The aim of the current study is to evaluate OSCE (Objective Structured Clinical Examination) stations elaborated to asses competencies of external students on the 5th year of Social Medicine internship at the Faculty of Medicine of Monastir, in Tunisia, carried out over a year. The total number of OSCE stations was 32 with an average of 5.3 ± 2.3 stations per session, each station lasting five minutes. More than half of OSCE stations were a clinical vignette type (68.7%), followed by photo-type stations in 8 cases (25%). The total number of tasks required was 76. The number of stations about a single task was 18.75%. More than two-thirds of tasks involved competencies of cognitive level type III (72.1%). The number of elements per correction grid varied between 4 and 10 with an average of 6.44 ± 1.8 elements. At the end of the different examination sessions, the success rate was low (15-19 / 30) for 61% of learners with a discrimination index -0.41 and a difficulty index of tests 66%. These results attest the feasibility of OSCE stations for evaluation of skills in medical specialty. However, a regular and more thorough evaluation of this method is necessary in order to promote skills of future general practitioner.
Purpose of the work: To assess the impact of fixed night shift on the vigilance of paramedical staff. Methods: The present study is an exhaustive cross-sectional survey which has been conducted at the University Hospital of Monastir, Tunisia, and it is about 92 care agents working permanently the night. The study of vigilance is based on Epworth scale and Super Lab program. Results: The average age was equal to 42.53 ± 9.45 years with a sex ratio of 1.72. Nurses accounted for 72%. The average score of alertness assessed with Epworth scale was equal to 14.5 ± 6. The use of the Super Lab software has objectified a tendency towards the increase in the average time of reaction of accomplishment of the simple task and the positive cueing task, which was evaluated while starting the shift, during the half time of the work and at the end of the shift. In addition, the average rate of errors evaluated at the beginning, half-time and at the end of the work has increased during 3 tests (simple task, positive and negative cueing tasks) without this difference being statistically significant. Conclusion: The alteration of vigilance with an ascent of the error rate among fixed night shift workers is a reality, which puts in question, not only the health of paramedical staff but also the care safety provided by these teams.
L’objectif de notre travail était d’étudier les conséquences socioprofessionnelles d’une libération chirurgicale du SCC. Il s’agit d’une étude transversale portant sur les sujets opérés pour un SCC d’origine professionnelle ; recensés dans le Service de Médecine de Travail et de Pathologies Professionnelles au CHU Tahar Sfar de Mahdia en Tunisie sur une période de 8 ans allant du 1 Janvier 2006 au mois Décembre 2013. Le recueil des données s’est basé sur une fiche d’enquête, portant sur la description des caractéristiques socioprofessionnelles, médicales, et sur le devenir professionnel des participants. Pour étudier les contraintes psychosociales au travail, nous avons adopté le questionnaire de Karasek. La durée d’arrêt de travail après libération chirurgicale du SCC était significativement liée à l’existence d’autres troubles musculo-squelettiques autre que le SCC, la déclaration du SCC en maladie professionnelle et à l’ancienneté professionnelle des salariés. Quant au devenir professionnel des salariés opérés, 50,7% ont gardé le même poste, 15,3% ont bénéficié d’un aménagement de poste et 33,8% ont bénéficié d’un changement de poste dans la même entreprise. Le devenir professionnel de ces salariés était corrélé à leurs qualifications professionnelles et au type de l’atteinte sensitive et/ou motrice du nerf médian à l’EMG. Un certain nombre de facteurs non lésionnels déterminaient la durée de l’arrêt de travail, alors que le devenir professionnel des opérés pour SCC dépendait essentiellement de leurs qualifications professionnelles et des données de l’électromyogramme. Il est certain que des travaux beaucoup plus larges permettraient d’affiner encore ces résultats.
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