Educacion Medica最新文献

The evaluation of the resident is a moral act, since its ultimate goal is to guarantee citizens a competent, safe and reliable professional, it is a process whose guiding principle is professional ethics. The tutor plays a key role in the resident evaluation process; it is especially important when this evaluation is negative, since the safety of the patients may be in danger. In this article we review the standard that regulates the evaluation of internal resident specialists in Spain, the importance of the participation of different teaching figures and institutions. We discuss the evaluation process, its importance and the methods that can be used, especially the tutor-resident interviews. We insist on the importance of the written record of all these activities, and we highlight the difficulties that we may encounter in the evaluation process of our residents.

Introduction-objectives

In the training of Health Science residents, it is essential to develop bioethical thinking. This teaching challenge must be adapted to current technologies. The online course “Introduction to everyday bioethics for first-year residents” is analysed. Few activities of this type have been designed for residents or analysed using quantitative methods.

Material and methods

Data were extracted from the online platform and from a satisfaction survey of 3 editions (2021-2023). Course performance variables and the influence of the design change after the 1^st edition were included. Quantitative variables were analysed using different statistical tests (R version 4.2.0).

Results

The course was completed by 1,268 students (72% female). Most accessed at least 75% of the audiovisual content; there were no differences between modules or by gender. After the first edition, participation increased significantly, as did satisfaction with the structure and timing of the course. 57.3% of the students scored more than 8/10 in the initial test and more than 90% in the final. 89% were satisfied with the learning.

Conclusions

The course seems to have been useful and formative for the learners. The self-management of the content as well as the format with short audio-visual pills were well appreciated. The e-learning methods still have limitations for the bioethical debate. In the long term, an impact on the quality of care could be seen.

“Evidence-based medicine” (EBM) proposes methods, techniques, and instruments for verifying, incorporating, and applying scientific information in individual and public health. However, the principles and postulates of EBM have evolved over time. Our objective was to analyze the principles and postulates of EBM and compare them with current research, to identify possible myths. We conducted a review and analysis of the literature to identify the current principles of EBM and its most disseminated postulates. Subsequently, we compared these postulates with scientific evidence and EBM principles to identify potential myths. We identified 3 current principles of EBM: “EBM is a systematic summary of the best available evidence”, “EBM provides guidance to determine the level of confidence in estimates”, and “Evidence is never enough to drive clinical decision making.” Additionally, we identified 4 widely disseminated postulates: (1) Systematic reviews are at the top of the evidence pyramid, (2) randomized clinical trials are the best type of evidence, (3) expert opinion is a type of scientific evidence, and (4) to make health decisions, we should only use scientific publications. We critically assessed these postulates against scientific evidence and EBM principles, revealing them to be "myths." We identified f4 myths of EBM and proposed solutions to foster a more accurate interpretation and utilization of scientific evidence.

Introduction

Scientific skills are a crucial foundation in the medical profession and should be addressed during undergraduate studies in universities and programs. Despite the necessity of acquiring such knowledge, evidence suggests its scarcity among medical professionals. This study aimed to evaluate the characteristics of the perception of scientific skills among students of Human Medicine in Peru and their associated factors.

Methods

This was an observational-analytical, cross-sectional study. Data were gathered from a secondary database created from the registration form of a virtual course conducted in 2022. The study population comprised students of Human Medicine from Peruvian universities enrolled in the aforementioned course. Associated factors were assessed using Poisson regressions with robust variances.

Results

Out of 750 surveyed students (mean age 22.7 ± 3.2 years), 27.6, 21.6, 25.5, and 20% reported a good perception of their skills in information retrieval, critical reading, research methodology, and scientific writing, respectively. The type of university attended and belonging to a scientific society or research group were associated with a 6% to 16% higher prevalence of these scientific skills.

Conclusion

There were low levels of perceived scientific skills, especially in writing and critical reading. Furthermore, being part of or having access to an environment that fosters research was associated with a positive perception of scientific skills.

Introduction

Communication is an important competence for nursing students. Despite its relevance, there are no valid and reliable instruments available to measure this competence in Chilean nursing students in simulated contexts. The aim of this research was to design and evaluate the psychometric properties of the CSASP.

Methods

A cross-sectional study was carried out in two stages: instrument construction and assessment of the psychometric properties of the scale. In the first stage, we conducted a literature review of English and Spanish-language articles on the CINHAL, PubMed, and ProQuest databases. In the second stage, we evaluated the face and content validity with simulated patients and experts. Then, the instrument was applied to 183 senior nursing students at a private university in Santiago de Chile. Construct validity was performed by exploratory factor analysis, homogeneity by Cronbach's Alpha, and Inter-rater reliability analysis with an intraclass correlation coefficient.

Conclusion

The CSASP is valid and reliable for measuring communication skills in nursing students in the context of clinical simulation.

Introduction

For at least a decade, medical faculties in various Latin American universities have undergone curricular reforms that involve the inclusion of topics and competencies related to the humanities and social sciences in the study plans of future healthcare professionals. The aim of this article is to analyze the integration of humanistic approaches and content in the declared curriculum of the medical program at the University of Chile for the development of competencies aimed at incorporating these dimensions.

Methods

A documentary review of course programs between 2016 and 2022 was conducted for the medical program, identifying competencies related to humanistic education, which were categorized using the Atlas.ti program and analyzed within the internal structure of the programs.

Results

Out of 84 course programs, 38 were found to declare contributions to 5 or more sub-competencies related to humanistic education within the educational plan. The inclusion of this dimension is evident in the educational goals, learning outcomes, achievement indicators, methodological strategy, and evaluation strategies, with a predominance in subjects within the ethical-social domain.

Conclusion

Within the educational plan of the medical program at the University of Chile, various elements are evident that directly contribute to what the literature describes as the humanistic dimension of medical education. However, there are discrepancies in the incorporation of humanistic competencies at various levels of the programs.

Introduction

Innovation in medical teaching in recent years has undergone major changes. Traditionally, the teacher used to rely exclusively on words, the blackboard, and anatomical dissection. Nowadays, classes are supported by numerous tools with the help of the computer.

Methods

In the Department of Human Anatomy of the Faculty of Medicine of our University, during the first 4-month period of the course, we introduced in the classes the projection of 13 short videos with an average duration of 2.33 min, from laparoscopic and open surgical interventions, endoscopic and radiological studies. We surveyed at the end of the first 4 months period to evaluate the student´s opinions of the videos shown.

Results

Regarding the usefulness of the video projection, 82.8% considered the projection very useful and 17.2% considered them somewhat useful. None of the students considered the projection of the videos to be useless for their learning. As for the duration of the videos, 97.3% considered the duration to be adequate. In the survey, the students freely expressed diverse opinions. Among others, they stated that they help to understand the real anatomy of the structures studied in 3 dimensions and that they help to review and consolidate theoretical knowledge of what has already been explained. They also said that they help with motivation in preclinical subjects. Others felt that the videos help to raise awareness of the practical usefulness of the subject in the context of the practice of medicine.

Conclusion

We can assure that the projection of short prepared videos, taking sequences of open or laparoscopic surgical interventions and endoscopic or radiological studies, is very useful for improving the understanding of the subject of human anatomy, helping to clarify concepts and consolidating knowledge and increasing the student's motivation, as well as the performance in the study.

Background

Emergency medicine (EM) is a developing specialty worldwide. In Chile, it has been developing for 25 years, however, there is a need for further progress.

Aim

We aimed to explore the current postgraduate curriculum in Chile and identify ways to standardise and improve it.

Methods

A qualitative case study approach was used to explore perspectives on EM curriculum development via interviewing residents, graduates and programme directors and documentary analysis of academic and governmental guidelines. Both data sets were evaluated through thematic analysis.

Results

Four documents were analyzed, and eight interviews were conducted. Four main themes emerged: curricular structure, influence of context, expectations of an emergency physician, EM perspectives. Current programs focus on workplace learning and protected time for learning; however, they differ in clinical exposure and quality of training. Collaboration was identified as a priority, emphasizing the need for programs to work together to ensure quality.

Conclusion

This study identifies the state of curriculum development of EM in Chile. It identifies similarities and differences between programs and areas for improvement. There is agreement on the need for a standardized curriculum, considering local context and societal needs.

Introduction

The aim of the study is to analyze the acceptability of an Integrative and Multidimensional Case Formulation Model implemented as an educational strategy in the first year of a child and adolescent psychiatry residency by a clinical supervisor within a one-way mirror room.

Materials and methods

A qualitative methodology is used through content analysis of interviews conducted with residents of the program who had participated consecutively in clinical supervision between 2018 and 2021. For the analysis, 5 theoretical constructs derived from the Theory of Planned Behavior and Fazio's MODE Model are used: attitudes, subjective norm, perceived behavioral control, motivation and opportunity.

Results

Twenty-six thematic codes that influence acceptability emerged from the analysis: 8 attitudinal codes (e.g. acceptability is favored by the usefulness of the Model to gain theoretical insight of the cases but with a high amount of time required); 4 normative codes (e.g. the approval or disapproval of the model by scholars outside the clinical supervision); 7 perceived behavioral control codes (e.g. the perceived self-efficacy increases over time); 4 motivational codes (e.g. the desire to learn) and 3 opportunity codes (e.g. joint deliberation with peers).

Conclusion

The results show valuable information for the development of educational strategies in the specialty residency program by approaching significant cognitive and affective factors which influence learning during the training periods. Aspects of the strategy that stand out as favoring the educational process are identified, along with other aspects that can be improved for better acceptability of the educational strategy.