Estructura factorial de la escala DREEM en estudiantes de medicina chilenos

Background: The entry to a University requires an adaptation process that not all students solve with the same kind of success. Even though students social adaptation and emotional skills are essential, the educational environmental that they perceive has a significant influence in their academic life. Aim: To describe the changes in the perception about academic environment that medical students experience during the first three years of undergraduate career. Material and Methods: The Dundee Ready Education Environment Measure (DREEM) scale was applied to 525 first to third year medical students and an exploratory factorial analysis was made. Results: Four factors were identified: Academic Perception: academic quality that students attribute to the process in which they take part, as well as to the assessment that they do of their learning outcomes (coefficient ± = 0.85); Academic Experience: refers to positive emotions that students experience during the career such as confidence, pleasure and energy (coefficient ± = 0.76); Atmosphere Perception, comfort and calm that students experiment during their academic activities (coefficient ± = 0.79); Teachers Perception: the perception that students have of teachers about their interest and disposition towards students (coefficient ± = 0.50). Conclusions: The assessment of academic environment quality is inversely associated with the lapse that the students have spent in their undergraduate careers.

Evaluación para el aprendizaje: experiencia en un curso teórico de pregrado en medicina / Assessment for learning: experience in an undergraduate medical theoretical course

Background: Assessment for learning is a paradigm that is taking shape in the field of medical education. This approach aims to embed the assessment process within the educational and learning process. Aim: To evaluate the impact of curricular changes, from a focus of assessment of learning to one of assessment for learning, in the perception of undergraduate students of medicine and their final grades obtained in a theoretical course (TCG). Material and Methods: In the year 2011 lectures were reduced and intermediate assessments followed by a feedback session were introduced. The activities of each program course, surveys about student perceptions of the course and the final grades of students (assessments with multiple choice questions) were compared between the periods prior and after curricular changes (2005-2010 and 2011-2013). Results: As a consequence of curricular changes, time for lectures was reduced by 19.5%, time for summative assessments was increased by 8.5%, and feedback activity, occupying 7.3% of the course time was added. There were significant improvements in student is perceptions in all areas assessed by surveys, emphasizing feedback and assessments. The overall grade assigned to the course dictated after implementing the changes increased from 6.18 to 6.59 (p < 0.001, 1-7 scale). The grades of students also improved from an average of 5.78 to 6.43 (p < 0.001, 1-7 scale). Conclusions: Assessment for learning achieved the desired educational impact without increasing the assigned curricular time. Programmatic assessment is favorably perceived by students.

Utilidad de la evaluación formativa en cursos clínicos integrativos en estudiantes de pregrado de medicina / Perception of medical students about formative assessments during clinical courses

Background: Formative evaluation is a range of formal assessment employed by professors during the teaching process in order to modify curriculum activities, to improve student attainment. For students, it is helpful to evaluate their learning process. Although recommended, it is seldom used. Aim: To evaluate the perception and performance of medical students subjected to formative assessments during an integrative clinical course. Material and Methods: Fourth year medical students that participated in a multiple choice formative assessment, similar to the final exam during 2007 and 2008, responded a survey about the usefulness and quality of such assessment. Student achievement was expressed as the percentage of correct answers of the tests. Results: The formative assessment was answered by 99% of students. In 2007 97% of students considered the experience as excellent or very good and 92% evaluated it as useful or very useful. During 2008 the figures were 89% and 79%. The students outlined that this assessment oriented their study, allowed them to discover their weaknesses and have a perception of the degree of difficulty of the final exam. Over 90% of students that took the formative evaluation, improved their academic achievement. Conclusions: Formative assessments are well evaluated by medical students and improve their academic achievement.

Análise de um sistema de avaliação de aprendizagem para internato em pediatria baseado em exame clínico objetivo estruturado, observação de prática clínica e exame escrito / Analysis of a learning assessment system for pediatric internship based upon objective structured clinical examination, clinical practice observation and written examination

OBJETIVO: Descrever e analisar três ferramentas usadas no sistema de avaliação aplicado ao internato em pediatria por um período de 7 anos na Faculdade de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile. MÉTODOS: Pesquisa observacional retrospectiva projetada para as modalidades de avaliação usadas de 2001 a 2007 que foram implementadas no internato em pediatria. As ferramentas foram as seguintes: exame clínico objetivo estruturado (objective structured clinical examination, OSCE), exame escrito e diretrizes de observação de prática clínica diária (DOPCD). Os métodos de avaliação foram aplicados ao internato em pediatria do sexto ano, com um total de 697 alunos. A análise estatística incluiu uma avaliação descritiva, com correlação e regressões linear simples e múltipla (ANOVA), teste de Bonferroni e coeficiente alfa de Cronbach. O nível de significância foi de 5 por cento. RESULTADOS: Escores de sucesso com a OSCE foram atingidos em 75,7±8 por cento, com melhor média entre o sexo feminino (p < 0,001). Os escores de OSCE melhoraram após o terceiro ano de implementação. O coeficiente alfa de Cronbach foi de 0,11-0,78. O exame escrito teve escore médio de 79,8±10 por cento, e não houve diferenças quanto a gênero. O escore médio de DOPCD 97,1±3 por cento, com melhores resultados entre as mulheres (p < 0,005). A correlação entre os três métodos de avaliação mostrou uma relação positiva moderada, exceto no ano de 2007, quando a correlação foi maior (p < 0,001). CONCLUSÕES: Análise do sistema de avaliação da aprendizagem foi realizada usando OSCE, exame escrito e DOPCD, que são complementares entre si, gerando bons resultados.

OBJECTIVE: To describe and analyze three tools used in the assessment system applied to the pediatric internship over a 7-year period at the School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile. METHODS: Retrospective observational research design for the assessment modalities implemented in the pediatric internship from 2001 through 2007. The tools were as follows: objective structured clinical examination (OSCE), written examination and daily clinical practice observation guidelines (DCPOG). The assessment methods were applied to the sixth-year pediatric internship with a total of 697 students. Statistical analysis included a descriptive assessment, with correlation and simple linear and multiple regressions (ANOVA), Bonferroni test and Cronbach's alpha coefficient. Significance level was set at p < 0.05. RESULTS: OSCE success scores were reached in 75.7±8 percent, with a better mean among females (p < 0.001). OSCE scores improved after the third year of implementation. Cronbach's alpha coefficient was 0.11-0.78. Written examination had a mean score of 79.8±10 percent and there were no sex differences. Mean DCPOG score was 97.1±3 percent and the results were better among females (p < 0.005). Correlation between the three assessment methods showed a moderate positive relationship except in the year of 2007, where the correlation was higher (p < 0.001). CONCLUSIONS: Analysis of the learning assessment system was performed using OSCE, written examination and DCPOG, which are complementary to each other, and yielded good results.

¿Están preparados los residentes e internos para enseñar?: Percepción de estudiantes de medicina de pre y postgrado / Are residents and interns prepared for teaching?: Perceptions of undergraduate and graduate medical students

Background: Every doctor is expected to be competent in teaching. There are few initiatives to prepare medical students for this role. Aim: To explore residents (graduate students) and interns (final year undergraduate students) perceptions of the importance of acquiring teaching skills and how prepared they feel to meet this role. To determine the importance that undergraduate students give to such teaching. Material and Methods: Residents and interns participated in focus groups, and completed the Medical Education Readiness Questionnaire (METRQ), 5th year medical students were also invited to complete it. Results: Three hundred and seventy seven subjects answered the questionnaire. The perceived importance of having teaching skills was 6.1 ±1.2 among residents and 5.7 ± 1.6 among interns, in a scale 1 to 7. Their perception of their own preparation for teaching was 4.3 ± 1.6 for both groups in the same scale. Students evaluated the preparation of the residents for teaching as 5.2 ± 1.6 and that of the interns as 4.4 ±1.7. Seventy-eight percent of 5th year medical students reported to learn more than two. 5 hours a week from residents. Fifty-nine percent of residents and 66 percent of interns reported to teach up to 2.5 hours per week to the same students. Focus groups participants agreed that teaching is an important role for a physician, and that to do it properly requires personal characteristics, along with teaching skills. They also found that the best opportunities to learn how to teach are during practical training. Conclusions. Our study contributes to the recognition of the teaching role of physicians and the need for teaching training among medical students.