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Abstract Articolo Cita questo articolo Abstract. The discussion during the sessions showed how difficult still is to manage the concept of inter-professional practice and education. The fundamental starting point is the awareness and the acceptance of the diverse epistemology underlying the various professional points of view on care. It is a huge change and the process of change management must be carefully considerate, across a set of steps addressed toward a medium term goal.

The way the city of Matera has changed along the centuries and the way a sea star moves and hunts, slowly and sensitive to the environment, may be a good metaphor of this process. Non degli astri notturni ma delle stelle marine, animali enigmatici ed eleganti con la loro simmetria pentagonale. Matera e le stelle marine condividono la stessa impressione di organismi che vengono da epoche remote, rocciosi, immobili.

Sono elementi ineludibili del problema educativo che fronteggiamo tutti i giorni e non pre-condizioni da rimuovere e che — se non rimosse — ci impediscono di lavorare o peggio giustificano il disimpegno. Occorre sporcarcisi le mani e sviluppare resilienza non a caso uno dei laboratori del congresso era dedicato proprio alla resilienza. I Corsi di Laurea devono fare la loro parte, con una introduzione lenta, sapiente ma continua di innovazione, un metro cubo di calcare scavato alla volta — come nei Sassi — una valva aperta alla volta, come fanno le stelle marine.

I presidenti di CL sono spesso forzatamente appiattiti sulla contingenza, come il resto di questo nostro paese in perenne emergenza, ma noi siamo educatori: non perdiamo la bussola di un orientamento strategico di medio periodo! Se poi la fatica vi sembra avere la meglio, avete sempre la Conferenza e gli eventi SIPeM per ritemprare le energie e il morale.

This short article wishes to emphasise the importance of the event, which witnessed the enhanced, active participation of our Italian colleagues at this prestigious international conference, and call once again for the renewal advocated in the opening lecture of the congress. An important contribution was made by the AMEE student taskforce which is a team of students from all over the world who worked side by side to help with the conference logistics and assist delegates.

As is the tradition, this, like all the previous editions of the congress, turned out to be an imposing event due to the number of those taking part and the high quality of the contributions. The representation of the Italian reality was substantial both in size and in quality on this occasion. The themes treated included curriculum planning, learning outcomes, teaching and learning, new technologies, assessment, selection, faculty development, education management, medical education research, postgraduate education, CPD and international issues.

Sabato, 27 Novembre, 2010

This type of organisation, which did not contemplate plenary sessions alone which in this instance were few in number and of the highest quality but a consistent number of parallel symposia, short communications, posters, e-posters and workshops, provided a variety of settings capable of fostering interactivity among participants who were free to focus on the topics of greatest interest to them, although the high quality of the sessions offered make it difficult for some to choose between the myriad events on the daily agenda Figs. Last but not least, we wish to mention the numerous Commercial, Not-for-Profit and Academic Exhibitors, whose stands made an excellent contribution by providing information concerning refresher and update opportunities.

In the edition of the Congress held this year in Milan, the Italian presence was more numerous and incisive than in the past, a testimony to greater international integration. Montagna, V. Ferro Allodola, L. Fieschi and L. In an international context a similarly sensitive issue represented a veritable challenge which the team managing the event faced and won. The workshop attracted an audience of 25 participants i.

Of the symposia, that regarding the important Italian experience of the Progress Test, conducted by the Council of Directors of Medical Curricula proved of particular impact. Schuwirth — Maastricht and a number of German Z. The Progress Test is important when testing knowledge, a valuable tool for the students who avail of it to monitor their progress. Particular attention needs to be paid, however, to efforts being made to transforming it into an inter-university benchmarking tool. This highly sensitive issue was discussed in depth and is one to which Prof.

Alfred Tenore intends dedicating a specific article. The general discussion and the data presented by Alfred Tenore show that the Italian experience is one of the most far-reaching data experiments regarding this theme carried out to date as far as numbers of participant universities and the quantity of data generated are concerned. The dimensions of the results obtained in Italy, compared to those of the Netherlands, where the Progress Test was actually drawn up, prove how up-to-date this practically mandatory procedure has become and how useful it is to students of medicine and surgery.

Ginsburg — University of Toronto, Canada. The goals of the symposium were to present different cultural contexts for researching dilemmas accruing to professionalism, to discuss cross-cultural similarities and differences in dilemmas regarding professionalism and to discuss how to conduct cross-cultural research. The core methodological concept was the idea of dilemma, a situation where two or more professional values clash.

The use of standardized scenarios, written or represented through video clips, proved to be a powerful tool to foster the reflection of learners on the values and motives informing professional action in the presence of complex elements. The inter-cultural comparison of the results carried out, made it even more evident that the construct of professionalism is culturally mediated. Barbaranelli, G. Cavaggioni, M. Strepparava, A. Lenzi and G. We wish to point out that, as far as undergraduate admission to university medical degree courses is concerned, three short communication sessions were held on the topic, as well as a poster session and an e-poster session, which shows how keen the international debate is concerning this issue of the greatest interest in our country at present too.

What is the impact in the core curricula of Italian Medical Students? Pegoraro, E. Giambelluca, M. Staccioni, B. Goletti and G. Dameri, A. Meleddu, G. Occhini, S. Bolchini and N. Leopardi, L. Ragazzoni, S. Lo Baido, F. Maccapani, P. Ingrassia and F. Della Corte. Tagliabue, D. Corrias, G. Rezzonico and M. Of the utmost interest, this talk addressed the often complex and difficult relationships existing between professional health-care training and global shifts, which impact not only on epidemiological but also on international political issues.

The moment has come to reflect deeply on the social and ethical implications of how we teach and manage our professional medical and health-care courses. Much has been done by the Council of Deans and Directors of Medical Faculties, the Council of Directors of Medical Curricula and by SIPeM, the Italian Society for Medical Education, a lot more still needs to be done in the better interests of health, equity and social justice to which we dedicate our passionate energies, our lives and our work, daily.

Excellence in Education — The 21st Century Teacher. A brief Report, Medicina e Chirurgia, , Competency based education is widely diffusing as a model of educational design, because it makes more explicit and clear the final outcome of a curriculum. This responds to the call for social liability of medical education and makes different curricula more easily comparable. Some models of competency for medical education were developed: the European Union set a framework to describe the outcome of education Dublin descriptors , which was used in Tuning Medicine project to define 12 competency domains.

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In Italy recent acts moved the focus of education design clearly toward a competency based education and the Conference of Presidents of medical curricula is in the way to developing a comprehensive framework of medical competencies. La Tab. La figura 1 rappresenta il modello, che come si vede ha il ruolo di Medical Expert al centro, come elemento unificante di altri 6 ruoli.

Ogni ruolo contiene da tre a sei competenze principali, ulteriormente precisate con livelli di dettaglio inferiore. Inoltre il d. La Conferenza ha recentemente prodotto un documento consultivo, in cui propone una possibile declinazione delle competenze e degli obiettivi formativi di un corso di laurea. Quadri nazionali ed internazionali di riferimento, Medicina e Chirurgia, , Professionalism is often defined as a set of personal traits, and there is a general consensus about a set of elements that are components of professionalism, even if their exact determination remains elusive.

Professionalism can also be conceived as the expression of the social contract between society at large and the profession. This paper briefly summarizes some basic assumptions about the nature of professionalism as a complex construct, highlights the main features of the development of professional image of medical doctors in Italy from the years of Risorgimento up to present time, to show how the cultural and political environment influenced this process. On these premises, the structure of a possible longitudinal curriculum for the development of professionalism in medical student is presented.

The foundation of this proposal is that professionalism is the context of medical expertise, as a combination of rules, conditions, and meanings in which the act of health care occurs. It encompasses the ability of critical reflection on technical expertise and it is expressed through the ability to act and make decisions when dilemmas or elements of complexity are present.

So, starting from the use of validates scales to measure theoretical knowledge and attitudes, a set of methods as reflective writings, critical cases analysis and simulated patients are incrementally added to the curriculum to challenge the ability of students to face professional dilemmas. Nel continuum delle diverse prospettive presenti in letteratura internazionale, possono essere rilevate alcuni nuclei di discussione.

Una recente review ha esaminato la gamma degli approcci utilizzati nella sociologia delle professioni 7. La sociologa Giovanna Vicarelli ha dedicato molta attenzione allo sviluppo della professione del medico, dagli anni post-risorgimentali fino ai giorni nostri. Essa identifica alcune grandi fasi di sviluppo.

Il sistema mutualistico viene superato e si sviluppa un sistema di welfare democratico che conduce nel alla nascita del Servizio Sanitario Nazionale. Nel la l. Nel contempo aumentano la domanda di salute e le aspettative del pubblico nei confronti della medicina, con attese al limite del miracolistico. Uno studio condotto a Milano dimostra come vengano spesso assimilati modelli di tipo paternalistico e proni a norme di condotta che ufficialmente non sono incoraggiate Doctors in society.

Medical professionalism in a changing world. Clin Med. Assessing professional behavior: yesterday, today, tomorrow. Teaching professionalism across cultural and national borders: lessons learned from an AMEE workshop. Context, conflict, and resolution: a new conceptual framework for evaluating professionalism. Sociological interpretations of professionalism. Med Educ. Assessment of medical professionalism: who, what, when, where, how, and … why? A blueprint to assess professionalism: results of a systematic review.

In Bianco A. Medical autonomy: open challenges from consumerism and managerialism. Assessment of professionalism: recommendations from the Ottawa Conference. Programmatic assessment: from assessment of learning to assessment for learning. Developing professionalism in Italian medical students: an educational framework. Adv Med Educ Pract. Implementation and evaluation of an undergraduate sociocultural medicine program. The Jefferson Scale of Physician Empathy: further psychometric data and differences by gender and specialty at item level. Behavioural elements of professionalism: assessment of a fundamental concept in medical care.

How Italian students learn to become physicians: a qualitative study of the hidden curriculum. Traits of professionalism in students challenged with dilemmatic situations in video recorded simulations: a qualitative study. AMEE , Abstract book, p. The increasing complexities of professionalism. In order to avoid duplications and to shorten the long training period spent by future doctors, the National Conference of Undergraduate Curricula Presidents has proposed to the Ministries of Education and of Health to unify the procedures and create a qualifying medical degree.

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Such a new examination will necessarily imply the check of practical abilities and this stresses the importance of teaching both practical skills and professional competencies. In this setting, the Educational Innovation Committee of the National Conference organized a workshop, open to all the Undergraduate Curricula Presidents, on the topic of teaching professional competencies in the undergraduate curricula.

The workshop was held in Milan State University on the 21st February The workshop was subdivided into four contemporary working groups. Each class was lead by an expert in medical education, introduced by a demonstration by a medical student, and guided by a chairperson, and worked separately on a different topic. At the end of the team work, a plenary debriefing allowed all participants to share the conclusions of the different groups.

The topics addressed in the single groups were: 1: the skill lab; 2: the simulated patient; 3: the technology-enhanced learning, and 4: the peer-clinical examination. Questo, oltre a calmierare il numero di laureati, ha permesso — insieme alla frequenza obbligatoria — di passare da una didattica teorica, frontale, ad un insegnamento professionalizzante, a piccoli gruppi, divenuto sostenibile grazie alla riduzione degli iscritti;.

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Il processo per renderle fruibili dovrebbe articolarsi attraverso tre fasi preparatorie tra loro interdipendenti: la progettazione della skill, la tecnica di insegnamento e quella di valutazione. Pazienti simulati e standardizzati vengono con crescente frequenza utilizzati nei percorsi formativi in medicina. Nella simulazione ibrida ai pazienti-attori si aggiungono dispositivi tecnologici che forniscono le componenti fisiche che i pazienti-attori non possono avere. Tradizionalmente il contatto con il paziente raccogliere la sua storia, visitarlo… rappresenta il momento fondamentale e irrinunciabile nella formazione dei futuri medici.

Si possono elencare una serie di condivisibili ragioni. Una prima serie di ragioni nasce dai percorsi di cura contemporanei che vedono una progressiva contrazione dei posti-letto ospedalieri e dei tempi di degenza ed una maggiore attenzione alla medicina territoriale: tutto questo determina una riduzione del numero dei pazienti che gli studenti possono incontrare nel loro percorso formativo. Una seconda serie di ragioni nasce dalla crescente riluttanza da parte di molti pazienti a collaborare con le esigenze educative di Ospedali universitari.

Sul piano comunicativo ci sono aree drammatiche o delicate — ad esempio, dare cattive notizie o raccogliere dati in ambito sessuale — in cui esercitarsi in un ambito protetto prima di incontrare pazienti reali appare doveroso addirittura da un punto di vista etico. Un ultimo, certo non trascurabile, vantaggio dei pazienti simulati risiede nel loro utilizzo nei momenti valutativi. Esistono problemi di tempo curriculare, di spazi dedicati e soprattutto di preparazione dei docenti.

Gli approcci TEL mostrati sono stati ordinati e tassonomizzati, in funzione di una classificazione proposta da Trentin. I temi dei 4 laboratori saranno. Churchill Livingstone, Edinburgh, Tecnologie Didattiche 37 1 Giuli, N. Lettieri, N. Palazzolo, O. Roselli, pp. Clinical Management Issue ; 3 4 Gallo P. This aspect of medical education has long become an ineluctable feature not only of the various core curriculum skills foreseen, but has also becomes a part of the formal documentation of academic achievement, as one of the foci around which new learning-teaching and assessment strategies, methodologies and approaches are built, and one of the chief means by which to address medical and health-care education and training issues and the define the leading role the Italian University must play in the field of medical education and health-care management.

This process of internationalisation needs to be grounded in the excellence of the medical teaching profession and referred to the highest standards determined by processes of global renewal; it must also remain associated with institutional leadership, availability of adequate resources, the possibility of recognising didactic excellence, but, above all, it needs to be rooted in an accurate definition and appraisal of procedures and results Lenzi, ; Familiari, ; Familiari et al. As stated elsewhere, AMEE www. The AMEE conference in Milan will provide an opportunity for all interested in medical and health-care educational issues to meet and learn about what is new in the field, share ideas and network with colleagues from all over the world.

Three thousand participants from one hundred countries are expected, bringing with them a wealth and broad range of cultural experiences, and making this the largest ever international medical and health-care education annual conference. As a teacher or trainer, a dean or course organizer, educationalist or researcher, administrator or student, participation at Milan edition of AMEE Congress will provide an important opportunity to follow key developments in curriculum planning, approaches to teaching and learning, assessment methods, educational management, and evidence-informed teaching.

The AMEE conference sessions will cover a continuum of education in medicine and the health-care professions from undergraduate to postgraduate levels, on to continuing professional development. The photographs in Fig. The University of Milan is also involved in the local committee, in the persons of the Dean and Rector of the Medical Faculty. SIPeM will conduct a pre-congress workshop concerning Medical Humanities and dwell in particular on the use of filmed material in medical training. The essential rationale underscoring a kind of participation which strives to be active and proactive, dwells, come as stated in the premise, in the fact that the process of the internationalisation of medical training we are so tenaciously endeavouring to implement, must be seen now as an irreversible to be followed.

A practical guide for medical teachers. Churchill Livingstone, Elsevier, The best evidence medical education and the essential skills on medical teaching : important keys for medical education internationalization.

Pensioni, lavoro parla Poletti

Med Chir ; MEDIC ; Insegnare nei corsi di laurea in medicina e odontoiatria. Espress Edizioni, Torino The challenge of reform: 10 years of curricula changes in Italian medical schools. Med Teach ; In genere, questi eventi sono raggruppati in trilogie una pillola, un atelier e un forum dedicate ad aspetti diversi dello stesso tema generale. Until lately, the Presidents of the Italian Undergraduate Curricula in Medicine were fully aware of their role in curriculum managing only.

A recent reform of the Italian University Structure, shifting the focus from the Schools of Medicine to the single Departments, gave the Curricula Presidents larger autonomy but also burdened them with new managerial tasks, especially in the field of quality assurance.

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In Janssen, Manca it is shown how to solve numerically a homogeneous renewal process and that the renewal process can be easily solved in a discrete time environment. Given that the claim amount process is function of the economic scenario, the non-homogeneity is strictly related to the time of the evaluation. Manca, G. Annals of Actuarial Science , vol. The claims reserving problem is currently one of the most debated in actuarial literature.

The high level of interest in this topic is due to the fact that Solvency II rules will come into operation in Indeed, it is expected that quantile computations will be compulsory in the evaluation of company risk and for this reason we think that the construction of the claims reserve random variable distribution assumes a fundamental relevance.

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The aim of this paper is to present a method for constructing the claims reserve distribution which can take into account IBNyR Issued But Not yet Reported claims in a natural way. The construction of the distribution function for each time of the observed interval is done by means of a Monte Carlo simulation model applied on a backward time semi-Markov process. It should be pointed out that this is the first time that a simulation model based on semi-Markov with backward recurrence time has been presented.

The method is totally different from the models given in the current literature. The most important features given in the paper are: 1 for the first time the Monte Carlo simulation method is applied to a backward semi-Markov environment; 2 the Monte Carlo simulation permits the construction of the random variable of the claims reserve for each year of the studied horizon in a natural way; 3 as already pointed out, the backward process attached to the semi-Markov process permits taking into account the evaluation of the IBNyR claims in a natural way.

In the last part of the paper an applicative example constructed from tables that summarise 4 years of claims from an important Italian insurance company will be given. Affronta quindi quattro questioni analiticamente circoscritte. In secondo luogo, sono discussi i fenomeni redistributivi che lo schema NDC produce in presenza di rendite reversibili e sono proposti correttivi per la loro eliminazione. Manca and A. The evolution salary is function of the rules of career development. These rules usually change if the company being observed changes.

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With this fact in mind, this paper presents a class of useful models for forecasting the number of workers at each grade of a given firm. The paper generalizes the results obtained in some previous papers giving, for the first time, the possibility of forecasting not only the cost of the salary but also its subdivision into its constituents parts both for the total and the unitary wage cost. The model also permits the forecasting of the future career path of the workers in each grade and also the taking in account the future gender percentage within the different grades.

Furthermore, the model presented offers the possibility of considering the changes in the job pyramidal structure considering also the change of the number of grades of the studied firm. A real data application is presented in which different hypotheses of the future evolution of the labour force are shown. The related algorithm is also presented. Link Abstract. The claim reserving problem is currently one of the most debated in actuarial literature;. The high level of interest in this topic is due to the fact that Solvency II rules were approved in May and will come into operation in In that data the rule that establishes having the accumulated capital necessary to limit the risk failure fixed at 0.

For this reason the reconstruction of the claim reserve random variable distribution assumes a fundamental relevance. The aim of this paper is to present a method that is able to reconstruct the claim reserve distribution and that can take into account, in a natural way, the IBNyR Issued But Not yet Reported claims. The proposed method is totally different from the models that are typically used in these problems given in the current literature. The claim reserve is one of the problems most debated in the actuarial literature in the ASTIN last issue 4 papers were on this topic.

The claim reserve should be considered a tool able to reduce the default risk of an insurance company that means its reliability. For this reason we retain that the claim reserve should be function of the rating evaluation given to the insurance company. This paper would face this kind of problem and report the first results on this new approach to the claim reserve problem.

International Finance Symposium , Istanbul, with R. Gismondi, W. Janko e P. This paper investigates the applicability of automated trading systems for the DAX Future, which were generated using a parallelized form of grammatical evolution and historic market data. The included test results are based on a single-CPU algorithm and a parallelized version, which was run on a cluster of the Research Institute for Computational Methods of the Vienna University of Economics and Business. TCC tiny C compiler was written by Fabrice Bellard and was used for the 32 bit version of the algorithm.

Unfortunately the compiler does not build on 64 bit targets, therefore the slower C compiler of the GNU Compiler Collection GCC was used as fall-back on the 64 bit cluster. The parallel implementation uses MPI message passing interface for the communication between nodes. Single-CPU results as well as the test results from the cluster are presented for day trading. Infatti, tendono a generare avanzi cronici di bilancio pur nel caso che i contributi siano remunerati in base al tasso di crescita della massima salariale.

The construction of mean salary lines useful to forecast the evolution of working people wages was not enough debated in literature.

Prof. Fulvio Gismondi

In this paper, first some theoretical results on the generalized binomial processes are presented, after models and algorithms useful to construct mean salary lines are given in both cases with constant and with variable promotion probabilities. XXVI, N. In order to spread notional capital accrued at retirement by members of a cohort over life expectancy, pay-as-you-go notional-defined-contribution payg-ndc scheme uses multipliers different by retirement age called conversion coefficients.

These are backward-looking b. Under increasing longevity, b. They also engender chronic deficits. Forward-looking f. Nevertheless, they face a rather serious political difficulty in that forecasting tools are fallible. This explains why switching to f.

In fact, they generate chronic surpluses. The paper also shows that frontloading pension profile helps sustainability because it reduces both surpluses and deficits generated, respectively, by f. In questo lavoro vengono presentate le conseguente che i recenti interventi normativi legge 24 dicembre , n. International Finance Symposium , Istanbul, in collaborazione con R. Gismondi e W. The models implemented in SPES allow the user to achieve two targets: to estimate market price mark-to-market and to calculate fair values to fulfill regulatory requirements.

Section 2 of this paper provides a short introduction into the use models for equity and interest rate products, the calibration technique and discretization methods for SDE and SSDE. Section 3 gives an introduction to technical and computational features of the platform. The MC framework is a very computing intensive technique.

In section 4 we will give an introduction to parallel computing, that will be implemented in SPES in the near future. La previdenza complementare in Italia, Il Mulino, in collaborazione con S. Il lavoro analizza la recente riforma del fondo che eroga, a ripartizione, le pensioni integrative dei rappresentanti di commercio, una categoria importante che conta quasi mila lavoratori autonomi. Il legislatore italiano ha edificato un sistema di previdenza complementare essenzialmente basato su fondi pensione a contribuzione definita.

Giappichelli, Viene introdotto il modello decisionale e vengono trattati criticamente i processi metodologici per la determinazione del prezzo equo della copertura assicurativa. Lovecchio e M. Montanari, A. Gambaro e D. Il mercato della R. De Angelis. Di Gregorio. Dipartimento di Scienze Attuariali e Finanziarie, Nota n. Rivista A. De Angelis e R. The problem of evaluating the solvency of insurance companies is tackled through the use of a non-parametric statistical model, constructed using decision-tree techniques.

The model is tested on a sample of Italian non-life insurance companies and its performance over the test period compared with those of linear and quadratic parametric models. De Angelis — R. Grifo Banca, Anno 2, n. Atti del XV Convegno A. All Rights Reserved Powered by Wordpress. Posts Comments Email fulvio gismondi. Manca Abstract. Strangio Link Abstract. We will give also the probabilities of migration among the interested countries and, furthermore, the calculation of the mean time that is necessary for the arrival into the final destination.

Manca Link Abstract. Volpe di Prignano Link Abstract. Silvestrov Link Abstract. Gronchi Link Abstract. Swishchuk Link Abstract. The claim reserving problem is currently one of the most debated in actuarial literature; The high level of interest in this topic is due to the fact that Solvency II rules were approved in May and will come into operation in Kreuzinger Abstract. Some models useful to the solution of the problem were presented.

Janko Abstract. Gronchi Abstract. Micocci Link Abstract. Giappichelli, Abstract.