La COVID-19 y la formación científica de los estudiantes de medicina / COVID-19 and medical students' scientific training

La enseñanza de pregrado en Medicina en Cuba se rige actualmente por el plan de estudios E, en el cual se define la función investigativa en el proceso de enseñanza; sin embargo, la investigación clínica no se ha logrado posicionar en el lugar que le corresponde. La escasa producción científica de los profesionales médicos es el resultado de una deficiencia en la formación científica de los mismos durante el proceso de enseñanza de pregrado, cuyas consecuencias se observan durante su desenvolvimiento profesional. La formación médica de pregrado es el momento idóneo para crear los cimientos del pensamiento científico. La formación de los estudiantes de medicina no puede ser óptima cuando es conducida por rutas pasivas de imitación. Es necesario aprender a convertir las experiencias en conocimiento, y la actual pandemia COVID-19 puede ser un elemento motivador en este sentido. Para analizar las causas de la escasa producción científica de los profesionales médicos hay que revisar con detalle las deficiencias que existen en la formación científica de nuestros estudiantes de pregrado. Esta pandemia nos ha demostrado que a los estudiantes se les puede motivar a investigar. Hay que aprovechar estos momentos para hacer modificaciones en el plan de estudios, que incluyan dedicarle un mayor tiempo a la enseñanza de las herramientas investigativas y vinculación a grupos de investigación donde desarrollen un pensamiento científico

Undergraduate medical studies in Cuba are currently governed by Curriculum E, which provides a definition of the role of research training in the learning process. However, clinical research has not managed to occupy the place it deserves. The scant scientific production of medical professionals stems from their poor undergraduate scientific training, whose consequences are visible in their professional performance. Undergraduate medical training is the ideal moment to lay the foundations for scientific thinking. Medical training will never be optimal if it is based on passive imitation. It is necessary to learn to transform experiences into knowledge, and the current COVID-19 pandemic may be a motivating factor in this respect. To analyze the reasons for the scant scientific production of medical professionals, detailed examination should be made of the deficiencies found in the scientific training of undergraduate students. The pandemic has shown that students may be motivated to do research. Occasions such as this should be used to make changes in the curriculum, allotting more time to the teaching of research tools and providing better links with research teams where scientific thinking may be developed.

Reflexões sobre a quarentena: uma estratégia de acolhimento de discentes em um grupo de mentoring / Reflections about quarantine: a strategy for undergraduate medical student reception in a mentoring group

Resumo: Introdução: Notícias sobre a pandemia de Covid-19 chegam constantemente via meios de comunicação, e, rapidamente, há elevada sobrecarga de informações e inseguranças cotidianas. Para os estudantes de Medicina, essas mudanças podem ter efeito ainda mais significativo, pois já apresentam certo grau de adoecimento e queda da qualidade de vida pelo estresse acadêmico. Nessas situações, estratégias de reflexão, fala e escuta ativa podem ser úteis para a saúde mental. Relato de experiência: Este relato apresenta, de forma descritiva, a análise reflexiva da percepção discente sobre facilidades e adversidades vivenciadas durante o distanciamento social proporcionado pela pandemia de Covid-19, bem como avalia de que modo a participação na mentoria interferiu nesse processo. Os estudantes responderam a um questionário de seis perguntas abertas sobre as experiências e a saúde mental deles. Esse questionário teve como objetivos refletir sobre o momento e compreendê-lo para melhorar a condução dos encontros do mentoring e minimizar um eventual impacto negativo na saúde mental dos discentes. Após a anuência dos participantes, por meio do Termo de Consentimento Livre e Esclarecido (TCLE) aprovado pelo Comitê de Ética em Pesquisa, as respostas foram analisadas em anonimato e coletivamente pelos próprios estudantes, de forma categorial temática, encontrando os núcleos de sentido a partir da leitura do corpus textual para identificação das unidades de análises. Discussão: Houve 12 respondentes, o que representa uma taxa de resposta de 92,3% dos estudantes aos quais foi enviado o questionário, no qual apontaram o impacto da pandemia na saúde mental, fizeram uma reflexão interior, indicaram os mecanismos adaptativos e apresentaram os aspectos da mentoria que a tornaram um ambiente seguro e de suporte. Conclusão: A análise revelou que muitos discentes estão enfrentando dificuldades de adaptação, sobretudo quanto à saúde mental, como instabilidade emocional, revolta e frustração. Todavia, relataram-se positividade, desenvolvimento de hobbies e aumento do autoconhecimento e da comunicação com familiares. Apesar das limitações dos encontros remotos, não houve prejuízos de aproveitamento do programa e alcance de seus objetivos.

Abstract: Introduction: The constant stream of news about the Covid-19 pandemic in the media has contributed to information overload and daily insecurities. For medical students, these changes can have an even more significant effect, as they already suffer a certain degree of illness and their quality of life is impaired by academic stress. In these situations, strategies for reflection, speech and active listening can be useful for mental health. Experience report: This report presents, in a descriptive way, the reflective analysis of the student's perception of the facilities and adversities experienced during the social distancing measures enforced by the Covid-19 pandemic and how participation in mentoring interfered in this process. The students answered a questionnaire of six open-ended questions about their experiences and mental health, to reflect and better understand the current situation and thus enhance the mentoring program meetings, supporting and minimizing any negative impact on the students' mental health. After informed consent was agreed by the participants and approval given by the Ethics Committee, thematic content analysis of the answers was performed anonymously and collectively by the students themselves. The core meanings were sought from reading the textual corpus, thus identifying the units of analysis. Discussion: There were twelve respondents, representing a response rate of 92.3% of the students to whom the questionnaire was sent, reporting the impact on their mental health, their inner reflections and adaptive mechanisms and mentoring as a safe environment of support. Conclusion: The analysis revealed that many students are facing difficulties in adapting, especially regarding mental health, reporting issues such as emotional instability, revolt and frustration. However, positivity, development of hobbies, increased self-knowledge and communication with family members were reported. Despite the limitations presented by the remote meetings, there were no adverse effects of using the program and achieving its objectives.

Fundamentos teóricos de la preparación del estudiante de Estomatología en función de la educación para la salud bucal periodontal / Theoretical foundations of the dentistry students preparation in terms of education for the periodontal oral health

RESUMEN Introducción: La aspiración de egresar un estomatólogo general suficientemente preparado para resolver los problemas de salud bucal periodontal más generales y prevalentes es una exigencia social que se revela en el actual plan de estudio de la carrera de Estomatología. Objetivo: Elaborar unos referentes teóricos de la preparación del estudiante de Estomatología en función de la educación para la salud bucal periodontal. Método: De enero a julio de 2020, en la Facultad de Estomatología de la Universidad de Ciencias Médicas Guantánamo se realizó una revisión narrativa sobre el tema a través de una búsqueda en bases de datos electrónicas (Biblioteca Virtual en Salud, LILACS, PubMed, SciELO, REDALYC, Scopus). Se sistematizaron referentes teóricos que sustentan la preparación del estudiante de Estomatología en función de la educación para la salud bucal periodontal. Conclusiones: Se evidencia la necesidad de esta preparación dada su implicación en el modo de actuación profesional para una Atención Bucal Periodontal Integral. Las bases para esta finalidad emergen de la conjugación armoniosa de referentes filosóficos, sociológicos, legales, psicológicos, pedagógicos y didácticos en función de la práctica de la profesión.

ABSTRACT Introduction: The aim to graduate a general dentist with a high standard in knowledge to solve the most general and prevalent periodontal oral health issues is a social demand that is revealed in the current study program of dentistry major. Objective: To elaborate some theoretical references concerning dentistry student preparation in terms of education for periodontal oral health. Method: From January to July 2020, at the Facultad de Estomatología in the Universidad de Ciencias Médicas Guantanamo, a narrative review on the subject was carried out through a search in electronic databases (Virtual Health Library, LILACS, PubMed, SciELO, REDALYC, Scopus). It was systematized all the theoretical references that support the preparation of the dentistry students in terms of education for periodontal oral health. Conclusions: It is evident the necessity of this type of training due to its implication in the way to the best professional performance for an integral oral care. The foundations for achieving this goal emerge from the harmonious conjugation of philosophical, sociological, legal, psychological, pedagogical and didactic referents, in accordance to the practice of the profession.

Multimedia educativa para el aprendizaje de la asignatura Educación Física en ciencias médicas / Educational Multimedia for the learning of Physical Education subject in medical sciences

Se decidió elaborar una multimedia educativa y didáctica para el aprendizaje y la correcta autopreparación en la asignatura Educación Física, como vía de solución a las insuficiencias detectadas en los estudiantes de primer y segundo años de la carrera de medicina. Esta se diseñó con la herramienta Mediator 9.0 y se estructuró en módulos que vinculan textos e imágenes, lo cual incentiva el aprendizaje y agiliza el estudio de los contenidos de la asignatura. Finalmente se logró una multimedia educativa con la integración de los contenidos de la asignatura en un solo material didáctico, muy fácil de usar en el trabajo individual, que mejora el interés y la motivación de los estudiantes, al mismo tiempo que estandariza e interrelaciona materias establecidas en el programa con otras asignaturas propias de la medicina.

It was decided to elaborate an educational and didactics multimedia for the learning and correct self-preparation in the Physical Education subject, as solution to the inadequacies detected in the students of first and second years of the medicine career. It was designed with the Mediator 9.0 tool and it was structured in modules that link texts and images, which motivates the learning and speeds up the study of the subject contents. Finally they managed to get an educational multimedia that integrates the contents of the subject in a single didactic material, very easy to use in the individual work, which improves the interest and motivation of the students, at the same time that it standardizes and interrelates established matters in the schedule with other subjects characteristic of the medicine.

Transdisciplinariedad en salud mental: Una propuesta de modelo de formación / Transdisciplinarity in mental health: A proposal of training model

Este artículo presenta los resultados de una investigación que tuvo como objetivo diseñar una propuesta de Modelo de Formación Transdisciplinar en Salud Mental para cuatro programas universitarios en la región de Antioquia (Colombia), con el propósito de contribuir al mejoramiento de esta formación en los profesionales de Psicología, Enfermería, Trabajo Social y Medicina. El estudio tuvo un enfoque cualitativo de tipo documental, aplicado y hermenéutico, que propició la participación de formadores, empleadores y profesionales de las nueve subregiones de Antioquia. Como estrategias de recolección de información, se realizó revisión documental y entrevistas semiestructuradas; se hizo análisis categorial a través de Nvivo, y finalmente se realizó un ejercicio de validación por medio de mesas de trabajo con informantes de la investigación. El desarrollo de la investigación permitió que los informantes pudieran dar cuenta de los principales eventos en salud mental de sus contextos, las necesidades de formación del recurso humano que los acompaña y de algunas estrategias para la formación profesional de este talento humano. Igualmente, se identificaron y describieron los principales eventos en salud mental que son reportados en medios oficiales del Departamento de Antioquia. En conclusión, se da lugar a la construcción del documento que presenta la Propuesta de Modelo de Formación Transdisciplinar en Salud Mental para cuatro programas de pregrado en Antioquia, que incluye modalidades de aplicación que bien pueden acogerse por los diferentes programas en su formación curricular y/o complementaria.

This article presents the results of a research that aimed to design a proposal of a Transdisciplinary Training Model for Mental Health (MH) for 4 Undergraduate Programs in the department (state) of Antioquia (Colombia), with the purpose of contributing to the improvement of the training for the professionals of Psychology, Nursing, Social Work and Medicine. The study had a qualitative approach of an applied, hermeneutic and documenting type, whose data collection strategies consisted of documentary review and semi-structured interviews. Under the first strategy the disciplinary objects of Psychology, Nursing, Social Work and Medicine were reviewed, which allowed the description of the objects of each discipline, the identification of points of convergence and therefore of the interdisciplinary and transdisciplinary possibilities. Likewise, we proceeded with the reading of some reports provided by government entities, responsible for ensuring the health and mental health of the inhabitants of Antioquia, to recognize the main events in MH reported in the state. After the documentary review, semi-structured interviews were conducted with different actors involved with the MH: trainers, employers and professionals from the nine subregions of Antioquia; therefore, there were three different interview scripts. Once the interviews were conducted, they were subjected to a categorical analysis through Nvivo. Finally, in a public event with the participants of the research a validation exercise of The Training Model Proposal was carried out, there the results obtained at that point were socialized, so that it was debated in small groups and feedbacks were given. These feedbacks were considered for the final formulation of the Transdisciplinary Training Model Proposal. The development of the research allowed the Interviewed people to account for the more significant mental health events in their areas, as well as the training needs of the human resource that go along with these events and, some strategies for the professional training of this human talent. Likewise, the more significant events in mental health that are reported in official media of the Department of Antioquia were identified and described. Based on these results, the conceptualization of MH was considered for the Thematic Component of the Proposal, training in the clinical area, which in turn implies training in psychopathology, psychiatric patient care and intervention strategies; courses oriented to the understanding and intervention of violence, consumption of Psychoactive Substances, family MH and community MH; knowledge in mental health care procedures, primary care in MH and different approaches to care in MH, such as psychosocial, social determinants of MH and differential approaches, especially the life cycle in relation to childhood and adolescence; Emphasis is also placed on the importance of training in public policies, public health and the functioning of the General Social Security and Health System. It takes place the creation of the document that presents the Proposal for a Model of Transdisciplinary Training in Mental Health for 4 Undergraduate Programs in Antioquia; this proposal includes modalities of application that can be accepted by the different programs in their curricular and/or complementary training. The curricular training, whose topics are stated in the results, must be accompanied by the strengthening of competencies associated with the ability to read contextualized MH issues, which contribute to interventions closer to the reality of the population; as well as, to attend to aspects related to the student's being, oriented to an ethical reflection, to the MH of the student and to the strengthening of their vocation.

Metodología para el perfeccionamiento de los tutores de formación de los estudiantes de pregrado / Methodology for the improvement of undergraduate training tutors

Fundamentación: el tutor constituye el eje fundamental de la formación de los estudiantes de ciencias médicas; de su dedicación y formación dependen, en gran parte, la adquisición de los conocimientos, habilidades y responsabilidades necesarios para ejercer eficazmente el rol que les corresponde y el grado de satisfacción de los estudiantes dentro del proceso docente educativo. Métodos: se realiza una investigación de desarrollo, que tiene como propósito diseñar una metodología para el perfeccionamiento de los tutores de formación de pregrado, que permita un proceso de formación de excelencia de los estudiantes de la carrera de Medicina. La metodología fue fundamentalmente cualitativa, se utilizaron varios procedimientos como: la opinión de tutores y asesores metodológicos, entrevistas a tutores y estudiantes, resultados de inspecciones docentes provinciales y nacionales, durante el curso académico 2011-2012, y se realiza revisión documental y bibliográfica. Resultados: se conceptualiza cómo debe ser un tutor de formación en la Universidad Médica de Villa Clara, acorde a la corriente filosófica imperante. Se constata que la situación actual en relación con la tutoría, presenta dificultades que pueden influir en la adquisición de las habilidades y hábitos prácticos que se pretenden lograr en el egresado de la carrera de Medicina. Conclusiones: como producto de la investigación se elabora una metodología para el perfeccionamiento de los tutores que contribuye a la visión que la Universidad de Ciencias Médicas de Villa Clara aspira para los tutores de formación de los estudiantes en el pregrado.

Tutors are the keystone of the training of medical students. The acquisition of the necessary knowledge, skills and responsibilities to play efficiently the role they are intended to play, and the level of satisfaction of the students within the process, depend to a great extend on their dedication and training. Methods: a development research was conducted with the aim of designing a methodology for the improvement of undergraduate training tutors, which would allow a training process of excellence for medical students. The methodology was primarily qualitative. Several procedures were used, for instance, the opinions of tutors and methodological advisors, interviews with tutors and students, the results of provincial and national teacher inspections, during the academic year 2011-2012, and bibliographical and document reviews. Results: there is a conceptualization about how a training tutor should be at the Medical University of Villa Clara, according to the prevailing philosophical trend. It was found that the current situation regarding tutoring presents difficulties that may influence the acquisition of the practical skills and habits intended to be achieved by the medical graduate. Conclusions: as a result of the research, a methodology for the improvement of tutors was developed. It would contribute to the vision the Medical University of Villa Clara has for undergraduate training tutors.

Estado actual de la formación médica para el enfrentamiento de desastres químicos, biológicos y nucleares / Current status of medical training for facing chemical, biological and nuclear disasters

Se efectuó un estudio descriptivo, longitudinal y prospectivo de 200 alumnos del sexto año de medicina del curso 2011-2012, de la Facultad de Ciencias Médicas No. 2 de Santiago de Cuba, con vistas a determinar algunas de las insuficiencias en ellos que afectaban la actuación ante la contingencia de desastres químicos, biológicos o nucleares, para lo cual se aplicaron una encuesta no estructurada y una guía de observación. En la serie se evidenció la desmotivación de unos cuantos estudiantes en relación con la temática, así como el insuficiente conocimiento teórico del tema, el desconocimiento de las vías para acceder a la información y la poca utilización de la materia en los eventos científicos desarrollados en la institución universitaria, lo que involucró la poca sistematización del contenido sobre desastres y afectaba los objetivos de la formación del médico con perfil amplio.

A descriptive, longitudinal and prospective study was conducted in 200 sixth year-medical students from the Faculty 2 of Medical University in Santiago de Cuba during 2011-2012, with the purpose of determining some of deficiencies affecting their performance during chemical, biological or nuclear disasters, for which an unstructured survey and an observation guide were applied. In the series demotivation of some students regarding the topic, poor theoretical knowledge of the topic, the ignorance of ways to access information and the little use of this topic in college scientific events were evidenced, which also involved the little systematization of the content on disasters and affected the objectives of medical training with comprehensive profile.

Is it time for integration of surgical skills simulation into the United Kingdom undergraduate medical curriculum? A perspective from King's College London School of Medicine / 보건의료교육평가

PURPOSE: Changes in undergraduate medical curricula, combined with reforms in postgraduate education, have training implications for surgical skills acquisition in a climate of reduced clinical exposure. Confidence and prior experience influences the educational impact of learning. Currently there is no basic surgical skills (BSS) programme integrated into undergraduate curricula in the United Kingdom. We explored the role of a dedicated BSS programme for undergraduates in improving confidence and influencing careers in King's College London School of Medicine, and the programme was evaluated. METHODS: A programme was designed in-line with the established Royal College of Surgeons course. Undergraduates were taught four key skills over four weeks: knot-tying, basic-suturing, tying-at-depth and chest-drain insertion, using low-fidelity bench-top models. A Likert-style questionnaire was designed to determine educational value and influence on career choice. Qualitative data was collected. RESULTS: Only 29% and 42% of students had undertaken previous practice in knot-tying and basic suturing, respectively. 96% agreed that skills exposure prior to starting surgical rotations was essential and felt a dedicated course would augment undergraduate training. There was a significant increase in confidence in the practice and knowledge of all skills taught (p<0.01), with a greater motivation to be actively involved in the surgical firm and theatres. CONCLUSION: A simple, structured BSS programme can increase the confidence and motivation of students. Early surgical skills targeting is valuable for students entering surgical, related allied, and even traditionally non-surgical specialties such as general practice. Such experience can increase the confidence of future junior doctors and trainees. We advocate the introduction of a BSS programme into United Kingdom undergraduate curricula.

A produção científica sobre a formação de psicólogos no Brasil / Scientific production about undergraduate training in psychology in Brazil

Esta pesquisa tem como objetivo analisar publicações sobre a formação graduada de psicólogos no Brasil. Foram coletados artigos, livros, capítulos de livros, dissertações e teses, publicados até 2011, em bases de dados on-line, resultando em 176 documentos. Foram analisados aspectos relativos aos seguintes tópicos: ano de publicação, autoria, distribuição geográfica, delineamento do estudo, área da psicologia e tema da formação graduada. Os resultados principais sugerem que: a produção sobre a temática encontra-se dispersa e possui caráter opinativo; grande parcela das publicações focaliza áreas tradicionais da Psicologia e aborda o tema por uma ótica internalista. Ressalta-se a necessidade de maior articulação entre os pesquisadores do campo e maior produção de estudos sobre o tema, além da consideração dos determinantes macro políticos para melhor compreensão do processo formativo.

This paper aims to analyze studies on psychology undergraduate training in Brazil. 176 documents (articles, books, book chapters, theses and dissertations) published until 2011 were collected. The following topics were analyzed: Year of publication, authorship, geographic distribution, study design, areas in psychology and the undergraduate training. The main results indicate that publications on this subject are dispersed and mostly composed of opinionative essays, and that a large part of the publications focus on traditional areas of psychology, and adopt an internalist perspective on the analysis. It is concluded that we need an increase in cooperation among researchers of this field as well as more empirical studies related to the subject, and that considering macropolitical determinants is important for a better understanding of the undergraduate training process.