Aprendizaje en investigación clínica: experiencia de enseñanza híbrida con estudiantes de medicina / Learning in Clinical Research: Hybrid Teaching Experience with Medical Students

Introducción: la pandemia de COVID-19 indujo un cambio en nuestro sistema de salud y de educación. Los programas formativos también tuvieron que adaptarse y exigieron un cambio rápido. Objetivos: describir una experiencia educativa de enseñanza virtual/híbrida en investigación clínica, entre docentes del Servicio de Clínica de un hospital universitario y estudiantes de Medicina de una institución privada, que participaron del Programa ESIN (EStudiantes en INvestigación). Metodología: los contenidos y las estrategias educativas incluyeron las clases teóricas audiograbadas o videograbadas (asincrónicas y autoadministradas), el aprendizaje basado en proyectos, los talleres prácticos (encuentros sincrónicos virtuales y grupales), mediante la adopción de modelos de aprendizaje como el aula invertida, y la tutoría individual entre docente-estudiante. Los datos se recopilaron mediante la observación en contextos académicos, y basándonos en elementos de encuestas anónimas de satisfacción, previo consentimiento informado de los participantes. Resultados: participaron 14 estudiantes, 6 durante el año 2021 y 8 durante 2022. Todas mujeres y estudiantes de medicina (50% de cuarto año, 35% de sexto año y 15% de quinto año). Las técnicas implementadas favorecieron la participación y promovieron el aprendizaje activo, basado en proyectos. Mencionaron aspectos positivos como el enfoque académico práctico, la disponibilidad del equipo docente para atender cualquier duda, el tiempo y el entusiasmo por enseñar y fomentar la participación. Los videos teóricos resultaron útiles como herramientas de repaso, y los encuentros grupales fueron especialmente valorados, si bien los encuentros individuales fueron destacados como ayuda y apoyo previo a los congresos científicos. En general, manifestaron que fue una experiencia enriquecedora que demostró que se puede lograr lo que se creía imposible. Todas participaron activamente de al menos un congreso científico, y el 50% resultó coautora de una publicación académica. Conclusión: los estudiantes asumieron compromisos y responsabilidades, e incorporaron competencias y habilidades en la implementación y en la difusión de los proyectos. Esta experiencia educativa facilitó que el tiempo de clase pudiera optimizarse para intercambio, discusión y dudas. Los recursos producidos, las actividades desarrolladas y los contenidos abordados quedan disponibles a nivel institución. (AU)

Introduction: the COVID-19 pandemic brought about a change in our health and education system. Training programs also had to adapt and required rapid change. Objectives: to describe an educational experience of virtual/hybrid teaching in clinical research between teachers of the Clinical Service of a university hospital and medical students of a private institution who participated in the ESIN Program (Students in Research). Methodology: the contents and educational strategies included audio or videotaped lectures (asynchronous and self-administered), project-based learning, practical workshops (virtual and group synchronous meetings) by adopting learning models such as the inverted classroom, and individual tutoring between teacher and student. We gathered the data through observation in academic contexts and based on elements of anonymous satisfaction surveys, with prior informed consent of participants. Results: fourteen students participated, six in 2021 and eight in 2022. All were women and medical students (50% fourth year, 35% sixth year, and 15% fifth year). The techniques implemented favored participation and promoted active, project-based learning. They mentioned positive aspects such as the practical academic approach, the availability of the teaching team for any doubts, the time and enthusiasm for teaching, and encouraging participation. The theory videos were a valuable review tool, and team meetings received high praise even if the one-on-one meetings received much attention as help and support before the scientific congresses. In general, they stated that it was an enriching experience that showed that you can achieve what you thought impossible. All of them actively participated in at least one scientific congress, and 50% were co-authors of an academic publication. Conclusion: the students assumed commitments and responsibilities and incorporated competencies and skills in project implementation and dissemination. This educational experience helped to optimize class time for exchange, discussion, and doubts. The resources produced, the activities developed, and the contents addressed are now available at the institutional level. (AU)

Food insecurity in Chilean university students during the COVID-19 pandemic

Background: Food and nutrition were affected by the COVID-19 pandemic, increasing levels of food insecurity. University students were a risk group for food insecurity due to the closure of educational establishments where they received their main meals. Aim: To assess food insecurity among Chilean public university students before and during the COVID-19 pandemic. Material and Methods: The study had a non-probabilistic before-and-after design. Undergraduate students from all colleges at the university were invited to answer an online survey about food insecurity, devised based on FAO Food Insecurity Experience Scale. Results: Nine hundred and one students answered the survey. The prevalence of moderate/severe food insecurity increased from 9.5% to 14.3% before and during the pandemic, respectively. Forty two percent (n = 196) of student households became food insecure during the sanitary crisis. Students commented on the positive and negative aspects of the pandemic in their eating behaviors. Conclusions: Undergraduate students are vulnerable to food insecurity. Mitigation actions should be carried out when educational establishments are closed.

Antecedentes: La alimentación y la nutrición se están viendo afectadas por la pandemia por COVID-19, aumentando los niveles de inseguridad alimentaria. Un grupo susceptible a la inseguridad alimentaria son los estudiantes universitarios debido al cierre de los establecimientos educativos donde ellos pueden recibir sus alimentos principales. Objetivo: Evaluar la inseguridad alimentaria de los estudiantes de una universidad pública de Chile, antes y durante la pandemia por COVID-19. Material y Métodos: El estudio tuvo un diseño de antes y después, no probabilístico. Se invitó a participar a estudiantes universitarios de todas las facultades de la universidad a contestar un cuestionario en línea, desarrollado basado en la escala de experiencia de inseguridad alimentaria de la FAO. Resultados: Novecientos y un estudiantes respondieron la encuesta. En estos estudiantes, la prevalencia de inseguridad alimentaria moderada/grave aumentó de 9,5% a 14,3% antes y durante la pandemia, respectivamente. El 42,3% (n = 196) de los hogares estudiantiles pasó a tener inseguridad alimentaria durante la crisis sanitaria. Los estudiantes comentaron aspectos positivos y negativos de la pandemia en sus conductas alimentarias. Conclusiones: Estos resultados reflejan que estos estudiantes son vulnerables para inseguridad y amerita acciones de mitigación cuando los establecimientos educativos están cerrados.

Percepción de docentes sobre habilidades comunicativas de sus estudiantes para una adecuada relación médico-paciente / Perception of teachers about communication skills of their students for an adequate doctor-patient relationship

Fundamento: la existencia de insatisfacciones en la relación médico-paciente constituye una preocupación por la dirección del Estado y del sector de salud cubanos. Objetivo: valorar el desarrollo de las habilidades comunicativas de los educandos, según la percepción docente sobre el cumplimiento de las funciones de la comunicación para una adecuada relación médico-paciente. Métodos: se realizó una investigación cualitativa en la Facultad de Medicina de la Universidad de Ciencias Médicas de Villa Clara, Cuba, entre mayo-junio 2021. Se aplicaron métodos teóricos: análisis-síntesis, inducción-deducción e histórico-lógico; y empíricos: análisis documental y encuesta de opinión estructurada a los docentes sobre la base de las funciones comunicativas. Los resultados se expresaron en porcientos según los indicadores para la valoración, y se ilustraron en figuras. Resultados: la malla curricular de la carrera de Medicina ofrece posibilidades de desarrollo de habilidades comunicativas como basamento para una adecuada relación médico-paciente, constituyen fortalezas las asignaturas y disciplinas propias de la formación en pregrado y la educación en el trabajo. La función informativa de la comunicación resultó ser la más favorecida en los criterios expresados por lo docentes; obtuvieron más bajos porcientos la reguladora y la afectiva. Conclusiones: la percepción docente mostró insuficiencias en la relación médico-paciente en todas las funciones, por lo que se precisa elaborar estrategias para el desarrollo de las habilidades comunicativas, imprescindibles en la formación médica humanitaria que caracteriza la asistencia médica cubana.

Background: the existence of dissatisfies in the doctor-patient relationship constitutes a concern for the direction of the State and the Cuban health branch. Objective: to assess the development of students' communication skills, according to the teacher's perception of compliance with communication functions for an adequate doctor-patient relationship. Methods: a qualitative research was carried out at the Faculty of Medicine of Villa Clara University of Medical Sciences, Cuba, from May to June 2021. Theoretical methods were applied: analysis-synthesis, induction-deduction and historical-logical; and empirical ones: documentary analysis and structured opinion survey of teachers based on communicative functions. The results were expressed in percentages according to the indicators for the assessment and were illustrated in figures. Results: the curriculum of the Medicine career offers possibilities for the development of communication skills as a basis for an adequate doctor-patient relationship, the subjects and disciplines of undergraduate training and the in-service training are strengths. The informative function of communication turned out to be the most favored in the criteria expressed by the teachers; the regulatory and affective obtained lower percentages. Conclusions: the teacher's perception showed insufficiencies in the doctor-patient relationship in all functions, which is why it is necessary to develop strategies for the development of communication skills, essential in humanitarian medical training that characterizes Cuban medical assistance.

Autorregulación del aprendizaje: análisis de su apreciación por estudiantes de primer año de Medicina / Self-regulation of learning: analysis of its appreciation by first￾year medical students

Fundamento: la autorregulación del aprendizaje es un parámetro importante para tomar decisiones docente-metodológicas, promotoras de la autogestión del conocimiento. Objetivo: analizar la apreciación sobre su autorregulación del aprendizaje, por estudiantes de primer año de Medicina del curso 2021-2022, en la Facultad de Ciencias Médicas "Salvador Allende". Métodos: se realizó una investigación exploratoria, descriptiva, transversal y no experimental, con un enfoque mixto. Se utilizaron métodos teóricos: análisis-síntesis, inductivo-deductivo y enfoque sistémico; empíricos: el instrumento de medición utilizado consistió en un cuestionario conformado a partir de una adaptación de la Escala de Autorregulación del Aprendizaje, con las dimensiones: actitud hacia el estudio, enfoque estratégico en el aprendizaje y regulación metacognitiva; y matemático-estadísticos para el procesamiento de los datos. Resultados: se determinó que la autorregulación del aprendizaje fue insatisfactoria, al presentarse deficiencias en dos de sus dimensiones: Enfoque estratégico en el aprendizaje y Regulación metacognitiva. La dimensión Actitud ante el estudio obtuvo una valoración satisfactoria; se apreció que el ítem correspondiente a la dedicación al trabajo con las tareas orientadas, tuvo una débil relación directa con el interés personal, las calificaciones obtenidas y el reconocimiento personal. De todos los ítems considerados en la encuesta, solamente hubo una relación débil e indirecta del sexo (p ˂ 0,01) con la solicitud de ayuda y el aprovechamiento de las explicaciones de los compañeros. Conclusiones: la percepción de la autorregulación del aprendizaje por la población objeto de estudio mostró dificultades en rasgos significativos de dicha conducta, lo que limita la disposición para el aprendizaje autónomo.

Background: self-regulation of learning is an important parameter for making teaching-methodological decisions, promoting self-management of knowledge. Objective: to analyze the appreciation of their self-regulation of learning, by first-year Medicine students of the 2021-2022 academic year, at the "Salvador Allende" Faculty of Medical Sciences. Methods: an exploratory, descriptive, cross-sectional and non-experimental investigation was carried out, with a mixed approach. Theoretical methods were used: analysis-synthesis, inductive-deductive and systemic approach; Empirical ones: the measurement instrument used consisted of a questionnaire made from an adaptation of the Self-regulation of Learning Scale, with the dimensions: attitude towards study, strategic approach to learning and metacognitive regulation; and mathematical-statisticalfor data processing. Results: it was determined that the self-regulation of learning was unsatisfactory, as there were deficiencies in two of its dimensions: strategic focus on learning and metacognitive regulation. The Attitude dimension towards the study obtained a satisfactory assessment, it was observed that the item corresponding to dedication to work with oriented tasks, had a weak direct relationship with personal interest, qualifications obtained and personal recognition. Of all the items considered in the survey, there was only a weak and indirect relationship between sex (p ˂ 0.01) with the request for help and taking advantage of the explanations of the classmates. Conclusions: the perception of self-regulation of learning by the study population showed difficulties in meaningful features of such behavior, which limits the willingness for autonomous learning.

Estrategia curricular de Medicina Natural y Tradicional desde la disciplina inglés en la educación médica / Curricular strategy of Herbal and folk Medicine from the English discipline in medical education

La formación de profesionales demanda que el proceso enseñanza aprendizaje tenga una visión integradora para alcanzar los objetivos generales con los niveles de profundidad y dominio requeridos. A partir de ello, es que se introduce una novedosa forma de abordar la interdisciplinariedad, aplicando estrategias curriculares. La aplicación de la Medicina Natural y Tradicional en la formación de los médicos generales no ha sido sistemática ni de forma coordinada por el colectivo de profesores de inglés en la Universidad de Ciencias Médicas de Villa Clara. Es objetivo de los autores describir una tesis de maestría que contiene: metodología y acciones para implementarla desde la disciplina y asignaturas de inglés, un curso de posgrado para profesores de este idioma y ofertas de bibliografías actualizadas impresas y digitales como materiales de consulta para el estudio independiente, cuyos contenidos se aplican de forma satisfactoria para solucionar las carencias mencionadas.

The training of professionals demands that the teaching-learning process have an integrating vision to achieve the general objectives with the required levels of depth and mastery. From this, a new way of approaching interdisciplinarity is introduced, applying curricular strategies. The application of herbal and folk Medicine in the training of general practitioners has not been systematic or coordinated by the group of English teachers at the Villa Clara University of Medical Sciences. The authors' objective is to describe a master's thesis that contains: methodology and actions to implement it from the discipline and subjects of English, a postgraduate course for teachers of this language and offers of updated printed and electronic bibliographies as reference materials for the independent study whose contents are satisfactorily applied to solve the aforementioned deficiencies.

Ensino da anatomia: dissecção em associação com a tecnologia no curso de Medicina / Teaching anatomy: dissection in association with technology in the Medical course

Resumo: Introdução: Um estudo de 2010 apontou as necessidades futuras da educação médica, com conteúdos e práticas integrados, fomentada pela tecnologia educacional virtual e pela prioridade na competência, não no tempo. A anatomia, indistinta de outros fundamentos da medicina, enfrenta restrições à dissecção de cadáveres. Objetivo: Ensaio sobre o ensino da anatomia em contextos clínicos e com emprego de tecnologias. Método: Utilizaram-se a plataforma PubMed da National Library of Medicine e os descritores ((anatomy [MeSH Terms]) AND (method, teaching [MeSH Terms])) AND (surgery [MeSH Terms]). Resultado: Há indicação de 316 artigos no período 2000-2022 (junho de 2022). A principal pergunta sobre o ensino de anatomia refere-se à substituição da técnica de dissecção e, por consequência, do uso do cadáver. Estudos sugerem a manutenção do uso da dissecção, da prossecção e de maior uso de meios digitais e modelares. Conclusão: O material cadavérico deve ser garantido com maior uso da prossecção, com a dissecção sendo dirigida ou eletiva. Realidade virtual e material de prossecção devem ser assimilados como instrumentais e supervisionados por anatomistas qualificados e enriquecidos pela interpretação e aplicabilidade clínica.

Abstract: Introduction: A 2010 study pointed out the future needs of medical education, with integrated contents and practices, fostered by virtual educational technology and by prioritizing competence, not time. Anatomy, indistinguishable from other fundamentals of medicine, faces restrictions on cadaver dissection. Objective: Essay on the teaching of anatomy in clinical contexts and the use of technologies Method: The "pubmed" platform of the National Library of Medicine and descriptors ((anatomy[MeSH Terms]) AND (method, teaching[MeSH Terms])) AND (surgery[MeSH Terms]) were used. Result: There are indications of 316 articles in the period 2000-2022 (June 2022). The main question about the teaching of Anatomy is the replacement of the dissection technique and, consequently, the use of the cadaver. Studies suggest maintaining the use of dissection, prosection and greater use of digital and model means. Conclusion: Cadaveric material should be secured with greater use of prosection and dissection being directed or elective. Virtual reality and permanent material must be assimilated as instrumental and supervised by qualified anatomists and enriched by interpretation and clinical applicability.

Semblance of a physician: medical students' experiences during Type 2 Diabetes Mellitus clinic simulation / Com o semblante de médico: experiências de estudantes de medicina durante a simulação clínica em Diabetes tipo 2 / Con el semblante de médico: experiencias de estudiantes de medicina durante la simulación clínica en Diabetes tipo 2

This qualitative research aimed to understand the experiences of a fourth-year medical class during two clinical simulation scenarios of type 2 diabetes management in Primary Care. Ten simulated students were interviewed. The results describe the symbolic conception of diabetes and its treatment as anguish, damage, condemnation and an unpleasant sentence that affects the appropriation and performance of the medical role by students. Considering Medical Psychology, we suggest that such subjective factors should be addressed in teaching-learning in addition to commonly cognitive aspects mentioned in the medical education literature in order for students to develop the work profile to cope with diabetes in Primary Care. Clinical simulation facilitates the subjective approach through its group support component to promote reflection, insights and self-awareness.(AU)

Esta pesquisa qualitativa objetivou compreender as experiências de estudantes de um quarto ano médico durante dois cenários de simulação clínica do manejo do diabetes tipo 2 na Atenção Primária. Dez estudantes simulados foram entrevistados. Os resultados descrevem a concepção simbólica do diabetes e seu tratamento como angústia, dano, condenação e uma sentença desagradável que afeta a apropriação e o desempenho do papel médico pelos estudantes. Considerando a Psicologia Médica, sugerimos que os fatores subjetivos apontados devem ser abordados no ensino-aprendizado além de aspectos cognitivos mais comuns na literatura de educação médica para que os estudantes desenvolvam o perfil de trabalho ao enfrentamento do diabetes na Atenção Primária. A simulação clínica permite esta abordagem subjetiva por seu componente de suporte grupal promovendo reflexão, insights e autoconsciência.(AU)

Esta encuesta cualitativa tuvo el objetivo de comprender las experiencias de estudiantes del cuarto año de medicina durante dos escenarios de simulación clínica del manejo de la diabetes tipo 2 en la Atención Primaria. Fueron entrevistados 10 estudiantes simulados. Los resultados describen la concepción simbólica de la diabetes y su tratamiento, tales como angustia, daño, condenación y una sentencia desagradable que afecta la apropiación y el desempeño del papel médico por parte de los estudiantes. Considerando la Psicología Médica, sugerimos que los factores subjetivos señalados deben abordarse en la enseñanza-aprendizaje, más allá de aspectos cognitivos más comunes en la literatura de educación médica para que los estudiantes desarrollen el perfil de trabajo para el enfrentamiento de la diabetes en la Atención Primaria. La simulación clínica permite este abordaje subjetivo por su componente de soporte grupal promoviendo reflexión, insights y autoconciencia.(AU)

Experiencias investigativas basadas en cursos, análisis de sus fundamentos y resultados en la Educación Médica

Introducción: las experiencias investigativas durante el pregrado son diversas y tienen como objetivo la formación de competencias en ese mismo ámbito de investigación. Objetivo: recopilar la información relacionada a las experiencias investigativas basadas en cursos (EIBC) que se han implementado en el contexto de la educación médica. Métodos: se realizó una revisión de la literatura narrativa donde se indagaron las bases de datos ERIC, SciELO, Redalyc, Scopus y PubMed a través de los términos: "ciencia", "basados en cursos", "investigación", "en el aula", "experiencia(s)", "pasantía(s)", "pregrado", "licenciatura", "formación". De las 780 fuentes iniciales, se analizaron 35. La información fue descrita según las categorías de: resultados de las mediciones, fundamentos teóricos, beneficios de la experiencia, limitaciones/ desventajas. Resultados: las EIBC se consideran como experiencias positivas y atractivas para los estudiantes, pues permiten exponerlos al proceso investigativo, desarrollar habilidades y oportunidades para futuros proyectos de investigación, permitir establecer redes y trabajo en equipo, brindar la oportunidad para trabajar en equipos de investigación y laboratorios de experimentación, y comprometer a los estudiantes y docentes a difundir los hallazgos a través de publicaciones científicas. Sus fundamentos se encuentran en el aprendizaje situado, las comunidades de práctica, el aprendizaje basado en problemas y el aprendizaje constructivista. El objetivo en común es el de involucrar a los estudiantes de pregrado en la investigación científica y que logren formar sus competencias a través del mismo acto investigativo. Conclusión: las EIBC permiten mejorar el aprendizaje estudiantil, la formación de competencias investigativas, otorgan ganancias en su identidad científica, autoconfianza, y persistencia en su carrera de estudios.

Summary Background: Investigative experiences during undergraduate education are diverse and their objective is the formation of investigative competences. Objective: to compile information related to coursebased research experiences (CBRE) that have been implemented in the context of undergraduate medical education. Methods: A review of the narrative literature was carried out where the ERIC, SciELO, Redalyc, Scopus and PubMed databases were investigated through the terms: "science", "course-based", "research", "in the classroom", "experience(s)", "internship(s)", "undergraduate", "bachelor", "training". Of the 780 sources initially searched, 35 references were analyzed. The information was analyzed according to the categories of: measurement results, theoretical foundations, benefits of the experience, limitations / disadvantages. Results: The CBRE are considered positive and attractive experiences for students, as they allow the student to be exposed to the research process, developing skills and opportunities for future research projects, allows networking and teamwork to be established, provides the opportunity to work in research teams and research laboratories, experimentation, and commits students and teachers to disseminate the findings through scientific publications. Its foundations are in situated learning, communities of practice, problembased learning and constructivist learning. The common objective is to involve undergraduate students in scientific research and that they manage to form their competencies through same investigative act. Conclusion: CBRE allow improving student learning, the formation of investigative competences, and gains in their scientific identity, self-confidence, and persistence in their study career.

Seminarios autogestionados de psiquiatría como modelo de participación estudiantil activa en pregrado. Experiencia 2014-2021 en la Pontificia Universidad Católica de Chile / Self-managed psychiatry seminars as a model of active student participation in undergraduate education

In the last decade, medical students stood out as active agents in their training, which implies their involvement in the design, implementation, evaluation, and curricular co-governance. This article describes a model of active undergraduate student participation from 2014 to 2021 and compares the face-to-face and synchronous online modalities, later brought forward by the SARS-COV-2 pandemic. Annually, a call was made to UC School of Medicine undergraduate students to establish the topics and areas to be addressed during self-managed seminars. Then, medical students located in Chile were invited to attend the activity. Psychiatry was established as a priority topic in six out of eight years. Five seminars were conducted, the last two in synchronous online mode. The number of people enrolled in the online modality increased by 251% compared to the face-to-face modality (face-to-face mean = 133 ± 33 SD; online mean = 336 ± 24SD), with no significant differences in rates of attendance between modalities (Odds ratio (OR) = 1,12; 95% CI= 0,82 - 1,55; p = 0,45). The online modality was associated with a higher proportion of enrollees belonging to an institution outside the Metropolitan Region (OR 12,63; 95% CI = 8,64 - 18,46; p < 0,01). The self-managed psychiatry seminars correspond to a model of active undergraduate student participation, with the synchronous online modality representing an opportunity to massify it throughout the national territory.

Common mental disorders among medical students: systematic review and meta-analysis of Brazilian studies

ABSTRACT BACKGROUND: Common mental disorders (CMDs) have been correlated with consequences in different domains of life. OBJECTIVE: To summarize the prevalence rates of CMDs and factors associated with them among students at Brazilian medical schools. DESIGN AND SETTING: Systematic review and meta-analysis of studies developed in Brazilian medical schools. METHODS: In October 2021, searches were carried out in seven electronic databases, in Google Scholar and in reference lists. Observational studies reporting prevalence rates of CMDs among students at Brazilian medical schools were sought. Variables associated with CMDs arising from multivariate regression models were included in the synthesis. A meta-analysis was developed using a random-effects model and the risk of bias was assessed using an instrument developed from previous references. RESULTS: Fourteen original studies were included. The pooled prevalence rate of CMDs among undergraduate students at Brazilian medical schools was 43.3% (95% confidence interval = 38.9% to 47.6%; I2 = 87%; n = 3,927). Among the nine studies in which multivariate analyses were conducted, five showed risk associations between CMDs and medical school-related dissatisfactions, among which the desire to abandon the medical course can be highlighted (n = 3). In three studies, CMDs were associated with sleep indicators. CONCLUSION: Considering that the prevalence of CMDs among medical students is higher than in the general population, we recommend that Brazilian medical schools should give greater attention to this topic, and should enable expansion of care offerings relating to mental health. SYSTEMATIC REVIEW REGISTRATION: Prospective Register of Systematic Reviews (PROSPERO) database (CRD42020142184).

Implementación de la reforma curricular de la Escuela de Medicina de la Pontificia Universidad Católica de Chile: analizando la experiencia / Implementation of curricular changes at a medical school

The accelerated scientific, technological, and social advances in recent years have posed new challenges for professional training institutions, where universities play a leading role. Medical schools have not been oblivious to this process. This is how Pontificia Universidad Católica de Chile implemented in 2015 a curricular reform derived from the joint work of academics, students and graduates. For this purpose, a model consisting of stages was followed, including the identification of the problem, general assessment of needs, definition of purpose and learning objectives. We worked with surveys, focus groups and committees of academics and students to identify and map content within the mesh, review terminal learning objectives while creating and reviewing courses for the vertically and horizontally integrated delivery of content and competencies. The first cohort of the new curriculum entered in 2015, consisting of 126 students. The implementation required constant follow-up and monitoring, establishing changes and adjustments according to educational needs and unforeseen conditions such as the COVID-19 pandemic. The implementation process of the new curriculum has been positive, adjusting to the defined strategic planning and responding to unexpected events.

Application of telesimulation in a medical undergraduate course during the SARS-CoV-2 pandemic: a quantitative and retrospective study

ABSTRACT BACKGROUND: Because of the social isolation and distancing measures that were imposed to stop the spread of coronavirus disease 19 (COVID-19), new ways of teaching were implemented. OBJECTIVES: To describe the implementation of telesimulation and seek to assess students' perceptions regarding telesimulation. DESIGN AND SETTING: Retrospective quantitative study conducted within the hospital simulation at a private medical school in São Paulo, Brazil. METHODS: After telesimulation training, students answered a questionnaire that provided an overall assessment of this activity, self-assessment and assessments of the facilitators and infrastructure provided by the University. RESULTS: Among the students, 50% reported that the activity was below expectations and 45% reported that it was in line with their expectations. The strong points of the activity were the clinical cases, workload and teachers. The main challenge was students' difficulty in reflecting on their learning and the infrastructure. CONCLUSIONS: Since students have less experience and fewer clinical encounters than residents or professionals, they also face more difficulty. Although telesimulation may have provided a valid alternative to replace simulation training during the COVID-19 pandemic, more face-to-face activities should be offered to students, when possible.

Medical education: the historical framing of the medical curriculum and the challenges of renewal in the 21st century / Educação médica: a construção histórica do currículo médico e os desafios de renovação no século XXI

The study proposes a critical and exploratory analysis of the historical formation of the medical curriculum, including the pedagogical models and contemporary challenges. Contemporary Medicine has faced challenging transformations in the 21st century, such as population aging, technological and scientific advances, epidemiological transition, wide access to informationby society. The knowledge society requires new generations of physicians to develop interdisciplinary professional skills and the technical-scientific domain. Given the ongoing transformations in contemporary medical practice, it is up to the academic community to deconstruct obsolete teaching paradigms, to foster the design of new pedagogical practices, congruent with the new medical profile desired in the 21st century.

O estudo propõe uma reflexão crítica e exploratória acerca da construção histórica do currículo médico, seus modelos pedagógicos e desafios contemporâneos. A Medicina contemporânea tem enfrentado transformações desafiadoras no século 21, como envelhecimento populacional, avanços tecnológicos e científicos, transição epidemiológica, facilidade de acesso e informação pela sociedade. A sociedade do conhecimento impõe às novas gerações de médicos o desenvolvimento de competências profissionais interdisciplinares, além do domínio técnico-científico. Diante das transformações em curso na prática médica contemporânea, cabe a comunidade acadêmica a desconstrução de paradigmas de ensino obsoletos, de maneira a propiciar a concepção de novas práticas pedagógicas, congruentes com novo perfil médico almejado no século XXI.

Application and prospect of the MOOC of Nuclear Medicine resource in teaching for undergraduates / 中华核医学与分子影像杂志

Massive open online course (MOOC), as an online teaching mode, has attracted widespread attention in the education field. It realizes the integration of online teaching and learning in medical education and brings profound changes in concepts and methods of medical education. It has proposed a new development direction for modern medical education. The first Nuclear Medicine online MOOC resource is not only a supplement to direct face-to-face courses in a special period, but also a strong support for the realization of online and offline hybrid teaching, thereby promoting the " student-centered" undergraduates′ autonomous learning ability. The students can achieve the goal of the development of learning ability. Based on the results of applying the Nuclear Medicine MOOC to the teaching of undergraduates in multiple schools, this article further explains the obvious advantages of MOOC as an online teaching resource library for students′ knowledge internalization. The foundation of the new teaching method ensures the effective implementation of the above teaching methods and provides ideas for further deepening the reform of undergraduate medical education.

La enseñanza de la genética médica y los problemas de la profesión / The teaching of medical genetics and the problems of the profession

La dirección del aprendizaje en la formación inicial del profesional de la medicina se orienta a la asimilación de contenidos, que integrados a través de la actividad práctica, se manifiestan en el modo de actuación de un médico general. La formación basada en problemas es hoy un imperativo. Si se desea que el futuro médico se prepare para el objeto de su actividad profesional, es necesario que a lo largo del proceso formativo inicial resuelva los problemas de esta naturaleza, lo cual implica que su formación debe estar basada en problemas, modelados desde el macrodiseño curricular y concretado durante la ejecución del proceso enseñanza aprendizaje, de manera que pueda transferir todo lo aprendido a nuevas situaciones. El presente artículo persigue como objetivo: argumentar sobre la importancia de los problemas de la profesión para la enseñanza de la genética médica.

The direction of learning in the initial training of the medical professional is oriented towards the assimilation of content, which, integrated through practical activity, manifests itself in the mode of action of a general practitioner. Problem-based training is today an imperative. If you want the future doctor to prepare for the object of his professional activity, it is necessary that throughout the initial training process he solves problems of this nature, which implies that his training must be based on problems, modeled from the macro design curricular and concretized during the execution of the teaching-learning process, so that everything learned can be transferred to new situations. The objective of this article is to argue about the importance of the problems of the profession for the teaching of medical genetics.

Niveles de formación del proyecto de vida profesional en estudiantes de la carrera de Medicina / Training levels of the professional life project in Medicine students

RESUMEN Fundamento: proponer los niveles de formación del proyecto de vida profesional para atender la diversidad estudiantil contribuye a la organización y la calidad del proceso pedagógico en la carrera Medicina. Objetivo: evaluar los niveles de formación del proyecto de vida profesional en estudiantes de la carrera Medicina. Métodos: se realizó una investigación descriptiva en la Universidad de Ciencias Médicas de Holguín, Facultad de Ciencias Médicas "Mariana Grajales Coello", desde el año 2020 hasta el 2021. Se utilizaron como métodos teóricos: análisis-síntesis, la inducción-deducción y la modelación; empírico: el instrumento Exploración del proyecto de vida profesional. La investigación se llevó a efecto en tres etapas y se utilizó el enfoque mixto para obtener evidencias de su viabilidad. La validación de los niveles y del instrumento aplicado ocurrió mediante el criterio de expertos. Resultados: se definieron los niveles de formación del proyecto de vida profesional para estudiantes de la carrera Medicina. El criterio de expertos permitió identificar una prevalencia de los indicadores evaluados como muy adecuados y bastante adecuados. El diagnóstico realizado en un grupo mostró dificultades en relación con el contenido y la estructura. Conclusiones: existen insuficiencias en el tratamiento del proyecto de vida profesional durante la formación inicial. La validación de los niveles fue aceptada por los expertos.

ABSTRACT Background: proposing the training levels of the professional life project to address student diversity contributes to the organization and quality of the pedagogical process in the Medicine degree. Objective: to evaluate the training levels of the professional life project in Medicine students. Methods: a descriptive research was carried out Holguín University of Medical Sciences in the Faculty of Medical Sciences "Mariana Grajales Coello", from 2020 to 2021. The following theoretical methods were used: analysis-synthesis, induction-deduction and modeling; empirical ones: the instrument Exploration of the professional life project. The research was carried out in three stages and the mixed approach was used to obtain evidence of its viability. The validation of the levels and the applied instrument occurred through the criteria of experts. Results: the training levels of the professional life project for Medicine students were defined. The expert criteria allowed us to identify a prevalence of the indicators evaluated as very adequate and quite adequate. The diagnosis made in a group showed difficulties in relation to content and structure. Conclusions: there are insufficiencies in the treatment of the professional life project during initial training. The validation of the levels was accepted by the experts.

Los métodos problémicos en la formación del estudiante de Medicina: ¿alternativa o necesidad? / The problematic methods in the training of the Medicine student. Alternative or necessity?

RESUMEN Introducción: la enseñanza problémica es considerada por muchos pedagogos como la forma de proceder más eficiente que puede adoptar el profesor durante el proceso enseñanza aprendizaje. Es uno de los modelos de aprendizaje que desarrolla el pensamiento creativo del estudiante. Objetivo: analizar el valor metodológico del método problémico en la formación del estudiante de Medicina, como necesidad y no como alternativa en el proceso de enseñanza aprendizaje. Métodos: se realizó una revisión bibliográfica sistemática para desarrollar un análisis del contenido de documentos: tesis de doctorado, maestrías, artículos originales y de revisión publicados entre 2007 y 2022 en español. Se consultaron 25 artículos y seleccionaron 20. La búsqueda fue realizada en las bases de datos SciELO y Google Académico de diciembre a febrero de 2022. Tras la identificación de los estudios preseleccionados, se llevó a cabo la lectura de los títulos, resúmenes y palabras clave para comprobar su pertinencia con el estudio. Desarrollo: asumir los métodos problémicos en la enseñanza de la Medicina significa apropiarse de métodos productivos y activos; constituye una vía para resolver los problemas profesionales y favorece el proceso de desarrollo autónomo y creador del estudiante. Conclusiones: en la formación del estudiante de Medicina los métodos problémicos constituyen una necesidad, una vía efectiva para lograr el desarrollo del pensamiento lógico; permiten acercarlo a la investigación científica.

ABSTRACT Introduction: problem teaching is considered by many pedagogues as the most efficient way of proceeding that the teacher can adopt during the teaching-learning process. It is one of the learning models that develops the student's creative thinking. Objective: to analyze the methodological value of the problematic method in the formation of the Medicine student, as a necessity and not as an alternative in the teaching-learning process. Methods: A systematic bibliographic review was carried out to develop an analysis of the content of documents: doctoral theses, master's degrees, original and review articles published between 2007 and 2022 in Spanish. 25 articles were consulted and 20 were selected. The search was carried out in the SciELO and Google Scholar databases from December to February 2022. After identifying the pre-selected studies, the titles, abstracts and keywords were read. To check its relevance to the study. Development: assuming the problematic methods in the teaching of Medicine means appropriating productive and active methods, it constitutes a way to solve professional problems. It favors the process of autonomous and creative development of the student. Conclusions: in the formation of the medical student, the problem methods constitute a necessity, an effective way to achieve the development of logical thinking, they allow him to approach scientific research.

Caracterización de habilidades comunicativas en estudiantes de Medicina / Characterization of communicative skills in medical students

RESUMEN Fundamento: la comunicación médica efectiva durante la promoción y prevención en salud constituye un reto profesional que enfrenta la educación médica superior en Cuba. Objetivo: caracterizar el desarrollo de habilidades comunicativas en estudiantes de Medicina de la Filial de Ciencias Médicas del municipio Palma Soriano, provincia Santiago de Cuba. Métodos: se realizó una investigación descriptiva, durante el curso 2018-2019. Se emplearon métodos teóricos: análisis-síntesis e inductivo-deductivo, y empíricos: observación, entrevista a profundidad para profesores y estudiantes y grupo focal; se realizó la triangulación de fuentes y metodológica y todo se sustentó en el enfoque dialéctico- materialista. Resultados: se identificaron dificultades en el desempeño comunicativo de los estudiantes, se aprecia que poseen dominio teórico sobre las habilidades comunicativas, pero las relegan a un segundo plano respecto a las habilidades clínicas y técnicas. Se considera que los profesores están insatisfechos con la preparación que muestran los estudiantes en su desempeño comunicativo comunitario y reconocen que es insuficiente el tratamiento didáctico en favor de las habilidades comunicativas. También se constató que en opinión de los estudiantes las habilidades comunicativas serán adquiridas y desarrolladas durante la práctica médica cotidiana del posgrado, y no realizaban un esfuerzo activo y consciente para su perfeccionamiento. Conclusiones: se caracterizaron las habilidades comunicativas de los estudiantes, insuficientes aún para la comunicación efectiva en la relación médico-comunidad; existe un insuficiente tratamiento didáctico y teórico-práctico de estas habilidades.

ABSTRACT Background: effective medical communication during health promotion and prevention is a professional challenge faced by higher medical education in Cuba. Objective: to characterize the development of communication skills in Medicine students of the Medical Sciences Branch of Palma Soriano municipality, Santiago de Cuba province. Methods: a descriptive research was carried out during the 2018-2019 academic year. Theoretical methods were used: analysis-synthesis and inductive-deductive, and empirical ones: observation, in-depth interviews with teachers and students, and focal group; the comparison of sources and methodology was carried out and everything was based on the dialectical-materialist approach. Results: difficulties were identified in the communicative performance of the students, it is appreciated that they have theoretical mastery over communicative skills, but relegate them to the background with respect to clinical and technical skills. It is considered that the professors are dissatisfied with the preparation that the students show in their community communicative performance and recognize that the didactic treatment in favor of communicative skills is insufficient. It was also found that, in the opinion of the students, communication skills will be acquired and developed during the daily postgraduate medical practice, and they did not make an active and conscious effort to improve them. Conclusions: the communication skills of the students were characterized, still insufficient for effective communication in the doctor-community relationship; there is insufficient didactic and theoretical-practical treatment of these skills.

Teste de Progresso para estudantes de Medicina: experiência de um consórcio na Região Nordeste do Brasil / Progress Test for medical students: experience of a consortium in Northeastern Brazil

Resumo: Introdução: A colaboração entre escolas médicas para a realização do Teste de Progresso (TP) vem sendo ampliada com o propósito de tornar-se um modelo de prática educacional. Relato de experiência: O núcleo de escolas médicas CIN1 foi instituído no ano de 2013, tendo na sua organização um coordenador-geral e coordenadores de cada escola participante. Realiza dois testes ao ano, variando o número de escolas participantes. O teste possui 120 questões distribuídas nas seis áreas (ciências básicas aplicada, saúde coletiva, pediatria, clínica médica, cirurgia/urgência e emergência, e ginecologia e obstetrícia) e tem seu blueprint baseado em matriz previamente validada. O teste é aplicado a todos os estudantes das escolas participantes, no mesmo dia e com duração de quatro horas. Aconteceu on-line em 2020 e 2021, por causa da pandemia da Covid-19. A pontuação total do estudante é calculada pelo número de questões corretas, sem a opção "não sei", nem penalidades para incorretas. A análise é realizada por meio da teoria clássica do item. Os estudantes recebem a análise do desempenho comparativamente com a média obtida pelos discentes no mesmo ano e a progressão em relação ao teste anterior. As escolas recebem o desempenho dos respectivos estudantes, a análise da dificuldade e discriminação geral dos itens, e uma avaliação global do teste. Discussão: A implantação do CIN1 representou um grande avanço para as escolas envolvidas. A colaboração não se deu apenas sobre o teste, mas também para o desenvolvimento docente de forma conjunta. Impedimentos de regimento interno e custos podem justificar a variação na participação das escolas. Conclusão: A organização de um núcleo de escolas para o TP traz benefícios e muitos desafios. O aperfeiçoamento dos critérios de análises e feedback e a inclusão de estudantes na avaliação de questões são etapas a serem discutidas e implantadas. A utilização do ambiente virtual, de mais baixo custo, pode ser um facilitador para ampliar a participação das escolas.

Abstract: Introduction: Collaboration between medical schools to hold the PT has expanded, constituting a model of educational practice. Experience report: The CIN 1 group of medical schools was established in 2013, organized with a general coordinator and coordinators from each participating school. It holds two tests a year, with a varying number of participant schools. The test has 120 questions distributed in 6 areas (Applied Basic Sciences, Public Health, Pediatrics, Internal Medicine, Surgery/Urgent and Emergency, Gynecology and Obstetrics) and its blueprint is based on a previously validated Matrix. The 4-hour test is applied to all students from participating schools, on the same day and at the same time. It was administered online in 2020 and 2021 due to the COVID-19 pandemic. The student's total score is calculated by the number of correct questions, excluding the "don't know" option, or penalties for incorrect ones, and is analyzed by classical item theory. Students receive performance analysis compared to the average attained by students in the same year, and the progression in relation to the previous test. The schools receive the performance of the respective students and analysis of the difficulty and general breakdown of the items and an overall evaluation of the test. Discussion: The implementation of CIN 1 represented a great advance for the schools involved. The collaboration was not only about the test, but also for the teacher development in a joint way. Bylaw impediments and costs may justify the variation in school participation. Conclusion: The organization of a group of schools for the TP brings benefits and many challenges. Improving analysis and feedback criteria and including students in the assessment of questions are steps to be discussed and implemented. The use of the lower cost virtual environment may facilitate increased participation of schools.