 responderam a um questionário previamente elaborado para este estudo, sendo que 291 foram considerados válidos. Duzentos e quatro estudantes são do sexo feminino e 87 do sexo masculino. Os fatores de influência foram comparados entre os estudantes dos diferentes anos e com resultados publicados na literatura. Os principais fatores considerados pelos estudantes nesta decisão foram: conhecimento mais amplo ou específico, contato com o paciente, local de atuação profissional e estilo de vida após a residência médica. Para as mulheres, a pressão do dia a dia durante o exercício da especialidade, a relação a longo prazo com o paciente e a facilidade de emprego foram significativamente mais relevantes na escolha da especialidade do que para os homens. Pai ou mãe médicos influenciam os estudantes na decisão da escolha da especialidade. O perfil financeiro do estudante influenciou a escolha quando relacionado a retorno financeiro a longo prazo, sendo mais relevante para os estudantes com renda familiar mensal entre 6 mil e 15 mil reais ou maior que 20 mil reais. A especialidade de Cirurgia Geral foi a preferida pelos estudantes, com predominância no sexo masculino, seguida de Pediatria, Clínica Médica e Psiquiatria. Conclusões Estilo de vida, local de atuação e retorno financeiro precoce foram considerados igualmente importantes por estudantes de todos os anos avaliados. Devido à grande quantidade de variáveis avaliadas e de fatores que influenciam esta decisão, estudos adicionais são necessários para comparações mais significativas com a literatura disponível.
Este estudo objetivou identificar o processo de aprendizado de Administração em Enfermagem no cotidiano de formação, na perspectiva de docentes dessa disciplina. Estudo exploratório- descritivo com abordagem qualitativa, realizado entre julho e setembro de 2012, com docentes de cinco Instituições de Ensino Superior, privadas e seis públicas do sul do Brasil. A análise de conteúdo das entrevistas de 25 docentes permitiu a emersão de duas categorias: processo de aprendizado no cotidiano de formação de Administração em Enfermagem e avaliação do processo de aprendizado de Administração em Enfermagem. Os resultados indicam que persistem currículos compartimentalizados, os cursos carecem de diversificação de cenários de prática e formação docente específica, aparece a utilização de estratégias/metodologias ativas. Indica recomendações às instituições de ensino e aos docentes para a melhoria das ações no processo de aprendizado em Administração em Enfermagem.
PALAVRAS-CHAVE-Estudos de Validação.-Estudantes de Ciências da Saúde.-Ensino Superior.-Saúde. RESUMOO ingresso na vida acadêmica traz mudanças significativas, ligadas ao modelo de ensino-aprendizagem e à rotina do estudante. O engajamento é considerado o oposto do burnout: ao contrário dos estudantes que sofrem de estresse acadêmico, os alunos engajados se sentem muito conectados às atividades, percebendo-as como um desafio positivo. Esta pesquisa teve como objetivo geral avaliar o escore de engajamento entre estudantes do ensino superior das Ciências da Saúde; e como objetivos específicos, validar o instrumento Utrecht Work Engagement Scale (UWES-S) com estudantes do ensino superior nas Ciências da Saúde; avaliar Vigor, Dedicação e Absorção do constructo engajamento e comparar os escores entre variáveis de duas ou mais categorias para obter o escore de engajamento entre estudantes do ensino superior nas Ciências da Saúde. Método: Estudo observacional analítico transversal, com abordagem quantitativa. Resultados: O UWES-S alcançou validade confirmatória ao ser aplicado a estudantes de cinco cursos da área da saúde nos níveis de Vigor, Dedicação e Absorção. No que tange ao escore das dimensões, tem-se que Medicina e Enfermagem apresentam maior Vigor e Dedicação; os turnos de estudo manhã e integral apresentam maior Vigor e Absorção; na dimensão Absorção, observou-se maior escore entre os estudantes que cursavam até o quarto período; quanto ao tempo de dedicação aos estudos fora da faculdade, observou-se que os escores se mantiveram altos nas três dimensões do constructo, assim como para estudantes que praticavam atividades de lazer. Estudantes de Medicina e Enfermagem dos turnos da manhã e integral, casados, com filhos, que dedicam grande parte do tempo aos estudos fora da faculdade, que têm atividades de lazer apresentam maior escore de engajamento com relação às demandas acadêmicas. Conclusão: O engajamento como constructo é recente no Brasil. Seu conhecimento possibilitou um novo olhar sobre o contexto acadêmico, os mecanismos de adaptação do estudante ao ensino superior e a necessidade da proximidade do docente como mediador e da universidade como sustentáculo do processo. I Faculdade Pequeno Príncipe, Curitiba, Paraná, Brasil. II Universidade de São Paulo, Ribeirão Preto, São Paulo, Brasil. RBEM42_N02-Miolo.indd 15 22/05/2018 15:46:41 REVISTA BRASILEIRA DE EDUCAÇÃO MÉDICA 42 (2) : 14 -25 ; 2018 16 Juliana Ollé Mendes da Silva et al. ABSTRACT Entry into academic life brings about significant changes in one's life, and these changes are linked to the teaching-learning model and the student's routine. Engagement is considered the opposite of Burnout, and unlike students who suffer from academic stress, engaged students feel very connected to the activities, perceiving them as positive challenges. This research had the general objective of evaluating the Engagement Score among Health Science undergraduate students; and, the specific objectives of validating the Utrecht Work Engagement Scale (UWES-S) instrument wi...
CONTEXT AND OBJECTIVE: Professionalism in medicine requires preparation for the globalized world.Our objective was to describe a project that introduces medical students to the community, hospital and laboratory activities, thereby allowing them to gain experience in people management, leadership and teamwork. DESIGN AND SETTING: Descriptive study of the process applied at a philanthropic medical school in Curitiba, Paraná. METHOD: Inclusion of management and leadership practices as part of the medical degree program. RESULTS:The study groups consisted of fifteen students. After six months, any of the participants could be elected as a subcoordinator, with responsibility for managing tasks and representing the team in hospital departments and the community. The activities required increasing levels of responsibility. In medical schools, students' involvement in practical activities is often limited to observation. They are not required to take responsibilities or to interact with other students and stakeholders. However, they will become accountable, which thus has an adverse effect on all involved. The learning space described here aims to fill this gap by bringing students closer to the daily lives and experiences of healthcare professionals. CONCLUSION: Being a physician requires not only management and leadership, but also transferrable competencies, communication and critical thinking. These attributes can be acquired through experience of teamwork, under qualified supervision from teaching staff. Students are thus expected to develop skills to deal with and resolve conflicts, learn to share leadership, prepare others to help and replace them, adopt an approach based on mutual responsibility and discuss their performance. RESUMO CONTEXTO E OBJETIVO:Profissionalismo na medicina requer formação para o mundo globalizado. Nosso objetivo é descrever um projeto que introduz os estudantes de medicina em atividades laboratoriais, comunitárias e hospitalares, oferecendo experiência em gestão de pessoas, liderança e trabalho em equipe. TIPO DE ESTUDO E LOCAL: Estudo descritivo do processo aplicado a uma escola medica filantrópica de Curitiba, Paraná. MÉTODO: Inclusão de práticas de gestão e liderança como parte do programa de graduação médica. RESULTADOS: Os grupos de trabalho eram constituídos por 15 estudantes. Após seis meses de participação, o estudante podia ser eleito como subcoordenador, responsável por gerenciar tarefas e representar a equipe junto aos setores do hospital e na comunidade. Na faculdade de medicina, frequentemente, o envolvimento dos alunos em atividades práticas restringe-se à observação, não existem demandas sobre a sua responsabilidade ou sua interação com outros alunos e atores. Entretanto, serão cobrados por isso, resultando em efeito adverso sobre todos os envolvidos. O espaço de aprendizagem aqui descrito visa preencher essa lacuna, trazendo os alunos para mais perto do cotidiano e das experiências dos profissionais de saúde. CONCLUSÃO: Ser médico exige, ao lado de gestão e lider...
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