Revista Medica Clinica Las Condes最新文献_第2页

Percepciones sobre educación interprofesional en estudiantes y docentes de primer año en carreras de Ciencias de la Salud a través de Aprendizaje-Servicio en contexto de COVID-19: un análisis mixto 在 COVID-19 的背景下，健康科学本科课程一年级学生和教师通过服务学习对跨专业教育的看法：混合分析。

IF 0.2 Q4 MEDICINE, GENERAL & INTERNAL

Revista Medica Clinica Las Condes

Pub Date : 2024-09-01 DOI: 10.1016/j.rmclc.2024.05.013

Nayadet Lucero-González MSc , Daniela Avello-Sáez MSc, PhD , Eduardo Fuentes-López PhD , Fernanda Calvo-Sánchez MSc , Alejandra Espinosa-Repenning MSc , Paz Jeldes-Díaz MSc , Javiera Fuentes-Cimma MSc , Ignacio Villagrán MSc , Arnoldo Riquelme-Pérez MD, MSc

Introduction

Interprofessional education (IPE) is crucial for the training of future health professionals, promoting collaboration and teamwork between disciplines. This study analyzes the perceptions about IPE of students and teachers in first year health sciences courses, using a Service Learning (S-L) methodology, which was conducted online during the COVID-19 pandemic.

Methodology

A sequential mixed-method approach was implemented involving 88 students and 12 faculty members from Occupational Therapy, Physiotherapy, Nutrition and Dietetics, and Speech Therapy.

Results

The findings revealed significant differences in the disposition towards interprofessional learning and interprofessional education after the intervention, especially in Nutrition and Dietetics students. Furthermore, the qualitative analysis highlighted the favorable perception of students and teachers towards IPE in virtual mode. Key skills such as interaction, communication, commitment, respect, and empathy were highlighted. The triangulation of qualitative and quantitative data showed convergence in “teamwork” and “patient-centeredness”.

Conclusion

This study supports the importance of IPE in the undergraduate training of health professionals, even in virtual environments like the present. Students demonstrated an excellent disposition and patient-centered approach. These findings underscore the need to continue developing undergraduate IPE programs, equipping students with skills and competencies for their future professional careers.

引言跨专业教育（IPE）对于培养未来的卫生专业人员、促进学科间的合作和团队精神至关重要。本研究采用服务学习（S-L）方法，分析了一年级健康科学课程的学生和教师对 IPE 的看法，研究在 COVID-19 大流行期间在线进行。此外，定性分析强调了学生和教师对虚拟模式 IPE 的良好看法。互动、沟通、承诺、尊重和移情等关键技能得到了强调。定性和定量数据的三角分析表明，"团队合作 "和 "以病人为中心 "是一致的。学生们表现出了良好的性格和以病人为中心的态度。这些发现强调了继续发展本科生 IPE 课程的必要性，使学生具备未来职业生涯所需的技能和能力。

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引用次数: 0

La toma de decisiones durante las prácticas clínicas: análisis desde la neuroeducación 临床实践中的决策制定：神经教育分析

IF 0.2 Q4 MEDICINE, GENERAL & INTERNAL

Revista Medica Clinica Las Condes

Pub Date : 2024-09-01 DOI: 10.1016/j.rmclc.2024.09.003

Janet Altamirano-Droguett PhD , Jessica Goset-Poblete PhD , Natalia Campillay-Arancibia , Melanie Castro-Escobar , Alexandra Letelier-Zárate , Bárbara Robledo-González

Introduction

Decision-making during clinical practices involves a series of interrelated mental processes such as working memory, inhibitory control, cognitive flexibility and emotional regulation, which influence the teaching and learning process.

Objective

To analyze the decision-making process in Obstetrics and Childcare students of the Universidad de Antofagasta, Chile during clinical practices in teaching-assistance fields from the neuroeducation.

Method

An exploratory qualitative research was carried out through semi-structured interviews with 16 female students. The narratives were analyzed through grounded theory.

Results

The experiences and knowledge gained allowed the consolidation of the memory and supported correct decisions in front of the patients. Adaptation to new situations, adverse events and critical incidents was conditioned by the teacher's supervision, as well as sustained attention during decision making in real environments. Negative emotions predominated from the beginning and at the end of all decision-making processes.

Conclusion

Since decision-making is a complex process that involves a synergy between working memory, cognitive flexibility, inhibitory control and emotional regulation, independent of temporality, it is therefore advisable to promote teaching based on neuroeducation, because it allows the teacher to understand the mental processes of students, to favor a harmonic educational climate and to strengthen pedagogical skills.

引言临床实践中的决策涉及一系列相互关联的心理过程，如工作记忆、抑制控制、认知灵活性和情绪调节，这些过程影响着教学和学习过程。结果获得的经验和知识有助于巩固记忆，并支持在病人面前做出正确的决定。对新情况、不利事件和危急事件的适应受到教师监督的制约，在真实环境中做出决策时也需要持续关注。结论由于决策是一个复杂的过程，涉及工作记忆、认知灵活性、抑制控制和情绪调节之间的协同作用，不受时间性的影响，因此，促进基于神经教育的教学是可取的，因为它可以让教师了解学生的心理过程，有利于营造和谐的教育氛围，并加强教学技能。

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引用次数: 0

Integridad académica desde la perspectiva de los estudiantes de primer año de carreras de Ciencias de la Salud de una universidad chilena 从智利一所大学健康科学学位一年级学生的角度看学术诚信问题

IF 0.2 Q4 MEDICINE, GENERAL & INTERNAL

Revista Medica Clinica Las Condes

Pub Date : 2024-09-01 DOI: 10.1016/j.rmclc.2024.10.006

María Isabel Ríos-Teillier MEd , Beatriz Parada-Romero MA , Paula Ligeti-Stuardo MEd , Rubén Munizaga-Ramírez MPH

Introduction

This study aimed to examine perceptions of academic integrity among first-year health career students at a Chilean university.

Method

A qualitative analysis was conducted using discussion forums with students from Medicine, Nursing, Kinesiology, and Nutrition and Dietetics.

Results

Four main categories were identified: concept of academic integrity, motives for the loss of integrity, good practices, and relationship with the graduate profile. The results reveal an understanding of academic integrity that is grounded in values such as honesty and respect. The reasons for the loss of integrity include academic and social pressures, along with concerns about well-being and mental health.

Good practices were identified at personal as well as academic and social levels, emphasizing the importance of the construction of the “being”, setting boundaries, and promoting participation in positive social groups. The relationship between academic integrity and graduate profiles is underscored in its relevance to professional training and the construction of an institutional ethical identity.

Overall, these findings highlight the need to promote strategies that cultivate a university culture committed to academic integrity.

引言本研究旨在考察智利一所大学一年级健康职业学生对学术诚信的看法。方法通过与来自医学、护理学、运动学以及营养与饮食学的学生进行讨论，对其进行了定性分析。结果确定了四个主要类别：学术诚信的概念、丧失诚信的动机、良好做法以及与毕业生档案的关系。研究结果表明，对学术诚信的理解以诚实和尊重等价值观为基础。丧失诚信的原因包括学业和社会压力，以及对幸福和心理健康的担忧。在个人、学业和社会层面都发现了良好做法，强调了 "存在 "的构建、设定界限和促进参与积极的社会团体的重要性。总之，这些研究结果突出表明，有必要推广培养学术诚信大学文化的战略。

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引用次数: 0

Atención de urgencia por ideación suicida en Chile, periodo 2020 al 2022 2020 年至 2022 年期间智利对有自杀倾向者的紧急护理

IF 0.2 Q4 MEDICINE, GENERAL & INTERNAL

Revista Medica Clinica Las Condes

Pub Date : 2024-09-01 DOI: 10.1016/j.rmclc.2024.08.006

Patricia Moya MSc , Carol Toro MSc , Carolina Vidal MSc , Sofía Sierra MSc

Introduction

Suicidal ideation is a common risk factor associated with suicide and an important indicator for its prevention. The objective of this study is to describe the rate of emergency care for suicidal ideation in the population served in the Chilean public health network during the years 2020 to 2022.

Methods

Descriptive study, based on records from the Department of Statistics and Health Information, of beneficiaries with emergency care for suicidal ideation. The rate of emergency care for suicidal ideation was estimated at the country and geographic region level, as well as with regards to the proportion of care by age group, type of health facility and month of occurrence. Pearson's Chi2 test was applied in STATA version 14.

Results

There were 15,325 emergency visits for suicidal ideation in the period studied. In 2020, the rate was 0.03 × 10,000 and 5.8 × 10,000 in 2022, higher in the central zone. Care predominated in the 15 to 64 year-old group and in hospital settings (p < 0.001).

Conclusions

An increase in the rate of emergency care for suicidal ideation is observed, with differences by age group and type of health facility. However, given the limited study time, these figures should be analyzed with caution.

导言：自杀意念是与自杀相关的常见风险因素，也是预防自杀的重要指标。本研究旨在描述 2020 年至 2022 年期间，智利公共卫生网络所服务人群中因自杀意念而接受急诊治疗的比例。研究估算了国家和地理区域层面的自杀意念急诊率，以及按年龄组、医疗机构类型和发生月份划分的急诊比例。在 STATA 14 版中进行了 Pearson's Chi2 检验。2020 年的发病率为 0.03 × 10,000，2022 年为 5.8 × 10,000，中部地区的发病率较高。15 至 64 岁年龄组和医院中的就诊率较高（p < 0.001）。结论：研究发现，自杀意念急诊就诊率有所上升，不同年龄组和医疗机构类型的就诊率存在差异。然而，由于研究时间有限，在分析这些数据时应谨慎。

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引用次数: 0

Explorando la alfabetización en feedback en la formación de profesionales de la salud: un estudio cualitativo 探索卫生专业人员培训中的反馈素养：一项定性研究

IF 0.2 Q4 MEDICINE, GENERAL & INTERNAL

Revista Medica Clinica Las Condes

Pub Date : 2024-09-01 DOI: 10.1016/j.rmclc.2024.10.004

Javiera Fuentes-Cimma MSc , Francisca Rammsy , Alanis Molina-Obreque , Valentina Murga-Alfaro , Catalina Neira-Silva , Daniela Olivares-Maturana , Ignacio Villagrán MSc

Introduction

Feedback is recognized as a process in which students make sense of information from various sources and use it to improve performance. Several studies have shown dissatisfaction from students about this process, which could mean there is no conceptual consensus about this process.

Feedback literacy refers to the understanding and capacities to make sense of the information received and use it to improve performance, which is considered essential for an effective feedback process. Despite its importance, the implications that student feedback literacy has in teaching and course design have not been sufficiently taken into account, and uncertainty persists about engaging them effectively, especially in clinical settings.

Methodology

Cross-sectional study with a pragmatic approach and qualitative methods. First and fourth-year students from health-related careers at the Pontificia Universidad Católica de Chile were invited to participate. Six focus groups were organized, and thematic analysis was used.

Results

Three themes guided the findings. Differences exist between first- and fourth-year students regarding their capacity to recognize feedback instances and how they make sense of their experiences with this educational strategy. Students perceive feedback as a one-way process. Higher-level students recognize more instances of feedback.

Conclusions

Understanding students’ feedback literacy will enable future educational interventions on feedback processes in Health Sciences.

导言反馈被认为是学生理解各种来源的信息并将其用于提高成绩的一个过程。一些研究表明，学生对这一过程并不满意，这可能意味着在这一过程的概念上还没有达成共识。反馈素养指的是对所收到的信息进行理解并将其用于提高成绩的理解和能力，这被认为是有效的反馈过程所必不可少的。尽管反馈素养很重要，但学生反馈素养对教学和课程设计的影响尚未得到充分考虑，如何有效地让学生参与其中，尤其是在临床环境中，仍存在不确定性。邀请智利天主教主教大学健康相关专业的一年级和四年级学生参加。研究组织了六个焦点小组，并采用了主题分析法。一年级学生和四年级学生在识别反馈实例的能力以及如何理解这一教育策略的经验方面存在差异。学生认为反馈是一个单向的过程。结论了解学生的反馈素养将有助于未来在健康科学中对反馈过程进行教育干预。

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引用次数: 0

Aportes de la neuroeducación a la simulación clínica 神经教育对临床模拟的贡献

IF 0.2 Q4 MEDICINE, GENERAL & INTERNAL

Revista Medica Clinica Las Condes

Pub Date : 2024-09-01 DOI: 10.1016/j.rmclc.2024.10.001

Jessica Goset-Poblete

Neuroeducation allows us to understand the learning process from a neuroscience standpoint. This knowledge makes it easier for academics to understand the importance of emotions and executive functions in learning. Based on this neuroscientific foundation, this article addresses the main characteristics of the brain processes that occur in active methodologies. This allows the reader to assess their importance and understand why active methodologies should be considered first choice methodologies for achieving deep learning. In particular, the clinical simulation strategy is reviewed, aligned with the active methodologies used in the training of health professionals. In conclusion, the importance of neuroeducation is highlighted for an effective and conscious implementation of clinical simulation, not only from the execution technique, but also from the neuroscientific foundation, which allows optimal benefit on the part of the students in the area of health.

神经教育使我们能够从神经科学的角度理解学习过程。这些知识使学术界更容易理解情绪和执行功能在学习中的重要性。基于这一神经科学基础，本文论述了积极教学法中大脑过程的主要特征。这使读者能够评估其重要性，并理解为什么主动式方法应被视为实现深度学习的首选方法。文章特别回顾了临床模拟策略，并将其与卫生专业人员培训中使用的主动式方法进行了对比。最后，强调了神经教育对于有效和有意识地实施临床模拟的重要性，不仅从执行技术上，而且从神经科学基础上，使学生在健康领域获得最佳收益。

引用次数: 0

La meditación como estrategia de intervención para disminuir el impacto del burnout en las funciones cognitivas de los estudiantes de Medicina: una revisión exploratoria 冥想作为减少职业倦怠对医学生认知功能影响的干预策略：探索性综述。

IF 0.2 Q4 MEDICINE, GENERAL & INTERNAL

Revista Medica Clinica Las Condes

Pub Date : 2024-09-01 DOI: 10.1016/j.rmclc.2024.10.002

María José Olivares , Ricardo Ramírez-Barrantes MSc, PhD

Introduction

The prevalence of burnout in the early years of medical training is a cause for concern and can negatively impact the learning and academic development of students. Meditation has been shown to be a set of techniques with the potential to reduce stress levels, improve attention and memory, and promote psychological well-being.

Objective

This study aims to analyze the current state of literature regarding the impact of meditation-based interventions on cognitive functions in medical students affected by burnout.

Method

A scoping review was conducted following PRISMA guidelines, examining studies found in PubMed and Scopus, which resulted in a total of 41 records.

Results

The studies indicate that burnout levels are established early in medical training. Although the literature reports impairments in cognitive functions such as attention, working memory, and executive functions, there is limited evidence regarding the impact on medical training itself.

Conclusion

Meditation shows promise in controlling both burnout and cognitive functions; however, a greater number of studies and a systematic review of the evidence are needed to obtain conclusive results for medical students.

引言医学培训初期普遍存在的职业倦怠令人担忧，会对学生的学习和学术发展产生负面影响。本研究旨在分析有关基于冥想的干预措施对受职业倦怠影响的医学生认知功能的影响的文献现状。方法按照PRISMA指南进行了范围综述，审查了在PubMed和Scopus上发现的研究，共获得41条记录。尽管文献报道了注意力、工作记忆和执行功能等认知功能的损伤，但有关对医学培训本身的影响的证据却很有限。结论瞑想在控制职业倦怠和认知功能方面显示出了前景；然而，需要更多的研究和对证据的系统性回顾，才能为医学生获得结论性的结果。

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引用次数: 0

Experiencia de acompañamiento biopsicosocial al recién nacido hospitalizado y su familia antes y durante la pandemia por COVID-19 在 COVID-19 大流行之前和期间对住院新生儿及其家人进行生物心理社会陪伴的经验

IF 0.2 Q4 MEDICINE, GENERAL & INTERNAL

Revista Medica Clinica Las Condes

Pub Date : 2024-09-01 DOI: 10.1016/j.rmclc.2024.08.003

Francisca Velozo-Ramírez MSc , Macarena Hernández-Fuentes MSc , Verónica Valdivia-Berdechefic , Marcia Olhaberry-Huber PhD , Mónica Morgues-Nudman MD, MSc

The COVID-19 pandemic generated new challenges in neonatal care. The need to maintain physical distance to prevent its spread resulted in a worldwide tendency to limit the presence of mothers and fathers in neonatal units, reducing the time spent with their baby. The aim of this article is to share the clinical experience in a neonatology with regards to the biopsychosocial care of hospitalized newborns and their families as well as present the adaptations made during the first months of the pandemic. The need to continue generating public policies and create family-centered protocols to protect the infant-caregiver relationship in order to provide continuity to neonatal care based on the promotion of neurodevelopment of the newborn, especially in highly complex health contexts, is discussed.

COVID-19 大流行给新生儿护理带来了新的挑战。由于需要保持物理距离以防止其传播，全世界都倾向于限制母亲和父亲在新生儿病房的逗留时间，从而减少了他们与婴儿在一起的时间。本文旨在分享新生儿科在住院新生儿及其家庭的生物-心理-社会护理方面的临床经验，并介绍大流行病最初几个月所做的调整。本文讨论了在促进新生儿神经发育的基础上，继续制定公共政策和创建以家庭为中心的协议以保护婴儿与照顾者之间关系的必要性，尤其是在高度复杂的健康环境中。

引用次数: 0

Predictores del éxito académico en estudiantes de pregrado de la carrera de Nutrición y Dietética de la Pontificia Universidad Católica de Chile 智利天主教主教大学营养与饮食学系本科生学业成功的预测因素

IF 0.2 Q4 MEDICINE, GENERAL & INTERNAL

Revista Medica Clinica Las Condes

Pub Date : 2024-09-01 DOI: 10.1016/j.rmclc.2024.09.002

Paulina Pettinelli MSc, PhD , Rodrigo Fernández-Verdejo MSc, PhD , Carolina Fredes MSc, PhD , Alejandra Parada MSc, PhD , Carolina Aguirre PhD

Introduction

Identifying the factors that determine academic success can help design strategies focused on increasing academic success. We aimed to identify predictors associated with academic success in undergraduate students of the Nutrition and Dietetics Program of the Pontificia Universidad Católica de Chile (PUC).

Methods

Retrospective study using the institutional database. Academic success was the main outcome, including two indexes: i) final grade point average (GPA-f) and; ii) timely graduation, defined as graduating in ≤10 semesters. Candidate predictors were: age, sex, region of origin, school attended, score at the university selection test (PSU-score), admission route, and preference for the program. Stepwise linear regression was used to identify predictors of GPA-f. Binary logistic regression was used to identify variables associated with timely graduation.

Results

PSU-score was the only predictor of GPA, explaining 24% of its variance. The odds (OR [95%CI]) for a timely graduation were influenced by PSU-score (1.017 [1.003–1.031]) and admission route (PSU 1.00 [Reference], Inclusive 0.30 [0.10–0.96], Special 0.46 [0.13–1.57]).

Conclusions and implications

PSU-score partially predicts the academic success of Nutrition and Dietetics students. In addition, students who accessed the program by the equity admission had lower odds of a timely graduation. As educational inequalities may affect academic success, the teaching and learning process needs to be addressed with specific strategies for these students to ensure academic success.

引言确定决定学业成功的因素有助于设计提高学业成功率的策略。我们的目的是找出与智利天主教大学（PUC）营养与饮食学专业本科生学业成功相关的预测因素。研究方法：使用院校数据库进行回顾性研究。学业成功是主要结果，包括两个指标：i) 最终平均学分绩点 (GPA-f) 和；ii) 按时毕业，定义为毕业时间不超过 10 个学期。候选预测因素包括：年龄、性别、原籍地区、就读学校、大学选拔考试成绩（PSU-score）、录取途径以及对专业的偏好。逐步线性回归用于确定 GPA-f 的预测因素。二元逻辑回归用于确定与按时毕业相关的变量。结果PSU-分数是唯一能预测GPA的因素，能解释24%的变异。按时毕业的几率（OR [95%CI]）受 PSU 分数（1.017 [1.003-1.031]）和入学途径（PSU 1.00 [参考]，Inclusive 0.30 [0.10-0.96]，Special 0.46 [0.13-1.57]）的影响。此外，通过公平录取入学的学生按时毕业的几率较低。由于教育不平等可能会影响学业成功，因此在教学过程中需要针对这些学生采取具体策略，以确保学业成功。

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引用次数: 0

Tormenta tiroidea desencadenante de paro cardiorrespiratorio: reporte de caso 甲状腺风暴引发心肺骤停：病例报告

IF 0.2 Q4 MEDICINE, GENERAL & INTERNAL

Revista Medica Clinica Las Condes

Pub Date : 2024-09-01 DOI: 10.1016/j.rmclc.2024.09.005

Eduardo Segovia-Vergara, Bárbara Reuse-Berner, Erick Rivera-Soto, Gabriela Ruiz-Cárcamo

Introduction

A thyroid storm is a rare but highly lethal disease. It is characterized by exaggerated symptoms of hyperthyroidism, and it can lead to multiorgan failure and cardiopulmonary arrest.

Case Report

A 35-year-old man with no prior medical history presented with a two-week history of palpitations and epigastric pain, which abruptly worsened over 24 hours, accompanied by nausea and diaphoresis. During transportation to the emergency department, he experienced cardiopulmonary arrest and multiorgan failure during his hospitalization. Family reported recent hyperthyroid symptoms led to the consideration of a thyroid storm diagnosis. Thyroid function tests revealed a free T4 level greater than 7.7 ng/dl and a TSH level less than 0.005 μIU/ml. The patient was treated with thiamazole, hydrocortisone, and propranolol, showing favorable progression.

Discussion and Conclusion

Opportune diagnosis of a thyroid storm is crucial, as early management and detection reduce complications and mortality. Once suspected, resuscitation measures and pharmacological treatment should be initiated to mitigate the effects of thyroid hormones.

导言甲状腺风暴是一种罕见但致死率极高的疾病。病例报告：一名 35 岁的男性患者，既往无病史，两周前出现心悸和上腹痛，24 小时后突然加重，伴有恶心和全身乏力。在送往急诊科的途中，他的心肺功能骤停，住院期间出现多器官功能衰竭。家人报告说他最近出现了甲状腺功能亢进症状，因此考虑诊断为甲状腺风暴。甲状腺功能检查显示游离 T4 水平高于 7.7 ng/dl，促甲状腺激素水平低于 0.005 μIU/ml。患者接受了噻马唑、氢化可的松和普萘洛尔治疗，病情进展良好。讨论与结论甲状腺风暴的及时诊断至关重要，因为早期处理和检测可减少并发症和死亡率。一旦确诊，应立即采取抢救措施和药物治疗，以减轻甲状腺激素的影响。

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引用次数: 0