Quality management of the teaching-assistance process in the Internal Medicine service of the Camilo Cienfuegos Provincial General Hospital in Sancti Spíritus

Abstract

Introduction: Quality management of the teaching and clinical process is key to ensuring patient safety and clinical training in hospital units, especially in Internal Medicine services where complex care and teaching activities converge.

Objective: To describe the state of quality management of the teaching and clinical process in the Internal Medicine Service of the Camilo Cienfuegos Provincial General Hospital in Sancti Spíritus.

Methods: A sequential, exploratory, descriptive, cross-sectional mixed-methods study was conducted in 2024 using a census of the 78 professionals in the service (26 nurses, 30 specialist physicians, and 22 resident physicians). A pre-test, semi-structured interviews, document audit, and review of medical records were administered. Quantitative data were analyzed using descriptive statistics; the interviews underwent thematic content analysis, and findings were triangulated.

Results: Of the total number of professionals, 26 (33.33%) were classified as having effective quality management and 52 (66.66%) as having ineffective management. By category, effective management was observed in 11/26 nurses (42.30%), 10/30 specialist physicians (33.33%), and 5/22 resident physicians (22.72%). Qualitative analysis identified organizational barriers (lack of formal coordination), excessive workload, insufficient protected time for teaching, gaps in pedagogical skills, and limitations in the incident reporting culture.

Conclusion: The current state of quality management in clinical teaching presents organizational and training weaknesses that require integrated governance actions, protection of teaching time, training in clinical teaching, and strengthening of a non-punitive safety culture.