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Massard G, Stolz D. Specialist training in Europe: introduction to a special issue of the Journal of Thoracic Disease. J Thorac Dis 2021; 13:2018-2020. [PMID: 33841988 PMCID: PMC8024810 DOI: 10.21037/jtd.2019.12.28] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Giuliani M, Martimianakis MA(T, Broadhurst M, Papadakos J, Fazelzad R, Driessen EW, Frambach J. Motivations for and Challenges in the Development of Global Medical Curricula: A Scoping Review. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2021; 96:449-459. [PMID: 32271225 PMCID: PMC7899747 DOI: 10.1097/acm.0000000000003383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
PURPOSE The aim of this scoping review is to understand the motivations for the creation of global medical curricula, summarize methods that have been used to create these curricula, and understand the perceived premises for the creation of these curricula. METHOD In 2018, the authors used a comprehensive search strategy to identify papers on existing efforts to create global medical curricula published from 1998 to March 29, 2018, in the following databases: MEDLINE; MEDLINE Epub Ahead of Print, In-Process, and Other Non-Indexed Citations; Embase; Cochrane Central Register of Controlled Trials; Cochrane Database of Systematic Reviews; PsycINFO; CINAHL; ERIC; Scopus; African Index Medicus; and LILACS. There were no language restrictions. Two independent researchers applied the inclusion and exclusion criteria. Demographic data were abstracted from publications and summarized. The stated purposes, methods used for the development, stated motivations, and reported challenges of curricula were coded. RESULTS Of the 18,684 publications initially identified, 137 met inclusion criteria. The most common stated purposes for creating curricula were to define speciality-specific standards (50, 30%), to harmonize training standards (38, 23%), and to improve the quality or safety of training (31, 19%). The most common challenges were intercountry variation (including differences in health care systems, the operationalization of medical training, and sociocultural differences; 27, 20%), curricular implementation (20, 15%), and the need for a multistakeholder approach (6, 4%). Most curricula were developed by a social group (e.g., committee; 30, 45%) or Delphi or modified Delphi process (22, 33%). CONCLUSIONS The challenges of intercountry variation, the need for a multistakeholder approach, and curricular implementation need to be considered if concerns about curricular relevance are to be addressed. These challenges undoubtedly impact the uptake of global medical curricula and can only be addressed by explicit efforts to make curricula applicable to the realities of diverse health care settings.
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Affiliation(s)
- Meredith Giuliani
- M. Giuliani is staff radiation oncologist and medical director, Cancer Education Program, Princess Margaret Cancer Centre, and associate professor, Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada; ORCID: https://orcid.org/0000-0003-1827-5590
| | - Maria Athina (Tina) Martimianakis
- M.A. Martimianakis is associate professor and director of medical education scholarship, Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada; ORCID: https://orcid.org/0000-0002-2531-3156
| | - Michaela Broadhurst
- M. Broadhurst is research analyst, Cancer Education Program, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Janet Papadakos
- J. Papadakos is codirector, Cancer Health Literacy Research Centre, Cancer Education Program, Princess Margaret Cancer Centre, and assistant professor, Institute of Health Policy, Management & Evaluation, University of Toronto, Toronto, Ontario, Canada; ORCID: https://orcid.org/0000-0001-6320-4156
| | - Rouhi Fazelzad
- R. Fazelzad is information specialist, Library and Information Services, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Erik W. Driessen
- E.W. Driessen is professor and chair, Department of Educational Development and Research, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands; ORCID: https://orcid.org/0000-0001-8115-261X
| | - Janneke Frambach
- J. Frambach is assistant professor, School of Health Professions Education, Maastricht University, Maastricht, the Netherlands; ORCID: https://orcid.org/0000-0003-1527-6539
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Massard G, Tabin N, Konge L, Frick AE, Batirel H, Brunelli A, Elia S, Huertgen M, Molins L, Papagiannopoulos K, Subotic D, van Schil P, Varela G, van Raemdonck D. Training curriculum for European thoracic surgeons: a joint initiative of the European Society of Thoracic Surgeons and the European Respiratory Society. Eur J Cardiothorac Surg 2020; 57:418-421. [PMID: 32025700 DOI: 10.1093/ejcts/ezz361] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2019] [Revised: 11/15/2019] [Accepted: 11/29/2019] [Indexed: 11/13/2022] Open
Abstract
Because of the differing definitions of the margins of thoracic surgery as a specialty and the variability in the training curricula among European countries, the European Society of Thoracic Surgeons formed a task force to elaborate a consensual proposal. The first step comprised creating a harmonized syllabus that was completed and published in 2018. This publication presents a proposal for a curriculum upon which the task force and the external expert reviewers have agreed. The curriculum was developed by the task force: each module and item describe the expected level of knowledge, skills and attitudes to be attained by the participants; learning opportunities, assessment tools and minimal clinical exposures have been defined as well. Competence in terms of non-technical skills has been defined for each module according to the CanMEDS (http://www.royalcollege.ca/rcsite/canmeds/canmeds-framework-e) glossary. The different modules were subsequently submitted to an internal and an external review process and re-edited accordingly before final validation. The authors hope that this document will serve as a roadmap for both thoracic surgical trainees and mentors. It should further guide continuous professional development. However, evolving scientific and technological advances are expected to modify the diagnosis and treatment of diseases and disorders in the future and hence will mandate periodical revisions of the document.
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Affiliation(s)
- Gilbert Massard
- Department of Medical Education, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | | | - Lars Konge
- Copenhagen Academy for Medical Education and Simulation, Copenhagen, Denmark
| | | | - Hasan Batirel
- Department of Thoracic Surgery, Marmara University Medical School, Istanbul, Turkey
| | | | - Stefano Elia
- Department of Thoracic Surgery, University of Rome Tor Vergata, Rome, Italy
| | - Martin Huertgen
- Clinic of Thoracic Surgery, Catholic Clinic Koblenz-Montabaur, Koblenz, Germany
| | | | | | | | - Paul van Schil
- Department of Thoracic and Vascular Surgery, Antwerp University Hospital and Antwerp University, Antwerp, Belgium
| | - Gonzalo Varela
- Salamanca Institute of Biomedical Research, Salamanca, Spain
| | - Dirk van Raemdonck
- Department of Thoracic Surgery, University Hospitals Leuven, Leuven, Belgium
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Massard G, Tabin N, Mitchell S, Batirel H, Brunelli A, Elia S, Frick A, Huertgen M, Lerut A, Molins L, Papagiannopoulos K, Subotic D, van Schil P, Varela G, van Raemdonck D. A harmonized European training syllabus for thoracic surgery: report from the ESTS-ERS task force. Eur J Cardiothorac Surg 2019; 54:214-220. [PMID: 29800238 DOI: 10.1093/ejcts/ezy206] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 04/02/2018] [Indexed: 11/14/2022] Open
Abstract
Training of European thoracic surgeons is subject to huge variations in terms of length of training, content of training and operative experience during training. Harmonization of training outcomes has been approached by creating the European Board of Thoracic Surgery, which has been accredited by the European Union of Medical Specialists (UEMS); however, a clear description of the content of training is lacking. Building on their recognized experience with curriculum building, task forces of the European Respiratory Society and the European Society of Thoracic Surgery agreed on a joint task force on training in thoracic surgery. The goal of this study is to report on the mission statement developed from the UEMS-driven survey, describe the Delphi method and the observed results and present the first large consensus-based syllabus. The working group is currently working on a description of the curriculum and assessment of learning outcomes.
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Affiliation(s)
- Gilbert Massard
- Department of Thoracic Surgery, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Nathalie Tabin
- Department of Education, European Respiratory Society Headquarters, Lausanne, Switzerland
| | - Sharon Mitchell
- Department of Education, European Respiratory Society Headquarters, Lausanne, Switzerland
| | - Hasan Batirel
- Department of Thoracic Surgery, Marmara University Hospital, Istanbul, Turkey
| | | | - Stefano Elia
- Department of Thoracic Surgery, University of Rome Tor Vergata, Rome, Italy
| | - Anna Frick
- Department of Thoracic Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Martin Huertgen
- Clinic of Thoracic Surgery, Catholic Clinic Koblenz-Montabaur, Koblenz, Germany
| | - Antoon Lerut
- Department of Thoracic Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Laureano Molins
- Department of Thoracic Surgery, Hospital Clinic & Sagrat Cor, University of Barcelona, Barcelona, Spain
| | | | - Dragan Subotic
- Department of Thoracic Surgery, University Hospital Basel, Basel, Switzerland.,Clinic for Thoracic Surgery, Clinical Center of Serbia, University of Belgrade School of Medicine, Belgrade, Serbia
| | - Paul van Schil
- Department of Thoracic and Vascular Surgery, Antwerp University Hospital, Antwerp University, Antwerp, Belgium
| | - Gonzalo Varela
- Chair of Thoracic Surgery, School of Medicine, Salamanca University, Salamanca, Spain
| | - Dirk van Raemdonck
- Department of Thoracic Surgery, University Hospitals Leuven, Leuven, Belgium
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Massard G, Tabin N, Mitchell S, Batirel H, Brunelli A, Elia S, Frick A, Huertgen M, Lerut A, Molins L, Papagiannopoulos K, Subotic D, van Schil P, Varela G, van Raemdonck D. A harmonised European training syllabus for thoracic surgery: report from the ESTS/ERS task force group. Eur Respir J 2018; 51:51/6/1800370. [PMID: 29903828 DOI: 10.1183/13993003.00370-2018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Accepted: 02/21/2018] [Indexed: 11/05/2022]
Affiliation(s)
- Gilbert Massard
- Dept of Thoracic Surgery, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | | | | | - Hasan Batirel
- Dept of Thoracic Surgery, Marmara University Hospital, Istanbul, Turkey
| | | | - Stefano Elia
- Dept of Thoracic Surgery, University of Rome Tor Vergata, Rome, Italy
| | - Anna Frick
- Dept of Thoracic Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Martin Huertgen
- Clinic of Thoracic Surgery, Catholic Clinic Koblenz-Montabaur, Koblenz, Germany
| | - Antoon Lerut
- Dept of Thoracic Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Laureano Molins
- Dept of Thoracic Surgery, Hospital Clinic and Sagrat Cor, University of Barcelona, Barcelona, Spain
| | | | - Dragan Subotic
- Dept of Thoracic Surgery, University Hospital Basel, Basel, Switzerland.,Clinic for Thoracic Surgery, Clinical Center of Serbia, Belgrade, Serbia.,School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Paul van Schil
- Dept of Thoracic and Vascular Surgery, Antwerp University Hospital and Antwerp University, Antwerp, Belgium
| | - Gonzalo Varela
- School of Medicine, Salamanca University, Salamanca, Spain
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Differential Perceptions of Noninvasive Ventilation in Intensive Care among Medical Caregivers, Patients, and Their Relatives: A Multicenter Prospective Study-The PARVENIR Study. Anesthesiology 2017; 124:1347-59. [PMID: 27035854 DOI: 10.1097/aln.0000000000001124] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Noninvasive ventilation (NIV) requires a close "partnership" between a conscious patient and the patient's caregivers. Specific perceptions of NIV stakeholders and their impact have been poorly described to date. The objectives of this study were to compare the perceptions of NIV by intensive care unit (ICU) physicians, nurses, patients, and their relatives and to explore factors associated with caregivers' willingness to administer NIV and patients' and relatives' anxiety in relation to NIV. METHODS This is a prospective, multicenter questionnaire-based study. RESULTS Three hundred and eleven ICU physicians, 752 nurses, 396 patients, and 145 relatives from 32 ICUs answered the questionnaire. Nurses generally reported more negative feelings and more frequent regrets about providing NIV (median score, 3; interquartile range, [1 to 5] vs. 1 [1 to 5]; P < 0.0001) compared to ICU physicians. Sixty-four percent of ICU physicians and only 32% of nurses reported a high level of willingness to administer NIV, which was independently associated with NIV case-volume and workload. A high NIV session-related level of anxiety was observed in 37% of patients and 45% of relatives. "Dyspnea during NIV," "long NIV session," and "the need to have someone at the bedside" were identified as independent risk factors of high anxiety in patients. CONCLUSIONS Lack of willingness of caregivers to administer NIV and a high level of anxiety of patients and relatives in relation to NIV are frequent in the ICU. Most factors associated with low willingness to administer NIV by nurses or anxiety in patients and relatives may be amenable to change. Interventional studies are now warranted to evaluate how to reduce these risk factors and therefore contribute to better management of a potentially traumatic experience. (Anesthesiology 2016; 124:1347-59).
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Migliori GB, Bel E, Joos G, Elliott M, Rohde G, Holgate ST, Gratziou C, Smyth D, Gaga M, Cordeiro CR, Burghuber OC, Brusselle G, Martin-Burrieza F, Bill W, Sax B, Vestbo J. The European Respiratory Society evaluates its 2013–2018 strategic plan implementation. Eur Respir J 2016; 47:693-8. [DOI: 10.1183/13993003.02110-2015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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Bion J, Rothen HU. Models for Intensive Care Training. A European Perspective. Am J Respir Crit Care Med 2014; 189:256-62. [DOI: 10.1164/rccm.201311-2058cp] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Martin-Loeches I, Artigas A, Gordo F, Añón JM, Rodríguez A, Blanch L, Cuñat J. [Current status of fibreoptic bronchoscopy in intensive care medicine]. Med Intensiva 2012; 36:644-9. [PMID: 23141554 DOI: 10.1016/j.medin.2012.09.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2012] [Revised: 09/04/2012] [Accepted: 09/13/2012] [Indexed: 11/27/2022]
Abstract
Flexible bronchoscopy (FB) has been of great help in the management of critically ill patients. Its safety and usefulness in the hands of experienced professionals, with the required measures of caution, has resulted in the increasingly widespread use of the technique even in unstable critical patients subjected to mechanical ventilation and with high oxygen demands. The Spanish Society of Intensive and Critical Care Medicine and Coronary Units (SEMICYUC), through its Acute Respiratory Failure (GT-IRA) and Infectious Diseases (GT-EI) Work Groups, aims to promote knowledge and standards of quality in the use of FB among all specialists in Intensive Care Medicine. Through an expert committee, the SEMICYUC has established the objective of accrediting such training, with the preparation of a curriculum and definition of those Units qualified for providing training in the different techniques and levels. The accreditation process seeks to stimulate good learning practice and quality in training. Both specialists in Intensive Care Medicine and other specialists, and the patients, will benefit from the commitment and control afforded by such accreditation, and from the learning and training which the mentioned process entails.
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Affiliation(s)
- I Martin-Loeches
- CIBER Enfermedades Respiratorias, Servicio de Medicina Intensiva, Corporació Sanitària i Universitària Parc Taulí, Institut Universitari Parc Taulí, Hospital de Sabadell, Universitat Autònoma de Barcelona, Barcelona, España.
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