[Instrument validation that measures disruptive education on clinical training]. / Validación de instrumento que mide la educación disruptiva en la formación clínica.

Background: During the contingency derived from the COVID-19 pandemic, there were no instruments assessing the aspects of clinical training, which is why it is necessary to have a questionnaire that let us know the opinion of medical students about the disruptive education. Objective: To validate a questionnaire designed to know the opinion of medical students about disruptive education in their clinical training. Material and methods: Validation cross-sectional study which was developed in three phases: 1) Elaboration of the questionnaire aimed at undergraduate medical students who include clinical science subjects in their curricular program; 2) validation of content by Aiken's V test with 7 expert judges and reliability estimation with Cronbach's alpha coefficient in a pre-sample test with 48 students; 3) analysis of the information through descriptive statistics, where the following results were observed: Aiken's V index of V = 0.816; Cronbach's alpha coefficient = 0.966. A total of 54 items were incorporated in the questionnaire after the pre-sampling test. Conclusions: We can rely on a valid and reliable instrument that objectively measures disruptive education in the clinical training of medical students.

Introducción: durante la contigencia sanitaria derivada de la pandemia por COVID-19, no hubo instrumentos que valoraran los aspectos de la formación clínica, por lo que es necesario contar con un cuestionario para conocer la opinión de los estudiantes de medicina sobre la educación disruptiva. Objetivo: validar un cuestionario diseñado para conocer la opinión de los estudiantes de medicina acerca de la educación disruptiva en su formación clinica. Material y métodos: estudio de validación con corte transversal que se desarrolló en tres fases: 1) elaboración del cuestionario dirigido a estudiantes de medicina de pregrado que tomaran materias de ciencias clínicas en su programa curricular; 2) validación de contenido mediante prueba V de Aiken con 7 jueces expertos y estimación de confiabilidad con coeficiente alfa de Cronbach en prueba premuestreo con 48 estudiantes; 3) análisis de la información por medio de estadística descriptiva, donde se observaron los siguientes resultados: índice V de Aiken de V = 0.816; coeficiente alfa de Cronbach = 0.966. El cuestionario quedó integrado con un total de 55 ítems posterior a la prueba premuestreo. Conclusiones: se cuenta con un instrumento válido y confiable para medir objetivamente la educación disruptiva en la formación clínica de estudiantes de medicina.

Diseño de un instrumento para evaluar las actividades profesionales confiables en cirugía general.

AIM: Competency-based medical education has become increasingly prevalent among surgical accreditation bodies that conduct assessments to ensure the competency of future professionals and judge the adequacy of training programs. MATERIALS AND METHODS: Cross-sectional study to validate an instrument to evaluate entrustable professional activities (EPA) according to the Single Program of Medical Specialties through content and construct validity by expert judgment, and internal consistency with Cronbach's alpha. RESULTS: Four of the rubrics scored high to optimal for univocity and relevance. Only one rubric had to be modified in two of its items. Internal consistency was high (Cronbach's alpha of 0.97). When applying the instrument, the residents showed differences in the level of competence according to postgraduate year, identifying better performance in the last year. DISCUSSION: The instrument was validated with a high degree of reliability in univocity and relevance, and high internal consistency. The residents demonstrated appropriate EPA to manage surgical patients safely, efficiently, with quality and warmth. The ability to reach the strategic level of performance is the main component of the competency-based medical education through the EPA.

OBJETIVO: La educación médica basada en competencias se ha vuelto cada vez más frecuente entre los organismos de acreditación quirúrgica que realizan evaluaciones para asegurar la competencia de los futuros profesionales y juzgar la idoneidad de los programas de formación. MATERIAL Y MÉTODOS: Estudio transversal para validar un instrumento para evaluar las actividades profesionales confiables (APC) según el Programa Único de Especialidades Médicas mediante validez de contenido y constructo por juicio de expertos, y consistencia interna con alfa de Cronbach. RESULTADOS: Cuatro de las rúbricas obtuvieron nivel alto a óptimo para univocidad y relevancia. Solo una rúbrica debió ser modificada en dos de sus ítems. La consistencia interna fue alta (alfa de Cronbach de 0.97). Al aplicar el instrumento, los residentes mostraron diferencias en el nivel competencial según el año de posgrado, identificando mejor desempeño el último año. DISCUSIÓN: El instrumento fue validado con un alto grado de fiabilidad en univocidad y relevancia, y una alta consistencia interna. Los residentes demostraron poseer las APC necesarias para tratar pacientes quirúrgicos de manera segura, eficiente, con calidad y calidez. La capacidad para alcanzar el nivel estratégico de desempeño es el componente principal de la educación médica basada en competencias a través de las APC.

[What and how to evaluate clinical-surgical competence. The resident and staff surgeon perspective]. / Qué y cómo se evalúa la competencia clínico-quirúrgica: perspectiva del adscrito y del residente de cirugía.

BACKGROUND: Evaluation is a means for significant and rigorous improvement of the educational process. Therefore, competence evaluation should allow assessing the complex activity of medical care, as well as improving the training process. This is the case in the evaluation process of clinical-surgical competences. MATERIALS AND METHODS: A cross-sectional study was designed to measure knowledge about the evaluation of clinical-surgical competences for the General Surgery residency program at the Faculty of Medicine, Universidad Autónoma de Chihuahua (UACH). A 55-item questionnaire divided into six sections was used (perception, planning, practice, function, instruments and strategies, and overall evaluation), with a six level Likert scale, performing a descriptive, correlation and comparative analysis, with a significance level of 0.001. RESULTS: In both groups perception of evaluation was considered as a further qualification. As regards tools, the best known was the written examination. As regards function, evaluation was considered as a further administrative requirement. In the correlation analysis, evaluation was perceived as qualification and was significantly associated with measurement, assessment and accreditation. In the comparative analysis between residents and staff surgeons, a significant difference was found as regards the perception of the evaluation as a measurement of knowledge (Student t test: p=0.04). CONCLUSION: The results provide information about the concept we have about the evaluation of clinical-surgical competences, considering it as a measure of learning achievement for a socially required certification. There is confusion as regards the perception of evaluation, its function, goals and scopes as benefit for those evaluated.