Educacion Medica最新文献

Toxicological training has disparities in relation to other areas of medical knowledge, which favors cognitive gaps in health professionals. This document presents an educational proposal for the approach of “major toxidromes” through a scheme that integrates their identification and treatment through clinical simulation scenarios with the use of simulated/standardized patients for the medical undergraduate degree at the Centro Universitario del Sur of the Universidad de Guadalajara, developed during the year 2023.

Introduction

Writing medical histories (MH) is a basic competence in the physician's training. It is the cornerstone for constructing diagnostic hypotheses and guaranteeing adequate, safe and effective care. In addition, MH has legal, epidemiological and quality of care implications. The aim of this study was to determine the concordance between the information collected from the patient in the consultation room and that recorded in the MH by medical students.

Methods

This is a cross-sectional descriptive observational study on a consultation with simulated patients and the subsequently written MH. A total of 112 5th-year medical students participated. The evaluators checked 59 items of anamnesis, anamnesis by organs and apparatus, physical examination and clinical judgment in the MH, contrasting them with the video recordings of the consultations, and classifying the concordance between both.

Results

Final population was 109 students (97.3%). The competency area with the highest concordance was clinical judgment (94.1%). All items exceeded 65% agreement. More than 20% of the students had not recorded some items in their MH, although they had collected them in the consultation. Anamnesis by organs and apparatus was the competency area with the most omitted or incorrect items. The only item that no student forgot to collect and record was “personal history of dyslipidemia”. Physical examination was the area where most students recorded findings in the MH without having made them in the interview.

Conclusion

The study demonstrates high concordance in the MH with the information collected in the consultation and shows aspects that will allow us to improve the medical semiology training of students.

Introduction

The objective structured clinical evaluation (OSCE) in nursing is essential to know the competence level of students, as well as to analyse their experience of this evaluative test. The aim of this study was to describe the experience of 2nd degree nursing students during the performance of a pilot OSCE test.

Method

Descriptive study with the participation of 84 students (74.3%) who took the OSCE pilot test. When OSCE was overed, an ad-hoc survey was used to collect data on the students' experience. For each question, the percentages of responses and their 95% confidence intervals were calculated.

Results

62.70% (54.25-71.19) showed a favourable opinion of their experience. The 73.80% (66.67-80.98) thought that the stations were representative of the nursing role. Regarding the difficulty of resolution, 42.20% (36.29-48.16) reported having difficulties. At the technical level, 61% (55.27-66.71) said that they understood well the statements of the situations to be solved, and 63.70% (50.02-69.39) thought that the 10 minutes of time was sufficient. A 46.20% (40.88-51.96) of the students reported feeling stress during the OSCE. Regarding the teachers involved in their evaluation, 79% (72.53-85.49) thought that their role was correct.

Conclusions

The realization of a pilot test allows to collect the students' experience to be considered in future editions, as well as to test their acquired level in the different areas of competence.

Introduction

The availability of instruments for measuring the learning environment in Spanish-language medical schools is limited. The Dundy ready environment Educational Measure (DREEM) is the only one available. The aim of this study was to determine the construct validity and internal consistency of the Johns Hopkins Learning Environment Scale (JHLES) in Spanish.

Methods

The JHLES instrument was translated into Spanish following the recommendations of the IQola project. Subsequently, it was administered to a cohort of 362 third to seventh-year medical students during the clinical training cycle. An exploratory factor analysis was conducted on the obtained responses. Factor retention was determined by eigenvalue criteria, as well as the researchers' criteria. Finally, a confirmatory factor analysis was conducted to assess the model's fit to the obtained data.

Results

After content validation in collaboration with the original instrument's author, exploratory factor analysis allowed the retention of seven factors with eigenvalue criteria greater than 1, consistent with the authors' interpretation criteria. Confirmatory factor analysis demonstrated adequate model fit to the data in the population. The Cronbach's α for the JHLES was 0.91.

Conclusions

The JHLES is an instrument that shows adequate content and construct validity in the Spanish language. Further studies are needed on other types of predictive and concurrent validity, as well as comparative studies on measurements in different Spanish-speaking countries.

Introduction

The growing number of online medical education programs demands rigorous evaluation. Previous studies have emphasized the importance of student perception in the effectiveness of these programs. Therefore, we aimed to adapt and validate the Course Experience Questionnaire (CEQ) for use in online medical education programs in Peru.

Material and methods

An adaptation and validation study of the CEQ was conducted at a preparatory academy for the national medical examination in Peru. The questionnaire items were modified to suit our context and administered to 127 participants anonymously. Exploratory Factor Analysis with oblique rotation and reliability calculations with Cronbach's and McDonald's coefficients were performed. Then, the correlation of the CEQ and its domains with satisfaction and the program's impact was assessed.

Results

83 participants responded, mainly sixth-year medical students. The analysis showed the suitability of the CEQ for factor analysis, with three factors identified that explained 59% of the total variance. The CEQ's reliability indices were high, indicating its consistency. The three domains identified were Adequate Teaching, Support, and Negative Program Experiences. Significant positive correlations were found between the total CEQ score, satisfaction measures, and perception of the program's impact.

Conclusion

The adapted CEQ showed evidence of validity for evaluating online medical education programs in Peru.

Western medicine is constantly evolving. Scientific and technological advances have improved the prevention, diagnosis, and treatment of diseases, but have also posed new humanistic challenges. In this context, pedagogy has become a fundamental pillar in the training of health professionals. This pedagogy has a unique purpose, which isthe holistic training of future doctors, who must be professionals capable of responding to contemporary challenges with professionalism, empathy, and passion for what they do. This educational reflection explores the relevance of pedagogical theories in the training of health professionals. It focuses on the approaches of seven works: Platon, Vygotsky, Stone, Masschelein, Herbart, Dewey, Daguaand Obando. These paradigms, although strengthenedin different times and contexts, converge on a fundamental point: to give a purpose to education and pedagogy from different contexts, based on the importance of training competent, empathetic, and ethical health professionals.

Introduction

Cardiac arrest in pregnant women is a challenge in out-of-hospital care and in Spain we have doctors in this setting who could perform perimortem caesarean sections.

Material and method

Initially, we evaluated the gaps in knowledge in the management of cardiac arrest (CRA) in pregnant women by out-of-hospital emergency personnel in order to create a blended learning course in advanced life support simulation in pregnant women (ALS-G). In a second phase, we conducted a course to determine the degree of learning of knowledge and skills acquired in life support in pregnant women.

Results

Prior to the creation of the course, it was analysed that the percentage of success in the management of CPR in pregnant women was 54.48% and 67.12% of the students stated that they were not sufficiently trained to do so. Based on these gaps, we created the VAS-G course. A total of 88 students participated in five editions of the course. Knowledge increased significantly after the course, regardless of the learner's profession. Satisfaction with the course, the knowledge acquired and the applicability of the contents to their activity was reported by the students to be very positive.

Conclusion

The SVA-G course improves the knowledge of CPR management in a pregnant woman and is a useful course for personnel working in out-of-hospital emergencies. For this reason, after the creation of the SVA-G course, it was included in the catalogue of courses of the National CPR Plan.