Atributos para caracterizar la satisfacción de estudiantes de enfermería en escenarios clínicos / Attributes for Characterizing Nursing Students' Satisfaction in Clinical Settings

Introducción: La evaluación de satisfacción de estudiantes de enfermería en entornos de aprendizaje clínico está mediada por atributos contextuales del clima de aprendizaje y acción tutorial. Objetivo: Explorar, desde la perspectiva cualitativa, atributos que identifican estudiantes de enfermería para caracterizar la satisfacción en escenarios clínicos. Métodos: Estudio de diseño descriptivo exploratorio. Las unidades de análisis fueron estudiantes de enfermería de dos unidades académicas de universidades chilenas, durante el período lectivo; marzo-noviembre del 2019. Se optó por un muestreo homogéneo. Se incluyeron al estudio alumnos regulares de enfermería, de tercero y cuarto año, que hayan tenido al menos un mes de prácticas clínicas ininterrumpidas y se excluyen, estudiantes de primer, segundo año e internos de enfermería. Para trabajo de campo se inició con vagabundeo y creación de mapas sociales y temporales y como técnica de recogida de información se usó grupo focal, cautelando saturación muestral y suficiencia del dato. Se cumplieron requisitos y principios éticos de investigación en seres humanos. Resultados: los estudiantes distinguen que los atributos para medir su satisfacción en espacios de enseñanza práctica están influenciados o afectados por condiciones del entorno clínico asistencial, profesionalismo del tutor que en su conjunto matizan su satisfacción y por ende el clima de aprendizaje. Conclusiones: Desde la categoría central del constructo de estudio se pudo verificar en los discursos las subcategorías y atributos para medir la satisfacción de los alumnos en los escenarios de prácticas clínicas(AU)

Introduction: Assessment of Nursing students' satisfaction in clinical learning environments is mediated by contextual attributes of the learning climate and tutorial action. Objective: To explore, from a qualitative perspective, attributes identified by Nursing students for characterizing satisfaction in clinical settings. Methods: Study with an exploratory descriptive design. The units of analysis were Nursing students from two academic units of Chilean universities, during school period: March-November 2019. Homogeneous sampling was chosen. Regular third- and fourth-year Nursing students who had had at least one month of uninterrupted clinical practice were included in the study, while first- and second-year students and Nursing interns were excluded. Fieldwork began with wandering and the creation of social and temporal maps, while focus group was used as a data collection technique, ensuring sample saturation and data sufficiency. Requirements and ethical principles for research in humans were met. Results: The students distinguish that the attributes for measuring their satisfaction in practical teaching settings are influenced or affected by conditions of the clinical care environment, as well as by tutor professionalism, which, as a whole, qualify their satisfaction and, therefore, the learning climate. Conclusions: From the central category of the study construct, it was possible to verify, within the discourses, the subcategories and attributes for measuring the students' satisfaction in the clinical practice settings(AU)

Fracturas Mandibulares Conminutadas por Impacto de Proyectil Balístico: Resultados Clínicos de Tratamiento Con Método de Fijación Alternativo

RESUMEN: Las fracturas mandibulares conminutadas por impacto de proyectil balístico son un desafío terapéutico debido a la presencia de múltiples fragmentos óseos y el compromiso a nivel de periostio, plano muscular y mucoso. Su tratamiento inicial requiere de una estabilización de las urgencias médico - quirúrgicas y posteriormente tratar los segmentos óseos fracturados. La fijación externa con tutores mandibulares permite estabilizar los segmentos mandibulares de forma cerrada manteniendo así la viabilidad de los fragmentos sin interrumpir su suministro de sangre. El objetivo de este trabajo es presentar los resultados post operatorios obtenidos en tres casos clínicos de pacientes con diagnóstico de fractura mandibular conminutada por trauma por impacto de proyectil balístico, tratados por un método alternativo a los tutores de fijación externa convencional.

ABSTRACT: Comminuted mandibular fractures from ballistic missile impact are a therapeutic challenge due to the presence of multiple bone fragments and the involvement of periosteum, muscle and mucous membrane. Their initial treatment requires emergency medical and surgical stabilization and later treatment of the fractured bone segments. External fixation with mandibular stakes makes it possible to stabilize the mandibular segments in a closed manner, thus maintaining the viability of the fragments without interrupting their blood supply. The aim of this work is to present the post-surgical results obtained in three clinical cases of patients with diagnosis of comminuted mandibularfracture by ballistic missile impact, treated by an alternative method to the conventional external fixation tutors.

Evaluación de competencias del proceso formativo de los residentes utilizando el portafolio: una revisión de la literatura / Assessment of competencies of the residents' training process using the portfolio: a literature review

In the dynamic process of curricular changes and improvements in the different specialties, knowledge, skills, attitudes and values have been taken into account; that is why new forms of study, supervision and evaluation of doctors in training have to be integrated. Recent experiences in our country try to introduce professional portfolios as assessment- learning tools in specialized postgraduate training. The portfolio is an instrument for evaluating the residents' training process that allows not only evaluating competencies, but fundamentally identifying what we should improve, allowing us to monitor the training media as they advance in the acquisition and development of competencies so that become a tool focused on helping us learn and at the same time provide elements to value the participation of tutors and their influence on learners. In the process of planning, designing and reviewing the portfolios, the training centers find an excellent opportunity to make a self-assessment of the consistency of their curricular structure, the clarity of the competences they seek to form and the evidence they may require in the training of its residents.

Os proprietários de cães podem compartilhar do mesmo perfil de resistência que seus cães? / Can dog owners share the same resistance profile that their dogs? / ¿pueden los propietarios de perros compartir el mismo perfil de resistencia que sus perros?

Atualmente, o uso indiscriminado de antimicrobianos tem contribuído para o aparecimento de microrganismos resistentes, pois, os mesmos ao entrarem em contato com o princípio ativo dessas drogas de forma indevida, desenvolvem características fisiológicas e genéticas tais como a mutação de seu DNA, podendo passar esses genes de resistência à sua descendência por meio de replicação ou por conjugação de plasmídeos, fazendo com que se reduzam as opções de tratamentos efetivos para as infecções bacterianas, aumentando assim as complicações clínicas de pacientes, sejam eles o homem ou os animais de companhia e/ou produção. Recentemente o nosso grupo de pesquisa realizou um estudo com proprietários de cães do curso de Medicina Veterinária e resultados prévios demonstraram alto perfil de resistência aos antimicrobianos da classe das penicilinas, sendo a amoxicilina o antimicrobiano que apresentou menor eficácia, dentre os antimicrobianos testados para aquela classe. Um dos principais fatores relacionados ao aparecimento de resistência está relacionado ao seu uso excessivo e segundo avaliação prévia dos questionários dos tutores verificou-se um predomínio do uso desse antimicrobiano, tanto pelos tutores quanto para tratamento dos animais. Além disso, a falta de informação dos pacientes e o comportamento dos mesmos em relação aos seus animais de companhia levam-os a utilizarem doses insuficientes dos antimicrobianos quando os mesmos suspendem seu uso quando o animal apresenta melhora clínica. Cabe salientar ainda, a existência de resistência intrínseca do micro-organismo à antimicrobianos específicos, demonstrando a necessidade do isolamento e identificação do micro-organismo e realização da antibiograma para escolha mais adequada do antimicrobiano a ser prescrito. Conclui-se que os proprietários de cães podem compartilhar do mesmo perfil de resistência aos antimicrobianos que seus cães, demonstrando a necessidade da orientação dos mesmos para se reduzir o índice de resistência aos antimicrobianos.(AU)

The indiscriminate use of antimicrobials in recent times has contributed to the emergence of resistant microorganisms by improperly coming into contact with the active principle of such drugs and developing physiological and genetic characteristics such as DNA mutation. These resistant genes can be passed along to their offspring by replication or plasmid conjugation, reducing the options of effective treatments for bacterial infections, thus increasing the clinical complications of patients, whether humans or pets and/or livestock. Recently, the authors held a study with dog owners from the Veterinary Medicine course and the initial results showed a high profile of resistance to antimicrobials belonging to the penicillin class, with amoxicillin being the least effective antimicrobial among the ones tested for the class. One of the main factors related to the appearance of resistance is related to its excessive use, and according to previous assessment of the tutors' questionnaires, there was a predominance of the use of this antimicrobial both by the tutors and for the treatment of their animals. In addition, the patients' lack of information and their behavior regarding their pets lead them to use insufficient doses of antimicrobials, since they discontinued its use when the animal presented signs of clinical improvement. It is also important to note the existence of microorganism intrinsic resistance to specific antimicrobials, demonstrating the necessity of isolation and identification of the microorganism, as well as carrying out an antibiogram for the most appropriate choice of antimicrobial to be prescribed. It can be concluded that dog owners can share the same antimicrobial resistance profile as their dogs, demonstrating the need for guidance in order to reduce the antimicrobial resistance index.(AU)

Actualmente, el uso indiscriminado de antimicrobianos ha contribuido a la aparición de microorganismos resistentes, ya que entran en contacto de manera inadecuada con el principio activo de estos fármacos, desarrollan características fisiológicas y genéticas como la mutación de su ADN, pudiendo transmitir esos genes de resistencia a su descendencia por replicación o conjugación de plásmidos, haciendo con que reduzcan las opciones de tratamientos efectivos para las infecciones bacterianas, aumentando así las complicaciones clínicas de los pacientes, sean humanos o mascotas y/o producción. Recientemente, nuestro grupo de investigación realizó un estudio con dueños de perros del curso de Medicina Veterinaria y los resultados anteriores mostraron un alto perfil de resistencia a los antimicrobianos de la clase de las penicilinas, siendo la amoxicilina el antimicrobiano menos efectivo entre los antimicrobianos probados para esa clase. Uno de los principales factores relacionados con la aparición de resistencia está relacionado a su uso excesivo y, según la evaluación previa de los cuestionarios de los tutores se verificó un predominio del uso de ese antimicrobiano, tanto por parte de los tutores como para el tratamiento de los animales. Además, la falta de información de los pacientes y el comportamiento de los mismos con respecto a sus mascotas los llevan a usar dosis insuficientes de antimicrobianos cuando el animal muestra una mejoría clínica. Todavía cabe mencionar la existencia de resistencia intrínseca del microorganismo a antimicrobianos específicos, lo que demuestra la necesidad de aislamiento e identificación del microorganismo y la realización de antibiograma para la elección más adecuada de antimicrobianos a recetar. Se puede concluir que los dueños de perros pueden compartir del mismo perfil de resistencia a los antimicrobianos que sus perros, lo que demuestra la necesidad de su orientación para reducir el índice de resistencia a los antimicrobianos.(AU)

O professor como modelo aos seus estudantes: perspectivas da área da saúde / The teacher as a role model to its students: perspectives from the health area

A formação do estudante nas profissões da saúde envolve a incorporação de habilidades e competências gerais e específicas, adquiridas em experiências práticas sob a supervisão de professores ou preceptores, cujas características podem influenciar os estudantes e os guiar na construção de sua identidade profissional. Nesse contexto, define-se "modelo" (role model) como o profissional que serve de exemplo, por suas qualidades positivas, sendo imitado pelos estudantes, por demonstrar habilidades e características pessoais que os impressionam e inspiram. Modelos positivos exibem expertise profissional, boa comunicação e relacionamento com seus pacientes e com os estudantes, boas habilidades de ensino e, sobretudo, características pessoais como integridade, solidariedade e entusiasmo. Por outro lado, os estudantes são capazes de reconhecer atributos negativos indesejáveis, opostos ás características positivas. Nossos estudos sugerem que a percepção dos estudantes brasileiros sobre os modelos não difere do que é descrito no cenário internacional e que talvez não existam diferenças apreciáveis entre as várias profissões da saúde. Os professores e preceptores considerados pelos estudantes como bons modelos, surpreendentemente, desconhecem que exercem essa influência, mas têm visão semelhante aos dos estudantes sobre os atributos positivos de um bom modelo. Dada a importância dos modelos na formação pessoal e profissional na área da saúde, é imperioso que as escolas tomem medidas para dispor em seu corpo docente de predomínio de modelos positivos e para evitar que seus professores e preceptores emitam comportamentos que expressem qualidades negativas. Estas medidas envolvem atividades de desenvolvimento docente e valorização dos docentes por sua atuação no ensino. No entanto, essas medidas somente farão sentido se as escolas oferecerem aos seus docentes boas condições de trabalho e de remuneração e, sobretudo, tiverem cultura institucional que privilegie relações humanizadas entre os seus membros.

Student education and training in the health professions involve acquisition of general and specific skills and competencies which happens throughout practical experiences under the supervision of teachers or clinical tutors. Supervisor characteristics may influence students and guide them in building their professional identity. In this context, a role model is defined as the professional whose positive qualities are likely to be imitated by the students, as they demonstrated skills and personal characteristics that impress and inspire them. Positive role models exhibit professional expertise, good communication and relationships with patients and students, good teaching skills and, most importantly, personal characteristics such as integrity, compassion and enthusiasm. On the other hand, students seem to be able to recognize undesirable negative attributes as opposed to the positive ones. Our studies suggest that the perception of Brazilian students on models attributes does not differ from what is described in the international literature and that there may not be substantial differences between students from the various health professions on their views. Teachers and preceptors who students consider to be good role models, surprisingly, are unaware that they have such influence, but have similar views as students about the positive attributes of a role model. Given the importance of role models in student personal and professional development, schools must take steps to have positive models prevailing in their faculty and to prevent clinical tutors from expressing behaviours that convey negative qualities. These measures involve teacher training and faculty development activities and appreciation of faculty members for their performance in teaching. However, these measures will only make sense if schools offer their teachers good working conditions and, above all, possess an institutional culture that favours humanized relationships within the academic community.

Evaluación de la educación en el trabajo del pregrado de medicina / Evaluation of undergraduate medical education at workplace

Introducción: La tarjeta de habilidades para la evaluación de la educación en el trabajo, ha permanecido invariable durante los perfeccionamientos de los planes de estudio de la carrera de medicina. Objetivo: Caracterizar el sistema de evaluación para las actividades de educación en el trabajo en las asignaturas de la disciplina principal integradora de la carrera de medicina. Métodos: Se realizó una investigación descriptiva de corte transversal, con enfoque mixto. La muestra estuvo constituida por 57 estudiantes del primer y segundo año de la carrera de Medicina, en el Policlínico Universitario "Dr. Mario Escalona Reguera", durante el curso académico 2016-2017, cinco profesores y 38 tutores. Se aplicaron cuestionarios semiestructurados a los estudiantes, profesores y tutores; y se evaluaron las tarjetas de habilidades portadas por los educandos durante ese período, mediante una guía. Los resultados obtenidos se llevaron a tablas de doble entrada y gráficos para su análisis, a los que se les aplicó el chi cuadrado. Resultados: Predominaron los tutores especialistas sin categoría docente; los categorizados poseían poca experiencia docente y priorizaron en la evaluación los acápites de las guardias médicas, disciplina, y no las habilidades profesionales. Los estudiantes valoraron el sistema de evaluación como bueno, contrario a los tutores quienes consideraron que las tarjetas no especifican las habilidades a alcanzar. Conclusiones: Se identificaron debilidades en el proceso de evaluación de la educación en el trabajo en el área estudiada, dadas por la existencia de escasos tutores categorizados, evaluación centrada en la calificación, poco sistemática y empírica. Se recomienda elaborar una guía para su estandarización(AU)

Introduction: The card for the evaluation of at work' education skills has remained unchanged during the processes of improvement of the curricula of the career of Medicine. Objective: to characterize the evaluation of education at work in the subjects of the main integrating discipline of medicine career. Methods: A descriptive cross-sectional investigation was carried out, with a mixed approach. The sample was constituted by 57 students of the first and second year of the Medicine career in the University Polyclinic "Dr. Mario Escalona Reguera", during the 2016-2017 academic year, five professors and 38 tutors. Semi-structured questionnaires were applied to students, teachers and tutors; and the skill cards carried by the students during that period were evaluated through a guide. The results obtained were taken for their best analysis to double entry tables to which the chi square was applied. Results: Specialist tutors with no teaching category predominated; the categorized ones had little teaching experience and prioritized in the evaluation the sections of the medical guards, discipline, and not the professional skills. The students rated the evaluation system as good, contrary to the tutors who considered that the cards do not specify the skills in education at work. Conclusions: Weaknesses were identified in the evaluation process of education at work in the undergraduate program subjects in the studied area, characterized by the existence of few categorized tutors, assessment focused on qualification, unsystematic and empirical. It is recommended to prepare a guide for its standardization(AU)

Control de la enseñanza tutelar: su caracterización en la Disciplina Medicina General Integral. Facultad de Ciencias Médicas "Manuel Fajardo", 2012-2015 / Control of the tutelary teaching: its characterization in the Integral General Medicine discipline. Faculty of Medical Sciences "Manuel Fajardo", 2012-2015

Introducción: El contexto actual en el que se desarrolla la educación médica superior nos reta a elevar continuamente la preparación pedagógica de nuestros profesores/tutores, quienes afrontan la enseñanza tutelar en sus consultorios médicos de familia donde se incorporan estudiantes a partir del primer año de la carrera de Medicina. Objetivo: Caracterizar el control de la enseñanza tutelar en la disciplina Medicina General Integral durante los cursos 2012-2013, 2013-2014 y 2014-2015 en la Facultad de Ciencias Médicas Comandante Manuel Fajardo. Material y Métodos: Se realizó estudio observacional, descriptivo, cuanticualitativo, retrospectivo de la disciplina Medicina General Integral en tres cursos escolares. El dato primario se obtuvo de información documental aportada por el departamento docente, relacionada con los controles a las actividades docentes de educación en el trabajo. Se calcularon frecuencias absolutas y relativas. Se aplicó Técnica de Ranqueo, Campo de fuerzas y se elaboró el árbol de problemas. Resultados: El curso 2012-2013 se caracterizó por el de menos controles realizados y mayor porciento de cumplimiento con 86,3 por ciento. En la evaluación del control predomina la evaluación de Bien en el curso 2012-2013 y Excelente en 2013-2014 y 2014-2015. En 57,1 por ciento de los controles no existe pirámide docente y donde está, predomina la presencia de estudiantes de dos años académicos. Conclusiones: En el curso 2012- 2013 se realizó menor número de controles con un mayor porcentaje de cumplimiento. Predominó la evaluación Bien en el curso 2012- 2013 y Excelente en los otros cursos, mientras que prevaleció la ausencia de pirámide docente. Se definió como problema central la deficiente preparación pedagógica de profesores/tutores(AU)

Introduction: The current context in which the superior medical education is developed challenges us to continuously raise the pedagogic preparation of our professors/tutors who have to confront the tutelary teaching in their medical family clinics where the students incorporate starting from the first year of the Medicine career. Objective: To characterize the control of the tutelary teaching in the Integral General Medicine discipline during the courses 2012-2013, 2013-2014 and 2014-2015 in the Faculty of Medical Sciences Comandante Manuel Fajardo. Material and Methods: It was carried out an observational, descriptive, retrospective, quantitative and qualitative study of the Integral General Medicine discipline in three school courses. The primary fact was obtained from documental information provided by the teaching department, related with the controls to the teaching activities of education at work. Absolute and relative frequencies were calculated. Ranking and Field of forces techniques were applied and the tree of problems was elaborated. Results: The course 2012-2013 was characterized by being the one where less controls carried out and it had the bigger execution percent with 86, 3 percent. In the control the evaluation prevails of well in the course 2012-2013 and Excellent in 2013-2014 and 2014-2015. In the 57, 1 percent of the controls the educational pyramid doesn't exist and where it does, prevails the presence of two academic years students. Conclusions: In the course 2012 - 2013 were carried out a smaller number of controls with a bigger execution percentage. The evaluation of well prevailed in the course 2012 - 2013 and the evaluation of Excellent prevailed in the other courses, while the absence of educational pyramid prevailed. It was defined as central problem the deficient pedagogic preparation of professors/tutors(AU)

Atresia bilateral de coanas en la adolescencia / Bilateral choanal atresia in adolescence / Atresia bilateral de choana na adolescência

Introducción: la atresia de coanas es una anomalía congénita nasal con una incidencia de 1/70.000 nacidos vivos en Argentina. Se presenta con dificultad respiratoria desde el nacimiento en el caso de las bilaterales. Presentaremos 2 casos de pacientes masculinos con atresia de coanas bilateral diagnosticados tardíamente. Para su tratamiento se utilizó técnica endoscópica transeptal con colgajos doblados sin tutores y azitromicina como antiinflamatorio de mucosa respiratoria en el postquirúrgico. Material y método: Se valoraron en forma descriptiva y retrospectiva 2 pacientes adolescentes diagnosticados e intervenidos quirúrgicamente en el Servicio de Otorrinolaringología del Hospital Posadas, mediante técnica endoscópica transeptal con colgajos doblados sin tutores. Se analizaron variables como tipo de placa atrésica, edad de diagnóstico, malformaciones asociadas y resultados quirúrgicos. Como tratamiento médico postquirúrgico, se utilizó azitromicina a dosis antiinflamatorias. Resultados: La técnica endoscópica transnasal con colgajos doblados sin tutor que hemos realizado en estos dos pacientes reduce el riesgo de reestenosis, no requiere reintervenciones posteriores para retirar el stent y genera una mejor tolerancia del paciente en el postoperatorio. El uso de azitromicina postoperatoria disminuyó el proceso inflamatorio favoreciendo la cicatrización, lográndose una correcta permeabilización de las coanas y una respiración nasal normal bilateral. Conclusiones: El diagnóstico temprano en este tipo de pacientes es fundamental, debido a la característica de respiradores nasales estrictos que presentan los neonatos. No se han encontrado reportes de pacientes diagnosticados en la adolescencia, por lo cual el diagnóstico y el tratamiento, en este caso, plantearon también un desafío.

Introduction: choanal atresia is a nasal congenital anomaly with an incidence of 1 / 70,000 live births in Argentina. It presents with respiratory difficulty from birth in bilateral cases. We will present 2 cases of male patients with bilateral choanal atresia of late diagnose. We used a trans-septal endoscopic technique with folded flap without tutors and azithromycin as an anti-inflammatory of the respiratory mucosa in the postoperative time. Material and method: A descriptive and retrospective study was carried out on 2 adolescent patients diagnosed and surgically treated in the Otorhinolaryngology Service of the Posadas Hospital, using transeptal endoscopy with a folded flap technique without tutors. Variables such as atresia plaque type, age of diagnosis, associated malformations, complications and surgical results were analyzed. Azithromycin was used at anti-inflammatory doses as a post-surgical medical treatment. Results: The transnasal endoscopic technique with folded flaps that we performed in these two patients reduces the risk of restenosis, does not require subsequent reinterventions to remove the stent and generates a better patient tolerance in the postoperative period. As for the use of postoperative azithromycin, the inflammatory process decreased, favoring cicatrization, being able to achieve a correct permeabilization of the choanas and a normal bilateral nasal breathing. Conclusions: We believe that early diagnosis in this type of patients is essential, due to the characteristic of strict nasal breathers presented by the neonates. There were no reports of patients diagnosed in adolescence, so the diagnosis and treatment, in this case, also posed a challenge.

Introdução: a atresia de choana é uma anomalia congênita nasal com incidência de 1 / 70.000 nascidos vivos na Argentina. Esse transtorno/a mesma apresenta dificuldade respiratória desde o nascimento no caso seja bilateral. (Em este estudo) apresentaremos dois casos de pacientes do sexo masculino com atresia de choana bilateral diagnosticada tardiamente. Uma técnica endoscópica trans-septal com aba curvada sem tutores e azitromicina como anti-inflamatório da mucosa respiratória foi utilizada como tratamento pós-cirurgico. Material e método: Foram avaliados de forma descritiva e retrospetiva dois pacientes adolescentes diagnosticados e tratados cirúrgicamente no serviço de Otorrinolaringologia do Hospital Posadas pela técnica transeptal endoscopica sem tutores aba dobrada. São analisados valores como tipo de placa de atresia, idade do diagnóstico, malformações associadas, complicações e resultados cirúrgicos. Como tratamento médico pós-cirúrgico, a azitromicina foi utilizada em dosagens anti-inflamatórias. Resultados: A técnica endoscópica trans-nasal com abas dobradas sem tutor que foi realizada em estes dois pacientes, reduz o risco de re-estenose, não precisando de novas intervenções cirúrgicas para remover o stent e gerar uma melhor tolerância do paciente no pós-operatório. Quanto ao uso de azitromicina pós-operatória, o processo inflamatório diminuiu, favorecendo a cicatrização, conseguindo uma permeabilização correta da choana e uma respiração nasal bilateral normal. Conclusões: Acreditamos que o diagnóstico precoce neste tipo de pacientes é fundamental, devido à característica de respiradores nasais estritos apresentada pelos neonatos. Não houve relatos de pacientes diagnosticados na adolescência, pelo que o diagnóstico e o tratamento, neste caso, também representaram um desafio.

Compliance survey and analyses of the guidance of tutors and the requirements of the graduate students based on the students' views / 中华医学教育探索杂志

Objective To survey on the graduate students about their own requirements, the guid-ance of tutors and the compliance, and put the gists for the educators and administrators. Methods Using the comprehensive questionnaires including Eugenie Creativity Test and Motivation Scale, the investigation surveyed on 900 graduate students in a medical university about their requirements and tutors' concerned aspects in their opinions, which was whether influenced by Intelligence (creativity), the Non-Intelligence factors (motivation) or not. Epidata 3.1 was used to input data of the investigation, and SPSS 16.0 statistical software was used to analyze it. The items were set as multiple-choices, and the percent of responses was used. Results The students thought the tutors' concerned aspects were mainly creative thinking [61.1%(1129/1847)], research methods [58.2%(1075/1847), specialty knowledge [41.8%(772/1847)], scientific spirit [35.4%(654/1847)], academic morality [24.3%(516/2124)] and book knowledge [5.4%(100/1847) ], while the graduate students paid more attention to its research methods [72.4%(1538/2124)], innovative thinking [64.0%(1359/2124), professional knowledge [60.0%(1274/2124)], the spirit of science [33.9%(720/2124)], academic morality [24.3%(516/2124)] and book knowledge [10.0%(212/2124)]. The percentages of research methods and specialty knowledge concerned by most of the students were higher than those tutors' con-cerned in the students' opinion. The percentages of specialty knowledge concerned by the students with high innovation and motivation were 56.2%(443/789) and 58%(345/595), which were higher than those concerned by the tutors 38.5%(255/662) and 29.4%(148/503). Conclusion In the students' opinion, tutors concerned more creative thinking, the students concerned more research methods, while they concerned similarly in the other aspects. For the students, the guidance of the tutors cannot still meet their study demands, espe-cially in research methods and specialty knowledge. Those with different motivations and innovations have different study requirements.

Clinical Reasoning Web-based Prototypic Module for Tutors Teaching 5^th Grade Medical Students : A Pilot Randomized Study / General Medicine

<b>Background: </b>At present clinical reasoning skills are not systematically taught in Japanese medical universities. We developed a prototypic preliminary module for clinical tutors to introduce clinical reasoning to Japanese medical students. We hypothesized that tutored medical students would outperform self-study students.<br><b>Method: </b>Using the web-based Sequential Question and Answer test that rewarded history and differential diagnosis as proxies for clinical reasoning, we compared the pre and posttest scores of 12 randomized fifth grade tutored students at two universities during four tutor-led 1.5-hour web-based seminars using a structured syllabus to 12 randomized self-study students.<br><b>Results: </b>The tutored and self-study groups’ pretest scores were statistically similar at about 40 out of 100 weighted correct points. The tutored students’ posttest scores were 62 points, significantly greater (p = 0.007) than the pretest mean 42 points, compared to the self-study students’ posttest scores of 52 points, significantly greater (p = 0.012) than pretest mean 40 points. The difference between the two posttest groups was of borderline statistical significance (p = 0.08).<br><b>Conclusions: </b>We successfully assessed a prototypic module for tutors to introduce clinical reasoning to Japanese medical students. The tutored students achieved higher scores than the self-study students. Further research is needed to exploit the potential of our modular clinical reasoning system.

A relação interpessoal preceptor-educando sob o olhar de Maurice Tardif: reflexão teórica / The interpersonal relation tutor-student from the perspective of Maurice Tardif: a theoretical reflection / La relación interpersonal preceptor-educando bajo la visión de Maurice Tardif: reflexión teórica

O objeto deste estudo consiste no Relacionamento Interpessoal entre o preceptor e o educando, enfatizando a interação desses atores e a importância da mesma como fator determinante para a formação profissional. A proposta tem por finalidade refletir sobre essa relação considerando a influência dela nos aspectos pedagógicos, sociais e culturais do processo de ensino- aprendizagem, explorando uma perspectiva teórica de Maurice Tardif acerca dos Saberes e da Interação humana. Um intercâmbio forte, autêntico e veraz proporciona o desenvolvimento de habilidades interpessoais, que é um componente de vida social, e atua em prol de benefício mútuo na formação e na profissionalização.

This study is focused on the Interpersonal Relationship between tutors and students, emphasizing the interaction between these actors and its importance as a determining factor for professional education. The objective of this proposal is to reflect on this relationship, considering its influence on the pedagogical, social and cultural aspects of the teaching-learning process, exploring a theoretical perspective by Maurice Tardif on Knowledge and Human interaction. A strong, authentic and truthful exchange leads to the development of interpersonal skills, which is a component of social life, and acts in favor of mutual benefits in education and professionalization.

El objeto de este estudio abarca la Relación Interpersonal entre el preceptor y el educando, enfatizando la interacción de eses actores y la importancia de esta como factor determinante para formación profesional. La propuesta tiene la finalidad de reflexionar acerca de esa relación considerando la influencia de ella en los aspectos pedagógicos, sociales y culturales del proceso de enseñanza-aprendizaje, explorando una perspectiva teórica de Maurice Tardif acerca de los Saberes y de la Interacción humana. Un intercambio fuerte, auténtico y veraz proporciona el desarrollo de habilidades interpersonales, que son componentes de vida social, y actúa en favor del beneficio mutuo en la formación y en la profesionalización.

Metodología para el perfeccionamiento de los tutores de formación de los estudiantes de pregrado / Methodology for the improvement of undergraduate training tutors

Fundamentación: el tutor constituye el eje fundamental de la formación de los estudiantes de ciencias médicas; de su dedicación y formación dependen, en gran parte, la adquisición de los conocimientos, habilidades y responsabilidades necesarios para ejercer eficazmente el rol que les corresponde y el grado de satisfacción de los estudiantes dentro del proceso docente educativo. Métodos: se realiza una investigación de desarrollo, que tiene como propósito diseñar una metodología para el perfeccionamiento de los tutores de formación de pregrado, que permita un proceso de formación de excelencia de los estudiantes de la carrera de Medicina. La metodología fue fundamentalmente cualitativa, se utilizaron varios procedimientos como: la opinión de tutores y asesores metodológicos, entrevistas a tutores y estudiantes, resultados de inspecciones docentes provinciales y nacionales, durante el curso académico 2011-2012, y se realiza revisión documental y bibliográfica. Resultados: se conceptualiza cómo debe ser un tutor de formación en la Universidad Médica de Villa Clara, acorde a la corriente filosófica imperante. Se constata que la situación actual en relación con la tutoría, presenta dificultades que pueden influir en la adquisición de las habilidades y hábitos prácticos que se pretenden lograr en el egresado de la carrera de Medicina. Conclusiones: como producto de la investigación se elabora una metodología para el perfeccionamiento de los tutores que contribuye a la visión que la Universidad de Ciencias Médicas de Villa Clara aspira para los tutores de formación de los estudiantes en el pregrado.

Tutors are the keystone of the training of medical students. The acquisition of the necessary knowledge, skills and responsibilities to play efficiently the role they are intended to play, and the level of satisfaction of the students within the process, depend to a great extend on their dedication and training. Methods: a development research was conducted with the aim of designing a methodology for the improvement of undergraduate training tutors, which would allow a training process of excellence for medical students. The methodology was primarily qualitative. Several procedures were used, for instance, the opinions of tutors and methodological advisors, interviews with tutors and students, the results of provincial and national teacher inspections, during the academic year 2011-2012, and bibliographical and document reviews. Results: there is a conceptualization about how a training tutor should be at the Medical University of Villa Clara, according to the prevailing philosophical trend. It was found that the current situation regarding tutoring presents difficulties that may influence the acquisition of the practical skills and habits intended to be achieved by the medical graduate. Conclusions: as a result of the research, a methodology for the improvement of tutors was developed. It would contribute to the vision the Medical University of Villa Clara has for undergraduate training tutors.

Challenges of Problem Based Learning.

Background: The cornerstone of problem-based learning (PBL) tutoring is its facilitation skills and is vital to student learning. PBL is a major component in the undergraduate medical curriculum at the Univeristi Kebangsaan Malaysia (UKM). Objectives: The objective of this study was to identify the knowledge, attitudes and skills of PBL tutors of different status and backgrounds. Methods: A cross sectional study was carried out on 55 tutors with medical and non-medical backgrounds, of various academic positions, who conducted 94 tutorials. Respondents were 240 semester-1, year-1, UKM medical students of the academic session of 2007-2008. Data was collected at the end of last session of each PBL case tutorial, utilizing an evaluation form. Results: The majority of tutors possessed knowledge on PBL process and showed positive attitudes towards students learning. Facilitation skills varied among the tutors. However, no significant difference was found between tutors of medical and non-medical backgrounds. Conclusion: Problem processing or facilitation is a challenging task. This also depends on problem structure or designing of the problem. Every PBL tutor irrespective of their background and status must have adequate training on PBL facilitation skills and designing of problem based on critical evaluation of educational theory.

Exploring the Tutorial System of Undergraduate in Military School / 中华医学教育探索杂志

In order to accelerate the pace of teaching reform,our school explores the tutorial system of undergraduate course this year,this article emphasize the necessity and beneficial effects of this system in clinical practice.