Implementación de la reforma curricular de la Escuela de Medicina de la Pontificia Universidad Católica de Chile: analizando la experiencia / Implementation of curricular changes at a medical school

The accelerated scientific, technological, and social advances in recent years have posed new challenges for professional training institutions, where universities play a leading role. Medical schools have not been oblivious to this process. This is how Pontificia Universidad Católica de Chile implemented in 2015 a curricular reform derived from the joint work of academics, students and graduates. For this purpose, a model consisting of stages was followed, including the identification of the problem, general assessment of needs, definition of purpose and learning objectives. We worked with surveys, focus groups and committees of academics and students to identify and map content within the mesh, review terminal learning objectives while creating and reviewing courses for the vertically and horizontally integrated delivery of content and competencies. The first cohort of the new curriculum entered in 2015, consisting of 126 students. The implementation required constant follow-up and monitoring, establishing changes and adjustments according to educational needs and unforeseen conditions such as the COVID-19 pandemic. The implementation process of the new curriculum has been positive, adjusting to the defined strategic planning and responding to unexpected events.

[Implementation of curricular changes at a medical school]. / Implementación de la reforma curricular de la Escuela de Medicina de la Pontificia Universidad Católica de Chile: analizando la experiencia.

The accelerated scientific, technological, and social advances in recent years have posed new challenges for professional training institutions, where universities play a leading role. Medical schools have not been oblivious to this process. This is how Pontificia Universidad Católica de Chile implemented in 2015 a curricular reform derived from the joint work of academics, students and graduates. For this purpose, a model consisting of stages was followed, including the identification of the problem, general assessment of needs, definition of purpose and learning objectives. We worked with surveys, focus groups and committees of academics and students to identify and map content within the mesh, review terminal learning objectives while creating and reviewing courses for the vertically and horizontally integrated delivery of content and competencies. The first cohort of the new curriculum entered in 2015, consisting of 126 students. The implementation required constant follow-up and monitoring, establishing changes and adjustments according to educational needs and unforeseen conditions such as the COVID-19 pandemic. The implementation process of the new curriculum has been positive, adjusting to the defined strategic planning and responding to unexpected events.

Chronic liver failure and concomitant distant infections are associated with high rates of neurological involvement in pyogenic spinal infections.

STUDY DESIGN: A retrospective study of a consecutive series of all patients with pyogenic spinal infections treated at a single institution over a 10-year period. OBJECTIVE: To investigate risk factors for neurologic impairment with pyogenic spinal infections. SUMMARY OF BACKGROUND DATA: Pyogenic spinal infections are frequently associated with neurologic deficit at the time of initial diagnosis. Current evidence suggests that advanced age, diabetes mellitus, rheumatoid arthritis, systemic corticosteroid therapy, impaired immune status, infection with Staphylococcus aureus, and more proximal infections are risk factors for neurologic involvement. To the authors' knowledge, however, the influence of chronic liver failure or concomitant nonspinal infection has not been previously investigated. METHODS: A review of all patients discharged with a diagnosis of pyogenic spinal infection was performed. Data were collected, including age, sex, site of infection, degree of neurologic impairment, bacterial organism isolated, and various medical comorbidities such as diabetes mellitus, rheumatoid arthritis, chronic corticosteroid therapy, chronic liver failure, chronic renal failure, smoking, human immunodeficiency virus infection, intravenous drug abuse, cancer, cardiac disease, and the presence of a distant, nonspinal site of infection. RESULTS: Fifty-five consecutive patients with pyogenic spinal infections were identified. Statistical analysis demonstrated that the presence of an epidural abscess, chronic liver failure, or a distant nonspinal infection were the only significant risk factors for neurologic involvement. CONCLUSION: The current data suggest that chronic liver failure and the presence of a distant nonspinal infection are possible risk factors for neurologic involvement in patients with pyogenic spinal infections. These risk factors have not been previously described. This knowledge warrants closer surveillance for neurologic deficit in patients with these conditions.

Arthroscopic fixation of displaced tibial eminence fractures: a new growth plate-sparing method.

PURPOSE: Fractures of the tibial eminence can be treated arthroscopically. Numerous ways to attach an anterior cruciate ligament avulsion from the tibial eminence have been designed. This report describes a new physis-sparing reduction and fixation technique using an anchor passing nonabsorbable braided sutures through the substance of the anterior cruciate ligament, holding the avulsed bone fragment by tying a locking knot. This study was performed to evaluate a consecutive group of patients who underwent reduction and fixation of tibial avulsion fractures fixed with an anchor with sutures. METHODS: The evaluation was performed by use of objective and subjective International Knee Documentation Committee (IKDC) scores, KT-1000 measurement (MEDmetric, San Diego, CA), Lachman and pivot-shift tests, and Lysholm score. RESULTS: The global IKDC objective score was normal (A) in 4 knees and nearly normal (B) in 3, without extension or flexion limitations. The mean IKDC subjective score was 92 out of 100 (range, 86 to 98). The results of the anterior drawer, Lachman, and pivot-shift tests were negative. The mean Lysholm score improved from 29 to 94. The mean side-to-side difference in anterior tibial translation was 2 mm (range, 1 to 3 mm). CONCLUSIONS: Arthroscopic stabilization by use of an anchor with sutures was possible in all cases of tibial spine fracture. We were able to obtain excellent results in this series using this fixation method. LEVEL OF EVIDENCE: Level IV, therapeutic case series.