Acreditación y resultados de la educación médica en México

Objective

To determine whether the medical education programs recognised for their quality achieve better results in the National Medical Residency Examination.

La acreditación internacional en educación médica a través de la WFME

IntroductionThis paper begins in the context of quality in medical training to conclude with the analysis of the benefits provided by international accreditations in this field.MethodsFor the development of this work the documentary research technique on the quality in medical training is used, which included the collection of information from documents published in journals and presented on web pages, through the search in different bases of international bibliographic data.ResultsThe procedure and evaluation criteria of one of the most relevant international accreditations in this area, the accreditation established by the World Federation for Medical Education (WFME), and its importance in the World University System.ConclusionsThere are many benefits that these accreditations bring to the university centers that get it, such as allowing all its graduates to apply for the Educational Commission for Foreign Medical Graduates (ECFMG) certification from the year 2024.     

La participación universitaria directa en la formación de médicos especialistas en México

Introduction

The University of Veracruz implemented the General Study Plan for Medical Specialties in 2013. The courses included in this study plan are mandatory, as they are important to improve specialised medicine skills for medical specialists of the future. Since it is not possible to deliver attendance-based courses, medical education, health services and systems and human development courses were offered online.

La educación médica como necesidad para la formación de los futuros médicos

This work highlights the need to establish Medical Education Units in Spain in response an increasingly demanding global society. As in Netherlands, England and the United States of America, we suggest establishing unified quality criteria and use them to promote changes in the Faculties of Medicine all along the country. Medical Education Units would assume a role in curricular evaluation and updating to ensure quality standards and academic excellence. Moreover, it would be essential to offer training in Medical Education for both teachers and students, including development of dedicated Master and PhD programs and associated research projects. Furthermore, Medical Education Units would work in favor of continuous training through the creation of the Chairs of Medical Education reinforcing the role of education in health sciences.     

Validación de la versión en español de un instrumento de evaluación de la comunicación centrada en el paciente en OSCE

ObjectiveThe aim of this study was to validate the Spanish version of the Communication Assessment Tool (CAT) to be used in an Objective Structured Clinical Evaluation (OSCE) to assess communication skills.MethodsData were collected from standardized patients evaluating 125 recent medical school graduates during a 12-station OSCE. A total of 1,500 completed CAT instruments were analyzed. Exploratory and confirmatory factorial analysis were performed and tested the internal consistency of the tool.ResultsWe found a single factor solution in the Spanish version of the instrument, similar to that described by the original author. Cronbach's alpha was high, ranging from 0.93 to 0.97. The overall mean percentage of ‘excellent’ ratings for the recent graduates was 38.07%.ConclusionsThe Spanish version of CAT is a feasible tool to be used in OSCE by standardized patients to assess communication skills in a standardized manner.     

¿Es la disección anatómica un método docente en decadencia?

IntroductionThe study of human anatomy based on cadaver dissection has historically been one of the most widely used resources. However, the generation gap between students and teachers has led to the search for new teaching methodologies for the practical study of human anatomy, in order to replace the practice of human dissection.Material and methodsA voluntary questionnaire were sent to 360 students enrolled in one of the Human Anatomy subjects of the degree in Medicine at the University of Zaragoza to find out their perception of the practice with human cadavers.ResultsThe questionnaire was answered by 69.1% of the students (235/360), of whom 74.5% were women (268/360) and 25.5% men (92/360), with ages ranging from 18-20 years old in 85% (306/360) and older in the remaining 15% (54/360). The student's initial feelings about the internship ranged from anticipation, motivation and enthusiasm (41.7% vs. 34.9% vs. 21.7%) to excessive chemical smell and apprehension (38.7% vs. 14.5%). However, and despite the fact that 20% of the students felt initial rejection, 100% of them consider it necessary to practice with cadavers and postulate the virtual dissection table (50%), digital platforms (36.4%) or anatomical models (13.6%) as teaching alternatives.DiscussionThe study of human anatomy in the Degree in Medicine, according to the students' responses, should be linked to practice with cadavers, complemented with other teaching tools.     

Evaluación de la efectividad de la versión en español de un curso de comunicación de malas noticias

IntroductionGood communication by health professionals is associated with better patient outcomes. The Program to Enhance Relational and Communication Skills (PERCS) has been adapted to other cultures. The objective of this study is to describe the effectiveness of the Spanish version of the PERCS program, from the perspective of the participants, at the end of the course and 6 months after the course.MethodsA process of cultural and epidemiological adaptation of the PERCS program to the reality of Peru was carried out. A qualitative and quantitative approach was used to evaluate the educational impact of the program.ResultsThirty-nine professionals participated voluntarily. Participants found it more difficult to communicate ominous diagnoses (48.15%). Anxiety is the most frequent emotion when faced with difficult communications (77.78%). Almost all (92%) stated that the course improved their preparation, and 88.9% that it reduced their anxiety. At 6 months, participants recognised the importance of honesty and empathy, as well as some steps in conducting the patient-centred interview.DiscussionAn intensive training program in difficult communication can be adapted to Spanish, and positively impact the skills, self-confidence, and self-perception of learning in Peruvian professionals, in relation to promoting communication focused on the needs of the patient and family.     

Perspectiva de los estudiantes de enfermería sobre la transformación de la atención primaria durante la pandemia de la enfermedad coronavirus-19: estudio cualitativo mediante fotoelicitación

IntroductionPrimary Care has undergone changes derived from COVID-19. Nursing student internships are a space to delve into key aspects of daily practice, but also for the analysis of its context. This paper aims to analyze the experience of third-year Nursing students during their clinical internships on the transformation of Primary Care due to the COVID-19 pandemic.MethodsWe followed a qualitative approach, through photo-elicitation.ResultsThe transformation of Primary Care can be seen through non-verbal communication, values and feelings, protection measures, direct attention to the citizen and the identification of vulnerable groups.ConclusionPhoto-elicitation favors students’ reflective thinking on the transformation of Primary Care during COVID-19.     

Estrategia colaborativa para la integración de competencias en la formación de grado en enfermería

Objective

Analyse academic results and explore satisfaction of students and professors from the experience of integration of two subjects in second year of Degree in Nursing.

La Tabla Periódica de la Equidad en Salud: experiencia de innovación educativa para la construcción colectiva de conocimiento

IntroductionHealth equity is a value linked to the concept of human rights and social justice, which seeks to enable people to develop their highest health potential regardless their social position. In order to articulate specific strategies aimed at health equity for health professionals, it is necessary reform teaching methodology and explore innovations that promote learning, exposing these professionals to community and global health challenges, while promoting understanding and awareness of equity, inequalities and social determinants of health. The overall objective of this paper is to disseminate an experience of educational innovation, which through the construction of collective knowledge, has resulted in a semantic framework around the concept of equity in health.MethodsThe participatory action research methodology was used, mediated by the use of ICTs, framed in the Horizon 2030 recommendations for responsible research and innovation. The data collection instrument was based on the didactic use of metaphor and consisted of a shared document called Periodic Table of Equity in Health.ResultsA sample of 15 students compiled a total of 117 terms related to health equity, grouped under human rights, cultural competence, intercultural mediation and others.ConclusionsIn a health education where the technological rational paradigm continues to prevail, proactive and creative educational innovations are necessary, which should not be articulated unrelated or indifferent to social and civic facets of the practices, especially if they are committed to improvements and transformations that affect people and society.     

Validación psicométrica de la Escala de gravedad de fatiga en médicos residentes mexicanos

Resident physicians are continually exposed to fatigue, which can lead to work, academic and personal problems, so it is important to have reliable and valid instruments to measure it. One of the most used is Fatigue Severity Scale, but, there are versions with different number of items in different populations. Therefore, the purpose of this work was to translate, adapt culturally relevant and compare versions with different numbers of items, to identify the most appropriate in Mexican resident physicians. With three different groups of participants; first one for translation by seven expert judges in the language, second for psychometric validation with 100 resident physicians, and third for confirmatory factor analysis and invariance test by type of program (specialty and high specialty) with 182 resident physicians. Distribution, discrimination, reliability and factor structure of the scale were tested in an exploratory and confirmatory analysis, leaving a final scale of 6 items with good fit (X²[9] = 9,39, p = 0,40; CFI = 0,99; RMSEA = 0,02), with a reliability = 0,91 and strict factorial invariance by type of residence program.     

La visión de los estudiantes de medicina sobre su profesión: obstáculos para la transición a la perspectiva centrada en el paciente

IntroductionThe medical profession is in a period of transition due to the improvements in the scientific, technological, and social advances that affecting health care. This new context requires the transformation from a model of total autonomy of the profession to a model centred on the patient, which has important implications for medical education.MethodThe objective of the present study was to identify the perception of medical students towards these changes and explore to what extent they reflect the classic paradigm that would entail a «physician centred» perspective vs the new «patient centred» trend. Semi-structured interviews were conducted with 55 medical students of three different schools.ResultsQualitative analysis showed that an interpretation based on the classic model that focuses on the autonomy and status of the profession prevails over the patient centred approach.ConclusionThe process of socialisation and the hidden curriculum are brought up for discussion in order to explore the way in which such paradigm is promoted instead of the patient centred approach.