La question du remplacement des chirurgiens vasculaires pour les années à venir est préoccupante du fait d’un grand nombre de départs en retraite. Mais la question du seul remplacement des effectifs ne suffit pas pour une spécialité qui s’adresse principalement à des patients âgés dans le contexte actuel d’augmentation et de vieillissement de la population française.Dans le but de répondre aux besoins en chirurgie vasculaire dans les années futures, nous avons dans un premier temps réalisé un état des lieux de la démographie des praticiens de la spécialité et estimé la cinétique des départs en retraite des prochaines années.Pour pouvoir tenir compte de l’évolution de la future activité, nous avons établi un modèle prédictif de cette activité concernant les actes de chirurgie carotidienne, de chirurgie des anévrysmes de l’aorte abdominale sous-rénale et de chirurgie des artères sous-inguinales, d’après le seul vieillissement de la population. Ce modèle applique les méthodes de l’INSEE aux actes recueillis dans le Programme Médicalisé des Systèmes d’Information. Nous l’avons ensuite affiné par l’intégration d’autres paramètres influençant l’évolution de l’activité grâce au calcul et à l’application d’un coefficient de pondération obtenu sur la période d’activité de 2000 à 2008. D’après le modèle, l’activité entre 2008 et 2030 augmentera de 38% sur les segments étudiés.Les projections pondérées permettent de prédire une augmentation de l’activité de 30% entre 2011 et 2025. D’un point de vue purement mathématique, les besoins de formation seraient de 120 chirurgiens pour le remplacement des départs en retraite, et de 59 chirurgiens supplémentaires du fait de l’augmentation de l’activité. / The question of replacement of vascular surgeons for the future is of concern because of a large number of retirements. But the question of replacement only is not sufficient for a specialty that is primarily for older patients in the current context of increasing and aging of the French population.In order to meet the need for vascular surgery in the coming years, we initially performed an overview of the demographics of practitioners of the specialty and estimated the retirements. To take into account the evolution of the future activity, we have established a predictive model for the acts of carotid surgery, surgery of infrarenal abdominal aortic aneurysms and surgery of peripheral arterial disease, according to the aging population. This model applies the methods of the INSEE for acts collected in the Medicalised Information System Program database.We then refined it by including other parameters modifying workload evolution. We have calculated and applied a weighting factor obtained during the period of activity from 2000 to 2008. According to the model, the activity between 2008 and 2030 will increase by 38% in the studied procedures.The weighted projections predict an acts’ increase 30% between 2011 and 2025.From a purely mathematical point of view, the training needs of 120 surgeons would be to replace retirements, and 59 more surgeons because of the increased workload.

Made available in DSpace on 2016-04-27T13:10:28Z (GMT). No. of bitstreams: 1 Bernardo Schubsky.pdf: 2235781 bytes, checksum: a5584947f5ce1f007009781d9989a842 (MD5) Previous issue date: 2016-03-07 / Background The diversity of the education of healthcare professionals, on their different levels (nurses and nurse technicians), added to the pressure of the work life, urges that professionals to engage into multiple jobs, which contributes with demoting training and technical updating to a second tier. Objectives The goal of this study was to develop a new process, capable of targeting the main educational gaps of the healthcare professionals on their work, to execute focused educational interventions and to reassess the sample. Methods Interventional retrospective study. A web-based tool was developed to identify knowledge gaps, by generating multiple-choice tests, segmented by area, as well as correcting the test, mapping those gaps. Three assessments were performed, between 2013 and 2014, with a large group of healthcare professionals, on different hospitals, on a six-month interval between them. During those intervals, educational interventions were executed, focused on the identified gaps. We decided to demonstrate the average performance through the grades, exclusively for the healthcare professionals that participated in the three cycles of assessment and training. Results 3531 healthcare professionals participated on the three cycles and the average grades, sequentially, were: 6.591, 6.613 and 6.909. The statistical analysis was the ANOVA test, and we found significant correlation between the last two assessments. Conclusion The development of an assessment process, accompanied by mapping knowledge gaps and intertwined with educational interventions, has shown itself efficient in promoting knowledge development among healthcare professionals / Background A diversidade na formação dos profissionais de enfermagem em seus diferentes níveis (auxiliares, técnicos e enfermeiros), somando-se às pressões do mercado, obriga estes profissionais a realizarem múltiplas jornadas de trabalho, contribuindo para que o treinamento e as atualizações técnicas sejam relegados a um segundo plano. Objetivos O objetivo deste trabalho foi desenvolver um processo que pudesse identificar as principais deficiências dos profissionais no ambiente de trabalho, executar ações educacionais focadas e reavaliar o grupo estudado. Casuística Foi realizado um estudo intervencional, com coletas retrospectivas de dados. Desenvolveu-se uma ferramenta web de mapeamento de deficiências, capaz de gerar avaliações do tipo múltipla-escolha segmentadas por áreas, corrigir as avaliações e mapear áreas específicas de deficiência de conhecimento. Realizaram-se 3 avaliações, em 2013 e 2014, em um grande quantitativo de profissionais de saúde, de diversos hospitais, com um intervalo semestral. Entre cada avaliação, foram realizadas intervenções educacionais focadas nas deficiências mapeadas. Optamos por demonstrar o desempenho médio, através das notas de avaliação, exclusivamente dos profissionais de enfermagem que participaram de todos os 3 ciclos avaliação-treinamento. Resultados 3531 profissionais realizaram as 3 avaliações e as notas médias obtidas, sequencialmente, foram: 6,591; 6,613 e 6,909. Realizou-se a análise estatística ANOVA e encontrou-se significância estatística entre as 2 últimas avaliações. Conclusão A criação de um processo de avaliação de desempenho, acompanhado pelo mapeamento de déficits de conhecimento, intercalado com intervenções educacionais mostrou-se eficiente em promover o desenvolvimento do conhecimento entre profissionais de enfermagem