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.     

Evidencias de validez de la versión en español del Simulation Effectiveness Tool - Modified (SET-M) aplicado en telesimulación

Introduction: Due to the increase in the use of telesimulation in the training of health professionals, having instruments to assess its effectiveness is a pressing need.Objective: To describe the validity evidence of the Simulation Effectiveness Tool - Modified (SET-M) for its use in telesimulation activities aimed at third-year students of the degree of medical surgeon of the National Autonomous University of Mexico.Methods: Through a prospective study, the translation and reverse translation of the instrument was performed, content validation, exploratory and confirmatory factor analysis, and reliability analysis were performed.Results: Three factors similar to the English, Brazilian, and Turkish versions were found, overall Cronbach's alpha 0.930. The Kaiser-Meyer-Olkin sample adequacy mean was 0.953, and Bartlett's sphericity test yielded significant values at 0.001Conclusion: The Spanish version of SET-M has sufficient evidence of validity to be used in evaluating the effectiveness of telesimulation from the perception of the participants in this context.     

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.     

Como diseñar un modelo de formación semipresencial en el aprendizaje en situaciones de urgencia

We present a guideline to create a simulation model with a blended format launched at the Valdecilla Virtual Hospital during the year 2022. The principle of clinical simulation is explained as well as the new opportunities in blended training. We can indicate that the implementation of the blended course format opens up a future full of possibilities for the use of distance simulation activities as a complement to training and learning activities.     

Estrategias de comunicación para la atención a la población inmigrante: desafíos en la formación de los estudiantes de Ciencias de la Salud

IntroductionTo explore the communication strategies used by Health Sciences students with the immigrant population during health care.Materials and methodsQualitative research of phenomenological/interpretive type with a Multiple Case Study design. 106 students from three universities and different Health Sciences careers in their final year of training were interviewed, with prior authorization from two institutional Ethics Committees, in addition to requesting informed consent. The content analysis was of inductive and was supported by the ATLAS.ti version 9 software.ResultsTwo categories were established; one, with the different semiotic modes used by the students and another, of personal skills present during clinical interaction. The student body reported having used different multimodal communication resources, from the non-verbal mode to the translator application mode, to provide care to foreigners, although they acknowledged not having received training on it. The choice and combination of the different modalities was guided by the context and personal skills were relevant for monitoring and adjustments during care.ConclusionsMultimodal communication and personal skills facilitate communicative interaction and allow offering quality health care for the immigrant population, overcoming linguistic and cultural barriers. This indicates that professional training in Health Sciences requires the explicit and systematic development of communication skills, as well as intra and interpersonal skills with a practical approach. Likewise, it needs technical and practical knowledge as well as praxeological knowledge that fosters a reflective attitude.     

Diseño e implantación de un proyecto docente para la formación de la identidad médica en estudiantes de Medicina

We describe the process of designing and implementation of a new teaching project in the University of Navarra. The aim of the project is to promote a patient-centered professional and personal identity for the future doctors. The educational process has 3 consecutive phases. First, workshops that take place prior to clerkships, where students actively reflect on a selected professional identity quality. Then, the student will identify real clinical scenarios during their clerkships where this professional behavior takes place. They should reflect on this, and they should learn through their own reactions and emotions and write a self-reflection. The educational process finishes with the formative and personal feedback from the clinical tutor.     

Programa de Entrenamiento en el Cultivo de la Compasión en los estudiantes de Medicina

Physicians, residents and medical students experience higher levels of stress, depression and burnout than the general population. This mental deterioration determines a less compassionate care of patients. The proposals of the universities and hospitals to prevent this situation are scarce. For this reason, we decided to examine the efficacy of a Compassion Cultivation Training (CCT) program in preventing psychological distress and increasing well-being in a sample of medical students from the Complutense University of Madrid. Participants were randomly distributed into two groups: receiving CCT and waitlist list control. Both groups completed online surveys before the intervention, at the end of it and two months after its completion. The variables studied were compassion, empathy, psychological distress, well-being, mindfulness, burnout, resilience, emotional regulation, and concern about COVID-19. Those who received the CCT program had significant improvements in self-compassion, mindfulness, and emotional regulation and experienced a significant reduction in anxiety, stress, and emotional exhaustion. Some of these effects persisted at two-month follow-up. The CCT seems to be an adequate intervention to take care of the mental health of medical students and favor compassionate care of patients.     

Integrando el aprendizaje activo de la Microbiología en el Grado de Medicina: evolución de la implicación de los estudiantes

Objective

The aim of this article is the improvement in the quality of the teaching in General Microbiology in the Medical Degree by updating the teaching practices. These practices included inquiry-based learning (IBL) in which students are actively engaged in the learning process for improving the skills to be acquired as part of their integrated training.

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.     

Desarrollo de un programa formativo transversal e integral en competencias clínicas,de comunicación e investigación en el 6.o curso del Grado en Medicina

IntroductionDuring 2015-16 academic implanted the 6th course of medicine degree in the Faculty of Medicine and Health Sciences of the Universidad de Alcalá. Includes clinical practices and master's dissertation. The Faculty of Medicine and Health Sciences wanted the training program to be integral and integrator focused on the acquisition and promotion of clinical skills, communication and research, with a coordination structure that would enable an assessment and continuous detection of deviations, and of course establish an assessment of results in the medium and long term. The objective of this work is to present the developed training programme.Materials and methodsA team of teachers and students was formed to design the course, with a calendar of meetings and a program of actions to be carried out, always trying to that all decisions were consensual, the different took into account scenarios, with common teaching tools and assessment, flexible and adapted to the different environments.ResultsThe course has diversity of environments and teaching activities. Rotations integrated student services and healthcare units. In addition, are cross-cutting innovative activities at the Faculty. A coordination of the program structure is designed and for their evaluation, both of student assessment and program, instruments are varied and complex. Numerous opinion tests that reflect a very high satisfaction and academic results are excellent have been designed.ConclusionsWe have managed to develop a training program comprehensive and inclusive, with a coordination structure and appropriate assessment tools. Academic and opinion indicators are very positive and indicate that the learning objectives are met with success. He has been established very effective coordination to homogenize the teaching in different environments, and facilitates the detection and correction of deficiencies.     

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.     

Experiencias sobre el impacto del Programa de Formación en Ética de la Investigación Biomédica y Psicosocial en el ámbito de la salud mental y la investigación conductual

El propósito de este trabajo es presentar el impacto y la integración que los conocimientos adquiridos en el Programa Internacional de Formación en ética de la Investigación Biomédica y Psicosocial de la Universidad de Chile han tenido en mi experiencia profesional, en el ámbito de la investigación psicosocial en un Instituto de Salud de México. Para este objetivo, expondré tres áreas en las cuales se ha podido evidenciar tal impacto: trabajo en los comités de ética, desarrollo de programas de académicos en bioética e investigación y publicación sobre ética y bioética. El motivo que me llevó a incursionar en el Programa fue que su ense?anza vincula la investigación psicosocial con la ética y la bioética, lo cual me permitió dirigir este tipo de reflexión hacia problemas como violencia, suicidio, adicciones, depresión y salud mental, y a nuevos campos como los estudios comunitarios, con poblaciones en riesgo o vulnerables, en los cuales las diversas implicaciones son difíciles de indagar.