Desempeño de las escuelas de medicina en México: resultados del Examen Nacional para Aspirantes a Residencias Médicas / Performance of medical schools in Mexico: Results from the Examen Nacional para Aspirantes a Residencias Médicas

Resumen: Objetivo: Evaluar el desempeño de las facultades y escuelas de medicina (FEM) utilizando como subrogado los resultados del Examen Nacional para Aspirantes a Residencias Médicas (ENARM). Material y métodos: Se analizaron las bases de datos oficiales del ENARM 2016 y 2017, empleando cinco criterios de desempeño (CD) por cada FEM: dos oficiales y tres creados exprofeso. Resultados. En 2016 y 2017 se registraron sustentantes de 112 y 115 FEM, respectivamente. Dependiendo del CD, la FEM que quedó clasificada en el primer lugar obtuvo entre 5 y 20 puntos más que la del segundo lugar, y entre 23 y 98 puntos más que la FEM ubicada en el último lugar. Aproximadamente 25% de los sustentantes fueron calificados como "deficientes en conocimientos" y aproximadamente 80% de éstos provenían de menos de un tercio de las FEM. Conclusiones: El ENARM arroja información sobre el desempeño de las FEM. Aproximadamente uno de cada cuatro sustentantes obtuvo puntajes menores al aprobatorio en cualquier especialidad.

Abstract: Objective: To assess the performance of medical schools (FEM) by analyzing the results of their applicants in the Examen Nacional para Aspirantes a Residencias Médicas (ENARM). Materials and methods: Five performance criteria, two official and three created on purpose, were calculated from the ENARM-2016 and -2017 official databases to assess FEM performance. Results: In 2016 and 2017, applicants registered from 112 and 115 FEM, respectively. Depending on the performance criteria, the FEM in the first place obtained 5 to 20 points more than the one placed second, and 23 to 98 points more than the FEM in the last place. Approximately 25% applicants were classified as "knowledge-deficient," and about 80% of these originated from less than one third of the FEM. Conclusion: The ENARM results provide information on the performance of the FEM. Approximately one of every four applicants obtained scores lower than the approval threshold of any specialty.

Flaws in the design of the Examen Nacional para Aspirantes a Residencias Médicas produce inequity / Fallas en el diseño del Examen Nacional para Aspirantes a Residencias Médicas generan inequidad

Abstract: Objective: To assess the assumption of 'equity' of Mexico's resident-selection assessment tool, the Examen Nacional para Aspirantes a Residencias Médicas (ENARM). Materials and methods: Official ENARM-2016 and -2017 databases were analyzed. Differences in the absolute number of correct answers (multivariable linear regression) and the number of applicants reaching their specialty minimum score (SMS) per test day (odds ratio [OR]) were calculated. Applicants affected by test-day inequity were estimated. Results: There were 36 114 applicants in 2016, and 38 380 in 2017. In 2016, day-2 applicants had significantly higher scores and more reached the SMS than on days 1-3-4 (OR 1.55), and 5 (OR 3.8); 3 565 non-passing applicants were affected by inequity (equivalent to 44.64% of those selected). In 2017, day-1 and -2 applicants had significantly higher scores and more reached the SMS than on days 3-4 (OR 1.85), and 5 (OR 4.04); 3,155 non-passing applicants were affected by inequity (37.2% of those selected). Conclusion: Analysis of official ENARM databases does not support the official attribution of equity, suggesting the test should be redesigned.

Resumen_ Objetivo: Evaluar el atributo de "equidad" asignado al Examen Nacional para Aspirantes a Residencias Médicas (ENARM). Material y métodos: Se analizaron las bases de datos oficiales del ENARM 2016 y 2017. Se compararon las diferencias inter-día de respuestas correctas (regresión linear multivariable) y de sustentantes que alcanzaron el puntaje mínimo de su especialidad (PME) (razón de momios [RM]). Se estimó a los afectados por la inequidad. Resultados: Hubo 36 114 sustentantes en 2016 y 38 380 en 2017. Los días 2 (ENARM-2016) y 1-2 (ENARM-2017) registraron puntajes significativamente más altos, y más sustentantes alcanzaron el PME que en los días 1-3-4 (RM 1.55) y 5 (RM 3.8) en 2016, y los días 3-4 (RM 1.85) y 5 (RM 4.04) en 2017. Se estimó que cuatro de cada diez sustentantes que aprobaron el ENARM no lo hubieran hecho si el examen fuera equitativo. Conclusión: Los resultados sugieren que el atributo de equidad del ENARM está en duda.

Diseño e implementación de OSCE para evaluar competencias de egreso en estudiantes de medicina en un consorcio de universidades chilenas / A standardized objective structured clinical examination to assess clinical competencies in medical students

Background: Outcomes-based education is a trend in medical education and its assessment is one of the main challenges. The Objective Structured Clinical Examination (OSCE) is one of the tools used to assess clinical competencies. Although Chilean medical schools have used OSCEs for 18 years, there is a vast variability in the way these examinations are administered. Aim: To design and implement an integrated OSCE to assess clinical competencies at the end of the medical program in Chilean medical schools, aiming to reduce variability between these schools. Material and Methods: Seven medical schools, supported by experts from the National Board of Medical Examiners, designed a 12 station OSCE to measure clinical outcomes at the end of the seventh year of medical training. Unlike traditional OSCEs, this new examination incorporated the assessment of clinical reasoning and communication skills, evaluated from patients' perspective. Results: One hundred twenty-five volunteers took the same exam at five different venues. The internal consistency was 0.62. Following a compensatory approach, 85% of students passed the exam. Communication assessment showed poorer results than those reported in the literature. Conclusions: Among Chilean medical students, the assessment of clinical outcomes in a collaborative way, through a valid and reliable exam, is feasible. A consensus on how to teach and assess clinical reasoning across the medical curriculum is required. The assessment of students' communication skills requires further development.

La motivación en el contexto del proceso enseñanza-aprendizaje en carreras de las Ciencias Médicas / Motivation in the context of the teaching-learning process in specialties of the Medical Sciences

La motivación es un elemento importante a considerar en el proceso de enseñanza-aprendizaje. Se entiende como la intención de producir en el estudiante la ejecución consciente y deseada de una actividad. Con este artículo se pretendió valorar la motivación en el contexto del proceso enseñanza-aprendizaje en carreras de las Ciencias Médicas. Se identificaron los elementos esenciales de la motivación y se reflexionó sobre los factores que inciden en el alumno, así como aquellos elementos que deben tenerse en cuenta a la hora de afrontar la actividad docente. La interacción entre los contextos creados por el profesorado y las características con las que el alumno aborda el trabajo escolar, así como las implicaciones de la interacción entre las actuaciones del profesor, la respuesta del alumnado y los efectos, paso a paso, de las formas en que estos acometen sus tareas, son cuestiones a tener en cuenta al tratar la motivación. Se abordó la preocupación de los directivos y docentes en el diseño curricular que ofrece alternativas de acción a los profesores, donde se incluye la motivación hacia la profesión elegida como encargo social, aseverándose que los futuros profesionales de la salud, deben estar bien motivados al elegir esta carrera que demanda de perenne amor, consagración y entrega intensa al trabajo. Por ello el docente deberá dirigir la práctica hacia la consecución de la motivación para el aprendizaje, como vía para la formación de un futuro profesional de la salud, competente, capaz de afrontar disímiles dificultades más allá de nuestras fronteras, y contribuir a elevar la calidad de vida de los pacientes (AU).

Motivation is an important element to take into consideration in the teaching-learning process. It is understood as the intention of producing in the student the conscious and desired performance of an activity. With this article we pretended to assess motivation in the context of the teaching-learning process in specialties of the Medical Sciences. The main elements of the motivation are identified and we took a hard look on the factors striking on the student and also on those elements that have to be taken into account at the time of dealing with the teaching activity. The interaction between the contexts created by the teaching staff and the characteristics of the student's approach to school work, and also the implication between the teacher's performance, the students' answer and the effects, step by step, of the forms in which the latter undertake their tasks, are questions to take into account when dealing with motivation. We approached the concern of managers and teachers in the curricular design offering alternatives of action to teachers, including the motivation to the chosen profession as social task; we affirm that the future health professional should be deeply motivated when choosing this profession demanding perpetual love, dedication and devotion to work. Therefore, the teacher should direct the practice to the attainment of the motivation to learning, as a way of training a future health professional competent, able of affronting dissimilar difficulties beyond our borders, and of contributing to increase the patients' life quality (AU).

Resultados académicos en Farmacología de estudiantes de Enfermería Universidad Kmpa Vita. Uíge, Angola / Academic results in Pharmacology obtained by Nursing students. Kimpa Vita University. Uíge, Angola

Introducción: Los conocimientos en Farmacología tienen un lugar destacado en el ejercicio de la Enfermería. Es imprescindible que el estudiante de Enfermería en lo académico pueda asimilar todos los aspectos de la Farmacología durante la formación universitaria. Objetivo: Describir los resultados académicos en Farmacología de los estudiantes de Enfermería de la Universidad Kimpa Vita de Uíge en Angola. Materiales y Métodos: Estudio retrospectivo de los estudiantes de tercero, cuarto y quinto años de Licenciatura en Enfermería. La Farmacología se impartió por el programa de estudio de 2008 de Cuba, y se utilizó el sistema de evaluación establecido en Angola. Se revisaron las actas de examen y se aplicó una pregunta de respuesta simple para evaluar el nivel de conocimientos en el tema fármacos antimicrobianos y antiparasitarios. Resultados: Los resultados en Farmacología I fueron fundamentalmente:suficiente (74,83 por ciento), y en Farmacologia II: suficiente (61,57 por ciento) y bien (34,01 por ciento). Los resultados del tema evaluado fueron principalmente en los estudiantes de tercer año: suspensos (41,75 por ciento), cuarto año: suficiente (45,10 por ciento), y en quinto año: suficiente (32,58 por ciento) y bien (37,08 por ciento). Conclusiones: Los resultados en Farmacología se obtienen por el progreso en los métodos de estudio, la atencion individualizada al estudiante y la integración de sus contenidos en las disciplinas propias de la profesión(AU)

Introduction: The knowledge of Pharmacology has a significant importance in the practice of Nursing. It is indispensable that the Nursing student achieves the assimilation of knowledge of all the aspects of Pharmacology from the academic point of view during the university formation. Objectives: To describe the academic results in Pharmacology obtained by Nursing students of the Kimpa Vita University of Uíge in Angola. Materials and Methods: A retrospective study was carried out with third, fourth and fifth year Nursing students. Pharmacology was taught according to the Cuban curriculum of 2008, and the evaluation system established in Angola was used. Official documents were reviewed, and a question with a simple answer was applied to evaluate the level of knowledge of antimicrobial and anti-parasitic drugs. Results: The results in Pharmacology I were mainly satisfactory (74.83 percent); and in Pharmacology II they were satisfactory (61.57 percent) and good (34.01 percent). The results of the evaluation related to the topics were: third-year students: failed (41.75 percent); fourth-year students: satisfactory (45.10 percent), and fifth-year ones: satisfactory (32.58 percent and good (37, 08 percent). Conclusions: The results in Pharmacology are achieved by the progress in the study methods, the individualized attention to the student, and the integration of their contents to the disciplines related to the profession(AU)

The appreciation of artistic aspects of the Code of Points in rhythmic gymnastics: an analysis of the last three decades / A valorização dos aspectos artísticos do Código de Pontuação na ginástica rítmica: uma análise das últimas três décadas

Abstract In pursuit of promoting the artistic aspects, the current Rhythmic Gymnastics Code of Points (RGCP) has been submeted significant changes that motivated this research, documentary and historical in character, which aimed to analyze the last eight Olympic cycles of RGCP. The research method used in this study is documentary and characterized by the information found in documents (RGCP) that had not received any scientific treatment. From the analysis of different RGCP cycles, we found artistic aspects, and their connection with RG technical requirements. We observed that the RG has distinct stages (technical aspects, flexibility etc). While retaining its artistic roots (from Dance and Rhythm), in pursuit of sportivization and systematization of the sport, the first stage was characterized by a search for the sportivization and standardization of the modality based on the inclusion of new body elements in the RGCP . The second stage confirms our previous hypothesis, that in the last RGCP the artistic component had undergone few changes. We noticed, in an overview, that at the present time the current RGCP brings back the relationship between RG and its origins, influenced by Aesthetic Gymnastics (Swedish), Rhythmic and Dance. Condition observed once the current Code of Points (2013-2016) marks the story of sports, by two aspects: the permissiveness of routines with singing wich has not allowed since since the creation the RGCP and significant changes to the appreciation of the routines’ artistic aspects.

Resumo Em busca de melhor promover os aspectos artísticos, tendo-se em vista os últimos ciclos olímpicos, o atual Código de Pontuação de Ginástica Rítmica (CPGR) foi submetido a significativas mudanças. É a partir desse contexto que essa pesquisa, de caráter documental e histórico, se desenvolve, tendo como objetivo, analisar as mudanças nos últimos oito ciclos Olímpicos de CPGR (1985-2016), com foco nos aspectos artísticos da modalidade. A partir da análise de diferentes ciclos do CPGR, conclui-se que há conexões de interdependência entre os aspectos artísticos e os técnicos, sendo nítido que quando há uma supervalorização do aspecto técnico há uma desvalorização do artístico. Foi possível identificar fases do CPGR, e portanto, da modalidade. Apesar de manter as suas raízes artísticas (de Dança e Ritmo), a busca pela esportivização e sistematização da modalidade, trouxe uma primeira fase caracterizada pela busca do caráter esportivo e pela padronização dos gestos da GR, baseada na inclusão de novos elementos do corpo no CPGR. A segunda fase se caracteriza por uma retomada do aspecto artístico, confirmando nossa hipótese sobre a grande mudança do último CPGR. Constatamos de maneira geral, que o CPGR atual retoma a relação entre a GR e suas origens, influenciado pela Ginástica Estética (sueca), Rítmica e Dança. Tal condição é observada, uma vez que o atual Código de Pontuação (2013-2016) marca a história da modalidade por dois aspectos: a permissão de rotinas com canto, que não eram permitidas desde a criação do CPGR; e mudanças significativas para a valorização de aspectos artísticos dos rotinas.