Teaching – ABC CARDIOL

IJCS

Review Article

Challenges and Opportunities in Teaching and Training Pediatric Cardiac Critical Care in Developing Countries: A Narrative Review

Carolina Vieira de Campos et al. Carlos Roberto Ribeiro Carvalho

Abstract

Congenital heart disease (CHD) is a public health issue in developing countries. Effective teaching and training are vital for healthcare professionals to provide adequate care for critically ill cardiac children, but there are many obstacles to adequately training a cohort of healthcare professionals in low- and middle-income countries (LMIC), where education practice is not always aligned with current education evidence. Work overload, time constraints, language, and the healthcare structure itself hinder standardization of an optimal training process for this highly complex scenario. This narrative review aims to explore how current teaching methodologies may help overcome challenges in pediatric cardiac critical care (PCCC) education, thus helping clinical practice, with a special focus on developing countries and the Brazilian scenario.

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IJCS

Original Article

First Evaluation of the Brazilian Advanced Life Support Training (TECA A)

Fabrício Nogueira Furtado et al. Antonio Carlos de Camargo Carvalho Iran Gonçalves Junior Manoel Fernandes Canesin … Sergio Timerman Rodrigo Marques Gonçalves Daniela Frizon Alfieri Dirceu Almeida

Abstract

Background

Cardiac arrest (CA) is a common condition associated with high mortality. The Brazilian advanced life support training TECA A (Treinamento em Emergências Cardiovasculares Avançado — Advanced Cardiovascular Emergency Training) was created to train healthcare professionals in the management of CA. However, there are no studies evaluating the effectiveness of TECA A.

Objective

To assess the impact of TECA A on the management of CA using a simulated CA situation.

Methods

Fifty-six students underwent a simulated case of CA in a manikin. The students’ performance in the management of CA was assessed for the time to first chest compression and defibrillation and for a global assessment score using a structured tool. These items were assessed and compared before and after the TECA A. Exclusion criteria were previous participation in CA trainings and absence from class. Categorical variables were compared using the McNemar test and quantitative variables using the Wilcoxon test. All tests were two-tailed, and statistical significance was set at p < 0.05.

Results

Compared with before TECA A, median global assessment scores were higher after TECA A (pre-training: 4.0 points [2.0-5.0] vs. 10 points [9.0-10.0]; p<0.001), the time to start chest compressions was shorter (pre-training: 25 seconds [15-34] vs. 19 seconds [16.2-23.0]; p=0.002) and so was the time to defibrillation (pre-training: 82.5 seconds [65.0-108.0] vs. 48 seconds [39.0-53.0]; p<0.001).

Conclusions

The TECA A promoted a higher adherence to cardiopulmonary resuscitation (CPR) guidelines and a reduction in the time elapsed from CA to first chest compression and defibrillation.

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ABC

Editorial

Fúlvio Pileggi: An Icon of Brazilian Cardiology

Protásio L. da Luz et al. Charles Mady Roberto Kalil Filho Carlos Eduardo Rochitte

Carlos Eduardo Rochitte

In this special editorial, we would like to pay tribute to an icon of Brazilian Cardiology who was directly responsible for developing one of the greatest cardiology institutions in the world, The Heart Institute (InCor), at the Hospital das Clínicas of the Faculty of Medicine of the University of São Paulo (USP). In the words of 3 people who were very close to him (Professors Kalil, Mady, and Protásio da Luz), we shall remember the career and the personality traits that characterized him as an undisputed leader for a generation of cardiologists. As a resident of InCor, I had the honor of meeting and interacting with Professor Pileggi, and he played a fundamental role in my academic career. First, there was apparently an obstacle to getting into a postgraduate program, “To enroll in a postgraduate program, you must have completed an internship abroad.” This, in association with the fact that nearly all scholarships to study abroad required, as a pre-requisite, that the applicant be enrolled in a postgraduate program, seemed to be an insurmountable barrier, which only served to stimulate me to look even harder for alternative ways to surmount it. And, in fact, he was the one who opened all the doors to make it possible for me to complete an internship at Johns Hopkins University. After that, the rest was history. I am eternally indebted to him for his teachings.

[…]

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ABC

Viewpoint

The New Faces of Medicine – a Journey and a Perspective

Adib Jatene

Professor Protásio da Luz, basic science and clinical researcher and renowned cardiologist, offers us his newest book The New Faces of Medicine. It is a presentation of his vision of the scientific and humanistic bases of medicine, its evolution and its future.

With expressive illustrations, the book presents us with the importance of the connection of technique with the human, of science with the relationship of physicians and patients. “It’s not the anamnesis yet. It’s just the first approach to know the person.” This seemingly trivial sentence contains deep wisdom and experience of the professional and professor of medicine practicing one of the major goals of the university: to propagate knowledge for improvement of students and physicians in general.

[…]

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ABC

Original Article

The Need for Pedagogical Qualifications for Teaching Cardiology to Undergraduate Students

Waldomiro Carlos Manfroi et al. Carmen Lúcia Bezerra Machado Ana Maria Petersen Maria Júlia P. Spina

OBJECTIVE: To report a training program in cardiology emphasizing changes in its pedagogical practice. These changes were put into practice by some teachers at the Medical School of Porto Alegre of the University of Rio Grande do Sul (FAMED/UFRGS) aiming to make faculty and student activities more dynamic and to promote more efficacious learning. The training program is directed at 5th semester medical students and aims at a behavioral change in teachers and students to promote more interaction, to favor exchanges, and to make the teaching-learning process easier, always maintaining the patient in the center of the medical activity. METHODS: The program emphasizes the definition of general and specific objectives for each activity to be developed by the students, with training in the area of admission to the cardiology service, with special emphasis on behavioral change in the cognitive, motor, affective, and attitudinal areas. Knowledge was developed by means of interactive seminars with initial and final assessment tests to identify students’ and teachers’ performance. The students were evaluated in an immediate, continuous, and progressive way in their daily activities and through comparison of the results of 2 tests, one applied at the beginning of the training and the other at its end. These 2 tests contained the same questions. RESULTS: We systematically assessed 560 students over 4 years. The mean grades of the tests performed prior to and after the 244 seminars were 7.38±1.66 and 9.17± 0.82, respectively (p<0.0001). For the tests applied at the beginning and at the end of the training, the mean grades were 5.61±1.61 and 9.37±0.90, respectively (p<0.0001). CONCLUSION: The program proved to be efficient both for the students' learning and for assessing their performance in a systematic and objective way.

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Challenges and Opportunities in Teaching and Training Pediatric Cardiac Critical Care in Developing Countries: A Narrative Review

Abstract

First Evaluation of the Brazilian Advanced Life Support Training (TECA A)

Abstract

Background

Objective

Methods

Results

Conclusions

Fúlvio Pileggi: An Icon of Brazilian Cardiology

The New Faces of Medicine – a Journey and a Perspective

The Need for Pedagogical Qualifications for Teaching Cardiology to Undergraduate Students

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