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[Residency Training in Infectious Diseases: Assessment and Perception of the Clinical Learning Environment].

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Titel:	[Residency Training in Infectious Diseases: Assessment and Perception of the Clinical Learning Environment].
Transliterierter Titel:	Internato de Formação Especializada em Doenças Infeciosas: Caracterização e Perceção sobre o Ambiente Clínico de Aprendizagem.
Autoren:	Ganicho J; Serviço de Doenças Infeciosas. Hospital de Curry Cabral. Unidade Local de Saúde São José. Lisboa. Portugal., Garrote AR; Serviço de Doenças Infeciosas. Hospital de Curry Cabral. Unidade Local de Saúde São José. Lisboa. Portugal., Manata MJ; Serviço de Doenças Infeciosas. Hospital de Curry Cabral. Unidade Local de Saúde São José. Lisboa. Portugal., Maltez F; Serviço de Doenças Infeciosas. Hospital de Curry Cabral. Unidade Local de Saúde São José. Lisboa. Portugal., Tavares R; Serviço de Doenças Infeciosas. Hospital Beatriz Ângelo. Unidade Local de Saúde Loures-Odivelas. Loures. Portugal.
Quelle:	Acta medica portuguesa [Acta Med Port] 2025 Dec 02; Vol. 38 (12), pp. 773-784. Date of Electronic Publication: 2025 Oct 13.
Publikationsart:	English Abstract; Journal Article
Sprache:	Portuguese
Info zur Zeitschrift:	Publisher: Centro Editor Livreiro da Ordem dos Médicos Country of Publication: Portugal NLM ID: 7906803 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1646-0758 (Electronic) Linking ISSN: 0870399X NLM ISO Abbreviation: Acta Med Port Subsets: MEDLINE
Imprint Name(s):	Publication: Lisboa : Centro Editor Livreiro da Ordem dos Médicos Original Publication: Lisboa [s.n.]
MeSH-Schlagworte:	Internship and Residency* , Infectious Disease Medicine/education , Attitude of Health Personnel, Humans ; Male ; Female ; Surveys and Questionnaires ; Adult ; Internal Medicine/education ; Cross-Sectional Studies
Abstract:	Introduction: The World Health Organization identified 13 critical threats to global health for the coming decade, including infectious disease prevention and antimicrobial resistance. Given the ongoing advancements in scientific evidence, it is imperative to discuss the Infectious Diseases training program. The aim of this study was to characterize and explore the respondents' perceptions regarding Infectious Diseases training and the clinical learning environment. Methods: A survey was developed to assess the clinical learning environment, targeting residents and young specialists who completed their training within the past five years. Results: The questionnaire received 73 responses, 75.3% from residents. Most respondents agreed with the duration of Internal Medicine (83.5%), Microbiology (76.7%), and General Infectious Diseases (71.2%) rotations, but considered that the Intensive Care rotation should last less than six months. The areas of Infection Control/Antibiotic Stewardship and Immunosuppression/Infectious Risk were suggested as mandatory rotations by 84.9% and 65.8% of participants, respectively. Most respondents (67.1%) considered prolonged Internal Medicine Emergency rotations beyond the first year detrimental. In contrast, 84.6% of ARS Norte participants only performed this activity during the first year, whereas 86.8% of ARS LVT participants continued, at least, until the fourth year. Regarding clinical and scientific output, ARS Norte interns reported, on average, higher numbers of weekly assisted (21.7 vs 17.1) and performed (20.8 vs 17.7) appointments, as well as higher annual participation (3.7 vs 3.1) and presentations (2.8 vs 2.4) in scientific events, published articles (1.1 vs 0.6), and weekly study hours (7.4 vs 4.5), compared with ARS LVT. The main challenges reported were a lack of dedicated study time during working hours, scientific updates, and clinical practice in Internal Medicine Emergency rotations. Regarding the evaluation of the residency program, only 2.7% agreed completely with the current exam model and 1.37% with the current curriculum grid. The majority (64.4%) of participants considered themselves at least satisfied with the specialty. Conclusion: The results suggest a need to review the Infectious Diseases training program, include new areas of specialization, and discuss evaluation models throughout residency. Regional asymmetries were observed in emergency work, clinical and scientific output, which affect the equity and quality of training. Discussion of the Infectious Diseases training program is crucial for adapting the curriculum to current and future challenges.
Contributed Indexing:	Keywords: Specialization; Infectious Disease Medicine/education; Internship and Residency/methods; Physicians; Portugal; Surveys and Questionnaires; linical Competence Local Abstract: [Publisher, Portuguese] Introdução: A Organização Mundial de Saúde definiu as 13 mais importantes ameaças à Saúde Global da década, das quais se destacam a prevenção de doenças infeciosas e a resistência antimicrobiana. Dada a evolução célere da evidência científica e a necessidade de atualização, é imperativo discutir a formação em Doenças Infeciosas. Este estudo teve como objetivo caracterizar e explorar a perceção dos inquiridos relativamente à formação em Doenças Infeciosas e ao ambiente clínico de aprendizagem. Métodos: Foi desenvolvido um questionário sobre os ambientes clínicos de aprendizagem, dirigido a médicos internos e recém-especialistas que tenham concluído o seu programa de formação nos últimos cinco anos, inclusive. Resultados: O questionário obteve 73 respostas, 75,3% de médicos internos. A maioria concordou com a duração dos estágios de Medicina Interna (83,5%), Microbiologia (76,7%) e Infeciologia Geral (71,2%), mas considerou que o estágio de Medicina Intensiva deveria ter uma duração inferior a seis meses. Foi sugerido que as áreas de Controlo de Infeção/Prescrição Antibiótica e de Imunossupressão/Risco Infecioso tivessem estágios obrigatórios, por 84,9% e 65,8% dos participantes, respetivamente. A maioria (67,1%) dos inquiridos considerou prejudicial a realização de urgência externa de Medicina Interna para além do respetivo estágio, sendo que 84,6% dos participantes da ARS Norte realizaram esta atividade apenas durante o 1.º ano, em contraste com 86,8% da ARS LVT cuja atividade se prolongou pelo menos até ao 4.º ano. No que concerne à produção assistencial e científica, comparativamente aos médicos internos da ARS LVT, os da ARS Norte reportaram, em média, um maior número de consultas assistidas (21,7/17,1) e realizadas (20,8/17,7), semanalmente, assim como um maior número de participações (3,7/3,1) e apresentações (2,8/2,4) anuais em eventos científicos, artigos publicados (1,1/0,6) e horas de estudo semanais (7,4/4,5). As principais dificuldades reportadas foram a ausência de tempo de estudo dedicado no horário, a atualização científica e a realização de Urgência Externa de Medicina Interna. Sobre a avaliação do internato, apenas 2,7% concordaram totalmente com o modelo de exame atual e 1,37% com a grelha curricular atual. A maioria (64,4%) dos participantes consideraram-se, pelo menos, satisfeitos com a especialidade. Conclusão: Os resultados sugerem uma necessidade de rever o programa formativo, incluir novas áreas de especialização e discutir os modelos de avaliação ao longo do Internato. Verificam-se assimetrias regionais ao nível do exercício de funções em contexto de urgência externa de Medicina Interna e da produção assistencial e científica, o que condiciona a equidade e qualidade da formação. A discussão da formação em Doenças Infeciosas é crucial para a adaptação do programa formativo aos desafios atuais e futuros.
Entry Date(s):	Date Created: 20251013 Date Completed: 20251207 Latest Revision: 20251207
Update Code:	20251207
DOI:	10.20344/amp.23187
PMID:	41081678
Datenbank:	MEDLINE

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Abstract:	Introduction: The World Health Organization identified 13 critical threats to global health for the coming decade, including infectious disease prevention and antimicrobial resistance. Given the ongoing advancements in scientific evidence, it is imperative to discuss the Infectious Diseases training program. The aim of this study was to characterize and explore the respondents' perceptions regarding Infectious Diseases training and the clinical learning environment.<br />Methods: A survey was developed to assess the clinical learning environment, targeting residents and young specialists who completed their training within the past five years.<br />Results: The questionnaire received 73 responses, 75.3% from residents. Most respondents agreed with the duration of Internal Medicine (83.5%), Microbiology (76.7%), and General Infectious Diseases (71.2%) rotations, but considered that the Intensive Care rotation should last less than six months. The areas of Infection Control/Antibiotic Stewardship and Immunosuppression/Infectious Risk were suggested as mandatory rotations by 84.9% and 65.8% of participants, respectively. Most respondents (67.1%) considered prolonged Internal Medicine Emergency rotations beyond the first year detrimental. In contrast, 84.6% of ARS Norte participants only performed this activity during the first year, whereas 86.8% of ARS LVT participants continued, at least, until the fourth year. Regarding clinical and scientific output, ARS Norte interns reported, on average, higher numbers of weekly assisted (21.7 vs 17.1) and performed (20.8 vs 17.7) appointments, as well as higher annual participation (3.7 vs 3.1) and presentations (2.8 vs 2.4) in scientific events, published articles (1.1 vs 0.6), and weekly study hours (7.4 vs 4.5), compared with ARS LVT. The main challenges reported were a lack of dedicated study time during working hours, scientific updates, and clinical practice in Internal Medicine Emergency rotations. Regarding the evaluation of the residency program, only 2.7% agreed completely with the current exam model and 1.37% with the current curriculum grid. The majority (64.4%) of participants considered themselves at least satisfied with the specialty.<br />Conclusion: The results suggest a need to review the Infectious Diseases training program, include new areas of specialization, and discuss evaluation models throughout residency. Regional asymmetries were observed in emergency work, clinical and scientific output, which affect the equity and quality of training. Discussion of the Infectious Diseases training program is crucial for adapting the curriculum to current and future challenges.
ISSN:	1646-0758
DOI:	10.20344/amp.23187