Educacion Medica最新文献_第5页

Reflexiones sobre la muerte por estudiantes de medicina a través del taller death café 医学院学生透过死亡咖啡工作坊对死亡的思考

Q2 Social Sciences

Educacion Medica

Pub Date : 2025-10-06 DOI: 10.1016/j.edumed.2025.101102

Marco Antonio Rodríguez Paz , Ancu Tatiana Feng Escobar , José Miguel Gutiérrez , Marina Menjivar , Daniella María Saade Saade , Willians López Chacón , José Mario López Saca

Introduction

The topic of death continues being taboo although along history it has been one of the most disputed themes by philosophers, sociologists and psychologists. Medical students during clinical rotations, possibly for the first time will observe death of a patient, as well as the psychosocial implications of it. Death cafe arises from the ideas of sociologist and ethnologist Bernard Crettaz and can be described as gatherings of people in an informal setting, with no set agenda and talk about death. There are few spaces for the discussion of these topics for society in Central American and El Salvador, especially directed towards medical students.

Materials and methods

This is an observational research paper; 30 sixth year medical students coursing Palliative Care took part, 25 (n = 25) of the reflections were later analyzed and computed.

Results

Of the analyzed reflections, 11 labels were created of these topics: “End of life wishes”, “End of life empathy”, “Mourning”, “Funeral rituals”, “Value of life”, "Life after death”, “Taboo”, “Legacy”, “Death coping”, “Human Connection”, and “Palliative care”, being the topics mentioned the most “End of life empathy” (n = 21/25), and “Taboo” (n = 13/25).

Conclusions

Death cafe is a space that propitiates an environment of introspective reflection, with the goal of sensibilizing undergraduate health care professionals. In our research we found how these spaces improve student´s perception of empathy and impact of death and how it´s processed by them.

尽管死亡一直是哲学家、社会学家和心理学家最具争议的话题之一，但它仍然是一个禁忌话题。医科学生在临床轮转期间，可能是第一次观察病人的死亡，以及它的社会心理影响。死亡咖啡馆源于社会学家和民族学家Bernard Crettaz的想法，可以被描述为人们在非正式的环境中聚会，没有固定的议程，谈论死亡。在中美洲和萨尔瓦多，很少有空间为社会讨论这些问题，特别是针对医科学生。材料与方法这是一篇观察性研究论文；30名六年级医学生参加了姑息治疗课程，对其中25名（n = 25）的反思进行了分析和计算。结果在分析的反思中，对“临终愿望”、“临终共情”、“哀悼”、“丧葬仪式”、“生命价值”、“死后生活”、“禁忌”、“遗产”、“死亡应对”、“人际关系”、“姑息治疗”等11个话题进行了标注，其中“临终共情”（ = 21/25）和“禁忌”（ = 13/25）是被提及最多的话题。死亡咖啡馆是一个营造内省反思环境的空间，其目标是提高本科医疗保健专业人员的敏感度。在我们的研究中，我们发现这些空间如何提高学生对同情和死亡影响的感知，以及他们如何处理死亡。

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引用次数: 0

Importancia de la fase preanalítica de la toma de muestras en la evaluación del proceso de soporte de laboratorio clínico 分析前取样阶段在评估临床实验室支持过程中的重要性

Q2 Social Sciences

Educacion Medica

Pub Date : 2025-09-29 DOI: 10.1016/j.edumed.2025.101101

Adolfo Romero-Arana , Jorge Martín-Pereira , Javier Fagundo-Rivera , Juan Gómez-Salgado , Adolfo Romero-Ruiz

Introduction

The increasing complexity of the Clinical Laboratory Process and the large number of professionals involved require effective coordination across different levels of care. Given the clinical and economic importance of these processes within the Andalusian healthcare system, this study focuses on analyzing the degree of implementation and quality of the clinical laboratory process in its pre-analytical phase in Primary Care.

Methods

A cross-sectional descriptive study was designed using an ad hoc online questionnaire, partially validated through a statistical pilot test. The research was conducted in healthcare centers of the Andalusian public system in the province of Huelva between January and March 2021. A total of 250 questionnaires were distributed, with 223 responses obtained (response rate: 89.2%), and a balanced participation between men (44.8%) and women (55.1%).

Results

The questionnaire showed excellent internal consistency (α > 0.9). A total of 223 questionnaires (89.2%) were completed by professionals from Huelva, mostly women and nurses. In sample collection, the highest-rated item was the staff's legal competence and skills (82.0% rated “excellent”), followed by collection schedules adapted to each center (62.1%). Regarding identification safety, the most notable result was the verification of correspondence between request and patient (65.9%).

Conclusion

Protocol adherence was particularly high among primary care professionals, who play a key role in the pre-analytical phase. The study concludes that process standardization is essential to reduce errors, ensure clinical safety, and improve healthcare outcomes.

越来越复杂的临床实验室流程和大量的专业人员需要在不同的护理水平之间进行有效的协调。考虑到安达卢西亚医疗保健系统中这些过程的临床和经济重要性，本研究侧重于分析初级保健前分析阶段临床实验室过程的实施程度和质量。方法采用临时在线问卷设计横断面描述性研究，并通过统计先导检验进行部分验证。该研究于2021年1月至3月在韦尔瓦省安达卢西亚公共系统的医疗中心进行。共发放问卷250份，获得回复223份（回复率89.2%），男性（44.8%）和女性（55.1%）参与均衡。结果问卷具有良好的内部一致性（α >； 0.9）。共有223份问卷（89.2%）由Huelva的专业人员完成，主要是女性和护士。在样本收集中，评价最高的项目是工作人员的法律能力和技能（82.0%的人认为“优秀”），其次是每个中心适应的收集时间表（62.1%）。在识别安全性方面，最显著的结果是验证请求与患者之间的对应关系（65.9%）。结论初级保健专业人员的方案依从性特别高，他们在分析前阶段起着关键作用。该研究得出结论，流程标准化对于减少错误、确保临床安全和改善医疗保健结果至关重要。

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引用次数: 0

Percepción de la gamificación en la educación médica: un estudio en estudiantes de Medicina en Paraguay 对医学教育中的游戏化的看法：对巴拉圭医科学生的一项研究

Q2 Social Sciences

Educacion Medica

Pub Date : 2025-09-29 DOI: 10.1016/j.edumed.2025.101104

Nelson Gabriel López Esquivel , Esther León-Castelao , Telmo Raul Aveiro-Róbalo

Introduction

Gamification, understood as the application of game dynamics in non-game environments, emerges as an innovative educational strategy to enhance student motivation and engagement. In medical education, this approach is particularly useful given the high academic demands and the need to meaningfully integrate theoretical and practical knowledge.

Objective

To analyze medical students' perceptions of gamification in their educational process.

Method

A cross-sectional quantitative study was conducted with 331 medical students from the Universidad del Pacífico, Paraguay, using specific questionnaires on player profile, PAMLES, and a survey on gamified experiences in the Medical Skills Training Workshop.

Results

Most students valued gamification positively, highlighting motivational and learning benefits. Some negative perceptions included difficulties with teamwork and a feeling of wasted time.

Discussion

Gamification represents a valuable pedagogical tool in medical education, with the potential to personalize teaching and increase student engagement. Its application should consider player profiles, institutional context, and potential resistance.

游戏化被理解为游戏动态在非游戏环境中的应用，是一种创新的教育策略，可以增强学生的动机和参与度。在医学教育中，由于学术要求高，需要有意义地整合理论和实践知识，这种方法特别有用。目的分析医学生在教育过程中对游戏化的认知。方法对来自巴拉圭Pacífico大学的331名医科学生进行了横断面定量研究，使用了关于玩家简介、PAMLES和医疗技能培训研讨会游戏化体验的具体问卷调查。结果大多数学生积极评价游戏化，强调了激励和学习的好处。一些负面看法包括团队合作困难和浪费时间的感觉。amification是医学教育中一种有价值的教学工具，具有个性化教学和提高学生参与度的潜力。它的应用应该考虑玩家的个人资料、制度背景和潜在阻力。

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引用次数: 0

Ideación suicida y variables asociadas en estudiantes universitarios de Medicina: un análisis de correspondencias múltiples 医学院学生的自杀意念和相关变量：多重对应分析

Q2 Social Sciences

Educacion Medica

Pub Date : 2025-09-29 DOI: 10.1016/j.edumed.2025.101105

Rosa Paola Figuerola-Escoto, Amalia Guadalupe Gómez-Cotero, Manuel Alejandro García-Martínez, Susana López-Rosas

Introduction

The suicide rate among medical students is higher than in the general population and has been associated with discrimination from superiors, depression, anxiety, burnout, and substance use. The objective of this study was to identify distinct profiles of suicidal ideation in medical students and to determine the variables that predict elevated levels of suicidal ideation.

Material and methods

A total of 440 medical students participated, completing a sociodemographic questionnaire, the University Student Burnout Scale, the Beck Depression and Anxiety Inventories, the Beck Scale for Suicide Ideation, and the ASSIST v3.0 substance use screening test.

Results

Multiple Correspondence Analysis identified four profiles: 1) no-risk participants; 2) low-risk participants, comprised primarily of men with low suicidal ideation, minimal levels of anxiety and depression, and low substance use; 3) medium-risk participants, comprised primarily of women with moderate suicidal ideation, moderate to severe anxiety, and moderate to severe depression; and 4) high-risk participants with severe suicidal ideation, elevated academic burnout, and high levels of substance use. Logistic Regression indicated that younger age, higher levels of anxiety and depression, and higher risk of tranquilizer use predict elevated levels of suicidal ideation.

Conclusion

The results demonstrate the need to implement specific interventions targeted at each identified profile, paying special attention to the variables that predict the presence of elevated suicidal ideation.

医学生的自杀率高于一般人群，并与上级歧视、抑郁、焦虑、倦怠和药物使用有关。本研究的目的是确定医学生自杀意念的不同特征，并确定预测自杀意念水平升高的变量。材料与方法440名医学生参与调查，完成社会人口学问卷、大学生倦怠量表、贝克抑郁与焦虑量表、贝克自杀意念量表和ASSIST v3.0药物使用筛选测试。结果多重对应分析确定了四种特征：1)无风险参与者；2)低风险参与者，主要包括自杀意念低、焦虑和抑郁水平低、药物使用低的男性；3)中等风险参与者，主要包括有中度自杀意念、中度至重度焦虑和中度至重度抑郁的女性；4)有严重自杀意念、学业倦怠程度高、药物使用水平高的高危参与者。Logistic回归分析表明，年龄越小、焦虑和抑郁水平越高、使用镇静剂的风险越高，自杀意念水平越高。结论：研究结果表明，有必要针对每个确定的特征实施具体的干预措施，特别注意预测自杀意念升高的变量。

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引用次数: 0

Mixed methods evaluation of megacode simulation training to enhance clinical reasoning and decision making in critical care nursing 巨码模拟训练提高重症护理临床推理和决策能力的混合方法评价

Q2 Social Sciences

Educacion Medica

Pub Date : 2025-09-24 DOI: 10.1016/j.edumed.2025.101094

Rudena A. Madayag , Christian Leandro Monieno , Jonel Mallari , Angela Apostol , Evangeline Bautista , Rei Angelo Mangibin , Dennison Jose Punsalan , Isabelito Nabong

Background

Effective clinical judgment is essential for critical care nursing, yet few studies have comprehensively examined how simulation training impacts both technical and cognitive development. This study evaluated the effectiveness of megacode simulation training, coupled with structured debriefing, in enhancing clinical reasoning and decision-making among fourth-year Bachelor of Science in Nursing (BSN) students.

Materials and methods

A convergent parallel mixed methods design was employed. Quantitatively, 150 BSN students completed pre- and post-tests using the Lasater Clinical Judgment Rubric (LCJR), analyzed with non-parametric tests. Qualitatively, ten focus groups and 20 interviews were thematically analyzed under a constructivist paradigm. Findings were integrated through data triangulation.

Results

Quantitative findings demonstrated significant improvements across all LCJR domains (p < .001), with large effect sizes (Cohen's d ≥ 1.01), particularly in prioritizing data and skillful intervention. Qualitative analysis revealed six themes, including growth from chaos to clarity, increased confidence under pressure, improved communication, and enhanced critical thinking. Students described transformative learning experiences that bridged the gap between theoretical knowledge and clinical application. Integration of findings confirmed that megacode simulations foster both technical proficiency and cognitive-emotional development.

Conclusion

Megacode simulation training significantly enhances students' clinical judgment, critical thinking, and teamwork. Despite limitations in sampling and short-term outcome evaluation, the findings affirm the value of experiential, reflective simulation learning. Systematic integration of simulation across nursing curricula and longitudinal follow-up studies are recommended to maximize and sustain clinical competence development.

有效的临床判断对重症护理至关重要，但很少有研究全面考察模拟训练如何影响技术和认知发展。本研究评估了巨码模拟训练，结合结构化述职，在提高四年级护理学学士（BSN）学生的临床推理和决策的有效性。材料与方法采用收敛平行混合法设计。在定量方面，150名BSN学生使用激光临床判断量表（LCJR）完成了前后测试，并采用非参数测试进行分析。定性上，在建构主义范式下对10个焦点小组和20个访谈进行主题分析。研究结果通过数据三角测量进行整合。结果定量结果显示，LCJR各域均有显著改善（p <； ）。0.001)，具有较大的效应量（Cohen's d ≥ 1.01），特别是在优先排序数据和熟练干预方面。定性分析揭示了六个主题，包括从混乱到清晰的成长，在压力下增强信心，改善沟通和增强批判性思维。学生们描述了在理论知识和临床应用之间架起桥梁的变革性学习经历。综合研究结果证实，巨码模拟促进了技术熟练程度和认知情感发展。结论megacode模拟训练能显著提高学生的临床判断能力、批判性思维能力和团队合作能力。尽管在抽样和短期结果评估方面存在局限性，但研究结果肯定了经验性、反思性模拟学习的价值。建议在护理课程和纵向随访研究中系统整合模拟，以最大限度地提高和维持临床能力的发展。

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引用次数: 0

Formación sistemática, integral y sostenida en la educación médica 系统的、全面的和持续的医学教育培训

Q2 Social Sciences

Educacion Medica

Pub Date : 2025-09-10 DOI: 10.1016/j.edumed.2025.101096

Susana Peña , Carlos Martinez-Santander , Veronica Cantos Reyes , Mireya Frausto Rojas

引用次数: 0

La formación en simulación clínica y su aporte a la cognición situada para fisioterapeutas 为物理治疗师提供临床模拟培训及其对认知的贡献

Q2 Social Sciences

Educacion Medica

Pub Date : 2025-09-08 DOI: 10.1016/j.edumed.2025.101099

Cyndi Yacira Meneses Castaño , Isabel Jimenez Becerra

Introduction

Clinical simulation has emerged as a valuable pedagogical tool in health education. Its integration with the theory of situated cognition has proven to be effective in offering authentic and challenging experiences that replicate conditions of professional practice.

Material and methods

In accordance with the purpose of the research, a mixed approach was used, this interest was due to the use of diverse techniques and instruments, used in the design phase, from which it was possible to decipher and recognize the thinking of the participants: students, graduates, teachers and directors, to operationalize this research a multiple case study design was assumed, in universities that train in physiotherapy with incorporation of high, medium and low clinical simulation. A textual narrative analysis of the findings was performed.

Results

The participants consider that clinical simulation should be a central methodology from the first semesters, not only as a complement, but also as a strategy that increases interest and motivation for learning, thus developing situated cognition. Likewise, they state that, by making use of technology, simulation allows some of the clinical processes to be more dynamic, without losing their scientific rigor, which generates a contribution in the improvement of physiotherapeutic criteria.

Conclusion

The need to transform curricula to incorporate situated cognition as a transversal pedagogical strategy is identified. This implies promoting the use of technologies as learning mediators, oriented to the development of integral human capacities in future physiotherapists.

临床模拟已成为健康教育中一种有价值的教学工具。它与情境认知理论的整合已被证明在提供真实和具有挑战性的经验方面是有效的，这些经验可以复制专业实践的条件。材料和方法根据研究的目的，使用了混合方法，这种兴趣是由于在设计阶段使用了不同的技术和工具，从中可以破译和识别参与者的想法：学生，毕业生，教师和主管，为了实施这项研究，假设了多案例研究设计，在物理治疗培训的大学中，结合高，中，低临床模拟。对调查结果进行了文本叙述分析。结果参与者认为临床模拟应该是第一学期的中心方法，不仅作为补充，而且作为增加学习兴趣和动机的策略，从而发展情境认知。同样，他们指出，通过利用技术，模拟可以使一些临床过程更加动态，而不会失去其科学严谨性，这对改善物理治疗标准做出了贡献。结论需要将课程转变为将情境认知作为一种横向教学策略。这意味着促进技术作为学习媒介的使用，面向未来物理治疗师整体人类能力的发展。

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引用次数: 0

Cuestionario de opinión para evaluar la integración de la dimensión ética en el modelo educativo de una carrera de las ciencias de la salud. Diseño y validación 评估健康科学职业教育模式中伦理维度的整合的意见问卷。设计和验证

Q2 Social Sciences

Educacion Medica

Pub Date : 2025-09-08 DOI: 10.1016/j.edumed.2025.101097

Eugenia Henríquez- D'Aquino , Pamela Muñoz Cortés , Christel Hanne Altermatt

Introduction

The teaching of ethical values in healthcare programs is fundamental, as they guide students' behavior and professional performance. The University of Chile has implemented a competency-based educational model that promotes comprehensive training. The objective of this study was to design and validate a questionnaire to determine the opinions of clinical instructors on the integration of the ethical dimension into the curricula of the Dentistry program.

Methods

A quantitative, cross-sectional, and exploratory study was conducted with 60 clinical instructors in the Dentistry program. A Likert-type opinion questionnaire with ethical dimensions was designed. The content was validated with expert judgment and the Individual Content Validity Index, the construct was validated with Exploratory Factor Analysis, and the instrument's reliability was assessed with Cronbach's Alpha coefficient.

Results

The questionnaire, consisting of five analytical axes and 25 items, was validated. The items were validated with an IVC value > 0.78, the construct with values > 0.5, and the overall reliability of the questionnaire with a value of 0.8185.

Conclusion

The questionnaire presents evidence of content, construct, and reliability validity, making it a useful tool for curriculum evaluation in ethics. Given the cross-curricular nature of ethics, it may also be relevant to other disciplines. Therefore, the instrument can be adapted to the educational realities of different institutions to assess the development of the ethical dimension in their curricula.

在医疗保健课程中，道德价值观的教学是基本的，因为它们指导学生的行为和专业表现。智利大学实施了以能力为基础的教育模式，促进全面培训。本研究的目的是设计并验证一份问卷，以确定临床教师对将伦理维度纳入牙科课程的意见。方法采用定量、横断面、探索性研究方法，对60名牙科专业临床教师进行调查。设计了带有伦理维度的李克特式意见问卷。采用专家判断和个体内容效度指数对内容进行验证，采用探索性因子分析对结构进行验证，采用Cronbach’s Alpha系数对量表的信度进行评估。结果该问卷包括5个分析轴，共25个题项。问卷的IVC值为>； 0.78，构式值为>； 0.5，整体信度值为0.8185。结论该问卷在内容、结构、信度效度等方面具有较好的证据性，可作为伦理课程评价的有效工具。鉴于伦理学的跨学科性质，它也可能与其他学科相关。因此，该工具可以适应不同机构的教育现实，以评估其课程中道德方面的发展情况。

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引用次数: 0

Evaluation of pharmacy students' experience toward internship practices in community pharmacy: A cross-sectional study from Türkiye 评量药学学生在社区药房的实习经验：来自<s:1> rkiye的横断面研究

Q2 Social Sciences

Educacion Medica

Pub Date : 2025-09-04 DOI: 10.1016/j.edumed.2025.101098

Inci Kayin , Anmar Al-Taie , Jouwana Elmasri

Introduction

Community pharmacy settings are considered the front line to provide effective patient care and safe use of medicines. A pharmacy internship program imposes considerable responsibility on pharmacy students to prioritize their education and training to become patient-centered healthcare providers and to support their further professional development. The aim of this study was to explore the perceptions and the experience of undergraduate pharmacy students who had their training practices in community pharmacies and to identify the related barriers during the internship training program in Türkiye.

Materials and methods

A cross-sectional study was conducted among pharmacy students who had received their training in community pharmacy settings in Istanbul, Türkiye. The study was conducted using validated online questionnaires consisting of five sections during the period from March to October 2024.

Results

A total of 231 pharmacy students responded to the questionnaires with a mean age of 22 ± 2.66 years. The majority of the students reported that the community pharmacy offered a practical setting that facilitates students' communication with patients (82.7%, mean 4 ± 0.86, p < 0.0001), the community pharmacy had the necessary resources for drug information (92.2%, mean 4 ± 0.75, p < 0.0001), their internship experience had increased their involvement in the pharmacy profession (92.2%, mean 4 ± 0.71, p < 0.0001), and 87.4% (mean 4 ± 0.77, p < 0.0001) showed that the pharmacy internship program alleviates the stress of direct patient contact. However, most of the trainees reported that there were difficulties in finding a pharmacy for internship training (53.7%, mean 4 ± 1.4, p < 0.0001).

Conclusion

The current study revealed that the pharmacy students acquired experience and knowledge during their internship and were equipped with the skills they needed to practice their future pharmacy profession effectively and efficiently. The learning outcomes related to these skills should be addressed during pharmacy degree courses and to implement structured preparation programs before the start of the internship or systematic training for preceptors in community pharmacies that could develop their skills required for the internship process.

社区药房被认为是提供有效患者护理和安全用药的一线。药学实习项目要求药学学生承担相当大的责任，优先考虑他们的教育和培训，成为以患者为中心的医疗保健提供者，并支持他们进一步的专业发展。本研究的目的是探讨在社区药房实习的药学本科学生的认知和体验，并找出在瑞基耶实习培训计划中的相关障碍。材料和方法对在土耳其伊斯坦布尔社区药房接受培训的药学专业学生进行了一项横断面研究。该研究在2024年3月至10月期间使用经过验证的在线问卷进行，包括五个部分。结果共有231名药学专业学生参与问卷调查，平均年龄为22岁 ± 2.66 岁。大多数学生报道,社区药房提供了一个实用的设置,便于学生与病人沟通(82.7%,意味着4 ± 0.86,p & lt; 0.0001),社区药房药品信息,有必要参考资料(92.2%,意味着4 ± 0.75,p & lt; 0.0001),他们的实习经历增加了参与制药行业(92.2%,意味着4 ± 0.71,p & lt; 0.0001),和87.4%(意思是4 ± 0.77,P <； 0.0001)表明药房实习项目缓解了直接接触患者的压力。然而，大多数实习生反映难以找到实习培训的药房（53.7%，平均4 ± 1.4,p <； 0.0001）。结论药学专业学生在实习过程中积累了丰富的经验和知识，具备了有效、高效地从事药学职业所需的技能。与这些技能相关的学习成果应在药学学位课程中得到解决，并在实习开始前实施结构化的准备计划，或对社区药房的领班进行系统培训，以培养他们在实习过程中所需的技能。

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引用次数: 0

Reconocimiento del tutor clínico: una estrategia para la sostenibilidad de la educación médica 认可临床导师：医学教育可持续性战略

Q2 Social Sciences

Educacion Medica

Pub Date : 2025-09-01 DOI: 10.1016/j.edumed.2025.101124

Javier de Miguel Díez

引用次数: 0