From Classroom to Action Training of New Staff in a New Specialty Hospital of a Non-Profit Organization

From Classroom to Action Training of New Staff in a New Specialty Hospital of a Non-Profit Organization | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Method Article From Classroom to Action Training of New Staff in a New Specialty Hospital of a Non-Profit Organization Luis Alberto Camputaro, Romina Georgina Bórtoli, Jose Luis Tamayo Ortiz, and 3 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-5367393/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract For the proper functioning of any health institution, it is necessary to unify and/or standardize the knowledge of its staff to achieve smooth teamwork, sharing the same language and criteria. This is even more necessary in health care work to provide the best patient care through an organized interdisciplinary team. Training in competencies, prioritizing the acquisition of practical skills while fostering theoretical self-education, has proven effective for health staff training, improving patient care. Acquiring the skills to detect life-threatening health conditions and their correct treatment and understanding the risk factors for unfavorable evolution are essential to provide timely treatment and avoid complications. Proper training is particularly relevant when a non-governmental hospital institution opens its doors and inaugurates its services to a specific community in the country's interior. To prepare staff for this new Non-Profit Organization (NPO) initiative, a hybrid training course that includes online theoretical classes and hands-on practical workshops was planned to train all the medical and paramedical staff of a new Specialty Hospital. Hospital Medicine Competency-Based Training Patient-Centered Care Healthcare Professionals Hospital Preparedness Interdisciplinary Teamwork Figures Figure 1 Figure 2 1. INTRODUCTION The Health System in the 21st Century [ 1 ] A resilient health system (RHS) is essential to ensure universal health coverage (UHC) and health security, as it allows the health system to prepare, respond, adapt, and transform in the face of severe crises. The United Nations (UN), through the Sustainable Development Goals (SDGs), has set the goal of achieving UHC by 2030, ensuring access to essential health services without financial hardship. UHC and health security are interconnected goals requiring robust multisectoral health systems. Strengthening the six pillars of the WHO health system (service delivery, health workforce, information systems, financing, leadership, and access to medicines) is crucial to achieving UHC and health security. The WHO European Region emphasizes preparedness for infectious diseases, disasters, and complex emergencies, considering future challenges such as climate change. Initiatives like the Global Health Security Agenda (GHSA) and One Health aim to improve the implementation of the International Health Regulations (IHR), which focus on preventing, detecting, and responding to international diseases. However, low- and middle-income countries progress slowly toward UHC due to outdated health systems. The COVID-19 pandemic has highlighted the need for a strong RHS and exposed the vulnerabilities of the current global health architecture, underscoring the importance of effective strategies to improve health system resilience and UHC during crises. An NPO with High Social Projection The Ágape Association of El Salvador was established on March 4, 1978, by Father Flavian Mucci, a Franciscan priest who has resided in El Salvador since 1967, with the mission of assisting the most vulnerable people in society through the charisma of his work. The Ágape Association of El Salvador is an entity dedicated to human development that implements care programs combined with productive projects or activities, thereby generating resources for its sustainability. This philosophy has allowed the Association to endure over time and increase its social impact. It has also served as a model for many national and international organizations in implementing projects. AGAPE and Community Health The San Francisco de Asís Clinic was founded in 1985 in Ágape in Sonzanate city, starting to provide medical care to low-income people, mainly from rural areas of Sonsonate, Ahuachapán, and La Libertad [ 3 ]. In 1990, the Clinical Laboratory was created, and in 1993, the Dental Clinic. High demand led to the construction of new facilities in 1993. In 1996, ophthalmology consultations were offered, increasing in frequency until they became daily, and in 1999, the first cataract surgeries were performed. The Visual Clinic, a regional ophthalmological referral center, was inaugurated in 2001. In 2004 and 2008, the facilities were expanded, integrating dental services, a clinical laboratory, and bone densitometry. In 2011 and 2012, psychology and cardiology services were initiated, respectively, and in 2013, physiotherapy was added, completing a wide range of medical and specialized services. AGAPE and Elderly Health In November 1985, the “Peace and Good” Nursing Home was founded at the Agape facilities in Sonzonate. Its initiative was to continue helping the elderly and complement the care provided in the “Open Dining Room” program since 1978. It began with the care of 15 elderly men and women, and over time, the population has increased to almost 100 adults. The "San Francisco de Asís" Nursing Home was established in Sonsonate between 2012 and 2013. It focuses on caring for older adults who require comprehensive care from highly trained staff and a multidisciplinary medical team to cover the residents' medical and physical needs [ 4 ]. As an NGO, its goal is to continue working on its commitment to the community. On May 2, 2016, the "San Francisco de Asís" residence opened in San Salvador, which could accommodate ten permanent residents or provide day care services as needed. AGAPE is deeply committed and responsible for collaborating with needy families and earning their trust as they care for their loved ones. Specialized Hospital “Fray Flavian Mucci” With a solid commitment to community care, the design and construction of the Specialized Hospital “Fray Flavian Mucci” began in 2023 to complete the healthcare mission for the community; it will open its doors on Monday, April 4, 2024. Its design includes an emergency area, seven general inpatient beds, three intensive care beds, a clinical analysis laboratory, a pharmacy, and an operating room. Thanks to an agreement with the private ambulance system (Fast Care®), a high-complexity ambulance transfer service is available 24 hours a day, 7 days a week. Preparation of Medical and Paramedical Staff The New Doctors of the 21st Century To ensure that medical care fulfills its assigned role in the future health system, the physician should have the necessary professional competencies (knowledge, skills, and attitudes) to carry out their tasks and maintain continuous improvement in efficiency and quality. Acute care aims to ensure continuity of medical care, minimize risks during care transitions (emergencies, intensive care, general ward), and ensure compliance with care standards for patients who, due to their clinical condition, must be hospitalized ("acute hospitalized patients"[ 5 ]) within the hospital's organizational design. This concept involves integrating emergency units, multipurpose acute hospitalization, and critical care within the same care process. This continuity of care is one of the most important challenges in healthcare. It would be the responsibility of a professional with a comprehensive and holistic vision of medical care and clinical management skills based on value. Although the internist is generally considered the best-prepared professional to assume this role, a trained general practitioner could perform it adequately. The principle of "continuity as a norm" is one of the pillars of the new model proposed by the Royal College of Physicians in its "Future Hospital" report [ 6 ]. The dimensions of "comprehensiveness and continuity" characterize the most recognized scope of action in Medicine. 2. MATERIALS AND METHODS A training strategy was chosen based on an intensive hybrid course to train all personnel in a short time. Some examples of these training strategies include the Fundamental Critical Care Support (FCCS - Society of Critical Care Medicine), the Advanced Trauma Life Support (ATLS - American College of Surgeons), Advanced Cardiovascular Life Support (ACLS - American Heart Association), and Emergency Neurological Life Support (ENLS - Neurocritical Care Society). This competency-based approach aimed to provide essential knowledge and specific job skills and motivate students to continue their training. Course Design A "de novo" course was designed based on a synchronous workshop strategy to train competencies tailored to Hospital Fray Flavian Mucci's specific needs, always focusing on "training professionals from practice to theory." Strategy for Course Implementation The medical and paramedical staff performing functions at the new Hospital comprised 35 resources. During the first week, a diagnostic process was carried out, which included: Interviews with the Medical and Paramedical staff who would begin their duties in the new Hospital to identify any training requirements. Design of practical face-to-face workshops for training skills and attitudes. These workshops were based on the experience gained from training staff at Hospital El Salvador during the COVID-19 Pandemic[ 7 ] for treating critically ill patients. Thus, the Foundations in Emergency Medicine Course was designed, entirely original in its design and tailored to the needs identified in the care of future patients. The course, conceptually designed for continuity in patient-centered care, aimed at the following objectives: Knowing how to classify patients according to their severity (triage). Knowing the admission criteria for general hospitalization and critical care. Correctly recognizing and evaluating a patient with respiratory failure. Knowing the treatment of a patient with respiratory failure. Correctly recognizing and evaluating a patient with a cardiological emergency. Knowing the treatment of a patient with a cardiological emergency. Correctly recognizing and evaluating a patient with an infectious emergency. Knowing the treatment of a patient with an infectious emergency. Correctly recognizing and evaluating a patient with a neurological emergency. Knowing the treatment of a patient with a neurological emergency. Knowing how to perform the evaluation of a polytraumatized patient. Detecting a patient with hemodynamic instability. Establishing the consciousness state of a patient. Acquiring the ability to perform basic and advanced CPR. Acquiring the skill for artificial airway management. Performing the initial programming of a mechanical ventilator. Knowing the indication and preparation of basic drugs. Acquiring the skill for the correct management of infusion pumps. To achieve these objectives, 4 online meetings with 3 half-hour theoretical classes were scheduled, covering the topics listed in Table 1 . Table 1 Course Outline for Introduction to Emergency Medicine Meeting 1 Admission criteria Patient acceptance criteria How to perform triage Meeting 2 Respiratory emergencies Cardiological emergencies Infectious emergencies Meeting 3 Neurological emergencies Evaluation of a polytraumatized patient Detection of a patient with hemodynamic instability Meeting 4 Vital signs control and warning signs Establishing the consciousness state of a patient Questions and doubts This was supplemented with two 4-hour workshops. Groups of 5 to 7 students per workshop were defined, and each group rotated every 50 minutes so that 100% of participants went through each workshop in small groups. See Table 2 . Table 2 Workshops. Conceptual Content WORKSHOP (Respiratory Therapist Instructor) Airway management. Artificial ventilatory support systems: Venturi mask, high-flow reservoir, endotracheal tube. Calculating PaO2/FiO2. Reading pulse oximetry. Time to declare “failure” of ventilatory strategy. Evaluation of artificial airway: High Flow Venturi, CPAP, endotracheal tube. WORKSHOP (Nursing Instructor) Pharmacology Workshop Intravenous drug use. Forms of presentation. Forms of dilution. Forms of administration: bolus dose, continuous infusion. Infusion calculation in mg/kg. Using an infusion pump. WORKSHOP (MD Instructor) Hemodynamic and Cardiopulmonary Resuscitation Concept of Shock. Fluid resuscitation types Drug resuscitation. Fundamentals Detection of life-threatening rhythms. Systematic implementation in Cardiac Arrest (CPR). Sequence of drugs to use. Number of operators. Duration of CPR DNR concept (Do Not Resuscitate) WORKSHOP (Intensivist MD Instructor) Mechanical Ventilatory Assistance Artificial respirator: turning on, programming, how to read alarms. Concept of adaptation and maladaptation. Ventilation with PEEP Arterial blood gases Prone positioning Care during transportation The workshops employed a "coach teacher"[ 8 ] strategy to encourage learning and the desire to continue training. The workshop coordinator welcomed both sessions, reinforcing the concept of transdisciplinary teamwork with patient-centered care, and concluded the sessions by highlighting the achievements obtained by the participants. Course Evaluation To assess the course's effectiveness, the following actions were carried out: Evaluation of its utility : An analog-visual survey of knowledge perception "before and after" was developed. The students completed this survey, which analyzed different domains (Table 3 ) and identified areas for improvement in care using a scale from 0 to 10 before and after the course. The survey was conducted online, maintaining participants' anonymity and allowing real-time recording of responses, centralizing them and reducing the risk of data loss and recording errors. Statistical Analysis : After converting the variables into numbers from the "before and after" test, measures of central tendency (mean) and dispersion (standard deviation) were calculated. An exploratory analysis of all variables was conducted to determine their normality and decide on the appropriate statistical processing (parametric or non-parametric); the Mann-Whitney U test was applied. Statistical significance was defined as p < .05. Safeguarding the confidentiality of participants . The tests were sent and processed in digital format without maintaining the identification of the respondents. Table 3 Domains Evaluated in Pre-Post Test SCORE (0–10) 1 Artificial Airway Has knowledge about Venturi mask management Has knowledge about reservoir mask management Has knowledge about laryngeal mask Has knowledge about Orotracheal Intubation 2 Mechanical Respiratory Assistance Has knowledge about artificial respirator management 3 Cardiology Has knowledge about cardiopulmonary resuscitation Has knowledge about arrhythmia detection 4 Pharmacology Has knowledge about the use of titratable intravenous drugs Has knowledge about the use of infusion pumps 5 Hemodynamics Has knowledge about shock resuscitation with fluids Has knowledge about shock resuscitation with drugs 3. RESULTS From January 10 to February 10, 2024, 34 professionals (100% of those who would start working at the Specialty Hospital) were trained. Of the 34 professionals trained, 30.3% were physicians, and 69.7% were licensed nurses. The gender distribution was 73.8% women and 26.2% men, with a mean age of 30.43 ± 4.12 years, ranging from 24 to 45 years. This range indicates a heterogeneous sample in age and experience, potentially improving learning perception outcomes due to the seniors' more significant experience. At the organizational level, longevity transforms the workforce and how we think about talent. A diverse age workforce is promoted, as it fosters stability and drives innovation and proactivity [ 9 ]. The mean years since graduation were 4.84 ± 3.44 years. This aspect, along with the diversity of ages, may have stimulated new learning for seniors and juniors and the sharing of the lessons learned from seniors. The comparative analysis of the before-and-after test showed significant differences in particular aspects: artificial airway (use of laryngeal mask and orotracheal intubation), respiratory (mechanical ventilatory assistance), and hemodynamics (use of fluids and drugs in shock). See Table 4 . Table 4 Pre-Post Test Results ITEM CHARACTERISTICS MEAN DST p Pre (n = 32) Post (n = 35) Pre (n = 32) Post (n = 35) 1 Artificial Airway Has knowledge about Venturi mask management 6.77 7.62 2.79 1.61 0,4 Has knowledge about reservoir mask management 7.28 7.71 2.46 1.75 0.6 Has knowledge of laryngeal mask 3.48 6.00 2.93 2.70 0,01 Has knowledge of Orotracheal Intubation 3.53 6.29 2.99 2.49 0,003 2 Mechanical Respiratory Assistance Has knowledge about artificial respirator management 3.58 6.03 2.86 2.58 0,0004 3 Cardiology Has knowledge about cardiopulmonary resuscitation 6.35 7.44 2.33 1.58 0,06 Has knowledge about arrhythmia detection 4.65 5.94 2.26 1.84 0,02 4 Pharmacology Has knowledge of the use of titratable intravenous drugs 6.23 7.35 2.53 2.20 0,06 Has knowledge of the use of infusion pumps 6.90 8.53 2.59 1.76 0,006 5 Hemodynamics Has knowledge for shock resuscitation with fluids 5.15 7.47 2.49 1.71 0,0001 Has knowledge for shock resuscitation with drugs 5.06 6.76 2.67 1.94 0,009 DISCUSSION The results obtained in this study reflect the effectiveness of competency-based and patient-centered training in improving the knowledge and clinical skills of healthcare professionals in a new hospital. A "before and after" analog-visual survey allowed for a precise and direct evaluation of the participant's perception of their learning. The data indicate that after the training, professionals feel better prepared to handle complex clinical situations, which is crucial in a high-demand hospital environment. This type of evaluation tool also facilitated real-time data collection and analysis, reducing errors and improving the efficiency of the training process. The demographic distribution of the participants, with 73.8% women and an average age of 30.43 years, reflects the current composition of the workforce in many health institutions. The variability in experience, with an average of 4.84 years since graduation, suggests that interaction between professionals with different experience levels can contribute to an enriching learning environment. Diversity in experience and age in work teams promotes knowledge sharing, improves decision-making, and fosters a culture of continuous learning. At the organizational level, competency-based training prepares professionals to face immediate clinical challenges and encourages continuous learning and development. Integrating medical and nursing professionals with different backgrounds and experience levels in a shared training environment is essential for building a united and competent team in a newly established hospital. Our study has some limitations, mainly due to the sample size, which, although it includes all the initial hospital staff, is too small to extrapolate the results to other institutions. On the other hand, the evaluation tool used — perception of competence — does not always directly translate into the acquisition of effective clinical competencies. It is necessary to conduct a longitudinal follow-up and further objective evaluations of clinical performance once hospital activity has begun. This training strategy has proven useful for training health professionals and can be adapted to the specific needs of each place or institution. In this case, the hospital has an ICU, making it crucial to acquire knowledge in critical conditions such as artificial airway management, mechanical ventilatory assistance, and hemodynamic monitoring in shock. The significant improvement in these areas underscores the relevance of initial training for clinical teams facing critical situations daily at Hospital Fray Flavian Mucci. Conclusions Implementing a competency-based training program for a hospital's medical staff about to start its activities has proven effective in improving knowledge and critical skills for patient care. Despite being a heterogeneous group in terms of profession, age, and years of experience, the analog-visual survey showed an increase in perceived knowledge of all the evaluated competencies, with statistically significant improvements in more specialized areas such as artificial airway management, mechanical ventilatory assistance, and hemodynamic assessment in shock situations. The results obtained in this evaluation highlight the usefulness of competency-based and patient-centered training as a valid tool for preparing health professionals in new and complex hospital settings. Declarations The authorities of AGAPE Health Services granted a Waiver for Informed Consent to the institution's participating staff since the data used in this protocol do not contain identifiable information and are completely anonymous. FUNDING STATEMENT This study did not receive public or private contributions. ACKNOWLEDGMENTS In Memoriam Fray Jack W. Hoak O.F.M. Tireless promoter of the ideas of Fray Flavian Mucci. Tireless collaborator in the execution and start-up of the "Fray Flavian Mucchi" Specialty Hospital We want to thank the Authorities of AGAPE El Salvador, specifically Eng. Ramón Alberto Vega Calvo, Executive Director of Agape, for his collaboration in developing this investigation. CONSENT FOR PUBLICATION All authors know and agree to the paper's content and will be listed as co-authors. COMPETING INTERESTS The authors declare that they have no competing interests. 324 AUTHORS’ CONTRIBUTIONS LAC wrote the manuscript, LAC RGB JLTO AQT Design the study. RGB JLTO AQT Field work Programming in Hospital LMCR Field data collection LMCR MCAG conceived the final approval of the version to be submitted. All authors have read and approved the final manuscript. References Debie A, Nigusie A, Gedle D, Khatri RB, Assefa Y (2024) Building a resilient health system for universal health coverage and health security: a systematic review. Glob Health Res Policy 4(1):2. 10.1186/s41256-023-00340-z PMID: 38173020; PMCID: PMC10765832 AGAPE El Salvador Available in: https://agapesv.com/home-1/ Clínica San Francisco de Asís (San Francisco de Asis Clinic). Available in: https://clinica.agapesv.com/historia.php Hogar de Ancianos San Francisco de Asis (St. Francis of Assisi Nursing Home). Available in: https://hogar.agapesv.com/nosotros.php Eddleston J, Goldhill D, Morris J, on behalf of the Council of the Intensive Care Society (2009). Levels of Critical Care for Adult Patients. Intensive Care Society. Available inn: http://www.ics.ac.uk/ICS/guidelines-and-standards Future Hospital Commission (2013) Future hospital: caring for medical patients. A report from the Future Hospital Commission to the Royal College of Physicians. Royal College of Physicians, London Camputaro LA, Bello Quezada ME, Hoyos Arango WA, Bortoli RG, Ruiz Zelaya FA, Diaz Moreno MM, Delgado Delgado JM, Márquez Magaña MS, Vigne Cuellar PA, Sanchez MI (2021) Intensive competency-based training strategy in a National Hospital in times of Pandemic. Med (Baltim) 100(39):e27152 Pérez Guerra Y, Reyes Fonseca AL, de la Matos Vítores H (2019) C, de la Guardia Casate AL. Coaching. Importancia del docente-coach. 2011 Multimed 23(2):364–374 El valor de la diversidad de edad en el lugar de trabajo (The value of age diversity in the workplace). Available in: https://www.aarp.org/espanol/trabajo/exito-laboral/info-2020/valor-diversidad-de-edad Additional Declarations The authors declare no competing interests. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-5367393","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Method Article","associatedPublications":[],"authors":[{"id":375428940,"identity":"ef7c44e1-c560-4777-8467-92e79ffc918a","order_by":0,"name":"Luis Alberto Camputaro","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA9UlEQVRIiWNgGAWjYBACPgbGBmS+DRAzNh7Ap4UNoYUZRKSBtDQQ0AIHYC2HwUz8WiSSmz8w1NhFm0vkH/xcUXHebm37YaAtNTbRuLUktkkwHEvO3TkjmVnyzJnbydvOJAK1HEvLbcCjBeh45twNN5IZJBvbbiebHQBqYWw4jE9L8wfGhnqQFuafjW3nks3OPySopUECpACohQ1oywE7sxuEbOF52CaRcOx47s6ex2aWDWeSE8xuAG1JwOMXfvb0xx8+1FTnbmdPfHyzocLO3ux8+sMHH2pscGoBgwQgNoCyExtgIgQBTIs9MYpHwSgYBaNgZAEAuxZh5ClstFcAAAAASUVORK5CYII=","orcid":"https://orcid.org/0000-0003-0291-0190","institution":"","correspondingAuthor":true,"prefix":"","firstName":"Luis","middleName":"Alberto","lastName":"Camputaro","suffix":""},{"id":375428941,"identity":"1b355158-2438-4b7a-9cfc-96ad92778962","order_by":1,"name":"Romina Georgina Bórtoli","email":"","orcid":"","institution":"","correspondingAuthor":false,"prefix":"","firstName":"Romina","middleName":"Georgina","lastName":"Bórtoli","suffix":""},{"id":375428942,"identity":"8a798c2b-790b-4a2f-a89c-cabcb17a97ba","order_by":2,"name":"Jose Luis Tamayo Ortiz","email":"","orcid":"","institution":"","correspondingAuthor":false,"prefix":"","firstName":"Jose","middleName":"Luis Tamayo","lastName":"Ortiz","suffix":""},{"id":375428943,"identity":"e0ec5265-ee28-479b-9305-6ac13d757a6f","order_by":3,"name":"Alfonso Quispe Torrez","email":"","orcid":"","institution":"","correspondingAuthor":false,"prefix":"","firstName":"Alfonso","middleName":"Quispe","lastName":"Torrez","suffix":""},{"id":375428944,"identity":"1a2273ed-1e66-41a2-8ad9-11b242fd2bdb","order_by":4,"name":"Luis Mario Campos Rosales","email":"","orcid":"","institution":"AGAPE El Salvador","correspondingAuthor":false,"prefix":"","firstName":"Luis","middleName":"Mario Campos","lastName":"Rosales","suffix":""},{"id":375428945,"identity":"4ff3c87a-0f9b-48fb-84ec-40b9cbe90801","order_by":5,"name":"Mirian del Carmen Avalos Garcia","email":"","orcid":"","institution":"AGAPE El Salvador","correspondingAuthor":false,"prefix":"","firstName":"Mirian","middleName":"del Carmen Avalos","lastName":"Garcia","suffix":""}],"badges":[],"createdAt":"2024-10-31 12:54:22","currentVersionCode":1,"declarations":{"humanSubjects":true,"vertebrateSubjects":false,"conflictsOfInterestStatement":false,"humanSubjectEthicalGuidelines":true,"humanSubjectConsent":true,"humanSubjectClinicalTrial":false,"humanSubjectCaseReport":false,"vertebrateSubjectEthicalGuidelines":false},"doi":"10.21203/rs.3.rs-5367393/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-5367393/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":68885341,"identity":"277e0274-40eb-4c5c-9fa9-a2709838a15d","added_by":"auto","created_at":"2024-11-13 06:37:20","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":8532,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eProfession Distribution\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-5367393/v1/201c5a1c960f71fa71dfa980.png"},{"id":68885343,"identity":"f05fb964-bfbf-4a2f-8148-48fd8c6b31ef","added_by":"auto","created_at":"2024-11-13 06:37:20","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":9909,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eGender Distribution\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-5367393/v1/d63ad13e2e231320bfe372ad.png"},{"id":68886880,"identity":"91096e6d-fe08-42fc-a75e-e03c95e9eaca","added_by":"auto","created_at":"2024-11-13 06:45:20","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":686659,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-5367393/v1/7beadd1b-fc5c-44c1-a06e-442a8f3f26f4.pdf"}],"financialInterests":"The authors declare no competing interests.","formattedTitle":"\u003cp\u003e\u003cstrong\u003eFrom Classroom to Action Training of New Staff in a New Specialty Hospital of a Non-Profit Organization\u003c/strong\u003e\u003c/p\u003e","fulltext":[{"header":"1. INTRODUCTION","content":"\u003cp\u003e \u003cb\u003eThe Health System in the 21st Century\u003c/b\u003e [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]\u003c/p\u003e \u003cp\u003eA resilient health system (RHS) is essential to ensure universal health coverage (UHC) and health security, as it allows the health system to prepare, respond, adapt, and transform in the face of severe crises. The United Nations (UN), through the Sustainable Development Goals (SDGs), has set the goal of achieving UHC by 2030, ensuring access to essential health services without financial hardship. UHC and health security are interconnected goals requiring robust multisectoral health systems.\u003c/p\u003e \u003cp\u003eStrengthening the six pillars of the WHO health system (service delivery, health workforce, information systems, financing, leadership, and access to medicines) is crucial to achieving UHC and health security. The WHO European Region emphasizes preparedness for infectious diseases, disasters, and complex emergencies, considering future challenges such as climate change.\u003c/p\u003e \u003cp\u003eInitiatives like the Global Health Security Agenda (GHSA) and One Health aim to improve the implementation of the International Health Regulations (IHR), which focus on preventing, detecting, and responding to international diseases. However, low- and middle-income countries progress slowly toward UHC due to outdated health systems. The COVID-19 pandemic has highlighted the need for a strong RHS and exposed the vulnerabilities of the current global health architecture, underscoring the importance of effective strategies to improve health system resilience and UHC during crises.\u003c/p\u003e \u003cp\u003e \u003cb\u003eAn NPO with High Social Projection\u003c/b\u003e \u003c/p\u003e \u003cp\u003eThe \u0026Aacute;gape Association of El Salvador was established on March 4, 1978, by Father Flavian Mucci, a Franciscan priest who has resided in El Salvador since 1967, with the mission of assisting the most vulnerable people in society through the charisma of his work.\u003c/p\u003e \u003cp\u003eThe \u0026Aacute;gape Association of El Salvador is an entity dedicated to human development that implements care programs combined with productive projects or activities, thereby generating resources for its sustainability. This philosophy has allowed the Association to endure over time and increase its social impact. It has also served as a model for many national and international organizations in implementing projects.\u003c/p\u003e \u003cp\u003e \u003cb\u003eAGAPE and Community Health\u003c/b\u003e \u003c/p\u003e \u003cp\u003eThe San Francisco de As\u0026iacute;s Clinic was founded in 1985 in \u0026Aacute;gape in Sonzanate city, starting to provide medical care to low-income people, mainly from rural areas of Sonsonate, Ahuachap\u0026aacute;n, and La Libertad [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. In 1990, the Clinical Laboratory was created, and in 1993, the Dental Clinic. High demand led to the construction of new facilities in 1993. In 1996, ophthalmology consultations were offered, increasing in frequency until they became daily, and in 1999, the first cataract surgeries were performed. The Visual Clinic, a regional ophthalmological referral center, was inaugurated in 2001. In 2004 and 2008, the facilities were expanded, integrating dental services, a clinical laboratory, and bone densitometry. In 2011 and 2012, psychology and cardiology services were initiated, respectively, and in 2013, physiotherapy was added, completing a wide range of medical and specialized services.\u003c/p\u003e \u003cp\u003e \u003cb\u003eAGAPE and Elderly Health\u003c/b\u003e \u003c/p\u003e \u003cp\u003e \u003cem\u003eIn November 1985, the \u0026ldquo;Peace and Good\u0026rdquo; Nursing Home was founded at the Agape facilities in Sonzonate. Its initiative was to continue helping the elderly and complement the care provided in the \u0026ldquo;Open Dining Room\u0026rdquo; program since 1978. It began with the care of 15 elderly men and women, and over time, the population has increased to almost 100 adults.\u003c/em\u003e \u003c/p\u003e \u003cp\u003eThe \"San Francisco de As\u0026iacute;s\" Nursing Home was established in Sonsonate between 2012 and 2013. It focuses on caring for older adults who require comprehensive care from highly trained staff and a multidisciplinary medical team to cover the residents' medical and physical needs [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eAs an NGO, its goal is to continue working on its commitment to the community. On May 2, 2016, the \"San Francisco de As\u0026iacute;s\" residence opened in San Salvador, which could accommodate ten permanent residents or provide day care services as needed.\u003c/p\u003e \u003cp\u003eAGAPE is deeply committed and responsible for collaborating with needy families and earning their trust as they care for their loved ones.\u003c/p\u003e \u003cp\u003e \u003cb\u003eSpecialized Hospital \u0026ldquo;Fray Flavian Mucci\u0026rdquo;\u003c/b\u003e \u003c/p\u003e \u003cp\u003e With a solid commitment to community care, the design and construction of the Specialized Hospital \u0026ldquo;Fray Flavian Mucci\u0026rdquo; began in 2023 to complete the healthcare mission for the community; it will open its doors on Monday, April 4, 2024. Its design includes an emergency area, seven general inpatient beds, three intensive care beds, a clinical analysis laboratory, a pharmacy, and an operating room. Thanks to an agreement with the private ambulance system (Fast Care\u0026reg;), a high-complexity ambulance transfer service is available 24 hours a day, 7 days a week.\u003c/p\u003e \u003cp\u003e \u003cb\u003ePreparation of Medical and Paramedical Staff\u003c/b\u003e \u003c/p\u003e \u003cp\u003e \u003cem\u003eThe New Doctors of the 21st Century\u003c/em\u003e \u003c/p\u003e \u003cp\u003eTo ensure that medical care fulfills its assigned role in the future health system, the physician should have the necessary professional competencies (knowledge, skills, and attitudes) to carry out their tasks and maintain continuous improvement in efficiency and quality.\u003c/p\u003e \u003cp\u003eAcute care aims to ensure continuity of medical care, minimize risks during care transitions (emergencies, intensive care, general ward), and ensure compliance with care standards for patients who, due to their clinical condition, must be hospitalized (\"acute hospitalized patients\"[\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]) within the hospital's organizational design. This concept involves integrating emergency units, multipurpose acute hospitalization, and critical care within the same care process.\u003c/p\u003e \u003cp\u003eThis continuity of care is one of the most important challenges in healthcare. It would be the responsibility of a professional with a comprehensive and holistic vision of medical care and clinical management skills based on value. Although the internist is generally considered the best-prepared professional to assume this role, a trained general practitioner could perform it adequately.\u003c/p\u003e \u003cp\u003eThe principle of \"continuity as a norm\" is one of the pillars of the new model proposed by the Royal College of Physicians in its \"Future Hospital\" report [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. The dimensions of \"comprehensiveness and continuity\" characterize the most recognized scope of action in Medicine.\u003c/p\u003e"},{"header":"2. MATERIALS AND METHODS","content":"\u003cp\u003eA training strategy was chosen based on an intensive hybrid course to train all personnel in a short time. Some examples of these training strategies include the Fundamental Critical Care Support (FCCS - Society of Critical Care Medicine), the Advanced Trauma Life Support (ATLS - American College of Surgeons), Advanced Cardiovascular Life Support (ACLS - American Heart Association), and Emergency Neurological Life Support (ENLS - Neurocritical Care Society).\u003c/p\u003e \u003cp\u003eThis competency-based approach aimed to provide essential knowledge and specific job skills and motivate students to continue their training.\u003c/p\u003e \u003cp\u003e \u003cb\u003eCourse Design\u003c/b\u003e \u003c/p\u003e \u003cp\u003eA \"de novo\" course was designed based on a synchronous workshop strategy to train competencies tailored to Hospital Fray Flavian Mucci's specific needs, always focusing on \"training professionals from practice to theory.\"\u003c/p\u003e \u003cp\u003e \u003cb\u003eStrategy for Course Implementation\u003c/b\u003e \u003c/p\u003e \u003cp\u003eThe medical and paramedical staff performing functions at the new Hospital comprised 35 resources.\u003c/p\u003e \u003cp\u003eDuring the first week, a diagnostic process was carried out, which included:\u003c/p\u003e \u003cp\u003e \u003col\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eInterviews with the Medical and Paramedical staff who would begin their duties in the new Hospital to identify any training requirements.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eDesign of practical face-to-face workshops for training skills and attitudes. These workshops were based on the experience gained from training staff at Hospital El Salvador during the COVID-19 Pandemic[\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e] for treating critically ill patients.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003c/ol\u003e \u003c/p\u003e \u003cp\u003eThus, the Foundations in Emergency Medicine Course was designed, entirely original in its design and tailored to the needs identified in the care of future patients.\u003c/p\u003e \u003cp\u003eThe course, conceptually designed for continuity in patient-centered care, aimed at the following objectives:\u003c/p\u003e \u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003eKnowing how to classify patients according to their severity (triage).\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eKnowing the admission criteria for general hospitalization and critical care.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eCorrectly recognizing and evaluating a patient with respiratory failure.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eKnowing the treatment of a patient with respiratory failure.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eCorrectly recognizing and evaluating a patient with a cardiological emergency.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eKnowing the treatment of a patient with a cardiological emergency.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eCorrectly recognizing and evaluating a patient with an infectious emergency.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eKnowing the treatment of a patient with an infectious emergency.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eCorrectly recognizing and evaluating a patient with a neurological emergency.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eKnowing the treatment of a patient with a neurological emergency.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eKnowing how to perform the evaluation of a polytraumatized patient.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eDetecting a patient with hemodynamic instability.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eEstablishing the consciousness state of a patient.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eAcquiring the ability to perform basic and advanced CPR.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eAcquiring the skill for artificial airway management.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003ePerforming the initial programming of a mechanical ventilator.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eKnowing the indication and preparation of basic drugs.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eAcquiring the skill for the correct management of infusion pumps.\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e \u003cp\u003eTo achieve these objectives, 4 online meetings with 3 half-hour theoretical classes were scheduled, covering the topics listed in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eCourse Outline for Introduction to Emergency Medicine\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"2\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eMeeting 1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAdmission criteria\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePatient acceptance criteria\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHow to perform triage\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u003cb\u003eMeeting 2\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRespiratory emergencies\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCardiological emergencies\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eInfectious emergencies\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u003cb\u003eMeeting 3\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNeurological emergencies\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eEvaluation of a polytraumatized patient\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDetection of a patient with hemodynamic instability\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u003cb\u003eMeeting 4\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eVital signs control and warning signs\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eEstablishing the consciousness state of a patient\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eQuestions and doubts\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eThis was supplemented with two 4-hour workshops. Groups of 5 to 7 students per workshop were defined, and each group rotated every 50 minutes so that 100% of participants went through each workshop in small groups. See Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eWorkshops. Conceptual Content\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"2\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWORKSHOP (Respiratory Therapist Instructor)\u003c/p\u003e \u003cp\u003eAirway management.\u003c/p\u003e \u003cp\u003eArtificial ventilatory support systems: Venturi mask, high-flow reservoir, endotracheal tube.\u003c/p\u003e \u003cp\u003eCalculating PaO2/FiO2.\u003c/p\u003e \u003cp\u003eReading pulse oximetry.\u003c/p\u003e \u003cp\u003eTime to declare \u0026ldquo;failure\u0026rdquo; of ventilatory strategy.\u003c/p\u003e \u003cp\u003eEvaluation of artificial airway: High Flow Venturi, CPAP, endotracheal tube.\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWORKSHOP (Nursing Instructor)\u003c/p\u003e \u003cp\u003ePharmacology Workshop\u003c/p\u003e \u003cp\u003eIntravenous drug use.\u003c/p\u003e \u003cp\u003eForms of presentation.\u003c/p\u003e \u003cp\u003eForms of dilution.\u003c/p\u003e \u003cp\u003eForms of administration: bolus dose, continuous infusion.\u003c/p\u003e \u003cp\u003eInfusion calculation in mg/kg. Using an infusion pump.\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eWORKSHOP (MD Instructor)\u003c/b\u003e\u003c/p\u003e \u003cp\u003eHemodynamic and Cardiopulmonary Resuscitation\u003c/p\u003e \u003cp\u003eConcept of Shock. Fluid resuscitation types\u003c/p\u003e \u003cp\u003eDrug resuscitation. Fundamentals\u003c/p\u003e \u003cp\u003eDetection of life-threatening rhythms. Systematic implementation in Cardiac Arrest (CPR).\u003c/p\u003e \u003cp\u003eSequence of drugs to use.\u003c/p\u003e \u003cp\u003eNumber of operators.\u003c/p\u003e \u003cp\u003eDuration of CPR\u003c/p\u003e \u003cp\u003eDNR concept (Do Not Resuscitate)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eWORKSHOP (Intensivist MD Instructor)\u003c/b\u003e\u003c/p\u003e \u003cp\u003eMechanical Ventilatory Assistance\u003c/p\u003e \u003cp\u003eArtificial respirator: turning on, programming, how to read alarms.\u003c/p\u003e \u003cp\u003eConcept of adaptation and maladaptation.\u003c/p\u003e \u003cp\u003eVentilation with PEEP\u003c/p\u003e \u003cp\u003eArterial blood gases\u003c/p\u003e \u003cp\u003eProne positioning\u003c/p\u003e \u003cp\u003eCare during transportation\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eThe workshops employed a \"coach teacher\"[\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e] strategy to encourage learning and the desire to continue training.\u003c/p\u003e \u003cp\u003eThe workshop coordinator welcomed both sessions, reinforcing the concept of transdisciplinary teamwork with patient-centered care, and concluded the sessions by highlighting the achievements obtained by the participants.\u003c/p\u003e \u003cp\u003e \u003cb\u003eCourse Evaluation\u003c/b\u003e \u003c/p\u003e \u003cp\u003eTo assess the course's effectiveness, the following actions were carried out:\u003c/p\u003e \u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003e \u003cem\u003eEvaluation of its utility\u003c/em\u003e: An analog-visual survey of knowledge perception \"before and after\" was developed. The students completed this survey, which analyzed different domains (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e) and identified areas for improvement in care using a scale from 0 to 10 before and after the course. The survey was conducted online, maintaining participants' anonymity and allowing real-time recording of responses, centralizing them and reducing the risk of data loss and recording errors.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003e \u003cem\u003eStatistical Analysis\u003c/em\u003e: After converting the variables into numbers from the \"before and after\" test, measures of central tendency (mean) and dispersion (standard deviation) were calculated. An exploratory analysis of all variables was conducted to determine their normality and decide on the appropriate statistical processing (parametric or non-parametric); the Mann-Whitney U test was applied. Statistical significance was defined as p\u0026thinsp;\u0026lt;\u0026thinsp;.05.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003e \u003cem\u003eSafeguarding the confidentiality of participants\u003c/em\u003e. The tests were sent and processed in digital format without maintaining the identification of the respondents.\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDomains Evaluated in Pre-Post Test\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eSCORE\u003c/p\u003e \u003cp\u003e(0\u0026ndash;10)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e\u003cb\u003e1\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eArtificial Airway\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eHas knowledge about Venturi mask management\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eHas knowledge about reservoir mask management\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eHas knowledge about laryngeal mask\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eHas knowledge about Orotracheal Intubation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003e2\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMechanical Respiratory Assistance\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eHas knowledge about artificial respirator management\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003e3\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eCardiology\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eHas knowledge about cardiopulmonary resuscitation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eHas knowledge about arrhythmia detection\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003e4\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003ePharmacology\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eHas knowledge about the use of titratable intravenous drugs\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eHas knowledge about the use of infusion pumps\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003e5\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eHemodynamics\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eHas knowledge about shock resuscitation with fluids\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eHas knowledge about shock resuscitation with drugs\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e"},{"header":"3. RESULTS","content":"\u003cp\u003eFrom January 10 to February 10, 2024, 34 professionals (100% of those who would start working at the Specialty Hospital) were trained.\u003c/p\u003e \u003cp\u003eOf the 34 professionals trained, 30.3% were physicians, and 69.7% were licensed nurses. The gender distribution was 73.8% women and 26.2% men, with a mean age of 30.43\u0026thinsp;\u0026plusmn;\u0026thinsp;4.12 years, ranging from 24 to 45 years.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eThis range indicates a heterogeneous sample in age and experience, potentially improving learning perception outcomes due to the seniors' more significant experience. At the organizational level, longevity transforms the workforce and how we think about talent. A diverse age workforce is promoted, as it fosters stability and drives innovation and proactivity [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe mean years since graduation were 4.84\u0026thinsp;\u0026plusmn;\u0026thinsp;3.44 years. This aspect, along with the diversity of ages, may have stimulated new learning for seniors and juniors and the sharing of the lessons learned from seniors.\u003c/p\u003e \u003cp\u003eThe comparative analysis of the before-and-after test showed significant differences in particular aspects: artificial airway (use of laryngeal mask and orotracheal intubation), respiratory (mechanical ventilatory assistance), and hemodynamics (use of fluids and drugs in shock). See Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003ePre-Post Test Results\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"8\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eITEM\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eCHARACTERISTICS\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003eMEAN\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003eDST\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003ep\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePre\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;32)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePost\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;35)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003ePre\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;32)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003ePost\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;35)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e\u003cb\u003e1\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eArtificial Airway\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eHas knowledge about Venturi mask management\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e6.77\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e7.62\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e2.79\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e1.61\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e0,4\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eHas knowledge about reservoir mask management\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e7.28\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e7.71\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e2.46\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e1.75\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e0.6\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eHas knowledge of laryngeal mask\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e3.48\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e6.00\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e2.93\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e2.70\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e0,01\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eHas knowledge of Orotracheal Intubation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e3.53\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e6.29\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e2.99\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e2.49\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e0,003\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003e2\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMechanical Respiratory Assistance\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eHas knowledge about artificial respirator management\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e3.58\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e6.03\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e2.86\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e2.58\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e0,0004\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003e3\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eCardiology\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eHas knowledge about cardiopulmonary resuscitation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e6.35\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e7.44\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e2.33\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e1.58\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e0,06\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eHas knowledge about arrhythmia detection\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e4.65\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e5.94\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e2.26\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e1.84\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e0,02\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003e4\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003ePharmacology\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eHas knowledge of the use of titratable intravenous drugs\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e6.23\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e7.35\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e2.53\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e2.20\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e0,06\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eHas knowledge of the use of infusion pumps\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e6.90\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e8.53\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e2.59\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e1.76\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e0,006\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003e5\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eHemodynamics\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eHas knowledge for shock resuscitation with fluids\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e5.15\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e7.47\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e2.49\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e1.71\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e0,0001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eHas knowledge for shock resuscitation with drugs\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e5.06\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e6.76\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e2.67\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e1.94\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003e0,009\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e"},{"header":"DISCUSSION","content":"\u003cp\u003eThe results obtained in this study reflect the effectiveness of competency-based and patient-centered training in improving the knowledge and clinical skills of healthcare professionals in a new hospital.\u003c/p\u003e \u003cp\u003eA \"before and after\" analog-visual survey allowed for a precise and direct evaluation of the participant's perception of their learning. The data indicate that after the training, professionals feel better prepared to handle complex clinical situations, which is crucial in a high-demand hospital environment. This type of evaluation tool also facilitated real-time data collection and analysis, reducing errors and improving the efficiency of the training process.\u003c/p\u003e \u003cp\u003eThe demographic distribution of the participants, with 73.8% women and an average age of 30.43 years, reflects the current composition of the workforce in many health institutions. The variability in experience, with an average of 4.84 years since graduation, suggests that interaction between professionals with different experience levels can contribute to an enriching learning environment. Diversity in experience and age in work teams promotes knowledge sharing, improves decision-making, and fosters a culture of continuous learning.\u003c/p\u003e \u003cp\u003eAt the organizational level, competency-based training prepares professionals to face immediate clinical challenges and encourages continuous learning and development. Integrating medical and nursing professionals with different backgrounds and experience levels in a shared training environment is essential for building a united and competent team in a newly established hospital.\u003c/p\u003e \u003cp\u003eOur study has some limitations, mainly due to the sample size, which, although it includes all the initial hospital staff, is too small to extrapolate the results to other institutions. On the other hand, the evaluation tool used \u0026mdash; perception of competence \u0026mdash; does not always directly translate into the acquisition of effective clinical competencies. It is necessary to conduct a longitudinal follow-up and further objective evaluations of clinical performance once hospital activity has begun.\u003c/p\u003e \u003cp\u003eThis training strategy has proven useful for training health professionals and can be adapted to the specific needs of each place or institution. In this case, the hospital has an ICU, making it crucial to acquire knowledge in critical conditions such as artificial airway management, mechanical ventilatory assistance, and hemodynamic monitoring in shock. The significant improvement in these areas underscores the relevance of initial training for clinical teams facing critical situations daily at Hospital Fray Flavian Mucci.\u003c/p\u003e "},{"header":"Conclusions","content":"\u003cp\u003eImplementing a competency-based training program for a hospital's medical staff about to start its activities has proven effective in improving knowledge and critical skills for patient care. Despite being a heterogeneous group in terms of profession, age, and years of experience, the analog-visual survey showed an increase in perceived knowledge of all the evaluated competencies, with statistically significant improvements in more specialized areas such as artificial airway management, mechanical ventilatory assistance, and hemodynamic assessment in shock situations.\u003c/p\u003e \u003cp\u003eThe results obtained in this evaluation highlight the usefulness of competency-based and patient-centered training as a valid tool for preparing health professionals in new and complex hospital settings.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003eThe authorities of AGAPE Health Services granted a Waiver for Informed Consent to the institution\u0026apos;s participating staff since the data used in this protocol do not contain identifiable information and are completely anonymous.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFUNDING STATEMENT\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study did not receive public or private contributions.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eACKNOWLEDGMENTS\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIn Memoriam Fray Jack W. Hoak O.F.M. Tireless promoter of the ideas of Fray Flavian Mucci. Tireless collaborator in the execution and start-up of the \u0026quot;Fray Flavian Mucchi\u0026quot; Specialty Hospital\u003c/p\u003e\n\u003cp\u003eWe want to thank the Authorities of AGAPE El Salvador, specifically Eng. Ram\u0026oacute;n Alberto Vega Calvo, Executive Director of Agape, for his collaboration in developing this investigation.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCONSENT FOR PUBLICATION\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll authors know and agree to the paper\u0026apos;s content and will be listed as co-authors.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCOMPETING INTERESTS\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests. 324\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAUTHORS\u0026rsquo; CONTRIBUTIONS\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eLAC wrote the manuscript,\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eLAC RGB JLTO AQT Design the study.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eRGB JLTO AQT Field work Programming in Hospital\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eLMCR Field data collection\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eLMCR MCAG conceived the final approval of the version to be submitted.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAll authors have read and approved the final manuscript.\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eDebie A, Nigusie A, Gedle D, Khatri RB, Assefa Y (2024) Building a resilient health system for universal health coverage and health security: a systematic review. Glob Health Res Policy 4(1):2. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1186/s41256-023-00340-z\u003c/span\u003e\u003cspan address=\"10.1186/s41256-023-00340-z\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003ePMID: 38173020; PMCID: PMC10765832\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAGAPE El Salvador Available in: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://agapesv.com/home-1/\u003c/span\u003e\u003cspan address=\"https://agapesv.com/home-1/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCl\u0026iacute;nica San Francisco de As\u0026iacute;s (San Francisco de Asis Clinic). Available in: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://clinica.agapesv.com/historia.php\u003c/span\u003e\u003cspan address=\"https://clinica.agapesv.com/historia.php\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHogar de Ancianos San Francisco de Asis (St. Francis of Assisi Nursing Home). Available in: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://hogar.agapesv.com/nosotros.php\u003c/span\u003e\u003cspan address=\"https://hogar.agapesv.com/nosotros.php\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eEddleston J, Goldhill D, Morris J, on behalf of the Council of the Intensive Care Society (2009). Levels of Critical Care for Adult Patients. Intensive Care Society. Available inn: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttp://www.ics.ac.uk/ICS/guidelines-and-standards\u003c/span\u003e\u003cspan address=\"http://www.ics.ac.uk/ICS/guidelines-and-standards\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFuture Hospital Commission (2013) Future hospital: caring for medical patients. A report from the Future Hospital Commission to the Royal College of Physicians. Royal College of Physicians, London\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCamputaro LA, Bello Quezada ME, Hoyos Arango WA, Bortoli RG, Ruiz Zelaya FA, Diaz Moreno MM, Delgado Delgado JM, M\u0026aacute;rquez Maga\u0026ntilde;a MS, Vigne Cuellar PA, Sanchez MI (2021) Intensive competency-based training strategy in a National Hospital in times of Pandemic. Med (Baltim) 100(39):e27152\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eP\u0026eacute;rez Guerra Y, Reyes Fonseca AL, de la Matos V\u0026iacute;tores H (2019) C, de la Guardia Casate AL. Coaching. Importancia del docente-coach. 2011 Multimed 23(2):364\u0026ndash;374\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eEl valor de la diversidad de edad en el lugar de trabajo (The value of age diversity in the workplace). Available in: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.aarp.org/espanol/trabajo/exito-laboral/info-2020/valor-diversidad-de-edad\u003c/span\u003e\u003cspan address=\"https://www.aarp.org/espanol/trabajo/exito-laboral/info-2020/valor-diversidad-de-edad\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"AGAPE El Salvador","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Competency-Based Training, Patient-Centered Care, Healthcare Professionals, Hospital Preparedness, Interdisciplinary Teamwork","lastPublishedDoi":"10.21203/rs.3.rs-5367393/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5367393/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eFor the proper functioning of any health institution, it is necessary to unify and/or standardize the knowledge of its staff to achieve smooth teamwork, sharing the same language and criteria. This is even more necessary in health care work to provide the best patient care through an organized interdisciplinary team.\u003c/p\u003e \u003cp\u003eTraining in competencies, prioritizing the acquisition of practical skills while fostering theoretical self-education, has proven effective for health staff training, improving patient care. Acquiring the skills to detect life-threatening health conditions and their correct treatment and understanding the risk factors for unfavorable evolution are essential to provide timely treatment and avoid complications.\u003c/p\u003e \u003cp\u003eProper training is particularly relevant when a non-governmental hospital institution opens its doors and inaugurates its services to a specific community in the country's interior. To prepare staff for this new Non-Profit Organization (NPO) initiative, a hybrid training course that includes online theoretical classes and hands-on practical workshops was planned to train all the medical and paramedical staff of a new Specialty Hospital.\u003c/p\u003e","manuscriptTitle":"From Classroom to Action Training of New Staff in a New Specialty Hospital of a Non-Profit Organization","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-11-13 06:37:15","doi":"10.21203/rs.3.rs-5367393/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"1a4d8ba8-cf47-4b1c-8249-20c9151931f3","owner":[],"postedDate":"November 13th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":40186623,"name":"Hospital Medicine"}],"tags":[],"updatedAt":"2024-11-13T06:37:15+00:00","versionOfRecord":[],"versionCreatedAt":"2024-11-13 06:37:15","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-5367393","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5367393","identity":"rs-5367393","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}