Research progress on moral distress of nursing interns / 中国实用护理杂志

Moral distress generally exists in the nursing interns and has a far-reaching impact. This paper analyzed and summarized the current situation, influencing factors and coping strategies of the nursing interns at home and abroad, in order to provide reference for promoting the professional development of nursing students, strengthening their professional beliefs and stabilizing the nursing team.

Segurança do paciente na prática clínica dos estudantes de enfermagem: conhecimentos e atitudes / Seguridad del paciente en la práctica clínica de los estudiantes de enfermería: conocimientos y actitudes / Patient safety in clinical practice of nursing students: knowledge and attitudes

Objetivos: mensurar os conhecimentos e atitudes de estudantes de enfermagem sobre segurança do paciente em campos de prática desenvolvido em unidades hospitalares. Método: pesquisa transversal e quantitativa, realizada em um centro universitário privado da capital paranaense. Foi aplicado o Latino Students Patient Safety Questionnaire a 26 estudantes entre os meses de junho e agosto de 2022. Os dados foram analisados por estatística descritiva. Itens/questões com escore ?4 pontos indicam resultado satisfatório Resultados: das 21 afirmativas, 57,1% foram consideradas insatisfatórias. A consciência do erro individual, das normas de segurança adotadas pela instituição e da impossibilidade de evitar a maioria dos erros clínicos obtiveram as menores médias (2,7 cada). Os itens da dimensão atitude proativa para evitar risco à segurança apresentaram-se satisfatórios (≥4 pontos). Conclusão: os estudantes apresentam atitude proativa para evitar risco à segurança, embora haja lacunas de conhecimento acerca da segurança do paciente em campos práticos.

Objetivos: medir los conocimientos y actitudes de estudiantes de enfermería sobre seguridad del paciente en campos de práctica desarrollado en unidades hospitalarias. Método: investigación transversal y cuantitativa, realizada en un centro universitario privado de la capital paranaense. Se aplicó el Latino Students Patient Safety Questionnaire a 26 estudiantes entre los meses de junio y agosto de 2022. Los datos fueron analizados por estadística descriptiva. Ítems/cuestiones con puntaje ?4 puntos indican resultado satisfactorio Resultados: de las 21 afirmativas, 57,1% fueron consideradas insatisfactorias. La conciencia del error individual, de las normas de seguridad adoptadas por la institución y de la imposibilidad de evitar la mayoría de los errores clínicos obtuvieron las menores medias (2,7 cada una). Los ítems de la dimensión actitud proactiva para evitar riesgo a la seguridad se presentaron satisfactorios (≥4 puntos). Conclusión: los estudiantes presentan actitud proactiva para evitar riesgo a la seguridad, aunque hay lagunas de conocimiento acerca de la seguridad del paciente en campos prácticos.

Objective: to measure the knowledge and attitudes of nursing students about patient safety in fields of practice developed in hospital units. Method: cross-sectional and quantitative research, conducted in a private university center in the capital of Paraná. The Latino Students Patient Safety Questionnaire was applied to 26 students between June and August 2022. Data were analyzed by descriptive statistics. Items/questions with ?4 points score indicate satisfactory result. Results: of the 21 statements, 57.1% were considered unsatisfactory. Awareness of individual error, safety standards adopted by the institution and the impossibility of avoiding most clinical errors obtained the lowest averages (2.7 each). The items of the proactive attitude dimension to avoid safety risk were satisfactory (≥4 points). Conclusion: students present a proactive attitude to avoid safety risk, although there are gaps in knowledge about patient safety in practical fields.

Obstetric simulation for undergraduate medical education: how to improve students' self-confidence and expectation according to gender

SUMMARY OBJECTIVE: The aim of this study was to evaluate the effects of obstetric simulation training on undergraduate medical students to improve their self-confidence. METHODS: Fifth-year undergraduate medical students were invited to a 2-week course of simulation in obstetrics during their clerkship. The sessions included were as follows: (1) care for the second and third periods of childbirth, (2) partograph analysis and pelvimetry, (3) premature rupture of membranes at term, and (4) diagnosis and management of third-trimester bleeding. Before the first session and at the end of the training period, a questionnaire about self-confidence in obstetric procedures and skills was applied. RESULTS: A total of 115 medical students were included, of whom 60 (52.2%) were male and 55 (47.8%) were female. Comparing initial and final scores, the median results of the subscales "comprehension and preparation" (18 vs. 22, p<0.001), "knowledge of procedures" (14 vs. 20, p<0.001), and "expectation" (22 vs. 23, p<0.01) were significantly higher at the end of the training period in all items of the questionnaire than in the beginning. Differences were found based on the students' gender, i.e., female students had a significantly higher sum of scores than the male students in the initial subscale for "expectation" (median, 24 vs. 22, p<0.001) and "interest" (median, 23 vs. 21, p=0.032), and a higher sum of scores in the subscale for "expectation" (median, 23 vs. 21, p=0.010) in the final questionnaire. CONCLUSION: Obstetric simulation enhances the improvement of students' self-confidence in understanding both the physiology of childbirth and the obstetric care procedures. Further studies are needed to understand the influence of gender on obstetric care.

Reform and exploration of teaching methods for eight-year program medical students' early exposure to clinical practice / 中华医学教育探索杂志

Objective:To explore the effect of early clinical clerkship training in the early exposure to clinical practice of eight-year program medical students.Methods:Experimental control method was used in this study. A total of 120 eight-year program medical students in the third year of Batch 2014 to 2016 from the Union Hospital, Tongji Medical College, Huazhong University of Science and Technology were selected as the research objects. The students of each grade were randomly selected by computer and divided into experimental group and control group, with 20 students in each group. Before early clinical exposure, the experimental group received 16 class hours of early clinical clerkship training, while the control group did not receive early clinical clerkship training. After the early clinical exposure, the clinical diagnosis and treatment ability of the two groups of students was compared. SPSS 24.0 software was used for t test. Results:The scores of medical history inquiry of experimental group and control group were [(17.45±1.96) points and (15.95±1.93) points; (18.30±1.03) points and (16.75±1.86) points; (17.95±1.36) points and (16.40±1.60) points, respectively]. The physical examination scores were [(17.75±1.65) points and (16.05±1.64) points; (17.85±1.18) points and (16.80±1.47) points; (18.25±1.16) points and (16.85±1.63) points, respectively]. The clinical judgment scores were [(18.15±1.42) points and (16.35±2.41) points; (18.20±1.24) points and (16.65±1.53) points; (18.35±1.35) points and (16.25±1.83) points, respectively]. Diagnosis and treatment scheme scores were [(17.15±1.57) points and (14.55±2.56) points; (17.30±1.42) points and (15.90±1.48) points; (17.80±1.06) points and (16.35±1.87) points, respectively]. The scores of communication skills were [(17.95±1.15) points and (17.00±1.19) points; (18.55±0.83) points and (17.45±1.50) points; (18.45±1.00) points and (17.45±1.23) points, respectively], with statistically significant differences (all P<0.05). Conclusion:The application of early clinical clerkship training in the early exposure to clinical practice of eight-year program medical students can improve the quality of students' clerkship.

História do Centro Docente Assistencial de Fonoaudiologia da Universidade Federal da Bahia / History of the Speech-Language Pathology Teaching Assistance Center at the Federal University of Bahia / Historia del Centro de Asistencia Docente de Logopedia de la Universidad Federal de Bahía

Introdução: As clínicas-escolas de fonoaudiologia exercem papel fundamental na formação dos futuros profissionais. O Centro Docente Assistencial de Fonoaudiologia (CEDAF) foi criado com o intuito de ser uma clínica-escola do Curso de Graduação em Fonoaudiologia da Universidade Federal da Bahia. Objetivo: Descrever a história do CEDAF, a fim de contextualizar as mudanças pelas quais passou, destacando os principais acontecimentos a partir do olhar de atores que fazem parte desse percurso. Método: Trata-se de um estudo qualitativo, caracterizado como exploratório e descritivo, realizado na clínica CEDAF. Foram utilizadas fontes de dados orais, coletadas por meio de entrevistas e grupo focal, gravadas em áudio, transcritas e analisadas conforme categoria temática, buscando identificar os núcleos de sentido. Resultados: Foi possível perceber a intensa transformação pela qual o CEDAF passou ao longo dos seus vinte anos de história. Entre as mudanças mais significativas estão a ampliação do espaço físico, aumento do número de alunos do curso e a contratação de novos docentes, a admissão de fonoaudiólogas na clínica e o convênio firmado com a rede municipal de saúde. Conclusão: Deixar registrada uma primeira versão da história do CEDAF pode contribuir para fazer deste local um campo de pesquisa em contínuo aperfeiçoamento na formação dos futuros profissionais de fonoaudiologia e na prestação de serviço.

Introduction: Speech therapy clinic-schools play a fundamental role in the training of future professionals. The Speech-Language Pathology Teaching Assistance Center (CEDAF) was created with the intention of being a clinic-school of the Graduation Course in Speech Therapy at the Federal University of Bahia. Purpose: Describe the history of CEDAF, to contextualize the changes it has gone through, highlighting the main events from the perspective of actors who are part of this path. Method: This is a qualitative study, characterized as exploratory and descriptive, carried out at the CEDAF clinic. Oral data sources were used, collected through interviews and focus groups, recorded in audio, transcribed, and analyzed according to thematic category, seeking to identify the core meanings. Results: It was possible to perceive the intense transformation that CEDAF has undergone throughout its twenty years of history. Among the most significant changes are the expansion of the physical space, the increase in the number of students in the course and the hiring of new professors, the admission of speech therapists in the clinic and the agreement signed with the municipal health network. Conclusion: Registering a first version of the history of CEDAF can contribute to making this place a field of research in continuous improvement in the training of future professionals in speech therapy and service provision.

Introducción: Las clínicas-escuelas de logopedia juegan un papel fundamental en la formación de los futuros profesionales. El Centro de Asistencia Docente de Logopedia (CEDAF) se creó con la intención de ser clínica-escuela del Curso de Graduación en Logopedia de la Universidad Federal de Bahía.Objetivo: Describir la historia del CEDAF, con el fin de contextualizar los cambios que ha atravesado, destacando los principales hechos desde la perspectiva de los actores que forman parte de este camino. Método: Se trata de un estudio cualitativo, caracterizado como exploratorio y descriptivo, realizado en la clínica CEDAF. Se utilizaron fuentes de datos orales, recolectadas a través de entrevistas y grupos focales, grabadas en audio, transcritas y analizadas según categoría temática, buscando identificar los significados centrales. Resultados: Se pudo percibir la intensa transformación que ha experimentado CEDAF a lo largo de sus veinte años de historia. Entre los cambios más significativos se encuentran la ampliación del espacio físico, el aumento del número de alumnos en el curso y la contratación de nuevos profesores, la admisión de logopedas en la clínica y el convenio suscrito con la red municipal de salud. Conclusión: Registrar una primera versión de la historia del CEDAF puede contribuir a hacer de este lugar un campo de investigación en mejora continua en la formación de los futuros profesionales en logopedia y prestación de servicios.

Application of situation video feedback combined with problem-based learning in clinical clerkship teaching of cardiac surgery for medical students in class of organ-systems-based curriculum / 中华医学教育探索杂志

Objective:To study the application effects of situation video feedback combined with problem-based learning (PBL) on the clinical clerkship teaching of cardiac surgery for medical students in experimental class of organ-systems-based curriculum (OSBC).Methods:Medical students of Batch 2016 and 2018 OSBC reform experimental class of Jianghan University were selected as the research objects. The study group used situation video feedback combined with PBL teaching method to conduct cardiac surgery clerkship teaching, and the control group used conventional teaching method. At the end of the clerkship, the self-made "Clerkship Satisfaction Questionnaire" was distributed for questionnaire survey and the theoretical test was carried out at the same time. After the course, the theoretical examination was conducted, and the results were compared. SPSS 17.0 was used for t-test and Chi-square test. Results:The clerkship satisfaction investigation results showed that the study group was more satisfied than the control group in such 10 aspects as improving the interest of learning, learning efficiency, the ability of teamwork, clinical thinking, interpersonal communication, combining theory with practice, active knowledge acquirement, language expression, understanding knowledge point, and confidence to become a real doctor. Moreover, there were significant differences in improving the interest of learning, the ability of clinical thinking, and combining theory with practice ( P<0.05). The two theoretical test scores of the study group [(77.46±4.73) points and (79.80±7.53) points] were significantly higher than those of the control group [(70.68±5.16) points and (75.94±8.16) points] ( P<0.05). Conclusion:Situation-based video feedback combined with PBL can improve the clinical clerkship teaching effect of cardiac surgery for medical students under the teaching mode of OSBC.

Application of Rain Classroom combined with situational teaching in clinical clerkship of internal medicine / 中华医学教育探索杂志

Objective:To explore the effect of Rain Classroom combined with situational teaching in clinical clerkship of internal medicine.Methods:A total of 72 undergraduate students with clinical majors of Batch 2015 were selected and randomly divided into a control group and an experimental group using computer scrolling pause method, with 36 students in each group. The control group adopted traditional teaching methods, and the research group adopted Rain Classroom combined with situational teaching. The teaching effect evaluation was carried out through a 10-point questionnaire based on the internal medicine theory examination, clinical skill assessment and learning interest, knowledge mastery and application, and clinical thinking and practical ability. SPSS 20.0 was used to conduct t-test. Results:The average scores of the students in the experimental group including the theoretical test (87.94±5.68) and the skill test scores (88.08±5.73) were significantly higher than those in the control group (83.00±5.89) and (83.86±4.80)( P<0.01). The results of the questionnaire showed that students' interest in learning improvement, self-learning ability, new knowledge acquisition, application of knowledge, clinical thinking, clinical practice, problem solving, self-expression, teamwork, doctor-patient communication ability in the study group were better than those in the control group ( P < 0.01). Conclusion:The Rain Classroom combined with situational teaching method is helpful to improve students' knowledge mastery and application, improve clinical thinking and practical ability, improve learning interest and clinical clerkship teaching effect.

Practice of organ system integration education in the clerkship teaching of digestive system / 中华医学教育探索杂志

The integration education is organized around "an organ system" of the body, and integrates multiple medical disciplines orderly, which is the main trend of medical education reformation at home and abroad. Digestive diseases are diverse and complicated, so that it is of great significance to apply integration education mode in the clinical teaching of digestive system. Taking the clinical clerkship teaching of digestive system in The First Affiliated Hospital of Chongqing Medical University as an example, through reasonably integrating the course content, fully applying problem-based learning (PBL) method, taking multiple teaching methods, combing ideological and political education, and paying more attention to improving the teachers' training, the learning enthusiasm of students could be stimulated, their independent thinking ability and holistic medical view could be cultured, and the teaching effect would be effectively improved.

Practice of online clinical clerkship teaching mode based on "3P" model / 中华医学教育探索杂志

In order to construct the online teaching mode of clinical clerkship course and improve the online clerkship teaching system of clinical medicine in China, based on the "3P" model, a complete set of online clinical clerkship mode has been constructed from three links of teaching, pre-class preparation, classroom teaching and after-class evaluation, and applied to clinical teaching practice of Internal Medicine. The practice suggests that students are highly satisfied and the teaching effect is good, which provides a new idea for the reform of online clerkship teaching of clinical medicine.

Avaliação do grau de satisfação dos profissionais de saúde frente a presença de estudantes de medicina nas Unidades de Saúde da Família / Assessment of the degree of satisfaction of health professionals regarding the presence of medical students in Family Health Units

A partir da reforma das Diretrizes Curriculares dos Cursos de Graduação em Medicina (DCN), os estudantes de medicina passaram a vivenciar a Atenção Primária à Saúde (APS) em seu contexto mais amplo. Porém, a satisfação dos profissionais de saúde frente a essa integração ensino-serviço-comunidade ainda não é plenamente evidenciada. Este estudo tem como objetivo determinar a satisfação dos profissionais das Equipes de Saúde da Família (ESF) em relação à presença de estudantes de medicina na APS. Trata-se de um estudo transversal com 95 profissionais de saúde que trabalham em Unidades de Saúde da Família (USF) do município de Lauro de Freitas-BA. A coleta de dados foi realizada por meio de um questionário elaborado pelos pesquisadores, e a satisfação dos profissionais quanto à presença de estudantes de medicina foi mensurada através da aplicação da escala Likert e da Escala Visual Analógica (EVA). Em relação à presença desses estudantes nas USFs, 40% dos profissionais concordam plenamente que a rotina de trabalho teve uma mudança positiva e 48,4% deles acreditam que a presença de estudantes contribui para a agilidade do serviço. O nível de satisfação com a presença dos estudantes nas USFs, apresentou mediana de 8,0 (7,0 ­ 10,0) na EVA [au]

Since the reform of the Curriculum Guidelines of Undergraduate Medical Courses (DCN), medical students have begun to experience Primary Health Care (PHC) in its broader context. However, the satisfaction of health care professionals regarding this teaching-service-community integration is not yet evidenced. This study aims to determine Family Health Teams (eSF) professionals satisfaction regarding the presence of medical students in PHC This is a cross-sectional study with 95 health care professionals from the ESF working in Family Health Units (FHUs) in the municipality of Lauro de Freitas-BA. The data collection has been done through a questionnaire prepared by the researchers, and the professionals' satisfaction regarding the presence of medical students in the FHUs was measured by applying the Likert scale and the Visual Analogue Scale (VAS). Regarding the presence of medical students at USFs, 40% of professionals fully agree that the work routine had a positive change and 48.4% of them fully believe that the presence of students helps to improve the service's promptness. The level of satisfaction with the presence of students in the FHUs, it presented a median of 8.0 (7.0 - 10.0) by VAS [au]

Support provided to nursing students in the face of patient safety incidents: a qualitative study / Soporte a los estudiantes de enfermería delante de incidentes de seguridad del paciente: investigación cualitativa / Suporte aos estudantes de enfermagem diante de incidentes de segurança do paciente: pesquisa qualitativa

ABSTRACT Objectives: to identify the support provided to nursing students after a patient safety incident. Methods: qualitative study developed with 23 students attending an undergraduate nursing program in southern Brazil. Data were collected between September and November 2021 and submitted to textual discursive analysis using the Iramuteq software. Results: the students reported that mainly classmates and professors of the practical courses provided support. The students showed no knowledge of organizational support or protocols available to students who become second victims of such incidents. Final Considerations: the primary support sources available to nursing students involved in patient safety incidents were identified. Note that support provided to nursing students is still incipient both in Brazil and internationally. Hence, further studies are needed to address potential victims and support resources to mitigate this phenomenon.

RESUMEN Objetivos: conocer el soporte ofrecido al estudiante de enfermería después de un incidente de seguridad del paciente. Métodos: investigación cualitativa, desarrollada en el curso de licenciatura de enfermería en el Sur de Brasil, con 23 estudiantes. Los datos fueron recolectados entre septiembre y noviembre de 2021 y sometidos al análisis textual discursivo, con la utilización del software Iramuteq. Resultados: los estudiantes relataron que recibieron apoyo principalmente de los compañeros y profesores de las materias del campo de práctica; también, ellos demostraron no conocer ningún tipo de soporte organizacional, protocolo o apoyo cuando son por segunda vez víctimas de esos incidentes. Consideraciones Finales: se identificaron las principales fuentes de apoyo, cuando el estudiante de enfermería se envuelve en incidentes de seguridad del paciente. Se destaca la insipiencia de los recursos de soporte ofrecidos al estudiante de enfermería, tanto en el ámbito nacional como internacional; así, es necesario realizar más investigaciones dirigidas a esas potenciales víctimas e proporcionar recursos de soporte para mitigar ese fenómeno.

RESUMO Objetivos: conhecer o suporte ofertado ao estudante de enfermagem após um incidente de segurança do paciente. Métodos: pesquisa qualitativa, desenvolvida com 23 estudantes de um curso de bacharelado de enfermagem do Sul do Brasil. Os dados foram coletados entre setembro e novembro de 2021 e submetidos à análise textual discursiva, com a utilização do software Iramuteq. Resultados: os estudantes relataram que receberam apoio principalmente dos colegas e professores das disciplinas do campo de prática, mas demonstraram desconhecer qualquer tipo de suporte organizacional, protocolo ou apoio quando se encontram na condição de segunda vítima desses incidentes. Considerações Finais: foram identificadas as principais fontes de apoio quando o estudante de enfermagem se envolve em incidentes de segurança do paciente. Destaca-se a incipiência dos recursos de suporte oferecidos a esse estudante, tanto nacional como internacionalmente, sendo prementes mais pesquisas direcionadas a essas potenciais vítimas, bem como recursos de suporte para mitigar esse fenômeno.

Patient Safety Incidents and the second victim phenomenon among nursing students / Los incidentes de seguridad del paciente y el fenómeno de la segunda víctima entre estudiantes de enfermeira / Incidentes de segurança do paciente e o fenômeno da segunda vítima entre estudantes de enfermagem

ABSTRACT Objective: To map the factors involved in incidents that harm patient safety and contribute to the second victim phenomenon among nursing students. Method: Qualitative, exploratory-descriptive study addressing 23 nursing students attending a Federal University in the South of Brazil. The interviews were analyzed using text and discoursive analysis. The Iramuteq software supported the processing of texts. Results: Communication failures within the health staff, a lack of protocols and equipment that prioritize patient safety, and factors related to the teaching-learning process favor the occurrence of patient safety incidents and the second victim phenomenon among nursing students. Conclusion: Addressing the topic concerning patient safety in nursing programs can promote the patient safety culture by encouraging reporting and admitting the possibility of errors and learning from them, strategies that can mitigate second victim effects.

RESUMEN Objetivo: mapear los factores que participan en incidentes que fragilizan la seguridad de los pacientes y que colaboran para el fenómeno de la segunda víctima entre los estudiantes de enfermería. Método: estudio de abordaje cualitativo, de carácter exploratorio y descriptivo, realizado en 23 estudiantes de enfermería de una Universidad Federal del sur de Brasil. Las entrevistas fueron analizadas a través del análisis textual discursivo. El software Iramuteq auxilió en el procesamiento de los textos. Resultado: las fallas en la comunicación entre el equipo de la salud; la ausencia de protocolos y de equipamientos que den prioridad a la seguridad del paciente; y, los factores relacionados al proceso de enseñanza y aprendizaje, favorecen la ocurrencia de incidentes de seguridad del paciente y corroboran el fenómeno de la segunda víctima entre estudiantes de enfermería. Conclusión: la incorporación de la temática sobre seguridad del paciente, en el curso de enfermería, puede auxiliar a desarrollar una cultura de seguridad del paciente al incentivar la cultura del relato, admitir la posibilidad del error e incentivar el aprendizaje; y, partiendo de este, crear estrategias que puedan auxiliar a mitigar los efectos de la segunda víctima.

RESUMO Objetivo: mapear os fatores envolvidos em incidentes que fragilizam a segurança dos pacientes e que colaboram para o fenômeno da segunda vítima entre os estudantes de enfermagem. Método: estudo de abordagem qualitativa, de caráter exploratório-descritivo, realizado com 23 estudantes de enfermagem de uma Universidade Federal do Sul do Brasil. As entrevistas foram analisadas através da análise textual discursiva. O software Iramuteq auxiliou no processamento dos textos. Resultado: falhas na comunicação entre a equipe de saúde, ausência de protocolos e de equipamentos que priorizem a segurança do paciente e os fatores relacionados ao processo de ensino-aprendizagem favorecem a ocorrência de incidentes de segurança do paciente e corroboram para o fenômeno da segunda vítima entre estudantes de enfermagem. Conclusão a incorporação da temática sobre segurança do paciente no curso de enfermagem pode auxiliar o desenvolvimento de uma cultura de segurança do paciente, ao incentivar a cultura do relato, admitir a possibilidade do erro e o aprendizado a partir dele, estratégias que podem propiciar na mitigação dos efeitos da segunda vítima.

A cross-sectional study on the knowledge in musculoskeletal medicine of undergraduate medical students in a national university

OBJECTIVES@#This study aimed to compare the evaluation results of University of the Philippines - College of Medicine (UPCM) Learning Unit VI (LU VI) students in their Musculoskeletal (MSK) year-end module examination and final module grade to their results in the MSK 30 examination. It likewise sought to assess the adequacy of the institution’s current curriculum on the basis of the most clinically relevant MSK topics included in the MSK 30.@*METHODS@#The knowledge of the students in Musculoskeletal medicine was determined using the MSK 30 validated exam and this was compared to their results in the various evaluation tools of the present MSK curriculum. The results were subjected to statistical analysis using (1) the Pearson correlation coefficient and (2) item analysis. @*RESULTS@#Despite exhibiting above average performance in the MSK module, the performance of the 66 (N=187) LU VI students in the MSK 30 showed otherwise with a passing rate of only 48.48%. There was no statistically significant correlation between the MSK 30 and the year-end module examination (p value = 0.77, CI 90%, ME 8%), and the final module grade (p value = 0.92, CI 90%, ME 8%). It was noted that the students did poorly in the following topics: Environmental Injury, Head Injury, Infection, Pediatrics, Spine, and Sports Injuries.@*CONCLUSION@#Undergraduate medical students of the University of the Philippines - College of Medicine performed poorly in the MSK 30 despite a generally good performance in the prescribed MSK module. Whether this is indicative of inadequacies in the existing MSK curriculum or is due to the MSK 30 not being appropriate to the local setting will need to be determined.

Two thumbs up! A review of the “PULMOSERYE: Pulmonary patient miniseries… Dead or Alive: The saga of Mang Jose”- a clerkship learning activity during the pandemic

@#The World Health Organization declared Covid 19 a pandemic in March 2020, disrupting medical education and creating a significant void in the hospital rotation of the clinical clerks. Alternative methods of teaching and learning had to be instituted, and since face-to-face encounters were still not allowed, all these activities had to be online. While the various activities were able to challenge critical analysis and thinking, the Section on Pulmonary Medicine felt that the clerks would benefit most from activities that would most closely simulate an actual patient encounter. And so, the PulmoSerye was born: a miniseries that followed the patient from initial consultation in the emergency room resulting in admission, events that happened in the ward, formulation of the Master Problem List, progress notes, giving discharge orders, writing the discharge summary, and finally a follow up via Telemedicine. This is what the clerks would have experienced if they had been in hospital. Activities such as the Pulmoserye should be highly considered as a viable option should clerkship hospital rotations once again be put on hold.

Application of flipped classroom combined with online interactive teaching in clinical clerkship of cardiology / 中华医学教育探索杂志

Objective:To explore the application effect of flipped classroom combined with online interactive teaching in clinical clerkship of cardiology.Methods:The study collected 56 students from Batch 2017 five-year clinical medicine undergraduate class of Medical College of China Three Gorges University and they were randomly divided into experimental group and control group in average. The control group adopted the traditional teaching method while the experimental group adopted the combined teaching method. The differences of test scores after teaching were compared between the two groups and the feedback of students on the two methods was also analyzed. SPSS 12.0 was used for t test and chi-square test. Results:The final score of clinical thinking in the experimental group (84.38±3.18) was significantly higher than in the control group (75.43±5.85) ( P<0.05), and the satisfaction of the experimental group to the teaching mode was [86% (24/28)], which was significantly higher than that of the control group [50% (14/28)]. More than 80% of the students in the experimental group regarded that the combined teaching method was helpful to promote the interaction between teachers and students, master relevant knowledge, and improve learning interest and learning efficiency. Conclusion:This combined teaching method can enhance students' clinical thinking ability, learning enthusiasm and efficiency, and finally effectively improve the effect of clerkship.

3. Learner Support for Medical Students Who Can't Communicate Well in Clinical Clerkship / 医学教育

In this paper, as support for “student who is not good at communication”, a fictional case of a pharmaceutical student will be examined from the followingthree perspectives. The first, from a developmental and social psychological perspective, is the possibility of “unlearning or mislearning of communication” and “discrepancy between the actual self, the ideal self, and the ought self.” In support, learning assertion skills can be effective. The second is from a clinical psychological perspective, in terms of “social anxiety disorder” and “narcissism”. In support, pharmacotherapy and cognitive behavioral therapy will be discussed. Third, from the perspective of neurodevelopmental syndrome, the possibility of “autism spectrum disorder” is considered. In this case, involvement that enhances self-understanding and self-affirmation will be important. Educators and supporters are required to make an accurate assessment of the cause of the difficulty.

Problemas que limitan la interdisciplinariedad entre la Farmacología y las asignaturas clínicas en Estomatología / Problems that limit interdisciplinary between Pharmacology and Stomatology clinical subjects

RESUMEN Fundamento: El desarrollo de la interdisciplinariedad entre la unidad curricular Farmacología y las asignaturas clínicas de la Disciplina Principal Integradora en la carrera Estomatología, resulta indispensable para la formación integral del futuro egresado. Objetivo: Identificar los problemas que limitan el desarrollo de la interdisciplinariedad entre la Farmacología y las asignaturas clínicas de la Disciplina Principal Integradora en la carrera Estomatología. Metodología: Se realizó un estudio observacional descriptivo transversal entre noviembre y diciembre de 2020 en la Facultad de Estomatología de la Universidad de Ciencias Médicas de Santiago de Cuba. Se consideraron como unidades de análisis: actividades docentes y directivos académicos, se seleccionó una muestra aleatoria en ambos casos (n=18 y n=8, respectivamente). Se estudiaron las variables: relaciones interdisciplinarias con la Farmacología (se observa, no se observa y se observa poco), categoría docente, categoría científica, grado académico/científico, grado de especialización y opinión de directivos académicos (siempre, a veces y nunca). Como instrumento de medición se empleó guía de observación y de entrevista, respectivamente. Se empleó el porcentaje como medida de resumen. Resultados: En más del 50 % de las actividades docentes de las asignaturas clínicas de la Disciplina Principal Integradora, no se observa las relaciones interdisciplinarias con la Farmacología. En las entrevistas realizadas a los directivos académicos, predominó la opinión: nunca. Conclusiones: Las insuficiencias didácticas, metodológicas, académicas e investigativas identificadas, limitan el desarrollo de la interdisciplinariedad entre la unidad curricular Farmacología y las asignaturas clínicas de la Disciplina Principal Integradora en la carrera Estomatología.

ABSTRACT Background: The development of interdisciplinarity between the curricular Pharmacology unit and the clinical subjects of the Main discipline in the Stomatology career is essential for the integral formation of the future graduate. Objective: To identify the problems that limit the development of interdisciplinarity between Pharmacology and the clinical subjects of the Main Comprehensive Discipline in the Stomatology career. Methodology: A cross-sectional descriptive observational study was conducted between November and December 2020 in the Stomatology Faculty at the Santiago de Cuba University of Medical Sciences. The following were considered as analysis units: teaching activities and academic directors, a random sample was selected in both cases (n=18 and n=8, respectively). The following variables were studied: interdisciplinary relations with Pharmacology (observed, not observed and little observed), teaching category, scientific category, academic/scientific degree, specialization degree and the academic directors´ opinion (always, sometimes and never). Observation and interview guides were used respectively as measurement instruments. Percentage was used as a summary measure. Results: In more than 50 % of the teaching activities of the clinical subjects of the Main Comprehensive Discipline, interdisciplinary relations with Pharmacology are not observed. In the interviews conducted with academic managers, the prevailed opinion was never. Conclusions: The didactic, methodological, academic and research inadequacies identified, limit the development of interdisciplinarity between the curricular unit Pharmacology and the clinical subjects of the Main Comprehensive Discipline in the Stomatology career.

Student perception of early simulation in dentistry / Percepción de los alumnos respecto a la primera simulación clínica en la carrera de odontología

Objective: To evaluate student perception of early simulation in dentistry. Material and Methods: The design of the study was quantitative, observational and cross-sectional. A total of 121 students, from third year to senior year were evaluated. The perception and its dimensions: satisfaction, self-confidence and good educational practices were evaluated by a survey with a high level of reliability (0.89), modified and adapted for the present investigation, checking coefficients for its use: Aiken's V, Cronbach's Alpha, Test-Retest (Spearman), classified in ability, scenario and general simulation practices, based on the Likert scale (from 1 to 5). For the univariate analysis, the descriptive statistics from qualitative and quantitative variables were obtained and for the bivariate analysis, Spearman's rank correlation coefficient and Kruskal Wallis and Mann-Whitney U-tests were employed. Results: The students rated the simulation perception positively with an average of 4.42±0.49, 4.14±0.63 y 4.73±0.66 regarding the ability, scenario and general simulation practices, respectively. No statistically significant differences were found between the perception of early preclinical practices with the variables age, gender, year of study and previous experience. Conclusion: The perception of students regarding early preclinical practices got a high score and it is not related with the variables studied, according to the survey modified and adapted.

Objetivo: Evaluar la percepción de los alumnos respecto a la primera simulación clínica en la carrera de Odontología. Material y Métodos: El diseño del estudio fue de tipo cuantitativo, descriptivo y transversal. Se evaluaron 121 alumnos de sexto a décimo ciclo. La percepción y sus dimensiones: satisfacción, autoconfianza y buenas prácticas educacionales fueron evaluadas mediante una encuesta con alto nivel de confiabilidad (0.89), modificada y adaptada para la presente investigación comprobando coeficientes para su uso: V de Aiken, Alfa de Cronbach, Test-Retest (Spearman), clasificada en prácticas de habilidad, escenario y simulación en general, basada en la escala de Likert (1 al 5). Se obtuvo la media y desviación estándar para la variable percepción, así como el coeficiente de correlación de Spearman y las pruebas U de Mann Whitney y Kruskal Wallis para evaluar covariables. Resultados: Los estudiantes tuvieron una percepción positiva respecto a la simulación obteniendo una media de puntuación de 4.42±0.49, 4.14±0.63 y 4.73±0.66 respecto a las prácticas de habilidad, escenario y simulación en general respectivamente. No se encontraron diferencias estadísticamente significativas entre la percepción de la primera simulación clínica con las variables edad, género, ciclo y experiencia previa. Conclusión: La percepción de los estudiantes respecto a la primera simulación clínica obtuvo un alto puntaje y no se encuentra relacionada con las variables estudiadas según la encuesta modificada y adaptada.

Intercâmbio internacional na era COVID-19 por que Portugal? / International exchange in COVID-19 era: why Portugal? / Intercambio internacional en la era COVID-19: ¿Por qué Portugal?

Problema: O intercâmbio internacional é um excelente instrumento de formação paraestudantes e Portugal apresenta diversas vantagens para os alunos brasileiros. No entanto, a literatura brasileira carece de relatos de experiência sobre tais atividades e os estudantesfrequentemente encontram- se preocupados sobre quais atividades serão desenvolvidas,sobre que tipo de sistema de saúde encontrarão e, recentemente, sobre como a pandemia se desenrolou no país de destino.Métodos: Trata-se de um estudo descritivo, do tipo relato de experiência, referente a um estágio internacional na área da saúde, realizado por um acadêmico brasileiro em Portugal. O trabalho foi elaborado a partir de pesquisas bibliográficas e resgate mnemônico da experiência. Resultados: O sistema de saúde português funciona de forma semelhante ao brasileiro, baseado na atenção primária à saúde e na descentralização, e apresentou bom desempenho em relação à pandemia da COVID-19. O intercâmbio foi realizado na área de medicina geral e familiar e de medicina de emergência pela Universidade de Lisboa, no início de 2020, e foi composto por uma vasta gama de atividades desenvolvidas, principalmente o acompanhamento de consultas. Os aprendizados do estágio incluem os conteúdos técnicos das consultas acompanhadas, os conhecimentos não científicos ensinados durante a rotina e as experiências sociais vivenciadas na viagem. Conclusão: Os estudantes brasileiros encontrarão familiaridades e diferenças positivas no sistema de saúde português e observarão excelentes números em relação ao controle da pandemia da COVID-19. O intercâmbio em Portugal possibilitou o crescimento profissional e pessoal do estudante e é recomendado para os estudantes brasileiros da área da saúde interessados em umaexperiência transcultural.

Problem:The international exchange is an excellent training tool for students and Portugal presents several advantages for Brazilianacademics. However, the Brazilian literature lacks experience reports about these activities and students are often concerned about what activities will be developed, about what kind of health system will they find, and, recently, about how the pandemic unfolded in the destination country.Methods:This is a descriptive study, experience report format, referring to an international exchange in the health field, performed by a Brazilian student in Portugal. The manuscript was elaborated with bibliographic research and mnemonic rescue of experience. Results: The Portuguese health system operates similarly to the Brazilian one, relying on primary health care and decentralization, and presented good performance regarding the COVID-19 pandemic. The exchange occurred in the family medicine and emergency medicine field from the University of Lisbon, in early 2020, and comprised a broad range of activities, specially consultation tracking. The internship's lessons include technical content of the consultations followed, non-scientific knowledge taught during routine and social experiences during the trip. Conclusion: Brazilian students will find familiarities and positive differences in the Portuguese health system and will observe excellent numbers regarding the control of the COVID-19 pandemic. The exchange in Portugal allowed the professional and personal growth of the student and it is recommended for Brazilian academics from the health field interested in a transcultural experience.

Problema: El intercambio internacional es una excelente herramienta de formación para los estudiantes y Portugal presenta numerosasventajas a los alumnos brasileños. No obstante, la literatura brasileña carece de relatos de experiencias sobre estas actividades y a losestudiantes a menudo les preocupa qué actividades se llevarán a cabo, qué tipo de sistema de salud encontrarán y, recientemente, cómo se desarrolló la pandemia en el país de destino. Método: Se trata de un estudio descriptivo, del tipo relato de experiencia, con relación a un pasantía internacional en el área de la salud, efectuado por un alumno brasileño en Portugal. El artículo se elaboró a partir de la investigación bibliográfica y el rescate mnemónico de la experiencia. Resultados: El sistema de salud portugués opera de manera similar al brasileño, apoyado en la atención primaria en salud y en la descentralización, y presentó un buen desempeño en relación con la pandemia de COVID-19. El intercambio fue realizado en el campo de la Medicina Familiar y Comunitaria y la Medicina de Emergencia por la Universidad de Lisboa, a principios de 2020, y fue compuesto por una amplia gama de actividades desarrolladas, principalmente el seguimiento de consultas. Las lecciones aprendidas en la pasantía incluyen los contenidos técnicos de las consultas seguidas, el conocimiento no científico enseñado durante la rutina y las experiencias sociales vividas en el viaje. Conclusión: Los estudiantes brasileños encontrarán familiaridades y diferencias positivas en el sistema de salud portugués y observarán excelentes números en relación con la pandemia de COVID-19. El intercambio en Portugal posibilitó el crecimiento profesional y personal del alumno y es recomendado para estudiantes brasileños del área de saludinteresados en una experiencia transcultural.

Supervisors' perceptions on errors of nursing students in clinical clerkship: a qualitative research / Percepciones de los supervisores sobre los errores de los estudiantes de enfermería en prácticas clínicas: una investigación cualitativa / Percepções dos supervisores sobre erros dos estudantes de enfermagem em estágio clínico: uma pesquisa qualitativa

ABSTRACT Objectives: to compare pedagogical supervisors' and clinical supervisors' perceptions about the errors made by nursing students in clinical clerkship. Methods: a qualitative exploratory-descriptive study developed with 105 participants. Data collection was performed with a questionnaire with open-ended questions. Content analysis performed according to the conceptual model of student errors in clinical teaching. Results: pedagogical supervisors perceive, in descending order, errors in transversal competencies, in the execution of care and medication. Clinical supervisors perceive, in descending order, the execution of care, medication, and transversal competencies. Final Considerations: there was coincidence and complementarity in clinical supervisors' and pedagogical supervisors' perceptions, although not in the same order, regarding the errors made. This study presents contributions related to the existing knowledge in relation to medication errors, which are not the most perceived, and those of transversal competencies, which take on a prominent position.

RESUMEN Objetivos: comparar la percepción de los supervisores pedagógicos y supervisores clínicos sobre los errores cometidos por los estudiantes de enfermería en práctica clínica. Métodos: estudio cualitativo exploratorio-descriptivo, desarrollado con 105 participantes. Recolección de datos realizada con un cuestionario con preguntas abiertas. Análisis de contenido realizado según el modelo conceptual de errores del alumno en educación clínica. Resultados: los supervisores pedagógicos perciben, en orden decreciente, los errores en las competencias transversales, en la ejecución de los cuidados y la medicación. Los supervisores clínicos perciben, en orden decreciente, la ejecución de cuidados, medicación y habilidades transversales. Consideraciones Finales: hubo coincidencia y complementariedad en las percepciones de los supervisores clínicos y los supervisores pedagógicos, aunque no en el mismo orden, sobre los errores cometidos. El estudio presenta aportes relacionados con el conocimiento existente en relación a los errores de medicación, que no son los más percibidos, y los de habilidades transversales, que asumen un lugar destacado.

RESUMO Objetivos: comparar a percepção de supervisores pedagógicos e de supervisores clínicos sobre os erros cometidos por estudantes de enfermagem em estágio clínico. Métodos: estudo qualitativo exploratório-descritivo, desenvolvido com 105 participantes. Coleta de dados realizada com questionário com perguntas abertas. Análise de conteúdo realizada segundo modelo conceptual de erros de estudantes em ensino clínico. Resultados: os supervisores pedagógicos percebem, em ordem decrescente, os erros nas competências transversais, na execução de cuidados e de medicação. Os supervisores clínicos percebem, por ordem decrescente, a execução de cuidados, de medicação e as competências transversais. Considerações Finais: verificou-se coincidência e complementaridade nas percepções de supervisores clínicos e de supervisores pedagógicos, embora não na mesma ordem, em relação aos erros cometidos. O estudo apresenta contribuições relativas ao conhecimento existente em relação aos erros de medicação, que não são os mais percebidos, e os de competências transversais, que assumem posição de destaque.