Sexual health educational intervention in medical students.

INTRODUCTION: The National Autonomous University of Mexico Faculty of Medicine created the Adolescent Pregnancy Prevention Program, which is aimed at students. OBJECTIVE: To determine the sexual-reproductive health profile of medical students through a diagnostic questionnaire and of those who participated in an educational intervention on sexuality (three modules). METHOD: First-year undergraduate students, schoolyear 2017-2018, participated. Students were considered to be trained when they took at least one module. RESULTS: The questionnaire was answered by 1157 students, 21.9 % participated in at least one module, 43.1% had initiated sexual activity and 25 % received the educational intervention. Not having used a condom in their last intercourse was identified in 20 %, and a high prevalence of intercourse under the influence of alcohol was observed. CONCLUSIONS: It is important for specific sexuality competences to be promoted among those who will be doctors in the future.

INTRODUCCIÓN: La Facultad de Medicina de la Universidad Nacional Autónoma de México creó el Programa de Prevención de Embarazo en Adolescentes, dirigido a estudiantes. OBJETIVO: Determinar el perfil de la salud sexual-reproductiva de estudiantes de medicina mediante un cuestionario diagnóstico y de quienes participaron en una intervención educativa de sexualidad (tres módulos). MÉTODO: Participaron estudiantes del primer año de la carrera, ciclo 2017-2018. Se consideró que el estudiante fue capacitado cuando cursó al menos un módulo. RESULTADOS: Contestaron el cuestionario 1157 estudiantes, 21.9 % participó en al menos un módulo, 43.1 % había iniciado vida sexual y 25 % recibió la intervención educativa. El 20 % no usó condón en su última relación y se observó alta prevalencia de relaciones sexuales bajo el influjo de alcohol. CONCLUSIONES: Es importante promover competencias específicas en sexualidad entre quienes serán los futuros médicos.

Intervención educativa sobre salud sexual en estudiantes de medicina / Sexual health educational intervention in medical students

Resumen Introducción: La Facultad de Medicina de la Universidad Nacional Autónoma de México creó el Programa de Prevención de Embarazo en Adolescentes, dirigido a estudiantes. Objetivo: Determinar el perfil de la salud sexual-reproductiva de estudiantes de medicina mediante un cuestionario diagnóstico y de quienes participaron en una intervención educativa de sexualidad (tres módulos). Método: Participaron estudiantes del primer año de la carrera, ciclo 2017-2018. Se consideró que el estudiante fue capacitado cuando cursó al menos un módulo. Resultados: Contestaron el cuestionario 1157 estudiantes, 21.9 % participó en al menos un módulo, 43.1 % había iniciado vida sexual y 25 % recibió la intervención educativa. El 20 % no usó condón en su última relación y se observó alta prevalencia de relaciones sexuales bajo el influjo de alcohol. Conclusiones: Es importante promover competencias específicas en sexualidad entre quienes serán los futuros médicos.

Abstract Introduction: The National Autonomous University of Mexico Faculty of Medicine created the Adolescent Pregnancy Prevention Program, which is aimed at students. Objective: To determine the sexual-reproductive health profile of medical students through a diagnostic questionnaire and of those who participated in an educational intervention on sexuality (three modules). Method: First-year undergraduate students, schoolyear 2017-2018, participated. Students were considered to be trained when they took at least one module. Results: The questionnaire was answered by 1157 students, 21.9 % participated in at least one module, 43.1% had initiated sexual activity and 25 % received the educational intervention. Not having used a condom in their last intercourse was identified in 20 %, and a high prevalence of intercourse under the influence of alcohol was observed. Conclusions: It is important for specific sexuality competences to be promoted among those who will be doctors in the future.

Efectividad de una intervención educativa semipresencial para la formación docente en el área de salud pública / Effectiveness of a blended learning education intervention for the teaching training in the Public Health area

Introducción. La formación docente debe orientarse a la actualización en contenidos específicos de una asignatura y en aspectos pedagógicos según los cambios educativos globales. En la Facultad de Medicina de la UNAM se imparten cursos dirigidos a estudiantes de pregrado que se formarán como docentes. El objetivo de este estudio fue diseñar, implementar y evaluar un curso-taller semipresencial de formación docente, dirigido a estudiantes con interés en profesionalizarse en una materia de salud pública. Sujetos y métodos. Ejes del curso: fundamentos de la asignatura y bases pedagógicas (impartido en 60 horas, 40 presenciales y 20 en línea). Se evaluó el avance con un test pre-postintervención, un instrumento de escenarios simulados y una rúbrica de presentación frente a grupo. Se calcularon medidas de resumen, pruebas de diferencias de medianas y dos modelos MANOVA para las calificaciones pre-post. Resultados. 49 participantes; un 73% concluyó el curso. La mediana de edad fue de 20 años, y la razón hombre-mujer, de 0,65. Medianas de calificaciones: preintervención, 4,53; postintervención, 7,24 (p < 0,05); bases pedagógicas, 9; presentación frente a grupo, 8,8. En ambos modelos MANOVA se observó que pertenecer a años avanzados de la carrera se relaciona con mayores puntuaciones (p < 0,05). El 16% de los participantes fueron seleccionados como docentes en formación para formar parte de la plantilla académica de la institución. Conclusiones. Este estudio puede considerarse como un referente para propiciar el reporte detallado de otros cursos, considerando el diseño instruccional, la evaluación de su impacto y su éxito en la incorporación temprana de estudiantes como profesores (AU)

Introduction. Teacher training must focus on updating specific contents of a subject and on pedagogical aspects according to global educational changes. At the Faculty of Medicine in UNAM there are courses addressed to undergraduate students who will be trained as teachers. The aim of the study was to design, implement and assess a blended learning course workshop in teacher training for medical students with an interest in specializing in Public Health subject. Subjects and methods. Course's axes: subject's foundations and pedagogical basis (taught in 60 hours, 40 on-site class and 20 online). The advancement was assessed with a pre- and post-test, a simulated scenario tool and a rubric for in front of a group presentation. Summary measurements were calculated, median differences tests and two MANOVA models for pre- and post-test grades. Results. 49 participants; 73% concluded the course. The age range was 20 years old and the male-female ratio was 0.65. Grades' median: pre-intervention, 4.53; post-intervention, 7.24 (p < 0.05); pedagogical bases, 9; in front of a group presentation, 8.8. In both MANOVA models it was observed that being at advanced levels of the career was related with higher scores (p < 0.05). Sixteen percent of the participants were chosen as 'teachers in training' to conform the academic board of our institution. Conclusions. This study may be considered as a referent to promote a detained report of other teacher training courses for students, considering the instructional design, the impact of its assessment and the success in an early incorporation of students as teachers (AU)

[Some observations on high specialty medical care in Mexico]. / Algunas observaciones acerca de la atención médica de alta especialidad en México.

OBJECTIVES: To put forth the concept of highly specialized medical care, in agreement with the nature of its practice, and evaluate the feasibility of creating a support service network. METHODS: Qualitative study of the current practice and requirements for 39 selected medical specialties, using the technique of focused groups of experts in each specialty. In accordance with the "Grounded Theory", variables were systematized and categorized and then compared in order to identify relationships between categories and link them to consensus testimonial references. On the basis of the characteristics of each kind of practice, one key expert integrated and validated service portfolios. RESULTS: We developed an integrated a concept for highly specialize medical care with 39 operational catalogs of those diagnoses that belong to each specialty, along with catalogs of the resources required by each specialty. CONCLUSIONS: Highly specialized care is a desirable model for clinical practice, but does not constitute a different level of care. Currently, medical practice is constrained by the lack of well-defined boundaries and scarcity of resources in order to be conceptualized as high specialty. It is therefore more convenient to strengthen the concept of third level of care in order to identify opportunities for the establishment of high specialty areas that will in turn serve as the focal points for medical innovation.

[The diagnosis of chronic kidney disease as a tracer of the technical capacity in care facilities of 20 Mexican states]. / Diagnóstico de la enfermedad renal crónica como trazador de la capacidad técnica en la atención médica en 20 estados de México.

OBJECTIVE: To assess knowledge and technical capacity of primary care physicians in the management of patients with diabetes mellitus and high blood pressure as well as patients at risk of developing chronic kidney disease, and to use the latter condition as a tracer of the quality of primary care of the Mexican health system. MATERIAL AND METHODS: A cross-sectional study included 149 primary health physicians in primary care units from state health care services in 20 states. An instrument with two clinical cases was applied. RESULTS: The average score of the physicians evaluated was 53.7 out of 100. Those physicians working in larger size units and graduated before the year 2000 tend to receive lower scores. CONCLUSIONS: The use of chronic kidney disease as a tracer of the technical capacity of the Mexican health care system is useful to understand the problems of primary care in the country's public settings.

Diagnóstico de la enfermedad renal crónica como trazador de la capacidad técnica en la atención médica en 20 estados de México / The diagnosis of Chronic Kidney Disease as a tracer of the technical capacity in care facilities of 20 Mexican states

OBJETIVO. Evaluar el conocimiento y la capacidad técnica de los médicos de primer nivel de atención en el manejo de los pacientes con diabetes mellitus e hipertensión arterial y de pacientes en riesgo de desarrollar enfermedad renal crónica (ERC) y utilizar la enfermedad terminal de esta última como trazador de la calidad de la atención primaria en el sistema de salud mexicano. MATERIAL Y MÉTODOS. Se realizó un estudio transversal en los servicios de salud de las secretarías de salud en 20 estados de junio a diciembre de 2008. Se construyó un cuestionario con dos casos clínicos. RESULTADOS. El promedio de calificación de los 149 médicos evaluados fue de 53.7 Los médicos que trabajan en las unidades de mayor tamaño tienden a tener mayor antigüedad y obtuvieron las calificaciones más bajas. CONCLUSIÓN. La utilización del diagnóstico de la ERC como un trazador permite detectar la capacidad de los médicos en el primer nivel de atención y el potencial del uso de esta metodología para evaluar procesos críticos en el sistema de salud.

OBJECTIVE. To assess knowledge and technical capacity of primary care physicians in the management of patients with diabetes mellitus and high blood pressure as well as patients at risk of developing chronic kidney disease, and to use the latter condition as a tracer of the quality of primary care of the Mexican health system. MATERIAL AND METHODS. A cross-sectional study included 149 primary health physicians in primary care units from state health care services in 20 states. An instrument with two clinical cases was applied. RESULTS. The average score of the physicians evaluated was 53.7 out of 100. Those physicians working in larger size units and graduated before the year 2000 tend to receive lower scores. CONCLUSIONS. The use of chronic kidney disease as a tracer of the technical capacity of the Mexican health care system is useful to understand the problems of primary care in the country´s public settings.