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Valoración del uso de casos clínicos orales como herramienta evaluativa en el desarrollo de la competencia diagnóstica en situaciones de salud en estudiantes de Semiología Médica II 评价医学符号学二专业学生在发展健康状况诊断能力方面使用口腔临床病例作为评估工具的情况
Q2 Social Sciences Pub Date : 2025-07-08 DOI: 10.1016/j.edumed.2025.101078
Nathalia Salazar-Falla , Paula María Tello Cabrales

Introduction

The assessment of diagnostic competence in health situations is essential in medical education, but traditional strategies often limit the development of critical thinking. This study analyzes the use of oral clinical cases as an assessment tool to enhance this competence in students of Medical Semiotics II.

Methods

A mixed-methods study with an intrinsic and interpretative case study design was conducted with 80 fifth-semester medical students at Universidad Icesi. Data were collected through semi-structured interviews, focus groups, evaluation rubrics, and non-participant observation. Data analysis was categorical, allowing key patterns to be identified from various sources.

Results

The strategy promoted skills such as metacognition and clinical reasoning. Students positively valued immediate feedback, while faculty members highlighted its practical applicability. Logistical challenges and the need to establish standardized evaluation criteria were identified.

Conclusion

Oral clinical cases are an effective strategy for formative assessment in medical education, fostering diagnostic competencies in real-life scenarios and strengthening skills such as clinical reasoning and reflection. Immediate feedback was identified as a key element in recognizing strengths and areas for improvement. However, standardizing evaluation criteria and enhancing faculty training are necessary to optimize the impact of this strategy on medical education.
在医学教育中,评估健康状况下的诊断能力是必不可少的,但传统的策略往往限制了批判性思维的发展。本研究分析使用口腔临床案例作为评估工具,以提高医学符号学II学生的这一能力。方法采用混合方法对80名伊塞西大学医学院五学期学生进行了本征性和解释性案例研究。通过半结构化访谈、焦点小组、评估标准和非参与性观察收集数据。数据分析是分类的,允许从各种来源识别关键模式。结果该策略提高了元认知和临床推理能力。学生们积极评价即时反馈,而教师们则强调了它的实用性。会议确定了后勤方面的挑战和建立标准化评价标准的必要性。结论口腔临床案例是医学教育形成性评价的有效手段,可培养学生在现实生活情境中的诊断能力,增强学生的临床推理和反思能力。即时反馈被认为是识别优势和需要改进的领域的关键因素。然而,规范评价标准和加强师资培训是优化这一战略对医学教育影响的必要条件。
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引用次数: 0
Tendencia, colaboración e impacto en la producción científica sobre el aprendizaje basado en simulación durante la formación médica 医学培训中基于模拟的学习对科学生产的趋势、协作和影响
Q2 Social Sciences Pub Date : 2025-07-03 DOI: 10.1016/j.edumed.2025.101080
John Barja-Ore , Jhonny Jesús Chafloque Chavesta , Zaida Zagaceta-Guevara , Brandon E. Guillen-Calle

Introduction

Simulation-based learning (SBL) has become a key tool in medical education by providing safe, realistic, and immersive experiences that strengthen students' clinical competencies. Despite its benefits, it faces challenges such as high costs and limitations in realism. This study analyzes the trends, collaboration, and impact of scientific production on SBL in medical education.

Materials and methods

A descriptive bibliometric study was conducted using the Scopus database. Original articles published between 2019 and 2024 were selected. Indicators of productivity, impact, and collaboration were analyzed using SciVal, Excel, and the Bibliometrix package in RStudio.

Results

A total of 791 publications were identified. The most productive institutions were the University of Copenhagen, Harvard University, and the University of California at San Francisco. Canada showed the highest field-weighted citation impact. Scientific output increased progressively, particularly in Q1 and Q2 journals. The most frequent terms were “simulation training,” “clinical competence,” and “medical education,” with emerging terms such as “virtual reality.” The United States led international collaboration, followed by active networks in Europe and Brazil. The most prominent authors were Konge and Andersen, with recurrent publications in BMC Medical Education and Simulation in Healthcare.

Conclusion

Scientific production on SBL in medical education shows a growing trend, with high international collaboration and the incorporation of emerging technologies, establishing it as a fundamental pedagogical strategy in modern medical training.
基于模拟的学习(SBL)通过提供安全、真实和身临其境的体验来增强学生的临床能力,已成为医学教育的关键工具。尽管有好处,但它面临着诸如高成本和现实主义局限性等挑战。本研究分析医学教育中科学产出对SBL的趋势、协作和影响。材料与方法使用Scopus数据库进行描述性文献计量学研究。选取2019年至2024年间发表的原创文章。使用RStudio中的SciVal、Excel和Bibliometrix包分析了生产力、影响和协作指标。结果共收录文献791篇。最具生产力的机构是哥本哈根大学、哈佛大学和加州大学旧金山分校。加拿大显示出最高的领域加权引用影响。科学产出逐步增加,特别是在第一季度和第二季度的期刊。最常见的术语是“模拟训练”、“临床能力”和“医学教育”,以及“虚拟现实”等新兴术语。美国主导了国际合作,其次是欧洲和巴西的活跃网络。最著名的作者是Konge和Andersen,他们经常在BMC医学教育和医疗保健模拟上发表文章。结论医学教育中关于SBL的科学生产呈现出日益增长的趋势,国际间的高度合作和新兴技术的结合使其成为现代医学培训的基本教学策略。
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引用次数: 0
Perfeccionando los métodos activos en la educación médica 完善积极的医学教育方法
Q2 Social Sciences Pub Date : 2025-07-03 DOI: 10.1016/j.edumed.2025.101081
Elena Vicenta Hernández Navarro , Jorge Luis Losada Guerra
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引用次数: 0
Del saber al ser: formar médicos, desarrollar el carácter, forjar la identidad 从知识到存在:培训医生,培养性格,塑造身份
Q2 Social Sciences Pub Date : 2025-07-01 DOI: 10.1016/j.edumed.2025.101090
Juan A. Díaz González
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引用次数: 0
Educational assessment and professional performance: Relationship between academic performance and the practical professional examination 教育评价与专业表现:学习成绩与实践专业考试的关系
Q2 Social Sciences Pub Date : 2025-07-01 DOI: 10.1016/j.edumed.2025.101079
Gonzalo Armando Navarro-Armendáriz, Aziel Alejandro Peralta-Ramírez, Sayil Alejandra DeLaTorre-Othón, María Elena Reguera-Torres, Izabel Navyla Madrid-Moreno, Héctor Clemente Baltierra-Ochoa

Introduction

This study examines the relationship between academic performance (Kardex grades) and clinical competence, measured by the Practical Professional Examination (PPT), in medical graduates from the Universidad de Sonora. While academic grades are often used to predict clinical success, their correlation with clinical skills remains uncertain.

Methods

An observational, retrospective analysis of 358 graduates (2019–2024) was conducted, assessing both final grades and PPT performance. Nine key clinical competencies, including diagnostic reasoning, physical examination, and patient communication, were evaluated. Spearman's correlation was used for non-normal distributions.

Results

The mean Kardex grade was 92.76, and the mean PPT score was 87.72. Significant correlations were found between clinical competencies (e.g., differential diagnosis and physical examination) and PPT performance, with the strongest correlation in differential diagnosis (r = 0.777, p < 0.001). However, the correlation between Kardex grades and PPT performance was weak (r = 0.152, p = 0.004), suggesting that academic grades do not reliably predict clinical competence.

Conclusion

Findings indicate that strong academic performance does not guarantee clinical skills. Essential competencies, such as diagnostic reasoning, are crucial in clinical assessments. Medical education should integrate theoretical knowledge with hands-on practice through strategies like problem-based learning (PBL) and Objective Structured Clinical Examinations (OSCE). While academic performance reflects theoretical knowledge, it is not a strong predictor of clinical competence. Enhancing the integration of theory and practice is essential to better prepare graduates for real-world clinical settings.
本研究考察了索诺拉大学医学毕业生的学业成绩(Kardex评分)与临床能力之间的关系,该关系通过实用专业考试(PPT)来衡量。虽然学术成绩经常被用来预测临床成功,但它们与临床技能的相关性仍然不确定。方法对358名应届毕业生(2019-2024)进行观察性、回顾性分析,评估期末成绩和PPT表现。九项关键临床能力,包括诊断推理、体格检查和患者沟通,被评估。Spearman相关用于非正态分布。结果两组患者Kardex评分平均为92.76,PPT评分平均为87.72。临床能力(如鉴别诊断和体格检查)与PPT表现存在显著相关性,其中鉴别诊断相关性最强(r = 0.777, p <; 0.001)。然而,Kardex评分与PPT表现的相关性较弱(r = 0.152, p = 0.004),表明学业成绩不能可靠地预测临床能力。结论学习成绩好并不能保证临床技能。基本能力,如诊断推理,在临床评估中是至关重要的。医学教育应该通过基于问题的学习(PBL)和客观结构化临床检查(OSCE)等策略,将理论知识与实践相结合。虽然学习成绩反映了理论知识,但它并不是临床能力的有力预测指标。加强理论与实践的结合对于毕业生更好地为现实世界的临床环境做好准备至关重要。
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引用次数: 0
Estrategias disruptivas en la formación médica: una nueva propuesta metodológica 医疗培训中的颠覆性策略:新方法建议
Q2 Social Sciences Pub Date : 2025-06-23 DOI: 10.1016/j.edumed.2025.101067
Luis Arturo Camacho Silvas , Rigoberto Marín Uribe , Isabel Guzmán Ibarra
Medical education faces growing challenges that demand innovative and flexible approaches. In this context, the complexity paradigm and Action-Research-Training (ART) emerge as disruptive strategies that allow for a comprehensive approach to medical training. This review examines the evolution of medical education from a fragmented approach to a complexity-based model, emphasizing the importance of self-socio-ecoformation and helical learning cycles. It explores how ART facilitates the co-construction of knowledge with teachers as active agents and discusses the implications of this approach in transforming health education. Finally, methodological phases and their application in a disruptive medical education model are presented.
医学教育面临越来越多的挑战,需要创新和灵活的方法。在这种情况下,复杂性范式和行动-研究-培训(ART)作为颠覆性战略出现,允许对医学培训采取综合方法。本综述考察了医学教育从碎片化方法到基于复杂性的模式的演变,强调了自我社会生态形成和螺旋学习周期的重要性。它探讨了抗逆转录病毒治疗如何促进与教师作为积极主体的知识的共同构建,并讨论了这种方法在改变健康教育方面的影响。最后,介绍了方法阶段及其在颠覆性医学教育模式中的应用。
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引用次数: 0
Does the level of realism of clinical simulators have an influence on empathy in Dentistry students? 临床模拟器的真实性水平对牙科学生的共情能力有影响吗?
Q2 Social Sciences Pub Date : 2025-06-20 DOI: 10.1016/j.edumed.2025.101072
Begoña Bartolomé Villar , María Fernández-Borque , Ana de la Hoz Calvo , Gleyvis Coro-Montanet

Introduction

Learning with phantoms in simulated dental offices allows students to develop not only skills but also empathy by recognizing the simulator as a real patient. This study investigates the level of empathy developed by 4th-year pediatric Dentistry students in a simulated scenario with two pediatric phantoms and analyzes whether the phantoms' degree of realism influences the established empathy.

Methods

A scenario was presented in a simulated dental office using two hand-made simulators: one involving a humanized mask -ELLA junior- and the other an Erler Zimmer phantom mask without the recreation of facial features. Two students performed the roles of dentist and assistant, and a professional actress was cast in the role of the mother. After the simulation, the Spanish-validated CARE questionnaire was distributed among 225 4th-year pediatric dental students, adding 4 questions on the level of perceived realism (obtaining 100% answers for empathy and 97.77% for realism). A statistical analysis was then carried out.

Results

The level of empathy for 9 out of 10 questions was “good”. The dentist's positivity was the highest-rated empathy indicator whilst the interest in the patient-phantom remained the lowest. The phantom without humanization obtained a significantly better empathy mean value (36.86 ± 43/31.19 ± 9.72), and no correlation was observed between the generated degree of realism and the empathy level obtained by students.

Conclusion

The level of empathy obtained by 4th-year dental students in the simulated scenario was good, not finding that the level of empathy improved when using a more realistic-looking phantom.
在模拟的牙科诊所里与幽灵一起学习不仅可以让学生培养技能,还可以通过将模拟器识别为真实的病人来培养同理心。本研究调查了牙科四年级儿童在两个儿童幻影的模拟情境中发展的共情水平,并分析了幻影的真实程度是否影响已建立的共情。方法在模拟的牙科诊所中,使用两个手工制作的模拟器进行模拟,一个是人工面具ella junior,另一个是不重建面部特征的Erler Zimmer模拟面具。两名学生扮演牙医和助理,一位专业演员扮演母亲的角色。模拟结束后,对225名四年级儿童牙科学生发放了西班牙语验证的CARE问卷,增加了感知真实性水平的4个问题(共情回答为100%,真实性回答为97.77%)。然后进行了统计分析。结果共情水平在10个问题中有9个为“好”。牙医的积极态度是评价最高的共情指标,而对病人幻像的兴趣仍然是最低的。无人化幻影的共情均值(36.86 ± 43/31.19 ± 9.72)显著高于无人化幻影,学生产生的真实度与共情水平无相关性。结论四年级牙科学生在模拟情景下获得的共情水平较好,使用更逼真的假体时未发现共情水平提高。
{"title":"Does the level of realism of clinical simulators have an influence on empathy in Dentistry students?","authors":"Begoña Bartolomé Villar ,&nbsp;María Fernández-Borque ,&nbsp;Ana de la Hoz Calvo ,&nbsp;Gleyvis Coro-Montanet","doi":"10.1016/j.edumed.2025.101072","DOIUrl":"10.1016/j.edumed.2025.101072","url":null,"abstract":"<div><h3>Introduction</h3><div>Learning with phantoms in simulated dental offices allows students to develop not only skills but also empathy by recognizing the simulator as a real patient. This study investigates the level of empathy developed by 4<sup>th</sup>-year pediatric Dentistry students in a simulated scenario with two pediatric phantoms and analyzes whether the phantoms' degree of realism influences the established empathy.</div></div><div><h3>Methods</h3><div>A scenario was presented in a simulated dental office using two hand-made simulators: one involving a humanized mask -<em>ELLA junior</em>- and the other an Erler Zimmer phantom mask without the recreation of facial features. Two students performed the roles of dentist and assistant, and a professional actress was cast in the role of the mother. After the simulation, the Spanish-validated CARE questionnaire was distributed among 225 4<sup>th</sup>-year pediatric dental students, adding 4 questions on the level of perceived realism (obtaining 100% answers for empathy and 97.77% for realism). A statistical analysis was then carried out.</div></div><div><h3>Results</h3><div>The level of empathy for 9 out of 10 questions was “good”. The dentist's positivity was the highest-rated empathy indicator whilst the interest in the patient-phantom remained the lowest. The phantom without humanization obtained a significantly better empathy mean value (36.86 ± 43/31.19 ± 9.72), and no correlation was observed between the generated degree of realism and the empathy level obtained by students.</div></div><div><h3>Conclusion</h3><div>The level of empathy obtained by 4<sup>th</sup>-year dental students in the simulated scenario was good, not finding that the level of empathy improved when using a more realistic-looking phantom.</div></div>","PeriodicalId":35317,"journal":{"name":"Educacion Medica","volume":"26 5","pages":"Article 101072"},"PeriodicalIF":0.0,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144322031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Propuesta metodológica para la mejora educativa de una facultad de medicina a partir del análisis comparativo entre la evaluación externa y evaluación interna 根据外部评价与内部评价的比较分析提出的改进医学院教育的方法建议
Q2 Social Sciences Pub Date : 2025-06-16 DOI: 10.1016/j.edumed.2025.101070
Gilberto Guzmán-Valdivia Gómez , Jennie Brand-Barajas , Luis Clemente Jiménez-Botello , Luis Daniel Amezcua-Pérez

Introduction

In Mexico, medical education operates in a fragmented health system, with diverse institutions and care levels, making standardization and comprehensive evaluation difficult. Resistance to educational evaluation by organizations such as COMAEM, often wrongly perceived as a threat, further hinders continuous improvement.

Methodology

This study, which aimed to propose an innovative methodology for educational management based on a comparative analysis of the external evaluation (COMAEM) and the internal self-evaluation of a medical school, was carried out with a mixed methodological approach. Both evaluations were contrasted, and the perception of educational quality was analyzed from the perspective of university actors.

Results

The results revealed a more favorable perception by the faculty regarding compliance with the evaluated indicators (87.24%) than the COMAEM evaluation (66.76%). It was observed that the directors were more rigorous in their evaluation than the teachers and students. The latter gave higher ratings in various chapters, including that of professors (4.43/5), in contrast to the COMAEM evaluation (3.25/5). The interviews show a lack of knowledge in the evaluation process and a perception of a lack of efficient feedback.

Conclusions

This study reveals a significant discrepancy between self-evaluation and external evaluation, especially in the perception of compliance with indicators and the assessment of the teaching staff. By integrating various perspectives, the proposed methodology is presented as a valuable tool to promote critical self-evaluation and continuous improvement in accreditation.
在墨西哥,医学教育在一个分散的卫生系统中运作,机构和护理水平各不相同,使得标准化和综合评估变得困难。诸如COMAEM等组织对教育评价的抵制,常常被错误地视为一种威胁,进一步阻碍了持续的改进。本研究采用混合方法学方法,在比较分析某医学院外部评价与内部自我评价的基础上,提出一种创新的教育管理方法学。对两种评价进行对比,并从高校行为主体的角度分析其对教育质量的感知。结果教师对评价指标的依从性满意度(87.24%)高于COMAEM评价(66.76%)。我们观察到,主任的评价比老师和学生更严格。与COMAEM的评价(3.25/5)相比,后者在包括教授在内的各个章节中给予了更高的评价(4.43/5)。访谈显示对评价过程缺乏了解,并认为缺乏有效的反馈。结论自我评价与外部评价存在显著差异,尤其是对指标依从性的感知和教师的评价。通过整合各种观点,所提出的方法是作为一种有价值的工具来促进关键的自我评估和认证的持续改进。
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引用次数: 0
Programa en simulación clínica del grado de Medicina de la Universidad Francisco de Vitoria (1.a parte): estructura y actividades 弗朗西斯科·德·维多利亚大学医学院临床模拟课程(1。部分):结构和活动
Q2 Social Sciences Pub Date : 2025-06-16 DOI: 10.1016/j.edumed.2025.101061
Sophia Denizon Arranz, Emilio Cervera Barba, Patricia Chica Martínez, Alonso Mateos Rodríguez, Salvador Espinosa Ramírez, Diego Palacios Castañeda, Fernando Caballero Martínez
Clinical simulation is an essential methodology for the acquisition of skills by students in Health Sciences. This first part of the article describes the infrastructure of the clinical and surgical simulation centers at the Universidad Francisco de Vitoria, as well as the activities and methodologies of the clinical simulation curriculum within the Medicine degree. It details the different types of activities, their planning, development, and evaluation.
临床模拟是健康科学专业学生获得技能的重要方法。本文的第一部分描述了维多利亚大学的临床和外科模拟中心的基础设施,以及医学学位中临床模拟课程的活动和方法。它详细说明了不同类型的活动及其计划、发展和评估。
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引用次数: 0
Programa Kay como estrategia para favorecer la implementación del cambio de paradigma en la Escuela de Enfermería de la Universidad Nacional de Córdoba, Argentina Kay方案作为支持阿根廷科尔多瓦国立大学护理学院实施范式转变的战略
Q2 Social Sciences Pub Date : 2025-06-09 DOI: 10.1016/j.edumed.2025.101063
Soledad de la Riva , Pedro Peyser , Sandra Cevilán , Malén Gautes Alcaraz , Fernanda Montenegro

Introduction

Evaluating the results of the Final Integrated Practice I, at the School of Nursing - Faculty of Medical Sciences of the National University of Córdoba, in Argentina, the teachers postulated that the transition towards a new paradigm of person-centered care was challenged by a persistent biologicist vision of health among students. Along with the Universidad Siglo 21, we set out to explore whether the Kay Program is an adequate tool to promote resources for teachers that favor the implementation of the change in the paradigm of care.

Material and methods

Participatory action research. Kay Program: Diagnosis, to know the state of the “inner learner” through self-knowledge (own learning experiences) and knowledge about natural ways of learning. Action/Training, resources to transform teaching: workshops approached with creative proposals, reflection groups, experiential activities. Reflection and evaluation of results.

Results

The results support the hypothesis of the research, that the application of the Kay Program (teacher training program to rethink human nature linked to the teaching-learning process; through sensitization, awareness and personal transformation of those who are responsible for education), favored the development of cultural competencies in people that facilitate the paradigm shift.

Conclusion

We conclude that the experience with the Kay Program has led to significant professional growth in the teachers, who now have the necessary tools to implement a paradigm shift towards humanization in nursing education.
在阿根廷国立大学Córdoba医学院护理学院,教师们对最终综合实践I的结果进行了评估,他们认为学生中坚持生物学家对健康的看法对向以人为本的护理新范式的过渡提出了挑战。与Siglo 21大学一起,我们开始探索Kay项目是否是一个足够的工具来促进教师资源,这些资源有利于在护理范式中实施变革。材料与方法参与式行动研究。凯程序:诊断,通过自我认识(自己的学习经验)和自然学习方式的知识来了解“内在学习者”的状态。行动/培训,转化教学的资源:采用创造性建议的研讨会,反思小组,体验活动。对结果的反思和评价。结果研究结果支持了本研究的假设,即应用Kay计划(教师培训计划)重新思考人性与教与学过程的联系;通过那些负责教育的人的敏感化、意识和个人转变,有利于人们文化能力的发展,促进范式转变。我们的结论是,Kay项目的经验导致了教师的显著专业成长,他们现在有必要的工具来实现护理教育向人性化的范式转变。
{"title":"Programa Kay como estrategia para favorecer la implementación del cambio de paradigma en la Escuela de Enfermería de la Universidad Nacional de Córdoba, Argentina","authors":"Soledad de la Riva ,&nbsp;Pedro Peyser ,&nbsp;Sandra Cevilán ,&nbsp;Malén Gautes Alcaraz ,&nbsp;Fernanda Montenegro","doi":"10.1016/j.edumed.2025.101063","DOIUrl":"10.1016/j.edumed.2025.101063","url":null,"abstract":"<div><h3>Introduction</h3><div>Evaluating the results of the Final Integrated Practice I, at the School of Nursing - Faculty of Medical Sciences of the National University of Córdoba, in Argentina, the teachers postulated that the transition towards a new paradigm of person-centered care was challenged by a persistent biologicist vision of health among students. Along with the Universidad Siglo 21, we set out to explore whether the Kay Program is an adequate tool to promote resources for teachers that favor the implementation of the change in the paradigm of care.</div></div><div><h3>Material and methods</h3><div>Participatory action research. Kay Program: Diagnosis, to know the state of the “inner learner” through self-knowledge (own learning experiences) and knowledge about natural ways of learning. Action/Training, resources to transform teaching: workshops approached with creative proposals, reflection groups, experiential activities. Reflection and evaluation of results.</div></div><div><h3>Results</h3><div>The results support the hypothesis of the research, that the application of the Kay Program (teacher training program to rethink human nature linked to the teaching-learning process; through sensitization, awareness and personal transformation of those who are responsible for education), favored the development of cultural competencies in people that facilitate the paradigm shift.</div></div><div><h3>Conclusion</h3><div>We conclude that the experience with the Kay Program has led to significant professional growth in the teachers, who now have the necessary tools to implement a paradigm shift towards humanization in nursing education.</div></div>","PeriodicalId":35317,"journal":{"name":"Educacion Medica","volume":"26 5","pages":"Article 101063"},"PeriodicalIF":0.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144243003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Educacion Medica
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