Educacion Medica最新文献_第9页

Eficacia de la formación ITLS (international trauma life support) en el manejo del paciente con trauma grave en un servicio de urgencias: creación de herramientas de mejora 国际创伤生命支持（ITLS）培训在急诊室管理严重创伤患者方面的有效性：开发改进工具

Q2 Social Sciences

Educacion Medica

Pub Date : 2025-05-24 DOI: 10.1016/j.edumed.2025.101056

Jerónima Vicens Ferrer , María Fiorella Sarubbo , David Salomón Sánchez Cuadrado Olea , Miguel González de Cabo , Miguel Agudo García , Ana Estremera Rodrigo

Introduction

In the emergency department, providing care to patient who are victims of severe trauma presents a challenge due to the potential severity of their condition. There are accepted guidelines for trauma management, such as those from the International Trauma Life Support (ITLS). However, the heterogeneity of emergency services (ES) does not always allow for their proper application.

Methodology

A pre- and post-intervention descriptive study was conducted to evaluate the effectiveness of structured training in the management of severe trauma in an ES of a secondary level hospital. The study was carried out in three phases: (1) Training of ES professionals through a course based on the ITLS methodology; (2) Review of medical records from the pre- and post-training periods for patients classified as "severe trauma," assessing the collected information according to the training specifications. A retrospective review of 182 medical records was conducted, including 117 from the pre-training period and 65 from the post-training period. Inclusion criteria were: patients who underwent a whole-body computed tomography (CT) scan for the diagnosis of severe trauma, adults of both sexes; (3) Compilation of a list of detected information gaps and the creation of an improvement tool for the assessment and management of severe trauma by the involved professionals.

Results and conclusion

In the pre-training period, deficiencies in information collection and structured assessment were identified, which improved in the post-training period. However, specific information gaps were still detected after the training, leading to the proposal of a tool called the "Polytrauma Patient checklist."

在急诊科，为严重创伤患者提供护理是一项挑战，因为他们的病情可能很严重。创伤管理有公认的指导方针，例如国际创伤生命支持（ITLS）的指导方针。然而，紧急服务的异质性并不总是允许它们得到适当的应用。方法采用一项描述性研究，对某二级医院ES重症创伤管理中结构化培训的有效性进行评估。该研究分三个阶段进行：(1)通过基于ITLS方法的课程培训ES专业人员；(2)对“严重创伤”患者训练前后的医疗记录进行审查，根据训练规范对收集到的信息进行评估。对182份医疗记录进行了回顾性审查，其中117份来自培训前，65份来自培训后。纳入标准为：接受全身计算机断层扫描（CT）诊断严重创伤的患者，男女皆可；(3)编制已发现的信息差距清单，并为相关专业人员评估和管理严重创伤创建改进工具。结果与结论在培训前发现了信息收集和结构化评估方面的不足，并在培训后得到了改善。然而，培训后仍然发现了具体的信息差距，这导致了一种名为“多发创伤患者检查表”的工具的提出。

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引用次数: 0

Academic transition from high school to an undergraduate medical program using active methodologies within an integrated curriculum: Qualitative research 从高中到本科医学课程的学术过渡，在综合课程中使用积极的方法：定性研究

Q2 Social Sciences

Educacion Medica

Pub Date : 2025-05-12 DOI: 10.1016/j.edumed.2025.101055

Alexandre Ferreia da Silva , Enzo Sá Pantoja da Silva , Daniel Figueiredo Alves da Silva , Selma Kazumi da Trindade Noguchi , Juarez Antônio Simões Quaresma

Introduction

When transitioning from high school to an undergraduate medical program that uses active teaching methodologies, students often encounter clear obstacles in their first semester, such as breaking down disciplinary barriers, adapting to the dynamics of different curricular components, adjusting to an evaluation process that is different from what they are used to, as well as a lack of understanding of the program's pedagogical proposal. This study aims to understand the challenges faced by medical undergraduate students in their first semester, specifically in relation to the use of active teaching methodologies within an integrated curriculum.

Material and methods

A qualitative study was conducted through interviews with 15 students from a private medical school who started in the first semester of 2018. The data were categorized and subjected to discourse analysis.

Results

The interviewees reported difficulties in understanding the educational proposal. Although they viewed the experience of adapting to the course's methodology positively, they found it challenging. They reported that there was insufficient explanation about the evaluation processes and proposed that clearer educational objectives be established for the students.

Conclusion

The need for a more comprehensive explanation of the pedagogical project and its teaching strategies, the importance of valuing practical training in health services, and the clarification of evaluation processes and educational objectives were highlighted by the interviewed students as key pillars for a successful transition from high school to medical education.

当从高中过渡到使用积极教学方法的本科医学课程时，学生经常在第一学期遇到明显的障碍，例如打破学科障碍，适应不同课程组成部分的动态，适应与他们习惯的不同的评估过程，以及缺乏对课程教学建议的理解。本研究旨在了解医学本科生在第一学期所面临的挑战，特别是在综合课程中使用主动教学方法方面的挑战。材料与方法通过访谈某私立医学院2018年第一学期入学的15名学生进行定性研究。对数据进行分类并进行语篇分析。结果受访者反映在理解教育建议方面存在困难。尽管他们积极地看待适应课程方法的经历，但他们发现这很有挑战性。他们报告说，对评价过程没有充分的解释，并建议为学生制定更明确的教育目标。结论受访学生认为有必要更全面地解释教学项目及其教学策略，重视卫生服务实践培训，明确评估过程和教育目标，这是高中向医学教育成功过渡的关键支柱。

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引用次数: 0

Abordando la soledad en la formación de profesionales sanitarios y en la práctica clínica 解决卫生专业人员培训和临床实践中的孤独问题

Q2 Social Sciences

Educacion Medica

Pub Date : 2025-05-08 DOI: 10.1016/j.edumed.2025.101050

María Antonia Parra-Rizo , Igor Cigarroa , Catarina Pereira , Sergio Hernández-Sánchez , Jesús González-Moreno

Population aging poses a challenge for public health, where loneliness emerges as a critical factor with a significant impact on the physical, mental, and social health of older adults. It is associated with depression, cognitive decline, chronic diseases, and increased mortality, affecting clinical decision-making and treatment adherence. Despite its relevance, health sciences training programs, particularly in medicine and nursing, do not adequately address this issue, creating a gap in professional education. It is essential for healthcare professionals to acquire skills to identify and manage loneliness, including empathy, ethical decision-making, and effective communication with older patients. However, current training prioritizes technical aspects without integrating the emotional and social factors that influence patient well-being. An innovative educational strategy is proposed to incorporate loneliness as a social determinant of health within health sciences curricula. This training would include workshops on communication with older adults, clinical simulations focused on loneliness, and an interdisciplinary approach involving social work, psychology, and medicine. This strategy would promote more comprehensive care, improving the quality of life and well-being of older adults.

人口老龄化对公共卫生构成挑战，孤独感成为对老年人身体、心理和社会健康产生重大影响的一个关键因素。它与抑郁、认知能力下降、慢性疾病和死亡率增加有关，影响临床决策和治疗依从性。尽管它的相关性，健康科学培训计划，特别是在医学和护理，没有充分解决这个问题，造成了专业教育的差距。医疗保健专业人员必须掌握识别和管理孤独的技能，包括同理心、道德决策以及与老年患者的有效沟通。然而，目前的培训优先考虑技术方面，而没有整合影响患者健康的情感和社会因素。提出了一项创新的教育战略，将孤独作为健康的社会决定因素纳入健康科学课程。这一培训将包括与老年人交流的讲习班，以孤独为重点的临床模拟，以及涉及社会工作、心理学和医学的跨学科方法。这一战略将促进更全面的护理，改善老年人的生活质量和福祉。

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引用次数: 0

Gamificación en la educación continua odontológica: una herramienta con potencial y la necesidad de más evidencia 牙科继续教育中的赌博行为：一个有潜力的工具，需要更多的证据

Q2 Social Sciences

Educacion Medica

Pub Date : 2025-05-02 DOI: 10.1016/j.edumed.2025.101052

Manuel Millán-Hernández , Jose Luis Becerra-Beltran , Aldo Urendez-Flores

引用次数: 0

Procrastinación académica en estudiantes de Medicina: ¿un desafío en su formación? 医科学生的学业延误：对他们的形成的挑战？

Q2 Social Sciences

Educacion Medica

Pub Date : 2025-05-02 DOI: 10.1016/j.edumed.2025.101053

Mónica Regalado Chamorro , Barbara Ponce Ponce , Aldo Medina Gamero , Giuliana Abucci Infantes

引用次数: 0

Modelado predictivo de actitudes y comportamientos ético-profesionales en médicos latinoamericanos mediante redes neuronales 利用神经网络预测拉丁美洲医生的职业道德态度和行为模型

Q2 Social Sciences

Educacion Medica

Pub Date : 2025-05-02 DOI: 10.1016/j.edumed.2025.101054

Alberto Guevara Tirado , Raul Emilio Real Delor

Introduction

Medical professionalism is key to ensuring quality of care and collaboration within the healthcare team. However, negative attitudes can undermine trust and affect teamwork. Artificial intelligence, through neural networks, offers an innovative approach to predicting and analyzing these behaviors, potentially strengthening professional ethics in Latin American physicians. The objective was to generate a predictive model of ethical and professional attitudes and behaviors among Latin American physicians through the use of neural networks.

Materials and method

A cross-sectional study was conducted using a survey of 424 physicians from Paraguay, Peru, and Cuba. The dependent variables were ignoring the opinions of other colleagues or healthcare professionals, and criticizing fellow physicians or other healthcare professionals in front of patients. The independent variables included age, gender, specialty, and indicators adapted from the questionnaire developed by Kwon HJ et al. A multilayer perceptron neural network was implemented.

Results

The model achieved an overall accuracy of 71.20% in training and 69.40% in testing. The area under the curve (AUC) values were close to 0.75 for the categories “Ignoring the opinions of colleagues” and “Criticizing colleagues in front of patients”, reflecting good model performance. The most influential variables included ethical and professional behaviors, such as discrimination toward colleagues, provision of incorrect information, and fulfillment of job responsibilities.

Conclusions

The multilayer perceptron neural network was efficient for analyzing ethical and professional attitudes and behaviors in medical practice.

医疗专业是确保医疗保健团队内护理质量和协作的关键。然而，消极的态度会破坏信任，影响团队合作。人工智能通过神经网络提供了一种预测和分析这些行为的创新方法，有可能加强拉丁美洲医生的职业道德。目的是通过使用神经网络，生成拉丁美洲医生的道德和专业态度和行为的预测模型。材料和方法对来自巴拉圭、秘鲁和古巴的424名医生进行了横断面研究。因变量是忽视其他同事或医疗保健专业人员的意见，并在患者面前批评同行医生或其他医疗保健专业人员。自变量包括年龄、性别、专业和Kwon HJ等人编制的问卷指标。实现了多层感知器神经网络。结果该模型在训练和测试中的总体准确率分别为71.20%和69.40%。“忽视同事意见”和“当着病人的面批评同事”两类的曲线下面积（AUC）值接近0.75，反映出模型性能较好。最具影响力的变量包括道德和专业行为，如对同事的歧视、提供不正确的信息和履行工作职责。结论多层感知器神经网络能有效地分析医疗实践中的伦理职业态度和行为。

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引用次数: 0

Las artes y la formación de profesionales de la salud 卫生专业人员的艺术和培训

Q2 Social Sciences

Educacion Medica

Pub Date : 2025-05-01 DOI: 10.1016/j.edumed.2025.101076

Jesús Morán Barrios

引用次数: 0

Ondas de densidad semántica para el análisis de la argumentación clínica multimodal en la formación de profesionales de la salud 在卫生专业人员培训中分析多模式临床论证的语义密度波

Q2 Social Sciences

Educacion Medica

Pub Date : 2025-04-12 DOI: 10.1016/j.edumed.2025.101045

Giovanni Garcia-Castro , Francisco Javier Ruiz-Ortega

Introduction

Clinical argumentation is a fundamental competence in medical education, fostering critical reasoning, problem-solving, and decision-making in complex scenarios. However, educational strategies often prioritize practical and instrumental approaches, neglecting the integration of advanced cognitive competencies. This study examines how semantic density, as conceptualized in the Legitimation Code Theory, and the use of multimodal resources contribute to developing argumentative skills in health sciences.

Methods

Using a qualitative-comprehensive approach, a case study was conducted with five faculty members from the Adult Medicine department at the Technological University of Pereira. Data collection included class recordings, semantic analyses, questionnaires, and rubrics to evaluate teaching and argumentative strategies. A Specific Translation Device was employed to analyze semantic density, and data were processed using NVivo software.

Results

The analysis revealed that semantic density is enhanced through the intentional use of multimodal resources such as gestures, graphics, and visual language, enabling the integration of complex concepts. The analysis of semantic waves demonstrated a progression in conceptual complexity and argumentative stability, highlighting the positive results of the training process on teachers' and students' ability to construct dense and coherent discourses.

Conclusion

The combination of Legitimation Code Theory with a multimodal approach provides an effective framework for evaluating and fostering clinical argumentation in medical education. This methodology strengthens students' cognitive, critical, and argumentative skills, equipping them to address the ethical, social, and clinical challenges of professional practice.

临床论证是医学教育的基本能力，培养在复杂情况下的批判性推理、解决问题和决策能力。然而，教育策略往往优先考虑实用和工具的方法，忽视了先进的认知能力的整合。本研究考察了合法化代码理论中概念化的语义密度，以及多模态资源的使用如何有助于发展健康科学中的辩论技能。方法采用定性综合方法，对佩雷拉科技大学成人医学系的5名教员进行个案研究。数据收集包括课堂录音、语义分析、问卷调查和评估教学和辩论策略的规则。语义密度分析采用Specific Translation Device，数据处理采用NVivo软件。结果通过有意使用手势、图形和视觉语言等多模态资源，增强了语义密度，实现了复杂概念的整合。语义波的分析显示了概念复杂性和论证稳定性的进步，突出了教师和学生构建密集连贯话语能力的培训过程的积极成果。结论合法化法典理论与多模态方法相结合，为医学教育中临床论证的评价和培养提供了有效的框架。这种方法加强了学生的认知、批判和论证能力，使他们能够应对专业实践中的道德、社会和临床挑战。

{"title":"Ondas de densidad semántica para el análisis de la argumentación clínica multimodal en la formación de profesionales de la salud","authors":"Giovanni Garcia-Castro , Francisco Javier Ruiz-Ortega","doi":"10.1016/j.edumed.2025.101045","DOIUrl":"10.1016/j.edumed.2025.101045","url":null,"abstract":"<div><h3>Introduction</h3><div>Clinical argumentation is a fundamental competence in medical education, fostering critical reasoning, problem-solving, and decision-making in complex scenarios. However, educational strategies often prioritize practical and instrumental approaches, neglecting the integration of advanced cognitive competencies. This study examines how semantic density, as conceptualized in the Legitimation Code Theory, and the use of multimodal resources contribute to developing argumentative skills in health sciences.</div></div><div><h3>Methods</h3><div>Using a qualitative-comprehensive approach, a case study was conducted with five faculty members from the Adult Medicine department at the Technological University of Pereira. Data collection included class recordings, semantic analyses, questionnaires, and rubrics to evaluate teaching and argumentative strategies. A Specific Translation Device was employed to analyze semantic density, and data were processed using NVivo software<strong>.</strong></div></div><div><h3>Results</h3><div>The analysis revealed that semantic density is enhanced through the intentional use of multimodal resources such as gestures, graphics, and visual language, enabling the integration of complex concepts. The analysis of semantic waves demonstrated a progression in conceptual complexity and argumentative stability, highlighting the positive results of the training process on teachers' and students' ability to construct dense and coherent discourses.</div></div><div><h3>Conclusion</h3><div>The combination of Legitimation Code Theory with a multimodal approach provides an effective framework for evaluating and fostering clinical argumentation in medical education. This methodology strengthens students' cognitive, critical, and argumentative skills, equipping them to address the ethical, social, and clinical challenges of professional practice.</div></div>","PeriodicalId":35317,"journal":{"name":"Educacion Medica","volume":"26 4","pages":"Article 101045"},"PeriodicalIF":0.0,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143824687","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

Clinical researchers: The relationship between the final degree project and future prospects for developing research tasks in the clinical setting 临床研究人员：最终学位项目与在临床环境中发展研究任务的未来前景之间的关系

Q2 Social Sciences

Educacion Medica

Pub Date : 2025-04-11 DOI: 10.1016/j.edumed.2025.101046

Julia L. Gutierrez-Arroyo , Alba Loras , Elvira Carbonell , Pia Gallego , Maria Victoria Ibañez , Maria Angeles Marques-Torrejon , Conrado Martinez-Cadenas

Introduction

Clinical research is vital for improving individuals' quality of life, yet many medical students find it complex and challenging. Therefore, it is essential to introduce research training programs early in undergraduate medical education to help students develop basic research skills. One example is the final degree project (FDP), which can be either experimental/research-based or a systematic review/clinical protocol. This study investigates medical students' perceptions of research FDPs based on effort and difficulty, as well as the associations between FDP-type election and the graduates' future interest in research.

Methods

A cross-sectional analytical study was conducted with 87 medical graduates from Jaume I University of Castellon. Data were collected through surveys, and both descriptive and inferential analyses were performed.

Results

A significant relationship was found between research in the graduates' routine and the intention to pursue a doctoral thesis, as well as between the graduates' choice of FDP topic as medical students (experimental or research-based vs. systematic review or clinical protocol) and future engagement in a doctoral thesis. As this is an observational study, we cannot establish causality in this relationship. No significant associations were found between routine research and hospital size, gender, or career motivation, except for a potential significance in the relationship between FDP topic choice and medical specialty.

Conclusions

Our main findings suggest that medical graduates' perceptions of the complexity of research FDPs depend on their prior research experience. Therefore, it is crucial to provide more training in this area during undergraduate programs to prevent a lack of training from becoming a barrier to pursuing a research career.

临床研究对提高个人生活质量至关重要，但许多医学生发现它既复杂又具有挑战性。因此，在本科医学教育中尽早引入科研训练项目，帮助学生培养基本的科研技能是十分必要的。一个例子是最终学位项目（FDP），它可以是基于实验/研究的，也可以是系统回顾/临床方案。本研究旨在探讨医学生对研究fdp的努力程度和难度的认知，以及fdp类型的选择与毕业生未来研究兴趣的关系。方法采用横断面分析方法，对87名医学院毕业生进行调查。通过调查收集数据，并进行描述性和推断性分析。结果毕业生日常研究与博士论文撰写意愿之间存在显著关系，毕业生作为医学生选择FDP主题（实验或研究型vs系统评价或临床方案）与未来博士论文撰写意愿之间存在显著关系。由于这是一项观察性研究，我们不能在这种关系中建立因果关系。常规研究与医院规模、性别或职业动机之间没有显著关联，但FDP主题选择与医学专业之间存在潜在的显著性关系。结论医学毕业生对科研fdp复杂性的认知依赖于其先前的科研经历。因此，在本科课程中提供更多这方面的培训是至关重要的，以防止缺乏培训成为追求研究事业的障碍。

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引用次数: 0

Identidad profesional diada docente-discente: Implicancias en el proceso de enseñanza-aprendizaje de matronería 教师-学生的职业身份：助产士教学过程中的影响

Q2 Social Sciences

Educacion Medica

Pub Date : 2025-04-07 DOI: 10.1016/j.edumed.2025.101043

Janet Altamirano-Droguett , Francisca Araya-Acuña , Katherine Jorquera-Carrasco , Amanda Peña-Peña

Introduction

Professional identity in midwifery begins in initial training with the support of the teaching staff, who must not only acquire pedagogical tools, but also consolidate their own version of themselves. This work aims to recognize the professional identity of the teacher-student dyad and its implications in the teaching-learning process through the analysis of narratives for continuous improvement in the training of this discipline.

Method

The research was qualitative interpretative by means of semi-structured interviews with 17 teachers and 16 students of the university degree of Obstetrics and Childcare of the Universidad de Antofagasta, Chile. The testimonies were analyzed through grounded theory.

Results

The interviewees recognized that the combination of theory and practice is fundamental to acquire professional competencies through active strategies. Teacher modeling was identified as a main factor influencing not only academic performance during clinical practice, but also professional identity. The interviewees stated that they did not feel part of the university degree.

Conclusion

The findings showed the need to improve social ties in order to acquire a sense of belonging to the profession. Likewise, it is imperative to offer training programs on socioemotional skills, which ensure reflective processes for the construction and reconstruction of identity in the educational dyad. It is also imminent to innovate teaching and evaluation methodologies, and to strengthen research for an improvement in the training of this discipline, which will be reflected in the quality of patient care.

助产士的专业身份从最初的培训开始，在教学人员的支持下，他们不仅要获得教学工具，还要巩固他们自己的版本。本研究旨在通过对叙事的分析，认识师生二元的专业认同及其在教学过程中的意义，以促进这一学科培训的持续改进。方法采用半结构化访谈法对智利安托法加斯塔大学产科学与托儿专业17名教师和16名学生进行定性分析。通过扎实的理论对证词进行分析。结果受访者认识到理论与实践的结合是通过积极的策略获得专业能力的基础。在临床实践中，教师模型不仅是影响学习成绩的主要因素，也是影响专业认同的主要因素。受访者表示，他们不觉得自己是大学学位的一部分。结论研究结果表明，为了获得职业归属感，需要改善社会关系。同样，必须提供有关社会情感技能的培训项目，以确保在教育领域建立和重建身份的反思过程。创新教学和评价方法，加强研究，改进本学科的培训，这将反映在病人护理的质量上。

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引用次数: 0