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Möller, R. & Hultin, M. (2019). Att examinera blivande kollegor: Vi behöver en bedömningskultur. Läkartidningen (116)
Open this publication in new window or tab >>Att examinera blivande kollegor: Vi behöver en bedömningskultur
2019 (Swedish)In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, no 116Article in journal, News item (Other (popular science, discussion, etc.)) Published
Abstract [sv]

Examensbeviset är kvittot på att studenten har  blivit läkare. Läkaren är både medicinsk  expert  och ansva- rig för att patientarbetet håller hög kvalitet. Brister i läkarens  kompetens medför försämrad  patientsäker- het. Hur vet vi att den nyutexaminerade läkaren  har de kunskaper, färdigheter och förhållningssätt som krävs för att vara läkare i Sverige?

Huvudbudskap

- God bedömningskultur främjar lärande och säkerstäl- ler uppnådd kompetens. För detta krävs att examina- tionerna är i linje med kursens mål och innehåll och en integrerad del av ett utbildningsprogram.

- Examinationerna ska ske systematiskt eftersom mer komplexa lärandemål kräver examinationer med olika metoder, flera bedömare och psykometrisk analys av resultaten.

- Bedömningskriterierna ska vara kända i förväg, och examinationerna ska återkopplas till studenterna så att de stöttar studenternas utveckling.

- Examinationerna ska genomföras med hänsyn till att det viktigaste bedömningsinstrumentet är bedömaren själv snarare än de verktyg som används vid bedöm- ningen.

- Examinationerna ska genomföras av lärare som har utbildats i att examinera rättssäkert.

National Category
Other Medical Sciences not elsewhere specified
Identifiers
urn:nbn:se:umu:diva-155076 (URN)
Available from: 2019-01-08 Created: 2019-01-08 Last updated: 2019-02-06Bibliographically approved
Hultin, M., Semb, O., Tano, K., Molander, E., Morén, G. & Wennberg, P. (2019). Design of a program for complementary education of International Medical Graduates in Sweden – to include Swedish or not. In: : . Paper presented at AMEE 2019, 24th - 28th August 2019, Vienna, Austria.
Open this publication in new window or tab >>Design of a program for complementary education of International Medical Graduates in Sweden – to include Swedish or not
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2019 (English)Conference paper, Oral presentation with published abstract (Refereed)
National Category
Pedagogical Work
Identifiers
urn:nbn:se:umu:diva-158846 (URN)
Conference
AMEE 2019, 24th - 28th August 2019, Vienna, Austria
Available from: 2019-05-11 Created: 2019-05-11 Last updated: 2019-05-13
Myrberg, T., Lindelöf, L. & Hultin, M. (2019). Effect of pre-operative fluid therapy on hemodynamic stability. Acta Anaesthesiologica Scandinavica, 63(8), E17-E17
Open this publication in new window or tab >>Effect of pre-operative fluid therapy on hemodynamic stability
2019 (English)In: Acta Anaesthesiologica Scandinavica, ISSN 0001-5172, E-ISSN 1399-6576, Vol. 63, no 8, p. E17-E17Article in journal, Meeting abstract (Other academic) Published
Place, publisher, year, edition, pages
John Wiley & Sons, 2019
National Category
Anesthesiology and Intensive Care
Identifiers
urn:nbn:se:umu:diva-162834 (URN)000479117900057 ()
Note

Abstract number: ABSSUB-149

Available from: 2019-09-16 Created: 2019-09-16 Last updated: 2019-09-16Bibliographically approved
Myrberg, T., Lindelöf, L. & Hultin, M. (2019). Effect of pre-operative fluid therapy on hemodynamic stability during anesthesia induction, a randomized study. Acta Anaesthesiologica Scandinavica, 63(9), 1129-1136
Open this publication in new window or tab >>Effect of pre-operative fluid therapy on hemodynamic stability during anesthesia induction, a randomized study
2019 (English)In: Acta Anaesthesiologica Scandinavica, ISSN 0001-5172, E-ISSN 1399-6576, Vol. 63, no 9, p. 1129-1136Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Preserving perfusion pressure during anesthesia induction is crucial. Standardized anesthesia methods, alert fluid therapy and vasoactive drugs may help maintain adequate hemodynamic conditions throughout the induction procedure. In this randomized study, we hypothesized that a pre-operative volume bolus based on lean body weight would decrease the incidence of significant blood pressure drops (BPD) after induction with target-controlled infusion (TCI) or rapid sequence induction (RSI).

METHODS: Eighty individuals scheduled for non-cardiac surgery were randomized to either a pre-operative colloid fluid bolus of 6 ml kg-1 lean body weight or no bolus, and then anesthetized by means of TCI or RSI. The main outcome measure was blood pressure drops below the mean arterial pressure 65 mm Hg during the first 20 minutes after anesthesia induction. ClinicalTrials.com Identifier: NCT03394833.

RESULTS: Pre-operative fluid therapy decreased the incidence of BPDs fivefold, from 23 of 40 (57.5%) individuals without fluids to 5 of 40 (12.5%) with fluid management, P < .001. The mean BPD was greater in the groups without pre-operative fluids compared to the groups with fluid management; 53 ± 18 mm Hg vs 43 ± 14 mm Hg, P = .007. The overall mean volume of pre-operative fluid bolus infused was 387 ± 52 ml. There was no difference in hemodynamic stability between TCI and RSI. No correlation was shown between incidence of BPDs and increasing age, medication, hypertension, diabetes, renal failure, or low physical capacity.

CONCLUSIONS: Pre-operative fluid bolus decreased the incidence of significant blood pressure drops during TCI and RSI induction of general anesthesia.

Place, publisher, year, edition, pages
John Wiley & Sons, 2019
Keywords
anesthesia, fluid therapy, hemodynamics, venous return
National Category
Anesthesiology and Intensive Care
Identifiers
urn:nbn:se:umu:diva-161401 (URN)10.1111/aas.13419 (DOI)000484988500002 ()31240711 (PubMedID)
Funder
Norrbotten County Council, NLL-733291
Available from: 2019-07-04 Created: 2019-07-04 Last updated: 2019-10-10Bibliographically approved
Hultin, M. & Möller, R. (2019). En grundutbildning i förändring. Läkartidningen, 116, Article ID FMSR.
Open this publication in new window or tab >>En grundutbildning i förändring
2019 (Swedish)In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 116, article id FMSRArticle in journal (Other (popular science, discussion, etc.)) Published
National Category
Other Medical Sciences not elsewhere specified
Identifiers
urn:nbn:se:umu:diva-162380 (URN)31192433 (PubMedID)
Available from: 2019-08-19 Created: 2019-08-19 Last updated: 2019-08-19Bibliographically approved
Hultin, M., Sandborg Englund, G., Momemi, S., Jansson, I. & Hultberg, P. (2019). Patienter har rätt att känna sig säkra i vården. Dagens samhälle
Open this publication in new window or tab >>Patienter har rätt att känna sig säkra i vården
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2019 (Swedish)In: Dagens samhälle, ISSN 1652-6511Article in journal (Other (popular science, discussion, etc.)) Published
Place, publisher, year, edition, pages
Stockholm: , 2019
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:umu:diva-163564 (URN)
Note

Replik på debattartikeln ”Kunskapsprovens resultat – en nattsvart läsning” i Dagens Samhälle (23/9)

Available from: 2019-09-26 Created: 2019-09-26 Last updated: 2019-10-04Bibliographically approved
Hultin, M., Jonsson, K., Härgestam, M., Lindkvist, M. & Brulin, C. (2019). Reliability of instruments that measure situation awareness, team performance and task performance in a simulation setting with medical students. BMJ Open, 9(9), Article ID e029412.
Open this publication in new window or tab >>Reliability of instruments that measure situation awareness, team performance and task performance in a simulation setting with medical students
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2019 (English)In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 9, no 9, article id e029412Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: The assessment of situation awareness (SA), team performance and task performance in a simulation training session requires reliable and feasible measurement techniques. The objectives of this study were to test the Airways-Breathing-Circulation-Disability-Exposure (ABCDE) checklist and the Team Emergency Assessment Measure (TEAM) for inter-rater reliability, as well as the application of Situation Awareness Global Assessment Technique (SAGAT) for feasibility and internal consistency.

DESIGN: Methodological approach.

SETTING: Data collection during team training using full-scale simulation at a university clinical training centre. The video-recorded scenarios were rated independently by four raters.

PARTICIPANTS: 55 medical students aged 22-40 years in their fourth year of medical studies, during the clerkship in anaesthesiology and critical care medicine, formed 23 different teams. All students answered the SAGAT questionnaires, and of these students, 24 answered the follow-up postsimulation questionnaire (PSQ). TEAM and ABCDE were scored by four professionals.

MEASURES: The ABCDE and TEAM were tested for inter-rater reliability. The feasibility of SAGAT was tested using PSQ. SAGAT was tested for internal consistency both at an individual level (SAGAT) and a team level (Team Situation Awareness Global Assessment Technique (TSAGAT)).

RESULTS: The intraclass correlation was 0.54/0.83 (single/average measurements) for TEAM and 0.55/0.83 for ABCDE. According to the PSQ, the items in SAGAT were rated as relevant to the scenario by 96% of the participants. Cronbach's alpha for SAGAT/TSAGAT for the two scenarios was 0.80/0.83 vs 0.62/0.76, and normed χ² was 1.72 vs 1.62.

CONCLUSION: Task performance, team performance and SA could be purposefully measured, and the reliability of the measurements was good.

Keywords
patient care team, resuscitation, situation awareness, task performance and analysis, teamwork
National Category
Other Medical Sciences not elsewhere specified
Identifiers
urn:nbn:se:umu:diva-163368 (URN)10.1136/bmjopen-2019-029412 (DOI)31515425 (PubMedID)
Available from: 2019-09-17 Created: 2019-09-17 Last updated: 2019-09-20Bibliographically approved
Samuelsson, L., Tyden, J., Herwald, H., Hultin, M., Walldén, J., Steinvall, I., . . . Johansson, J. (2019). Renal clearance of heparin-binding protein and elimination during renal replacement therapy: Studies in ICU patients and healthy volunteers. PLoS ONE, 14(8), Article ID e0221813.
Open this publication in new window or tab >>Renal clearance of heparin-binding protein and elimination during renal replacement therapy: Studies in ICU patients and healthy volunteers
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2019 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 14, no 8, article id e0221813Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Heparin-binding protein (HBP) is released by neutrophils upon activation, and elevated plasma levels are seen in inflammatory states like sepsis, shock, cardiac arrest, and burns. However, little is known about the elimination of HBP. We wanted to study renal clearance of HBP in healthy individuals and in burn patients in intensive care units (ICUs). We also wished to examine the levels of HBP in the effluent of renal replacement circuits in ICU patients undergoing continuous renal replacement therapy (CRRT).

METHODS: We measured plasma and urine levels of HBP and urine flow rate in 8 healthy individuals and 20 patients in a burn ICU. In 32 patients on CRRT, we measured levels of HBP in plasma and in the effluent of the CRRT circuit.

RESULTS: Renal clearance of HBP (median (IQR) ml/min) was 0.19 (0.08-0.33) in healthy individuals and 0.30 (0.01-1.04) in burn ICU patients. In ICU patients with cystatin C levels exceeding 1.44 mg/l, clearance was 0.45 (0.15-2.81), and in patients with cystatin C below 1.44 mg/l clearance was lower 0.28 (0.14-0.55) (p = 0.04). Starting CRRT did not significantly alter plasma levels of HBP (p = 0.14), and the median HBP level in the effluent on CRRT was 9.1 ng/ml (IQR 7.8-14.4 ng/ml).

CONCLUSION: In healthy individuals and critically ill burn patients, renal clearance of HBP is low. It is increased when renal function is impaired. Starting CRRT in critically ill patients does not alter plasma levels of HBP significantly, but HBP can be found in the effluent. It seems unlikely that impaired kidney function needs to be considered when interpreting concentrations of HBP in previous studies. Starting CRRT does not appear to be an effective way of reducing HBP concentrations.

Place, publisher, year, edition, pages
Public Library of Science, 2019
National Category
Anesthesiology and Intensive Care
Identifiers
urn:nbn:se:umu:diva-162913 (URN)10.1371/journal.pone.0221813 (DOI)31465432 (PubMedID)
Available from: 2019-09-02 Created: 2019-09-02 Last updated: 2019-09-12Bibliographically approved
Hultin, M. & Möller, R. (Eds.). (2019). Tema läkares grundutbildning. Paper presented at Läkartidningens symposium Läkares grundutbildning, 9 maj 2019. Läkartidningen
Open this publication in new window or tab >>Tema läkares grundutbildning
2019 (Swedish)Conference proceedings (editor) (Refereed)
Place, publisher, year, edition, pages
Läkartidningen, 2019. p. 22
National Category
Health Sciences Clinical Medicine
Identifiers
urn:nbn:se:umu:diva-158847 (URN)
Conference
Läkartidningens symposium Läkares grundutbildning, 9 maj 2019
Note

Temanummer, Läkartidningen 2019 vol. 116, nr. 19-20

Available from: 2019-05-11 Created: 2019-05-11 Last updated: 2019-05-29Bibliographically approved
Andersson, J., Wennberg, P., Hultin, M. & Rolandsson, O. (2018). Att skapa läkare i glesbygd. Allmänmedicin (3)
Open this publication in new window or tab >>Att skapa läkare i glesbygd
2018 (Swedish)In: Allmänmedicin, ISSN 0281-3513, no 3Article in journal (Other (popular science, discussion, etc.)) Published
Place, publisher, year, edition, pages
Stockholm: , 2018
Keywords
Allmänmedicin, glesbygd
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:umu:diva-153039 (URN)
Available from: 2018-11-02 Created: 2018-11-02 Last updated: 2018-11-02
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0003-2935-7161

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