Efectividad del procedimiento para la formación del proyecto de vida profesional en estudiantes de Medicina

Fundamento: el proyecto de vida profesional constituye una formación psicológica compleja que debe ser desarrollada y evaluada durante las acciones que se realizan en los procesos sustantivos universitarios: formación, investigación y extensión universitaria. Objetivo: validar la efectividad del procedimiento para la formación del proyecto de vida profesional en estudiantes de Medicina. Métodos: se realizó una investigación cuantitativa de tipo preexperimental en la Universidad de Ciencias Médicas de Holguín, Facultad de Ciencias Médicas Mariana Grajales Coello, desde enero de 2021 hasta diciembre del 2022. Se utilizaron como métodos teóricos el analítico sintético, inductivo-deductivo y la modelación. Los métodos empíricos aplicados fueron el cuestionario a expertos, la observación y el instrumento "Exploración del proyecto de vida profesional". La investigación se llevó a efecto en tres etapas para la presentación, la valoración y la evaluación del procedimiento. Resultados: se aportó un procedimiento para la formación del proyecto de vida profesional en estudiantes de la carrera Medicina a implementarse durante los procesos sustantivos universitarios. El criterio de expertos permitió evaluar el procedimiento como bastante adecuado. El preexperimento mostró su efectividad para alcanzar el objetivo. Conclusiones: existen insuficiencias en el tratamiento del proyecto de vida profesional durante la formación inicial. La validación del procedimiento fue aceptada por los expertos porque contribuye a la calidad del proceso pedagógico en la carrera Medicina.

Foundation: the professional life project constitutes a complex psychological training that must be developed and evaluated during the actions carried out in the substantive university processes: training, research and university extension. Objective: validate the formation procedure effectiveness for the professional life project in medical students. Methods: a pre-experimental quantitative research was carried out at the Holguín Medical Sciences University, Mariana Grajales Coello Medical Sciences Faculty, from January 2021 to December 2022. Synthetic analytical, inductive-deductive and analytical methods were used as theoretical methodsand modeling. The empirical methods applied were the expert questionnaire, observation and the Exploration of the professional life project instrument. The research was carried out in three stages for the presentation, assessment and evaluation of the procedure. Results: a procedure was provided for the professional life project formation in Medicine students to be implemented during the substantive university processes. Expert judgment allowed the procedure to be evaluated as quite adequate. The pre-experiment showed its effectiveness in achieving the objective. Conclusions: there are insufficiencies in the treatment of the professional life project during initial training. The validation of the procedure was accepted by the experts because it contributes to the pedagogical process quality in the Medicine career.

Percepção de alunos ingressantes de Medicina sobre o aprendizado durante a pandemia da Covid-19 / Perception of freshmen Medical students about learning during the Covid-19 pandemic

RESUMO Introdução: No ano de 2019, com o surgimento pandemia pelo coronavírus, o mundo teve que se adaptar e utilizar medidas de distanciamento social visando ao controle da disseminação do vírus. Um dos setores que sofreram maior impacto com essas medidas foi a educação que precisou se adaptar ao ensino remoto emergencial. Objetivo: Este estudo teve como objetivo compreender a percepção dos alunos de um curso de Medicina sobre o próprio aprendizado durante o período da pandemia pela Covid-19. Método: Trata-se de uma pesquisa descritiva e exploratória, de abordagem qualitativa. O referencial teórico foi o interacionismo simbólico. O estudo foi realizado em uma instituição de ensino superior privada do Distrito Federal. Participaram do estudo 14 alunos do terceiro ano da graduação em Medicina de turmas que tiveram a oportunidade de cursar períodos da graduação por meio do ensino remoto emergencial. Os dados foram coletados por meio de entrevista gravada, na modalidade grupo focal, e analisados por meio da análise temática indutiva. Respeitaram-se todos os conceitos éticos da Resolução nº 466/2012 do Conselho Nacional de Saúde. Resultado: A análise dos discursos resultou em três categorias temáticas que exploram a percepção dos estudantes sobre o aprendizado. A primeira categoria, "Vivendo como se fosse em um balão de ensaio", aborda as mudanças vivenciadas pelos alunos no ingresso na faculdade, com sentimentos de medo, insegurança e falta de motivação devido ao estresse da pandemia. A segunda categoria, "Sentindo-se isolados e desolados", observou a percepção do adoecimento mental e a falta de apoio dos colegas, dos professores e da instituição, influenciando no desempenho e aprendizado dos alunos. A terceira categoria, "Lidando com erros e acertos", identificou a percepção dos resultados do aprendizado durante e após a pandemia, destacando o impacto no déficit de conhecimento e a necessidade de adaptação no retorno ao ensino presencial. Conclusão: O ensino remoto emergencial trouxe drásticas mudanças no ensino médico. Entender essas mudanças e compreender a percepção dos alunos sobre o aprendizado nesse período nos permite reconhecer os desafios enfrentados, entender a necessidade de suporte emocional adequado e pensar em estratégias de aprendizado eficazes para superar essas e outras adversidades.

ABSTRACT Introduction: In 2019, with the emergence of the coronavirus pandemic, the world had to adapt to using social distancing measures to control the spread of the virus. Social isolation measures were imposed and one of the sectors that suffered the greatest impact from these measures was the education sector, having to adapt to emergency remote education (ERE). Objectives: To understand the perception of students attending a medical course in relation to their own learning during the period of the Covid-19 pandemic. Method: This is a descriptive and exploratory research with a qualitative approach. The theoretical framework was Symbolic Interactionism. The study was carried out in a private higher education institution in the Federal District. The study included 14 students attending the third semester of medical undergraduate school from classes that had the opportunity to attend undergraduate periods through ERE. Data were collected through recorded interviews, in the Focus Group modality, and analyzed using Inductive Thematic Analysis. All ethical concepts of Resolution n. 466/2012 from the Health National Council were respected. Results and Discussion: The analysis of the discourses resulted in three thematic categories that explore the students' perception of learning. The first category, "Living as if in a test balloon", addresses the changes experienced by students when entering college, with feelings of fear, insecurity and lack of motivation due to the stress of the pandemic. The second category, "Feeling isolated and desolate", observed the perception of mental illness and the lack of support from classmates, teachers and the institution, influencing the students' performance and learning. The third category, "Dealing with mistakes and successes", identified the perception of learning outcomes during and after the pandemic, highlighting the impact on the knowledge deficit and the need to adapt when returning to face-to-face teaching. Final considerations: the Emergency Remote Education brought drastic changes in medical teaching. Understanding these changes and understanding the students' perception of learning in this period allows us to recognize the challenges faced, understand the need for adequate emotional support and think of effective learning strategies to overcome these and other adversities.

Aprendizaje en investigación clínica: experiencia de enseñanza híbrida con estudiantes de medicina / Learning in Clinical Research: Hybrid Teaching Experience with Medical Students

Introducción: la pandemia de COVID-19 indujo un cambio en nuestro sistema de salud y de educación. Los programas formativos también tuvieron que adaptarse y exigieron un cambio rápido. Objetivos: describir una experiencia educativa de enseñanza virtual/híbrida en investigación clínica, entre docentes del Servicio de Clínica de un hospital universitario y estudiantes de Medicina de una institución privada, que participaron del Programa ESIN (EStudiantes en INvestigación). Metodología: los contenidos y las estrategias educativas incluyeron las clases teóricas audiograbadas o videograbadas (asincrónicas y autoadministradas), el aprendizaje basado en proyectos, los talleres prácticos (encuentros sincrónicos virtuales y grupales), mediante la adopción de modelos de aprendizaje como el aula invertida, y la tutoría individual entre docente-estudiante. Los datos se recopilaron mediante la observación en contextos académicos, y basándonos en elementos de encuestas anónimas de satisfacción, previo consentimiento informado de los participantes. Resultados: participaron 14 estudiantes, 6 durante el año 2021 y 8 durante 2022. Todas mujeres y estudiantes de medicina (50% de cuarto año, 35% de sexto año y 15% de quinto año). Las técnicas implementadas favorecieron la participación y promovieron el aprendizaje activo, basado en proyectos. Mencionaron aspectos positivos como el enfoque académico práctico, la disponibilidad del equipo docente para atender cualquier duda, el tiempo y el entusiasmo por enseñar y fomentar la participación. Los videos teóricos resultaron útiles como herramientas de repaso, y los encuentros grupales fueron especialmente valorados, si bien los encuentros individuales fueron destacados como ayuda y apoyo previo a los congresos científicos. En general, manifestaron que fue una experiencia enriquecedora que demostró que se puede lograr lo que se creía imposible. Todas participaron activamente de al menos un congreso científico, y el 50% resultó coautora de una publicación académica. Conclusión: los estudiantes asumieron compromisos y responsabilidades, e incorporaron competencias y habilidades en la implementación y en la difusión de los proyectos. Esta experiencia educativa facilitó que el tiempo de clase pudiera optimizarse para intercambio, discusión y dudas. Los recursos producidos, las actividades desarrolladas y los contenidos abordados quedan disponibles a nivel institución. (AU)

Introduction: the COVID-19 pandemic brought about a change in our health and education system. Training programs also had to adapt and required rapid change. Objectives: to describe an educational experience of virtual/hybrid teaching in clinical research between teachers of the Clinical Service of a university hospital and medical students of a private institution who participated in the ESIN Program (Students in Research). Methodology: the contents and educational strategies included audio or videotaped lectures (asynchronous and self-administered), project-based learning, practical workshops (virtual and group synchronous meetings) by adopting learning models such as the inverted classroom, and individual tutoring between teacher and student. We gathered the data through observation in academic contexts and based on elements of anonymous satisfaction surveys, with prior informed consent of participants. Results: fourteen students participated, six in 2021 and eight in 2022. All were women and medical students (50% fourth year, 35% sixth year, and 15% fifth year). The techniques implemented favored participation and promoted active, project-based learning. They mentioned positive aspects such as the practical academic approach, the availability of the teaching team for any doubts, the time and enthusiasm for teaching, and encouraging participation. The theory videos were a valuable review tool, and team meetings received high praise even if the one-on-one meetings received much attention as help and support before the scientific congresses. In general, they stated that it was an enriching experience that showed that you can achieve what you thought impossible. All of them actively participated in at least one scientific congress, and 50% were co-authors of an academic publication. Conclusion: the students assumed commitments and responsibilities and incorporated competencies and skills in project implementation and dissemination. This educational experience helped to optimize class time for exchange, discussion, and doubts. The resources produced, the activities developed, and the contents addressed are now available at the institutional level. (AU)

Impact of the "Journal Club" activity among medical students' knowledge of scientific methodology / Avaliação de impacto da atividade "journal club" no conhecimento de metodologia científica entre os estudantes de medicina

Introduction: The Journal Club is an environment for exchanging information within the medical context concerning updated literature and evidence-based medicine. Considering the importance of constantly updating the acquired knowledge and scenarios of social isolation imposed by the COVID-19 pandemic, the Journal Club event was held virtually, aiming to expand the understanding of the scientific methodology among medical students by understanding the differences among each type of evidence pyramid study by reading and discussing scientific articles. Methodology: An analytical, prospective, and cross-sectional study was conducted in October 2021. The Journal Club event took place in nine classes where each type of evidence pyramid study was addressed. The sample included 20 medical students. A questionnaire was used at the beginning and end of the event to assess the participants' knowledge from the classes taught and was divided into two parts: participant identification data and 19 questions regarding the types of studies present on the pyramid of evidence. Results: It was found that after the pre- and post-event analysis of the questionnaire among the 19 questions, correct answers increased in 17, among which 3 obtained a statistically significant value: questions 1 (p = 0.031), 15 (p = 0.039), and 18 (p = 0.016). Discussion: An increase in the number of correct answers was noted between pre- and post-classes, which may indicate an improved understanding of the subject among students. Furthermore, the study demonstrated that the students had little involvement in scientific research (only 25% had ever been involved in a project). Conclu-sion: Based on the analysis of the participants' performance in the pre- and post-event questionnaires, it can be concluded that the medical students were able to expand their knowledge of scientific methodology (AU).

Introdução: O Journal Club é um ambiente para troca de informações dentro do contexto médico, diante de uma literatura atualizada e medicina baseada em evidências. Tendo em vista a importância da atualização constante de conhecimentos adquiridos e o cenário de isolamento social imposto pela pandemia da COVID-19, o evento Journal Club foi realizado virtualmente, com o objetivo de ampliar o entendimento sobre metodologia científica entre estudantes de medicina por meio da compreensão das diferenças de cada tipo de estudo da pirâmide de evidências a partir da leitura e discussão de artigos científicos. Metodologia: Estudo analítico, prospectivo e transversal realizado em outubro de 2021. O evento Journal Club ocorreu em nove aulas onde foram abordados cada tipo de estudo da pirâmide de evidência. A amostra foi composta por 20 estudantes de medicina. Um questionário foi aplicado no início e ao final do evento para avaliar o conhecimento dos participantes a partir das aulas ministradas, e foi dividido em duas partes, a primeira com dados de identificação do participante e a segunda com 19 questões sobre os tipos de estudos presentes na pirâmide de evidência. Resultados: Observou-se que, após a análise do questionário pré e pós-evento, dentre as 19 questões realizadas, houve um aumento de acertos em 17 entre as quais 3 obtiveram um valor estatístico significativo: questões 1 (p= 0,031), 15 (p=0,039) e 18 (p= 0,016). Discussão: Notou-se aumento dos acertos de questões entre o pré e pós-aulas, podendo indicar uma melhora no entendimento por parte dos acadêmicos acerca do assunto. Além disso, o estudo mostrou uma baixa atuação dos acadêmicos em pesquisas científicas (apenas 25% já se envolveram em algum projeto). Conclusão: A partir da análise do desempenho dos participantes nos questionários pré e pós-evento é possível afirmar que os estudantes de medicina conseguiram ampliar seu conhecimento sobre metodologia científica (AU).

Identificación de contenidos de pertinencia intercultural para la atención de salud para el plan de estudios de odontología

Introducción: La diversidad cultural en Chile y las inequidades en el acceso y calidad de la atención requiere del desarrollo de competencias culturales en los profesionales de la salud debido a las inequidades en el acceso y calidad de la atención. A nivel internacional, se ha integrado la competencia cultural en los planes de estudio de las carreras de salud, pero en Chile está en sus etapas iniciales. Métodos: Se utilizó una metodología mixta que incluyó: revisión documental (búsquedas y análisis en bases de datos y documentos oficiales), entrevistas a informantes clave y consenso de expertos. Las entrevistas se transcribieron textuales y se realizó un análisis temático utilizando el software ATLAS.ti. Resultados: La revisión documental identificó dominios, objetivos e instrumentos utilizados para medir la competencia cultural en odontología. Las entrevistas revelaron cuatro categorías principales: concepciones de salud, facilitadores y barreras, y características de los profesionales de la salud. Se elaboró un listado de contenidos y resultados de aprendizaje, evaluados y consensuados por expertos. Conclusiones: La inclusión de la competencia cultural en los planes de estudio de odontología es esencial para una atención de salud más inclusiva y culturalmente segura. Se recomienda su integración longitudinal en diversos cursos, empleando metodologías efectivas de enseñanza y evaluación. Los resultados de este estudio ofrecen una guía para identificar los conocimientos, habilidades y actitudes necesarios para formar a los profesionales de salud que finalmente deben entregar una apropiada atención de salud con pertinencia intercultural.

Introduction: Cultural diversity in Chile and inequities in access and quality of care require the development of cultural competencies in health professionals. Internationally, cultural competence has been integrated into the curricula of health professional programs; however, in Chile it is still in its early stages. Methods: A mixed methodology included documentary review (searches and analysis in databases and official documents), key informant interviews and expert consensus. The interviews were transcribed verbatim, and thematic analysis was carried out using ATLAS.ti software. Results: The documentary review identified domains, objectives and instruments used to measure cultural competence in dentistry. The interviews revealed four main categories: conceptions of health, facilitators and barriers, and characteristics of health professionals. Experts developed, evaluated and agreed upon content and learning outcomes. Conclusion: Including cultural competence in dental curricula is essential for more inclusive and culturally safe health care. Its longitudinal integration into various courses, employing effective teaching and assessment methodologies, is recommended. The results of this study provide a guide to identifying the knowledge, skills, and attitudes needed to train health professionals who ultimately deliver appropriate health care with cultural pertinence.

Food insecurity in Chilean university students during the COVID-19 pandemic

Background: Food and nutrition were affected by the COVID-19 pandemic, increasing levels of food insecurity. University students were a risk group for food insecurity due to the closure of educational establishments where they received their main meals. Aim: To assess food insecurity among Chilean public university students before and during the COVID-19 pandemic. Material and Methods: The study had a non-probabilistic before-and-after design. Undergraduate students from all colleges at the university were invited to answer an online survey about food insecurity, devised based on FAO Food Insecurity Experience Scale. Results: Nine hundred and one students answered the survey. The prevalence of moderate/severe food insecurity increased from 9.5% to 14.3% before and during the pandemic, respectively. Forty two percent (n = 196) of student households became food insecure during the sanitary crisis. Students commented on the positive and negative aspects of the pandemic in their eating behaviors. Conclusions: Undergraduate students are vulnerable to food insecurity. Mitigation actions should be carried out when educational establishments are closed.

Antecedentes: La alimentación y la nutrición se están viendo afectadas por la pandemia por COVID-19, aumentando los niveles de inseguridad alimentaria. Un grupo susceptible a la inseguridad alimentaria son los estudiantes universitarios debido al cierre de los establecimientos educativos donde ellos pueden recibir sus alimentos principales. Objetivo: Evaluar la inseguridad alimentaria de los estudiantes de una universidad pública de Chile, antes y durante la pandemia por COVID-19. Material y Métodos: El estudio tuvo un diseño de antes y después, no probabilístico. Se invitó a participar a estudiantes universitarios de todas las facultades de la universidad a contestar un cuestionario en línea, desarrollado basado en la escala de experiencia de inseguridad alimentaria de la FAO. Resultados: Novecientos y un estudiantes respondieron la encuesta. En estos estudiantes, la prevalencia de inseguridad alimentaria moderada/grave aumentó de 9,5% a 14,3% antes y durante la pandemia, respectivamente. El 42,3% (n = 196) de los hogares estudiantiles pasó a tener inseguridad alimentaria durante la crisis sanitaria. Los estudiantes comentaron aspectos positivos y negativos de la pandemia en sus conductas alimentarias. Conclusiones: Estos resultados reflejan que estos estudiantes son vulnerables para inseguridad y amerita acciones de mitigación cuando los establecimientos educativos están cerrados.

Ensino da anatomia: dissecção em associação com a tecnologia no curso de Medicina / Teaching anatomy: dissection in association with technology in the Medical course

Resumo: Introdução: Um estudo de 2010 apontou as necessidades futuras da educação médica, com conteúdos e práticas integrados, fomentada pela tecnologia educacional virtual e pela prioridade na competência, não no tempo. A anatomia, indistinta de outros fundamentos da medicina, enfrenta restrições à dissecção de cadáveres. Objetivo: Ensaio sobre o ensino da anatomia em contextos clínicos e com emprego de tecnologias. Método: Utilizaram-se a plataforma PubMed da National Library of Medicine e os descritores ((anatomy [MeSH Terms]) AND (method, teaching [MeSH Terms])) AND (surgery [MeSH Terms]). Resultado: Há indicação de 316 artigos no período 2000-2022 (junho de 2022). A principal pergunta sobre o ensino de anatomia refere-se à substituição da técnica de dissecção e, por consequência, do uso do cadáver. Estudos sugerem a manutenção do uso da dissecção, da prossecção e de maior uso de meios digitais e modelares. Conclusão: O material cadavérico deve ser garantido com maior uso da prossecção, com a dissecção sendo dirigida ou eletiva. Realidade virtual e material de prossecção devem ser assimilados como instrumentais e supervisionados por anatomistas qualificados e enriquecidos pela interpretação e aplicabilidade clínica.

Abstract: Introduction: A 2010 study pointed out the future needs of medical education, with integrated contents and practices, fostered by virtual educational technology and by prioritizing competence, not time. Anatomy, indistinguishable from other fundamentals of medicine, faces restrictions on cadaver dissection. Objective: Essay on the teaching of anatomy in clinical contexts and the use of technologies Method: The "pubmed" platform of the National Library of Medicine and descriptors ((anatomy[MeSH Terms]) AND (method, teaching[MeSH Terms])) AND (surgery[MeSH Terms]) were used. Result: There are indications of 316 articles in the period 2000-2022 (June 2022). The main question about the teaching of Anatomy is the replacement of the dissection technique and, consequently, the use of the cadaver. Studies suggest maintaining the use of dissection, prosection and greater use of digital and model means. Conclusion: Cadaveric material should be secured with greater use of prosection and dissection being directed or elective. Virtual reality and permanent material must be assimilated as instrumental and supervised by qualified anatomists and enriched by interpretation and clinical applicability.

Semblance of a physician: medical students' experiences during Type 2 Diabetes Mellitus clinic simulation / Com o semblante de médico: experiências de estudantes de medicina durante a simulação clínica em Diabetes tipo 2 / Con el semblante de médico: experiencias de estudiantes de medicina durante la simulación clínica en Diabetes tipo 2

This qualitative research aimed to understand the experiences of a fourth-year medical class during two clinical simulation scenarios of type 2 diabetes management in Primary Care. Ten simulated students were interviewed. The results describe the symbolic conception of diabetes and its treatment as anguish, damage, condemnation and an unpleasant sentence that affects the appropriation and performance of the medical role by students. Considering Medical Psychology, we suggest that such subjective factors should be addressed in teaching-learning in addition to commonly cognitive aspects mentioned in the medical education literature in order for students to develop the work profile to cope with diabetes in Primary Care. Clinical simulation facilitates the subjective approach through its group support component to promote reflection, insights and self-awareness.(AU)

Esta pesquisa qualitativa objetivou compreender as experiências de estudantes de um quarto ano médico durante dois cenários de simulação clínica do manejo do diabetes tipo 2 na Atenção Primária. Dez estudantes simulados foram entrevistados. Os resultados descrevem a concepção simbólica do diabetes e seu tratamento como angústia, dano, condenação e uma sentença desagradável que afeta a apropriação e o desempenho do papel médico pelos estudantes. Considerando a Psicologia Médica, sugerimos que os fatores subjetivos apontados devem ser abordados no ensino-aprendizado além de aspectos cognitivos mais comuns na literatura de educação médica para que os estudantes desenvolvam o perfil de trabalho ao enfrentamento do diabetes na Atenção Primária. A simulação clínica permite esta abordagem subjetiva por seu componente de suporte grupal promovendo reflexão, insights e autoconsciência.(AU)

Esta encuesta cualitativa tuvo el objetivo de comprender las experiencias de estudiantes del cuarto año de medicina durante dos escenarios de simulación clínica del manejo de la diabetes tipo 2 en la Atención Primaria. Fueron entrevistados 10 estudiantes simulados. Los resultados describen la concepción simbólica de la diabetes y su tratamiento, tales como angustia, daño, condenación y una sentencia desagradable que afecta la apropiación y el desempeño del papel médico por parte de los estudiantes. Considerando la Psicología Médica, sugerimos que los factores subjetivos señalados deben abordarse en la enseñanza-aprendizaje, más allá de aspectos cognitivos más comunes en la literatura de educación médica para que los estudiantes desarrollen el perfil de trabajo para el enfrentamiento de la diabetes en la Atención Primaria. La simulación clínica permite este abordaje subjetivo por su componente de soporte grupal promoviendo reflexión, insights y autoconciencia.(AU)

Percepción de docentes sobre habilidades comunicativas de sus estudiantes para una adecuada relación médico-paciente / Perception of teachers about communication skills of their students for an adequate doctor-patient relationship

Fundamento: la existencia de insatisfacciones en la relación médico-paciente constituye una preocupación por la dirección del Estado y del sector de salud cubanos. Objetivo: valorar el desarrollo de las habilidades comunicativas de los educandos, según la percepción docente sobre el cumplimiento de las funciones de la comunicación para una adecuada relación médico-paciente. Métodos: se realizó una investigación cualitativa en la Facultad de Medicina de la Universidad de Ciencias Médicas de Villa Clara, Cuba, entre mayo-junio 2021. Se aplicaron métodos teóricos: análisis-síntesis, inducción-deducción e histórico-lógico; y empíricos: análisis documental y encuesta de opinión estructurada a los docentes sobre la base de las funciones comunicativas. Los resultados se expresaron en porcientos según los indicadores para la valoración, y se ilustraron en figuras. Resultados: la malla curricular de la carrera de Medicina ofrece posibilidades de desarrollo de habilidades comunicativas como basamento para una adecuada relación médico-paciente, constituyen fortalezas las asignaturas y disciplinas propias de la formación en pregrado y la educación en el trabajo. La función informativa de la comunicación resultó ser la más favorecida en los criterios expresados por lo docentes; obtuvieron más bajos porcientos la reguladora y la afectiva. Conclusiones: la percepción docente mostró insuficiencias en la relación médico-paciente en todas las funciones, por lo que se precisa elaborar estrategias para el desarrollo de las habilidades comunicativas, imprescindibles en la formación médica humanitaria que caracteriza la asistencia médica cubana.

Background: the existence of dissatisfies in the doctor-patient relationship constitutes a concern for the direction of the State and the Cuban health branch. Objective: to assess the development of students' communication skills, according to the teacher's perception of compliance with communication functions for an adequate doctor-patient relationship. Methods: a qualitative research was carried out at the Faculty of Medicine of Villa Clara University of Medical Sciences, Cuba, from May to June 2021. Theoretical methods were applied: analysis-synthesis, induction-deduction and historical-logical; and empirical ones: documentary analysis and structured opinion survey of teachers based on communicative functions. The results were expressed in percentages according to the indicators for the assessment and were illustrated in figures. Results: the curriculum of the Medicine career offers possibilities for the development of communication skills as a basis for an adequate doctor-patient relationship, the subjects and disciplines of undergraduate training and the in-service training are strengths. The informative function of communication turned out to be the most favored in the criteria expressed by the teachers; the regulatory and affective obtained lower percentages. Conclusions: the teacher's perception showed insufficiencies in the doctor-patient relationship in all functions, which is why it is necessary to develop strategies for the development of communication skills, essential in humanitarian medical training that characterizes Cuban medical assistance.

Autorregulación del aprendizaje: análisis de su apreciación por estudiantes de primer año de Medicina / Self-regulation of learning: analysis of its appreciation by first￾year medical students

Fundamento: la autorregulación del aprendizaje es un parámetro importante para tomar decisiones docente-metodológicas, promotoras de la autogestión del conocimiento. Objetivo: analizar la apreciación sobre su autorregulación del aprendizaje, por estudiantes de primer año de Medicina del curso 2021-2022, en la Facultad de Ciencias Médicas "Salvador Allende". Métodos: se realizó una investigación exploratoria, descriptiva, transversal y no experimental, con un enfoque mixto. Se utilizaron métodos teóricos: análisis-síntesis, inductivo-deductivo y enfoque sistémico; empíricos: el instrumento de medición utilizado consistió en un cuestionario conformado a partir de una adaptación de la Escala de Autorregulación del Aprendizaje, con las dimensiones: actitud hacia el estudio, enfoque estratégico en el aprendizaje y regulación metacognitiva; y matemático-estadísticos para el procesamiento de los datos. Resultados: se determinó que la autorregulación del aprendizaje fue insatisfactoria, al presentarse deficiencias en dos de sus dimensiones: Enfoque estratégico en el aprendizaje y Regulación metacognitiva. La dimensión Actitud ante el estudio obtuvo una valoración satisfactoria; se apreció que el ítem correspondiente a la dedicación al trabajo con las tareas orientadas, tuvo una débil relación directa con el interés personal, las calificaciones obtenidas y el reconocimiento personal. De todos los ítems considerados en la encuesta, solamente hubo una relación débil e indirecta del sexo (p ˂ 0,01) con la solicitud de ayuda y el aprovechamiento de las explicaciones de los compañeros. Conclusiones: la percepción de la autorregulación del aprendizaje por la población objeto de estudio mostró dificultades en rasgos significativos de dicha conducta, lo que limita la disposición para el aprendizaje autónomo.

Background: self-regulation of learning is an important parameter for making teaching-methodological decisions, promoting self-management of knowledge. Objective: to analyze the appreciation of their self-regulation of learning, by first-year Medicine students of the 2021-2022 academic year, at the "Salvador Allende" Faculty of Medical Sciences. Methods: an exploratory, descriptive, cross-sectional and non-experimental investigation was carried out, with a mixed approach. Theoretical methods were used: analysis-synthesis, inductive-deductive and systemic approach; Empirical ones: the measurement instrument used consisted of a questionnaire made from an adaptation of the Self-regulation of Learning Scale, with the dimensions: attitude towards study, strategic approach to learning and metacognitive regulation; and mathematical-statisticalfor data processing. Results: it was determined that the self-regulation of learning was unsatisfactory, as there were deficiencies in two of its dimensions: strategic focus on learning and metacognitive regulation. The Attitude dimension towards the study obtained a satisfactory assessment, it was observed that the item corresponding to dedication to work with oriented tasks, had a weak direct relationship with personal interest, qualifications obtained and personal recognition. Of all the items considered in the survey, there was only a weak and indirect relationship between sex (p ˂ 0.01) with the request for help and taking advantage of the explanations of the classmates. Conclusions: the perception of self-regulation of learning by the study population showed difficulties in meaningful features of such behavior, which limits the willingness for autonomous learning.

Estrategia curricular de Medicina Natural y Tradicional desde la disciplina inglés en la educación médica / Curricular strategy of Herbal and folk Medicine from the English discipline in medical education

La formación de profesionales demanda que el proceso enseñanza aprendizaje tenga una visión integradora para alcanzar los objetivos generales con los niveles de profundidad y dominio requeridos. A partir de ello, es que se introduce una novedosa forma de abordar la interdisciplinariedad, aplicando estrategias curriculares. La aplicación de la Medicina Natural y Tradicional en la formación de los médicos generales no ha sido sistemática ni de forma coordinada por el colectivo de profesores de inglés en la Universidad de Ciencias Médicas de Villa Clara. Es objetivo de los autores describir una tesis de maestría que contiene: metodología y acciones para implementarla desde la disciplina y asignaturas de inglés, un curso de posgrado para profesores de este idioma y ofertas de bibliografías actualizadas impresas y digitales como materiales de consulta para el estudio independiente, cuyos contenidos se aplican de forma satisfactoria para solucionar las carencias mencionadas.

The training of professionals demands that the teaching-learning process have an integrating vision to achieve the general objectives with the required levels of depth and mastery. From this, a new way of approaching interdisciplinarity is introduced, applying curricular strategies. The application of herbal and folk Medicine in the training of general practitioners has not been systematic or coordinated by the group of English teachers at the Villa Clara University of Medical Sciences. The authors' objective is to describe a master's thesis that contains: methodology and actions to implement it from the discipline and subjects of English, a postgraduate course for teachers of this language and offers of updated printed and electronic bibliographies as reference materials for the independent study whose contents are satisfactorily applied to solve the aforementioned deficiencies.

Experiencias investigativas basadas en cursos, análisis de sus fundamentos y resultados en la Educación Médica

Introducción: las experiencias investigativas durante el pregrado son diversas y tienen como objetivo la formación de competencias en ese mismo ámbito de investigación. Objetivo: recopilar la información relacionada a las experiencias investigativas basadas en cursos (EIBC) que se han implementado en el contexto de la educación médica. Métodos: se realizó una revisión de la literatura narrativa donde se indagaron las bases de datos ERIC, SciELO, Redalyc, Scopus y PubMed a través de los términos: "ciencia", "basados en cursos", "investigación", "en el aula", "experiencia(s)", "pasantía(s)", "pregrado", "licenciatura", "formación". De las 780 fuentes iniciales, se analizaron 35. La información fue descrita según las categorías de: resultados de las mediciones, fundamentos teóricos, beneficios de la experiencia, limitaciones/ desventajas. Resultados: las EIBC se consideran como experiencias positivas y atractivas para los estudiantes, pues permiten exponerlos al proceso investigativo, desarrollar habilidades y oportunidades para futuros proyectos de investigación, permitir establecer redes y trabajo en equipo, brindar la oportunidad para trabajar en equipos de investigación y laboratorios de experimentación, y comprometer a los estudiantes y docentes a difundir los hallazgos a través de publicaciones científicas. Sus fundamentos se encuentran en el aprendizaje situado, las comunidades de práctica, el aprendizaje basado en problemas y el aprendizaje constructivista. El objetivo en común es el de involucrar a los estudiantes de pregrado en la investigación científica y que logren formar sus competencias a través del mismo acto investigativo. Conclusión: las EIBC permiten mejorar el aprendizaje estudiantil, la formación de competencias investigativas, otorgan ganancias en su identidad científica, autoconfianza, y persistencia en su carrera de estudios.

Summary Background: Investigative experiences during undergraduate education are diverse and their objective is the formation of investigative competences. Objective: to compile information related to coursebased research experiences (CBRE) that have been implemented in the context of undergraduate medical education. Methods: A review of the narrative literature was carried out where the ERIC, SciELO, Redalyc, Scopus and PubMed databases were investigated through the terms: "science", "course-based", "research", "in the classroom", "experience(s)", "internship(s)", "undergraduate", "bachelor", "training". Of the 780 sources initially searched, 35 references were analyzed. The information was analyzed according to the categories of: measurement results, theoretical foundations, benefits of the experience, limitations / disadvantages. Results: The CBRE are considered positive and attractive experiences for students, as they allow the student to be exposed to the research process, developing skills and opportunities for future research projects, allows networking and teamwork to be established, provides the opportunity to work in research teams and research laboratories, experimentation, and commits students and teachers to disseminate the findings through scientific publications. Its foundations are in situated learning, communities of practice, problembased learning and constructivist learning. The common objective is to involve undergraduate students in scientific research and that they manage to form their competencies through same investigative act. Conclusion: CBRE allow improving student learning, the formation of investigative competences, and gains in their scientific identity, self-confidence, and persistence in their study career.

Common mental disorders among medical students: systematic review and meta-analysis of Brazilian studies

ABSTRACT BACKGROUND: Common mental disorders (CMDs) have been correlated with consequences in different domains of life. OBJECTIVE: To summarize the prevalence rates of CMDs and factors associated with them among students at Brazilian medical schools. DESIGN AND SETTING: Systematic review and meta-analysis of studies developed in Brazilian medical schools. METHODS: In October 2021, searches were carried out in seven electronic databases, in Google Scholar and in reference lists. Observational studies reporting prevalence rates of CMDs among students at Brazilian medical schools were sought. Variables associated with CMDs arising from multivariate regression models were included in the synthesis. A meta-analysis was developed using a random-effects model and the risk of bias was assessed using an instrument developed from previous references. RESULTS: Fourteen original studies were included. The pooled prevalence rate of CMDs among undergraduate students at Brazilian medical schools was 43.3% (95% confidence interval = 38.9% to 47.6%; I2 = 87%; n = 3,927). Among the nine studies in which multivariate analyses were conducted, five showed risk associations between CMDs and medical school-related dissatisfactions, among which the desire to abandon the medical course can be highlighted (n = 3). In three studies, CMDs were associated with sleep indicators. CONCLUSION: Considering that the prevalence of CMDs among medical students is higher than in the general population, we recommend that Brazilian medical schools should give greater attention to this topic, and should enable expansion of care offerings relating to mental health. SYSTEMATIC REVIEW REGISTRATION: Prospective Register of Systematic Reviews (PROSPERO) database (CRD42020142184).

Seminarios autogestionados de psiquiatría como modelo de participación estudiantil activa en pregrado. Experiencia 2014-2021 en la Pontificia Universidad Católica de Chile / Self-managed psychiatry seminars as a model of active student participation in undergraduate education

In the last decade, medical students stood out as active agents in their training, which implies their involvement in the design, implementation, evaluation, and curricular co-governance. This article describes a model of active undergraduate student participation from 2014 to 2021 and compares the face-to-face and synchronous online modalities, later brought forward by the SARS-COV-2 pandemic. Annually, a call was made to UC School of Medicine undergraduate students to establish the topics and areas to be addressed during self-managed seminars. Then, medical students located in Chile were invited to attend the activity. Psychiatry was established as a priority topic in six out of eight years. Five seminars were conducted, the last two in synchronous online mode. The number of people enrolled in the online modality increased by 251% compared to the face-to-face modality (face-to-face mean = 133 ± 33 SD; online mean = 336 ± 24SD), with no significant differences in rates of attendance between modalities (Odds ratio (OR) = 1,12; 95% CI= 0,82 - 1,55; p = 0,45). The online modality was associated with a higher proportion of enrollees belonging to an institution outside the Metropolitan Region (OR 12,63; 95% CI = 8,64 - 18,46; p < 0,01). The self-managed psychiatry seminars correspond to a model of active undergraduate student participation, with the synchronous online modality representing an opportunity to massify it throughout the national territory.

Implementación de la reforma curricular de la Escuela de Medicina de la Pontificia Universidad Católica de Chile: analizando la experiencia / Implementation of curricular changes at a medical school

The accelerated scientific, technological, and social advances in recent years have posed new challenges for professional training institutions, where universities play a leading role. Medical schools have not been oblivious to this process. This is how Pontificia Universidad Católica de Chile implemented in 2015 a curricular reform derived from the joint work of academics, students and graduates. For this purpose, a model consisting of stages was followed, including the identification of the problem, general assessment of needs, definition of purpose and learning objectives. We worked with surveys, focus groups and committees of academics and students to identify and map content within the mesh, review terminal learning objectives while creating and reviewing courses for the vertically and horizontally integrated delivery of content and competencies. The first cohort of the new curriculum entered in 2015, consisting of 126 students. The implementation required constant follow-up and monitoring, establishing changes and adjustments according to educational needs and unforeseen conditions such as the COVID-19 pandemic. The implementation process of the new curriculum has been positive, adjusting to the defined strategic planning and responding to unexpected events.

Application of telesimulation in a medical undergraduate course during the SARS-CoV-2 pandemic: a quantitative and retrospective study

ABSTRACT BACKGROUND: Because of the social isolation and distancing measures that were imposed to stop the spread of coronavirus disease 19 (COVID-19), new ways of teaching were implemented. OBJECTIVES: To describe the implementation of telesimulation and seek to assess students' perceptions regarding telesimulation. DESIGN AND SETTING: Retrospective quantitative study conducted within the hospital simulation at a private medical school in São Paulo, Brazil. METHODS: After telesimulation training, students answered a questionnaire that provided an overall assessment of this activity, self-assessment and assessments of the facilitators and infrastructure provided by the University. RESULTS: Among the students, 50% reported that the activity was below expectations and 45% reported that it was in line with their expectations. The strong points of the activity were the clinical cases, workload and teachers. The main challenge was students' difficulty in reflecting on their learning and the infrastructure. CONCLUSIONS: Since students have less experience and fewer clinical encounters than residents or professionals, they also face more difficulty. Although telesimulation may have provided a valid alternative to replace simulation training during the COVID-19 pandemic, more face-to-face activities should be offered to students, when possible.

Medical education: the historical framing of the medical curriculum and the challenges of renewal in the 21st century / Educação médica: a construção histórica do currículo médico e os desafios de renovação no século XXI

The study proposes a critical and exploratory analysis of the historical formation of the medical curriculum, including the pedagogical models and contemporary challenges. Contemporary Medicine has faced challenging transformations in the 21st century, such as population aging, technological and scientific advances, epidemiological transition, wide access to informationby society. The knowledge society requires new generations of physicians to develop interdisciplinary professional skills and the technical-scientific domain. Given the ongoing transformations in contemporary medical practice, it is up to the academic community to deconstruct obsolete teaching paradigms, to foster the design of new pedagogical practices, congruent with the new medical profile desired in the 21st century.

O estudo propõe uma reflexão crítica e exploratória acerca da construção histórica do currículo médico, seus modelos pedagógicos e desafios contemporâneos. A Medicina contemporânea tem enfrentado transformações desafiadoras no século 21, como envelhecimento populacional, avanços tecnológicos e científicos, transição epidemiológica, facilidade de acesso e informação pela sociedade. A sociedade do conhecimento impõe às novas gerações de médicos o desenvolvimento de competências profissionais interdisciplinares, além do domínio técnico-científico. Diante das transformações em curso na prática médica contemporânea, cabe a comunidade acadêmica a desconstrução de paradigmas de ensino obsoletos, de maneira a propiciar a concepção de novas práticas pedagógicas, congruentes com novo perfil médico almejado no século XXI.

Los métodos problémicos en la formación del estudiante de Medicina: ¿alternativa o necesidad? / The problematic methods in the training of the Medicine student. Alternative or necessity?

RESUMEN Introducción: la enseñanza problémica es considerada por muchos pedagogos como la forma de proceder más eficiente que puede adoptar el profesor durante el proceso enseñanza aprendizaje. Es uno de los modelos de aprendizaje que desarrolla el pensamiento creativo del estudiante. Objetivo: analizar el valor metodológico del método problémico en la formación del estudiante de Medicina, como necesidad y no como alternativa en el proceso de enseñanza aprendizaje. Métodos: se realizó una revisión bibliográfica sistemática para desarrollar un análisis del contenido de documentos: tesis de doctorado, maestrías, artículos originales y de revisión publicados entre 2007 y 2022 en español. Se consultaron 25 artículos y seleccionaron 20. La búsqueda fue realizada en las bases de datos SciELO y Google Académico de diciembre a febrero de 2022. Tras la identificación de los estudios preseleccionados, se llevó a cabo la lectura de los títulos, resúmenes y palabras clave para comprobar su pertinencia con el estudio. Desarrollo: asumir los métodos problémicos en la enseñanza de la Medicina significa apropiarse de métodos productivos y activos; constituye una vía para resolver los problemas profesionales y favorece el proceso de desarrollo autónomo y creador del estudiante. Conclusiones: en la formación del estudiante de Medicina los métodos problémicos constituyen una necesidad, una vía efectiva para lograr el desarrollo del pensamiento lógico; permiten acercarlo a la investigación científica.

ABSTRACT Introduction: problem teaching is considered by many pedagogues as the most efficient way of proceeding that the teacher can adopt during the teaching-learning process. It is one of the learning models that develops the student's creative thinking. Objective: to analyze the methodological value of the problematic method in the formation of the Medicine student, as a necessity and not as an alternative in the teaching-learning process. Methods: A systematic bibliographic review was carried out to develop an analysis of the content of documents: doctoral theses, master's degrees, original and review articles published between 2007 and 2022 in Spanish. 25 articles were consulted and 20 were selected. The search was carried out in the SciELO and Google Scholar databases from December to February 2022. After identifying the pre-selected studies, the titles, abstracts and keywords were read. To check its relevance to the study. Development: assuming the problematic methods in the teaching of Medicine means appropriating productive and active methods, it constitutes a way to solve professional problems. It favors the process of autonomous and creative development of the student. Conclusions: in the formation of the medical student, the problem methods constitute a necessity, an effective way to achieve the development of logical thinking, they allow him to approach scientific research.

Teste de Progresso para estudantes de Medicina: experiência de um consórcio na Região Nordeste do Brasil / Progress Test for medical students: experience of a consortium in Northeastern Brazil

Resumo: Introdução: A colaboração entre escolas médicas para a realização do Teste de Progresso (TP) vem sendo ampliada com o propósito de tornar-se um modelo de prática educacional. Relato de experiência: O núcleo de escolas médicas CIN1 foi instituído no ano de 2013, tendo na sua organização um coordenador-geral e coordenadores de cada escola participante. Realiza dois testes ao ano, variando o número de escolas participantes. O teste possui 120 questões distribuídas nas seis áreas (ciências básicas aplicada, saúde coletiva, pediatria, clínica médica, cirurgia/urgência e emergência, e ginecologia e obstetrícia) e tem seu blueprint baseado em matriz previamente validada. O teste é aplicado a todos os estudantes das escolas participantes, no mesmo dia e com duração de quatro horas. Aconteceu on-line em 2020 e 2021, por causa da pandemia da Covid-19. A pontuação total do estudante é calculada pelo número de questões corretas, sem a opção "não sei", nem penalidades para incorretas. A análise é realizada por meio da teoria clássica do item. Os estudantes recebem a análise do desempenho comparativamente com a média obtida pelos discentes no mesmo ano e a progressão em relação ao teste anterior. As escolas recebem o desempenho dos respectivos estudantes, a análise da dificuldade e discriminação geral dos itens, e uma avaliação global do teste. Discussão: A implantação do CIN1 representou um grande avanço para as escolas envolvidas. A colaboração não se deu apenas sobre o teste, mas também para o desenvolvimento docente de forma conjunta. Impedimentos de regimento interno e custos podem justificar a variação na participação das escolas. Conclusão: A organização de um núcleo de escolas para o TP traz benefícios e muitos desafios. O aperfeiçoamento dos critérios de análises e feedback e a inclusão de estudantes na avaliação de questões são etapas a serem discutidas e implantadas. A utilização do ambiente virtual, de mais baixo custo, pode ser um facilitador para ampliar a participação das escolas.

Abstract: Introduction: Collaboration between medical schools to hold the PT has expanded, constituting a model of educational practice. Experience report: The CIN 1 group of medical schools was established in 2013, organized with a general coordinator and coordinators from each participating school. It holds two tests a year, with a varying number of participant schools. The test has 120 questions distributed in 6 areas (Applied Basic Sciences, Public Health, Pediatrics, Internal Medicine, Surgery/Urgent and Emergency, Gynecology and Obstetrics) and its blueprint is based on a previously validated Matrix. The 4-hour test is applied to all students from participating schools, on the same day and at the same time. It was administered online in 2020 and 2021 due to the COVID-19 pandemic. The student's total score is calculated by the number of correct questions, excluding the "don't know" option, or penalties for incorrect ones, and is analyzed by classical item theory. Students receive performance analysis compared to the average attained by students in the same year, and the progression in relation to the previous test. The schools receive the performance of the respective students and analysis of the difficulty and general breakdown of the items and an overall evaluation of the test. Discussion: The implementation of CIN 1 represented a great advance for the schools involved. The collaboration was not only about the test, but also for the teacher development in a joint way. Bylaw impediments and costs may justify the variation in school participation. Conclusion: The organization of a group of schools for the TP brings benefits and many challenges. Improving analysis and feedback criteria and including students in the assessment of questions are steps to be discussed and implemented. The use of the lower cost virtual environment may facilitate increased participation of schools.