Obezita je v poslední době vnímána většinou zdravotníků jako onemocnění se závažnými zdravotními a socioekonomickými následky. Přesto, podle několika šetření prováděných napříč světem, je léčba obezity jako chronické nemoci s opakovanými relapsy podceňována jak lékaři, tak ostatními zdravotníky. Článek shrnuje hlavní překážky v patřičné léčbě pacientů s obezitou. Nedostatečné znalosti o obezitě u zdravotníků představují významnou zábranu v implementaci sofistikovaných principů v její léčbě. Proto jsou zde představeny zkušenosti s postgraduálním vzděláváním v obezitologii v České republice a v zahraničí. Autoři rovněž popisují různé přístupy při vzdělávání a certifikaci obezitologů jako lékařů, kteří dosáhli způsobilosti v péči o pacienty s obezitou. Obezitologové by měli sehrávat významnou úlohu nejen v komplexní multidisciplinární léčbě obezity, ale i při vzdělávání ostatních zdravotníků v obezitologii. To se jeví významné zejména dnes, kdy lze očekávat častou indikaci k dlouhodobé léčbě novými účinnými antiobezitiky a méně invazivními bariatrickými operacemi.
Obesity has recently been recognized as a disease with serious health and socioeconomic consequences by most health professionals. However, according to several surveys conducted across the world, comprehensive management of chronic relapsing disease such obesity continues to be underestimated by both physicians and other healthcare providers. The paper highlights the main obstacles to the appropriate treatment of patients with obesity. One key barrier is the insufficient knowledge about obesity among healthcare providers, which hinders the implementation of advanced principles in obesity management. This paper also explores experiences in postgraduate education on obesity both in the Czech Republic and abroad. The authors further describe different attitudes toward educating and certifying obesity specialists, i.e. physicians who achieved a competency in obesity care. Obesity specialists should play an important role not only in comprehensive multidisciplinary treatment of obesity but also in educating other health professionals about obesity medicine. This role is increasingly significant nowadays as the demand for long-term treatment with new, efficient anti-obesity drugs and less invasive bariatric surgery grows.
- Klíčová slova
- obezitologie,
- MeSH
- endokrinologie MeSH
- kontinuální vzdělávání lékařů * MeSH
- lidé MeSH
- obezita * MeSH
- odborná způsobilost MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- práce podpořená grantem MeSH
BACKGROUND: Despite efforts to improve undergraduate clinical pharmacology & therapeutics (CPT) education, prescribing errors are still made regularly. To improve CPT education and daily prescribing, it is crucial to understand how therapeutic reasoning works. Therefore, the aim of this study was to gain insight into the therapeutic reasoning process. METHODS: A narrative literature review has been performed for literature on cognitive psychology and diagnostic and therapeutic reasoning. RESULTS: Based on these insights, The European Model of Therapeutic Reasoning has been developed, building upon earlier models and insights from cognitive psychology. In this model, it can be assumed that when a diagnosis is made, a primary, automatic response as to what to prescribe arises based on pattern recognition via therapy scripts (type 1 thinking). At some point, this response may be evaluated by the reflective mind (using metacognition). If it is found to be incorrect or incomplete, an alternative response must be formulated through a slower, more analytical and deliberative process, known as type 2 thinking. Metacognition monitors the reasoning process and helps a person to form new therapy scripts after they have chosen an effective therapy. Experienced physicians have more and richer therapy scripts, mostly based on experience and enabling conditions, instead of textbook knowledge, and therefore their type 1 response is more often correct. CONCLUSION: Because of the important role of metacognition in therapeutic reasoning, more attention should be paid to metacognition in CPT education. Both trainees and teachers should be aware of the possibility to monitor and influence these cognitive processes. Further research is required to investigate the applicability of these insights and the adaptability of educational approaches to therapeutic reasoning.
BACKGROUND: Cross-sectional anatomy is a challenging yet a vital foundation to clinical practice. The traditional teachings of gross anatomy cadaveric dissections do not cover adequate training of recognizing anatomical structures on CT, MRI and sonographic cross-sections. New modern technologies are emerging as teaching tools in anatomy aiming to deliver visual interactive experience. The Visible Human Project provides a library of cross-sectional images compiled from cryosectioned body donors that was utilized by modern technologies such as the virtual dissection table (Anatomage) in constructing 3D software applications visualizing the internal composition of the human body virtually. Hereby, this article explores an integrative approach utilizing the Visible Human Project based applications and basic radiological modalities. PURPOSE: The purpose of our newly implemented teaching approach was to test and assure technology fitness to the medical curriculum and its potential influence on students' performance in learning gross as well as cross-sectional anatomy in much depth. BASIC PROCEDURES: A three years (2021-2024) observational study was conducted by implanting a practical cross-sectional anatomy optional course by selectively utilizing Anatmage interactively beside CT, MRI and ultrasound practice. The performance of 50 participants was evaluated in the form of a written test comprised of labeling of ten cross-sectional images and drawing of two cross-section schemes. Their optional course test scores were compared to their obligatory anatomy subject test scores; and to a non-participants control group of 50 retrospective obligatory anatomy subject test scores. In addition, the participants' attitude toward the training lessons was assessed through a survey focused on satisfaction level, competence and ability to recognize structures on radiological images. MAIN FINDINGS: The participants reported a high level of practical engagement. The test scores in the anatomy obligatory subject were positively influenced by this implemented practical course. Students showed improved test scores in the standardized labeling keyword questions, while the scheme questions showed discrepancy. PRINCIPAL CONCLUSIONS: Integrating Visible Human Project based applications with radiological modalities showed positive efficacy on the students' engagement and learning performance. Inevitably, cadaveric dissection and prosection remain the cornerstone of gross anatomy education. Integrating both modalities of teaching would excel students' practical skills in applied clinical anatomy.
- MeSH
- anatomie průřezová * výchova MeSH
- anatomie výchova MeSH
- disekce výchova MeSH
- dospělí MeSH
- kurikulum * MeSH
- lidé MeSH
- magnetická rezonanční tomografie MeSH
- mladý dospělý MeSH
- mrtvola MeSH
- projekty vizualizace člověka * MeSH
- průřezové studie MeSH
- školy lékařské MeSH
- studenti lékařství MeSH
- studium lékařství pregraduální metody MeSH
- zobrazování trojrozměrné MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- pozorovací studie MeSH
BACKGROUND AND PURPOSE: Centers for training in autonomic nervous system (ANS) disorders are not widely available and the recent coronavirus 2019 pandemic temporarily reduced training opportunities in autonomic medicine across European countries. Here we evaluated the current state of education, clinical skills and postgraduate educational preferences on ANS disorders of European neurology residents and consultants. METHODS: A 23-item questionnaire was developed and distributed online amongst European neurology residents and consultants via mailing lists of the European Academy of Neurology. The questions assessed demographics, current training opportunities and learning preferences in ANS disorders. Six multiple-choice questions were used to self-evaluate knowledge of ANS disorders. RESULTS: In all, 285 individuals answered the survey (60% female, mostly 25-34 years of age). All respondents considered clinical autonomic skills necessary for good clinical neurological practice, and 92% would like to increase their ANS knowledge. Female respondents and those who trained in Southern/Eastern/Greater Europe more frequently judged ANS skills important for clinical practice than male respondents (p = 0.012) and respondents from Northern/Western Europe (p = 0.011). Female and younger respondents felt less confident in managing ANS disorders (p = 0.001 and p < 0.001, respectively). Respondents below 45 years of age (p < 0.001) and those with lower confidence in managing ANS disorders (p = 0.004) were more likely to recommend that ANS education is embedded in the residency curriculum. CONCLUSIONS: Most European neurology residents and consultants reported a need for more autonomic education, with additional gender, age and regional differences. These findings underscore the importance of increasing the educational content on autonomic medicine in European medical and postgraduate curricula.
- MeSH
- autonomní nervový systém patofyziologie fyziologie MeSH
- dospělí MeSH
- klinické kompetence * MeSH
- konzultanti MeSH
- kurikulum * MeSH
- kurzy a stáže v nemocnici * MeSH
- lidé středního věku MeSH
- lidé MeSH
- nemoci autonomního nervového systému terapie MeSH
- neurologie * výchova MeSH
- průzkumy a dotazníky MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Evropa MeSH
- MeSH
- kurzy a stáže v nemocnici MeSH
- lidé MeSH
- neurologie MeSH
- Check Tag
- lidé MeSH
- Geografické názvy
- Spojené státy americké MeSH
- MeSH
- dějiny 20. století MeSH
- dějiny lékařství MeSH
- studium lékařství dějiny MeSH
- terapie dějiny MeSH
- učebnice jako téma * dějiny MeSH
- vnitřní lékařství * dějiny výchova MeSH
- Check Tag
- dějiny 20. století MeSH
- Publikační typ
- historické články MeSH
- MeSH
- lidé MeSH
- studium lékařství specializační postgraduální * MeSH
- studium lékařství MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- úvodníky MeSH
152 stran : ilustrace ; 21 cm
Publikace, které se zaměřuje na použití simulace v lékařství a ošetřovatelství; konkrétně ve výuce, výkumu, hodnocení a praxi. Určeno odborné veřejnosti.
- MeSH
- akademie a ústavy dějiny MeSH
- dějiny 20. století MeSH
- dějiny 21. století MeSH
- lidé MeSH
- šedá literatura * MeSH
- studium lékařství specializační postgraduální dějiny organizace a řízení MeSH
- výročí a významné události MeSH
- Check Tag
- dějiny 20. století MeSH
- dějiny 21. století MeSH
- lidé MeSH
- Geografické názvy
- Česká republika MeSH
- Československo MeSH
