¿Se relaciona la capacitación docente con las prácticas pedagógicas en académicos de carreras de la salud de Chile? / The influence of pedagogic and discipline training on the teaching quality of university professors

Background: University teachers prioritize acquiring knowledge about their disciplines over pedagogic training. However, the latter is becoming increasingly important in the present teaching scenario. Aim: To relate pedagogic practices with pedagogic training of teachers from health care careers of public and private universities. Material and Methods: Pedagogic practice and training activities participation questionnaires were answered by 296 teachers of undergraduate students from Chilean public and private universities. Results: There was a direct correlation between discipline training and all pedagogic practice factors. However, pedagogic training correlated with all the factors with the exception of teacher centered learning. Teachers with a master degree had higher scores in factors related to teaching planning and process assessment. Having a doctor degree had no impact on these factors. A multiple regression analysis showed that both discipline and pedagogic training and having a master degree were associated with pedagogic practices of teachers. Conclusions: Both pedagogic and discipline training influence the quality of teaching provided by undergraduate teachers.

Factores que afectan al ambiente educativo en la formación preclínica de medicina según sus docentes / Factors affecting the educational environment in undergraduate medical schools

Background: Educational environment has an important effect on the quality of learning and student satisfaction in medicine. Most of previous studies have been conducted using questionnaires that assess the phenomenon considering overall dimensions, without paying attention to the specific manifestations of this topic, especially those aspects that are related to the protagonists of the learning process: teachers and students. Aim: To describe factors that affect the educational environment in the preclinical Medical formation, according to Medical teachers in Concepción, Chile. Material and Methods: Qualitative study, using the Grounded theory method. Semi-structured interviews were performed to 10 medical teachers in Concepcion, Chile. They were selected by theoretical sampling. Data were analyzed using open coding. Results: Four emerging categories about the factors that affect the learning environment were identified: Personal factors of students, academic factors of students, personal factors of teachers and academic factors of teachers. Conclusions: According to interviewed teachers, both personal factors in teachers and students that promote a positive learning environment are related with an attitude oriented towards others and communication skills. Academic factors are related with the responsible exercise of student and teacher roles and with the promotion of participation in the educational process.

Relación entre prácticas pedagógicas y estrategias de aprendizaje en docentes de carreras de la salud / Teaching practices and learning strategies in health careers

Background: Medical Education, according to the constructivist education paradigm, puts students as the protagonists of the teaching and learning process. It demands changes in the practice of teaching. However, it is unclear whether this new model is coherent with the teachers’ ways to cope with learning. Aim: To analyze the relationship between teaching practices and learning strategies among teachers of health careers in Chilean universities. Material and Methods: The Teaching Practices Questionnaire and Learning Strategies Inventory of Schmeck were applied to 200 teachers aged 24 to 72 years (64% females). Results: Teachers use different types of teaching practices. They commonly use deep and elaborative learning strategies. A multiple regression analysis showed that learning strategies had a 13% predictive value to identify student-centered teaching, but they failed to predict teacher-centered teaching. Conclusions: Teaching practices and learning strategies of teachers are related. Teachers frequently select constructivist model strategies, using different teaching practices in their work.

Determinantes biopsicosociales de depresión en pacientes atendidos en Centros de Atención Primaria de Concepción, Chile / Biopsychosocial depression determinants in patients treated in Primary Health Centers at Concepción, Chile

Introducción: Los factores de riesgo asociados a la depresión han sido estudiados ampliamente, pero no se dispone de estudios prospectivos sobre factores que predigan la incidencia de depresión en personas sanas. Tampoco se dispone de una ecuación predictiva que incorpore factores genéticos. Método: Estudio de cohorte, prospectivo con evaluaciones en línea base y a los doce meses, sobre una muestra aleatoria de consultantes en centros de atención primaria de la Provincia de Concepción, Chile (n = 1.596). Se midieron 8 factores psicosociales y se realizó genotificación de los polimorfismos para la monoaminooxidasa A, la uMAO, y para la región transportadora del gen del transportador de serotonina, el 5-HTTLPR, gen SLC6A4 del cromosoma 17, como factores genéticos y la variable de resultado fue la presencia/ausencia de depresión a los 12 meses de seguimiento. Se empleó regresión logística binaria. Resultados: Las dos variables genéticas no muestran relación estadísticamente significativa con la variable depresión a los 12 meses de seguimiento. Las variables sexo, nivel educacional, satisfacción con las condiciones de vida, antecedente personal de depresión, autopercepción de la salud física y de la salud mental y satisfacción con las relación de pareja se relacionan con la aparición de depresión en el seguimiento. Conclusiones: Los resultados permitirán identificar personas vulnerables entre los consultantes de atención primaria que podrían participar de programas preventivos. El estudio de otros genes será necesario para mejorar la capacidad predictiva del modelo.

Introduction: Riskfactors associated to depression have been extensively studied, though there is a lack ofprospective studies on factors thatpredict the incidence of depression in healthy people. There is not a predictive equation that incorporates genetic factors is not available. Method: A cohort study, prospective, with baseline assessments at 12 months was carried out on a random sample of attendees in primary care centers form the Concepción Province, Chile (n = 1,596). Eight psychosocial factors were measured and the genotyping of the uMAO and 5-HTTLPR in SLC6A4 as genetic factors polymorphisms was also carried out. The outcome variable was the presence/absence of depression at 12 months follow-up. A predictive model for depression was obtained by means of analyses of binary logistic regression. Results: Genetic variables have no statistically significant relation with the variable depression at 12 months follow up. Variables such as gender, educational level, satisfaction with living conditions, personal background ofdepression, selfperception ofboth physical and mental health and satisfaction with relationship are related to the onset ofdepression in the follow up. Conclusions: Outcomes will allow identifying vulnerable people among the primary care attendees, who could participate in prevention programs. The study offurther genes will be necessary in order to improve the predictive capacity of the model.

Aspectos motivacionales involucrados en el aprendizaje autodirigido en estudiantes de medicina. un enfoque cualitativo / Motivation and self-directed learning among medical students

Background: Motivation is an essential aspect in the training process of medical students. The association that motivation can have with learning self-regulation is of utmost importance for the design of curriculum, teaching methods and evaluation. Aim: To describe the motivational aspects of self-directed learning among medical students from a traditional Chilean University. Material and Methods: A qualitative, descriptive study based on grounded theory of Strauss and Corbin. Twenty 4th and 5th year medical students were selected using a maximum variation sampling technique. After obtaining an informed consent, semi-structured interviews and field notes were carried out. Data were analyzed to the level of open coding through Atlas-ti 7.5.2. Results: From the student point of view, personal motivational aspects are linked to the search for information, constant updating, the perception of the physician-patient relationship and interest in subject matters. From the scope of teachers, a main issue is related to their ability to motivate students to develop independent study skills. Conclusions: Personal motivational aspects facilitate the development of independent study skills, specifically in the search of information. The role of teachers is crucial in promoting these skills and the perception of medical students from their learning process.

Repensando la selección de la carrera de Medicina desde los factores que inciden en la formación / Rethinking the selection of medical students, considering non-cognitive skills

In Chile the only requirement to study medicine is to obtain an academic achievement score over a certain cutoff value. However, the literature states that this type of selection is insufficient, since the medical profession requires cognitive and non-cognitive skills. These abilities are associated with better adaptation and academic success, as well as less dropping out. Therefore, those skills should be considered in the selection process to assure that the education goals are met. The aim of this study was to review the existing literature regarding the selection and evaluation criteria for students who are applying to medical schools. It was evident that Chilean medical schools need to establish appropriate criteria to ensure a more inclusive and fair admission. They need to design a system of admission with solid evidence of validity and reliability, complementary to the current form of student selection. This system should be considered common to all schools of medicine and, in turn, consider the sensibilities of the particular mission of each school, since academic, cognitive, inter- and intrapersonal aspects may vary among them.

Relación entre el bienestar y el rendimiento académico en alumnos de primer año de medicina / Academic achievement, engagement and burnout among first year medical students

Background: Stress may affect the sense of wellbeing and academic achievement of university students. Aim: To assess the relationship of academic engagement and burnout with academic achievement among first year medical students. Material and Methods: The Utrecht Work Engagement Scale-Student and Maslach Burnout Inventory Student Survey (MBI-SS) were applied to 277 first year medical students of four universities. Their results were correlated with the grades obtained in the different courses. Results: Moderately high engagement and low burnout levels were detected. There was a high level of satisfaction with studies and a moderate exhaustion level. Academic achievement was associated with the degree of engagement with studies but not with burnout. Conglomerate analysis detected a group of students with high levels of wellbeing, characterized by high levels of academic engagement and low burnout. Other group had moderate levels of engagement and lack of personal fulfilment. Other group, identified as extenuated, had high levels of personal exhaustion and depersonalization. Finally the disassociated group had a low academic engagement, low emotional exhaustion, high levels of depersonalization and lack of personal fulfillment. Conclusions: Academic achievement is associated with the level of engagement with studies but not with burnout.

Estructura factorial de la escala DREEM en estudiantes de medicina chilenos

Background: The entry to a University requires an adaptation process that not all students solve with the same kind of success. Even though students social adaptation and emotional skills are essential, the educational environmental that they perceive has a significant influence in their academic life. Aim: To describe the changes in the perception about academic environment that medical students experience during the first three years of undergraduate career. Material and Methods: The Dundee Ready Education Environment Measure (DREEM) scale was applied to 525 first to third year medical students and an exploratory factorial analysis was made. Results: Four factors were identified: Academic Perception: academic quality that students attribute to the process in which they take part, as well as to the assessment that they do of their learning outcomes (coefficient ± = 0.85); Academic Experience: refers to positive emotions that students experience during the career such as confidence, pleasure and energy (coefficient ± = 0.76); Atmosphere Perception, comfort and calm that students experiment during their academic activities (coefficient ± = 0.79); Teachers Perception: the perception that students have of teachers about their interest and disposition towards students (coefficient ± = 0.50). Conclusions: The assessment of academic environment quality is inversely associated with the lapse that the students have spent in their undergraduate careers.

Predictores afectivos y académicos del aprendizaje autodirigido en estudiantes de medicina / Factors associated with self-directed learning among medical students

Background: Self-directed learning is a skill that must be taught and evaluated in future physicians. Aim: To analyze the association between self-directed learning, self-esteem, self-efficacy, time management and academic commitment among medical students. Material and methods: The self-directed learning, Rosemberg self-esteem, general self- efficacy, time management and Utrecht work engagement scales were applied to 297 first year medical students. Results: A multiple regression analysis showed a significant association between self-efficacy, time management and academic commitment with self-directed learning. Self-esteem and satisfaction with studies did not enter in the model. Conclusions: self-esteem, academic commitment and a good time management were associated with self-directed learning in these students.

Aprendizaje autodirigido y su relación con estilos y estrategias de aprendizaje en estudiantes de medicina / Relationship between self-directed learning with learning styles and strategies in medical students

Background: Self-directed learning (SDL) skills are particularly important in medical education, considering that physicians should be able to regulate their own learning experiences. Aim: To evaluate the relationship between learning styles and strategies and self-directed learning in medical students. Material and Methods: One hundred ninety nine first year medical students (120 males) participated in the study. Preparation for Independent Learning (EPAI) scale was used to assess self-direction. Schmeck learning strategies scale and Honey and Alonso (CHAEA) scales were used to evaluate learning styles and strategies. Results: Theoretical learning style and deep processing learning strategy had positive correlations with self-direct learning. Conclusions: Medical students with theoretical styles and low retention of facts are those with greater ability to self-direct their learning. Further studies are required to determine the relationship between learning styles and strategies with SDL in medical students. The acquired knowledge will allow the adjustment of teaching strategies to encourage SDL.

Evaluación de componentes del currículum oculto en estudiantes de medicina / Assessment of hidden curriculum components by medical students

Background: Hidden curriculum refers to the unwritten, unofficial, and often unintended lessons, values, and perspectives that students learn at the university, which influences the acquisition of professional skills. Aim: To analyze the perception about the influence of the hidden curriculum in the education of medical students at the Universidad de Concepción, Chile. Material and Methods: Qualitative investigation with case study approach. Seventeen graduated medical students were selected by probability sampling. A semi-structured interview was used to collect the information and a content analysis was applied. Results: Forty seven percent of participants recognized having fulfilled their academic expectations. As favorable factors for academic achievement the students underlined clinical practice, access to patients and to clinical fields. As negative factors, they identified the lack of commitment, educational support and over-specialization of their mentors. Conclusions: The results show the strengths and weaknesses of the educational environment of undergraduated medical students. This information should be used to modify teaching environments.

Construcción y análisis psicométrico de un cuestionario para evaluar el comportamiento médico socialmente responsable / Development of a professional social responsibility questionnaire for physicians

Professional Social Responsibility is now imperative for the practice of medicine. However, there are no instruments to assess it among physicians. Aim: To construct and evaluate the factorial structure and reliability of a questionnaire designed to measure socially responsible behavior in physicians. Material and Methods: The Questionnaire on Medical Socially Responsible Behavior, consisting of 34 items, was constructed. It was applied to 284 physicians and medical students. After eliminating respondents who omitted questions, a valid sample of 214 individuals aged 23 to 67 years (51.4% males) was obtained. We assessed the factorial structure, reliability, discriminative ability of the items and correlation between factors. Results: Exploratory factorial analysis, conducted using the principal axis method, identified the presence of three factors and considered 30 items. The reliability of the factors, assessed using Cronbach's alpha, ranged from 0.73 to 0.89. Only one item had a low correlation of 0.3. Correlations between the three factors were direct and high. Conclusions: The developed questionnaire presents a definite factorial structure, with internally consistent and correlated factors and with adequate psychometric properties.

Autodirección y variables sociodemográficas y académicas relacionadas con la redacción de artículos científicos en estudiantes de odontología / Self-direction and socio demographic and academic factors related to writing scientific papers skills in dental students

La capacidad para redactar comunicaciones científicas es considerada una competencia importante a desarrollar en estudiantes de Odontología, siendo escasa la evidencia que evalúa esta habilidad en los estudiantes de pregrado. Los objetivos fueron evaluar las habilidades para redactar comunicaciones científicas y establecer su relación con la predisposición al aprendizaje autoridirigido, factores sociodemográficos y rendimiento académico previo. Participaron 71 alumnos de segundo año de la carrera de Odontología quienes desarrollaron informes de laboratorio con un formato de publicación científica. Se diseñaron los siguientes instrumentos: pauta diseñada por los autores para evaluar la calidad de los artículos, Escala de Predisposición al Estudio Autodirigido de Fischer, King y Tague validada al español. El 15,5 por ciento de los alumnos logró redactar una comunicación científica conforme a criterios, el 66,2 por ciento y el 91,5 por ciento de los alumnos logró desarrollar la introducción y los materiales y método, respectivamente. El 9,8 por ciento logró exponer los resultados en relación a los objetivos propuestos y sólo el 7 por ciento de los alumnos planteó conclusiones pertinentes. Los hombres (M = 5,23; DE= 0,54) mostraron mejor desempeño que las mujeres (M = 4,93; DE= 0,67), p< 0,03, y no hubo relación con tipo de establecimiento de origen, notas de enseñanza media, prueba de selección universitaria y predisposición al aprendizaje independiente. Se comprueba la carencia de habilidades para redactar artículos científicos en estudiantes de Odontología, generando la necesidad de propiciar acciones remediales.

In the educational development of dental students, the ability to write scientific papers is considered an important skill. Evidence that assesses this skill in undergraduates is scarce. The aims were to evaluate scientific communication writing skills and establish their relationship of predisposition to self-directed learning, to socio demographic factors and to prior academic performance. Seventy-one students in their second year of dentistry developed laboratory reports in a scientific publication format. Instruments: pattern designed by the authors to evaluate the quality of the articles, Predisposition Scale Self-Directed Study Fischer, King and Tague validated in Spanish. In 15.5 percent of students achieved scientific writing in accordance with criteria. 66.2 percent and 91.5 percent of students achieved the introduction and development of materials and methods, respectively. In 9.8 percent were able to present the results achieved in relation to objectives, and only 7 percent of students presented relevant conclusions. Men (M = 5.23, SD = 0.54) showed better performance than women (W = 4.93, SD = 0.67), p <0.03, and there was no connection with the educational establishment, high school grades, college admission selection exam, and independent learning preparedness. The lack of ability to write scientific papers in dental students at the Universidad San Sebastián, generates the need to provide remedial actions.

Aprendizaje autodirigido en estudiantes de primer año de medicina de la Universidad de Concepción y su relación con el perfil sociodemográfico y académico / Association between self-directed learning behaviors, socio-demographic and academic variables among medical students

Medical education must encourage autonomous learning behaviors among students. However the great income profile disparity among university students may influence their capacity to acquire such skills. Aim: To assess the association between self-directed learning, socio-demographic and academic variables. Material and Methods: The self-directed learning readiness scale was applied to 202 medical students aged between 17 and 25 years (64% males). Simultaneously information about each surveyed participant was obtained from the databases of the medical school. Results: There is an association between socio-demographic and academic variables with the general scale of self-directed learning and the subscales learning planning and willingness to learn. Participants coming from municipal schools have a greater willingness to learn than their counterparts coming from subsidized and private schools. High school grades are related to self-directed learning and the subscales learning planning and self-assessment. Conclusions: Among the surveyed medical students, there is a relationship between self-directed learning behaviors, the type of school where they come from and the grades that they obtained during high school.

Percepción de académicos de carreras de la salud de Chile sobre el perfeccionamiento docente / Perceptions about continuous training of Chilean health care teachers

Background: Continuous training of teachers, in discipline ana pedagogical topics, is a key step to improve the quality of educational processes. Aim: To report the perception of Chilean teachers of undergraduate health care programs, about continuous training activities. Material and Methods: Twenty teachers working at different undergraduate health care programs in Chile were interviewed. Maximum variation and theoretical sampling methods were used to select the sample. Data was analyzed by open coding, according to the Grounded Theory guidelines. Results: Nine categories emerged from data analysis: Access to continuous training, meaning of training in discipline, activities of continuous training in discipline, meaning of continuous training in pedagogy, kinds of continuous training in pedagogy, quality of continuous training in pedagogy, ideal of continuous training in pedagogy, outcomes of continuous training in pedagogy and needs for continuous training in pedagogy. Conclusions: Teachers of health care programs prefer to participate in contextualized training activities. Also, they emphasize their need of training in evaluation and teaching strategies.

Estructura factorial y confiabilidad de la escala de aprendizaje autodirigido de Fisher, King & Tague en alumnos de medicina chilenos / Factorial structure and reliability of Fisher, King & Tague's self-directed learning readiness scale in Chilean medical students

Background: Continuous education is crucial among physicians. Therefore, medical schools must teach self-directed learning skills to their students. Aim: To evaluate the factorial structure and reliability of the Spanish version of the Self-Directed Learning Readiness Scale of Fisher, King & Tague, applied to medical students. Material and Methods: The survey was answered by 330 students aged between 17 and 26years (58% men, with 10 missing cases). Factorial structure, internal reliability and temporary stability of scale was evaluated. Results: The Exploratory Factorial Analysis, conducted using a principal factor method, identified five factors in the structure of the survey. Internal consistency was adequate with a Cronbach's alpha between 0.66 and 0.88. Test retest reliability, comparing the results of the survey applied six months after the first application, showed Pearson correlation coefficients that fluctuated between 0.399 and 0.68. Conclusions: These results show a defined factorial structure with adequate reliability of the survey.