Turning points: puntos de inflexión en la vida de los estudiantes de medicina / Turning points: moments of inflection in the lives of medical students

El objetivo del presente trabajo es contribuir con un acercamiento inicial al estudio de los turning points en cuanto temática relevante en la formación de los estudiantes de medicina. Hasta ahora los turning points se han estudiado poco dentro del campo de la educación médica. Se trata de un concepto que pone el acento en una variedad de situaciones y experiencias que tienen impacto significativo en las trayectorias vitales de los estudiantes, pero que no son fácilmente visibles. Los turning points son eventos que cambian la vida de los estudiantes. Sin embargo, muchas veces pasan desapercibidos y sólo se reconocen sus efectos años después del paso por la facultad. En esta colaboración se intenta una aproximación a su delimitación conceptual y a los mecanismos o metodología para identificarlos. De esta forma, surgen nuevos desafíos para el campo de la educación médica tanto desde la captación y la comprensión de un fenómeno difícil de identificar como desde las exigencias que implican su reconocimiento y promoción en el interior de las facultades de Ciencias de la Salud.(AU)

The aim of this paper is to contribute with an initial approach to the study of turning points in medical students training. Until now, there has been few research regarding turning points in the field of medical education. This concept highlights a variety of events and experiences that have a significant impact in life paths. Turning points in education are not easily visible, they often go unnoticed and they are only recognized years after graduation. It is relevant to study turning points in student's life paths in the field of medical education, both in terms of capturing and understanding a phenomenon that is difficult to identify, as well as from the demands that imply its recognition and promotion within the medical school.(AU)

Posta las lilas: A model of integral commitment to the community.

Background: The Posta Sanitaria Las Lilas (La Posta) is a health promotion project of the medical school. Its purpose is to improve the health of individuals and the society by fostering qualitative changes in people's attitudes and habits in relation to every aspect of their health. The project serves a population of 25,000 inhabitants that live in conditions of vulnerability and poverty. It is based on a specific approach to social commitment and accountability that integrates teaching, research, and care with the whole community. Activities: The project activities are oriented toward key dimensions for each person and the community. There are two programs: health and education that involve physicians, students, residents, teachers, volunteers, and community members. Outcomes: The project has increased the number of medical appointments, medical records, and workshop participants. It is difficult to establish objective indicators that may reflect the changes in the life of the community members. In this article, findings of an impact evaluation study are presented. We also describe unexpected results for those who participated in the project. Conclusion: La Posta is part of the University's agenda and a place of meaningful and formative learning. All program activities are implemented with the support and resources of the institution. A network of various organizations cooperates with La Posta in order to help promote the welfare of the community. They are all committed to contributing to the development of project participants' personal resources rather than merely addressing their unmet needs. This requires thinking about people in all dimensions (biological, psychological, social, and spiritual).

La educación médica en Argentina / Medical education in Argentina

Se describen las características de la educación médica en Argentina. Se revisa la información demográfica y estadística, y las investigaciones llevadas a cabo por los ministerios de Educación, Salud, y Ciencia y Técnica. Los resultados muestran un crecimiento sostenido del número de carreras de medicina, sin una política establecida acerca del número de médicos necesario. Hay problemas no resueltos, como las altas tasas de deserción y los procesos de admisión. Las escuelas de medicina tienen diferentes perfiles curriculares que responden a unos estándares mínimos de acreditación fijados desde el Ministerio de Educación. El sistema de salud es heterogéneo y diversificado, y la formación profesional de posgrado se realiza en diferentes instituciones, unas académicas y otras asistenciales. La certificación está a cargo de distintas instancias regulatorias. Es necesario reforzar la interacción entre los ministerios y los diferentes grupos de interés con el fin de responder a todos estos temas no resueltos (AU)

We describe the characteristics of medical education in Argentina, and revise available demographic and statistical information, and research conducted by the ministries of education, health and science. There is a sustained growth of the number of medical schools, without a planned policy on the number of physicians that the country requires. Unresolved problems are high attrition rates and admission processes. Medical schools have different curricular profiles, adapted to basic accreditation standards required by the Ministry of Education. Certification depends on different independent regulatory agencies. The health system is heterogeneous and diversified, and postgraduate education takes place at different institutions, some academic some exclusively oriented to healthcare. It is necessary to promote interaction between both ministries and stakeholders to find an answer to these unresolved issues (AU)

A systematic review of faculty development initiatives designed to enhance teaching effectiveness: A 10-year update: BEME Guide No. 40.

BACKGROUND: This review, which focused on faculty development initiatives designed to improve teaching effectiveness, synthesized findings related to intervention types, study characteristics, individual and organizational outcomes, key features, and community building. METHODS: This review included 111 studies (between 2002 and 2012) that met the review criteria. FINDINGS: Overall satisfaction with faculty development programs was high. Participants reported increased confidence, enthusiasm, and awareness of effective educational practices. Gains in knowledge and skills, and self-reported changes in teaching behaviors, were frequently noted. Observed behavior changes included enhanced teaching practices, new educational initiatives, new leadership positions, and increased academic output. Organizational changes were infrequently explored. Key features included evidence-informed educational design, relevant content, experiential learning, feedback and reflection, educational projects, intentional community building, longitudinal program design, and institutional support. CONCLUSION: This review holds implications for practice and research. Moving forward, we should build on current success, broaden the focus beyond individual teaching effectiveness, develop programs that extend over time, promote workplace learning, foster community development, and secure institutional support. We should also embed studies in a theoretical framework, conduct more qualitative and mixed methods studies, assess behavioral and organizational change, evaluate transfer to practice, analyse key features, and explore the role of faculty development within the larger organizational context.

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La predicción de rendimiento académico y deserción en estudiantes universitarios / Predicting academic performance and attrition in undergraduate students

The purpose of this study is to analyze whether educational aptitudes can predict academic performance and attrition. To measure educational aptitudes, the Differential Aptitude Test (DAT) was applied to a nonrandom sample of 1530 first year undergraduate students of a private university in Argentina. For the analysis, multiple and logistic regression models were used. The results showed that DAT scores can predict academic performance, but there is a moderate to low relationship between these scores and dropout rates. To summarize, this study is a first step to predict studentsÆ academic success, in order to save resources and prevent frustration...

El propósito de este estudio es analizar si las aptitudes educativas pueden predecir el rendimiento académico y la deserción. Para medir las aptitudes educativas se aplicó el Test de Aptitudes Diferenciales (Differential Aptitude Test û DAT) a una muestra no probabilística de 1530 estudiantes de primer año de grado de una universidad privada de la Argentina. Para el análisis se utilizaron modelos de regresión múltiple y logística. Los resultados muestran que el DAT puede predecir el rendimiento académico, mientras que la relación entre el DAT y la deserción es de moderada a baja. Este estudio es un primer paso para predecir el éxito académico de los estudiantes, con el objetivo de ahorrar recursos y evitar la frustración...

Assessment for selection for the health care professions and specialty training: consensus statement and recommendations from the Ottawa 2010 Conference.

Assessment for selection in medicine and the health professions should follow the same quality assurance processes as in-course assessment. The literature on selection is limited and is not strongly theoretical or conceptual. For written testing, there is evidence of the predictive validity of Medical College Admission Test (MCAT) for medical school and licensing examination performance. There is also evidence for the predictive validity of grade point average, particularly in combination with MCAT for graduate entry but little evidence about the predictive validity of school leaver scores. Interviews have not been shown to be robust selection measures. Studies of multiple mini-interviews have indicated good predictive validity and reliability. Of other measures used in selection, only the growing interest in personality testing appears to warrant future work. Widening access to medical and health professional programmes is an increasing priority and relates to the social accountability mandate of medical and health professional schools. While traditional selection measures do discriminate against various population groups, there is little evidence on the effect of non-traditional measures in widening access. Preparation and outreach programmes show most promise. In summary, the areas of consensus for assessment for selection are small in number. Recommendations for future action focus on the adoption of principles of good assessment and curriculum alignment, use of multi-method programmatic approaches, development of interdisciplinary frameworks and utilisation of sophisticated measurement models. The social accountability mandate of medical and health professional schools demands that social inclusion, workforce issues and widening of access are embedded in the principles of good assessment for selection.

The programs and context of medical education in Argentina.

There are 29 medical schools in Argentina (this number has increased rapidly in the last decade) offering a 6-year curriculum that usually consists of 3 years of basic science, 2 years of clinical sciences, and one internship year. Annually, 5,000 physicians graduate from these programs. Admission requirements vary depending on each university's policy. Some do not have entry requirements; others require a course, usually on the basics of mathematics, biology, chemistry or physics, and some introduction to social and humanistic studies. Each year, there are approximately 12,000 first-year medical students attending the 29 schools, which suffer a high dropout rate during the first years because of vocational problems or inability to adapt to university life. Some schools have massive classes (over 2,000 students), which makes it difficult for the schools to perfect their teaching. The number of full-time faculty members is low, and some of them have appointments at more than one medical school. Residency programs offer an insufficient number of places, and fewer than 50% of the graduates can obtain a residency position because of strict admission requirements. Coordination between the Ministry of Health, representing the health care system, and the Ministry of Education, representing the medical education system, needs to be improved. Despite the problems of medical education in Argentina, the movement to improve the education of health care workers is growing. The author offers two recommendations to help accomplish this goal.

A systematic review of faculty development initiatives designed to improve teaching effectiveness in medical education: BEME Guide No. 8.

BACKGROUND: Preparing healthcare professionals for teaching is regarded as essential to enhancing teaching effectiveness. Although many reports describe various faculty development interventions, there is a paucity of research demonstrating their effectiveness. OBJECTIVE: To synthesize the existing evidence that addresses the question: "What are the effects of faculty development interventions on the knowledge, attitudes and skills of teachers in medical education, and on the institutions in which they work?" METHODS: The search, covering the period 1980-2002, included three databases (Medline, ERIC and EMBASE) and used the keywords: staff development; in-service training; medical faculty; faculty training/development; continuing medical education. Manual searches were also conducted. Articles with a focus on faculty development to improve teaching effectiveness, targeting basic and clinical scientists, were reviewed. All study designs that included outcome data beyond participant satisfaction were accepted. From an initial 2777 abstracts, 53 papers met the review criteria. Data were extracted by six coders, using the standardized BEME coding sheet, adapted for our use. Two reviewers coded each study and coding differences were resolved through discussion. Data were synthesized using Kirkpatrick's four levels of educational outcomes. Findings were grouped by type of intervention and described according to levels of outcome. In addition, 8 high-quality studies were analysed in a 'focused picture'. RESULTS: The majority of the interventions targeted practicing clinicians. All of the reports focused on teaching improvement and the interventions included workshops, seminar series, short courses, longitudinal programs and 'other interventions'. The study designs included 6 randomized controlled trials and 47 quasi-experimental studies, of which 31 used a pre-test-post-test design. KEY POINTS: Despite methodological limitations, the faculty development literature tends to support the following outcomes: Overall satisfaction with faculty development programs was high. Participants consistently found programs acceptable, useful and relevant to their objectives. Participants reported positive changes in attitudes toward faculty development and teaching. Participants reported increased knowledge of educational principles and gains in teaching skills. Where formal tests of knowledge were used, significant gains were shown. Changes in teaching behavior were consistently reported by participants and were also detected by students. Changes in organizational practice and student learning were not frequently investigated. However, reported changes included greater educational involvement and establishment of collegiate networks. Key features of effective faculty development contributing to effectiveness included the use of experiential learning, provision of feedback, effective peer and colleague relationships, well-designed interventions following principles of teaching and learning, and the use of a diversity of educational methods within single interventions. Methodological issues: More rigorous designs and a greater use of qualitative and mixed methods are needed to capture the complexity of the interventions. Newer methods of performance-based assessment, utilizing diverse data sources, should be explored, and reliable and valid outcome measures should be developed. The maintenance of change over time should also be considered, as should process-oriented studies comparing different faculty development strategies. CONCLUSIONS: Faculty development activities appear highly valued by participants, who also report changes in learning and behavior. Notwithstanding the methodological limitations in the literature, certain program characteristics appear to be consistently associated with effectiveness. Further research to explore these associations and document outcomes, at the individual and organizational level, is required.

Superficies de respuesta de la transferencia de masa durante la deshidratación osmótica del melón (cucumis melo, variedad edisto) / Surface of answer of foods during the osmotic dehydration of the melon (cucumis melo variety edisto)

El objetivo fue obtener las superficies de respuesta de la pérdida de agua, ganancia de soluto y pérdida de peso que ocurren durante la deshidratación osmótica de melon (Cucumis melo, variedad Edisto) cortado en forma cilíndrica. Para ello, se utilizó un diseño experimental compuesto central rotable de tres factores (concentración, temperatura y tiempo) con tres niveles, dos puntos estrella y seis repeticiones del punto central. Los modelos ajustados por regresión lineal múltiple explicaban la variabilidad de las variables respuesta entre un 80,7-98,54 por ciento con un nivel de confianza del 95 por ciento. Para visualizar el efecto de los factores y tomar decisiones sobre las condiciones de deshidratación, se obtuvieron las superficies de respuesta correspondientes

Innovaciones, investigación y evidencias en educación médica. La colaboración EMBE (Educación Médica Basada en la mejor Evidencia) / Innovations, research and evidences in medical education. The BEME Collaboration (Best Evidence Medical Education)

Aunque la educación ha constituido siempre un componente esencial de la profesión médica, su desarrollo explícito y específico sólo se ha iniciado en las últimas décadas. La investigación en educación médica está todavía en una etapa muy inicial de su desarrollo. Las intervenciones educativas son habitualmente complejas y de carácter cualitativo; resulta, por ello, difícil, aunque indispensable, obtener evidencias científicas que avalen tanto los diversos métodos educativos utilizados como los instrumentos de evaluación que se emplean en los diferentes niveles de la formación médica. A partir de la perspectiva y de las estrategias generadas por las metodologías de la medicina basada en la evidencia, ha surgido recientemente la Colaboración EMBE como una red internacional que tiene como objetivo prioritario recoger y promover el despliegue de la mejor evidencia de la cual se pueda disponer sobre el rigor y la calidad de los actuales y de los nuevos métodos educativos y evaluativos en el ámbito de la profesión médica, a fin de optimizar el uso de la extraordinaria inversión que realiza la sociedad en la formación de los profesionales en atención primaria (AU)

How to enjoy your mentee's success and learn from it.

Mentoring plays a central role in academic life. It is based mainly on mutual respect between mentor and mentee, and requires effort, continuity and consideration for different learning styles. It demands hard work, discipline, rigour, creativity, honesty and integrity. Both mentor and mentee must profit and learn from the process of mentoring in order to fulfil an essential purpose of the university. Their relationship represents the bond between the past and the future.