Portfólio on-line: estratégia para melhorar o sistema de avaliação da disciplina de Atenção Integral à Saúde do curso de Medicina / Online portfolio: strategy to improve the assessment system of the Integral Health Care discipline in the medical course / Portafolio on-line: estrategia para mejorar el sistema de evaluación de la disciplina de Atención Integral de Salud del Curso de Medicina

Resumo Este estudo relata a estratégia para aprimorar o portfólio como instrumento de avaliação da aprendizagem em uma disciplina oferecida aos estudantes do quarto ano de graduação em Medicina, por meio do portfólio on-line. A disciplina é constituída de atividades práticas de atendimento integral à saúde da criança, do adolescente, do adulto e da mulher na atenção primária do município de Campinas. A utilização do portfólio permite que os estudantes reflitam sobre os atendimentos realizados em relação ao conhecimento, à habilidade clínica e ao vínculo médico-paciente na consulta. O portfólio on-line possibilitou rever os critérios de avaliação, agilizar e facilitar a gestão da correção, realizada por oitenta avaliadores de três especialidades médicas. O acesso às informações do portfólio na plataforma moodle permitiu a rápida tomada de decisão em aspectos que precisam ser adequados para a melhoria do processo ensino-aprendizagem.(AU)

Abstract This study reports on the strategy to improve the use of online portfolios as a learning assessment instrument of a discipline taught to fourth-year medical students. The discipline comprises practical activities of comprehensive care of children, teenagers, adults, and women in primary care in the Brazilian city of Campinas. Using portfolios, students are able to reflect upon the provided care as to the knowledge, clinical skills, and doctor-patient bond shown in the appointment. The online portfolio enabled to review the assessment criteria, and streamline and facilitate managing the assessment conducted by 80 evaluators from three medical specialties. Access to the portfolio's information in the Moodle platform enabled a fast decision-making process in aspects that need to be adequate to improve the teaching and learning process.(AU)

Resumen Este estudio relata la estrategia para perfeccionar el portafolio como instrumento de evaluación del aprendizaje en una disciplina ofrecida a los estudiantes del 4º. año de la graduación en medicina, por medio del portafolio online. La asignatura se compone de actividades prácticas de atención integral a la salud del niño, del adolescente, del adulto y de la mujer en la atención primaria del municipio de Campinas. La utilización del portafolio permite que los estudiantes reflexionen sobre las atenciones realizadas con relación al conocimiento, a la habilidad clínica y al vínculo médico-paciente en la consulta. El portafolio online posibilitó revisar los criterios de evaluación, agilizar y facilitar la gestión de la corrección realizada por 80 evaluadores de tres especialidades médicas. El acceso a las informaciones del portafolio en la plataforma Moodle permitió la rápida toma de decisiones en aspectos que tienen que adecuarse para la mejora del proceso enseñanza-aprendizaje.(AU)

The alternative model of silicone for experimental simulation of suture of living tissue in the teaching of surgical technique

Abstract Purpose: To develop a silicone alternative model of tissue suture simulation to be used in the teaching of surgical technique. Methods: Twelve alternative models of silicone for tissue suture simulation were manufactured and implemented as a tool for suture pattern training of undergraduate medical students of Universidade Federal do Amazonas. Forty-eight students participated in the research. The evaluation of the proposed model was done through a questionnaire using the Likert scale, in order to verify the student satisfaction index of the alternative resource and its performance as opposed to the model historically used in the discipline, which is to suture in cloths. Results: The alternative model showed satisfactory results, especially with respect to the structural aspect, such as, better perception of anatomical planes, handling and transport. About 89.58% of positive concordant responses demonstrating expressive approval for incorporation of a complementary form of the alternative methodological proposal of the discipline of surgical technique. Conclusions: The model developed for experimental simulation of tissue sutures has proved to be a fully feasible alternative method for the training of this surgical skill. It is a simple, reproducible and low-cost model.

Comunicação efetiva para o cuidado seguro ao paciente com implante de dispositivo de assistência ventricular / Comunicación efectiva para el cuidado seguro al paciente con implante de dispositivo ventricular / Effective communication for the safe care of patients with ventricular assist device implantation

Resumo OBJETIVO Relatar a atuação da equipe multidisciplinar na comunicação efetiva e no cuidado seguro aos pacientes com dispositivo de assistência ventricular. MÉTODO Relato de experiência sobre o uso da comunicação efetiva no cuidado a pacientes com dispositivo de assistência ventricular em hospital universitário do sul do Brasil. A referida assistência iniciou em 2017, pautada na individualização das ações e na perspectiva do cuidado centrado no paciente. RESULTADOS Na instituição foram capacitadas equipes multiprofissionais, estruturados protocolos assistenciais, realizadas sessões educativas sistemáticas para pacientes e cuidadores. Foram executadas visitas domiciliares para planejamento de alta hospitalar e plano para situações de urgência, além de capacitações básicas para as equipes dos hospitais próximos à residência dos pacientes. CONCLUSÕES A comunicação efetiva entre equipe multiprofissional, pacientes e cuidadores no planejamento do cuidado em saúde tem papel fundamental para identificar precocemente possíveis complicações, preveni-las e possibilitar maior sobrevida e qualidade de vida a esses pacientes.

Resumen OBJETIVO Informar la actuación del equipo multidisciplinario en la comunicación efectiva y cuidado seguro a los pacientes con dispositivo de asistencia ventricular. MÉTODO Se trata de un relato de experiencia sobre el uso de la comunicación efectiva en la asistencia a pacientes con dispositivo de asistencia ventricular em un hospital universitario del sur de Brasil. Esse cuidado, inició en 2017, pautado em la individualización de las acciones y em la perspectiva del cuidado centrado em el paciente. RESULTADOS En la institución se capacitaron equipos multiprofissionales, estructurados protocolos asistenciales, realizadas sesiones educativas sistemáticas para pacientes y cuidadores, visita domiciliares para la planificación de alta hospitalaria y plan para situaciones de urgência, además de capaccitaciones de urgência, además de capacitaciones básicas para los equipos de los hospitales cercanos a la residencia de los pacientes. CONCLUSIONES La comunicación efectiva entre el equipo multiprofesional, pacientes y familiares en la planificación del cuidado en salud tiene un papel fundamental para identificar precozmente posibles complicaciones, prevenirlas y posibilitar mayor sobrevida y calidad de vida.

Abstract OBJECTIVE To report the role of multiprofessional teams in the effective communication and safe care of patients with left ventricular assist device. METHODS This is an experience report about the use of effective communication for patients with ventricular assist device in a university hospital in southern Brazil. Care based on individualized action and centered on the patients started in 2017. RESULTS At the institution, the multiprofessional teams attended training sessions and care protocols were established. The patients and caregivers attended systematic educational sessions and home visits were made to arrange patient discharge and urgency plans. Also, the hospital teams located near the patients' homes received basic training. CONCLUSION Effective communication between multiprofessional teams, patients, and their families when planning care plays a pivotal role in the early identification of possible complications and their prevention, resulting in a greater survival rate and a better quality of life.

Docencia en violencia y abuso sexual en estudiantes de pregrado de medicina: percepción de los docentes sobre barreras y facilitadores / Teaching medical students about domestic violence and sexual abuse: teachers' perception of barriers and facilitators

Background: Considering the frequency of sexual abuse and domestic violence (SA-DV) in the population, the likelihood of a medical student meeting patients with this problem is substantial. However, most students do not consider SA-DV in their differential diagnoses. Since 2014, this team has been working in strengthening undergraduate curriculum in SA-DV. It has been a challenging and slow process. Purpose: To identify barriers and facilitators perceived by the undergraduate teaching team in order to suggest modifications in the curriculum in relation to the competencies required for screening and early intervention for victims of SA-DV. The conclusions obtained may be useful for other medical schools and universities facing this challenge. Methods: Qualitative study using grounded theory method for the analysis of interviews and focus groups. Results: SA-DV are perceived as a problem that is pertinent for physicians. However, there is a common belief that teaching about SA-DV should be limited to only certain specific specialties. The main barriers are the limited curricular time, the need to prioritize contents and the lack of specific training of the teachers. A key facilitator is the fact that gender violence is on the public agenda today. Conclusions: The identified barriers coincide with those reported in the literature; limited curricular time and prioritization of contents. Although this study does not show the perception of SA-DV as 'not a medical issue' nor as a subject that pertains to other health professionals, there is the perception that teaching clinical approach to SA-DV only pertains to specialists who are directly involved in this topic.

Educación médica y diversidad cultural en Chile: un diálogo pendiente / Medical education and cultural diversity in Chile: a pending dialogue

Medical education in Chile has a good research productivity. National educators are skilled in complex curricular design processes and in didactic innovation. However, the question of what it means to be doctor in a society that moves towards interculturality, has not been addressed thoroughly. Using the structure of a clinical record, we outline our critical view about the relationship between medical education and diversity. To describe the medical history, we refer to some variables of the training process such as the Hegemonic Model of Medicine, the epistemological beliefs of the students, the hidden curriculum and the educational environment. Then, the empirical evidence of the clinical picture, diagnosis and internationally recommended treatment is described, to end with a local therapeutic proposal.

La motivación en los estudiantes de primer año de la carrera de Medicina. Curso 2015-2016 / Motivation in first-year students of Medicine degree. School year 2015-2016

Introducción: la Educación Médica Superior en Cuba tiene como misión la educación integral de los estudiantes de las Ciencias Médicas que implica conocimientos teóricos, habilidades profesionales, éticas, formación y desarrollo de valores, por lo que deben estar motivados y los profesores lograr un proceso de estimulación que les permita alcanzar su meta deseada. Objetivo: se caracteriza la motivación profesional de los estudiantes de primer año de la carrera de Medicina del curso 2015-2016. Materiales y Métodos: se caracterizó los aspectos relacionados con la motivación y los intereses asociados a la profesión elegida en los estudiantes de primer año, a través de la encuesta diseñada para la investigación. Resultados: menos del 50% de los estudiantes encuestados siempre quisieron estudiar Medicina, el 61% deseaba otras profesiones. Las razones que influyeron en la selección fueron: permitirle acercarse a otras personas, hacerle bien a los demás, amor y respeto a esta profesión, comprender la necesidad e importancia social de la misma y consejos de los padres y familiares. El 87% de los encuestados disfrutan de estudiar las asignaturas, a ninguno le es indiferente, el 13% le resulta estresante, no lo disfruta o no sabe qué decir. Conclusiones: la motivación constituye un pilar importante en la formación de los estudiantes en la nueva universidad. No todos tenían como primera opción la carrera en curso, se fueron motivando en la medida que se desarrollaron las asignaturas. Aplicar en las diferentes formas de organización de la enseñanza vías y métodos, para incrementar la orientación profesional (AU).

Introduction: high Medical Education in Cuba has the mission of the integral education of the Medical Sciences students, involving theoretical knowledge, professional skills, ethics and values formation and development; therefore, they should be motivated and the teachers should develop a stimulation process allowing them to reach the desired aim. Aim: it is analyzed the professional motivation of the first-year students of Medicine degree in the school year 2015-2016. Materials and Methods: the aspects related with motivation and the interests associated to the chosen profession in first year students are characterized through the survey designed for the research. Results: less than 50 % of the surveyed students always wanted to study Medicine. 61 % wanted to study other professions. The reasons influencing the choice were: allowing them to be near to other persons, doing well to other persons, love and respect to the profession, understanding the necessity and social importance of this specialty, and the advises of their parents and relatives. 87 % of the students enjoy studying the matters; they are not indifferent to none of them; 13 % of them think the matters are stressful, they do not enjoy them or they do not know what to say. Conclusions: motivation is an important milestone in the students´ training in the new university. Not all of the students chose the specialty they study now as their first choice; they became motivated as they were studying the matters. Ways and methods to increase professional orientation should be applied in the different forms of teaching organization (AU).

Factores que afectan al ambiente educativo en la formación preclínica de medicina según sus docentes / Factors affecting the educational environment in undergraduate medical schools

Background: Educational environment has an important effect on the quality of learning and student satisfaction in medicine. Most of previous studies have been conducted using questionnaires that assess the phenomenon considering overall dimensions, without paying attention to the specific manifestations of this topic, especially those aspects that are related to the protagonists of the learning process: teachers and students. Aim: To describe factors that affect the educational environment in the preclinical Medical formation, according to Medical teachers in Concepción, Chile. Material and Methods: Qualitative study, using the Grounded theory method. Semi-structured interviews were performed to 10 medical teachers in Concepcion, Chile. They were selected by theoretical sampling. Data were analyzed using open coding. Results: Four emerging categories about the factors that affect the learning environment were identified: Personal factors of students, academic factors of students, personal factors of teachers and academic factors of teachers. Conclusions: According to interviewed teachers, both personal factors in teachers and students that promote a positive learning environment are related with an attitude oriented towards others and communication skills. Academic factors are related with the responsible exercise of student and teacher roles and with the promotion of participation in the educational process.

Geriatric teaching in Brazilian medical schools in 2013 and considerations regarding adjustment to demographic and epidemiological transition / Ensino da Geriatria nas faculdades de medicina do Brasil em 2013 e reflexões sobre a adaptação ao processo de transição demográfica e epidemiológica

Summary Objective: This study aims to describe the profile of medical schools that introduced courses on Geriatrics and Elderly Health or Aging in their curriculum, and compare such information with the age distribution and health epidemiological data of the Brazilian population, using data until the year of 2013. Methods: 180 universities offering medical undergraduate courses and registered with the Ministry of Education and Culture of Brazil (MEC) were found, as seen on the MEC website (www.emec.mec.gov.br) in February 2013. Based on the list of institutions, the authors created a database. Results: Brazil's Southeast region is the one presenting most of the courses, both offered as core or elective subjects, in the area of Geriatrics. The Midwest region had the least offer of Geriatrics and Elderly Health and Care courses. The Southeast region presents the greater absolute number of institutions with elective subjects, followed by the South and Northeast regions, each with a single institution. The Southeast region was at the same time the one that presented the biggest absolute number of institutions offering core subjects in the area of Geriatrics, being followed by the Northeast, South, North, and Midwest regions. Conclusion: By analyzing the availability of courses that emphasize aging and Geriatrics in brazilian medical schools, the present study reveals that specialized training should be encouraged with respect to the specificities of health care given to the elderly population, which has a higher frequency of chronic and degenerative diseases.

Resumo Objetivo: o estudo tem como objetivo delinear o perfil de instituições de ensino médico que adotaram em grade curricular disciplinas de Geriatria, saúde dos idosos ou envelhecimento, e comparar esse perfil com distribuição demográfica e dados epidemiológicos de saúde da população brasileira, utilizando dados de até 2013. Métodos: foram pesquisadas 180 instituições de ensino superior (IES) contendo cursos de medicina cadastrados no sistema do Ministério da Educação e Cultura (MEC), que constavam no site: emec.mec.gov.br, acessado em fevereiro de 2013. A partir da lista de instituições encontradas, fez-se a construção do banco de dados. Resultados: a região Sudeste é a que apresenta maior oferta de disciplinas na área de Geriatria, tanto obrigatórias quanto optativas. A região Centro-oeste foi a que menos se destacou na oferta de disciplinas de cuidado ao idoso. A região Sudeste apresenta maior número absoluto de disciplinas optativas, seguida pelas regiões Sul e Nordeste, com apenas uma instituição cada. A região Sudeste também foi a que apresentou maior número absoluto de instituições que ofertavam disciplinas obrigatórias na área de Geriatria, sendo seguida pelas regiões Nordeste, Sul, Norte e Centro-oeste. Conclusão: o presente estudo, por meio da análise do perfil de oferta de disciplinas que enfatizam o envelhecimento e a saúde do idoso nas instituições de ensino médico brasileiras, aponta como essencial o estímulo à capacitação dos profissionais no que tange às especificidades do atendimento de saúde à população idosa, com aumento crescente de doenças crônico-degenerativas.

Acortar los estudios de pre título en Medicina, en Chile: ¿Ahora y para todos? / Shortening undergraduate medical training: now and for all medical schools in Chile?

In Chile, undergraduate medical education starts after High School, it lasts seven years, with the final two dedicated to a rotary internship, taking to an M.D. degree that allows the graduate to enter working activities. The country needs more M.D.s in primary care, but there is also a shortage of specialists, mainly out of the main cities. In recent decades, post graduate programs leading to specialty titles have become competitively adopted by a large proportion of medical graduates. This is the case at the Pontificia Universidad Católica de Chile, stimulating its faculties and medical students to develop a collaborative review of their teaching programs, leading to a curricular reform with a new graduate profile and a new curriculum oriented to learning objectives, that will allow to obtain the M.D. degree in six instead of seven years of undergraduate education. This new program awakened expectations in other universities in Chile, that will have to face the attraction of this shortened program for future candidates to enter medical schools. However, any shortening of medical school careers should first consider the local conditions in quality of applicants, number of accepted students, the training of teachers in integrated teaching programs, the availability of adequate campuses. Furthermore, for students with different academic backgrounds and diverse personal and familial interests, the seven years programs may still be necessary to gain the expertise required to become medical doctors.

Dermatology relevance to graduates from the Universidade Estadual de Campinas Medical School

AbstractBACKGROUND:Some research indicates that physicians do not dominate the expected dermatological content for the proper exercise of the profession. This fact compromises their diagnostic and therapeutic performance, generating unnecessary costs.OBJECTIVE:The aim of this study was to evaluate the relevance of Dermatology and the knowledge acquired in the specialty during the undergraduate course in clinical practice of graduates at the State University of Campinas Medical School (FCM/UNICAMP).METHOD:A questionnaire with 22 closed questions and two open ones was electronically sent to physicians who had graduated more than 10 years ago and others for less than 10 years. In the first group, physicians were trained by the same curriculum and in the second group there were subjects trained by the old and the new curriculum.RESULTS:Of the 126 respondents, 83% had completed a specialization course. Among all, 82% did not study dermatology after graduation. The majority considered that Dermatology has high relevance in clinical practice, regardless of the group. There was a statistically significant difference between non-dermatologist doctors graduated for more than 10 years and those graduated for less than 10 years regarding confidence about lesion diagnosis, diagnostic investigation and treatment of skin diseases. Physicians who have graduated for a longer time feel more insecure in relation to patients with dermatoses. Concerning contributions offered by graduation program completion they prioritized outpatient care, ability to diagnose, knowledge of pathology, research and knowledge of lesions.CONCLUSION:This study has shown that Dermatology is relevant in medical practice and more recent graduates from the FCM/UNICAMP feel less insecure when treating a patient with dermatoses.

Opiniones sobre terapias complementarias por parte de los estudiantes de medicina de la Pontificia Universidad Católica de Chile. Año 2014 / Opinions of medical students about complementary therapies

Background: There is increasing national and worldwide interest on complementary therapies (CT). Aim: To describe and analyze the opinions and interest about CT among medical students. Material and Methods: An anonymous and voluntary survey with questions used in previous studies, was applied to students from first to fifth year. Results: The survey was answered by 526 medical students, corresponding to 86% of the target population. The students knew about an average of 4.7 therapies, out of 12 displayed. The better known therapy was acupuncture, followed by homeopathy and reiki, which raised the greater interest. The knowledge and interest was higher among women, who also had a more favorable opinion about CT. The interest decreases and the proportion of unfavorable opinions increases among students of upper level courses. Forty nine percent of respondents have used CT for themselves and 22% had no experience whatsoever with them. Conclusions: In general, there is an appreciable knowledge, experience, interest and positive opinions toward CT. This favorable attitude is higher in women and decreases as career progresses. Medical students consider that they should have some approach to CT during their career.

Percepción de examen oral estandarizado vs no estandarizado en el internado de medicina interna / Students’ perceptions comparing standardized and non-standardized oral exams in internal medicine

Background: Oral examinations are a useful tool to appraise certain medical skills compared to other examinations. However, they have some disadvantages that might be reduced with standardization. Aim: To compare students’ perception comparing a standardized oral exam (SOE) versus a traditional, non-standardized oral exam (NSOE). Material and Methods: During the first semester of 2013 a NSOE was applied to internal medicine undergraduate students. During the second semester, a SOE was applied. An anonymous and voluntary perception questionnaire, consisting in 10 questions based on a 5-level Likert scale, was answered by these students. Statistical analysis was done using the Mann-Whitney U test. Results: Among the 118 students, 50.8% were evaluated using NSOE and 49.2% using SOE. Questionnaire response rate was 84%. Among respondents, 52% took the SOE and 48%, the NSOE. Students evaluated using SOE perceived that the degree of complexity of clinical cases was similar for all examinees (p < 0.05), that exam duration was standardized (p < 0.05), and that grades obtained were less influenced by the clinical site where the exam was taken (p < 0.05). However, anxiety level remained high in both groups, as well as the overall satisfaction experience. Conclusions: Standardization of an oral examination improves the perception of medical students about levels of difficulty, duration and external influences on the final grade.

Perfiles de egreso de las carreras de Medicina en Chile / Professional profiles of graduates from Chilean Faculties of Medicine

Background: The professional profile of health care professionals should incorporate recommendations of international agencies and adapt to the local conditions of each country. Aim: To conduct a qualitative analysis of Medical Graduate Profiles of universities grouped in the Chilean Association of Medicine Faculties (ASOFAMECH), characterizing its Social Focus, Humanist Approach, Social and Communication Skills. Material and Methods: Documentary analysis of profiles published on the respective web pages, using Atlas Ti software, establishing emerging categories and subcategories. These profiles were compared with the recommendations of the Pan-American Health Organization. Results: Data in Social Focus suggests that although community issues are a common element, the work in primary health and health promotion are rarely included. The Humanist Approach is addressed more commonly than the Social Focus, emphasizing humanization of care, ethical and religious values. Although, social and communication skills are scarcely acknowledged, those mentioned are teamwork and leadership role. Conclusions: There is a marked heterogeneity in the information declared and universities have not fully incorporated the recommendations of international organizations.

Teaching patient safety in the medical undergraduate program at the Universidade Federal de São Paulo / Ensino sobre segurança do paciente no curso de Medicina da Universidade Federal de São Paulo

Objective To analyze the Educational Project of the undergraduate medical course to verify what is taught regarding Patient Safety and to enable reflections on the educational practice. Methods A descriptive study, using document research as strategy. The document of investigation was the Educational Project of the medical course, in 2006, at the Escola Paulista de Medicina of the Universidade Federal de São Paulo. The theoretical framework adopted was the Multi-Professional Patient Safety Curriculum Guide of the World Health Organization, which led to the preparation of a list with 153 tracking terms. Results We identified 65 syllabus units in the Educational Project of the course, in which 40 (61.5%) addressed topics related to Patient Safety. Themes on the topic “Infection prevention and control” were found in 19 (47.5%) units and teaching of “Interaction with patients and caregivers” in 12 (32.5%); however content related to “Learning from errors to prevent harm” were not found. None of the framework topics had their proposed themes entirely taught during the period of education of the future physicians. Conclusion Patient safety is taught in a fragmented manner, which values clinical skills such as the diagnosis and treatment of diseases, post-treatment, surgical procedures, and follow-up. Since it is a recent movement, the teaching of patient safety confronts informative proposals based on traditional structures centered on subjects and on specific education, and it is still poorly valued. .

Objetivo Analisar o Projeto Pedagógico do curso de graduação em Medicina para verificar o que se ensina sobre segurança do paciente e propiciar reflexões sobre a prática educacional. Métodos Estudo descritivo, utilizando-se como estratégia a pesquisa documental. O documento de investigação foi o Projeto Pedagógico do curso de Medicina (ano base 2006), da Escola Paulista de Medicina da Universidade Federal de São Paulo. O referencial teórico adotado foi o Multi-Professional Patient Safety Curriculum Guide da Organização Mundial da Saúde, elaborando-se uma lista de 153 termos rastreadores. Resultados Foram identificadas 65 unidades curriculares no Projeto Pedagógico do curso, dentre as quais 40 (61,5%) lidavam com assuntos relacionados à segurança do paciente. Temas do tópico “Prevenção e controle da infecção” foram encontrados em 19 (47,5%) unidades e o ensino sobre “Interação com paciente e cuidadores” em 12 (32,5%), no entanto, conteúdos relacionados a “Aprendendo com os erros para evitar danos” não foram encontrados em nenhuma. Verificou-se que nenhum dos tópicos do referencial teve os temas propostos ensinados em sua totalidade durante o período de formação do futuro médico. Conclusão O ensino sobre segurança do paciente é ministrado de forma fragmentada valorizando-se as habilidades clínicas como diagnóstico e tratamento da doença, pós-tratamento, procedimentos cirúrgicos e acompanhamento. Por se tratar de um movimento recente, o ensino sobre segurança do paciente se confronta com propostas formativas baseadas em estruturas tradicionais, centradas nas disciplinas e na formação específica, sendo ainda pouco valorizado. .

Evaluación de componentes del currículum oculto en estudiantes de medicina / Assessment of hidden curriculum components by medical students

Background: Hidden curriculum refers to the unwritten, unofficial, and often unintended lessons, values, and perspectives that students learn at the university, which influences the acquisition of professional skills. Aim: To analyze the perception about the influence of the hidden curriculum in the education of medical students at the Universidad de Concepción, Chile. Material and Methods: Qualitative investigation with case study approach. Seventeen graduated medical students were selected by probability sampling. A semi-structured interview was used to collect the information and a content analysis was applied. Results: Forty seven percent of participants recognized having fulfilled their academic expectations. As favorable factors for academic achievement the students underlined clinical practice, access to patients and to clinical fields. As negative factors, they identified the lack of commitment, educational support and over-specialization of their mentors. Conclusions: The results show the strengths and weaknesses of the educational environment of undergraduated medical students. This information should be used to modify teaching environments.