The presence of humanities in the curricula of medical students in Italy and Spain

Introduction

There is an increasing interest in the usefulness of humanities to improve the training of medical students. In this article, an analysis is made of the presence of humanities subjects in medical curricula of Italy and Spain.

Conventional and electronic portfolios in medical residencies

Portfolio is a new tool that gathers evidence of knowledge, abilities, attitudes, and values. This form of evaluation has arisen in the context of a competency based learning and evaluation. Conventional portfolios can be mainly divided in summative and formative. Summative portfolio can evaluate the final learning product of the student and formative portfolio can guide the student through the learning process with various evaluations. Also, electronic portfolios have increased the range of evidences that can be added to the portfolio, is highly accessible and is more agreeable to students. Recommendations are made on how to start and maintained a portfolio in medical residencies.     

Transitions in medical education: Filling in the blanks

Transitions in medical education are moments of intense learning, bringing significant challenges for the trainees, the medical programs and healthcare provision. Frequently, transitional periods are not prepared or mentored; this process of transformation in the trainee is left to occur by chance and opportunity. Promotion of medical education continuity requires formal support in the continuous process of learning and professionalization. This is a review of the formal transitional periods in medical education considering the most significant points of transition. The challenges of each period of transition are analyzed and strategies for improvement are discussed. Educational strategies should not be directly translated to other settings; however, they need to be adapted to the cultural context of medical training to be effective. Research on transitions, considering the socialization process and the cultural environment, should be performed to better support the medical professional pathway.     

Reflexiones sobre la deshumanización de la educación médica: empatía,emociones y posibles recursos pedagógicos para la educación afectiva del estudiante de medicina

While medicine is going through a phase of increasing technical growth, it is also a time of increasing depersonalisation in the doctor-patient relationship. Empathy is a required element to build this relationship, and is a bridge between evidence-based medicine and patient centred clinical practice. Studies that have appraised empathy demonstrate its erosion during the undergraduate years. This fact has boosted the development of tools for assessing empathy, such as the Jefferson Scale of Physician Empathy, or the Interpersonal Reactivity Index adapted by Davis. However, the real challenge is how to promote strategies aimed at promoting empathy and to prevent its erosion. This, in short, requires strategies on how to educate student emotions and feelings that are intrinsically related to empathy. Educational tools for this purpose are emerging in the teaching scenario, represented by literature, music, poetry, narrative medicine, opera and, especially Cinematic Education. Academic and Medical Educators find it difficult to find effective answers for the current mandatory challenge of promoting empathy in the training of medical students.     

The role of virtual interactive simulators in medical education: Exploring their integration as an assessment methodology in clinical years

IntroductionAssessment takes a fundamental role in medical education. In Portugal, the main assessment method used is multiple-choice questions (MCQ). The virtual interactive patients (VIP) as an assessment method can be indicated for the development of clinical reasoning for medical students of the clinical years. This study compared the use of MCQ and VIP as assessment methodologies in medical students.MethodsA randomized crossover study carried out, which 35 Portuguese medical students from clinical years evaluated by MCQ and VIP in four medical specialties. In each specialty, students randomized into two groups. One group started being evaluated by MCQ and finished with VIP, the other vice-versa. After the evaluation, students asked to complete a satisfaction questionnaire.ResultsThe final score was higher with the VIP than MCQ method (MCQ: 67.40 ± 8.96 vs. VIP: 73.34 ± 10.8; p < 0.01) with significant differences higher in Clinical History and Physical Examination. The satisfaction quiz showed although both methodologies are adequate and satisfactory, but VIP method allows to improve knowledge.ConclusionVIP is more accurate for clinical reasoning, accepted by medical students and should be integrated into the pre-graduate medical curriculum with other methodologies already used. The COVID-19 pandemic allowed a digital transformation of medical education and VIP will have a crucial role as a knowledge and evaluation method.     

Undergraduate medical students. Simulation-based activity to conduct the informed consent process for health research studies

IntroductionTraining through medical simulation allows for continuous learning under controlled conditions. Simulation-based training activities can be used simultaneously with other educational strategies to strengthen the attitudinal skills needed to develop an informed consent process in the context of health research.ObjectiveTo facilitate learning in undergraduate medicine students, and to evaluate their competences to carry out an informed consent process in a scenario that resembles reality.Materials and methodsIn this semi-longitudinal study, a simulation-based activity was conducted with 136 medical students of the fourth (Group A) and fifth year (Group B) of the Marist University of Mérida, in southern Mexico.ResultsThe mean score for both groups was 72.48 ± 1.05 (95% CI = 70.4–74.5); 86.2 ± 0.96 (95% CI = 84.2–88.0); and 77.7 ± 0.72 (95% CI = 76.3–79.1), in the pre-test, the simulation and the post-test, respectively. The students of group A self-evaluated their performance with 3.93/5.00, and those of Group B, 4.04/5.00.DiscussionThis study showed that Group A students did not score lower on simulation-based activity when compared to students in Group B, suggesting that before the fifth year of undergraduate medical education, students could properly develop an informed consent-process for health research if they receive early education about medical ethics and research bioethics. Issues related to bioethics in human health research can be included as soon as medical students initiate research methodology courses.     

Fisiopatología y semiología clínica. ¿Dónde estamos y hacia dónde deberíamos dirigirnos?

The teaching methodology of many subjects must be rethought. In an environment where physicians have a lot of immediate access information in different formats, the memorization of concepts exposed in classical lectures followed by a multiple-choice test is clearly obsolete. The process of learning should be based on an active work by the student based on the resolution of situations that simulate what in the future will be found in the daily clinical work. In this context and aware of the enormous difficulty of a change of this depth, the interest of rehearsing new teaching experiences such as the one discussed in this same issue of Educación Médica is discussed. Only a more active participation of the students in their learning, in which the teachers become companions rather than protagonists, can guarantee the training that we want the doctors of the XXI century to achieve.     

Point of care ultrasound knowledge among resident doctors in Madrid's university hospitals. Influence of the induction in emergency departments with point of care ultrasound practice

BackgroundPoint of care ultrasound study (POCUS) is a relatively new technique in Spanish Emergency Departments (EDs). Nonetheless, its use is increasing, and the number of emergency doctors and the number of papers published in our country has skyrocketed in last decade. Despite this fact, there is still no evidence of how POCUS is taught in our medical schools.ObjectiveTo ascertain the level of knowledge about POCUS in first year resident doctors of three hospitals in Madrid, and one year after having worked in ED with POCUS practice.Methods and study designThe study looked at demographic aspects, POCUS knowledge, and opinions about its usefulness in the ED, prior to and after working in ED with routine use of POCUS.ResultsOf the 265 questionnaires, 197 were first-year residents (Group 1) and 68 second-year residents (Group 2). Another 55 senior medical students completed the questionnaire (Group 3). The majority of Groups 1 and 3 stated to have a very low POCUS level. Almost three-quarters (73%) of Group 2 stated having an intermediate or high level, and 26% even declared having full knowledge. More than half of the students agreed that POCUS was a useful tool in ED.ConclusionsThere is a low level of knowledge about POCUS among first-year residents. After working in POCUS qualified EDs, these resident doctors state both the importance and their higher level of knowledge of POCUS.     

Autonomía y supervisión del residente de cirugía: ¿se cumplen las expectativas en el quirófano?

Introduction

Effective supervision and gradual autonomy for surgical residents are important educational resources related to their future independent and safe practice. The aim of this study is to compare the perceptions about the supervision and autonomy that residents and the faculty have in the operating room, with reference to the standards defined in the curriculum.

¿Cómo impulsar una sociedad científica de estudiantes de medicina?

In recent decades the student undergraduate research initiatives have increased; so the scientific societies of medical students have an increasingly important role in the development of research in Latin America. The growth and consolidation of these organizations depends on strengthening its technical capabilities, organizational skills and leadership. The basic strategies to improve the organization are: Establish permanent training programs in research knowledge; implement journal clubs; encourage self-learning and use of the various resources offered by web 2.0; training in management and administration; standardize processes and procedures; establish partnerships with other institutions; promote the exchange of experiences with similar organizations.     

Interacción multidisciplinaria programada: una estrategia de actualización en medicina de posgrado

Introduction

A multidisciplinary interaction strategy in postgraduate medicine is presented, which has as its aim the academic update and the carrying out of research activities related to paediatric lipidology.

Error humano,seguridad del paciente y formación en medicina

Despite of the expectation that physicians must have a diagnostic and therapeutic reliability of 100%, the truth is that the human condition is linked to error in any activity and the practical exercise of medicine is no exception, as it is by nature imperfect science, and the expectation of perfection is neither realistic nor possible. This does not mean that nothing can be done to decrease the frequency and mitigate the consequences of medical errors. The complexity of health organizations and health processes has led us to consider that, in order to guarantee the quality of care and patient safety, new models of training of health professionals are needed. In the current situation, patient safety is one of the new challenges facing medical education in undergraduate and posgraduate courses. This involves incorporating the culture of patient safety into the training plans of resident physicians in particular and other health professions in general. This article is a review on this topic.     

Community of Studies and Technical Scientific Development of the Campos Gerais: A Brazilian experience in medical pathology

IntroductionPathology is a discipline that allows students of medicine to integrate their knowledge learned in the initial years of graduation with clinical practice.ObjectiveTo report the experience of the “Comunidade de Estudos e Desenvolvimento Técnico-Científico dos Campos Gerais (CEDTEC-CG)”.MethodologyData were collected from extension testimonials and informational data, focusing on the importance of the project in the academic training, and the potential benefits of the activity for the local community, correlated with the scientific literature.Results and discussionCEDTEC-CG is a project created in 2012, with the main objective of working in university extension, and is an initiative involving teachers, students and researchers in order to generate accessible scientific knowledge and promote health education. The project has several aspects of action, such as the availability of online content, high-level scientific production, and the promotion of health in the community in general, revealing an opportunity for improvement in student learning and social integration. The project tries to better integrate the undergraduate education strand, bringing the student closer to medical practice, increasing scientific production with dissemination of results, and acting directly with the community, bringing improvements in health promotion and production.     

El feedback como herramienta docente en la formación clínica: parte 2

Supervision of the training of physicians requires conducting tutor-resident interviews; nevertheless, neither the tutors nor the clinical teachers feel that they have received hardly any training to be able to carry them out effectively. In this second part we describe how to conduct a tutorial session providing constructive and satisfactory feedback for both the learner and the teacher (formal feedback). We propose to structure the tutor-resident interview in 10 simple steps that allow to complete it with positive results and we illustrate the process through a story. Finally, we invite the tutors and clinical teachers to dedicate time and effort to the training and practice of feedback.     

Formación de médicos especialistas en México

Medical education in Mexico is heterogeneous since there are more than 140 public and private Schools and Faculties of medicine, with particular Programs and characteristics. However, the predominant educational model is the traditional initial training in basic sciences followed by clinical practice, some of them, with incorporation in their programs of competencies instead of objectives and attention to learning more than teaching. In postgraduate training there is greater uniformity, since although there is diversity in the Programs, a significant number follows the program of the National Autonomous University of Mexico (UNAM), since about 50% of the students of specialty are enrolled in this University. There are other programs in some State Universities and Private Universities.What stands out for being uniform throughout the country is the National Medical Residency System, since the process of incorporation and development of the process are regulated by the Interinstitutional Commission for the Training of Human Resources in Health (CIFRHS). An organization made up of representatives of educational and health institutions, which has among its functions the elaboration and application of the National Examination of Aspirants for Medical Residencies (ENARM), and the intervention in the training process, highlighting the great disproportion between the demand of these postgraduate studies and the capacity of supply.     

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 evaluación de residentes en las Unidades Docentes de Atención Familiar y Comunitaria de Madrid: ¿qué opinan los residentes y sus tutores?

Introduction

Assessment of residents is a complex process, for which the evaluation tools hardly ever produce certainty about the competence level. Residents’ teaching units have the responsibility of proposing the award of specialist degrees in health sciences, therefore they make a continuous effort to improve the process within the new regulatory framework in Spain. The opinion of tutors and residents were determined in order to address changes in the evaluation model of Primary Care teaching units in Madrid, Spain.

El feedback como herramienta docente en la formación clínica. 1.ª parte

The 2 most important concerns of tutors and clinical teachers are how to get residents and students motivated and how to offer feedback constructively. In addition, clinical teachers feel that they do not have enough knowledge or training on how to give feedback. In this article, we describe how to use feedback so that supervision is a productive and stimulating experience for both the learner and the teacher. We review the basic characteristics that a feedback should have to be constructive and focused on the learner and their teaching program at the same time. We propose a systematic structure for giving informal feedback in 4 steps and we offer some examples for its staging.