Educative Hybrid Intervention as a Strategy for Reintegration to the Clinical Courses of Undergraduate Students in COVID-19 Pandemic.

The SARS-CoV-2 pandemic generated the need to modify the current clinical educational model with the challenge of promoting safety and the continuity of clinical education through the use of virtual platforms. Since clinical training in hospital institutions cannot be substituted, a strategic training plan was developed to guarantee protection, safety, and academic continuity for students upon returning to clinical clerkships. The objective of this project was to develop and evaluate the impact of a massive hybrid training plan as an educative strategy to give the theoretical and practical knowledge required for the safe return of undergraduate students to their respective clinical activities in the context of this pandemic. An academic program was designed through a massive hybrid strategy to train 616 undergraduate students studying clinical cycles by presential, virtual, synchronous, and asynchronous activities. To know the program's impact, a study based on an initial evaluation and a final evaluation was carried out to evaluate the acquisition of the critical knowledge and skills of the program. A significant difference was found between the means of the initial and final evaluations (p <0.001), as well as a high impact of the intervention (d 1.6). Significant improvements in the areas of COVID-19 initial management (p <0.001) and personal protective equipment use (p <0.001) were seen in the post-test when compared to the initial evaluation. Both a quantitative and a qualitative analysis were carried out, finding positive results on the course design, quality of didactic resources, and instructors' performance. Massive hybrid training is an effective strategy to facilitate the reintegration of undergraduate students into their face-to-face clinical rotations.

Response to comment on "The ENARM and the schools and faculties of medicine. An analysis that nobody will like". / Respuesta al comentario sobre «El ENARM y las escuelas y facultades de medicina. Un análisis que no le va a gustar a nadie¼.

The authors give their point of view to the comments received on the article "The ENARM and the schools and faculties of medicine. An analysis that nobody will like", published in 2017, stating that, in their opinion, the important thing is to contribute to improve the fate of the graduates of the different medical schools.

Los autores otorgan su punto de vista a los comentarios recibidos sobre el artículo «El ENARM y las escuelas y facultades de medicina. Un análisis que no le va a gustar a nadie¼, el cual publicaron en 2017, manifestando que, en su opinión, lo importante es contribuir a mejorar el destino de los egresados de las diferentes facultades de medicina.

[The ENARM and the schools and faculties of medicine. An analysis that nobody will like]. / El ENARM y las escuelas y facultades de medicina. Un análisis que no le va a gustar a nadie.

In Mexico, the career of Doctor of Medicine has been considered as a prerequisite stage to access the specialization. Of course the majority of medical graduates aspire to undertake postgraduate courses in the different institutions that have a university program. The Examen Nacional de Aspirantes a Residencias Médicas (ENARM) (National Evaluation for Medical Residency Applicants) has become for the supporters a gap between the possibility of practicing the profession in a decent way and with a regular remuneration or exercising it in very limited conditions and with low economic income or even without exercising it. For educational institutions, the ENARM and the percentages of selection of their graduates are indicators of efficiency and a source of prestige and even of propaganda among the aspirants to study medicine. In this study, we carried out an analysis of the results of the ENARM in the last 15 years. For this we refer to the reports of the Postgraduate and Continuing Education Committee of the CIFRHS of the Directorate of Health Education of the General Directorate of Quality and Health Education Of the Undersecretariat of Innovation and Quality of the Ministry of Health, from the examination carried out in 2001 to the one carried out in 2016.

En México, la carrera de médico cirujano se ha considerado como una fase propedéutica para acceder a la especialización. Desde luego, la mayoría de los egresados de la carrera de medicina aspiran a realizar cursos de posgrado en las diferentes instituciones que tienen un programa universitario. El Examen Nacional de Aspirantes a Residencias Médicas (ENARM) se ha convertido para los sustentantes en un parteaguas entre la posibilidad de ejercer la profesión de una manera digna y con una retribución en promedio buena o ejercerla en condiciones muy limitadas y con ingresos económicos bajos o incluso no ejercerla. Para las instituciones educativas el ENARM y los porcentajes de selección de sus egresados son indicadores de eficiencia y motivo de prestigio e incluso de propaganda entre los aspirantes a estudiar medicina. En el presente estudio, realizamos un análisis de los resultados del ENARM en los últimos 15 años. Para ello consultamos los informes del Comité de Posgrado y Educación Continua de la Comisión Interinstitucional para la Formación de Recursos Humanos para la Salud (CIFRHS) de la Dirección de Educación en Salud de la Dirección General de Calidad y Educación en Salud de la Subsecretaría de Innovación y Calidad de la Secretaría de Salud, a partir del examen realizado en el año 2001 al realizado en 2016.

[The training of healthcare personnel and the improvement in health care]. / La capacitación del personal de salud y la mejora en la atención.

As part of its commitment to improve healthcare services persistently, the Instituto Mexicano del Seguro Social (IMSS) takes part in the constant training of its healthcare personnel, since the Institute knows that this has an impact on creating a virtuous circle of higher quality and giving cordial attention to patients. That is the reason why the Unidad de Educación, Investigación y Políticas en Salud has set up different programs, which offer diverse oportunities of study, always in line with the needs of the Institute.

El Instituto Mexicano del Seguro Social, como parte de su compromiso en la mejora incesante de los servicios de salud, se involucra en la capacitación constante del personal de salud, pues sabe que eso redunda en una mejor calidad y una mayor calidez en la atención. Por esa razón la Unidad de Educación, Investigación y Políticas de Salud ha establecido diferentes programas que brindan diversas oportunidades para estudios de diferentes tipos, siempre pensados en tópicos que reflejan la mayor problemática del Instituto.

[Linking learning theory with practice]. / Consultorio escuela. El aprendizaje vinculado de la teoría con la práctica.

It is often said that it is easier to learn what is observed and practiced on a daily basis; to the need to effectively link theory with practice considered in the process of teaching and learning, many strategies have been developed to allow this process to be carried out in a more efficiently maner. It is, therefore, very important to recognize that an appropriate teacher/student relationship is essential for students to acquire the skills and abilities required.

Frecuentemente se dice que es más fácil aprender aquello que se observa y se practica de manera cotidiana; ante la necesidad de vincular efectivamente la teoría con la práctica considerada en el proceso de enseñanza-aprendizaje, se han desarrollado estrategias que permitan que este proceso se lleve a cabo de maner más eficiente. Por tanto, es importante reconocer que una adecuada relación profesor/alumno es fundamental para que este adquiera las las habilidades y destrezas requeridas.

[The professional differentiation in medical practice. A theoretical model of the process of changing]. / Diferenciación profesional de la práctica médica. Un modelo del proceso de cambio.

The structure of the change process on medical professionalization has not being studied enough. The physicians are made aware of the necessity of changing their medical practice in ways that also affect their personal life. A change involves the need to plan, evaluate possibilities and resources with efficacy and outline competencies. The aim is to contribute in the design of educational strategies that promote professional change and an understanding of change, as an evolution; we describe a theoretical-schematic model based on five consecutive ordained scopes: background, intentions, planning and making decisions, carrying out decisions and achieving the goal.