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.     

Innovación e investigación sobre el currículum de Enfermería Comunitaria: revisión de la literatura

A literature review has been carried out in the period of 1983-2014. The aim has been to know the curricular development of the Community Nursing subject in the university degree of Nursing in the Spanish context. The search was conducted in nine databases of Nursing, Education, Health Sciences and other Social Sciences, in addition to TESEO. The selection criteria for documents were: the type of document, the nationality and the date of publication. 43 documents were analyzed, 24 of which were innovation experiences and 19 curricular investigations. The most frequent topic in the publications was the practical-clinical training of the students in the field of Primary Care. The most studied curricular elements were the evaluation and the methodology. The students were the most studied population in a research with clear quantitative perspective, in which the survey stands out as the main data collection technique.The scientific-curricular development has been greatly reduced. Very few publications have been located and curricular research has been limited, diverse in thematic areas and curricular elements, and homogeneous in methodological approaches.     

Evaluación de competencias en residentes de pediatría en el primer nivel de atención mediante la utilización del Mini-CEX

BackgroundA residency is a professional training system based on supervised clinical practice. The Mini Clinical Evaluation Exercise (Mini-CEX) is a method of assessment through direct observation that enables the design of strategies to improve professional performance.The purpose of this study is to analyze the results of implementing the Mini-CEX to assess pediatric residents during their rotation at the first level of care while exploring differences according to the training site to which they belong.MethodsWe conducted an analytical cross-sectional study that included 2nd-year pediatric residents on rotation at the first level of care in pediatric and general hospitals. Each resident underwent two Mini-CEX encounters for the assessment of 8 domains: history taking, communication skills with patients and with caregivers, physical examination, clinical judgment, clinical management, professionalism, and organization.ResultsThirty-four residents participated in the study. The total overall rating of residents from pediatric hospitals and general hospitals was 4.20 (4.07-4.34) and 4.14 (3.94-4.34), respectively. We found no statistically significant differences in the areas assessed according to the residents’ training site.ConclusionThe Mini-CEX as an assessment tool within the first level of care allowed the detection of strengths and weaknesses in residents’ training. Implementation was affected by limitations inherent to this setting. Standardization of assessors was a key element for criteria unification.     

La importancia de la educación interprofesional en la enseñanza de la odontología: una revisión sistemática exploratoria analizando el dónde,el porqué y el cómo

In recent years, inter-professional education has increased its popularity in the teaching and learning of dentists, with the aim of improving collaboration and quality of service. The purpose of this study, therefore, is to describe and analyse the where, why and how of inter-professional education in dental education. A scoping systematic review was conducted by searching multiple databases, a manual search of relevant journals, and in the grey literature. A thematic analysis was then performed on the data. Most of the 30 articles retrieved were produced in North American and European settings, and mainly jointly with medical, nursing and pharmacy students. The main justification was the need to promote and value teamwork in order to meet the needs of patients. Team-based, problem-based, and case-based learning were the most common learning strategies found. These reported positive changes with regards to communication and collaboration between inter-professional students. The discussion is centred on the benefits and recommendations when planning inter-professional education interventions in dental education.     

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.     

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.     

Asociación entre la calidad de 3 tipos de rotación clínica y el enganche académico de estudiantes de Medicina

IntroductionThe association between academic quality of clinical rotations and academic engagement of medical students is not well known. This work aims to study this association in three clinical rotations (hospital, simulation, and during the pediatrics course in the context of the Covid-19 pandemic.Material and methodsCross-sectional correlation study with medical students who completed pediatric clinical rotation. Academic quality and engagement were assessed using the ROTA-Q and UWES-S 17 questionnaires, respectively. The means and standard deviations of each variable were computed, and the correlations were evaluated using the Pearson test (significant if p < 0.05).Results44 students participated. The average of the ROTA-Q scale was 4.39 ± 0.62 [1–5] and that of the UWES-S 17 scale was 4.28 ± 0.90 [1.76–6]. The Pearson coefficient between the quality of the rotations and the students’ academic engagement was 0.319 (p < 0.05). The association with academic engagement was highest in the tele-education rotation, followed by the simulation rotation, and finally, by the hospital rotation.ConclusionsThe academic quality of the pediatric rotation is positively related to students’ engagement in academic activities. The perception of academic quality, engagement levels, and the association between these variables were highest in the tele-education rotation. Actions are necessary for the continuous improvement of quality and the promotion of training mediated by tele-education and simulation.     

Relación entre la autopercepción y autoeficacia para el desarrollo de competencias en soporte vital en entornos de simulación clínica de alta fidelidad

Objective

To determine if there is a correlation between self-perception and self- efficacy in the development of learning abilities associated with the care of the critically ill patient in a Clinical Environment of High Fidelity Simulation, as part of the training for nursing students in the field of Life Support.

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.     

Aceptación de actividades de fomento de la investigación en estudiantes de Grado en Medicina

AimTo present activities for the initiation of research in the medical degree.MethodResearch skills have been included as a compulsory subject with methodological contents (theoretical and practical) and seminars related to scientific discoveries, as well as in three optional subjects in which students perform a scientific project supervised by a tutor.ResultsThe grades of the tasks of the compulsory subject are high (3.7 ± 0.07 out of 4 points), and 43.8% of the enrolled students completed the three optional subjects. Satisfaction with the activities was high (3.46 and 3.9 out of 5 points), which suggests that they contribute to acquiring scientific skills in medical education, and that the work of the tutors is important (4.4 out of 5 points).ConclusionExposure to research tasks in the medical degree is well accepted by the students.     

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.     

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.

Valoración por los estudiantes de la formación práctica de grado de Medicina. El caso de la Neumología

IntroductionPractical training for medical students is provided during the final years of study and is determined by several conditioning factors, including the MIR training that students receive simultaneously. In general, practical training evaluation receives much less attention than the theoretical one; its quality is not evaluated, and the professors do not receive feedback. The objective of our study was to determine how students value practical training in pulmonology rated the experience after completing a three-week rotation, in order to apply the information gained toward a process of continual improvement.MethodsThe study included 2 anonymous surveys taken by medical students during the same academic year-one internal, prepared by the Department of Pneumology, itself, and another external one, prepared by the Evaluation Unit for Teaching Excellence at the University of Salamanca.ResultsOn the internal evaluation, student opinions of their practical training ran high (8.26) and the perceived usefulness was also high (8.23), on a scale of 0 to 10 and no differences were noted according to whether the survey was taken during their fourth, fifth, or sixth year of study. These results agree with those obtained in the external evaluation with a mean value of 4.56 on a scale of 0 to 5. Student preferences during their rotation in the department were for hospitalization and consultation units, with the technical areas being lesser valued.ConclusionsAchieving and maintaining a high quality of practical training is a goal that should be consistently evaluated so that professors may receive feedback (internal and external). Rotations in the Department of Pneumology provide an opportunity to improve the perception that medical students have regarding this specialty. It is imperative to reflect upon the contents of these rotations, seeking a balance between clinical areas and technical areas.