Aprendizaje Basado en Casos Clínicos (CCBL): una metodología activa aplicable a carreras de ciencias de la salud / Clinical Case-based Learning (CCBL): an active methodology applicable to health sciences careers

Se realizó un análisis bibliográfico sobre la utilización de casos clínicos como estrategia didáctica en las carreras de medicina, enfermería, kinesiología y nutrición. Es fundamental para los docentes estar innovando continuamente en las estrategias de aprendizaje, y promover una flexibilización curricular, para mejorar los procesos de enseñanza universitaria, impulsando un cambio en las metodologías docentes en función del estudiante de manera activa, dando paso a un proceso de enseñanza-aprendizaje dinámico que se adapta a las circunstancias históricas sociales. El objetivo de esta revisión es analizar las evidencias disponibles sobre la utilización de casos clínicos y su aporte a las habilidades y competencias exigidas en los perfiles de estas cuatro carreras de la salud

A bibliographical analysis was carried out on the use of clinical cases as a didactic strategy in medicine, nursing, kinesiology and nutrition undergraduate programs. Is essential for teachers to be continuously innovated in learning strategies, and promote curricular flexibility, to improve university teaching processes, promoting a change in teaching methodologies based on the student in an active way, giving way to a teaching process -dynamic learning that adapts to historical-social circumstances. The objective of this review was to analyze the available evidence on the use of clinical cases and their contribution to the skills and competencies required in the profiles of these four health undergraduate programs

Gestión de una oficina de educación médica: evidencia de 10 años y planteamientos de nuevos desafíos para el siglo XXI

Background: Training of health care students at universities is a great challenge for Medical Education Offices. Our office made clear and explained the teaching-learning process from the perspective of teachers, programs, and students. Aim: To report a ten years' analysis of a Medical Education Office (MEO) work, describing the different processes and systematized decisions aimed to improve the quality of the programs and learning results. Material and Methods: A 10 years retrospective analysis of the Medical Education Office processes directed to Medicine, Nursing, Physical Therapy, and Nutrition careers of a Faculty of Medicine. Flunks between 2013 and 2017 were compared. Results: A progressive reduction in flunks was observed in the four careers. Specifically, the proportion of flunks in Nutrition decreased from 30 to 9%. When comparing flunks using a Chi-square test of homogeneity in the four careers, a significant decrease in four of six courses was observed. This led to a sustained increase in number of students who completed their career and obtained their title. Specifically, in Medicine there was a 7.5-fold increase in these figures. The Diploma course trained 90% of the teachers in charge of courses of the four careers. The master's degree generated research that allowed to increase the productivity in health sciences education. Conclusions: The Office of Medical Education created knowledge and management models for the education of health sciences students, enhancing the quality of training and learning processes.

Las percepciones del tutor clínico sobre su desempeño docente: un estudio reflexivo / Tutorial teaching in medicine from the perspective of teachers

Background During clinical tutoring, medical students are trained to transfer theoretical knowledge to real life situations that need to be solved. Tutors should be trained to acquire skills to encourage motivation, transfer experience and inspire interest in learning among students. Aim To inquire about interests and needs during the daily work of clinical tutors. Material and Methods A qualitative study inserted in the Grounded Theory, based on the description of the meanings, in which ten clinical tutors responded to an interview in their own workplace. After obtaining consent, the responses were recorded and transcribed using Georgi's method for analysis. Results Teachers feel that there is a gap between the theoretical basis of tutorial teaching and the reality. They are especially interested in a teaching process based on values. They recognize that their pedagogical skills should be improved to improve their communication with students. They also feel that they require more skills to transfer theoretical knowledge to clinical situations. Conclusions A personal satisfaction for educating and training, the transmission of experiences, empathy and being assertive are emerging values that motivate tutors to deliver a quality education, above remunerations or contractual ties. However, the skills to transfer clinical knowledge to students should be improved.

Impacto de la aplicación del enfoque de autorregulación del aprendizaje sobre los resultados en asignaturas de corte científico en estudiantes de medicina de la Universidad Finis Terrae / The impact of a self-directed teaching approach on academic performance of medical students

Background: Students should be encouraged to become reflexive and develop autonomous, lifelong learning habits. Therefore, teachers should focus on learning strategies which stimulate autonomous learning. Aim: To assess the impact of a self-directed teaching methodology on the academic performance of medical students in cellular biology and biochemistry. Materials and Methods: During 2013, 85 students received a traditional teaching methodology and during 2014, 85 students received a self-directed learning methodology. The grades obtained and the number of failures in the courses of cellular biology and biochemistry were compared in both groups. Results: The percentages of students approved at the end of the courses during 2013 and 2014 were 64 and 96% respectively (p < 0.01). The grades obtained by the 2014 students were also significantly higher than those obtained by 2013 students. Conclusions: This study confirms that academic performance improves with a self-directed teaching approach.

Evaluación de un programa de perfeccionamiento docente implementado en la Facultad de Medicina de la Universidad Finis Terrae / Evaluation of a teaching training program implemented in a faculty of medicine

Background: Since 2010, the Faculty of Medicine at Finis Terrae University implemented a training program aiming to train health professionals in effective educational practices. Aim: To evaluate the effect of training in teachers who are in charge of planning courses, conducting classes and learning assessment. Material and Methods: Quality of planning, lecture performance and academic performance of students were evaluated in 55 teachers prior and after attending the training course on teaching methodologies and in 47 teachers not attending the course. Results: The percentage of trained teachers complying with the aforementioned indicators was significantly higher than those without training (p < 0.01). There were significant differences in favor of the group of teachers who attended and passed the Diploma. Trained teachers had significantly higher students’ approval rate. (Odds ratio 4.5, p < 0.01). Conclusions: The teaching Diploma in Health Sciences improved the planning, teaching and academic performance of teachers.

Efecto del enfoque de autorregulación del aprendizaje en la enseñanza de conceptos científicos en estudiantes universitarios en ciencias de la salud / The efficiency of self-regulated learning in the teaching of scientific concepts to health sciences students

Background: In health sciences, the predominant teaching methodology is traditional and emphasizes conveying knowledge. Nonetheless, new abilities must be taught now. This change shifts the prominence from professor to student and incorporates a concept called self-regulated learning, which involves the professor as a mediator and incorporates guidelines that facilitate learning diverse skills. Aim: To compare the effects of two teaching methodologies on the learning of key scientific concepts among health science students. Material and Methods: Two subgroups of equally complex concepts were randomly chosen to be taught either using traditional or self-regulation methodology. For the self-regulation methodology, two groups were formed. One learned only through self-regulation guidelines and the other learned through classes where the professor was a mediator. One hundred thirty seven freshman students from medicine, physical therapy, and nursing careers participated voluntarily in the study. Results: Self-regulation methodology impacted the learning process of scientific concepts in a positive way and showed significant differences with traditional teaching. The sole use of self-regulation guidelines alone generated similar results, compared to those obtained by students who attended lectures. Conclusions: Self-regulated learning would improve in learning efficiency and would reduce face-to-face class time.

Impacto de un programa de nivelación de ciencias básicas en estudiantes de primer año de la carrera de Medicina / Effects on academic performance of a leveling program in basic sciences in first year medical students

Background: A significant number of students in health careers do not have the knowledge to approve basic courses. Therefore, educational programs to level off knowledge have been developed. Aim: To associate the results of a leveling program with the academic performance in cell biology (CB) and biochemistry (BC) of first year medical students. Material and Methods: We applied a test to first year medical students at the beginning and end of the leveling program (control test). The results obtained at the end of the leveling program were correlated with the results obtained in CB and BC. Results: Fifty seven of89 (64%) first year medical students met the study entry criteria (54% female). Students who completed the leveling program had a significantly higher approval rate in CB (93% versus 75%, P = 0.024), and in BC (95% versus 69%, P = 0.001). After completing the leveling program, the risk of failing CB and BC, decreased by 72 and 84% respectively Conclusions: This study shows that medical students who participate in the leveling program decrease the chances of failing in CB and BC.

Valor diagnóstico de la PPD en la detección de tuberculosis / Diagnostic Value of PPD for the detection of tuberculosis

Objetivos: Realizar una revisión sistemática de la bibliografía publicada sobre el valor de la prueba de Mantoux como método diagnóstico en la infección por Mycobacterium tuberculosis. Métodos: La revisión de artículos fue limitada a aquellos que incluían población pediátrica y con fecha de publicación dentro de los últimos 20 años. Fueron incluídos en nuestra selección aquellos artículos en los que se estimó el valor diagnóstico de la PPD comparada con una prueba de diagnóstico de certeza en poblaciones pediátricas. Resultados: De los 96 artículos encontrados, solamente 3 artículos cumplieron los criterios de inclusión. En la mayoría de ellos los autores concuerdan que no existe un único método patrón para el diagnóstico de tuberculosis. Una prueba positiva de PPD no implica enfermedad, y a su vez presenta falsos negativos. Los pacientes incluídos fueron categorizados según parámetros clínicos, epidemiológicos, radiológicos e histopatológicos; y luego, se realizó la PPD. Luego de la lectura de la prueba de tuberculina ningún paciente necesitó ser recategorizado. La mayoría de los trabajos actuales se encuentran enfocados en nuevas pruebas diagnósticas como el dopaje de IFN gamma específico para la detección de tuberculosis. Conclusión En el último tiempo todos los esfuerzos de investigación de esta enfermedad se están centrando en métodos de diagnóstico rápido y se ha dejado de publicar investigaciones válidas de la PPD. La prueba de tuberculina asilada no brinda información diagnóstica certera de enfermedad aguda, sino que debe ser tenido en cuenta conjuntamente con el cuadro clínico y epidemiológico. Nuevos métodos confirmatorios como el dosaje de INF gamma en sangre pueden ayudar a la hora de definir casos de enfermedad por tuberculosis, aunque aún la experiencia en niños es escasa.