Medicina Clinica Practica最新文献

The characteristics of students who begin a medical degree in Spain are determined by the results of the entrance tests (EBAU). In order to select a student profile more closely aligned with the skills that must be acquired in order to practice the profession, the medical schools of Catalonia, with the health and university departments of the Generalitat, carried out a pilot test, inspired by the selection processes that are carried out in other countries around us.

Objective

To develop a test for the detection of non-technical skills in students who are admitted to the degree.

Methodology

The test consisted of answering three types of tests, to measure communication and relationship with the professional environment (CREP), ethical judgment in specific situations (JUESC) and, finally, critical reasoning ability (CRAC). There was a total of 134 multiple-choice questions that had previously been validated by members of the dean's teams. 511 first-year students (49% of the total) answered the test in September 2022.

Results

The means and standard deviations of the three tests were: CREP (7.18, 0.99), JUESC (4.68, 0.81), CRAC (5.43, 1.02), and the total of the test (5.67, 0.62). The reliability tests (Cronbach) were: CREP (0.56), JUESC (0.54), CRAC (0.49), total (0.65).

Conclusion

A test that better selects medical students based on a profile more in line with humanistic values is perfectly feasible, although based on this experience, the instrument needs to be improved to make it more reliable.

The Schools of Medicine are the responsible centers for the Graduate Degree that qualifies for the practice of the medical profession, regulated by European and national legislation. Their number has increased from 28 to 50 in the last 15 years, a decision that should depend solely on academic and health criteria.

"It is necessary to provide future physicians with the best possible scientific, professional and human training, so that they are capable of solving health problems, in a coordinated and continuous itinerary that begins with the degree and specialized health training, followed by continuous professional development” (Declaration of Malaga 2022. Standards for undergraduate medical education: thinking about the future, endorsed by national and international institutions).

We need to continue working in a coordinated manner between university and healthcare leaders to stabilize, promote and increase our faculty.

We face challenges, with the desire to improve, thanks to the dedication of all the people who are formed and form to care for the health of others, with our greatest gratitude.

Background

Prognostic assessment of early cardiovascular events in patients with acute coronary syndrome (ACS) can be aided by the HEART, TIMI, and GRACE scores. However, their combined use has not been extensively researched.

Objectives

Determining the prognostic value of in-hospital and 6-month mortality using the GRACE, TIMI, and HEART scores in patients with acute coronary syndrome.

Methods

We conducted a cross-sectional descriptive study on 68 patients with acute coronary syndrome, following them longitudinally for 6 months at Can Tho Central General Hospital, Vietnam.

Results

The GRACE score demonstrated good prognostic value for in-hospital mortality, with an area under the curve (AUC) of 0.805. Sensitivity and specificity were 90% and 65.51%. Conversely, the TIMI risk score had a poor prognostic value for in-hospital mortality (AUC = 0.682; sensitivity = 60%, specificity = 63.79%) and 6-month mortality (AUC = 0.692; sensitivity = 60%, specificity = 66.03%). On the other hand, the HEART score had quite good prognostic value for in-hospital mortality (AUC = 0.726; sensitivity = 50%, specificity = 89.74%) and good prognostic value for 6-month mortality (AUC = 0.805; sensitivity = 57.1%, specificity = 97.14%).

Conclusion

The GRACE scores demonstrate greater prognostic value for in-hospital mortality in patients with acute coronary syndrome compared to the TIMI and HEART scores.

Introduction/objectives

Artificial intelligence (AI) holds indisputable potential in solving global challenges faced in healthcare provision, resulting in its ever-increasing utilization in various medical fields. This review aims to present a thorough evaluation of the advantages, challenges, and leading strategies for utilizing AI in the field of medical education.

Methods

In order to access the latest studies and documents, a comprehensive literature search was conducted in Medline (via PubMed), Scopus, and Web of Science databases, using free keywords and MeSH terms representing artificial intelligence, medical education, curriculum, medical student, and their equivalents, without any restriction in time and language, until October 2023.

Results

The expanding integration of AI into medical practice, especially in recent decades, has also led to an increase in the use of different AI methods in medical education. However, integrating AI into medical education comes with advantages and obstacles. The advantages include objective student assessment, better clinical simulation organization, and enhanced education transparency. Conversely, the main challenges of AI integration in education are ethical and legal issues, scalability limitations, evaluating the effectiveness of these educational methods, and technical difficulties.

Conclusions

Further research is needed to specifically identify the potential benefits and challenges, and analyze the proposed solutions for these challenges. Also, the academic curriculum should be evaluated periodically in order to improve the effectiveness of incorporating AI in medical education.

Background

Helicobacter pylori (H. pylori) infection may cause gastric ulcers or extra-gastroduodenal disorders, including iron deficiency anemia. This study aimed to determine the relationship between H. pylori infection and iron deficiency anemia (IDA).

Methods

A case–control study was conducted on participants aged ≥ 18 with an indication for gastric endoscopy. The cases were identified by positive rapid urease tests with biopsy specimens obtained during gastric endoscopy. The controls were negative rapid urease tests. Blood samples from the participants were taken for hematological indices and other iron-related parameters.

Results

A total of 230 participants including 115 cases and 115 controls were eligible for the study. H. pylori positive group had significantly a lower mean value of hemoglobin (P < .001), mean corpuscular volume (MCV) (P < .001), mean corpuscular hemoglobin concentration (MCHC) (P < .001), serum iron (P < .001), and transferrin saturation (TSAT) (p < .001) compared to the counterparts; meanwhile, ferritin levels showed an insignificant difference between 2 groups (P > .05). The rate of iron deficiency anemia was significantly higher in the cases than in the controls (χ2 = 16.05; P < .001). A significant association was found between H. pylori infection and anemia, iron deficiency with age and sex-adjusted ORs of 7.59 (95% CI = 3.83–15.05, P < .001) and 2.12 (95% CI = 1.05–4.25, P = .035), respectively.

Conclusions

Our study found a significant association between H. pylori infection and anemia, and iron deficiency. The relationship between H. pylori infection and iron deficiency anemia has not been conclusively established. H. pylori-infected individuals should be screened for IDA.

Using featured films and TV series as pedagogical tools in medical education has recently surged in popularity. This paper presents a systematic review evaluating their pedagogical applications and analyzing expertise in this field. A total of 17 papers, spanning from 1983 to 2023, were comprehensively analyzed. Results were categorized by original journal, themes, population characteristics, target groups, specific films/series used, instructional methods, and outcomes. Diverse topics emerged, including medical professionalism, bioethics, and critical thinking. 2871 medical students participated in these experiences, mainly from the first- or second year. Most experiences relied solely on films. Articles highlighted the importance of debates around audiovisual materials. The review found featured films and TV series to be valuable supplements to traditional medical education. They enrich students' learning experiences, deepen engagement with complex subjects, and foster critical skills development, offering an innovative teaching approach.

Medicine has evolved positively throughout my professional life. It is currently more decisive and respectful, and less invasive than a few decades ago. The proof of this is that life expectancy has increased and the general health of the population is clearly better. However, there seems to be some discrepancy between these objective data and the self-perception of health by a large part of the population. Various possible causes are pointed out, among which stands out the progressive technification of medicine at the cost, frequently, of a loss of humanistic values of the profession. From these premises, we ponder on possible actions aimed at alleviating this problem.

Medical specialty training in Spain the so-called MIR system, is one of the pillars of the quality of the health care system by ensuring standardized training in accredited units. After decades of experience, the medical specialty training has some obvious strengths, but also some weaknesses. This article reviews these characteristics and proposes improvement measures.