ABSTRACT
Resumen Introducción: Hasta donde se tiene conocimiento, la investigación que se presenta constituye el primer trabajo multicéntrico en México que estudia el desarrollo de la aptitud clínica en unidades formadoras de cardiólogos. Objetivo: Determinar el grado de desarrollo de la aptitud clínica en residentes de cardiología en tres unidades médicas de alta especialidad. Métodos: Diseño transversal multicéntrico. Se analizaron todos los estudiantes del ciclo académico 2019-2020. Se construyó un instrumento que evaluó la aptitud clínica a partir de ocho indicadores y 170 ítems; la validez conceptual/de contenido y la confiabilidad fueron valoradas por cinco cardiólogos con experiencia docente y en investigación educativa. Resultados: Por indicador y año de residencia se observaron diferencias estadísticas significativas en la sede CMN20Nov; en HCSXXI e INCICh se observaron diferencias estadísticamente significativas en uno de ocho indicadores. Se estimaron diferencias entre residentes R1 (n = 41) de las tres sedes por indicador, con significación estadística en tres de ocho indicadores. El resultado fue semejante al comparar R2 (n = 35) y R3 (n = 43). Conclusiones: El grado de desarrollo de la aptitud clínica se puede considerar medio en las tres sedes académicas, probablemente debido a que el instrumento exploró situaciones clínicas problematizadas que exigieron del residente la reflexión crítica de su experiencia clínica.
Abstract Introduction: To the best of our knowledge, the research herein presented is the first multicenter study in Mexico to analyze the development of clinical aptitude in medical units that train cardiologists. Objective: To determine the degree of development of clinical aptitude in cardiology residents at three High Specialty Medical Units. Methods: Multicenter, cross-sectional design. All students of the 2019-2020 academic year were included in the study. An instrument was constructed that evaluated clinical aptitude based on eight indicators and 170 items; conceptual/content validity and reliability were assessed by five cardiologists with teaching and educational research experience. Results: By indicator and year of residence, significant statistical differences were observed in the CMN20Nov academic site. At HCSXXI and INCICh, statistically significant differences were observed in one of eight indicators. Differences between R1 residents (n = 41) of all three academic sites were estimated by indicator, with statistical significance being recorded in three of eight indicators. Between R2 (n = 35) and between R3 residents (n = 43), the result was similar. Conclusions: The degree of clinical aptitude development can be considered intermediate in all three academic sites, probably because the instrument explored problematized clinical situations that required the residents to critically reflect on their clinical experience.
ABSTRACT
INTRODUCTION: To the best of our knowledge, the research herein presented is the first multicenter study in Mexico to analyze the development of clinical aptitude in medical units that train cardiologists. OBJECTIVE: To determine the degree of development of clinical aptitude in cardiology residents at three High Specialty Medical Units. METHODS: Multicenter, cross-sectional design. All students of the 2019-2020 academic year were included in the study. An instrument was constructed that evaluated clinical aptitude based on eight indicators and 170 items; conceptual/content validity and reliability were assessed by five cardiologists with teaching and educational research experience. RESULTS: By indicator and year of residence, significant statistical differences were observed in the CMN20Nov academic site. At HCSXXI and INCICh, statistically significant differences were observed in one of eight indicators. Differences between R1 residents (n = 41) of all three academic sites were estimated by indicator, with statistical significance being recorded in three of eight indicators. Between R2 (n = 35) and between R3 residents (n = 43), the result was similar. CONCLUSIONS: The degree of clinical aptitude development can be considered intermediate in all three academic sites, probably because the instrument explored problematized clinical situations that required for the residents to critically reflect on their clinical experience.
INTRODUCCIÓN: Hasta donde se tiene conocimiento, la investigación que se presenta constituye el primer trabajo multicéntrico en México que estudia el desarrollo de la aptitud clínica en unidades formadoras de cardiólogos. OBJETIVO: Determinar el grado de desarrollo de la aptitud clínica en residentes de cardiología en tres unidades médicas de alta especialidad. MÉTODOS: Diseño transversal multicéntrico. Se analizaron todos los estudiantes del ciclo académico 2019-2020. Se construyó un instrumento que evaluó la aptitud clínica a partir de ocho indicadores y 170 ítems; la validez conceptual/de contenido y la confiabilidad fueron valoradas por cinco cardiólogos con experiencia docente y en investigación educativa. RESULTADOS: Por indicador y año de residencia se observaron diferencias estadísticas significativas en la sede CMN20Nov; en HCSXXI e INCICh se observaron diferencias estadísticamente significativas en uno de ocho indicadores. Se estimaron diferencias entre residentes R1 (n = 41) de las tres sedes por indicador, con significación estadística en tres de ocho indicadores. El resultado fue semejante al comparar R2 (n = 35) y R3 (n = 43). CONCLUSIONES: El grado de desarrollo de la aptitud clínica se puede considerar medio en las tres sedes académicas, probablemente debido a que el instrumento exploró situaciones clínicas problematizadas que exigieron del residente la reflexión crítica de su experiencia clínica.
Subject(s)
Cardiology , Internship and Residency , Humans , Aptitude , Cross-Sectional Studies , Reproducibility of Results , Clinical CompetenceABSTRACT
AIM: To determine the effect of an educational strategy promoting participation in the development of critical reading of educational research reports on professors of Educational Research and Teacher Education (CIEFD's). MATERIAL AND METHODS: We performed an intervention study, multicenter professors (medical specialists) who enrolled in the courses: Diploma in teaching methodological level 1 and 2 (n = 46, n = 29, respectively) in the six CIEFD's (D.F. Siglo XXI, DF. La Raza, Nuevo León, Sonora, Puebla and Jalisco), in the period March to August 2007. A tool was built that assessed the variables critical appraisal of educational research reports, the construct validity, content and reliability was assessed by experts in education research. The educational strategy developed in the form of seminars, which were held three times a week in the Certification in teaching methodological level 1 and twice per week in the Certification Level 2 in teaching methodology duration per session: 6 h. The instrument was applied at the beginning and end of the course. RESULTS: In the two Graduates it was observed in the total group, an advance in the three indicators of critical reading, which was expressed with statistically significant differences; in the global score of the Diploma level 1 (final vs. initial measurement) the following mediums were observed: 36-67 (p = 0.0001); in the Diploma level 2, it was observed in its overall rating: 42-78 (p = 0.0001). DISCUSSION: This inquiry from the results observed some of theoretical approaches to mainstreaming participatory. CONCLUSION: An educational strategy promoting participation produced a breakthrough in the three indicators (to interpret, to judge and to formulate proposals) for critical reading of educational research reports.
Subject(s)
Education , Faculty , Reading , Research Report , Academies and Institutes , Adult , Certification , Comprehension , Faculty/standards , Female , Humans , Judgment , Male , Mexico , Prospective Studies , Social SecurityABSTRACT
AIM: Determine what the relationship between participation in classroom of students attending courses at the Educational Research and Teacher Education (CIEFD's) and the development of proficiency in critical reading of theoretical texts in education. MATERIAL AND METHODS: Intervention study, multicenter students (medical specialist) level Diploma in teaching methodology (DMDN) 1 and 2 (n=46 n=29) of the six CIEFD's (DF Siglo XXI, Mexico City La Raza, Nuevo Leon, Sonora, Puebla and Veracruz), period: March to August 2007 and a Masters in education (n=9, generation 2007-2008). Two instruments were constructed that evaluated the participation variables and critical reading of theoretical texts in education, conceptual validity; content and reliability were assessed by experts in education research. The educational intervention was in the form of seminars (three times a week in DMDN 1 and twice weekly in DMDN 2 and Masters). Participation was assessed halfway through the course and on completion, critical reading at the beginning as well as the end. RESULTS: Statistically significant associations were observed in DMDN 1 (four Centers) and the Masters, but not DMDN 2. DISCUSSION: In this investigation some of the theoretical proposals of the participatory education were recreated, starting from the analysis of our results. CONCLUSION: In some centers and in the masters, strengthening participation in this educational intervention is related to the development of critical reading of theoretical texts in education.
Subject(s)
Community Participation , Education, Graduate/methods , Faculty, Medical , Reading , Teaching , Comprehension , Educational Measurement , Humans , Mexico , Prospective StudiesABSTRACT
INTRODUCTION: The study of clinical competence is essential because it summarizes the attributes that characterize a specialist capable of providing quality health care OBJECTIVE: Investigate the development of clinical competence among anesthesiology residents that care for patients in a tertiary level facility. MATERIAL AND METHODS: In February 2007 we conducted a cross-sectional study among 42 anesthesiology residents, 21 were in second and 21 in third year. In order to measure the degree of development of clinical competence we created an instrument with four case studies that summarized patients undergoing surgical anesthetic procedure. The instrument included 200 items that explored eight indicators and covered a range of time periods: pre-trans and post anesthesia. The instrument was validated by a group of experts with clinical, teaching and publication experience. We carried out a pilot test and estimated the instrument's internal reliability using the Kuder-Richardson test (KR-21). We obtained a coefficient of 0.95. We collected the study data and instrument rating technique using a blinded design. Statistical analysis was performed using nonparametric tests. RESULTS: In the overall ranking, third-year medical residents versus sophomores, achieved the highest scores, which resulted in statistically significant differences (p = 0.045). Regarding the degree of expertise we found that most participants had scores of "very low" and "low". In the study of ratings by indicator, we noted that when comparing second vs third year residents we only found statistically significant differences in default decisions that were also potentially iatropathogenic (p = 0.026). CONCLUSION: The clinical competence of anesthesiology residents who care for patients attending a tertiary level facility is low when compared with the maximum theoretical scores they should obtain.
Subject(s)
Anesthesiology/education , Anesthesiology/standards , Clinical Competence , Internship and Residency , Cross-Sectional Studies , Humans , Prospective StudiesABSTRACT
Durante el metabolismo el O2 produce radicales que son moléculas sumamente reactivas que pueden actual como mediadores en la fisiopatología de la muerte celular. Su principal mecanismo de citotoxicidad es la generación de las reacciones en cadena (peroxidación lipídica) en las cuales cualquier célula o estructura celular puede ser blanco (membranas celulares, ácidos nucleoicos, proteínas estructurales, etc.). Ante una producción excesiva de radicales de O2 el organismo cuenta con mecanismos de defensa (SOD, catalasa, peroxidasa, Vitamina C y E, etc.), para prevenir del daño celular. Durante los procesos isquémicos (principalmente en el SNC), se demuestra la asociación de los radicales de O2 con los eventos fisiopatológicos secundarios que causan muerte celular, por lo que la manipulación adecuada del uso farmacológico de los barredores de radicales de O2 en un proceso isquémia-anoxina-reperfusión puede servir como un coadyuvante en la terapéutica que ayude a limitar la degeneración celular y a mejorar la recuperación funcional
