Profesionalismo y medicina narrativa / Professionalism and narrative medicine

This work is a bibliographical review of the challenges of professionalism in medical training. Medicine practiced with narrative competence, called narrative medicine, is proposed as a model for humane and effective medical practice. By virtue of the changes in the practice of medicine during the last years, professionalism values emerge as qualities that should reshape medicine. Several medical associations are redefining professionalism and insist that this issue should be included in the training curriculum. Thus, several medical education institutions are pursuing strategies to teach and assess professionalism. Modeling is still relevant as a learning strategy, but it must be tutored and directed. Also, timely and formative feedback appears as the most frequently suggested evaluative action. Both processes incorporate a personal reflective practice. Several recent studies suggest that a reflective experience is relevant for the formation of a professional identity. Narrative Medicine methodology emerges as an innovative strategy to address this issue, as it seeks to deliver valuable learning experiences to the students through reflection and the search for a new paradigm for medical practice.

The training of a new social-responsible generation of health professionals with a patient-centered vision / A formação de uma nova geração socialmente responsável de profissionais de saúde com uma visão centrada no paciente

Abstract The challenges that Latin America faces in health are deeply related to others, such as access to clean water, the right to education, and housing. Health professionals that work in an environment where the population faces constant barriers to accessing care in the public health system or has limited resources to pay for it in a private sector will face an ethical dilemma, the question of how to honor the call to care for patients when there is not enough support system or infrastructure to do so. Within the schools of medicine and health sciences, the question is how to train students to face or resolve these conflicts. The social responsibility approach is a proposal that allows the alignment of education for health professionals and health systems to contribute to the creation of an effective, equitable, and sustainable system. The present article aims to discuss this problem from the importance of training health professionals, ethical and committed to their communities, that have the skills and attitudes to implement a patient-centered vision. The involvement of universities and training institutions of the next generation of health professionals cannot be postponed.

Resumo Os desafios que a América Latina enfrenta em matéria de saúde estão profundamente relacionados a outros, como o acesso à água limpa, o direito à educação e à moradia. Os profissionais de saúde que trabalham em um ambiente onde a população enfrenta constantes barreiras ao acesso aos cuidados no sistema público de saúde ou tem recursos limitados para pagá-los em um setor privado enfrentarão um dilema ético, a questão de como honrar o chamado para cuidar dos pacientes quando não há sistema de apoio ou infraestrutura suficiente para fazê-lo. Dentro das escolas de medicina e ciências da saúde, a questão é como treinar os estudantes para enfrentar ou resolver estes conflitos. A abordagem da responsabilidade social é uma proposta que permite o alinhamento da educação dos profissionais de saúde e dos sistemas de saúde para contribuir para a criação de um sistema eficaz, equitativo e sustentável. O presente artigo visa discutir este problema a partir da importância de formar profissionais de saúde, éticos e comprometidos com suas comunidades, que tenham as habilidades e atitudes necessárias para implementar uma visão centrada no paciente. O envolvimento de universidades e instituições de treinamento da próxima geração de profissionais de saúde não pode ser adiado.

Poder y género en las relaciones entre docentes y estudiantes de la carrera de medicina

Background: Education is a continuous, critical, holistic process that not only intends to transmit knowledge, abilities, and skills, but also permeates attitudes, values and dispositions, becoming a decisive element to fight inequality in all its nuances. Aim: To characterize the type of power that is established in relation to gender, between teachers and students, from the perspective of students and medical teachers from two Chilean universities. Material and Methods: Qualitative study, according to Grounded Theory. Nine medical teachers were interviewed, and a focus group was conducted with ten medical students. Open coding was performed for the analysis. Results: The presence of five types of power and the gender of the receivers of such expressions was described. Power was expressed also as fair or unfair treatment, pressure, and sexual harassment. Conclusions: Power exercised by teachers over their students is differentiated according to the gender of students. The ways in which that power is exercised do not go unnoticed when they become arbitrary obstacles or benefits for the students and their learning process. It also affects the way in which they subsequently relate with their environment.

When it is time to decide: factors associated to the choice of a medical specialty / Cuando es tiempo de decidir: factores asociados a la elección de especialidades médicas

Abstract After finishing their initial education, physicians can enter post-graduate training programs. In Chile, there are multiple medical specialties options. This review synthesizes the factors associated with the choice of specialty, according to international publications. Students coming from rural areas or small towns would tend to choose Family Medicine. Men prefer specialties such as Surgery. Having relatives in the medical profession, specializing in a specific field, also influence the choice. Concerning interests and preferences, these are linked to personal traits and some biological variables. The inclination towards clinical or surgical fields could be predicted. Academically, the curriculum, good learning experiences and teacher models favor choice, while the harassment suffered could contribute to avoidance. Besides, both prestige and economic prospects are influential factors in the choice and specialties such as Surgery are preferred. The choice of specialty must reach a balance between the students' interests and public health needs. Identifying these factors would allow a better understanding of the present shortfall (or surplus) in certain fields and contribute to the definition of policies and decision-making.

Concluida su formación, los médicos pueden acceder a programas de formación de postgrado; en Chile existen múltiples opciones de especialización médica. Esta revisión narrativa busca sintetizar los diversos factores asociados con la elección de especialidad médica según la literatura internacional. Entre los resultados se observa que los alumnos provenientes de zonas rurales o ciudades pequeñas tenderían a elegir Medicina Familiar. Los hombres tendrían mayor predilección por especialidades como Cirugía. También influiría ser hijos de médicos especialistas en un área específica. En cuanto a los intereses y preferencias, éstas se conjugan con rasgos de personalidad y algunas variables biológicas, que podrían predecir la elección de especialidades hacia el tipo clínico o quirúrgico. En lo académico, el curriculum, una buena experiencia y modelos docentes favorecen la elección, mientras el maltrato sufrido podría contribuir al descarte. Además, tanto el prestigio como el potencial económico de ciertas especialidades ha sido un factor influyente en la elección: se prefieren especialidades como Cirugía. La elección de especialidad debería encontrar un equilibrio entre los intereses del estudiante y las necesidades de salud pública. Identificar todos estos factores, permitiría una mejor comprensión de la actual escasez o sobrecarga en determinados campos, y contribuiría en la construcción de políticas y toma de decisiones, con el fin de mejorar el reclutamiento de estudiantes.

Psychometric properties of the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12) on Chilean women / Propiedades psicométricas del instrumento Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12) en mujeres chilenas

Abstract Introduction: Pelvic floor dysfunctions have an impact on women's sexual function. A Chilean study found that 74% of women have pelvic floor dysfunctions, but there is no validated tool for them. Objective: To evaluate the psychometric properties of the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12) for assessing sexual function in Chilean women with pelvic floor dysfunctions. Methods: Cross-sectional study of psychometrics in 217 women with pelvic floor dysfunction, age 18 or older, and sexually active (last 6 months). Non-probability, convenience sampling. Tool: PISQ-12. Experts checked content validity, construct validity with confirmatory factor analysis, reliability with Cronbach's alpha, and discriminating capacity with Pearson and McDonald's omega. Results: Population is mainly perimenopausal, highly educated with no income and with urinary incontinence (89.4%). Psychometric analysis supports a three-factor structure: sexual response, female sexual problems, and male sexual problems, with a good (α= 0.85), acceptable (α= 0.73), and poor (α= 0.63) reliability, respectively, but McDonald's omega was acceptable for all three. These were related to age (rs: -0.33), education (rs: 0.36), number of pregnancies (rs: -0.18) and vaginal births (rs: -0.25). Conclusions: PISQ-12 is valid and reliable for measuring sexual dimension and problems. Age, education, and number of pregnancies and vaginal births are moderately correlated to sexual response.

Resumen Introducción: Las disfunciones del piso pélvico impactan la función sexual de mujeres que la padecen. En un estudio chileno un 74% de las mujeres presentó disfunción sexual sin tener un instrumento validado para esta población. Objetivo: Evaluar las propiedades psicométricas del Pelvic Organ Prolapse Urinary Incontinence Sexual Questionnaire (PISQ-12) para medir la función sexual en mujeres chilenas con disfunciones del piso pélvico. Métodos: Estudio transversal psicométrico de 217 mujeres con disfunción del piso pélvico, igual /mayor a 18 años, sexualmente activas (últimos 6 meses). Muestreo no probabilístico de conveniencia. Cuestionario: PISQ-12. Se realizó juicio de expertos para validez de contenido, análisis factorial confirmatorio para validez de constructo y el α de Cronbach para confiabilidad y capacidad discriminativa con Pearson y ω de McDonald. Resultados: Población principalmente perimenopáusica, alta escolaridad sin ingresos y con Incontinencia Urinaria (89.4%). El análisis psicométrico apoyó una estructura de tres factores: respuesta sexual, limitaciones sexuales femeninas y limitaciones sexuales masculinas, con confiabilidad buena (α= 0.85) aceptable (α= 0.73) y pobre (α= 0.63), respectivamente, aunque el ω de McDonald mostró valores aceptables para los tres. Éstos se relacionaron con edad (rs: -0.33), escolaridad (0.36), número de embarazos (-0.18) y partos vaginales (-0.25). Conclusiones: El PISQ-12 es válido y confiable, midiendo la dimensión sexual y limitaciones sexuales. La edad, escolaridad, número de embarazos y partos vaginales se correlaciona con la respuesta sexual en intensidad moderada.

Experiencias de estudiantes de medicina que interrumpen sus estudios universitarios: un estudio cualitativo / Experiences of medical students dropping out studies. A qualitative approach

Background: Medical students have a higher prevalence of mental health problems and are more likely to drop out their studies as a result. Aim: To comprehend the academic experiences of medical students who dropped out medical studies in a university that experienced an increase in drop out by medical students and consultations to mental health services. Material and Methods: A qualitative study with a phenomenological design, in which in-depth interviews were conducted with eight medical students who dropped out studies. The analysis was carried out by means of the constant comparison method up to the level of open coding. Results: Two categories were identified, namely experiences prior to interrupting studies, which comprised the subcategories of academic and social experiences, and motives that lead to drop-out, which considered the subcategories related to vocation, mental health and pursuing other projects. Conclusions: These results identified the challenges faced by students prior to stopping-out, that are related to academic aspects, peer relations and student-teacher relationship. The main motives for drop-out reported by students were mental health problems.

Estructura factorial y confiabilidad de la escala de evaluación de debriefing para simulación en salud / Factorial structure and reliability of the debriefing evaluation scale for health simulation

Introducción: Las prácticas pedagógicas del docente en el debriefing son importantes para asegurar mejores resultados de aprendizaje en la educación basada en simulación clínica. Objetivo: Evaluar la estructura factorial de una versión adaptada de la escala de evaluación del debriefing para simulación en salud en estudiantes de Enfermería. Métodos: Estudio cuantitativo metodológico. Fueron elegidos 159 estudiantes de la carrera de Enfermería de una universidad privada de Concepción (Chile) mediante muestreo no probabilístico por accesibilidad. Estos respondieron la versión adaptada de la escala de evaluación del debriefing para simulación en salud más un cuestionario sociodemográfico, previo consentimiento informado. Se realizó un análisis factorial exploratorio de esta versión adaptada, se evaluó la confiabilidad del factor encontrado a través de alfa de Cronbach y luego se condujo un análisis descriptivo de estos. Resultados: Solo un factor fue identificado, el cual permite evaluar la calidad del debriefing en simulación clínica. El análisis de la confiabilidad del factor identificado mostró un alfa de Cronbach de 0,97, por lo que se clasificó como excelente, según los tramos sugeridos por George y Mallery. Conclusiones: Los resultados presentan evidencia psicométrica que apoya la validez y confiabilidad de la versión adaptada de la escala de evaluación del debriefing para simulación en salud, para emplearla en la evaluación de la calidad del debriefing en simulación clínica en la carrera de Enfermería. No obstante, se asume que su uso debe ser complementario y no excluyente, con un abordaje cualitativo de este fenómeno(AU)

Introduction: Professors' pedagogical practices in debriefing are important to ensure better learning outcomes in clinical simulation-based education. Objective: To assess the factorial structure of an adapted version of the Debriefing Evaluation Scale for health simulation in Nursing students. Methods: A methodological quantitative study was carried out with 159 Nursing students from a private university in Concepción, Chile, chosen through nonprobabilistic sampling for accessibility. They answered the adapted version of the Debriefing Evaluation Scale for health simulation and a sociodemographic questionnaire, with prior informed consent. An exploratory factor analysis of this adapted version was carried out, the reliability of the factor found was assessed using Cronbach's alpha, and then a descriptive analysis of these elements was carried out. Results: Only one factor was identified, which allows assessing the quality of debriefing in clinical simulation. The analysis of the reliability of the identified factor showed a Cronbach's alpha of 0.97, a reason why it was classified as excellent, according to the ranges suggested by George and Mallery. Conclusions: The results present psychometric evidence that supports the validity and reliability of the adapted version of the Debriefing Evaluation Scale for health simulation, to be used for assessing the quality of debriefing in clinical simulation in the Nursing major. However, it is assumed that its use must be complementary and not exclusive, with a qualitative approach to this phenomenon(AU)

Maltrato en el pregrado de la carrera de Medicina: percepción de los estudiantes / Students' perception about mistreatment in undergraduate medical training

Background: Alarms about mistreatment in medical education have been raised for almost 30 years. Aim: To describe the frequency of abuse reports among medical students at a university in Chile, investigating their association with age, sex, and educational level. Material and Methods: The Mistreatment by Teachers Questionnaire was applied to 264 first to seventh year medical students (54% males). An exploratory factorial analysis of the instrument was performed, a descriptive analysis was made and its relationship with age, sex and level of training were evaluated. Results: Ninety eight percent of respondents reported having been mistreated at least once. Mistreatment was grouped into three factors with a confidence ranging between α = 0.79 and 0.93, namely demoralization, deregulated demands and physical aggression. The first two were associated with age and level of education. There were no differences by sex. Conclusions: Mistreatment is common in undergraduate medical education, as it has been found in other universities around the world.

¿Enseña diferente un docente comprometido? Relación entre compromiso docente y prácticas pedagógicas en académicos de carreras de la salud / Relationship between occupational commitment and teaching practices among healthcare teachers

Background: A central aspect of professional identity is occupational commitment, which has a significant relationship with motivation and positive mental states in healthcare environments. However, it is not clear how occupational commitment is related to teaching practices in universities. Aim: To apply the Occupational Commitment Questionnaire (OCQ) to university teachers and relate its results with the Teaching Practices Questionnaire. Material and Methods: OCQ and Teaching Practices Questionnaire were answered by 319 university teachers from 13 Chilean regions, who were selected through a non-probabilistic volunteer sampling. Data collection was done after informed consent. An exploratory factor analysis was performed for OCQ. The internal consistency of each factor was calculated with Cronbach's Alpha. Spearman correlations were used to explore the relationship between the two questionnaires. Results: Two factors were identified in OCQ, namely Teacher Commitment and Ethical-Professional Commitment. Cronbach's Alpha was 0.85 for both factors. A moderate direct relationship between teacher commitment, ethical-professional commitment, and the Teaching Practices Questionnaire was found. Conclusions: OCQ showed an adequate internal consistency, and it was directly related with teaching practices. Committed teachers had better teaching practices. This confirms the importance of teachers' values and perceptions on their professional performance.

Relación entre aprendizaje autorregulado, antecedentes académicos y características sociodemográficas en estudiantes de medicina / Relationship between self-regulated learning, academic antecedents and sociodemographic characteristics in medical students

Introducción: Las exigencias de la educación superior requieren que los estudiantes movilicen variadas competencias que les permitan enfrentar de manera exitosa las nuevas demandas dentro y fuera del aula. En este sentido, cobra especial interés el aprendizaje autorregulado, ya que involucra la puesta en práctica de una serie de estrategias cognitivas, metacognitivas, motivacionales y de apoyo, que permiten al estudiante construir conocimientos de forma significativa. Objetivo: Describir la relación entre el aprendizaje autorregulado, los antecedentes académicos y las características sociodemográficas en estudiantes de medicina de primer año. Métodos: Se realizó un estudio descriptivo, cuantitativo, no experimental transversal, de alcance correlacional. Se obtuvo una muestra de 106 estudiantes, mediante muestreo no probabilístico por accesibilidad. La autorregulación se evaluó mediante Motivated Strategies for Learning Questionnaire, adaptado para estudiantes universitarios chilenos. Resultados: El valor de la tarea, la autorregulación, las expectativas y la organización presenta más alta ponderación. Los hombres reportan altas expectativas y pensamiento crítico; en cambio, las mujeres muestran un mayor nivel de ansiedad y organización. Bajo número de subescalas de motivación y estrategias de aprendizaje se correlacionaron con el rendimiento, las pruebas de ingreso y el tipo de establecimiento educacional. Conclusiones: Esta muestra de estudiantes utiliza preferentemente componentes motivacionales y estrategias de procesamiento profundo para autorregular su aprendizaje. Hombres y mujeres difieren en aspectos motivacionales y cognitivos para autorregular su aprendizaje. La supervisión, el compromiso y la gestión de recursos se relacionan con un mayor rendimiento en la asignatura(AU)

Introduction: The demands of higher education require that students activate several competencies that allow them to face new demands successfully inside and outside the classroom. In this respect, self-regulated learning is of special interest, since it involves the implementation of a series of cognitive, metacognitive, motivational, and support-related strategies that allow the student to construct knowledge in a meaningful way. Objective: To describe the relationship between self-regulated learning, academic background, and sociodemographic characteristics in first-year medical students. Methods: A descriptive, quantitative, non-experimental, cross-sectional study was carried out, with a correlational scope. A sample of 106 students was obtained through non-probability sampling by accessibility. Self-regulation was assessed using the Motivated Strategies for Learning Questionnaire, adapted for Chilean university students. Results: The value of the task, self-regulation, expectations, and organization have a much higher importance. The men reported high expectations and critical thinking; on their part, the women showed a higher level of anxiety and organization. Low number of motivational subscales and learning strategies were correlated with performance, entrance tests, and type of educational institution. Conclusions: This sample of students preferably uses motivational components and deep processing strategies for their self-regulated learning. Men and women differ in motivational and cognitive aspects for their self-regulated learning. Supervision, commitment, and resource management are related to higher performance in the subject(AU)

Factores asociados a respuesta favorable de tratamiento corticoidal en pacientes con polirradiculoneuropatía desmielinizante inflamatoria crónica / Variables associated with a good response to steroids in chronic inflammatory demyelinating polyradiculoneuropathy

Background: The treatment of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is based on corticosteroids, immunoglobulin and plasmapheresis. In our Health System, corticosteroids are commonly used as first line therapy for economic reasons and accessibility. However, the factors associated with a good response are not well known. Aim: To assess the association of demographic, clinical and laboratory variables with a favorable response to corticosteroid therapy in patients with CIDP. Material and Methods: Observational, descriptive, longitudinal and retrospective study of 33 patients with a diagnosis of typical, definitive or probable CIDP, treated with corticosteroids for at least six months. Results: Twenty-three patients had a good clinical response to corticosteroid treatment and 10 were non-responders. The variables significantly associated with a good response to steroids were a disease lasting less than 1 year prior to the start of treatment, the absence of axonal damage in electromyography a relapsing-recurrent course and a favorable response within two months of treatment. Conclusions: Most of these patients with CIDP had good response to corticosteroid therapy.

Formación clínica en carreras de la salud: ¿dónde se incluye la diversidad? / The inclusion of diversity in clinical training

Background Educational inclusion, a concept that has changed over time, is becoming relevant. It initially considered only disability and now contemplates education for all people. Educational inclusion has special relevance in health care workers' training, who will have direct contact with heterogeneous populations, where diversity-oriented treatments are required. Aim To describe how diversity is integrated into health care training in a clinical context. Material and Methods qualitative study, based on Grounded Theory. Two group interviews and thirteen semi-structured interviews were conducted among 11 teachers and 25 students of health careers. Data was analyzed using Atlas-ti 7.5.2. A constant comparison method, reaching an axial coding level, was used. Results The category of training in health careers in the context of diversity emerged. It is a process that operates in cognitive, affective and behavioral dimensions. It accounts for the diversity of system actors and the model of a health professional and teacher facing diversity. Conclusions These dimensions should be understood during clinical training. Socio-cultural diversity encompassing gender, sex, ethnicity, religion and disability should be considered. Therefore, educational inclusion is an important issue to be considered by universities.

Autoeficacia académica en estudiantes de carreras de la salud de una universidad tradicional chilena / Academic self-efficacy among health care undergraduate students in a Chilean university

Background: Self-efficacy refers to people's expectations about personal resources available for goal achievement. Higher self-efficacy expectations are correlated with higher academic performance. Aim: To analyze the psychometric properties of the Academic Behavior Self-Efficacy Scale (ABSES) and to describe Self-efficacy expectations of students from health-related careers. Material and Methods: A non-probabilistic sample of 479 first- and second-year students from Nursing, Physiotherapy, Medicine, Nutrition and Medical Technology in a public university in Chile, answered the ABSES. Results were analyzed by Exploratory Factor Analysis and its reliability was evaluated using Cronbach's alpha. Also a descriptive analysis and a non-parametric relational analysis were performed. Results: Two factors were identified: Attention and Participation. Attention obtained significantly higher scores than Participation (p < 0.001). Compared to their second-year counterparts, first year students had higher scores in Attention (p < 0.001) and Participation (p < 0.01). Medicine students had higher scores in Participation than students from other careers. Conclusions: A two factor solution was identified for ABSES. Surveyed students had a predominantly passive Self-efficacy, focused in attention. Also, a reduction in self efficacy was noted among second year students.

Escala de autoeficacia de competencias clínicas en estudiantes de odontología: estudio psicométrico / Self-Efficacy in clinical competences scale in dental students: psychometric study

El período de transición entre el ciclo básico y el clínico de la carrera de odontología ha demostrado presentar problemas de adaptación para los estudiantes, influyendo factores propios de la carrera como del estudiante. Dentro de estos últimos está su percepción de autoeficacia, que se define como la impresión sobre la capacidad de si mismo de desempeñarse de una cierta forma y de alcanzar las metas propuestas. Objetivo : Validar instrumento para evaluar autoeficacia de competencias clínicas percibida del estudiante de Odontología. Método: Estudio cuantitativo no experimental de alcance analítico relacional. Universo estuvo constituido por estudiantes de odontología cursando cuarto, quinto año e internado asistencial, obteniendo muestra por accesibilidad de 76 por ciento. Se realizó análisis factorial exploratorio, empleando como método de extracción el análisis de ejes principales. Resultados: El análisis factorial exploratorio identificó solo un factor. La consistencia interna mediante el coeficiente de confiabilidad Alfa de Cronbach, fue 0,896. La capacidad discriminativa de los ítems de la escala mostró que todos los ítems aportan información a la variable, por lo que se mantienen en ésta. Los resultados indican que la escala de autoeficacia de competencias clínicas presenta adecuada confiabilidad para medir la variable de estudio(AU)

The transition period between basic clycle and clinical cycle in dental students has shown to have integration problems, been influence by career and student´s factors. Within the lasts it´s the self-efficacy, defined as the impression that one is able to perform in a certain way and to achieve certain goals. Aim: This work focuses on validate an instrument to assess the cognitive variable self-efficacy of clinical competencies perceived student of Dentistry. Method: No experimental quantitative study of relational analytical scope.This is a It was determined as universe dental students enrolled in fourth, fifth year and intership, obtaining a sample availability of 76 percent (169 students). It was realized an Exploratory Factor Analysis using the straction method of Principal Axes Analysis. Results: The Kaiser-Guttman criterion identified only one factor with eigenvalue greater than 1.0, and these eigenvalues of 5.76, which explain 82.40 percent of the items total variance. Cattell criteria by the scree plot also clearly identified a single factor. Internal consistency reliability coefficient using Cronbach´s Alpha was 0.896, considered as good reliability. Determining the discriminative ability of the items on the of self-efficay of clinical competencies it is observed that all items provide information to the variable, so remain on the scale. Conclutions: According to the results of psychometric analysis, it is valid to be used to measure the study variable(AU)

Percepción de las competencias docentes del tutor clínico según estudiantes de odontología de universidad chilena / Perception of the teaching competencies of the clinical tutor according to dentistry students of a Chilean university

Introducción: La etapa clínica de la carrera de Odontología involucra la atención de pacientes bajo la supervisión de tutores clínicos, los cuales no solo deben ser instructores de técnicas, sino que además, demostrar habilidades del saber, saber hacer y saber ser. Actualmente, no se cuenta con un instrumento específico para medir competencias docentes en tutores de odontología en la Universidad de Concepción. Objetivos : Evaluar la validez y confiabilidad de un instrumento de medición de competencias docentes del tutor de Odontología. Determinar la percepción de las competencias docentes que exhibe el tutor clínico según los estudiantes del ciclo clínico de la carrera de Odontología de una universidad tradicional chilena. Métodos: Estudio no experimental de alcance analítico relacional y corte transversal en muestra no probabilística de 70 estudiantes de ciclo clínico de Odontología de la Universidad de Concepción. Se determinaron propiedades psicométricas del Cuestionario de Evaluación de Docentes Clínicos de Odontología (CEDC-O) y se aplicó para analizar la percepción de las competencias docentes. Resultados: CEDC-O presentó propiedades psicométricas adecuadas para evaluar competencias docentes de tutores de Odontología, encontrándose tres factores. Los estudiantes consideraron que sus tutores asignaron autonomía y tareas clínicas acorde a su nivel de experiencia, pero consideraron que no los estimularon a pensar en cómo potenciar sus fortalezas. Conclusión: El CEDC-O presenta evidencia de validez para utilizarlo en tutores de Odontología. Los estudiantes de este estudio tienen una percepción moderada de las competencias docentes de sus tutores, haciendo énfasis en la falta de feedback efectivo(AU)

Introduction: The clinical phase of dental career involves real patients treatment under the supervision of clinical tutors, who mustn´t be just instructors of techniques, but also demonstrate skills of "to know, to know how and to know how to be". Currently, there is no specific instrument that measures teachers competencies in tutors of dentistry at the University of Concepcion. Objectives : Evaluate the validity and reliability of an instrument of measurement of teaching competences of the tutor of dentistry. Establish the perception of the teaching competences that the clinical tutor shows according to students of the clinical cycle of the dental career of a traditional Chilean university. Methods : Cross-sectional study in a non-probabilistic sample of 70 students from the clinical cycle of dentistry of the University of Concepción. The psychometric properties of the Evaluation Questionnaire for Clinical Teachers of Dentistry (CEDC-O) were determined and applied to analyze the perception of teaching competencies. Results: CEDC-O presented adequate psychometric properties to evaluate teacher competences of tutors of dentistry, with three factors. The students considered that their tutors assigned autonomy and clinical tasks according to their level of experience, but considered that they didn´t stimulate them on how to increase their strengths. Conclusion: The results showed that CEDC-O presents evidence of validity for use in dental tutors, and that students of this study have a moderate perception of the teaching competencies of their clinical tutors, emphasizing the lack of effective feedback(AU)

Estructura factorial y consistencia interna del Cuestionario de Evaluación de Docentes Clínicos en el Internado de Fonoaudiología / Factorial structure and internal consistency of Clinic Teachers Assessment Questionnaire in Speech Therapy Internship

Introducción : Los estudiantes del último año de la carrera de Fonoaudiología, son supervisados en la clínica, por un tutor que ejerce un rol de profesor sin necesariamente tener formación pedagógica, y, para la evaluación de su docencia, no se dispone de un instrumento con evidencias de validez y confiabilidad. Objetivo : Evaluar las propiedades psicométricas del "Cuestionario de evaluación de docentes clínicos (CEDC)" en el internado de la carrera de Fonoaudiología de una universidad tradicional de Concepción. Métodos : Estudio mixto y analítico relacional, mediante encuestas. Las encuestas fueron respondidas por 43 estudiantes elegidos mediante muestreo no probabilístico por accesibilidad, quienes efectuaron 137 valoraciones empleando el CEDC, siendo evaluados 38 tutores. Se realizó consentimiento informado y se contó con autorización de la jefatura de carrera. Resultados : Se efectuó un análisis factorial exploratorio mediante el cálculo estadístico de adecuación muestral de Kaiser-Meyer-Olkin=0,95 y la prueba de esfericidad de Bartlett c 2(325)=4092,05; p<0,001. En la estimación del número de factores se empleó el criterio de Kaiser-Guttman identificando tres factores con autovalores de 16,71, 1,23 y 1,07. Estos factores mostraron una confiabilidad con coeficientes Alfa de Cronbach de a=0,97, a=0,93 y a=0,89, y correlaciones con la nota global del tutor estadísticamente significativas y directas. Conclusiones : El CEDC presenta evidencias de confiabilidad, validez de constructo y validez de criterio. Se compone de los factores: "Promotor de un diálogo permanente", "Promotor de condiciones para un desempeño seguro" e "Instructor de técnicas". El CEDC permitirá caracterizar a los profesores clínicos, posibilitando innovaciones pedagógicas en el internado(AU)

Introduction : Final year Speech Therapy students are supervised by a tutor in the clinic, who plays a role of teacher without necessarily being qualified. There are not instruments available to evaluate if these tutors teaching is proven to be reliable. Objective: The aim is to evaluate the psychometric properties of "Clinic Teachers Assessment Questionnaire (CTAQ)" in Speech Therapy degree internships in a traditional university in Concepción. Method : Analytical, relational and mixed studies, using surveys. The surveys were answered by 43 students who were selected using a sampling method that was not probabilistic in terms of accessibility. These students carried out 137 reviews using the CTAQ, evaluating 38 tutors. Informed consent was given and it was authorized by the person in charge of the major. Results: An exploratory factor analysis was carried out using the Kaiser-Meyer-Olkin=0,95 statistical calculation of sampling adequacy and Bartlett's test of sphericity c2(325)=4092,05; p<0,001. The Kaiser-Guttman criterion was used when estimating the number of factors, identifying three factors with eigenvalues of 16,71, 1,23 and 1,07. These factors displayed reliability with Cronbach's alpha coefficients a=0,97, a=0,93 and a=0,89. They also displayed a direct correlation with the teacher's overall score of that were statistically significant. Conclusions : The CTAQ shows signs of reliability and validity of design and criteria. The CTAQ displays the following factors: "promotes ongoing dialogue", "promotes conditions for safe performance" and "teaches techniques". The CTAQ allows the clinical teachers to be characterized, and enables teaching innovation in the internships(AU)

Identidad ocupacional en docentes de carreras de la salud y su relación con las prácticas pedagógicas / Psychometric properties of a newly developed occupational identity questionnaire for university teachers

Background: Occupational identity is defined as the perception of occupational interests, abilities, goals, and values, and the structure of the meanings that link these self-perceptions to career role. We developed an occupational identity questionnaire suitable to be used with university teachers. Aim: To evaluate the psychometric properties of the Occupational Identity Questionnaire (OIQ) and relate its results with those of the Teaching Practices questionnaire. Material and Methods. The OIQ and Teaching Practices Questionnaire were answered by 311 university teachers along Chile, who were selected through a non-probabilistic volunteer sampling. An exploratory factor analysis was performed and the internal consistency of each factor was calculated with Cronbach's Alpha. Spearman correlations were used to explore the relationship between the two questionnaires. Results: Two factors were identified in OIQ: Teaching Vocation and Sense of Competence. Cronbach's Alpha was 0.75 for teaching vocation and 0.82 for the sense of competence. There was a moderate direct relationship between teaching vocation, sense of competence and the results of the Teaching Practices Questionnaire. Conclusions: OIS has an adequate internal consistency, its factorial structure showed two different types of identities and it is directly related to the results of the Teaching Practices Questionnaire.

Experiencia interdisciplinaria para el diseño de productos para la salud / Interdisciplinary experience for the design of health care products

Background: Training of innovative health professionals is necessary for the development of an effective health system in a limited resources context. However, the professionals underestimate their innovative role and receive sparse training in this issue. Meanwhile, industrial designers are trained to innovate but have a weak knowledge about health issues. Aim: To describe the outcomes of a study based on Challenge-Based Learning (CBL) where health and industrial design students learned about product development aimed to solve health problems. Material and Methods: Twenty industrial design students, seven health care students and nine teachers of both disciplines participated in a User Centered Design workshop. Using the CBL method, they were challenged to develop products to tackle a health problem. At the end of the challenge, teachers and students evaluated the products using a semantic differential method and answered a questionnaire assessing the activity. Results: In the semantic differential method, all participants evaluated usefulness, functionality and organization of the product rather than its originality. The greatest discrepancies in evaluation were found between design and health teachers. Students positively evaluated the challenge, although the weakest point was its coordination. Conclusions: CBL and interdisciplinary work are adequate tools for the development of innovative competences, as well as understanding the central elements of innovation.

¿Cómo han cambiado los estudiantes que ingresan a medicina? Aprendizaje autodirigido y antecedentes académicos de las cohortes 2010 a 2014 de una universidad tradicional / Self-directed learning and academic background of 2010 to 2014 cohorts of medical students

Background: The widespread growth of higher education is increasing the heterogeneity of university students in terms of socioeconomic characteristics, academic story and cultural background. Medical schools are not an exception of this phenomenon. Aim: To compare the academic background and self-directed learning behavior of students who entered to a public medial school between 2010 and 2014. Material and Methods: A non-probabilistic sample of 527 medical students aged between 17 and 29 years (60% men), was studied. Their academic information was collected from the University data base; they answered the Self-directed learning readiness scale of Fisher. Results: Students from the 2014 cohort had higher high school grades than their counterparts. The scores in mathematics of the Scholarship Aptitude Test (SAT) were higher in the cohorts of 2010 and 2011. Those of the sciences test were superior in the 2013 cohort. The 2014 cohort had the lower general score of self-directed learning behaviors. Conclusions: The lower SAT and self-directed learning scores of the students entering medical school in 2014, indicate the progressive increase in the heterogeneity of Medical students.

Antecedentes académicos como predictores de Burnout en estudiantes de primer año de Odontología / Academic antecedents as burnout predictors in first-year Dentistry students

Introducción: en los últimos años, el bienestar psicológico del estudiante ha sido motivo de estudio debido a su influencia en el rendimiento académico y adaptación a la educación universitaria. Objetivo: asociar los antecedentes académicos de los estudiantes de primer año de Odontología y sus niveles de Burnout. Métodos: se aplicó un cuestionario sociodemográfico y el Inventario de Burnout de Maslach para estudiantes, luego de un proceso de consentimiento informado, a una muestra de 79 estudiantes de primer año de la carrera de Odontología de la Universidad de Concepción obtenida mediante muestreo no probabilístico por accesibilidad. A partir de la base de datos universitaria, se obtuvo información sobre los antecedentes académicos de los participantes. Resultados: se encontraron relaciones estadísticamente significativas entre puntajes de Prueba de Selección Universitaria de matemáticas y niveles de Agotamiento emocional y Falta de realización personal y entre las calificaciones promedio de enseñanza secundaria y niveles de Agotamiento emocional (p< 0,05). Asimismo, los antecedentes académicos entregaron predicciones estadísticamente significativas para el factor Agotamiento emocional (p< 0,05), dando cuenta de un 10,5 por ciento de variación de él, donde sólo la calificación promedio de enseñanza secundaria (p< 0,05) fue un predictor estadísticamente significativo explicando 6,59 por ciento de la variación del nivel de Agotamiento emocional. Conclusiones: antecedentes académicos como el puntaje en la Prueba de Selección Universitaria de matemáticas y las calificaciones promedio de enseñanza secundaria se vieron asociados a los niveles de Burnout de los estudiantes de Odontología de primer año de la Universidad de Concepción(AU)

Introduction: In recent years, students' psychological well-being has been studied because of its influence on academic achievement and adaptation to university education. Objective: To associate the academic antecedents of first-year Dentistry students and their burnout levels. Method: A sociodemographic questionnaire and the Maslach Burnout Inventory were applied to students, after an informed consent process, to a sample of 79 first-year Dentistry students at the University of Concepción, obtained through non-probabilistic sampling by accessibility. From the university database, information was obtained as based on the academic antecedents of the participants. Results: Statistically significant relationships were found between the scores of university admission tests in Mathematics and emotional exhaustion levels, as well as lack of personal achievement; and between average secondary school grades and emotional exhaustion levels (p< 0.05). Also, the academic antecedents provided statistically significant predictions for the emotional exhaustion factor (p< 0.05), accounting for its 10.5 percent variation, where only the average secondary education score (p< 0.05) was a statistically significant predictor explaining that 6.59 percent of the variation in the emotional exhaustion level. Conclusiones: Academic antecedents such as the scores in university admission tests in Mathematics and the average secondary school grades were associated with burnout levels of first-year Dentistry students at the University of Concepción(AU)